Surely that all went away in the Middle Ages-Robin Hood and all that?
Well, not really. It’s still endemic in many countries, including the United States. Between 2010 and 2015 there were 3248 cases around the world, causing 584 deaths.
Is it a fairly painless way to go?
Not quite. Let’s say you get bitten by a flea. The bacteria (Yersinia pestis) invade your lymph nodes, which swell up to agonising proportions, called buboes. You also get muscle cramps and spasms, coughing blood and your skin decays and peels off. In the end death is due to generalised organ failure. If untreated you have about a 90% chance of death. But it’s not exactly a fun thing to go through even if you live.
But if I keep away from fleas?
Unfortunately, there are also the septicaemic and pneumonic forms which are even more deadly. But they usually depend on a good flea-born infection rate to get going.
So that’s all right then. Surely there aren’t as many rats and fleas around as there were in the good old days?
We keep them under control with public health measures. But don’t forget, rats are becoming more and more resistant to poisons, and so are fleas. And the general response of public health to Covid 19 has been quite poor in some countries. Anyway the disease can hide in many types of small mammals.
Why are Doctors worried?
It so deadly that it could make a deadly biological weapon. This has been tried several times in history, most recently by the Japanese Imperial Army in 1941. We now have the knowledge that could let someone quickly engineer resistant rats and fleas-and Bob’s your uncle, as they say.
Remind me –what happened in the past?
Well, there’s been lots of outbreaks. The Big Ones were the Black Death of 1347, which is estimated to have wiped out between 30%-60% of the population. And the Plague of Justinian in 541. Records are scarcer but contemporary chroniclers speak of 5000 people a day dying in Constantinople, and ships drifting with all the crews dead.
Have we any hope?
Yersinia pestis can be killed with antibiotics. But as you know, bacteria too are becoming more and more resistant, just like fleas and rats. Unless we try to get ahead, we could be at the mercy of a rogue state or terrorist organisation at any time.
Could I just deny it exists?
Of course-it’s your right as a free person! However the long term outlook for those who try to make up reality is never good, as certain American politicians know only too well. Having an opinion and being right are not always the same thing.
The Fate of Rome by Kyle Harper Princeton 2017
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