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Everything You Know Is Wrong.
March 31, 2014 5:28 PM   Subscribe

Research on DNA extracted from the skulls of Black Death victims has revealed that the plague was not spread by rat fleas after all, and instead must have been airborne.

In other words, the plague was not a bubonic plague, at all, but a pneumonic plague.

The skulls were taken from recently rediscovered Black Death burial sites in London, revealed during excavations for the Crossrail rail line.

Previously, DNA isolated from the same skulls proved conclusively that the Black Death was caused by the Yersenia pestis bacterium.
posted by Sara C. (93 comments total) 32 users marked this as a favorite

 
This research was generously funded by FleaCo, serving your pestilence needs since 1412.
posted by shothotbot at 5:32 PM on March 31 [30 favorites]


And there is no danger whatsoever of reintroducing this fast-spreading lethal pneumonic plague by digging into a trove of bodies which died from the disease, amirite?
posted by localroger at 5:33 PM on March 31 [15 favorites]


Antibiotics make plague much less of a threat than it was 666 years ago.

Also it seems like it was pretty difficult to get at the DNA -- it's not like the bodies were covered in lung sputum or something.

(OMG GUYS ITS BEEN 666 YEARS SINCE THE BLACK DEATH WHAT IF I'M WRONG ABOUT THIS)
posted by Sara C. at 5:37 PM on March 31 [45 favorites]


And there is no danger whatsoever of reintroducing this fast-spreading lethal pneumonic plague by digging into a trove of bodies which died from the disease, amirite?

No danger. The remaining DNA has been so damaged by the passage of time that all it does now is transform its victims into brain-eating zombies. This means that technically it doesn't count as "lethal" any more. So we're good.
posted by anonymisc at 5:38 PM on March 31 [44 favorites]


So we're good.

A confident statement like that really should be followed with a few coughs for maximum effect.
posted by Dip Flash at 5:40 PM on March 31 [25 favorites]


Now watch this.
posted by meinvt at 5:42 PM on March 31 [3 favorites]


Antibiotics make plague much less of a threat than it was 666 years ago.

Also cheap soap, clean drinking water and the germ theory of disease, all of which are far more important.
posted by mhoye at 5:42 PM on March 31 [14 favorites]


Also cheap soap, clean drinking water and the germ theory of disease

You read the part where it was airborne, right?

I mean, I suppose that, if something like this happened now, people would know to wash their hands and stay home from work, and maybe it wouldn't be quite as virulent. But it's still airborne. People know how to prevent colds and flu, and yet millions of people come down with them every year.
posted by Sara C. at 5:46 PM on March 31 [7 favorites]


Obligatory.
posted by Fizz at 5:47 PM on March 31 [2 favorites]


Clearly all this new so-called "research" was secretly funded by Big Miasma.
posted by Bromius at 5:50 PM on March 31 [45 favorites]


This is some of the most painfully bad science reporting I've read in ages. What, exactly, is this new evidence? We've known for 3ish years that the strain of Y. pestis that infected plague victims is nearly identical to the modern form, and it's been known for ages that the modern Y. pestis can cause both bubonic and pneumonic disease. Yes, it makes sense that for the disease to have spread so rapidly during the 1300s that it would have been the pneumonic form, and it also makes sense that the pneumonic form, which is relatively mild in modern times, would have been absolutely deadly to people living in the sanitary conditions, and with the comorbid conditions, that were prevalent in the 1300s. BUT WHAT IS THIS NEW DATA? SHOW ME THE DATA. At the very least, for the love of Xenu, describe the data to me, or cite the paper you're reporting on, or a single scientist involved with it, or something. UGH.
posted by amelioration at 5:55 PM on March 31 [78 favorites]


Most of what I know about the Black Death comes from reading The Great Mortality. Which is a very good read indeed.

I'm pretty sure it has been known for some time that the Black Death was at least sometimes airborne. First-hand accounts from the time make it clear that the disease progressed differently in different places and times. Modern outbreaks often include pneumonic cases.
posted by Western Infidels at 5:55 PM on March 31 [10 favorites]


instead must have been airborne.

Oh snap!

Also cheap soap, clean drinking water and the germ theory of disease

Well no doubt the plague was nasty. But if all it takes to defeat it is hygiene, antibiotics, and clean water...then that old plague is not really a threat for anyone reading this.

But what if Mr. Plague hooks up with Mrs.A. Shit is going down SyFi Channel style.
posted by hal_c_on at 5:56 PM on March 31 [1 favorite]


Sara, I *hate* those people.
posted by DigDoug at 5:56 PM on March 31


Is this really a startling new discovery? In my college medieval history class we learned there were 3 types of plague during the Black Death -- bubonic, pneumonic, and septicemic -- and that was seven or eight years ago now (my class, not the plague). I remember it pretty clearly because my teacher told us the mortality rates for each one, and bubonic came out looking pretty good: it had something like a 60% fatality rate and took a couple weeks to die, pneumonic had something like a 90-95% mortality rate and took a few days, and septicemic was something like a 99% mortality rate and within hours you were bleeding out from every orifice in your body.

At any rate, to keep this from being just a "when I was in school..." cranky comment, here's a link to the Florentine Chronicle, about when the plague first struck Florence. The part that always sticks in my mind is how family members would abandon each other to the illness:
And many died with no one looking after them. And many died of hunger because when someone took to bed sick, another in the house, terrified, said to him: "I'm going for the doctor." Calmly walking out the door, the other left and did not return again. Abandoned by people, without food, but accompanied by fever, they weakened. There were many who pleaded with their relatives not to abandon them when night fell. But [the relatives] said to the sick person, "So that during the night you did not have to awaken those who serve you and who work hard day and night, take some sweetmeats, wine or water. They are here on the bedstead by your head; here are some blankets." And when the sick person had fallen asleep, they left and did not return. If it happened that he was strengthened by the food during the night he might be alive and strong enough to get to the window. If the street was not a major one, he might stand there a half hour before anyone came by. And if someone did pass by, and if he was strong enough that he could be heard when he called out to them, sometimes there might be a response and sometimes not, but there was no help. No one, or few, wished to enter a house where anyone was sick... Many died unseen. So they remained in their beds until they stank.
posted by lilac girl at 6:00 PM on March 31 [34 favorites]


One thing that I've never really understood is the seeming derision that a lot of pop medical historians have for those backwards folk in the pre-Germ Theory years who believed in concepts like "bad air" and "miasma"

Given that some diseases are, in fact, airborne, why is it so silly to believe that breathing the air near a sick person is a bad idea?
posted by sparklemotion at 6:01 PM on March 31 [12 favorites]


From reading The Black Death by Robert Gottfried, I thought this was common knowledge. The really scary kind was the sort you could catch in the morning and which would kill you by nightfall.
posted by Ray Walston, Luck Dragon at 6:08 PM on March 31 [2 favorites]


Antibiotics make plague much less of a threat than it was 666 years ago.

Not if it turns out to be viral.
posted by yoink at 6:09 PM on March 31 [8 favorites]


a single scientist involved with it, or something

The article may be a blurb for an upcoming Channel 4 documentary, but it does quote Dr Tim Brooks at the Special Pathogens Reference Unit at Porton Down, which is a real person and a real place.
posted by effbot at 6:10 PM on March 31 [1 favorite]


Am I crazy, I thought it was widely and generally believed that the plague was pneumonic? I'd swear I read it in a few of my history texts.
posted by sotonohito at 6:10 PM on March 31


Does this mean they didn't have buboes? I thought they had buboes.
posted by unknowncommand at 6:10 PM on March 31 [6 favorites]


The article may be a blurb for an upcoming Channel 4 documentary, but it does quote Dr Tim Brooks at the Special Pathogens Reference Unit at Porton Down, which is a real person and a real place.

Right, but it says Brooks is promoting a theory, not new data, and nowhere does it indicate that Brooks is related to this mysterious! new! data! Thus my suspicion that this is not science reporting, but advertising copy.
posted by amelioration at 6:14 PM on March 31 [7 favorites]


Now I'm wondering where my copy of The Doomsday Book got itself to.
posted by rewil at 6:15 PM on March 31 [14 favorites]


What about Justinian's Plague? Which type was that?
posted by Area Man at 6:16 PM on March 31


"I mean, I suppose that, if something like this happened now, people would know to wash their hands and stay home from work, and maybe it wouldn't be quite as virulent. But it's still airborne. People know how to prevent colds and flu, and yet millions of people come down with them every year."

You chastised him for perhaps not reading the link, but your links include the information that the plague was and is known to take the pneumonic form and that the older strain is no more virulent than the current strain.

I don't see anything here that wasn't already well-known, at least to scientists.

It's the same pathogen, but the disease has very different symptoms and different vectors depending upon where and how the pathogen infects specific victims. The bubonic form with its buboes is highly infectious but not as easily and quickly spread as pneumonic and septicemic. The septicemic form is extremely virulent, which works against its infectiousness although airborne and ingested blood products spread it easily. The pneumonic version is the sweet spot where the virulence isn't so high as to too quickly incapacitate and kill the victims, but also, unlike the bubonic version, is very easily spread (airborne, coughing). So it wins the "high rate of transmission" sweepstakes.

Furthermore, the historical record shows that the disease progressed at different rates in different areas. It's always been apparent that in some places it spread extremely rapidly, and in other places it spread slowly. This has always been explained by the contagion route in the context of which form the disease took.

And the bubonic form has always been important because the slower contagion, less deadly version spread indirectly by rats (fleas bite person, pathogen moves to the lymph nodes) allows for the disease to spread widely, and via boat, when high-contagion, high-morality pneumonic and septicemic wouldn't, they'd burn themselves out. Which they did. That the disease can take these different forms, with their varied vectors, mortality, and degrees of incapacitation all combine to create a plague that could have high mortality rates but spread widely and, also, have greatly varying mortality rates and outcomes in different areas. Which is what happened. Also, we call it "bubonic plague" because the buboes are very characteristic and notable.
posted by Ivan Fyodorovich at 6:27 PM on March 31 [24 favorites]


New or old, this theory does nothing to improve the lousy PR situation of the central Asian marmots.

Also, wasn't the 1918 flu the most lethal pandemic in history? I'm currently finishing The Great Influenza, and it says, "Plague in the 1300s killed a far larger proportion of the population -- more than one-quarter of Europe -- but in raw numbers influenza killed more than plague then, more than AIDS today."
posted by FelliniBlank at 6:30 PM on March 31


And there is no danger whatsoever of reintroducing this fast-spreading lethal pneumonic plague by digging into a trove of bodies which died from the disease, amirite?

The movie will come soon if it isn't out already.

Not if it turns out to be viral.

Of course, hence the use of word antibiotics rather than antivirals.

It's 9:30pm right now in Toronto.

Not if you're in Vancouver.
posted by juiceCake at 6:30 PM on March 31


I have to chime in and agree: not news in the least. Both Gottfried's account, and Philip Ziegler's very layman-friendly book "The Black Death" go into this in great detail. The Ziegler book dates to 1969. Moreover, it was noted even in the 14th century by chroniclers that the type of plague would vary depending on the season, and accounts of the time show they were aware of the three varieties, at least in a rudimentary fashion. If I remember right—and this is purely off memory, so please correct me if I've misremembered—the pneumonic version was much more likely to take hold in a community during the winter months, and would often trail off in the spring, being replaced by the bubonic version as the weather warmed. Septicæmic plague just seems to have been rotten luck to have show up, and was not nearly as common, perhaps because its virulence caused it to burn out too quickly to keep spreading.

The Black Death is one of those subjects I keep getting dawn back to, and was always a favorite to go over in European history classes. There's something just so horrifyingly mesmerizing to imagine losing one third of the population. And to really rub salt into the wounds, it tended to recur across Europe in cycles of a couple of decades, cruelly killing off more population just as they were reaching an age to bear children. Vast swaths of Europe ended up reclaimed by the forest as farms and communities simply vanished.
posted by los pantalones del muerte at 6:30 PM on March 31 [2 favorites]


Also, wasn't the 1918 flu the most lethal pandemic in history?

In terms of absolute numbers, sure. However the Black Death killed 30%-50% of Europe's population.

In contrast, WWII was the deadliest war in history and still cataclysmic in human memory, with 85 million killed as a result of war, which was something like 4% of the population of the countries, territories, and regions affected by the war.
posted by KokuRyu at 6:39 PM on March 31 [2 favorites]


Not if it turns out to be viral.

But plague isn't viral; it's bacterial, and it's endemic in lots of rodent colonies in the western part of the U.S., so it's not like some exotic, arcane thing nobody ever gets anymore. Sure, not at all pleasant and still capable of killing folks, but it's not going to wipe out half the planet or anything.
posted by FelliniBlank at 6:40 PM on March 31 [4 favorites]


> why is it so silly to believe that breathing the air near a sick person is a bad idea?

Poor predictive ability. Without understanding the underlying cause of disease, it does nothing to prevent or treat the disease.

For example, does breathing the air in a chemotherapy ward cause cancer? Does breathing the air in a lepers colony cause leprosy? Does clean, fresh air cure syphilis or schizophrenia?

Miasma was a pseudo-scientific catch-all for "I don't know." But people being people and all, it became a dogmatic explanation which prevented further investigation of any underlying problem. It feed into the natural inclination to stigmatize and discriminate against the sick and diseased instead of an honest investigation into the cause.

That's why it's silly, and that's why the miasma theory has been correctly derided by educated modern people.
posted by peeedro at 6:40 PM on March 31 [2 favorites]


I was in England for a few years as a military brat, and in DoD schools overseas there's this class called Host Nation where you learn about the country you're in, and Host Nation had a ton of really, really cool field trips to learn history. The thing about those field trips, though, is that there was always a stop in some spooky dark building with plague-era paraphernalia (those goddamn masks), where the Host Nation teacher would scare the living shit out of you with basically just plague-themed ghost stories. If it wasn't plague themed, it was torture themed, because of course it was. To be fair, scaring all of us children really helped the history lesson stick.
posted by jason_steakums at 6:47 PM on March 31 [3 favorites]


This is not a new idea
posted by pbrim at 6:50 PM on March 31


This was expanded quite a bit on tumblr - relevant pull quote

… And there are accounts of the fleas sounding like rain hitting glass they were so thick inside some buildings during the height of the last major plague outbreak in London. Let that nightmare image seep in a moment.

posted by The Whelk at 6:53 PM on March 31 [10 favorites]


The Black Death is one of those subjects I keep getting dawn back to, and was always a favorite to go over in European history classes. There's something just so horrifyingly mesmerizing to imagine losing one third of the population.

Yeah, I had that same morbid interest in it, and then I read the The Doomsday Book and found it so devastating and deeply disquieting that I lost that interest. The Doomsday Book just made it all too visceral to bear.

Now I just have a continued morbid interest in Pompeii.
posted by yasaman at 7:06 PM on March 31 [5 favorites]


To be fair, scaring all of us children really helped the history lesson stick.

I was beaten with that stick several times.
posted by hal9k at 7:08 PM on March 31 [4 favorites]


The really scary kind was the sort you could catch in the morning and which would kill you by nightfall.

No. Well, I mean, yes, that is very scary, but on a population level, the scary stuff is the flu you catch Monday, incubate and spread as you go back and forth to work and the market and the school until Thursday, and then pass out at work from on Friday. That's why the flu kills more people than Ebola. Yeah, Ebola's mortality rate is way higher, but it limits its own spread that way.

On preview: Er, what Ivan said.
posted by maryr at 7:14 PM on March 31 [1 favorite]


A gruesome online video course from Yale U. is Frank Snowden History of Epidemic Diseases since 1600.
posted by bukvich at 7:32 PM on March 31 [10 favorites]


further proof that it was caused by vaccinations.
posted by philip-random at 7:43 PM on March 31


Sorry, does the pneumonic form *also* cause buboes, in spite of the different name? Do the buboes reflect a notable symptom of the disease (which was said to be caused by fleas and spread to lymph nodes), but they're not truly indicative of a "bubonic" (i.e., flea-based) mode of transfer? I promise I have Wikipedia'd the crap out of this question.
posted by unknowncommand at 7:46 PM on March 31 [2 favorites]


But plague isn't viral; it's bacterial

The whole point of the argument is that we don't know what the Black Death was--and, more specifically, that it could not have been bubonic plague.
posted by yoink at 7:47 PM on March 31 [1 favorite]


What really killed William Henry Harrison?
posted by Blazecock Pileon at 7:52 PM on March 31 [2 favorites]


the plague was not spread by rat fleas after all, and instead must have been airborne.

Completely false dichotomy. Doubtless many people died due to the Pneumonic and septicaemic variants of the disease [and the enteric variant as well - why does nobody remember that one?]. None of this precludes the flea as an additional vector.
posted by HiroProtagonist at 7:56 PM on March 31 [2 favorites]


Sure, not at all pleasant and still capable of killing folks, but it's not going to wipe out half the planet or anything.


Now that could work out to some famous last words.


...people would know to wash their hands and stay home from work...

Oh, I love the sound of optimism! ! First of all, the wonderful folks who serve you your cuppa joe and breakfast sammich in the morning are the last ones to be able to stay at home from work. Just think of all those sick service folks who don't take sick leave, because ha ha, their job doesn't give 'em any!

And maybe you and I wash our hands, but that guy over there--not hardly. Here's your change, and have a nice day, sir. *cough cough*
posted by BlueHorse at 8:09 PM on March 31 [13 favorites]


Jesus, that article is terrible. Yes, we've known for a very long time that there's three means of transmitting Yersinia pestis (flea bites, contact, droplet inhalation) and three different manifestations (bubonic, septicemic, pneumonic). Untreated bubonic plague can result in the organism breaking into the bloodstream, producing septicemic plague. Sometimes the organisms travel to the lungs, where they are be transmitted to other hosts' lungs via coughing up droplets of infectious sputum.
There hasn't been a pneumonic plague case in the US since 1924, but there's a couple thousand cases of plague a year worldwide, some of which are pneumonic. The most recent I'm aware of was in Madagascar in late 2013/early 2014. CDC plague overview and FAQ.

Handwashing and staying away from obviously sick animals and people are good ideas even if you're not worried about the Black Death. (Pneumonic plague patients are pretty easy to avoid, since they're generally in a state of complete collapse. Bioterrorists are another story.)
posted by gingerest at 8:18 PM on March 31 [6 favorites]


"The whole point of the argument is that we don't know what the Black Death was--and, more specifically, that it could not have been bubonic plague."

What? No, it was the bubonic plague.

"Sorry, does the pneumonic form *also* cause buboes, in spite of the different name? Do the buboes reflect a notable symptom of the disease (which was said to be caused by fleas and spread to lymph nodes), but they're not truly indicative of a 'bubonic' (i.e., flea-based) mode of transfer? I promise I have Wikipedia'd the crap out of this question."

This is all the same pathogen. The illness spreads, presents, and progresses differently depending upon what part of the body it primarily infects. We have three names for this not because the pathogen is different, but because the symptoms are different.

So, bubonic is where the disease goes to the lymph nodes. Given enough time, it will likely spread further around the body but just infecting the lymph system is a big deal and enough to kill someone. And those lymph nodes will swell, producing the characteristic buboes. But if it spreads to either the lungs or the blood before the person dies from it, then it can be also the pneumonic or septicemic versions and spread that way.

Flea bites by infected fleas are likely to be bubonic, less likely to be septicemic, and least likely to be pneumonic. This is because a flea bite is responded to by your immune system and the bacteria from the flea is taken up by the immune cells and transported into the lymph system. If the immune system doesn't get it quickly enough, or whatever, then it might just spread into the bloodstream. It's not likely to get into the lungs (primarily, originally) from a flea bite, though.

But, as I wrote, the bubonic infection can become septicemic and/or pneumonic. If it spreads to the lungs, then the infected person will have infected coughing, it will spread to other people in the air and into their lungs, and so those people will present with the pneumonic version. Some of those people will develop bubonic and/or septicemic, assuming they don't die too quickly before it spreads from their lungs.

If it's in the bloodstream, it's septicemic and this will cause a very rapid, systemic failure accompanied by bleeding and vomiting of blood and such. There will be the bacteria in the blood and vomit, some of that might be a little airborne (from vomiting), some of it might be ingested. I don't know this, this is all memory, but I am guessing that it's not so easy for the bacteria to infect the gastrointestinal tract, so that's not really a way it presents or spreads.

So you can see that this involves a number of variables. Chance and some cultural and local factors. Also, the weather as mentioned previously. Some conditions will favor it being pneumonic, others won't. If it were only pneumonic or septicemic, then the virulence and mortality would be so high that it would tend to run through smaller populations very quickly, burning itself out before it could spread widely and persistently. If it were only bubonic, then it wouldn't have as high a mortality or transmission rate. If it were only septicemic, it wouldn't infect many people at all, but they'd all mostly die of it (as is the case).

That the pathogen is comfortable in several different systems but doesn't attack them all simultaneously, but more just by the chance of its introduction to its host, means that it has several quite different progressions and modes of transmission. This is an evolutionary strength of the pathogen, it's more versatile and can prosper under several different kinds of environmental conditions.

On preview: or, what gingerest wrote more concisely.
posted by Ivan Fyodorovich at 8:31 PM on March 31 [11 favorites]


Oh, I see from previous comments that there is an enteric version.
posted by Ivan Fyodorovich at 8:33 PM on March 31 [1 favorite]


No. Well, I mean, yes, that is very scary, but on a population level, the scary stuff is the flu you catch Monday, incubate and spread as you go back and forth to work and the market and the school until Thursday, and then pass out at work from on Friday. That's why the flu kills more people than Ebola. Yeah, Ebola's mortality rate is way higher, but it limits its own spread that way.

Ebola's a fuckton scarier than the flu man
posted by Ray Walston, Luck Dragon at 8:34 PM on March 31


Why, this plague is bubonic
*BAMP*
Pneumonic
*BAMP*
Se-e-epticemic
*BAMP*
Why, it's greased lightning!
posted by Atom Eyes at 8:37 PM on March 31 [21 favorites]


Flu's killed a fuckton more people, dude.
posted by maryr at 8:45 PM on March 31 [3 favorites]


I'm more concerned about the next flu pandemic than Ebola, but the recent outbreak had me watching the news to see if I need to hedge my bets.
posted by arcticseal at 8:49 PM on March 31 [1 favorite]


Well, the minute Ebola gets a longer incubation I'm closing my fucking ports.
posted by maryr at 8:51 PM on March 31 [13 favorites]


Wait, did I accidentally wander back into the Walking Dead thread?
posted by The Underpants Monster at 9:03 PM on March 31 [5 favorites]


Everything You Know Is Wrong

Ha. I knew it!
posted by pompomtom at 9:09 PM on March 31 [6 favorites]


It all started with marmotes (groundhogs etc) in Kazakhstan/Mongolia which even to this day people are still getting plague from eating wild caught.
posted by stbalbach at 9:13 PM on March 31 [1 favorite]


Sorry about the mixup, rats. No hard feelings?
posted by current occupation: at 9:39 PM on March 31 [1 favorite]


Ebola's a fuckton scarier than the flu man

Just like air crashes are scarier than car crashes. But Ebola kills way fewer people than air crashes do, and Influenza kills roughly as many people as car crashes do, just in a typical year.
posted by wotsac at 9:40 PM on March 31 [2 favorites]


Ebola's a fuckton scarier than the flu man

Nope nope nope. Unless it mutates to be closer to the flu, Ebola burns itself out. The flu spreads worldwide. Slow and nasty is where my apocalyptic money is on.
posted by Dip Flash at 9:49 PM on March 31


As Sara C. said, it's 666 years to the day that Bubonic Plague first arrived in England. There's a popular children's rhyme that takes on a grim meaning when you know the implications of the words: rice was an expensive imported delicacy used for making blancmange, considered to be "an ideal food for the sick"; treacle was another name for theriac, a medicinal compound; and a lump, bump or bubo could be called a weasel (or a rat, or mouse, or whatever). The plague made medicine and personal care wildly expensive, which led to the original version of the famous rhyme:
Half a pound to pay for the rice
Half a pound for treacle
Call the priest to say the last rites
Pop goes the weasel!
Quite chilling, when you think about it.
posted by Joe in Australia at 11:03 PM on March 31 [11 favorites]


And maybe you and I wash our hands, but that guy over there--not hardly. Here's your change, and have a nice day, sir. *cough cough*

One of the interesting things about recent studies of black death victims is that the DNA of the yersinia pestis they found is near identical to the modern version. We still have the plague, it never went away, and it still infects a few people every year. Mortality rate is very high if untreated, especially for the pneumonic (person to person) type.

The reasons we're unlikely to have another black death (I hope) are these:
a) far, far better public sanitation (sewers), garbage collection and food storage. This means the rat population is not living in our houses, eating our food, running down the streets - or rather, not in the same numbers, anyway. That largely eliminates the primary infection route via fleas. The 1994 outbreak in India was largely caused by the flooding of the sewers, forcing the rats out and into the population.

b) we're better fed and much healthier. While general nutrition varies widely of course, rickets is not widespread on the streets of London any more for example. Healthier individuals with decent immune systems are better able to fight off a number of infections, and that includes Y Pestis to some extent.

c) and this is the biggie - Y Pestis is easily treated with antibiotics. When cases are spotted, both the infected and those at risk are given antibiotics, which usually saves those who are still living, and stops it spreading. You also isolate the victims, again stopping the spread.

Tuberculosis is another airborne bacterium that used to kill millions, but has been brought under control by the use of antibiotics, though it does take a lengthy course to do so as it's a tough sonuvabitch, and many more people get that every year than plague. Of course, we have multi-drug resistant strains now, and it's probably only a matter of time before we see untreatable cases spreading from totally resistant tuberculosis - which has already been spotted.

If you want to be scared of a mass public infection that we can't do anything about spreading around the world, totally resistant TB gets my money. Going back to TB wards where we quarantine the infected? Yay.

Well, that or a more virulent flu virus of course. We're about due for another nasty one.
posted by ArkhanJG at 12:12 AM on April 1 [2 favorites]


Joe in Australia: I can't tell if you're taking the piss or not soooo.... "Pop Goes the Weasel" isn't about the Black Death. That's one of those made up things like Ring Around the Rosie being about the plague or Sing a Song of Sixpence being a recruiting tool for pirates.
posted by Justinian at 12:26 AM on April 1 [2 favorites]


If you want to be scared of a mass public infection that we can't do anything about spreading around the world, totally resistant TB gets my money.

If it was good enough for Keats it's good enough for me.
posted by Justinian at 12:27 AM on April 1


Devastating Plague Strains Arose Twice, Could Return
posted by homunculus at 12:36 AM on April 1 [1 favorite]


Many centuries before the Black Death wiped out a third to half of Europe, an equally virulent pandemic called the Plague of Justinian killed upwards of 100 million people
I didn't do it.
posted by Justinian at 12:46 AM on April 1 [15 favorites]


maryr: "Flu's killed a fuckton more people, dude."

One of the rare occasions where fuckton simply isn't a strong enough word.

Just the 1918 flu pandemic killed somewhere in the vast range of 50M to 100M people globally, and Ebola has killed somewhere from the range of 2k - 5k mostly in Africa*. That's not counting other flu strains. That's one year.

Ebola may be scarier than an inoperable brain tumor, but it's much, much more likely you're gonna die from heart failure.

*hey, nothing against Africa or Africans, that's where it showed up, that's where it got so deadly that it didn't spread very much, because it kills you dead before you can infect too many others. Sure, that's scary, but I'm getting to be more actuarial about death the older I get. It helps with flying.
posted by Sphinx at 12:58 AM on April 1


And I just read the government couldn't cope with a fast moving epidemic.

Deep breaths, deep breaths... unless, maybe that's exactly what the virus wants me to do.
posted by Ned G at 1:59 AM on April 1


(virus ≠ bacteria, oops)
posted by Ned G at 2:06 AM on April 1


Sara C--Thanks for the post and links. I am reasonably well read in medicine but this is actually news to me--unlike the posters who said--old news, no news or bad news I appreciated the information. I was particularly impressed at the research indicating the near perfect DNA congruence between ancient and current strains
posted by rmhsinc at 2:51 AM on April 1 [1 favorite]


Things I did not want to know:

1) Yersinia pestis can swap antibiotic resistance genes with a variety of agricultural disease-causing bacteria that are regularly treated with prophylactic antibiotics.

2) In the late 90s, plague outbreaks in Madagascar involved at several strains not responding to each one of eight antibiotics effective against plague, and one ("strain 17/95") that was resistant to all eight.

3) There is no evidence for widespread multi-drug resistant plague at present, but the mechanisms underlying the Madagascan outbreaks are not known.


http://contagions.wordpress.com/2013/08/08/antibiotic-resistance-agriculture-and-the-plague/

Brrrrrr.
posted by cromagnon at 3:10 AM on April 1 [3 favorites]


Speaking of ebola:

How Much Should People Worry About The 'Unprecedented' Ebola Outbreak In Guinea?

(Spoiler, not that much, unless you read The Hot Zone almost 30 years ago, in which case, AAAAAAAAAHHHHHHHHHHH!!!!!!!)
posted by KatlaDragon at 4:32 AM on April 1 [2 favorites]


FWIW, there are still reported cases of the plague to this day. Here, for instance, is the CDC page on plague cases in the US since 1970. Northern New Mexico and Arizona seem to be the home base for plague in the US.

Oh, and, props for the Firesign Theater drop in the FPP title, intended or no.
posted by Thorzdad at 5:04 AM on April 1 [1 favorite]


Justinian wrote: That's one of those made up things like Ring Around the Rosie being about the plague or Sing a Song of Sixpence being a recruiting tool for pirates.

Oh no. Nothing to do with pirates. It was originally about the scandal that erupted when the Prince Regent's mistress was found to have syphilis. Birds were (still are) used as rhetorical references to women; in this case the "blackbirds" were expensive prostitutes. A "London pye", sometimes called a "stewe", was a brothel. Tertiary syphilis can cause deeply ulcerated gummas, or tumours, which explains the odd reference to facial disfigurement at the end. Really, children's rhymes are better than a medical dictionary.
posted by Joe in Australia at 5:34 AM on April 1 [2 favorites]


There should be universal governmental pressure to provide everyone everywhere with high-speed internet as part of a disease control effort. When something nasty starts spreading, you will want all students and other information workers to stay home for the duration. Also, Netflix.
posted by pracowity at 6:08 AM on April 1


Which is better, the plague that kills you in a day, or takes a weeks or so, during which time you may be without care, meaning without water, blankets, or human contact? Flu has and does kill a lot of people, Ebola is really fatal, and hey, gross.

I didn't know about antibiotic-resistant plague, so that's something new to fear. Cheery start to my Tuesday.
posted by theora55 at 6:36 AM on April 1


And, public health workers, the ones who track down people who might have a contagious disease, are heroes.
posted by theora55 at 6:37 AM on April 1 [1 favorite]


The always-interesting ProMED Mail mailing list on infectious disease news mentioned this today: http://promedmail.org/direct.php?id=2370079

They included their usual links to a nifty map, to recent relevant posts, and to some commentary.

I highly recommend this list for…well, everyone, actually.
posted by wenestvedt at 7:32 AM on April 1 [3 favorites]


FWIW, there are still reported cases of the plague to this day.

Which I know because I watched season 1 (or 2?) of House.
posted by jeather at 8:13 AM on April 1


Frontline just did an episode on drug-resistant TB. (I haven't been able to watch it all the way through, honestly.)
posted by epersonae at 9:22 AM on April 1


I'm curious about how virulent TB was before antibiotics. From reading 19th century literature, I get the sense that it was omnipresent, that it would kill you slowly, and that it was somewhat contagious, but not, like "everyone in this apartment building is just marking time" Black Death level contagious.

I mean, TB seems like nothing compared to cholera.

You know what I'd like to do with my day? Read long-form journalism about Consumption. Yup.
posted by Sara C. at 9:51 AM on April 1 [1 favorite]


Here, by the way, is a quick run down on the "Black Death not bubonic plague and possibly viral" argument.
posted by yoink at 10:15 AM on April 1


Yoink, my understanding from reading the links in this FPP is that the Black Death has been conclusively proven to have been Yersenia pestis. Which is a bacterium.

Is there still any legitimate alternate theory about this?
posted by Sara C. at 10:33 AM on April 1


Everything you know is wrong?

NOPE.
posted by craven_morhead at 10:36 AM on April 1 [3 favorites]



I'm curious about how virulent TB was before antibiotics.


Active TB will kill you fairly slowly over a few months - from other opportunistic lung infections, simply losing too much lung tissue that you can no longer breath enough, or if you're really unlucky, just literally drowning in your own blood. The fatality rate is very high for active TB if untreated - around 70% IIRC.

The nasty thing about TB is you can catch it, and it can stay latent (and non-infectious) for many years before becoming fully active. You do need relatively close contact with an infected person in the active stage to catch it via coughed up droplets - but the symptoms are mild at first, akin to stubborn cold, and it's fairly expensive to diagnose, so a victim can easily infect a few dozen others before they get diagnosed (and hopefully treated)

Estimates vary, but it still kills between 1.3 to 1.7 million people a year. These days, most of those killed are in the poorest parts of the world, with limited or no access to effective antibiotics - usual treatment is a 6 month course of multiple antibiotics, with different ones swapped out depending upon which ones your particular strain is resistant to. In some parts of africa and asia, TB infection (in its latent state, mostly) is present in pretty much the entire population; about 1/3 of the entire world population has latent TB.

TB is much more likely to go active if you're immuno-compromised - it's not the AIDS that kills you per se, it's the untreated TB (for example) that you don't have a strong enough immune system to fight any more, and it's one of the main eventual killers of HIV victims, especially in parts of the world where HIV and TB are both common. The same is true for other factors that weaken the immune system, such as in malnourished young children.

They used to call it consumption, because it gave the appearance of an invisible something slowly eating you alive from the inside out. You'd lose weight, your skin would become pale, you'd struggle to sleep, your chest pain would slowly worsen and your persistent dry cough would start to turn wet as you eventually start coughing up more and more blood and the struggle to breath just gets harder and harder until it kills you. In the 1800's, 1 in 4 european deaths were caused by it.

It's also thought that vampire myths sprang up because of TB - the pale skin, awake at night, blood stained lips - and even after your death, some time later your family would also begin to 'turn' as you haunted them from the grave...

And unlike cholera and plague, our main weapon against TB - multispectrum antibiotics - is slowly failing, the vaccine is proving fairly ineffective in 'hotspots', and we've pretty much stopped making new antibiotics.

Pre-antibiotics and modern sanitation, plague would sweep through your town like a wildfire. People would die in days or even hours of being infected, and within a week half or 2/3 the people would be just... dead. And a decade later, it would do it again. And yes, that's horrifying.

But fully resistant TB, that finally beats back our only way to fight it? That secretly infects you when you don't know it's even happening. That when symptoms appear, it's very likely going to be a slow, painful death, gasping for one more breath, and there's nothing you can do but be shut away from the world so you don't infect anyone else while you cough over and over and over yet know that you've probably infected your own friends and family anyway and condemned them to the same fate ? That's its own special horror for me.

And it's not some mythical horror either. It's a simple fact of life right now, today, for millions of people, with TB so prevalent and insufficiently treated in far too many places on this planet.
posted by ArkhanJG at 12:06 PM on April 1 [7 favorites]


Wait, if some of the plague was airborne, does that mean those nose cones with stuff in them we always make fun of actually were effective?
posted by corb at 12:09 PM on April 1


Corb, not so much: TB lies around in dried sputum and so forth, so you can get infected even when you're not aware of a "plague". Proper masks would definitely help with airborne diseases, but I think those things were just nose-cones filled with herbs, and the big problem was public spitting and the general failure to wash hands and so forth.

Sara C., I would think that basically everybody was exposed to TB, historically; I don't know why the disease progressed in some patients and not in others. I do know that two of my grandfather's siblings died from it; one as a child, and one in a military sanitarium. He had the quick-acting ("galloping") form, but most people with a severe case of active TB died within a few years, anyway.

Wikipedia has an article on the history of TB if you're interested.
posted by Joe in Australia at 12:22 PM on April 1


Northern New Mexico and Arizona seem to be the home base for plague in the US.

Yep - I know a few people that have gotten the plague, and it's something that's always sort of at the back of your mind during certain months here.
posted by stoneweaver at 12:32 PM on April 1


In the 1800's, 1 in 4 european deaths were caused by it.

Whoa. Came for this, stayed for what I flagged as a FANTASTIC COMMENT!
posted by Sara C. at 12:43 PM on April 1


And while we all read and try to ignore the tickles at the backs of our throats, let's take a minute to listen to Jimmie Rodgers sing The TB Blues.

During his last recording session in New York City on May 24, 1933, after years of fighting the tuberculosis, Rodgers was so weakened that he needed to rest on a cot between songs.
posted by The Underpants Monster at 12:58 PM on April 1


"It was originally about the scandal that erupted when the Prince Regent's mistress was found to have syphilis."

No. Justinian is correct. I don't know what your source is, but there's no scholarship establishing the origin you describe. It's just one of many theories, some more fanciful than others, that cluster around children's folklore. The Opies were the preeminent scholars of children's folklore; I have two of their books and I highly recommend them.

I also recommend great skepticism regarding all such pieces of trivia, especially folk etymologies of various words, but also of very poorly documented folklore such as children's folklore, which was pretty much never studied until the Opies.

Children's folklore is an intensely fascinating topic because it represents a self-propagating subculture (not that there are any cultures that aren't self-propagating, but just to emphasize that children's folklore and subculture is primarily transmitted child-to-child with little adult intermediation) that adults mostly ignore and which therefore has been little studied.
posted by Ivan Fyodorovich at 7:00 PM on April 1 [3 favorites]


i think he was joking.
posted by Justinian at 7:43 PM on April 1


Oh. Er, lots of people believe this sort of thing, so it's hard to tell sometimes.
posted by Ivan Fyodorovich at 8:52 PM on April 1


It was April Fools'. Sorry.

Why are we whispering?
posted by Joe in Australia at 9:09 PM on April 1 [1 favorite]


> Wait, if some of the plague was airborne, does that mean those nose cones with stuff in them we always make fun of actually were effective?

Perhaps not effective, but still quite a reasonable response to their uncertainty of how the plague was transmitted, and not deserving of our derision. The nose cones were in case it spread miasmatically, but not only that; the plague doctor's garments were waxed in case it was spread by sneeze droplets vel sim and could seep through clothing, they had red eyepieces in case it was through vision, etc.

I saw a Tumblr post a little while ago that went through this nicely but I can't find it again. I don't think it was this one, that chalks more up to superstition than what I remember ("impervious to evil" etc.).
posted by finka at 3:52 PM on April 2 [4 favorites]


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