Bubonic plague



, along with Pneumonic plague and Septicemic plague, are the three plagues which form Black Death. The first major appearance of Black Death occurred in 1348 in Europe. This outbreak lasted for five years killing anywhere from 1/3 to 1/2 of Europe's population. Black Death has had an enormous impact on history, and still does to this day. For example, the nursery rhyme "Ring around the Rosy" was written about they symptoms of Black Death. Italian author Boccaccio claimed that the plague victims "Ate lunch with their friends and dinner with their ancestors in paradise." Although it is not as widespread as it was in the the Middle Ages, the Plague still appears across the world.

Causes
The plague is caused by the bacteria Yersinia pestis. This bacterium is responsible for the most common forms of the Plague, and the different names come from the areas where the bacteria is found. The bacteria is most commonly spread through fleas. When a flea bites something infected with the Plague, such as a human or a rat, they take blood that has the bacteria in it. Therefore, when they bite something else, the infected blood is released into their bloodstream. Once the bacteria enters into the flea it begins to rapidly reproduce, and in doing so it blocks off the flea's digestive track. This causes the flea to slowly starve to death, as it cannot get enough nutrients from the blood it drinks. As its hunger grows, the flea will continue to bite mammals, mainly rats and humans. When the flea bites something they secrete saliva in order to stop the blood from clotting. Some of the bacteria is also secreted along with their saliva, and once in the new host it begins to multiply quickly.

The plague can also be transmitted by contact with infected tissues. Once infected with the plague, the host is highly contagious, and any contact with the sick could lead to the spread of the disease. If left untreated, the Bubonic plague can form Pneumonic plague. This is an advanced form of the Bubonic plague and is found in the lungs. When a victim has this there is almost a 100% fatality rate, and is also the most infectious form of Black Death. Bacteria filled droplets are coughed up and turn the Bubonic plague into an airborne pandemic. This plague, while rare, is incredibly hard to stop because it is an airborne pathogen. Bubonic plague can also progress to Septicemic plague, which infects the blood. As with Pneumonic plague, this form has almost a 100% fatality rate. However, Septicemic plague is not as contagious as Pneumonic as it is not airborne.

Bubonic Plague
The symptoms of the Bubonic plague can appear anywhere from a day to a week after the initial exposure. Although, the sick might die before any symptoms appear. With the Bubonic plague typical symptoms include:

• Fever

• Malaise

• Headaches

• Seizures

• Chills

• Muscle pain

• Buboes

•	[Ddeath]].

The first definite sign of the Bubonic plague is the Bubo. Buboes are swellings of the Lymphatic glands that can grow to the size of an apple. These incredibly painful swellings form because the bacteria gathers at the lymph nodes closest to their entry point into the body. As time goes on the other symptoms begin to appear, if they had not already formed before the Bubo appeared. Without treatment, the Bubonic plague, with a morality rate of around 50%-80%, will turn into the Pneumonic plague or Septicemic plague.

Pneumonic plague
If the Bubonic plague progresses into the Pneumonic plague then they will typically suffer from:

•	Troubled breathing

• Coughing (sometimes with blood in it)

• Chest pain

• Weakness

• Fever

• Headaches

• Death

Pneumonic plague, while similar to the Bubonic plague, is found in the lungs whereas the Bubonic plague is found in the Lymph nodes. Pneumonic plague is the most deadly form of the Bubonic plague with a mortality rate of nearly 100%. Pneumonic plague kills incredibly fast, and people can become infected and die the same day.

Septicemic plague
Septicemic plague forms from Bubonic plague, or Pneumoinc plague, if they moves to the blood stream. Symptoms of Septicemic plague include:

•	Abdominal pain

•	Bleeding resulting from blood failing to clot

•	Diarrhea

•	Fever

•	Nausea

•	Vomiting

•	Death

Septicemic plague occurs in the blood stream and like Pneumonic plague it nearly has a 100% mortality rate. The symptoms of Septicemic plague will typically appear after a day or two. However, there have been many cases of where people die before any symptoms appear. This form of the Plague kills incredibly fast, and people may die before they realize that they have even been infected.

Treatment
In the Middle Ages there was no cure for the Plague. The nature of how the plague killed, and how it spread was a mystery to those living in the time. This caused massive panic as people tried to avoid becoming sick by avoiding those already infected. This fear resulted, in part, from superstitions because no one had ever seen a disease like this. However, in today's world scientists have discovered a treatment for the Bubonic plague. Instead of having a mortality rate of 60%-90%, treatment lowers the mortality rate to around 11%. This greatly increases survival of the infected.

Antibiotics
The Bubonic plague can be treated with antibiotics. People who receive treatment early on have a significantly greater chance of surviving then those who are not treated immediately. There are two antibiotics that doctors will typically prescribe, they are: Gentamicin and Streptomycin. When someone receives treatment for the plague the doctor will either administer the antibiotics in the form of a IV, shot, or pills. However, each antibiotic can have major side effects, so doctors have to verify that the patients are suffering from the Plague.

Gentamicin
Gentamicin belongs to a family of drugs called aminoglycoside antibiotics. When used for treatment of the plague, this antibiotic stops the growth of bacteria. By halting the growth of bacteria, it allows the body to fight off the remaining bacteria.

Streptomycin
Streptomycin is a member of aminoglycoside antibiotics. It is successful in fighting the plague because it kills off sensitive bacteria, and halts the production of proteins that the bacteria needs in order to survive.

Prevention
The best way to prevent the spread of the Bubonic plague is to monitor the rodent population. Flea bites are the most common way for humans to contract the Bubonic plague. Then the Plague will spread when people come in contact with infected tissues, bodily fluids, or if bitten by an infected flea. Occasionally the Plague can spread through contact with an infected rodent. In an area where the Plague has been reported all people should work together to get rid of rodents by moving garbage away, applying insect repellent, treating pets with flea medicine, and hiring exterminators to kill off fleas. If someone develops symptoms of the Bubonic plague, then they should immediately be placed in an isolation ward. To confirm that they are dealing with the Bubonic plague, samples should be taken from the patient and sent to a laboratory for testing. If the patient has the Bubonic plague then the antibiotic Streptomycin and Gentamicin may be administered to fight the disease.

History
The Plague could be considered as one of the most important event ever to happen in the Middle Ages. The first known arrival of the plague occurred in Europe in October of 1348. In Sicily, Italy, twelve Genoese trading vessels arrived, bringing the Plague to Europe. The majority of traders on the ships were already dead, and the remainder of them were sick. The port officials forced the ships to leave, but the plague had already entered the city. As the Europeans did not know how the plague spread, there was little they could do to stop it. Over the next five years the Plague killed over twenty-five million people. The population of Europe went from thirty-eight million people in 1000 A.D. to seventy-five million in 1347 A.D. to suddenly fifty million in 1352 A.D.

Reactions
The fear of the Plague caused several different reactions in the people of Europe. There were three main responses to the Plague, and they all varied greatly. The first group thought that the Plague occurred because God was angry with the world and therefore unleashed the plague on it. People felt that if they abandoned all excess then God would spare them from the Plague. Another group felt that there was nothing that could be done to stop the Plague so they might as well live life to the fullest. Meanwhile, other people lived normally, carrying around perfume and other scented objects in order to mask the smell of death. Still others felt that the only way to survive was to flee the cities and live on their own away from all other people. All of these views share the same thing in common, staying away from the infected. Almost no treatment was given to those who were infected and only a few monks and friars would offer help to the sick. The fear of the Plague lasted for centuries after the initial five year outbreak, and it was not until after the 1600's when the Plague finally disappeared.

Impact
Because of the enormous fear of the Plague, some people in Europe abandoned the Church feeling that the Plague was God's curse on them. Because large amounts of churchmen were killed by the Plague, as they tried to save the sick, there was a shortage of trained clergy. This caused the Church to replace them with Clergy who were not fully trained, and this led to corruption in the church. The political system was also changed because of the Plague. Because 1/3 of Europe's population was killed in a five year period, there was a great labor shortage across all of Europe. The ruling powers granted property to those who remained, and this allowed most of the European population to work their own land. The peasants also learned that the ruling class needed their support, leading an increase in wages and personal freedom. The ruling governments also had to readjust to life after the Plague. Because they lost so many people and animals there was a shortage of food, wool, and other vital items.