1. Yersinia pestis

2. What is the Plague?

3. Disease Causing Agent  Gram negative, rod shaped bacteria  Yersinia pestis  Facultative anaerobe  Discovered in 1894 by Alexander Yersin  Swiss/French Physician and Bacteriologist

4. Symptoms and Signs  Swelling of lymph nodes (buboes)  Acral gangrene  Fever  Chills  Coughing  Headache  Seizures  Nausea  Heavy breathing  Vomiting  Joint aching  Bleeding from ears

5. Vectors and Transmission  Bacteria (pathogen)  Flea (in gut)  Rodent (carrier)  Human (in blood)

6. Treatment  Antibiotics  Circulatory support  Ventilation  Renal support

7. Plague through History

8. The Plague of Justinian  541 – 542, Byzantine Empire  Spread through Asia, North Africa, and Europe  Probably originated in Egypt or China  Killed as many as 5,000 people per day in Constantinople, for a total of ~40% of the population  ~25 million total deaths

9. The Plague of Justinian

10. The Black Death  1347, Black Death hit Europe, killing around a third of the population  Originated near China, and first passed through Italy  Once sick, plague victims had approximately a 50% survival rate

11. The Black Death  Killed around 25 million people in Europe  Estimated to have killed around 75 million people worldwide

12. The Black Death  Doctors thought that the plague was caused by bad air  Many people wore flowers to ward off the ‘bad air’

13. The Black Death  Controversial explanation of the “Ring Around the Rosie” children’s rhyme

14. The Black Death  Monty Python Monty Python

15. The Third Plague Pandemic  1855, started in China, spread worldwide  Lasted for approximately 100 years

16. The Third Plague Pandemic  Killed 12 million people in India over 30 years  Came from endemic population living in rodents  Was stable, but a rebellion caused movement of populations out of the region  Did not hit mainland America, but did hit Hawaii (1899) and Puerto Rico (1912)

17. The Third Plague Pandemic

18. Plague Today  10 – 15 cases in U.S. per year  1,000 – 3,000 cases worldwide per year  Found in NM, AZ, CO, CA, & OR

19. Plague in New Mexico http://nmhealth.org/ERD/HealthData/plague.shtml

20. Plague in New Mexico http://nmhealth.org/ERD/HealthData/plague.shtml

21. Biological Warfare  14 th century armies catapulted diseased corpses over city walls  1940 Imperial Japanese Army bombed Chinese cities with plague fleas during the Second Sino- Japanese War  Concerns for the future…

22. Biological Warfare  Classified by the CDC as a Category A Pathogen  Requires preparation for a possible terrorist attack

23. Discussion Questions  What was the most important factor for plague to spread?  What made plague such a terrible disease?  What is the best way to prevent the spread of plague?  What would happen if plague was used as a biological weapon today?  Do you think there would be a pandemic?

24. Assessment 1. List the transmission chain of bubonic plague. 2. What are 5 symptoms of this disease? 3. Why haven’t we eradicated plague like we did smallpox? 4. Approximately what percentage of the population of Europe died during the Black Death? 5. What did doctors think caused plague during the Black Death pandemic?

25. Assessment 6. Write 8 to 12 sentences discussing whether bubonic plague is a major threat to national security today. Justify your position.

26. Bibliography  Biddle, Wayne (2002). A Field Guide to Germs (2nd Anchor Books ed.). New York: Anchor Books.  McCormick, Michael (2007). "Toward a Molecular History of the Justinian Pandemic." In: Little, Lester K. editor. (2007), Plague and the End of Antiquity: The Pandemic of 541–750. Cambridge University Press. (2007).  Scott, Susan, and C. J. Duncan (2001). Biology of Plagues: Evidence from Historical Populations. Cambridge, UK; New York, NY: Cambridge University Press.  Bartelloni, Peter J.; Marshall, John D., Jr.; Cavanaugh, Dan C. (1973). "Clinical and serological responses to plague vaccine U.S.P". Military Medicine 138 (11): 720–722. "Clinical and serological responses to plague vaccine U.S.P"  Echenberg, Myron J. (2007). Plague Ports: The Global Urban Impact of Bubonic Plague, 1894-1901. New York, NY: New York University Press.  Echenberg,Myron (2002). Pestis Redux: The Initial Years of the Third Bubonic Plague Pandemic, 1894-1901. Journal of World History,vol 13,2