Bubonic plague case in the USA. Why the “Black Death” still persists
Bubonic plague in the USA: “Black Death” – symptoms and treatment
Wild rodents in the American West are often carriers of bubonic plague. Authorities advise avoiding contact with animals and keeping an eye on pets.
The plague is no longer the scourge of humanity that it was during the “Black Death,” when it wiped out entire generations in medieval Europe and Asia.
Moreover, it no longer poses the same threat as it did at the beginning of the 20th century, when the densely populated and unsanitary port cities along the west coast gave free rein to the plague.
Still, a few Americans contract the plague each year, and when Colorado state authorities confirmed this week that a person in Pueblo County had fallen ill, they responded quickly and issued warnings.
They warned against contact with rodents such as prairie dogs, which are known to carry fleas carrying the plague bacterium Yersinia pestis. They also advised people to be cautious when pets hunt or roam near rodent populations. And they advised people to have their pets treated for fleas and not to share beds with pets.
Times have changed and the plague can now be treated with antibiotics, but experts say it is still a serious disease.
“The living conditions were very different then than they are now,” Rebecca Eisen, a biologist with the Centers for Disease Control and Prevention in Colorado, told USA TODAY. “We had densely populated urban areas where there were often rats. That was an ideal breeding ground for the plague to spread.”
However, a century after the last urban plague outbreak in the United States, the disease still poses a serious risk to populations living near infected rodents in parts of the Western United States. Outbreaks, even when limited or rare, become the subject of extensive media coverage when cases occur.
The plague terrorized the globe and killed millions of people
The first confirmed cases of bubonic plague claimed millions of lives throughout the Mediterranean. They began in the 6th century and lasted until the 8th century.
In the 14th century, the Black Death broke out along the Silk Road, the trade route between what is now China and Europe. According to the Science Museum in London, it killed around 50 million people in Europe, more than a quarter of the population. Some estimates are even higher.
At the end of the 16th century, outbreaks occurred again and continued into the 18th century. Historians estimate that between 1600 and 1670, 2.5 million people died from the disease in France alone.
Another pandemic began in Yunnan in southwest China in the mid-19th century. Outbreaks of bubonic plague occurred in several Asian port cities such as Hong Kong and Bombay (now Mumbai) at the end of the 19th century. In India, over 10 million people died from the disease at that time.
After 1900, rats and stowaways on board ships from countries where the disease was present brought the plague to American ports such as Honolulu and San Francisco. Health authorities in the western United States scapegoated the Chinese and Mexicans, falsely accusing them of being carriers of the disease.
Honolulu officials began burning homes in the city’s Chinatown, resulting in a fire that destroyed nearly the entire neighborhood.
San Francisco authorities attempted to quarantine all of Chinatown, forcing Chinese people to live in unsanitary conditions in a densely populated area. Authorities assumed Chinese people carried the disease, but allowed white people to leave the quarantined area.
Los Angeles experienced the country’s largest and last urban plague outbreak in the mid-1920s. The outbreak was traced to a dead rat under a house in the Little Mexico neighborhood east of downtown. In response to 30 deaths, the city’s health department imposed a quarantine on the area. Thousands of buildings in the neighborhood were destroyed.
The plague has never disappeared and is still circulating in the West
Plague, which comes in several forms, has not had the same prevalence over the past century, although it is considered endemic in parts of Africa and South America, according to the World Health Organization. In the United States, the disease was first transmitted by fleas on rats in West Coast cities. It retreated into the interior of the western United States, and fleas, which carry the bacteria, found plentiful reservoirs in rodent populations such as squirrels and prairie dogs in rural and semi-rural areas.
According to the CDC, the plague is now found primarily in semi-arid highland forests and grasslands.
“This was not an endemic disease that already existed,” says Dr. Amesh Adalja, a scientist at the Johns Hopkins Center for Health Security. “It basically only came to the United States in the early 20th century and is very geographically limited.”
People are not as exposed to fleas today as they were in the 20th century, he added.
Most cases in the United States occur in the Southwest and West. According to CDC data, about seven people contract the plague each year. Between 1970 and 2022, there were 500 cases of plague in the United States
According to the CDC, three people have been infected with the plague so far this year. In March, a man from New Mexico died of bubonic plague. In February, an Oregon man contracted the plague. Authorities believe the disease was likely transmitted by the patient’s infected cat. The case in Colorado this month is the third.
Fortunately, bubonic plague is not transmitted from person to person
According to the WHO, symptoms of plague develop within one to seven days after infection. Typically, sudden fever and chills, severe headache, muscle pain, nausea and vomiting occur.
A common symptom is swollen, painful lymph nodes, called buboes. Buboes give bubonic plague, the most common form of plague, its name. According to the Mayo Clinic, they appear on the body as swellings in the armpits, groin and neck.
Bubonic plague and plague sepsis are not transmitted from person to person. According to the CDC, direct contact with fleas is required.
A third type, pneumonic plague, which caused the 1924 outbreak in Los Angeles, occurs when bubonic or septicemic plague is left untreated and spreads to the lungs. It can also occur when Y. pestis infects the lungs. In this case, it can spread from person to person when someone inhales the bacteria exhaled by the infected person.
Antibiotics administered early can easily treat the plague. Vaccines have been developed but are not available in the United States.
Take the plague seriously, but don’t worry too much
Thanks to public health and hygiene measures, the plague no longer poses as great a threat as it did in past centuries.
Still, Colorado health officials took precautions, warning residents to destroy areas where rodents can hide and breed near their homes. Officials also urged people to be cautious about pets hunting or roaming near rodent habitats. Pets need to be treated regularly for fleas, officials said. They warned people not to let pets sleep with them.
“Humans are actually accidental hosts,” said Dr. Michelle Barron, chief medical officer for UCHealth Infection Prevention and Control and a professor of medicine and consultant at the Colorado School of Public Health. “It’s only when they come into contact with the animals or the fleas associated with the animals that they become infected.”
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