This year in many countries throughout the world, the flu has been deadly. The CDC reported that in America it has been unusually active, and in January it was revealed that the virus was killing around 100 people every week in the US. In the UK, they’ve had the worst flu season in many years. But it’s also been a global concern, with countries all over Asia and Africa experiencing what many are calling one of the worst global flu outbreaks in a long time. So much so, that scientists said it’s imperative to create a much more effective universal influenza vaccine. We might regard ourselves as fortunate, though, based on what you’re about to hear, in this episode of the Infographics Show, Could the Black Death Happen Again?

First of all, what is, or what was, The Black Death, also known as the plague? Well, it was one of the worst pandemics in history, killing somewhere between 75 to 200 million people in Europe and Eurasia in just a few years from 1346 to 1353. After it was done, something like 30-60 percent of Europe’s population had been wiped out, with many others dying in other parts of the world, as well. In fact, it killed so many people, it took centuries for the world’s population to stabilize. It also made comebacks in Europe later on, such as The Great Plague of London from 1665–66, but the 14th century Black Death was the worst pandemic the world has ever seen in terms of loss of life.

It’s thought it made its way to Europe on Genoese trading ships. The ships arrived at the Sicilian port of Messina, only for those who came to greet them to be faced with a nasty surprise: most of the occupants of the ships were either dead or dying. It’s thought the ships had been to parts of Central Asia and there it’s said rats carrying the bacterium, Yersinia pestis, came aboard the ships. Fleas on these rodents were the vectors that passed the disease to humans. Authorities in Sicily soon ordered all the “death ships” out of the harbor. But it was too late, and soon people all over Europe were getting infected. It spread so easily, because it was airborne, which meant coughing or sneezing was enough to spread the disease around.

So, what’s it like to get down with a dose of Black Death? During the pandemic, an Italian poet called Giovanni Boccaccio described it like this: “At the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.” These eggs that he describes are called buboes. Once they appeared, soon after, the victim would have a very high fever, usually start coughing up blood because of lung infection, and between two and seven days, it was often game over. If you got it, you most likely died. But not everyone did, and true to Nietzschean philosophy, what didn’t kill them made them stronger. Studies have found those that survived became healthier. It’s believed the plague had a mortality rate of 30% to 75%. It was a time of chaos, as whole communities lived in fear. Doctors didn’t want to treat the infected for fear of being infected themselves, while mobs were busy ascribing the blame on any minority, such as lepers, Jews, foreigners or even people with acne. Entire Jewish communities were destroyed and 1000s of Jewish people were murdered.

You get the picture: this was a grim time to be European. As we said, it came back many times, but never as virulent as those years in the thirteen-hundreds. What might surprise you though, is that the bubonic plague is still making appearances around the globe. It killed 10 million in China in the 19th century, more than 1,000 in Australia in the early 20th century, and over a hundred in San Francisco also in the early 19th century. It’s thought that in 2017, around 202 people died in Madagascar from the pneumonic plague, according to the WHO. This was from 2,348 confirmed, probable and suspected cases. Fewer people died of course because of modern medicine and healthcare. By the way, there are three kinds of plague: bubonic, pneumonic and septicemic. The difference is in how it infects you, with bubonic getting your lymph nodes, hence the ugly eggs; pneumonic gets the lungs, and septicemic is an infection in the blood. You can be treated for pneumonic plague with antibiotics, but left untreated you will surely die. Most modern cases have been in developing nations, but there have also been some cases in the USA.

In fact, in 2015, 16 and 17, a handful of bubonic plague cases occurred in the country. The CDC reports that more than 80% of United States plague cases have been the bubonic form. It stated that from 2000-2016, around seven cases of plague occurred in the country every year, and most of those were in the rural West, and some in Northern New Mexico and northern Arizona. The worst year this century for the U.S. was 2015, when 15 people were infected and four of them died. Also according to the CDC, the Europeans are now in good shape, with the department stating that all continents report instances of plague, except Europe, Australia, and Antarctica.

The advice given by health professionals if you want to stay plague free, is don’t get bitten by fleas and don’t mess with rats or other animals that could carry fleas. Easier said than done. In 2014, a man from Oregon was infected with plague after his infected cat bit him. News media reports that he had lumps under his arms the size of lemons, his hands and feet turned black due to gangrene, and he was in a coma on life support for a month. He told The Guardian, “I had collapsed lungs, my heart stopped, and my hands and feet turned black. Technically, I shouldn’t be here.” He was so violently sick because he had all three kinds of plague. His cat didn’t fare well, and it ended up being buried in the garden before the man got really sick. The man lives a full life again, minus most of his fingers and toes.

So, now we come to the essential question? Could there be another massive plague outbreak? The answer is that it is very unlikely because we can treat it before it spreads. Most of us these days don’t live in rat infested squalor as many Londoners did back in those bleak times. When The Smithsonian asked a scientist this question, he, like most others, said an outbreak was unlikely. What was possible, though, was a plague-based bioterror weapon that spreads the disease. Yes, our wonderful species has in the past created plague bioweapons, with some of the guilty countries being Japan, The former Soviet Union, and the United States of America.

We’ll leave it there; don’t be too freaked out, it’s highly unlikely you’ll be the victim of plague. But do you have any thoughts on whether the Black Death could happen again? Let us know in the comments! 




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