The Bubonic Plague and You

Justin Thomas (jthomas105@unm.edu)

October 25, 2015

2015 has been a big year for the bubonic

plague in the United States, and the
American South West is the heart of plague
country. Between 1970 and 2012 the
majority of human plague cases have been in
Arizona, Colorado, and New Mexico. The
bubonic plague is a dangerous, disgusting,
and possibly fatal disease caused by the
bacteria Yersinia pestis. It is characterized
by flu-like symptoms and the eponymous
swollen lymph nodes, or buboes.
This briefing is written to inform you, section
004 of English 219, and the people of
Figure 1-Plague Map
Albuquerque, New Mexico, that yes, the
plague is still a thing. It will contain a brief history of the plague, how to recognize it, how to
avoid getting it, and what to do if you get it. Hopefully, equipped with adequate knowledge of
the plague situation in the United States today, you will be able to decide the appropriate level of
panic and take proper precautions to avoid dying from the plague.

A Brief History of the Plague

The bubonic plague has been making people miserable, and killing them, for centuries. There
were three major plague pandemics before the modern era. The first recorded outbreak was in
the spring of 542, during the reign of Justinian I, creatively named the
Plague of Justinian. The second outbreak, known as the Black
Death, began in 1347. It killed one third of the human population,
increased warfare, crime, persecution, and inspired a classic childrens
song. Brutal. In 1892 the third major outbreak began in China.
Although not as devastating as the Black Death, the World Health
Organization considered the pandemic active until 1959 (Bubonic Plague).
In the early 20th century, America got into the plague scene with a major
outbreak in San Francisco. The outbreak response was bungled, and the
chance to eliminate the plague in the U.S. was missed, and now here we
Figure 2 - Justinian I
are, reading about the plague in 2015 (Smith).

Plague Facts
There are three kinds of plague, that all come from the Y. pestis bacteria.
Bubonic: Bubonic plague occurs when the bacteria invade the lymph system, causing painful
swelling of the lymph nodes. These are the buboes for which the plague is named.
Untreated, it can progress to become other forms of the plague.
Septicemic: When the plague enters the blood stream it is known as Septicemic Plague. It
causes tiny clots which can deprive tissue of blood flow while depleting bloods
clotting resources. This leads to uncontrolled bleeding and hemorrhaging into the skin
and internal organs.
Pneumonic: A plague infection in the lungs appears to be similar to other respiratory infections.
A pneumonic infection is extremely contagious as the bacteria inhabits the airborne
droplets that are the result of the afflicted coughing and sneezing.
(Bubonic Plague).

In all cases, the Y. pestis bacteria that causes the plague

is carried by fleas that infest rodents such as squirrels,
rats, and prairie dogs. The fleas transfer the bacteria by
biting people or domestic animals. The plague can also
be transmitted by the airborne particles that are the
result of the coughing and sneezing of infected people
and animals, or by handling or skinning infected
animals (New Mexico Department of Health).
Figure 3 - The Circle of Life

The Plague Today

So far this year, there have been fourteen confirmed cases of the plague reported nation-wide,
with 4 reported in New Mexico (Entomology Today). Since April there have been three deaths
caused by the plague. This year, we have seen more plague infections than any other year since
2006 (Goldschmidt). Although this has been a big year for the plague, there has been no indication
that this is part of a trend. The number of plague cases fluctuates, with human outbreaks usually
occurring after an epizootic, an event in which large numbers of plague carrying animals die.
The dead animals fleas are forced to flee in search of other hosts. In the southwest, epizootics
are more likely to occur during cooler summers that follow wet winters. As of now, it is
unknown why this year is a particularly big year for the plague (Kwit)(New Mexico Department of
Health).

Why It Matters
There are several reasons why you do not want the plague. In the 21st century, it is just plain
embarrassing to have an affliction associated with medieval-level poor hygiene. Plus, everyone
will know you had fleas. You dont want people to know youve had fleas do you? The threat
of embarrassment should be enough to discourage you from getting the plague but, if you need
further convincing, the plague was nicknamed the Black Death, because it is particularly
unpleasant. The afflicted will suffer hemorrhaging, lesions, swollen, discolored glands, and
necrosis, all while coughing up blood. Gross. Finally, if left untreated, the plague is almost
certainly fatal (Kwit).

What You Can Do

With a name like The Black Death, your first instinct may be to
take to the streets with a wave of flagellants to appease the gods
(Bubonic Plague). There are better solutions. The best way to avoid
dying from the plague is to not get it in the first place. This section
will present steps you can take to avoid dying from the plague. First,
we will cover how to avoid getting the plague.
Figure 4 - Flagellants

Take care that your pets and livestock do not become carriers of the plague.
o Do not allow pets to roam or hunt in rodent habitats, such as prairie dog colonies.
o Treat pets for fleas regularly.
o Keep animal feed in rodent proof containers.
o Take sick animals to the veterinarian immediately.
o Do not let pets sleep in bed with you. Fleas love beds.
Plague prevention is everyones responsibility.
o Eliminate nesting areas for rodents around homes, sheds, garages, and recreation
areas.
o Avoid touching sick or dead animals.
o Use insect repellent that contains DEET to prevent flea bites.
o Report sick or dead animals to the local health department Zoonotic Disease
program or law enforcement.
(New Mexico Department of Health).

Sometimes, even the best of us cannot resist taking home one of those adorable prairie dogs.
Because nobody is perfect, it is important to be able to recognize the symptoms of the plague,
and know what to do if you have the plague.
How to recognize the symptoms

Symptoms will develop within a week of a flea bite or contact with an infected animal.
Symptoms include fever, muscle ache, headache, chills, and weakness. This might seem
like the flu, so try to remember if you have recently had fleas.
Bubonic plague infection will be accompanied by a painful swelling of the lymph nodes
and possible discoloration.
Bacteria that invade the lungs may develop into pneumonia.

If you suspect you might have the plague, it is very important that you
see a doctor immediately. Early plague symptoms are very similar to
the flu, so it is very important to inform the doctor that you have
recently handled dead rodents, or have had fleas, so the doctor can
make the correct diagnosis. The plague can be treated with antibiotics,
and you can expect to make a full recovery, if treated promptly.
However, if your plague progresses a Septicemic or Pneumonic
infection, you run the risk of serious complications, or even death (New
Mexico Department of Health). If untreated, the mortality rate for the
plague is between 66% to 93% (Kwit).

In Conclusion
It may be surprising in this day and age, that the plague is still a threat.
Because of this it is tempting to let our guard down when it comes to
issues of rodents and hygiene. The plague is here to stay in New
Figure 5 - A Plague Doctor
Mexico, and it is important that you are knowledgeable of the dangers
it presents. Now, armed with this information, you are well equipped to avoid a medieval
peasants death from a preventable affliction.

Works Cited
Belluz, Julia. Bubonic plague cases are on the rise in the US. Yes, really. Vox. 9 September 2015. Web.
25 October 2015. http://www.vox.com/2015/9/9/9279775/bubonic-plague-black-death-fleasrats
Botelho, Greg. Bubonic plague reported in Michigan. CNN. 14 September 2015. Web. 25 October
2015. http://www.cnn.com/2015/09/14/health/michigan-plague/
Bubonic Plague. Wikipedia. Web. 25 October 2015.
https://en.wikipedia.org/wiki/Bubonic_plague#History
Four Cases of Human Plague Confirmed in New Mexico. Entomology Today. 29 September 2015. Web.
25 October 2015. http://entomologytoday.org/2015/09/29/human-plague-cases-confirmed-innew-mexico/
Kwit, Natalie, DVM, et al. Human Plague United States, 2015. Morbitity and Mortality Weekly
Report. Centers for Disease Control and Prevention. 28 August 2015. Web. 25 October 2015.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a6.htm
Goldschmidt, Debra. CDC reports 11 cases of human plague since April. CNN. 25 August 2015. Web. 25
October 2015. http://www.cnn.com/2015/08/25/health/human-plague-cases-2015/
New Mexico Department of Health. Plague. Web. 17 October 2015.
http://nmhealth.org/about/erd/ideb/zdp/plg/
Smith, Tara C. Why the United States Is Plagued With Plague. Slate. 15 October 2015. Web. 25 October
2015.
http://www.slate.com/articles/health_and_science/medical_examiner/2015/10/plague_kills_a
mericans_and_spreads_in_yosemite_national_park.html