10 Signs of Black Death Plague (Bubonic Plague)

The bubonic plague, also known as the Black Death, is a serious disease that caused about 50 million deaths across Europe in the fourteenth century. It has not been eradicated but is considered a rare infection in the twenty-first century. However, there has been recent outbreak of Black Death (bubonic plague) in Africa in 2017. The plague can be treated but is potentially life-threatening when it is diagnosed late and if treatment is delayed.

In order to understand the signs and symptoms of the bubonic plague, it is important to look at what happens in this type of infection. Immediate medical attention is necessary when the bubonic plague is suspected, particularly if there is an outbreak in the region or if there was exposure to an infected person. The early signs and symptoms may not be a clear indication of the plague and the necessary tests need to be conducted.

What happens in the bubonic plague?

Bubonic plague is caused by a bacterium known as Yersinia pestis. It enters the human body through flea bites, if these fleas have previously fed on infected animals. It can also be spread from person to person through respiratory droplets from an infected person with pneumonic plague, one type of the plague that affects the lungs. These respiratory droplets may be expelled during coughing and can then be inhaled by another person.

Read more on dangers of flea bites.

In this way the plague bacteria can be quickly spread among people. Pneumonic plague is a less common type of plague. When the plague bacteria enters the human body, usually through a flea bite, the bacteria quickly move to nearby lymph nodes. Here it multiplies within macrophages, a type of immune cell found in high numbers within lymph nodes.

Eventually these macrophages burst and release the bacteria. In this way the bacteria are able to overwhelm the body by entering the bloodstream and traveling to all parts of the body over time. Without prompt treatment, the bacterial inection can result in death.

Is the plague curable?

There are several antibiotics that can be used to effectively treat the “Black Death” plague. However, treatment is most effective whent the infection is detected as early as possible and treatment is commenced immediately. It is therefore important to suspect the plague as a possible cause of the symptoms below, especially after making contact with an infected person or traveling to areas where there is an outbreak of the plague. A doctor should be notified about these risks and the appropriate tests conducted to confirm or exclude the plague as a cause of the symptoms.

How To Spot The Plague

The signs and symptoms of the “Black Death” plague depend on how the infection was contracted as this usually determines the type of plague. The three main types are the bubonic plague, septicemic plague and pneumonic plague. In bubonic plague, the bacteria multiple in the lymph nodes while in septicemic plague it multiplies in the blood. Pneumonic plague is where the bacteria are in the lungs.

Fever and Headaches

Fever is one of the early signs of the plague. However, it is a non-specific sign meaning that it can be due to any number of diseases, apart from the plague. Most of the time a fever is associated with an infection. In the plague, the fever arises suddenly. The fever tends to be high, particularly in pneumonic plague. Chills are also present.

A headache is another early sign of the plague that arises suddenly. However, a headache is also a non-specific symptom since it occurs in a host of different diseases other than the plague. A headache with a fever are some of the first symptoms of the plague and is often mistaken for other more common infections, like the flu.

Fatigue, Malaise, Body Aches and Weakness

Other generalized and non-specific symptoms of the plague includes fatigue, malaise and body aches. Fatigue is extreme tiredness that occurs little to no activity. Malaise is a general feeling of being unwell. Body aches refers to dull pain felt at various sites throughout the body for no clearly identifiable reason. Weakness is another common symptom and is often extreme in people who are infected with the plague.

Enlarged Lymph Nodes

Enlarged lymph nodes occur with many infections but with the bubonic plague it is excessively swollen at certain areas. It is painful and tender to touch. Heat may be felt over the swollen lymph node. These abnormally enlarged lymph nodes are called buboes, hence the term bubonic plague. The swollen lymph nodes can be as large as a chicken egg and tend to more commonly occur in the region of the groin (most common), armpits or neck.

Read more on swollen groin lymph nodes.

Abnormal Bleeding and Black Discoloration of the Skin

Another characteristic feature of the plague, specifically the septicemic plague, is abnormal bleeding and black discoloration of the skin. This abnormal bleeding occurs internally even without an injury and may be seen as blood from the orifices such as the mouth, nose and rectum. Bleeding may also occur under the skin and along with death of tissue (gangrene) it leads to a blackish discoloration of the skin. This discoloration is more evident in the toes and feet, fingers and hands as well as the tip of the nose.

Cough and Breathing Problems

The plague, particularly the pneumonic plague, may also cause a persistent and worsening cough with mucus production. This mucus may be watery and bloody. There may also be other respiratory symptoms, like shortness of breath. Chest pain is also prominent in the pneumonic plague. Respiratory failure can occur within days of developing pneumonic plague symptoms as this infection progresses rapidly. It can lead to death in a relatively short period of time.

Other Signs and Symptoms

There are several other signs and symptoms that may also occur with the plague. Some of these symptoms are more likely to occur with certain types of plague.

  • Abdominal pain
  • Nausea and vomiting
  • Diarrhea
  • Sore throat
  • Rapid breathing
  • Rapid heart rate
  • Low blood pressure

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