US resident dies from plague, officials say

On July 11, health officials in northern Arizona confirmed a fatal case of pneumonic plague, marking the first death from the disease in the state since 2007. The case occurred in Coconino County. Authorities did not release the identity of the individual, nor further details surrounding the case.

Pneumonic plague is an extremely rare disease in humans, with an average of about seven cases reported annually in the United States, mostly in western states, according to federal health authorities.

The Black Death remains the most fatal pandemic recorded in human history. A devastating sweep of bubonic plague, caused by the same bacterium responsible for pneumonic plague, struck Europe and Asia in the mid-1300s and is estimated to have killed some 200 million people. But where did this pernicious pestilence originate, how was it transmitted, and what were its consequences?

Click through to find out more about this deadly medieval killer.

What was the Black Death?

The Black Death was the most fatal pandemic recorded in human history. It marked the beginning of the so-called Second Pandemic, a series of devastating outbreaks that spanned from the 1300s to the early 1800s. A bubonic plague, the Black Death was caused by the bacterium Yersinia pestis or Y. pestis.

Black rat

The PNAS report counters conventional wisdom that suggests black rats and their fleas were responsible for the transmission of the disease. That said, scientists generally agree that the pandemic was probably carried by fleas living on black rats, the rodents serving as reservoir hosts. But where did the Black Death originate?

Outbreak

From Crimea, several vessels departed for various European destinations. One ship arrived in Constantinople, where over 90% of the city's population would eventually succumb to the plague. The rapid demise of the populace supports the provocative PNAS study, that once it came ashore fleas and lice picked up the plague by biting an infected human, and could potentially hop onto another person in close quarters and transmit the disease.

Spread to Italy

Later in 1347, another vessel arrived in Sicily, the crew barely alive. The disease spread rapidly all over the island. Fleeing residents then carried it with them to mainland Italy, where one third of the population were dead by the following summer. Pictured is an infected patient in Florence being carried by stretcher-bearers wearing masks to ward off the plague.

The Black Death arrives in France

More ships unwittingly served as ocean-going vectors. Also in 1347, a galley expelled from Italy arrived in Marseille. The crowded port provided perfect conditions for further transmission. The Black Death migrated exponentially across France and remained in the country until 1352. In Paris alone up to 80,000 people⁠—around one third of the population⁠—died from the outbreak.

Iberia infected

The Black Death arrived in Spain in the spring of 1348. Portugal also recorded its first deaths from the plague. 

The plague visits the Holy Roman Empire

From England the plague spread north to Scotland and east, crossing the North Sea to arrive in the Holy Roman Empire, first in isolated regions of Belgium and the Netherlands at the beginning of 1349.

Germany infected

The plague arrived in southern Germany from Switzerland in the summer of 1349. By autumn, much of the country was infected. Seeking to apportion blame for their predicament, the population again pointed the finger at the Jews. 

The plague and pogroms

The first pogrom against the Jews in Cologne took place in 1349, when they were blamed for the outbreak of plague, accused of poisoning the water supply. Retribution was swift and brutal, with hundreds rounded up and thrown into bonfires. In Strasbourg, meanwhile, 2,000 Jewish residents met a similar fate.

Scandinavia succumbs

In the same year, 1349, an English ship inadvertently delivered Yersinia pestis to Norway when it ran aground in Bergen. The vessel's crew quickly perished, but not before infecting the local population. The pestilence then speedily traveled to Denmark and Sweden.

The bacterium spreads beyond Europe

By 1349, most of Europe had been infected by the Black Death. But the deadly bacterium continued its relentless advance, reaching various regions in the Middle East and North Africa by 1350. Yersinia pestis even managed to engulf Mecca, the city infected by pilgrims performing the Hajj.

Suffering the Black Death

Bubonic plague also causes fever, fatigue, shivering, headaches, and giddiness. As the condition worsens, sufferers also endure hemorrhaging, bloody sputum, vomiting, and delirium. Seven hundred years ago, the pain and distress experienced would have been simply unbearable.

Crude treatments

In the 14th century, physicians relied on crude, unsophisticated, and wholly unsanitary techniques such as bloodletting and boil-lancing to treat plague victims. They also employed superstitious practices such as burning aromatic herbs and bathing in rosewater or vinegar in an attempt to alleviate suffering.

Burying the dead

Burying the dead was a grim and dangerous task. Fearing the contagious disease that killed within days, most victims were buried in mass unmarked graves, or "plague pits." Usually, men, women, and children were interred together in their hundreds in a hurried and undignified manner. The Black Death knew no decorum.

Aftermath

In the wake of the pandemic, Europe and the wider world experienced significant social upheaval. The population of Western Europe did not again reach its pre-1348 level until the beginning of the 16th century. Ironically for some, the effect of the plague may have been ultimately favorable. A decimated workforce meant that labor was in great demand. As such, wages soared in response to the shortage of able hands. Image: Museo del Prado

Digging up the past

Nearly 700 years after its advent, the consequences of the Black Death still reverberate. For instance, excavations in East Smithfield, London, in 2010 revealed a burial trench and rows of individual graves of plague victims unearthed between the concrete foundations of the Royal Mint.