Monday, August 27, 2012

The "Black Death": Not So Nasty After All?

In  a previous blog I considered whether the "Black Death" could strike again, especially in the more developed parts of the world - such as the U.S. I also noted the case of a  a 50-something male in Oregon (monitored with the disease and  then in critical condition).   In addition, some years earlier a couple from New Mexico contracted the plague - evidently from contact with prairie dogs in that state. (This case was highlighted on an episode of 'Discovery Health'). They didn't find out they had it until they went on a Christmas vacation to the Big Apple - where one pathologist finally recognized it. Alas, the poor plauge-infected dude had to have a gangrenous foot lopped off.

But maybe we're getting worked up, or at least I am, for nothing. According to a paper published in the Oct. 27, 2011 issue of Nature, The Black Death or Plague was really no "biggie". Certainly not as fierce, or foreboding as made out to be. For example, recall from the earlier link I cited Sean Martin, the author of 'The Black Death'  (2007), who claimed that the disease was "traditionally thought to be a mixture of bubonic, septicaemic, and pneumonic plague" and he speculates on some unnamed 'third factor' that may have made it even more virulent.

The Nature authors point out that Yersinia pestis, though genetically similar to the modern strain, is confined almost exclusively to rodents and encounter difficulty in transferring from human to human. Moreover, antibiotics and other advances have rendered this disease more amenable to treatments. Still, it remains a  mystery why exactly the ancient strain was so devastating to humans - wiping out nearly half of Europe's population between 1347 and 1351. In a modern era in which we confront new bugs like Avian Flu and five forms of Ebola (one not yet in humans), these are issues that need settling.

Then there is Dengue fever, which infected mosquitoes are being driven ever more northward by climate change-global warming. I contracted Dengue once while in the West Indies, following a one month junket to St. Lucia where we trained new Peace Corps volunteers, and it was like having a bad flu but one in which at least half your bones felt broken.  I escaped a 2nd and worst, a 3rd infection, which likely would have left me with Dengue hemorraghic fever where you bleed almost as bad as from Ebola.

By comparison, West Nile Fever now terrorizing some 46 states, is small pocket change. I sympathize with the residents of Big D, but they better hope Dengue fever never comes their way.

Anyway, an international team investigating Yersinia pestis and having plucked DNA from the remains of plague victims buried in London's East Smithfield cemetary found the medieval microbe had nearly the same genetic code as its modern variant. They found absolutely no evidence that some genetic mutation was unleashed in the 14th century and enhanced the death toll. (This appeared in the same paper published in the Journal Nature, Oct. 27, 2011.)

Their verdict? The massive deaths were most likely a result of the deplorable, unsanitary living conditions peculiar to the time ....what with human waste and garbage left out to breed maggots and rot in the open in streets, along with other refuse. Thus, non-genetic factors reflecting a lower quality of life that made the disease more lethal than it ought to have been - say if it erupted today.   Malnutrition also provided a ready made source of easy infection, given that the victims had already had their immune systems weakened by hunger and terrible living conditions. Hence, they were unable to fight off the ravages of plague.

But again, the other question that remains to be answered is whether such a massive return of the plague might recur IF our living conditions also worsened to make them similar to those of 14th century Europe, say under massive austerity pressure fueled by bond pirates and Neoliberal imps. Contrary to the wishful thinking of many, this isn't as far fetched as they'd like to believe. Assume a Mitt Romney administration entering the scene next year and governing with their proposed massive tax cuts requiring enormous cuts in food stamps (affecting 45 million), Medicaid (affecting nearly 54 million) and other key programs. Imagine also that no infrastructure repair is mandated while Pentagon budgets increase 40%.. Sewer lines break, water mains rupture..What do you suppose might happen? (And btw, let's bear in mind a resistant bacteria are everywhere and neutralzing even the most powerful antibiotics, and global warming is ramping up to the point of causing our power grids to crash.)

Well, increasingly unsanitary living conditions, as sewage ruptures into the streets and in homes from thousands of sewage systems reaching the end of the line, for one. Then add malnourished citizens, hence weakened immune systems, prey to every bug that comes down the pike, and no place to go for treatment with Medicaid sliced and diced.

In other words, the perfect brew for Yersinia pestis if it emerged when such conditions had readed a nadir, say after 3 years of Romney-ism, and especially after he mandates no more antibiotics except for the wealthiest- too big a cost for the nation.

Unlikely? Maybe, but I wouldn't want to test the scenario by voting Romney-Ryan!

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