Medieval pestilence in a modern world
An engraving depicting the plague from the sixteenth century (Wellcome Library, London).
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The scourge of the plague persists in many areas of the world.
If, like me, you thought that the bubonic plague died out long ago with other medieval relics, you may be surprised to hear that it is alive, kicking and in Libya. Following a number of reported cases in the northeast and northwest Libya, the World Health Organisation (WHO) have sent a team to investigate.
The bubonic plague is primarily transmitted to humans through the bite of an infected flea, as such outbreaks of the disease are focused around their natural habitat. Following the initial flea bite the plague bacillus – Yersinia pestis – journeys to the nearest lymph node where it forms a swollen ‘bubo’. It is a very serious condition, left untreated many of those infected may die, although with rapid diagnosis, antibiotic treatment and supportive therapy almost all patients can be cured.
There are reports of up to 18 cases and one death in Libya, although exact figures will have to be confirmed by the WHO envoy. Of major concern is the proximity of the outbreak to the border with Egypt. The Egyptian health system, overwhelmed by bird flu in 2006, is working hard to cope with a proportionately high number of cases of H1N1 swine flu in the country. At present there are no reports of the plague in Egypt.
The recent outbreak in Libya is not unique; the scourge of the plague persists in many areas of the world, even in countries such as the USA where approximately 10-20 cases occur each year. In 2003 WHO reported that the various forms of the plague – bubonic, pneumonic and septicaemic – were endemic in Africa, Asia, and the former Soviet Union. Although the vast majority (98%) of the thousands of cases worldwide and nearly 200 reported deaths occurred in Africa. This is likely to be indicative of the dire need for the health systems strengthening present in much of Africa. In our modern era of diagnostic testing and antibiotic treatment the plague need no longer result in certain suffering – it is the deficit of health workers, drugs, funding, infrastructure and all the other components of a strong health system that causes the plague deaths in the 21st century.
For more information:
WHO Fact Sheet on plague.
Medsin’s Health Systems Campaign.