DOES BUBONIC PLAGUE COME FOR A REVENGE?

YERSINIA PESTIS BETWEEN MEDICINE AND BIOLOGICAL WEAPONS

“Every outbreak across the globe today stems from a descendant of the medieval plague.”

Hendrik Poinar

One of the historians of medicine wrote about the plague in medieval times and described the horror of the disease but also its social impact back in centuries. That was a plague which erased human relations, separated families and lovers, brought hatred among sick and bestiality among survivors. The famous BLACK DEATH didn’t show only the powerless knowledge of the mankind but also  the real face of the humanity,ugly face.

It was almost shocking to read that according to the CDC and The American Journal of Tropical Medicine and Hygiene, the plague still affects the public health around the world. Especially it is the big problem in Africa, Asia but also in the American West. For developing countries in Asian and African region, which are struggling with poverty and lack of sanitary standards and medical equipment, it doesn’t surprise the phenomena of plague nowadays. However, the rural areas of America are those what are endangered too by Yersinia pestis bacteria. The main reason for one developed country like the U.S. to be on plague list is the fact that this disease has become endemic in wild rodents over there: Colorado, Nevada, New Mexico, California and Arizona.  Europe doesn’t have a real problem with awakened black death because it controls the rodent population and makes impossible for pathogen to find a host and start a chain of infection.

The deadly image of plague came out from the bloody historical memories. The European book of cases is one which never stopped really to count the dead and those who will die. If we look back on the  dark European  medieval age,  we will be amazed by the number of 60% of population killed by plague in 14th century. Whoever exposes the plague in our modern times and believes that the black monster is rising again risks to cause the global panic and atmosphere of fear because it has never really  forgotten what this disease can make with the  humans.

Under the Latin name Yersinia pestis it is accumulated the caution of the whole world as well as the mood of respect. This bacteria maybe has no killing  capacity of Ebola virus but it still lurks people and their lives, along  with  the rats from undergrounds in some happy city. The role of the mentioned microbe has never been changed in spite of the medical advanced research and treatments. The fear is still in the air because we never know when it will crawl and attack.First only one person and then, many of them. All. That is a black death. Awakened.

How disease will be processed depends on how the patient has been exposed to bacteria.Based on that, the symptoms can be various and this is why we distinct bubonic, pneumonic, and septicemic.The CDC gives the best categorization:“Bubonic plague: Patients develop sudden onset of fever, headache, chills, and weakness and one or more swollen, tender and painful lymph nodes (called buboes). This form usually results from the bite of an infected flea. The bacteria multiply in the lymph node closest to where the bacteria entered the human body. If the patient is not treated with the appropriate antibiotics, the bacteria can spread to other parts of the body.Septicemic plague: Patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. Skin and other tissues may turn black and die, especially on fingers, toes, and the nose. Septicemic plague can occur as the first symptom of plague, or may develop from untreated bubonic plague. This form results from bites of infected fleas or from handling an infected animal.Pneumonic plague: Patients develop fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. Pneumonic plague may develop from inhaling infectious droplets or may develop from untreated bubonic or septicemic plague after the bacteria spread to the lungs. The pneumonia may cause respiratory failure and shock. Pneumonic plague is the most serious form of the disease and is the only form of plague that can be spread from person to person (by infectious droplets).”  The illness is very serious but it has a cure and as soon as the medical response is given, the patient or the patients can count on the fast and fully recovery. It is very often that people lose precious life times in passive reaction on the occurred symptoms so when the diagnosis is finally set up, the bacteria has already got the war and the fatality goes from 30-60%. The common antibiotics solve the plague puzzle but during the medical past of our civilization, it hasn’t been always like that. The plague has been the nightmare without any chance to be battled.

The deadly bacteria had a long journey from the hearts of Gobi Desert of Mongolia in the 1320s, where it was hidden for centuries to the new continent of  Europe, opened for the trade from the east. One scholar stated the following regarding the historical links of plague:“The cause of this sudden eruption of the plague is not exactly known. From the desert, it spread out in all directions. Of most importance was the spread eastward to China. China suffered an emergence of bubonic plague during the early 1330s. During the expansion of trade during the Early and High Middle ages, trade routes with China were strengthened and ventured greatly. European traders, particularly those from the Italian city states, traveled the Black Sea region regularly. Surviving documents show that one group of traders from Genoa arrived in Sicily In October of 1347, fresh from a voyage to China. This was most likely the introduction of the plague to European lands. Along with the Chinese goods on board, the traders carried the bacterium yersinia pestis in the rats on board as well as in some of the sailors themselves. The Black Death had arrived in Europe.From Sicily, the plague spread at an alarming rate.The Plague reached France shortly after Italy.England felt the effects in September of 1348. 1348 Europe suffered the most. By the end of 1348, Germany, France, England, Italy, and the low countries had all felt the plague. Norway was infected in 1349, and Eastern European countries began to fall victim during the early 1350s. Russia felt the effects later in 1351. By the end of this circular path around Europe, one third of all people in the infected areas had perished.” 

In one second, the whole world was infected by unknown disease which was taken as a God’s punishment in the religious countries for the sins and orgies which were the part of the European daily life.That is the line of paradox. On one side, we are talking  about the countries which are scared from God and Church but still they allow the prostitution and lack of moral on the streets. The doctors and healers were accused for witchcraft and were  burnt but the local missioners were glorified for public ethic in spite of fact they were corrupted and found in bed with one of the main city’s prostitutes. The irony of hypocrisy and it seems that plague didn’t care about fake doctors, lying politicians and abounded ladies from the street corners. The plague delivered death to everyone everywhere with no mercy. The black death, the alphabet of chaos, the reminder of European sins and failures.No matter if it is Justinian Plague, Black Death or Modern Plague,  it is always the synonym for traumatic feelings, the oath from above that we messed up all.

When Sir Alexander Fleming, a Scottish biologist,discovered enzyme lysozyme (1921) and the special antibiotic substance penicillin (1928), it has started a new age for modern pharmacology. The antibiotics like streptomycin, chloramphenicol, and tetracycline  have been found and taken as a good cure against the bacterial attack. Selman Waksman used the expression “antibiotics” to describe them all in 1942 and to present the  efficient set of medicament for anti bacterial treatment.

But, the ability of any bacteria and especially of Yersinia pestis to be hidden and then suddenly to be alive and aggressive turns the plague into the potential biological weapon. The history of warfare recognizes the  role of killer plague in the battles and how it could be dangerous to be abused in local or international symmetric or asymmetric conflicts. In the ancient times, the plague was a typical “weapon” in wars between armies or tribes. Some cities infected enemy cities by delivering the dead bodies affected by plague. Others intentionally  delivered the infected products to the targeted communities. During the World War II, Japanese army weaponized the plague and attacked the Chinese in Manchuria. Later, the American and the Soviet bio war program has never abounded the plague for military purposes. The ideal structure of this bacteria to be misused as a biological agent is not only attractive for states but also for non-state subjects (e.g. terrorists and lone fanatics) so the control of the laboratory property and supplies must be built. This is not the Armageddon weapon but it could cause the serious consequences and social disturbances above all. Just the name of the disease lead us back in the darkness of our world, when the candles of common sense have never defeated the primitive instincts for survival.