Although plague is associated with the Middle Ages, it continues to circulate in some parts of the world. This disease is caused by the bacterium Yersinia pestis and, according to the Robert Koch Institute in Germany, leads to up to 3 thousand cases annually. Without timely diagnosis and treatment, the disease can be fatal.
The risk of infection depends on the form of the infection. With pneumonic plague, which affects the lungs and can be transmitted from person to person, death can occur within 48 hours of symptom onset.
Plague was known for its pandemic that swept through Europe starting in 1347. Between 1347 and 1353, approximately 25 million people died, which accounted for about 60% of the European population. However, the bacterium survived that period and remains in certain regions.
The infection can manifest in three ways. Initial symptoms often make it difficult to detect the disease. For example, Paul Gelford, a resident of Oregon state in the USA, was bitten by an infected cat and received antibiotics for a possible scratch. Since his condition did not improve, he was hospitalized in intensive care, where he fell into a coma. The correct diagnosis was only made later. Gelford survived and recounted this case to The Guardian in 2014.
Currently, the disease is mainly reported in the Democratic Republic of Congo, Uganda, and Madagascar. According to the Robert Koch Institute, between 250 and 500 infections are registered in the island nation annually. Sporadic cases also occur in the western United States.
A more ancient history of the bacterium
Nevertheless, the bacterium is older than the medieval pandemic. Remains of Yersinia pestis have been found in skeletons over 5500 years old. During evolution, the appearance of the ymt gene allowed it to be transmitted by fleas, contributing to the spread of the disease.
In Europe, the last cases were recorded on the French island of Corsica in 1945. According to specialists, the cessation of plague circulation in the region occurred due to the absence of infected rodents inside dwellings.
Effective antibiotics exist against plague, but treatment must begin immediately. In areas where access to testing and medication is limited, a delay in confirming the infection can be critical. Holger Scholz, a specialist at the Robert Koch Institute, emphasizes the problem: 'The problem is that the first patients of an outbreak often die before a correct diagnosis is established and treatment begins.'
Despite the seriousness of the disease, experts consider the emergence of a new global pandemic highly unlikely. Plague does not spread as easily as influenza or Covid-19, and antibiotics and better sanitary conditions help contain its spread. Rapid detection of cases remains critically important for reducing mortality and controlling outbreaks.