American Plague Update: The Black Death Is Here In 2019

The Plague, or Black Death, was one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people in Eurasia and peaking in Europe in the years 1346–1353.

That’s how the Wikipedia article about The Black Death starts. 

1346-1353 Europe. That’s a LONG way from the United States in 2017, right? Surely the plague has long since died out, right? Isn’t there an antibiotic that knocks it on the head?

Well, yes… and no…

Yes it has been a long time since there have been mass deaths from the plague… at least in people. In prairie dogs in the American Southwest? Not so long. 

And yes, you can catch the plague from a prairie dog (or many other animals that live in the desert Southwest as well). 

At this point in time, I’m turning the writing over to the scientist in the family, Spice, who will explain why this topic is even being discussed (other than a chance to post one of Salty’s wildlife photos… these particular dogs live in the South Dakota badlands area)

What is the Plague?

The basic outlines are familiar.  The Plague is caused by a bacterium, Yersinia pestis. It’s normal life cycle is to parasitize rats, being transferred from one to another by rat fleas.  If the rat flea bites a human, the human can get the disease. That’s how most infections of humans have happened from the 14th century through today.

The form of disease one usually gets through flea bites is bubonic plague, named for the large, nasty swellings (called buboes) that form in the lymph nodes of the affected.  Before it kills, the bacteria will escape the lymph nodes and run rampant in the blood stream, causing the form called septicemic plague. Contact with the body fluids of an infected person can transmit septicemic plague. This form is nasty enough, with a fatality rate of 30 – 60% and highly unpleasant even to the survivors.

The worst part about this version though is that as it gets into the lungs, it can morph into the nastiest version:  pneumonic plague.  Pneumonic plague is nearly 100% fatal if untreated, after a very short illness characterized by wracking coughs.  Those coughs spray out tiny droplets brimming with the bacteria.  Anyone who inhales these droplets is also likely to be affected with the pneumonic form. 

Pneumonic Plague

Once someone gets the pneumonic form, you have the potential for a significant human outbreak.  Over 1200 people got the plague in Madagascar last year, and over a hundred and twenty five of them died.  Some variants of the disease are more easily spread this way than others. This means a natural outbreak is a possibility, even in the U.S., since we do see cases of it and a victim can pass infection around very soon after beginning to feel ill. The infection can be spread before the person seeks medical care. 

That combination of very high fatality rate with person to person transmission is the profile of a germ that can be ‘weaponized’ — delivered intentionally as an aerosol with the intent to start an epidemic. This is why our Centers for Disease Control puts plague in the highest risk category for outbreaks:  Not from the natural sources, but because of potential terrorist activity.

Here’s a podcast where Salty and I did a a couple of years ago (when we first touched on this subject, an article that this one supersedes) talking about what plague is and what to do about it:

Here’s The Thing

Prepping for the plague is important because the same preps cover the majority of infectious diseases, and as a whole group there is a very high risk (in my opinion) of seeing a significant epidemic in the fairly near future.  I’d be surprised if I didn’t see one in my own lifetime.

Avoidance is the best strategy.  When there’s a pandemic on, most people know it.  The single most effective defense is frequent hand washing; as mundane as that is.  Most infections even from airborne germs come when the germ lands on a surface that a new host handles and then transfers to her own nose or mouth by touching. Alcohol gels (hand sanitizers) aren’t as good as soap and water but are pretty good.  Are those items in your bags and abundant in your home preps?

Handling of the sick and dead are danger points.  Gloves are important to reduce contact with body fluids (and they also remind you not to touch your face).  Masks help; the non-surgical versions we can pick up for cheap aren’t truly reliable but do reduce how much we’re exposed to. Having the sick person wear the mask is more effective than having the well people wear them.

Preparing a body for burial is a common transmission point.  For plague victims, for example, antiseptic (such as bleach)-soaked cloth should be draped over the head and upper torso of the deceased.*

Be Where They Ain’t

If being caught in a terror-inspired outbreak is a worry for you, to mangle an old baseball truism, “Be where they ain’t.”  Large groups of people on a single ventilation system are the tempting targets.  In general, population centers and transportation hubs get hit sooner and harder than more rural areas.

On a brighter note, antibiotics work great against plague; especially streptomycin.  Americans don’t use much of that drug, but gentamycin and fluoroquinones are very good.  Others also work. Cipro and Doxycyline, which many preppers have on hand, are among the suggestions the Mayo Clinic provides. (That’s Spice, who is not a physician, reporting from the literature, not giving medical advice.)** 

Antibiotic therapy with the right drug started within the first day after a pneumonic plague victim starts to show symptoms will often save them.  Later than that is … too late.

So is a visit by the Black Death a likely disaster for you and yours?  Not really likely, no.  But infectious disease in general is a much higher risk; and if it’s the plague that gets people’s attention and motivation to get prepped to be safer from those, old Yersinia pestis will have done us a favor for once.  It owes us a good turn, I’d say.