The “Black Death” that struck mankind in the Middle Ages in 1346 and reaped an estimated 50 to 70 million lives has made a comeback.

Having infected close to 50,000 humans over the last two decades, the World Health Organization (WHO) has now listed the bubonic plague as a re-emerging disease.

And there is a bleak note from the journal of National Center for Biotechnology Information, an organization under the umbrella of the US National Library of Medicine and the National Institutes of Health.

“Plague, in the Middle Ages known as Black Death, continues to occur…in many countries, in Africa, Asia South America and even the USA,” the organization said.

While the disease is a threat, antibiotics have proven to be an effective cure, but only if administered quickly.

That is especially true of the pneumonic plague, the most deadly of the three strains where failure to give a patient antibiotics within 24 hours of symptoms can result in death.

The pneumonic strain had not been active since early in the last century until it broke out in India in Surat in west-central India, population about 4.4 million. Surat is famous for its textile industry and the largest centre of man-made fibre in the country.

But in 1994, it became famous for something else, an epidemic of the Black Death that killed more than 100 people in a few days.

According to a New York Times Sept. 24 article that year, the pneumonic plague had not raised its deadly spectre for decades, with experts saying they could not even recall where the last outbreak had occurred.

There were a few cases of the bubonic plague reported, but not the deadly pneumonic strain. But the bubonic plague can lead to the pneumonic strain through the lymph nodes, which then causes bacteria to form in the lungs, bringing on pneumonic pneumonia.

It is spread rapidly to others through respiratory droplets in coughing and sneezing and that is why patients are quarantined.

It is the bubonic plague that wreaked havoc in the mid-1300s as it was transmitted through droplets from person to person and people were infected by bites from fleas hosted by rats.

Untreated, the bubonic strain kills about 50 per cent of those who contract the disease.

While antibiotics are largely responsible for dampening down the disease, superbugs are beginning to become immune to antibiotics. As well, the drugs are not available everywhere or in time to save lives.

The disease is transmitted by fleas that often infect rodents like rats and squirrels, and other animals such as rabbits, so insecticides are employed to control them.

But the World Health Organization is on record as saying that “only after the fleas have been controlled should rodent control be considered, because infected fleas, which feed on warm blood, quickly leave their dead hosts, spreading the disease to humans.”

Chillingly, experts said in a report that there is a high risk of a worldwide pandemic of some sort.

“There is a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people,” the report stated.

Such a pandemic broke out in 1918. Known as the Spanish flu, it killed 50-to 100 million, rivalling the Black Death in ferocity. More people died in a year than the Black Death in four years and more than perished in the First World War.

And alarmingly, the report says that we’re are not ready to battle a pandemic, be it bubonic plague, flu or other health threat.

The world is not prepared,” the report stated. “For too long, we have allowed a cycle of panic and neglect when it comes to pandemics: we ramp up efforts when there is a serious threat, then quickly forget about them when the threat subsides. It is well past time to act.”

The World Health Organization has issued a clarion call to world leaders, urging them to take measures such as creating long-range disaster plans, putting more emphasis on United Nations co-ordination of diseases and establishing preparation systems.

Yet another scenario – experts have warned that the bubonic plague could be released as a cloud over a city, killing thousands.

The Center for Disease Control in the United States lists the bubonic plague as one the highest biological risks for use as a weapon that would have a major public health impact.

It would appear the Black Death is still a threat, almost 700 years after it first reaped the whirlwind.

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