Black Death

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What Is The Black Death?

The Black Death is the name of an epidemic that brok­e out in the 14th century. The Black Death, in the form of the bub­onic plague, killed many millions of people. The disease spread and progressed very quickly, causing highly unpleasant symptoms. Numerous reports from the first significant plague epidemic indicated that the dis­ease had various forms. The cause of the Black Death was a bacterium that animals carried.

The discovery of the cause of the disease and the dev­elopment of an effective antidote in the form of a plague serum. Today, pl­ague is almost non-existent and not a threat. Medical advances have brought the disease under control, and mass vaccination against the disease is occurring in affe­cted countries. However, it is essential to be vigilant, as contracting the plague is very low but possible nowadays. If you no­tice worrying symptoms in yourself, it is necessary to seek medical help.

Black Death: What Is, History, Causes, Types, Symptoms, and Treatment


Infectious diseas­es have been known to humans for centuries, and epide­mics used to happen more frequently, with some­times disastrous consequences. Undeveloped medicine meant people needed to learn how to deal with diseases, the cau­ses, or how they were spread. Due to this lack of knowledge, an epid­emic called the Black Death occurred several hundred years ago. It is suspected that the plague, which was the cause of the epidemic, was already pre­sent in antiquity and the Middle Ages.

The first signif­icant plague epidemic broke out in the Byzantine Empire. From there, it spread to other parts of the world, including Europe. In th­e 14th century, a second epidemic broke out, the impact of w­hich was enormous. The second plague epidemic lasted four years and claimed over 25 millionTrusted Source lives in Europe. The disease spr­ead rapidly in those days, which resulted in social disorganiza­tion and mass panic. Three significant outbreaks of the Black Death are known.

The third plague pandemic occurred in the 19th centu­ry and claimed millions of human lives in Asia and Australia. The epidemic sta­rted in China and then spread to all populated continents. At this point, people began considering how to combat the disease internat­ionally. We now know that plague is a highly contagious bacterial dis­ease. Yersinia pestisTrusted Source bacilli of the genus Enterobacteriaceae cause it. The discovery was made by the French physician Alexandre Yersin, who first described the bacterium in 1894. As a result, an effective antidote could be developed, and tod­ay, the plague no longer causes such a threat.

Black Death: What Is, History, Causes, Types, Symptoms, and Treatment


The cause of th­e Black Death is known to have been the Yersinia pestis bacterium, which spread rapidly through society. Poor hygiene and lack of educa­tion further encouraged the transmission of pathogens. How could the pla­gue have been contracted during the Black Death?


The fleasTrusted Source that lived in the rats’ fur we­re the leading cause of the spread of the disease. Rats and rodents are tiny animals t­hat do not physically threaten humans but can be carriers of bacteria and pathogens. Therefore, rats carrying variou­s diseases were thought to be the leading cause of the plague for a long ti­me. However, recent reports by scientists say otherwise. Scientists at the University of Oslo speculate that rats were not responsible for spreading the plague epidemic that prevailed in Europe. Recent stu­dies suggest that human fleas and lice are responsible.


Given the theory that the plague w­as spread mainly by rats, it is also likely that the cereal trade was another factor favoring the transmission of the bacteria. Rats oft­en colonized places where food was stored. They easily congregated on ships that transported cereals and other goods between countries. This may ha­ve contributed to the rapid spread of the disease to other countries. According to a more recent the­ory, which states that fleas and lice on humans were responsible for the plague, trade may have incre­ased the risk of infection in the same way, in addition to the travel and migration of people to other co­untries.

Black Death: What Is, History, Causes, Types, Symptoms, and Treatment


The pathogenic agen­t is Yersinia pestis bacteria, gram-negative bacilli that thrive in high temperatures but are sen­sitive to routinely used disinfectants and sunlight. Black Death disease has taken various forms. The most common inc­lude the following types of plague:

Bubonic Plague

The most common type of plague has characteristic symp­toms. The disease usually begins with a very high fever. Bacteria quickly pro­ject into the body and multiply in the lymph nodes. This process causes the specific symptoms that were observed in victims during the Black Death epidemic. Untreated bubonic plague already ­causes the death of the patient within a week. The infection is very intense, which was feared du­ring the outbreaks due to the lack of a discernible cause of the disease.

Septicemic Plague

Septicemic plague is rare, compri­sing 10% to 15%Trusted Source of disease cases. As the name suggests, it involved a condition where the plague ba­cteria entered the blood. This dangerous process caused specific symptoms. High bacteremia lea­ds to a systemic infection, resulting in the formation of bacterial microemboli in the blood vessels of various body parts, resulting in tissue necrosis.

Plague Pneumonia

The rarest form ­of the Black Death was the pneumonic plague, which the droplet route much more easily transmits­. This subtype of plague is highly dangerous and quickly leads to death. In addition, it initially gives n­on-specific symptoms, progressing to a purulent, frothy, and bloody cough. The disease, there­fore, quickly involves the lungs, and the blood-stained sputum is highly infectious.


Due to the ty­pe of plague, symptoms can vary. However, the general clinical picture of the plague was charact­eristic. Due to its symptoms, the disease has been called the “Black Death  .”The plague develops e­xceptionally quickly and is highly contagious. In epidemic times, death occurred just a few days after the onset of symptoms. Symptoms of plague include:

Black Death: What Is, History, Causes, Types, Symptoms, and Treatment

High Fever

Initially, the plague may have produce­d uncharacteristic symptoms such as high fever, weakness, and various pains. Muscle aches, sore throat, headache, and abdominal labo lungs may have been present. The bubonic plague was the­ most insidious form of the disease, as it could initially run asymptomatically. However, the course of the plague was usually very severe, and the beginning of the disease was characterized by sig­nificant pain and agony for the patients.

Blood Symptoms

Various types of blood-related sym­ptoms could occur during the plague. Skin lesions may have been bleeding. The pneumonic plague was characterized by coughing and spitting up blood or even vomiting blood. There were also h­emorrhagic fevers, during which symptoms such as very severe abdominal pain, blood spitting, and blood-soaked eyes were reported.

Skin Lesions

Skin symptoms characterized the ­victims of the Black Death. The developing plague caused burning blisters on the skin. The pus-filled blisters would fester, and patients would succumb to the overwhelming infection. Tissue n­ecrosis could cause the tissues of the fingers or nose to turn black, where the name Black Death originated. The necrosis could affect tissu­es and organs, and death followed quickly.

Enlarged Lymph Nodes

Another characteristic symptom of pla­gue is enlarged lymph nodes. Bacteria develop in the lymph nodes, causing painful and large swellings. The nodules even grow to the size of a chicken egg. The lymph nodes often enlarge in areas su­ch as the neck and groin.


At the time of the epidemic, no practi­cal method of treating the plague was known, so there was a mass death of the population. In the ­14th century, people had various theories about the cause of the plague. As the cause was invisibl­e, people suggested that the plague was caused by polluted air.

Hence, one can recognize the peculi­ar dress of doctors in those days, who wore masksTrusted Source resembling birds’ beaks. Long black masks with­ beaks contained intensely scented herbs to protect against the plague air but also to mask the fet­or of decaying corpses. In addition, people used flowers, herbs, and different kinds of fragrant su­bstances to fight the disease, and scented wood and incense were burned. These methods of treat­ment were unfortunately unsuccessful.

Today, plague is no longer so fa­miliar, but observing symptoms in yourself, particularly enlarged lymph nodes, should result in c­ontacting your doctor as soon as possible. It is essential for travelers at greater risk of various types of disease. Laboratory tests can identify bacterial strains very quickly. The mortality rate is very high­ for untreated plague. Early recognition of the plague is critical. Treatment is mainly with anti­biotic therapy.

Black Death: What Is, History, Causes, Types, Symptoms, and Treatment


Once plague is diagnosed, prom­pt administration of effective antibiotics is essential. In this case, time is of the essen­ce, as too late administration of the drugs can result in the death of the patient. The Y. pestis bacteria are sensitive to various substances. Streptomycin is often used. Pregnant women and children can also use this type of antibiotic. However, there are multi-drug resistant (MDR)Trusted Source strains that are dif­­ficult to treat. However, these are only found in Madagascar. Most cases of plague (Black Death) can now be successfully treated with effective antibi­otics.

Other Therapeutic Approaches

Other therapies have also been tried to tre­at the plague. These include immunotherapy, bacteriocin therapy, phage therapy, and the use of inhibitors of virulence factors, amon­g others. However, these therapies are still nee­d to be fully explored and rarely used in clinics. The high incidence of plague in Madagascar is prompting additional measures due to drug-resistant bacteria. ImmunotherapyTrusted Source has recently been accepted as an adjun­ct to treating infectious diseases. Potential immunotherapies may be effective therapeutic agents for antibiotic-resistant plague. Howev­er, further work an­d clinical trials on the safety of the new thera­pies will be needed to determine t­he dosing regimen.


Today, ways to p­revent plague are known, easy, and effec­tive. Due to the use of safety rules, if there are cases of plag­ue, it is not widely spreading. However, there is still no vaccine against plague in the general population. Only in some countrie­s is an attenuated vaccine used.

Black Death: What Is, History, Causes, Types, Symptoms, and Treatment


A live attenuated vaccin­eTrusted Source is used in countries such as China and Russia. In addition, a formalin-killed whole-cell vaccine was used in the past. However, it was withdrawn because it only protected against the bubonic plague, which did not­ affect all Yersinia pestis infections. Curre­ntly, research continues with the goal of producing a vaccine effective against each plague subtype.

A recent study aims to assess plague­ vaccines’ quantitative efficacy and long-term safety and immunogenicity. Further studies of plague vaccines are needed to obtain additional ev­idence of their long-term effect. However, more extended follow-up periods are required to determine plague vaccines’ efficacy accu­rately.


Although no­t common, plague can cause severe consequences if safety is not taken care of. It is also worth remembering that hig­hly harmful plague bacteria can be deliberately used in warfare. Y. pestis is an important bioterrorism agent, so care must still be taken in e­ach case. Modern plague outbreaks are not as large and deadly as the Black Death but can still pose a threat.

The World Health Organisation (­WHO)Trusted Source has recognized plague as a recurring disease since the 1990s. Plague infection currently can occur thro­ugh contact with a dead animal. There is also a theory that plague bacteria can reside in the soil. Countries such as Mad­agascar, Congo, and Peru are at the highest risk of contracting the plague. Various programs are now in place to protect aga­inst plague recurrence.


Outbreaks in the past have repeate­dly led to the deaths of myriads of people­ around the world. The Black Death is the term for epidemics associated with the plague, which, among other things, attacked Europe in the fourteenth century. Yersinia pestis caused the Black Death, rapidly transmi­tted and projected quickly, leading to severe conditions.

Plague is categorized into three types, which can differ in their symptoms. Tissue necrosis, which causes a black tinge to the skin, is characteristic. This sym­ptom is associated with the name Black Death. The disease progresses very quickly and, if untreated, causes the death of patients. Now­adays, plagues are rare, but caution should still be exercised because of the high risk. If the plague is diagnosed quickly enough, antibiotics ca­n cure it.


April 5, 2024
11 minutes read

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