When the Black Plague struck Europe during the Middle Ages, the continent had been experiencing years of poor harvest and famine. As stated in the text (“Power of Plagues” by Sherman, copyright 2017), Yersinia pestis generally resides in rat or other rodent hosts but will move to “less preferred” human hosts when the rodent population drops. Famine likely meant less food for rodents (decreasing population) as well as humans, leading to weakened human immune systems, increased poverty, and armed conflict. Furthermore, the introduction of new Mongol trade routes meant more interaction with the far East and potential introduction of sickness from areas previously untouched by Europeans.

The film “Plague” describes medieval response to the emergence of Y. pestis. Many people believed that the plague was a result of sinners angering God, and as a result sought to increase prayer. Religious movements like the flagellants grew in popularity, practicing self-harm in an imitation of Christ to gain God’s pity. As priests became sick and began refusing last rites to protect themselves, trust in the church hierarchy decreased (though overall religious sentiments remained strong). Scapegoat groups such as Jews were thought to have poisoned wells or rivers, and women believed to be witches were violently persecuted to prevent further plague. Some more scientifically-minded individuals believed that an alignment of planets led to the release of noxious vapors, called miasmas, into the air. Attempts to prevent further spread included fires or strong perfumes to “cleanse” the air, and some cities utilized quarantine, to varying degrees of success. Armed guards were occasionally used in a technique called “cordon sanitaire” to fight against those fleeing the disease.

Also described extensively in the film were the social impacts of the disease. Aside from loss of trust in the church, people lost trust in their doctors, who were often unable or unwilling to try to treat the disease for fear of catching it themselves. Friends and family members refused to take care of each other to protect themselves, and in some cases even committed murder to prevent the disease from taking their loved ones. Fortunately, there were some positive results: better hygiene and corpse treatment/disposal standards were just a few of the public health reforms during that time period. The feudal system crumbled as a result of the high number of deaths. Since there were not enough serfs to do all the farmwork, nobles forced to find other labor or work the land themselves. Once the disease had passed, reduced population meant higher wages and more people able to own land, and the birthrate increased. A 2014 Smithsonian.com article by Beth Griggs, titled “The Black Death Actually Improved Public Health” describes modern scientific skeleton analysis revealing improved living conditions and longer lifespans for 200 years in London following the end of the plague.

Today we know that Y. pestis is usually transmitted by fleas from small rodents, though it is also capable of being spread pneumatically (human-to-human via infected droplets from the lungs). As discussed during class, it is endemic (ie continues to live in animal populations) in the western US, though the average for the entire country is only seven cases per year and treatment is simple with modern antibiotics (provided that the disease is caught quickly enough). The main method of prevention in the US is avoiding contact with small rodents, while treating house pets with flea collars and preventing them from entering areas with known carriers. Madagascar has suffered several outbreaks of Y. pestis since the 1990s, reaching epidemic levels since 2009. This was discussed in class to be primarily a result of poor sanitation and infrastructure, with problems like overflowing landfills and lack of proper waste disposal. Large amounts of waste allow for rodents to breed freely and poverty among humans is extremely high, meaning that many people encounter rodents daily. Children have even been known to play with the dead bodies of small animals. As described in the “Echoes of Ebola” article by Leslie Roberts in 2017, treatment methods that have been found effective in Madagascar include oral antibiotics, disinfection, and rat/flea control. According to the article, the primary concern of doctors is that the plague will spread beyond Madagascar to the rest of the world, and their focus in the future is combating the disease effectively in an urban setting.

HR: References as listed in text, class discussion, Microsoft Word for spelling/grammar check