The Next Pandemic? Bubonic Plague Didn’t Vanish It’s Still Here


Bubonic plague smear showing yersinia pestis bacteria

Almost everyone seems under the impression that bubonic plague, and its more dangerous big brothers pneumonic plague and septicemic plague vanished when the plague wiped out half the population of Europe between 1346-1353. It didn’t vanish, it’s still here.

Schools all over the United Kingdom still teach children about the plague from a historical perspective:

This nasty disease is carried and spread by fleas living on dirty rats. When the fleas bite someone they inject bacteria into the wound and after being bitten your body becomes infected. The rats were often on ships and this means it would spread quickly all over Europe.

In humans the disease caused swellings in the groin, under the arms and behind the ears. These swellings were huge and were black and sometimes purple hence the name the black death.

People were in pain and sadly victims died from this horrible disease. The symptoms could be seen 3-7 days after victims were bitten by an infected flea. Over 25 million people died.

(Maddy A. Aged 11)

I couldn’t have put it any better than my granddaughter did. Sadly children are not taught that the plague still exists and that bites from infected fleas can still cause disease and death. Admittedly at this point the UK is plague free, a small benefit of being an island.

British children do travel though, many of them to countries where plague still sickens and kills people. Fleas can also travel. We can move from one side of the world to the other in less than a day. We visit exotic locations, many of them off the beaten track.

Around 2000 cases of plague are recorded each year by the World Health Organisation. These are reported confirmed cases and therefore are likely to be underestimated as many people who die in remote locations are assumed to have died of other causes and the cases never received medical attention and therefore didn’t make it into the statistics.

The very rare cases that do occur make national headline news. There were four fatalities out of 15 cases in the United States last year.

Plague is carried by ground squirrels, prairie dogs, rats, gerbils, mice and even cats and dogs. Fleas that bite an infected animal and then bite a human pass the yersinia pestis bacterium from one to the other and a few days later flu like symptoms appear.  It’s possible to be infected directly from the bite of an infected animal and even from handling a dead animal that carries yersinia pests if you have open wounds, grazes or scratches. If treated with antibiotics and in the case of pneumonic plague oxygen therapy full recovery is possible from all three strains of the disease. most people will recover.

As stated plague comes in three forms:

  • Bubonic that causes enlarged lymph nodes, buboes that blacken, hence the name Black Death.
  • Pneumonic plague that affects the lungs and spreads via respiratory droplets like the flu.
  • septicemic plague causes blood poisoning.

Professor of Medicine Thomas Campbell of the Division of Infectious Diseases at the University of Colorado School of Medicine said:

” …although the bubonic plague still exists and sickens some individuals, better living and sanitary conditions keep it from wiping out millions of people as it did in the Middle Ages. In addition, a strong public health infrastructure allows outbreaks to be identified and stopped early, and victims can be treated with antibiotics. It’s a combination of knowing the science and having good public health and medical care,” (source)

So all that stands between us and a resurgence of plague is better living conditions and the availability of medical care including antibiotics – and therein lies the problem.

As far back as 2013 Dame Sally Davies warned that we face a future without antibiotics. Antibiotic resistance is increasing and new drugs are not being developed.

“Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics.” She said. Here is the video of the whole lecture.


Antibiotics are the only thing that stands between us and the next plague pandemic. As a society we need to take more responsibility towards our antibiotic use.

  • Courses prescribed should be finished.
  • Old or unused antibiotics should be returned to a pharmacy and not disposed of where they can enter the food chain.
  • We need to force through legislation that prevents low dose antibiotics getting put into animal feed. (it bulks the muscles making the beasts heavier and therefore worth more)
  • Antibiotics should not be in chicken feed for the same reason.
  • Doctors who vastly over-prescribe antibiotics (either for profit or to shut up irritating patients who insist they need them) should be suspended from practice.

We already have antibiotic resistant diseases, gonorrhoea that is untreatable is spreading. MRSA, tuberculosis and some strains of pneumonia are all partially or fully resistant to the antibiotics we currently have. If the trend continues we will be back to common, simple infections killing us. When we get to that stage the possibility of fighting a pandemic of a disease such as bubonic plague is zero.

Take Care


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