Imagine a world in which medicine was utterly defenseless against a disease that could kill within hours. Vaccines and antibiotics had not yet been discovered, nor was the existence of germs and their role in contagion understood. While treatments existed, their efficacy was limited, and medical knowledge was unequally understood across regions and within class structures.
At times, the defenses against illness were prayers, divination, the protective aromas of flowers and spices, and for the select few who could afford to flee heavily populated areas, retreat to the countryside. Such was the world of the Mediterranean basin and Afro-Eurasia in the middle of the fourteenth century when the bubonic plague ravaged central Asia, the Middle East, North Africa, and Europe. After the plague had run its course by the s, it recurred in cyclical fashion several times during the second half of the fourteenth century.
It was never fully eradicated, though subsequent waves were not as deadly as the initial outbreak, with the exception of the Great Plague of London in the s and an especially virulent outbreak that began in China in Outbreaks have occurred more recently in parts of Asia, Africa, and Latin America, but surveillance, preventive measures, early diagnosis, and treatment with antibiotics remain the most effective approaches to preventing its spread.
Other symptoms include fever, nausea, vomiting, aching joints, and general malaise. For the vast majority in the Middle Ages, death generally occurred within three days. The bubonic plague pandemic, which had far-reaching economic, political, social, and cultural effects throughout Afro-Eurasia, came to be known as the Black Death. This name, inspired by the blackened tissue the disease caused on the body, also came to express the fear and awe brought by a disease with a mortality rate ranging from 30 to 80 percent.
That is significantly higher than the deadliest smallpox, influenza, and polio pandemics of the modern era. Although in its bubonic form the plague could not be spread from human to human, the rat flea became a major plague vector, an organism that spreads plague from one organism to another. The black rat was one of the most capable animal hosts for the plague-carrying fleas. It was highly susceptible to the disease itself and an especially inconspicuous stowaway on trade caravans and merchant ships.
