Xenopsylla chepsis (oriental rat flea) engorged with blood
The plague is primarily a disease of rodents which is transmitted to people through the bite of fleas that are normally parasitic on the rodents. When the original host dies the fleas desperately seek new animal hosts – humans. The plague bacillus is extremely virulent. Laboratory mice die after being infected with just three bacilli – and fleas can disgorge up to 24,000 in one bite. Plague is a very severe disease in people, with death occurring in 50 to 60 per cent of untreated cases.
The illness has been known of for over 3000 years and is often called the Black Death. This name was derived from the purple colour that all plague victims develop during their last hours, a symptom caused by respiratory failure. Great pandemics have affected whole continents and wiped out whole village populations and decimated towns and cities. Thankfully there has not been an epidemic in the UK for hundreds of years but the plague is still endemic in many countries in Africa, the Americas and Asia. The annual average number of cases in recent years is 2,547 with 181 deaths with about three quarters of cases occurring in Africa.
Today, if diagnosed in time, most patients can survive if treated with antibiotics and other therapies, but this was not always the case. During the last plague epidemic (1664-1666) in excess of 68,000 people died in London. Vauxhall is known to have had its own plague pits and Kennington its plague houses. These houses were in Cumberland Row which was the short line of houses north of the Old Town Hall, Kennington Road. They were being built around 1666 and were called Plague Houses because victims of the Great Plague were laid out in the partially completed buildings.
There are three main forms of plague in humans:
Bubonic Plague – the most common form is the result of an insect bite in which the plague bacillus travels through the lymphatic system to the nearest lymph node (usually in the groin but sometimes in the armpit or the neck) which becomes painful, inflamed and enlarged (the bubo formation); SYMPTOMS the early symptoms include headache, nausea, vomiting, aching joints, and a general feeling of ill health. The lymph node(s) become painful and swollen and the pulse rate and respiration rate and temperature rises, the patient becomes exhausted and apathetic. The buboes swell until they approximate a chicken egg in size. Death can occur within 4 days but in non-fatal cases the illness lasts about two weeks.
Septicaemic Plague – this form occurs when infection spreads directly through the bloodstream either by handling infected tissue or spreading from the lungs of other sites. This form is usually fatal in the absence of antibiotic therapy. SYMPTOMS fever, chills, prostration, abdominal pain, shock and bleeding into skin and other organs causing the patient to turn deep purple within several hours, often dying within the same day that symptoms first develop.
Pneumonic Plague – an infection of the lungs caused by airborne plague bacillus droplets coughed out by an infected person or animal and is often fatal. SYMPTOMS the sputum is at first slimy and tinted with blood; it later becomes free-flowing and bright red, other symptoms include chills, cough and difficulty breathing; rapid shock and death if not treated early,. Death occurs in most cases two or three days after the first appearance of symptoms.