The epidemic originated in Ethiopia in Africa and spread to Pelusium in Egypt in 540. The first great pandemic of bubonic plague where people were recorded as suffering from the characteristic buboes and septicaemia was the Justinian Plague of 541 CE, named after Justinian I, the Roman emperor of the Byzantine Empire at the time. The fleas multiply prolifically on their host and when the host dies they leave immediately, infesting new hosts and thus creating the foundations for an epidemic.10, 11 The flea continues to feed, biting with increasing frequency and agitation, and in an attempt to relieve the obstruction the flea regurgitates the accumulated blood together with a mass of Yersinia pestis bacilli directly into the bloodstream of the host. When infected, the proventriculus of the flea becomes blocked by a mass of bacteria.
In the pandemics, the infected fleas were able to spread the plague over long distances as they were carried by rats and by humans travelling along trade routes at sea and overland, and also by infesting rice and wheat grain, clothing, and trade merchandise. The human flea, Pulex irritans, and the dog and cat fleas, Ctenocephalides canis and felis, were secondary vectors. The primary vectors for transmission of the disease from rats to humans were the Oriental or Indian rat flea, Xenopsylla cheopis, and the Northern or European rat flea, Nosopsyllus fasciatus. The brown rat flourished in Europe where there were open sewers and ample breeding grounds and food and in the 18th and 19th centuries replaced the black rat as the main disease host.4, 9 Four years later in 1898 his successor, Paul-Louis Simond, a fellow Asia and migrated westward on the sea routes from China and India. The causative organism, Yersinia pestis, was not discovered until the 1894 pandemic and was discovered in Hong Kong by a French Pastorien bacteriologist, Alexandre Yersin.
The third pandemic, that of 1894, originated in Yunnan, China, and spread to Hong Kong and India, then to the rest of the world.2 The Black Death of 1347 originated in Asia and spread to the Crimea then Europe and Russia. The Justinian Plague of 541 started in central Africa and spread to Egypt and the Mediterranean. The three great plague pandemics had different geographic origins and paths of spread. If the disease spread to the lung through the blood, it caused an invariably fatal pneumonia, pneumonic plague, and in that form plague was directly transmissible from person to person.
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When bacteraemia followed, it caused haemorrhaging and necrosis of the skin rapidly followed by septicaemic shock and death, septicaemic plague. boubon = ‘swelling in the groin’), this was bubonic plague. In most human plague epidemics, infection initially took the form of large purulent abscesses of lymph nodes, the bubo (L. On more than one occasion plague irrevocably changed the social and economic fabric of society. There have been three great world pandemics of plague recorded, in 541, 1347, and 1894 CE, each time causing devastating mortality of people and animals across nations and continents.
Bubonic plague also has military significance and is listed by the Centers for Disease Control and Prevention as a Category A bioterrorism agent.1 Yersinia pestis is a very pathogenic organism to both humans and animals and before antibiotics had a very high mortality rate. Plague is also transmissible person to person when in its pneumonic form.
The primary hosts of the fleas are the black urban rat and the brown sewer rat. In epidemics plague is transmitted to humans by the bite of the Oriental or Indian rat flea and the human flea. Plague is an acute infectious disease caused by the bacillus Yersinia pestis and is still endemic in indigenous rodent populations of South and North America, Africa and Central Asia.
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