The Black Death caused about 50 million deaths across Africa, Asia
and Europe in the 14th Century. It wiped out up to half of Europe's
population.
Its last terrifying outbreak in London was the Great
Plague of 1665, which killed about a fifth of the city's inhabitants.
Then there was a 19th Century pandemic in China and India, which killed
more than 12 million.
But the disease has not been consigned to
the dustbin of history. It is endemic in Madagascar, the
Democratic
Republic of Congo and Peru. What's perhaps more surprising is that it is
still killing people in the US.
There have been 15 cases in the
US so far this year - compared to an average of seven, according to the
Centers for Disease Control and Prevention (CDC) - and the figure of
four deaths is higher than in any year this century.
The bacterium responsible - yersinia pestis - was introduced to the
US by rat-infested steamships in 1900, according to Daniel Epstein of
the World Health Organization (WHO).
"Plague was pretty
prevalent, with epidemics in Western port cities. But the last urban
plague was in Los Angeles in 1925. It spread to rural rats and mice, and
that's how it became entrenched in parts of the US," he says.
The
disease - typically transmitted from animals to humans by fleas - has a
30-to- 60% fatality rate if left untreated, however, antibiotics are
effective if patients are diagnosed early.
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