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What is Bubonic Plague?

Mary McMahon
Updated Feb 26, 2024
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Bubonic plague is a form of the plague which manifests in the form of swollen lymph nodes, known as “buboes” historically. Many people think of the plague as a historical disease, but in fact there are up to 3,000 cases worldwide annually, according to the World Health Organization. Fortunately, this form of the plague is very easy to treat, especially if it is addressed early, and in areas where the plague is endemic, such as the American Southwest, doctors are usually adept at recognizing the early signs.

Like other forms of the plague, bubonic plague is caused by the Yersinia pestis bacteria. In the bubonic form of the plague, the bacteria are introduced into the body through the skin, via a bite from a flea which carries the disease from an infected rodent. Once the patient has been exposed, the bacteria start to spread through the body, causing the lymph nodes to swell and eventually rupturing the blood vessels, causing large bruises and black spots to appear under the skin.

The bubonic plague has played an important role in human history, ever since cases were first recorded around the sixth century. Before the advent of antibiotics, the plague was devastating, and it could stop armies in their tracks, empty cities, and decimate communities. During the medieval era in particular, bubonic plague was a major public health issue, and the “black death” swept across Europe in multiple waves which some historians estimate may have wiped out up to half of the population.

Most cases of this contagious disease are the result of exposure to infected rodents such as rats and prairie dogs. In the medieval era, people also passed the plague from person to person, because many homes were infested with fleas which could leap from patients to healthy people. Today, person to person transmission is much less common, thanks to better hygiene.

In addition to developing the distinctive buboes, patients also experience fevers, chills, nausea, headaches, and vomiting. Classically, the tongue also becomes white and thickened with advanced plague infection. The bacteria responsible for the disease are very susceptible to antibiotics, and most people infected in the modern day experience no long term ill effects as a result of their plague infections. When cases of bubonic plague are documented, public health officials usually track down the source of the exposure, and steps may be taken to protect the community, such as eradicating an infected rodent population.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGeek researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By Malka — On Sep 07, 2011

It's kind of sad, but I had no idea up until now that the bubonic plague mainly affects the lymph nodes. I'd heard of the typical bubonic plague symtoms -- the bruises and spots and horrible pain -- but now it makes a lot more sense with an explanation.

I've had a cold that gave me swollen lymph nodes once, and it hurt horribly just to have my skin touched anywhere near the lymph nodes. They literally swelled and made bumps under my skin.

I imagine that there was a similar agonizing effect for the poor sufferers of the bubonic plague, only they had a bunch of other symtoms too, plus they lived in a time when there was no assurance you'd get better from ANY illness. People got a cold, pneumonia or the flu and died all the time back then.

This all makes me really glad I live in the modern age that I do.

By hanley79 — On Sep 07, 2011

#Bhutan - I think the difference between a regular yucky disease and a legendary one like the bubonic plague is that the plague made history with how many cases it had. Think about it -- in a time when there was no regular mail system, internet, television, journalistic presence, this epidemic was so big and terrifying that people learned about it regardless. And they had enough knowledge to be scared, not just a vague idea that it was happening.

All of the cases you mentioned either had an epidemic or were declared by the CDC to have the potential for an epidemic. I'll bet if suddenly there were CDC calls for bubonic plague vaccine distribution, people would panic about this history-making murder disease all over again.

By ahain — On Sep 06, 2011

@Esther11 - Isn't it interesting how people talk about things like the Bubonic plague like they're a part of history, done and gone? They're still around.

The difference, of course, is that now we have more medical knowledge. Having doctors who don't interpret Bubonic plague symptoms as some kind of punishment from God helps, as does having technology to treat it that's better than putting you to bed and possibly doing some bloodletting. The Middle Ages were a terrible time to get sick, because "doctoring" was pretty much barbaric. It was the best they could do, but really, they couldn't do much at all.

By malmal — On Sep 05, 2011

@sweetPeas - I know what you're talking about. I once watched a PBS series about deadly diseases, and of course the Bubonic plague Middle Ages outbreak was on the list. That episode disturbed me as a kid, because it was reenactment style, and the actors did a very convincing job of wheezing and groaning and looking like they were suffering horribly.

One notable point of the PBS program was a woman who, legend had it, got the plague but cured herself by drinking from a pot of lard when she was deliriously sick.

Apparently she had been left alone as they did with people who were so sick they knew they wouldn't survive, and so when she got thirsty in the middle of the night, nobody was there to help. She stumbled to the kitchen in her nightgown and drank straight from the pot on the stove...which was liquid fat rather than water.

And she lived. I wish I could remember the woman's name so I could verify it now. The show had historians talking about it, and a descendant of hers talking about it. If they had a family member then she must have survived, right? It was an interesting story, that's for sure.

By sweetPeas — On Sep 04, 2011

In the face of so many people dying of the plague during the medieval times, maybe half of the population of Europe, and added on to that, the deaths from warfare and other causes, it's no wonder the world took so long to gain much in population.

I've read a couple of books on the plague in Europe and those people really suffered. The symptoms were awful and so many of them were just left to die, because the healthy ones didn't want to get near them to help. They understood that a sick person could give it to another. The children suffered horribly. Someone would take care of them at the start, but when bad symptoms started to appear, they were left alone.

By Esther11 — On Sep 04, 2011

I don't think that most of the viral and bacterial diseases ever disappear. The bubonic plague epidemics have no doubt hit other groups of people than the ones in middle age Europe. Conditions have to be right for an epidemic, like filthy, crowded living conditions along with a large population of rats and fleas.

Viral flu of various kinds have probably caused epidemics every so often. Yellow fever, scarlet fever and other contagious illnesses have caused epidemics.

Fortunately, we now have health workers who can recognize these diseases and slow them down before they turn into an epidemic. And we're lucky to have antibiotics and flu shots.

By Bhutan — On Sep 04, 2011

What I think is amazing is that I read that the song, “Ring around the Rosy” was actually about the bubonic plague of 1347. I have sung this song as a kid countless times, and I never realized what the song was actually about.

I think that there will always be diseases or illnesses that will be the sign of the times that we are living in. The bubonic plague virus may have been the talk of the town in the 1300’s but in the early 1900’s I read that millions died of the Spanish flu.

Also in the 1980’s we learned of the AIDS epidemic and until recently we were exposed to the avian flu. I think that when people hear of these dreadful diseases they always panic and spread fear all over the world. In a way I can understand the hysteria because these conditions did lead to death and many of these diseases were exposed through casual contact, but the odds were still slim that anyone would actually pick up any of these diseases today.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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