Plague Classification and external resources
Yersinia pestis seen at 200× magnification with a fluorescent label. Yersinia pestis (formerly Pasteurella pestis) is a Gram-negative rod-shaped Bacterium belonging to the family This bacterium, carried and spread by fleas, is the cause of the various forms of the disease plague.
ICD-10	A20.
ICD-9	020
DiseasesDB	14226
MedlinePlus	000596
eMedicine	med/3381
MeSH	D010930

Plague is a deadly infectious disease caused by the enterobacteria Yersinia pestis (Pasteurella pestis). The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings A00-A79 - Bacterial infections and other intestinal infectious diseases and STDs (A00-A09 Intestinal Infectious diseases ( The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books An infectious disease is a clinically evident Disease resulting from the presence of Pathogenic microbial agents including Pathogenic viruses Pathogenic The Enterobacteriaceae are a large family of bacteria, including many of the more familiar Pathogens such as Salmonella and Escherichia Yersinia pestis (formerly Pasteurella pestis) is a Gram-negative rod-shaped Bacterium belonging to the family Plague is a zoonotic, primarily carried by rodents (notably rats) and spread to humans via fleas. A zoonosis (ˌzoʊəˈnoʊsɨs or zoonose is any Infectious disease that is able to be transmitted (by a vector) from other Animals both wild and domestic Rats are various medium sized long-tailed Rodents of the superfamily Muroidea Plague is notorious throughout history, due to the unprecedented scale of death and devastation it wrought. Plague is still endemic in some parts of the world.

Name

The epidemiological use of the term plague is currently applied to bacterial infections that cause buboes, although historically the medical use of the term plague has been applied to pandemic infections in general. A bubo (Greek boubôn, "groin" (plural form= buboes is a swelling of the Lymph nodes found in an infection such as Bubonic plague, A pandemic (from Greek παν pan all + δήμος demos people is an Epidemic of Infectious disease that spreads through Plague is often synonymous with "bubonic plague" but this only describes one of its manifestations. Bubonic plague is the best-known manifestation of the bacterial disease plague, caused by the bacterium Yersinia pestis (formerly known as Other names have been used to describe this disease, such as "The Black Plague" and "The Black Death", the latter is now used primarily to describe the second, and most devastating pandemic of the disease.

Infection and transmission

Xenopsylla cheopis primary vector of Bubonic plague

Bubonic plague is mainly a disease in rodents and fleas (Xenopsylla cheopis). The Oriental rat flea ( Xenopsylla cheopis) is a Parasite of Rodents, primarily of the genus Rattus, and is primary vector for Bubonic plague is the best-known manifestation of the bacterial disease plague, caused by the bacterium Yersinia pestis (formerly known as Rodentia is an order of Mammals also known as rodents, characterised by two continuously-growing incisors in the upper and lower jaws which must Flea is the Common name for any of the small wingless Insects of the order Siphonaptera (some authorities use the name Aphaniptera The Oriental rat flea ( Xenopsylla cheopis) is a Parasite of Rodents, primarily of the genus Rattus, and is primary vector for Infection in a human occurs when a person is bitten by a flea that has been infected by biting a rodent that itself has been infected by the bite of a flea carrying the disease. The bacteria multiply inside the flea, sticking together to form a plug that blocks its stomach and causes it to begin to starve. The flea then voraciously bites a host and continues to feed, even though it cannot quell its hunger, and consequently the flea vomits blood tainted with the bacteria back into the bite wound. The bubonic plague bacterium then infects a new victim, and the flea eventually dies from starvation. Serious outbreaks of plague are usually started by other disease outbreaks in rodents, or a rise in the rodent population.

In 1894, two bacteriologists, Alexandre Yersin of France and Shibasaburo Kitasato of Japan, independently isolated the bacterium in Hong Kong responsible for the Third Pandemic. Alexandre Emile Jean Yersin ( September 22, 1863 &ndash March 1, 1943) was a French This article is about the country For a topic outline on this subject see List of basic France topics. was a Japanese Physician and bacteriologist. He is remembered as the co-discoverer of the infectious agent of Bubonic plague in Hong Kong in For a topic outline on this subject see List of basic Japan topics. Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders Third Pandemic is the designation of a major plague pandemic that began in the Yunan province in China in 1855 Though both investigators reported their findings, a series of confusing and contradictory statements by Kitasato eventually led to the acceptance of Yersin as the primary discoverer of the organism. Yersin named it Pasteurella pestis in honor of the Pasteur Institute, where he worked, but in 1967 it was moved to a new genus, renamed Yersinia pestis in honor of Yersin. The Pasteur Institute (Institut Pasteur is a French Non-profit private foundation dedicated to the study of Biology, Micro-organisms Diseases Yersinia pestis (formerly Pasteurella pestis) is a Gram-negative rod-shaped Bacterium belonging to the family Yersin also noted that rats were affected by plague not only during plague epidemics but also often preceding such epidemics in humans, and that plague was regarded by many locals as a disease of rats: villagers in China and India asserted that, when large numbers of rats were found dead, plague outbreaks in people soon followed.

In 1898, the French scientist Paul-Louis Simond (who had also come to China to battle the Third Pandemic) established the rat-flea vector that drives the disease. Paul-Louis Simond ( July 30, 1858 - 1947 was a French Bacteriologist who was born in Beaufort-sur-Gervanne Third Pandemic is the designation of a major plague pandemic that began in the Yunan province in China in 1855 In Epidemiology, a vector is an Organism that does not cause Disease itself but which transmits Infection by conveying Pathogens from He had noted that persons who became ill did not have to be in close contact with each other to acquire the disease. In Yunnan, China, inhabitants would flee from their homes as soon as they saw dead rats, and on the island of Formosa (Taiwan), residents considered handling dead rats a risk for developing plague. These observations led him to suspect that the flea might be an intermediary factor in the transmission of plague, since people acquired plague only if they were in contact with recently dead rats, but not affected if they touched rats that had been dead for more than 24 hours. In a now classic experiment, Simond demonstrated how a healthy rat died of plague after infected fleas had jumped to it from a plague-dead rat.

Pathology

Bubonic plague

Main article: Bubonic plague

When a flea bites a human and contaminates the wound with regurgitated blood, the plague carrying bacteria are passed into the tissue. Bubonic plague is the best-known manifestation of the bacterial disease plague, caused by the bacterium Yersinia pestis (formerly known as Y. pestis can reproduce inside cells, so even if phagocytosed, they can still survive. Phagocytosis is the cellular process of engulfing solid particles by the Cell membrane to form an internal Phagosome, or "food vacuole Once in the body, the bacteria can enter the lymphatic system, which drains interstitial fluid. The lymphatic system in Vertebrates is a network of conduits that carry a clear fluid called Lymph. Interstitial fluid (or tissue fluid) is a solution which bathes and surrounds the cells of multicellular animals Plague bacteria secrete several toxins, one of which is known to cause dangerous beta-adrenergic blockade. A toxin ( Greek:, toxikon, lit (poison for use on arrows is a Poisonous substance produced by living cells or organisms that is active at very low Beta blockers (sometimes written as β-blocker) are a class of drugs used for various indications but particularly for the management of Cardiac arrhythmias

Y. pestis spreads through the lymphatics of the infected human until it reaches a lymph node, where it stimulates severe haemorrhagic inflammation (the root "haem" means "blood" and "haemorrhage" means to bleed) that causes the lymph nodes to expand. Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens The expansion of lymph nodes is the cause of the characteristic "bubo" associated with the disease.

Septicemic plague

Main article: Septicemic plague

Lymphatics ultimately drain into the bloodstream, so the plague bacteria may enter the blood and travel to almost any part of the body. Septicemic (or septicaemic) plague is a deadly blood infection by Yersinia pestis, a Gram-negative Bacterium. In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), causing tiny clots throughout the body and possibly ischaemic necrosis (tissue death due to lack of circulation/perfusion to that tissue) from the clots. Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused Disseminated intravascular coagulation ( DIC) also known as consumptive coagulopathy, is a pathological activation of Coagulation (blood clotting mechanisms DIC results in depletion of the body's clotting resources, so that it can no longer control bleeding. Consequently, there is bleeding into the skin and other organs, which can cause red and/or black patchy rash and hemoptysis/haemoptysis (coughing up or vomiting of blood). Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the There are bumps on the skin that look somewhat like insect bites; these are usually red, and sometimes white in the center. Untreated, septicemic plague is usually fatal. However, during the plague epidemics many people must have come in contact with the bacteria but survived; otherwise nearly everyone in Europe would have died. Early treatment with antibiotics reduces the mortality rate to between 4 and 15 percent. In modern usage an antibiotic is a Chemotherapeutic agent with activity against Microorganisms such as Bacteria, fungi or Protozoa ^[1][2][3] People who die from this form of plague often die on the same day symptoms first appear.

Pneumonic plague

Main article: Pneumonic plague

The pneumonic plague infects the lungs, and with that infection comes the possibility of person-to-person transmission through respiratory droplets. Pneumonic plague is the most virulent and least common form of plague, caused by the bacterium Yersinia pestis. Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal lung is the essential Respiration organ in air-breathing Animals including most Tetrapods a few Fish and a few Snails The most primitive The incubation period for pneumonic plague is usually between two and four days, but can be as little as a few hours. The initial symptoms, of headache, weakness, and coughing with hemoptysis, vomiting blood, are indistinguishable from other respiratory illnesses. Hemoptysis or haemoptysis (see American and British spelling differences) is the expectoration ( Coughing up of Blood or of blood-stained Without diagnosis and treatment, the infection can be fatal in one to six days; mortality in untreated cases is 50–90%. ^[4]

Other forms

There are a few other rare manifestations of plague, including asymptomatic plague and abortive plague.

Cellulocutaneous plague

Plague sometimes causes infection of the skin and soft tissue, often around the bite site of a flea.

Plague meningitis

Plague can cause meningitis in very rare cases of septicemic plague.

Treatments

Vladimir Havkin, a doctor of Russian-Jewish origin who worked in India, was the first to invent and test a bubonic plague vaccine,^[5] on January 10, 1897

The traditional treatments are:

• Streptomycin 30 mg/kg IM twice daily for 7 days
• Chloramphenicol 25–30 mg/kg single dose, followed by 12. Waldemar Mordecai Wolff Haffkine ( March 15, 1860, Odessa, Ukraine - October Events 49 BC - Julius Caesar crosses the Rubicon, signaling the start of civil war. Year 1897 ( MDCCCXCVII) was a Common year starting on Friday (link will display the full calendar of the Gregorian Calendar (or a Common Streptomycin is an Antibiotic drug the first of a class of drugs called Aminoglycosides to be discovered and was the first antibiotic remedy for Tuberculosis Intramuscular injection is the injection of a substance directly into a Muscle. Chloramphenicol is a Bacteriostatic Antimicrobial originally derived from the Bacterium Streptomyces venezuelae, isolated by 5–15 mg/kg four times daily
• Tetracycline 2 g single dose, followed by 500 mg four times daily for 7–10 days (not suitable for children)

More recently,

• Gentamicin 2. This article deals with the specific antibiotic called tetracycline Gentamicin is an Aminoglycoside Antibiotic, used to treat many types of bacterial infections particularly those caused by Gram-negative 5 mg/kg IV or IM twice daily for 7 days
• Doxycycline 100 mg (adults) or 2. Intravenous therapy or IV therapy is the giving of Liquid substances directly into a Vein. Intramuscular injection is the injection of a substance directly into a Muscle. Doxycycline ( INN) (ˌdɒksɪˈsaɪkliːn is a member of the Tetracycline antibiotics group and is commonly used to treat a variety of Infections Doxycycline 2 mg/kg (children) orally twice daily have also been shown to be effective. ^[6]

History

Nicolas Poussin (1594-1665), French. The Plague of Ashdod, 1630. Oil on canvas, 148 x 198 cm. Musée du Louvre, Paris, France, Giraudon/Bridgeman Art Library.

"Der Doktor Schnabel von Rom" (English: "Doctor Beak of Rome") engraving by Paul Fürst (after J Columbina). The Black Death, or the Black Plague, was one of the deadliest Pandemics in human history widely thought to have been caused by a bacterium named Yersinia The beak is a primitive gas mask, stuffed with substances (such as spices and herbs) worn by physicians thought to ward off the plague. A gas mask is a Mask worn over the face to protect the wearer from inhaling airborne Pollutants and Toxic materials A spice is a dried Seed, Fruit, Root, Bark or vegetative substance used in Nutritionally insignificant quantities as a Food additive A(n herb (ˈhɝb or /ˈɝb/ see pronunciation differences) is a plant that is valued for qualities such as medicinal properties flavor scent or the like

The earliest (though unvalidated) account describing a possible plague epidemic is found in I Samuel 5:6 of the Hebrew Bible (Tanakh). In Epidemiology, an epidemic (from Greek epi- upon + demos people is a classification of a disease that appears as new cases in a The term Hebrew Bible is a generic reference to those books of the Bible originally written in Biblical Hebrew (and the related Biblical Aramaic See also Old testament, Septuagint, Targum, Peshitta The Tanakh (תַּנַ"ךְ (taˈnax or; also Tenakh or Tenak is In this account, the Philistines of Ashdod were stricken with a plague for the crime of stealing the Ark of the Covenant from the Children of Israel. The Philistines ( Hebrew פלשתים plishtim) (see "other uses" below were a people who inhabited the southern coast of Canaan, Ashdod (אַשְׁדּוֹד اشدود إسدود Isdud) located in the South District of Israel, on the Mediterranean Sea coast The Ark of the Covenant (אָרוֹן הָבְרִית ʔārōn hāb’rīθ, Modern aron habrit) is described in the Bible as a sacred container wherein These events have been dated to approximately the second half of the eleventh century B. C. The word "tumors" is used in most English translations to describe the sores that came upon the Philistines. See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic The efforts of translating the Bible from its original languages into over 2000 others have spanned more than two millennia. The Hebrew, however, can be interpreted as "swelling in the secret parts". The account indicates that the Philistine city and its political territory were stricken with a "ravaging of mice" and a plague, bringing death to a large segment of the population.

In the second year of the Peloponnesian War (430 B. C. ), Thucydides described an epidemic disease which was said to have begun in Ethiopia, passed through Egypt and Libya, then come to the Greek world. Thucydides ( C 460 BC &ndash C 395 BC) ( Greek Θουκυδίδης Thoukydídēs) was a Greek NOTE This intro is the result of careful NPOV work Please do not make potentially controversial edits to it without first discussing on the talk page This article is about the country of Egypt For a topic outline on this subject see List of basic Egypt topics. Libya ( ليبيا ar-Latn Lībiyā; Libyan vernacular: Lībya; Amazigh:) officially the Great Socialist People's Libyan Arab In the Plague of Athens, the city lost possibly one third of its population, including Pericles. The Plague of Athens was a devastating Epidemic which hit the City-state of Athens in ancient Greece during the second year of the Peloponnesian Pericles (also spelled Perikles) (c 495 – 429 BC Greek:, meaning "surrounded by glory" was a prominent and influential Statesman, orator Modern historians disagree on whether the plague was a critical factor in the loss of the war. Although this epidemic has long been considered an outbreak of plague, many modern scholars believe that typhus[1], smallpox, or measles may better fit the surviving descriptions. Typhus is any of several similar diseases caused by Louse -borne bacteria Smallpox is an Infectious disease unique to humans caused by either of two virus variants named Variola major and Variola minor. Measles (rubeola is a Disease caused by a virus specifically a Paramyxovirus of the genus Morbillivirus. A recent study of the DNA found in the dental pulp of plague victims, led by Manolis J. Papagrigorakis, suggests that typhoid was actually responsible. Typhoid fever, also known as enteric fever, bilious fever, Yellow Jack or commonly just typhoid, is an illness caused by the Bacterium Other scientists dispute this conclusion, citing serious methodological flaws in the DNA study.

In the first century A. D. , Rufus of Ephesus, a Greek anatomist, refers to an outbreak of plague in Libya, Egypt, and Syria. Rufus of Ephesus ( fl late 1st century AD was an ancient physician and author who wrote treatises on Dietetics, Pathology, Anatomy, and patient Libya ( ليبيا ar-Latn Lībiyā; Libyan vernacular: Lībya; Amazigh:) officially the Great Socialist People's Libyan Arab This article is about the country of Egypt For a topic outline on this subject see List of basic Egypt topics. Syria ( سوريّة or) officially the Syrian Arab Republic (Arabic ar الجمهورية العربية السورية He records that Alexandrian doctors named Dioscorides and Posidonius described symptoms including acute fever, pain, agitation, and delirium. Buboes—large, hard, and non-suppurating—developed behind the knees, around the elbows, and "in the usual places. " The death toll of those infected was very high. Rufus also wrote that similar buboes were reported by a Dionysius Curtus, who may have practiced medicine in Alexandria in the third century B. Alexandria ( Egyptian Arabic: اسكندريه Eskendereyya; Standard Arabic: ar الإسكندرية Al-Iskandariyya; Ἀλεξάνδρεια C. If this is correct, the eastern Mediterranean world may have been familiar with bubonic plague at that early date. ^[7][8]

First Pandemic: Plague of Justinian

Main article: Plague of Justinian

The Plague of Justinian in A. The Plague of Justinian was a Pandemic that afflicted the Byzantine Empire, including its capital Constantinople, in the years 541 – 542 The Plague of Justinian was a Pandemic that afflicted the Byzantine Empire, including its capital Constantinople, in the years 541 – 542 D. 541–542 is the first known attack on record, and marks the first firmly recorded pattern of bubonic plague. This outbreak is thought to have originated in Ethiopia. The huge city of Constantinople imported massive amounts of grain, mostly from Egypt, to feed its citizens. Constantinople (Κωνσταντινούπολις Konstantinoúpolis, or gr ἡ Πόλις hē Polis, Latin: la CONSTANTINOPOLIS The grain ships were the source of contagion for the city, with massive public granaries nurturing the rat and flea population. At its peak the plague was killing 10,000 people in Constantinople every day and ultimately destroyed perhaps 40% of the city's inhabitants. It went on to destroy up to a quarter of the human population of the eastern Mediterranean.

In A. D. 588 a second major wave of plague spread through the Mediterranean into what is now France. It is estimated that the Plague of Justinian killed as many as 100 million people across the world. The Plague of Justinian was a Pandemic that afflicted the Byzantine Empire, including its capital Constantinople, in the years 541 – 542 ^[9][10] It caused Europe's population to drop by around 50% between 541 and 700. Medieval Demography is the study of human Demography in Europe during the Middle Ages. ^[11] It also may have contributed to the success of the Arab conquests. The initial Arab Muslim conquests (632–732 (فتح Fatah, literally opening, also referred to as the Islamic conquests or Arab ^{[12] [13]} An outbreak of it in the A. D. 560s was described in A. D. 790 as causing "swellings in the glands. . . in the manner of a nut or date" in the groin "and in other rather delicate places followed by an unbearable fever". While the swellings in this description have been identified by some as buboes, there is some contention as to whether the pandemic should be attributed to the bubonic plague, Yersinia pestis, known in modern times. ^[14]

Second Pandemic: Black Death

Main article: Black Death

Map showing the spread of bubonic plague in Europe

From 1347 to 1351, the Black Death, a massive and deadly pandemic originated in Central Asia, swept through Asia, Europe and Africa. The Black Death, or the Black Plague, was one of the deadliest Pandemics in human history widely thought to have been caused by a bacterium named Yersinia The Black Death, or the Black Plague, was one of the deadliest Pandemics in human history widely thought to have been caused by a bacterium named Yersinia A pandemic (from Greek παν pan all + δήμος demos people is an Epidemic of Infectious disease that spreads through It may have reduced the world's population from 450 million to between 350 and 375 million. ^[15] China lost around half of its population, from around 123 million to around 65 million; Europe around 1/3 of its population, from about 75 million to about 50 million; and Africa approximately 1/8th of its population, from around 80 million to 70 million (mortality rates tended to be correlated with population density so Africa, being less dense overall, had the lowest rate). China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National This makes the Black Death the largest death toll from any known non-viral epidemic. Although accurate statistical data does not exist, it is thought that 1. 4 million died in England (1/3 of England's 4. 2 million people), while an even higher percentage of Italy's population was likely wiped out. On the other hand, Northeastern Germany, Bohemia, Poland and Hungary are believed to have suffered less, and there are no estimates available for Russia or the Balkans. It is conceivable that Russia may not have been as affected due to its very cold climate and large size, hence often less close contact with the contagion.

The Black Death contributed to the destruction of the feudal system in Medieval Time. As more slaves and workers died, there were fewer people to work for the nobles and they had to give higher wages to the workers willing to work on the nobles' lands. The Black Death also killed many great kings and nobles. In its aftermath, the Black Death may also have favoured the use of more advanced farming tools as a smaller workforce was available and plots grew larger as a result of the population loss.

The Black Death continued to strike parts of Europe sporadically until the 17th century, each time with reduced intensity and fatality, suggesting an increased resistance due to genetic selection. ^[14] Some have also argued that changes in hygiene habits and efforts to improve public health and sanitation had a significant impact on the falling rates of infection.

Nature of the disease

In the early 20th century, following the identification by Yersin and Kitasato of the plague bacterium that caused the late 19th and early 20th century Asian bubonic plague (the Third Pandemic), most scientists and historians came to believe that the Black Death was an incidence of this plague, with a strong presence of the more contagious pneumonic and septicemic varieties increasing the pace of infection, spreading the disease deep into inland areas of the continents. Third Pandemic is the designation of a major plague pandemic that began in the Yunan province in China in 1855 It was claimed that the disease was spread mainly by black rats in Asia and that therefore there must have been black rats in north-west Europe at the time of the Black Death to spread it, although black rats are currently rare except near the Mediterranean. This led to the development of a theory that brown rats had invaded Europe, largely wiping out black rats, bringing the plagues to an end, although there is no evidence for the theory in historical records. Some historians suggest that marmots, rather than rats, were the primary carriers of the disease. Marmots are members of the Genus Marmota, in the Rodent family Sciuridae (squirrels Rats are various medium sized long-tailed Rodents of the superfamily Muroidea [2] The view that the Black Death was caused by Yersinia pestis has been incorporated into medical textbooks throughout the 20th century and has become part of popular culture, as illustrated by recent books, such as John Kelly's The Great Mortality.

Many modern researchers have argued that the disease was more likely to have been viral (that is, not bubonic plague), pointing to the absence of rats from some parts of Europe that were badly affected and to the conviction of people at the time that the disease was spread by direct human contact. According to the accounts of the time the black death was extremely virulent, unlike the 19th and early 20th century bubonic plague. Samuel K. Cohn has made a comprehensive attempt to rebut the bubonic plague theory. ^[16] In the Encyclopedia of Population, he points to five major weaknesses in this theory:

• very different transmission speeds — the Black Death was reported to have spread 385 km in 91 days in 664, compared to 12-15 km a year for the modern Bubonic Plague, with the assistance of trains and cars
• difficulties with the attempt to explain the rapid spread of the Black Death by arguing that it was spread by the rare pneumonic form of the disease — in fact this form killed less than 0. 3% of the infected population in its worst outbreak (Manchuria in 1911)
• different seasonality — the modern plague can only be sustained at temperatures between 50 and 78 °F (10 and 26 °C) and requires high humidity, while the Black Death occurred even in Norway in the middle of the winter and in the Mediterranean in the middle of hot dry summers
• very different death rates — in several places (including Florence in 1348) over 75% of the population appears to have died; in contrast the highest mortality for the modern Bubonic Plague was 3% in Mumbai in 1903
• the cycles and trends of infection were very different between the diseases — humans did not develop resistance to the modern disease, but resistance to the Black Death rose sharply, so that eventually it became mainly a childhood disease

Cohn also points out that while the identification of the disease as having buboes relies on accounts of Boccaccio and others, they described buboes, abscesses, rashes and carbuncles occurring all over the body, the neck or behind the ears. Manchuria ( Romanized Manchu: Manju,, Маньчжурия Mongolian: Манж is a historical name given to a vast geographic region in northeast Norway ( Norwegian: Norge ( Bokmål) or Noreg ( Nynorsk) officially the Kingdom of Norway, is a Constitutional Florence ( Italian: Firenze Florentia and Fiorenza) is the Capital City of the Italian region of Tuscany Mumbai ( Marathi:,, IPA: formerly Bombay, is the capital of the Indian state of Maharashtra and the financial An abscess (abscessus is a collection of Pus (dead Neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process A rash is a change of the Skin which affects its color appearance or Texture. A carbuncle is an Abscess larger than a Boil, usually with one or more openings draining Pus onto the Skin. In contrast, the modern disease rarely has more than one bubo, most commonly in the groin, and is not characterised by abscesses, rashes and carbuncles. ^[14]

Researchers have offered a mathematical model based on the changing demography of Europe from 1000 to 1800 AD demonstrating how plague epidemics, 1347 to 1670, could have provided the selection pressure that raised the frequency of a mutation to the level seen today that prevent HIV from entering macrophages that carry the mutation (the average frequency of this allele is 10% in European populations). Macrophages ( Greek: "big eaters" from makros "large" + phagein "eat" ( Mø) are cells within the tissues that In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism An allele (ˈæliːl (UK /əˈliːl/ (US (from the Greek αλληλος allelos, meaning each other) is one member of a pair or series of different forms ^[17] It is suggested that the original single mutation appeared over 2,500 years ago and that persistent epidemics of a haemorrhagic fever struck at the early classical civilizations. The viral hemorrhagic Fevers ( VHFs') are a diverse group of animal and human illnesses that are caused by five distinct families of

Third Pandemic

Main article: Third Pandemic

The Third Pandemic began in China in 1855, spreading plague to all inhabited continents and ultimately killing more than 12 million people in India and China alone. Third Pandemic is the designation of a major plague pandemic that began in the Yunan province in China in 1855 Third Pandemic is the designation of a major plague pandemic that began in the Yunan province in China in 1855 China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National India, officially the Republic of India (भारत गणराज्य inc-Latn Bhārat Gaṇarājya; see also other Indian languages) is a country Casualty patterns indicate that waves of this pandemic may have come from two different sources. The first was primarily bubonic and was carried around the world through ocean-going trade, transporting infected persons, rats, and cargos harboring fleas. A bubo (Greek boubôn, "groin" (plural form= buboes is a swelling of the Lymph nodes found in an infection such as Bubonic plague, The second, more virulent strain was primarily pneumonic in character, with a strong person-to-person contagion. Pneumonic device is a generic term for equipment designed for use with or relating to the lungs This strain was largely confined to Manchuria and Mongolia. Manchuria ( Romanized Manchu: Manju,, Маньчжурия Mongolian: Манж is a historical name given to a vast geographic region in northeast Mongolia (mɒŋˈɡoʊliə, literally Mongol country/nation,) is a Landlocked Country in East Researchers during the "Third Pandemic" identified plague vectors and the plague bacterium (see above), leading in time to modern treatment methods.

Plague occurred in Russia in 1877–1889 in rural areas near the Ural Mountains and the Caspian Sea. Russia (Россия Rossiya) or the Russian Federation ( Rossiyskaya Federatsiya) is a transcontinental Country extending Riphean redirects here For the time period see Riphean stage The Ural Mountains (Ура́льские го́ры Uralskiye The Caspian Sea is the largest enclosed body of water on Earth by area variously classed as the world's largest lake or a full-fledged Sea. Efforts in hygiene and patient isolation reduced the spread of the disease, with approximately 420 deaths in the region. Significantly, the region of Vetlianka in this area is near a population of the bobak marmot, a small rodent considered a very dangerous plague reservoir. The bobak marmot ( Marmota bobak) also known as the steppe marmot, is a Species of Marmot that inhabits the Steppes of Russia The last significant Russian outbreak of Plague was in Siberia in 1910 after sudden demand for Marmot skins (a substitute for Sable) increased the price by 400 percent. Siberia (Сиби́рь Sibir) is the name given to the vast region constituting almost all of Northern Asia and for the most part currently serving SABLE is an XML Markup language used to annotate texts for Speech synthesis. The traditional hunters would not hunt a sick Marmot and it was taboo to eat the fat from under the arm (the axillary lymphatic gland that often harboured the plague) so outbreaks tended to be confined to single individuals. A Lymph node ( lɪmf noʊd is an organ consisting of many types of cells and is a part of the Lymphatic system. The price increase, however, attracted thousands of Chinese hunters from Manchuria who not only caught the sick animals but ate the fat which was considered a delicacy. The plague spread from the hunting grounds to the terminus of the Chinese Eastern Railway and then followed the track for 2,700 km. The Chinese Eastern Railway or CER (also known as the Chinese Far East Railway) was a Railway in northeastern China ( Manchuria) The plague lasted 7 months and killed 60,000 people.

The bubonic plague continued to circulate through different ports globally for the next fifty years; however, it was primarily found in Southeast Asia. An epidemic in Hong Kong in 1894 had particularly high death rates, greater than 75%. Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders As late as 1897, medical authorities in the European powers organized a conference in Venice, seeking ways to keep the plague out of Europe. Venice ( Italian: Venezia, Venetian: Venesia or Venexia) is a city in Northern Italy, the capital of the The disease reached the Republic of Hawaii in December of 1899, and the Board of Health’s decision to initiate controlled burns of select buildings in Honolulu’s Chinatown turned into an uncontrolled fire which led to the inadvertent burning of most of Chinatown on January 20, 1900 according to the Star Bulletin's Feature on the Great Chinatown Fire. The Republic of Hawaii was the formal name of the government that controlled Hawai{{okina}}i from 1894 to 1898 when it was run as a Republic Events 250 - Emperor Decius begins a widespread persecution of Christians in Rome. Year 1900 ( MCM) was an exceptional Common year starting on Monday (link will display the full calendar of the Gregorian calendar Plague finally reached the United States later that year in San Francisco.

Although the outbreak that began in China in 1855 is conventionally known as the Third Pandemic, (the First being the Plague of Justinian and the second being the Black Death), it is unclear whether there have been fewer, or more, than three major outbreaks of bubonic plague. Third Pandemic is the designation of a major plague pandemic that began in the Yunan province in China in 1855 The Plague of Justinian was a Pandemic that afflicted the Byzantine Empire, including its capital Constantinople, in the years 541 – 542 Most modern outbreaks of bubonic plague amongst humans have been preceded by a striking, high mortality amongst rats, yet this phenomenon is absent from descriptions of some earlier plagues, especially the Black Death. The buboes, or swellings in the groin, that are especially characteristic of bubonic plague, are a feature of other diseases as well.

Plague as a biological weapon

Plague has a long history as a biological weapon. Biological warfare (BW — known as a germ warfare, biological weapons and bioweaponry — is the use of any Pathogen ( Bacterium Historical accounts from ancient China and medieval Europe detail the use of infected animal carcasses, such as cows or horses, and human carcasses, by the Xiongnu/Huns, Mongols, Turks, and other groups, to contaminate enemy water supplies. Chinese civilization originated in various city-states along the Yellow River ( valley in the Neolithic era The Xiongnu ( Turkish: Doğu Hun were a confederation of nomadic tribes from Central Asia with a ruling class of unknown origin and other subjugated tribes The Huns were an early confederation of Central Asian equestrian nomads or semi-nomads with a Turkic core of aristocracy The Turkic peoples are Eurasian peoples residing in northern central and western Eurasia who speak languages belonging to the Turkic language family Han Dynasty General Huo Qubing is recorded to have died of such a contamination while engaging in warfare against the Xiongnu. The Han Dynasty ( 206 BC–220 AD followed the Qin Dynasty and preceded the Three Kingdoms in China. Huo Qubing ( b 140 BC - d 117 BC born in Linfen, Shanxi, was a general of the western Han dynasty under Emperor Wu. Plague victims were also reported to have been tossed by catapult into cities under siege. A catapult is any one of a number of non-handheld mechanical devices used to throw a Projectile a great distance without the aid of an explosive substance—particularly various

During World War II, the Japanese Army developed weaponised plague, based on the breeding and release of large numbers of fleas. World War II, or the Second World War, (often abbreviated WWII) was a global military conflict which involved a majority of the world's nations, including The Imperial Japanese Army ( IJA) ( Kyūjitai: 大日本帝國陸軍 Shinjitai: ja 大日本帝国陸軍 Romaji: Dai-Nippon Teikoku During the Japanese occupation of Manchuria, Unit 731 deliberately infected Chinese, Korean, and Manchurian civilians and prisoners of war with the plague bacterium. Manchuria ( Romanized Manchu: Manju,, Маньчжурия Mongolian: Манж is a historical name given to a vast geographic region in northeast was a covert biological and Chemical warfare research and development unit of the Imperial Japanese Army that undertook lethal human experimentation during A civilian under International humanitarian law is a person who is not a member of his or her Country 's Armed forces. These subjects, termed "maruta", or "logs", were then studied by dissection, others by vivisection while still conscious. Dissection (also called anatomization) is usually the process of disassembling and observing something to determine its internal structure and as an aid to discerning the function Human subject research (HSR or human subject use (HSU involves the use of human beings as research subjects Members of the unit such as Shiro Ishii were exonerated from the Tokyo tribunal by Douglas MacArthur but twelve of them were prosecuted during the Khabarovsk War Crime Trials in 1949. was a Microbiologist and the Lieutenant general of Unit 731, a Biological warfare unit of the Imperial Japanese Army during the Second General MacArthur redirects here for other meanings see General MacArthur (disambiguation. Khabarovsk War Crime Trials were a series of hearings held between December 25 - 31st 1949 in the Russian industrial city of Khabarovsk, (Хабáровск situated

After World War II, both the United States and the Soviet Union developed means of weaponising pneumonic plague. The United States of America —commonly referred to as the The Union of Soviet Socialist Republics (USSR was a constitutionally Socialist state that existed in Eurasia from 1922 to 1991 Experiments included various delivery methods, vacuum drying, sizing the bacterium, developing strains resistant to antibiotics, combining the bacterium with other diseases (such as diphtheria), and genetic engineering. Diphtheria ( Greek διφθερα ( diphthera)—“pair of leather scrolls" is an upper respiratory tract illness characterized by sore Scientists who worked in USSR bio-weapons programs have stated that the Soviet effort was formidable and that large stocks of weaponised plague bacteria were produced. The Union of Soviet Socialist Republics (USSR was a constitutionally Socialist state that existed in Eurasia from 1922 to 1991 Information on many of the Soviet projects is largely unavailable. Aerosolized pneumonic plague remains the most significant threat. The plague can be easily treated with antibiotics, thus a widespread epidemic is highly unlikely in developed countries. In Epidemiology, an epidemic (from Greek epi- upon + demos people is a classification of a disease that appears as new cases in a

Worldwide distribution of plague infected animals 1998

1994 Epidemic in Surat, India

In 1994, there was a pneumonic plague epidemic in Surat, India that resulted in 52 deaths and in a large internal migration of about 300,000 residents, who fled fearing quarantine ^[18]. India, officially the Republic of India (भारत गणराज्य inc-Latn Bhārat Gaṇarājya; see also other Indian languages) is a country

A combination of heavy monsoon rain and clogged sewers led to massive flooding which resulted in unhygienic conditions and a number of uncleared animal carcasses. It is believed that this situation precipitated the epidemic. ^[19]. There was widespread fear that the flood of refugees might spread the epidemic to other parts of India and the world, but that scenario was averted, probably as a result of effective public health response mounted by the Indian health authorities ^[20].

Much like the Black Death that spread through medieval Europe, some questions still remain unanswered about the 1994 epidemic in Surat^[21]. The Black Death, or the Black Plague, was one of the deadliest Pandemics in human history widely thought to have been caused by a bacterium named Yersinia

Initial questions about whether it was an epidemic of plague arose because the Indian health authorities were unable to culture Yersinia pestis, but this could have been due to poor laboratory procedures^[21]. Yet, there are several lines of evidence strongly suggesting that it was a plague epidemic: blood tests for Yersinia were positive, a number of individuals showed antibodies against Yersinia and the clinical symptoms displayed by the affected were all consistent with the disease being plague ^[22].

Other Contemporary cases

Two non-plague Yersinia - Yersinia pseudotuberculosis and Yersinia enterocolitica - still exist in fruit and vegetables from the Caucasus Mountains east across southern Russia and Siberia, to Kazakhstan, Mongolia, and parts of China; in Southwest and Southeast Asia, Southern and East Africa (including the island of Madagascar); in North America, from the Pacific Coast eastward to the western Great Plains, and from British Columbia south to Mexico; and in South America in two areas: the Andes mountains and Brazil. This article is about the terrestrial Eurasian mountain range Russia (Россия Rossiya) or the Russian Federation ( Rossiyskaya Federatsiya) is a transcontinental Country extending Siberia (Сиби́рь Sibir) is the name given to the vast region constituting almost all of Northern Asia and for the most part currently serving Kazakhstan, also Kazakstan ( Қазақстан, Qazaqstan, qɑzɑqˈstɑn Казахстан, Kazakhstán,) officially the Mongolia (mɒŋˈɡoʊliə, literally Mongol country/nation,) is a Landlocked Country in East China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National Southwest Asia or Southwestern Asia (largely overlapping with the Middle East) is the southwestern portion of Asia. Southern Africa is the Southernmost Region of the African Continent, variably defined by Geography or Geopolitics. East Africa is the Easternmost Region of the African Continent. Madagascar, or Republic of Madagascar (older name Malagasy Republic) is an Island nation in the Indian Ocean off the southeastern The Pacific Ocean is the largest of the Earth 's Oceanic divisions The Great Plains are the broad expanse of Prairie and Steppe which lie east of the Rocky Mountains in the United States and Canada British Columbia (ˌbrɪtɨʃ kəˈlʌmbiə ( BC) ( (la Colombie-Britannique C The United Mexican States ( or commonly Mexico (ˈmɛksɪkoʊ () is a federal constitutional Republic in North America. South America is a Continent of the Americas, situated entirely in the Western Hemisphere and mostly in the Southern Hemisphere, with a The Andes form the world's longest exposed Mountain range. They lie as a continuous chain of highland along the western coast of South America. |utc_offset = -2 to -4 |time_zone_DST = BRST |utc_offset_DST = -2 to -5 |cctld There is no plague-infected animal population in Europe or Australia. For a topic outline on this subject see List of basic Australia topics.

• On 31 August 1984, the Centers for Disease Control and Prevention reported a case of pneumonic plague in Claremont, California. Events 1056 - Byzantine Empress Theodora becomes ill dying suddenly a few days later without children to succeed the Throne Year 1984 ( MCMLXXXIV) was a Leap year starting on Sunday (link displays the 1984 Gregorian calendar) The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal Claremont is a College town in eastern Los Angeles County, California, USA, about 30 miles (45 km east of downtown Los Angeles The CDC believes that the patient, a veterinarian, contracted plague from a stray cat. A veterinarian ( American English) or a Veterinary surgeon ( British English) often shortened to vet, is a Physician This could not be confirmed since the cat was destroyed prior to the onset of symptoms. ^[23]
• From 1995 to 1998, annual outbreaks of plague were witnessed in Mahajanga, Madagascar as per a study done by Pascal Boisier and other scientists and publish in Emerging Infectious Diseases journal in March 2002.

• In the U. S. , about half of all food cases of plague since 1970 have occurred in New Mexico. New Mexico ( is a state located in the southwestern region of the United States of America. There were 2 plague deaths in the state in 2006, the first fatalities in 12 years. ^[24]

• In Fall of 2002, a New Mexico couple contracted the disease, just prior to a visit to New York City. They both were treated by antibiotics, but the male required amputation of both feet to fully recover, due to the lack of blood flow to his feet, cut off by the bacteria.

• On 19 April 2006, CNN News and others reported a case of plague in Los Angeles, California, lab technician Nirvana Kowlessar, the first reported case in that city since 1984. Events 1012 - Martyrdom of Alphege in Greenwich London. 1529 - At the Second Diet of Speyer Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Cable News Network, usually referred to by its Initialism CNN, is a major English language Television network founded in 1980 by Ted Turner Los Angeles (lɑˈsændʒələs los ˈaŋxeles in Spanish) is the largest City in the state of California and the American West California ( is a US state on the West Coast of the United States, along the Pacific Ocean. ^[25]

• In May 2006, KSL Newsradio reported a case of plague found in dead field mice and chipmunks at Natural Bridges about 40 miles (64 km) west of Blanding in San Juan County, Utah. KSL Newsradio is a Radio programming service based in Salt Lake City, Utah. Blanding is a city in San Juan County, Utah, United States. The population was 3162 at the 2000 census San Juan County is a County located in the southeastern portion of the U The State of Utah (ˈjuːtɔː or) is a western state of the United States. ^[26]

• In May 2006, AZ Central reported a case of plague found in a cat. The Arizona Republic is a daily newspaper published in Phoenix, Arizona. ^[27]

• One hundred deaths resulting from pneumonic plague were reported in Ituri district of the eastern Democratic Republic of the Congo in June 2006. The Democratic Republic of the Congo (République démocratique du Congo often referred to as DR Congo, DRC or RDC, and formerly known or referred to Control of the plague was proving difficult due to the ongoing conflict. The Ituri conflict is a conflict between the agriculturalist Lendu and pastoralist Hema ethnic groups in the Ituri region of northeastern Democratic ^[28]

• It was reported in September 2006 that three mice infected with Yersinia pestis apparently disappeared from a laboratory belonging to the Public Health Research Institute, located on the campus of the University of Medicine and Dentistry of New Jersey, which conducts anti-bioterrorism research for the United States government. The University of Medicine and Dentistry of New Jersey is the state-run Health sciences institution of New Jersey and comprises eight distinct academic units the New For the use of biological agents in warfare see Biological warfare. The United States of America —commonly referred to as the ^[29]

• On 16 May 2007, an 8-year-old hooded capuchin monkey in the Denver Zoo died of the bubonic plague. Events 1204 - Baldwin IX Count of Flanders is crowned as the first Emperor of the Latin Empire. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. The Denver Zoo is an 80- Acre facility located in City Park of Denver Colorado. Five squirrels and a rabbit were also found dead on zoo grounds and tested positive for the disease. ^[30]

• On 5 June 2007 in Scotland, UK a 68 year old woman developed bubonic plague, which progressed to pneumonic plague. Events 70 - Titus and his Roman Legions breach the middle wall of Jerusalem in the Siege of Jerusalem Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Scotland ( Gaelic: Alba) is a Country in northwest Europethat occupies the northern third of the island of Great Britain. Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal ^[31]

• On 2 November 2007, Eric York, a 37 year old wildlife biologist for the National Park Service's Mountain Lion Conservation programPDF (144 KiB) and The Felidae Conservation Fund, was found dead in his home at Grand Canyon National Park. Events 1570 - A Tidal wave in the North Sea devastates the coast from Holland to Jutland, killing more than 1000 Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. A kibibyte (a contraction of ki lo bi nary byte) is a unit of Information or Computer storage, established by the International Grand Canyon Grand Canyon National Park is one of the United States' oldest national parks and is located in Arizona. On 27 October, York performed a necropsy on a mountain lion that had likely perished from the disease and three days afterward York complained of flu-like symptoms and called in sick from work. Events 312 - Constantine the Great is said to have received his famous Vision of the Cross. The cougar ( Puma concolor) also puma, mountain lion, or panther, depending on region is a Mammal of the Felidae family He was treated at a local clinic but was not diagnosed with any serious ailment. The discovery of his death sparked a minor health scare, with officials stating he likely died of either plague or hantavirus, and 49 people who had come in to contact with York were given aggressive antibiotic treatments. Hantaviruses belong to the Bunyaviridae family of Viruses There Bunyaviridae family is divided into 5 genera None of them fell ill. Autopsy results released on November 9th, confirmed the presence of Y. pestis in his body, confirming plague as a likely cause of death. ^[32][33]

Literary and popular culture references

• The Decameron by Giovanni Boccaccio (1350). The Decameron (subtitle Prencipe Galeotto) is a collection of 100 Novellas by Italian author Giovanni Boccaccio, probably begun in Takes place in Florence in 1348, during the outbreak of the Black Death.
• Romeo and Juliet (1597) Friar John was unable to go to Mantua and deliver a letter to Romeo because of Bubonic Plague quarantine. Romeo and Juliet is a tragedy written early in the
• A Journal of the Plague Year by Daniel Defoe (1722). A Journal of the Daniel Defoe (1659/1661 — April 24, 1731 was an English Writer, Journalist, and Pamphleteer, who gained enduring fame for A fictional first hand account of the London outbreak of 1665. London ( ˈlʌndən is the capital and largest urban area in the United Kingdom. Probably based on the experiences of Defoe's uncle.
• "The Masque of the Red Death" (1842) by Edgar Allan Poe includes a vivid description of pestilence that some scholars have interpreted to be septicemic plague. " The Masque of the Red Death " originally published as " The Mask of the Red Death " is a Short story written by Edgar Allan Poe Edgar Allan Poe (January 19 1809 – October 7 1849 was an American poet, short-story Writer, editor and Literary critic, ^[34]
• I Promessi Sposi (The Betrothed) (1842) by Alessandro Manzoni set in early 17th century in Northern Italy, is one of the most read and better known classical novels in Italian literature. The Betrothed (orig I Promessi Sposi is an Italian Historical novel by Alessandro Manzoni, first published in 1827, in The Betrothed (orig I Promessi Sposi is an Italian Historical novel by Alessandro Manzoni, first published in 1827, in Alessandro Francesco Tommaso Manzoni ( March 7, 1785 May 22, 1873) was an Italian Poet and Novelist. Contains a detailed and vivid account of society during the plague outbreak in its time.
• Narcissus and Goldmund by Hermann Hesse (1930). Narcissus and Goldmund is a Novel written by the German Swiss Author Hermann Hesse and was first published in Hermann Hesse (ˈhɛʀman ˈhɛsə ( 2 July, 1877 — 9 August, 1962) was a German - Swiss poet novelist and painter A fictional account in which the main character ends up witnessing the effects of the plague first-hand.
• The Plague by Albert Camus (1947) depicts an outbreak of plague at the Algerian city of Oran. The Plague ( Fr. La Peste) is a Novel by Albert Camus, published in 1947, that tells the story Albert Camus ( (7 November 1913 – 4 January 1960 was an Algerian born French Author, philosopher, and journalist who won the Nobel prize French rule of Algeria lasted from 1830 to 1962 under a variety of governmental systems Oran ( Arabic:ar وهران pronounced Wahran; also transliterated as Ouahran, Spanish: Orán. The disease, often interpreted as a metaphor for the German occupation of France in World War II, serves as a means for the author to examine his characters' responses to hardship, suffering and death. Metaphor (from the Greek: μεταφορά - metaphora, meaning "transfer" is language that directly compares seemingly unrelated subjects The German occupation of France in World War II occurred during the period between May 1940 to December 1944
• Panic in the Streets (1950) by Elia Kazan. Panic in the Streets ( 1950) Semidocumentary Film noir directed by Elia Kazan shot exclusively on location in New Orleans Louisiana Elia Mother, ( Greek: Ηλίας Καζάν September 7 1909 &ndash September 28 2003) was a Greek - American A murder victim is found to be infected with pneumonic plague. To prevent a catastrophic epidemic, the police must find and inoculate the killers and their associates.
• (Don't Fear) The Reaper (1976) by Blue Öyster Cult. Blue Öyster Cult is an American rock band formed in New York in 1967 and still active in 2008 The line "40,000 men and women everyday. . . Like Romeo and Juliet - 40,000 men and women everyday. . . Redefine happiness - Another 40,000 coming everyday. . . We can be like they are" is a reference to the number of people dying daily during The Black Plague"
• The Plague Dogs (1977), by Richard Adams. The Black Death, or the Black Plague, was one of the deadliest Pandemics in human history widely thought to have been caused by a bacterium named Yersinia The Plague Dogs is the third novel by Richard Adams, author of Watership Down. Richard George Adams (born May 9, 1920) is an English Novelist who is best known as the writer of three novels featuring animal characters A fictional story in which two dogs, Rowf and Snitter, escape from a British government research laboratory and are hunted down by the government as potential carriers of the plague.
• Doomsday Book by Connie Willis (1992). Doomsday Book is a 1992 Science fiction novel by American Author Connie Willis. Constance Elaine Trimmer Willis (born 31 December 1945) is an American Science fiction writer A Hugo award and Nebula award-winning historical science fiction novel, in which a time-traveler inadvertently ends up in the plague-ridden England of 1348. The Hugo Awards are given every year for the best Science fiction or Fantasy works and achievements of the previous year The Nebula Award is an award given each year by the Science Fiction and Fantasy Writers of America (SFWA for the best Science fiction / Fantasy fiction England is a Country which is part of the United Kingdom. Its inhabitants account for more than 83% of the total UK population whilst its mainland
• King of Shadows (1999), by Susan Cooper. King of Shadows is a children's novel by Susan Cooper published in 1999 by Penguin. Susan Mary Cooper (born 23 May 1935) is a British Author best known for The Dark Is Rising, an award-winning five-volume Nathan Field, an actor, is infected with the bubonic plague while staying in London, which sends him back in time to the Elizabethan ages.
• Confessions of an Ugly Stepsister (1999), a novel by Gregory Maguire, takes place in 17th Century Haarlem, Netherlands, where a resurgence of the plague occurred. Confessions of an Ugly Stepsister is a Novel by Gregory Maguire, retelling the tale of Cinderella through the eyes of her "ugly stepsisters Gregory Maguire (born June 9, 1954 in Albany, New York) is an American author As a means of recording the passage of Time, the 17th Century was that Century which lasted from 1601 - 1700 in the Gregorian calendar in the past usually Harlem in English is a city in the Netherlands.
• Year of Wonders by Geraldine Brooks (2001), a fictional story of an historical event in which the small Derbyshire village of Eyam quarantines themselves once infected with the plague. Year of Wonders A Novel of the Plague is a 2001 international bestselling Historical fiction Novel by Geraldine Brooks. Geraldine Brooks (born 1955 is an Australian American Journalist and Author. History The area that is now Derbyshire was first visited probably briefly by humans 200000 years ago during the Aveley Interglacial as evidenced by a Middle Eyam (iːm is a small village in Derbyshire, England. The village is best known for being the "plague village" that chose to isolate itself when
• The Years of Rice and Salt by Kim Stanley Robinson (2002). The Years of Rice and Salt ( 2002) is an alternate history Novel with major Buddhist and Islamic religious elements written Kim Stanley Robinson (born March 23 1952) is an American Science fiction Writer, probably best known for his award-winning Presents an alternate history of the world where the population of Europe is obliterated by the Black Death setting the stage for a world without Europeans and Christianity.
• In Dies the Fire by S. M. Stirling in (2004), an epidemic of the Black Death is described around the city of Portland, Oregon. Dies the Fire is a post-apocalyptic 2004 novel by Alternate history author S Stephen Michael Stirling is a French -born Canadian - American Science fiction and Fantasy author
• Episode 18 of the second season of American television show House features the bubonic plague. Sleeping Dogs Lie is the eighteenth episode of the second season of House, which premièred on the FOX network on April 18, 2006 House, also known as House MD, is an American Medical drama, which debuted on the FOX network on November 16 2004
• In the season one episode of Torchwood, "End of Days", a woman from the 14th century infected by the plague falls through the rift into Cardiff, causing an infection of dozens of people in a local hospital. "End of Days" is the final episode of the first series of the British science fiction television series Torchwood, which The Cardiff Rift is a fictional wormhole in the Science fiction Television series Doctor Who and Torchwood, Cardiff ( 'kɑːdɪf) is the Capital and the largest city and county in Wales.
• Third Watch In the third episode of the fifth season, a number of illegal immigrants are discovered in the back of a truck and brought to hospital where they are diagnosed with the plague. This article is about the television show For information about naval watches see Watch system. The situation is complicated by the fact one of the immigrants managed to flee.
• In The Keys to the Kingdom by Garth Nix, Suzy Turquoise Blue, one of the Piper's children, was led to the House by the Piper from London during the Great Plague of London. The Keys to the Kingdom is a Fantasy &ndash Adventure Book series, written by Garth Nix; having started in 2003 with plans to Garth Nix (born 19 July 1963 in Melbourne) is an Australian author of young adult Fantasy novels most notably the The Keys to the Kingdom is a Fantasy - Adventure Book series, written by Garth Nix, started in 2003 with Mister The Great Plague (1665-1666 was a massive outbreak of Disease in England that killed 75000 to 100000 people up to a fifth of London 's population
• Grey's Anatomy In the first episode of the third season, a couple comes into the hospital because of flu symptoms, but get in a car crash along the way because the woman passed out while driving. Grey’s Anatomy is an American Primetime television medical drama. Different rooms in the hospital are quarantined, and the woman in the crash dies after surgery, due to complications from the plague.
• In Grand Theft Auto Advance, Liberty City is said to be affected by Bubonic plague. Grand Theft Auto Advance is a Handheld console game developed by Digital Eclipse, published by Rockstar Games, and released on October Liberty City is a fictional city in Rockstar Games ' Video games series Grand Theft Auto, based primarily on New York City
• The band Modest Mouse references "the rats and the fleas" that caused the disease to spread to humans in their song March into the Sea. Modest Mouse are an American Alternative rock band formed in 1993 in Issaquah Washington by singer/lyricist/guitarist Isaac Brock, drummer
• An episode of the TV show Wire in the Blood features a strain of bubonic plague as a biological weapon. Wire in the Blood is an ITV Television series, based on characters created by Val McDermid, which teams a university Clinical psychologist
• In Spooks Series 6 (episodes one and two) a fictional virus that causes symptoms mimicking pneumonic plague is accidentally released in London. Spooks is a BAFTA award-winning British television drama series produced by the independent production company Kudos for BBC One
• Lux perpetua (2006) by Andrzej Sapkowski. Lux perpetua (Ceaseless Light is a Historical novel with fantasy elements, written by Andrzej Sapkowski. Andrzej Sapkowski, born June 21, 1948 in Łódź, is a Polish Fantasy writer One of the main characters is murdered by magically induced septicemic plague.
• World Without End (2007) by Ken Follett. World Without End is a 2007 Novel by Ken Follett and the Sequel to 1989's The Pillars of the Earth. Ken Follett (born June 5, 1949) is a British Author of thrillers and historical novels The plague's spread throughout Europe in the 14th century is an integral part of the book's storyline.
• The Shifting Tide (2004) by Anne Perry. Anne Perry (born Juliet Marion Hulme in Blackheath, London on 28 October 1938 is an English Author of historical The plague enters England via a ship transporting ivory.
• In an episode of the TV show NCIS, SWAK, a team member gets infected with an engineered variant of pneumonic plague after opening a contaminated envelope. " SWAK " is the 45th episode of the Television series NCIS. Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal

References

Notes

Bibliography

• Weatherford 2004: 242-250
• Benedictow, Ole J. The Black Death 1346-1353: The Complete History. DS Brewer, 2006. ISBN 978-1843832140.
• Biraben, Jean-Noel. Les Hommes et la Peste The Hague 1975.
• Buckler, John and Bennet D. Hill and John P. McKay. "A History of Western Society, 5th Edition. " New York: Houghton Mifflin Co. , 1995.
• Cantor, Norman F. , In the Wake of the Plague: the Black Death and the World It Made New York: Harper Perennial, 2002. ISBN 978-0060014346.
• de Carvalho, Raimundo Wilson; Serra-Freire, Nicolau Maués; Linardi, Pedro Marcos; de Almeida, Adilson Benedito; and da Costa, Jeronimo Nunes (2001). Small Rodents Fleas from the Bubonic Plague Focus Located in the Serra dos Órgãos Mountain Range, State of Rio de Janeiro, Brazil. Memórias do Instituto Oswaldo Cruz 96(5), 603–609. PMID 11500756. this manuscript reports a census of potential plague vectors (rodents and fleas) in a Brazilian focus region (i. e. region associated with cases of disease); free PDF download Retrieved 2005-03-02
• Chase, Marilyn. The Barbary Plague: The Black Death in Victorian San Francisco. New York: Random House Trade Paperbacks, 2004. ISBN 978-0375757082.
• Cohn, Samuel K. (2003). The Black Death Transformed: Disease and Culture in Early Renaissance Europe. A Hodder Arnold, 336. ISBN 0-340-70646-5.  
• Gregg, Charles T. Plague!: The shocking story of a dread disease in America today. New York, NY: Scribner, 1978, ISBN 0-684-15372-6.
• Ernest Jawetz, et al. Medical Microbiology. 18th ed. United States: Prentice-Hall International Inc. , 1989. ISBN 0-8385-6238-8
• Kelly, John. The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of All Time. New York: HarperCollins Publishers Inc. , 2005. ISBN 0-06-000692-7.
• McNeill, William H. Plagues and People. New York: Anchor Books, 1976. ISBN 0-385-12122-9. Reprinted with new preface 1998.
• Mohr, James C. Plague and Fire: Battling Black Death and the 1900 Burning of Honolulu's Chinatown. New York, NY: Oxford University Press, 2005, ISBN 0-19-516231-5.
• Moote, A. Lloyd, and Dorothy C. Moote. The Great Plague: The Story of London's Most Deadly Year. Baltimore, MD: Johns Hopkins University Press, 2004. ISBN 978-0801877834.
• Orent, Wendy. Plague: The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease. New York: Free Press, 2004. ISBN 0-7432-3685-8.
• Papagrigorakis, Manolis J. , Christos Yapijakis, Philippos N. Synodinos, and Effie Baziotopoulou-Valavani. "DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens," International Journal of Infectious Diseases 10 (2006): 206-214. ISSN 1201-9712.
• Patrick, Adam. "Disease in Antiquity: Ancient Greece and Rome," in Diseases in Antiquity, editors: Don Brothwell and A. Recognised for his work in both human and animal Paleopathology, Don Brothwell has interests in the broad field of the archaeological sciences but particularly in Human T. Sandison. Springfield, Illinois; Charles C. Thomas, 1967.
• Platt, Colin. King Death: The Black Death and its Aftermath in Late-Medieval England Toronto University Press, 1997.
• Rosen, William (2007). Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Justinian's Flea: Plague, Empire, and the Birth of Europe. Viking Penguin, 367. ISBN 978-0-670-03855-8.  
• Simpson, W. J. A Treatise on Plague. Cambridge, England: Cambridge University Press, 1905.
• Spielvogel, Jackson J. Western Civilization: A Brief History Vol. 1: to 1715. Belmont, Calif. : West/Wadsworth, 1999, Ch. 3, p. 56, paragraph 2. ISBN 0-534-56062-8.

External links

• World Health Organization
  • Health topic
  • Communicable Disease Surveillance & Response - Impact of plague & Information resources
• Centers for Disease Control and Prevention
  • CDC Plague map world distribution, publications, information on bioterrorism preparedness and response regarding plague
  • Infectious Disease Information more links including travelers' health
• Symptoms, causes, pictures of bubonic plague
• Secrets of the Dead . Mystery of the Black Death PBS
• Flea As WeaponPDF (281 KiB)
• Researchers sound the alarm: the multidrug resistance of the plague bacillus could spread
• Plague - LoveToKnow 1911
• Genome information is available from the NIAID Enteropathogen Resource Integration Center (ERIC)