The Black Death: Reflections Of 21st Century - Past & Present Treatment

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A number of diseases have plagued humankind since the very ancient times. However, through the innovations of modern medicine in the latter part of the past centuries, both diseases and treatments have become more responsive and helpful in both prevention and treatment aspects. Overall, though the presence of some lingering diseases reveals the idea that through the proper improvement of living conditions and availability of medication throughout the world, it is possible to almost completely extinguish certain viruses and infections. One significant example is the Black Death (or bubonic plague), which despite being almost non-existent because of the above-mentioned contributing factors, still persists to the present day. While in the past, the 1300s, the infection has caused the death of a third of the European population, nowadays the World Health Organization reports 1000 to 3000 cases annually (Cicetti, 2013). In the process of exploring the modern reflection of the plague on the human history, one other significant consideration appears to be the psychological effect of mass casualty as a result of a health scare (Cohn, 2002). Therefore, the same present elaborations would imminently incorporate the analysis of the plague in historical aspects, as well as current and future considerations to present a more comprehensive description of the disease to possibly continue strides towards complete extinction. The plague killed millions in the past centuries as we try to prevent the plague from reoccurring we have to find out the cause and concerns, and the improvements in past and present treatments.

Causes & Concerns

The disease is caused by the Yersinia pestis bacteria with the main concern of the fatality ratio of 30-100% if left untreated. The contact is possible in several ways, through the bite of an infected flea, possibly coming from an infected rodent, which is called bubonic; pneumonic type, directly transmitted through the air in a human to a human pathway, and septicaemic (Stenseth et al., 2008). After patients contact the bacteria, the incubation period is up to a week, followed by flu-like symptoms like chills, headaches, body aches, weakness, vomiting, and nausea. If the symptoms are not addressed in time, complications are rather likely, which can lead to exacerbations including death (Stenseth et al., 2008).

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Yet, the different types of the illness are associated with different symptoms, where the bubonic plague can take on other forms known as septicemic plague (accounts for the highest mortality rate) or the pneumonic plague, which can possibly help the treating physician to distinguish between the particular type of plague the patient has contacted, after examination and taking into consideration social and travel history, as well as living conditions. The septicemic plague type is associated with fever, weakness, headache, abdominal pain, chills, and massive hemorrhaging, with possible tissue bleeding causing some skin areas to appear black, leading to death. The pneumonic type manifest signs resembling pneumonia, like chest pain, shortness of breath, cough, fever, chills, nausea, vomiting, and diarrhea. The bubonic plague’s symptoms are often evident in the lymph nodes, chills, headache, fever, fatigue, and weakness (Stoppler, 2008). All kinds are effectively addressed if caught in the initial stages, which can prevent complications and extreme outcomes, such as fatalities. Yet, in order to accomplish these objectives, adequate medical care and resources are vital to the patients, and the containment efforts made by the local health organizations and providers, especially when it comes to distant and rural areas, such as Africa.

Past & Present Treatment

The development of antibiotics in the past centuries have significantly helped the case of treating bacterial infections, including plague, even though the initial improvements have been made as a result of improving the living conditions, and overall health, in the absence of medical treatment (prior to the discovery of antibiotics). Another contributing factor to treatment and recovery to patients, such as isolation (quarantine) of patients, has been relevant to avoid transmission of the bacteria, the timely diagnosis and rapid treatment also contribute to complete recovery. The historical occurrence of the disease reveals that after the initial epidemy, the situation has improved as a result of better living conditions, and some treatment options, especially for those most susceptible to the infection, like the elderly (DeWitte, 2014). The present treatment options available are a course of antibiotics, such as streptomycin, tetracyclines, gentamicin, chloramphenicol, and sulfonamides (Stenseth et al., 2008). Given the notion that some regions that do not readily have access to treatments, like Africa, the occurrence of the infection are more concentrated than others, such as Europe and America, and non-existent like in Australia (Cicetti, 2013). Travelers that are traveling to countries with a risk of exposure to the bubonic plague should be advised to consider have prophylactic measures; tetracycline, doxycycline, and insect repellent. However, while medication treatment is important in the process of combatting the infection, other elements of considerations are also significant when addressing the likelihood, such as climate and living conditions in the regions where the plague still occurs. In terms of prevention, there is no vaccination option for the disease (Stoppler, 2008).


Given the analysis of the history of the Black Death, and the presently available resources, the main focus falls on the steps to be taken to attempt to completely eradicate the disease, even only among the human and not animal species. The impact has been widely spread, not only in a social aspect, but also impacting economy, culture, religion, politics, and many other aspects of life (Stenseth et al., 2008). Since the occurrence falls solely within particular boundaries, the emphasis should fall on that area, and provide sufficient resources to work towards the goal. In the history of humankind, the notion of an epidemic that has wiped a third of a population is greater than the basic resources available for prevention; it is a psychological problem that continues to persists centuries after the first cases have been reported and the first treatment discovered. The Black Death as more of a symbol of medicine and epidemiology reveals the idea that humankind is vulnerable, and knows of dire instances that threaten the entire population, and should be considered in various levels of prevention and medical means to provide a more secure and healthy future for the entire world.


  1. Cicetti, F. (2013, May 30). Do people still catch the plague? Live Science.
  2. Cohn, S.K. (2002, June 1). The Black Death: End of a paradigm. American Historical Review. Retrieved from the EBSCO Host.
  3. DeWitte, S.N. (2014, May 1). Mortality risk and survival in the aftermath of medieval Black Death. PLoS One, 9(5). Doi:10.1371/journal.pone.0096513
  4. Stenseth, N.C., Atshabar, B.B., Rahalison, L., et al. (2008). Plague: Past, present, and future. PLoS Medicine, 5(1).
  5. Stoppler, M.C., (2008) Plague (Black Death). MedicineNet.
  6. Sherman, I. W., (2007) Twelve diseases that changed the world. American Society of Microbiology.


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