Origination
The Black Plague originated in China in the 1330's and moved West with the Mongol invaders and traders. It first hit Europe in 1346 in a Crimean port by the name of Caffa. The plague soon struck the people in the surrounding areas -- Tartars -- and killed tens of thousands. The Muslim Tartars blamed the nearby Christian Geonese and laid seige to the city, hurling plague-infected corpses over the city walls. Some Geonese managed to escape the seige and flee to Italy, carrying the plague with them.

From Italy, the plague quickly spread to France, England, Germany, Denmark, Finland, Sweden, and Poland. It even reached Greenland. During this first and most serious bout, the plague is estimated to have killed one-third to one-half of Europe's population.

The plague reached England at Michaelmas in 1348. The custom at the time was to ring the church bells at funerals, and it is reported that in the city of Bath, it was decreed that no bells could be rung, for the endless ringing frightened a great many of the residents. Outbreaks continued in England sporadically until the Great Fire of London, which is speculated to have killed off many rats and their fleas.

Transmission
The plague is spread by two means: contact with infected bodily fluids, and by the Oriental Rat Flea, Xenopsylla cheopsis. The bacteria that causes the plague is aptly named Yersinia pestis. A flea ingests the bacteria from a rat, and the bacteria multiplies in the flea's intestinal tract. Soon, the flea's stomach is blocked, and since it cannot not fill its stomach (satisfy its hunger, the flea will bite its host repeatedly. Blood from the host enters the digestion tract, becomes infected with bacteria, and because the stomach is blocked, the blood returns to the host through the flea's vomit. Since the Rat Flea prefers rats as hosts, there is no real danger to humans until large numbers of rats begin to die, and the fleas move on to their secondary host: humans.

Symptoms
There are three types of plague: bubonic, septicemic, and pneumonic. In bubonic plague, the most common form in the Middle Ages, the mortality rate was 30-75%. Symptoms took from 1 to 7 days to appear. Initial symptoms include headache, nausea, vomiting, aching joints, and fever. The bubonic plague's signature was the enlarged lymph node, or bubo. The lymph node would swell, and become black and hardened. Lancing the bubo sometimes helped to cure the patient.

Septicemic plague is the form that gives this plague its most common name: The Black Plague. It is the rarest form of the disease. The mortality rate was very near 100%. Symptoms include high fever, and a discoloration of the skin: wherever the patient's skin received pressure, it turned black or purple. Patients usually died with a day of contracting the septicemic plague.

The pneumonic plague was the most communicable form. This form infected the patient's lungs. Mortality rate was 90-95%. The patients coughed up spetum tinted with blood. As the disease progressed, the spetum became bright red. Symptoms took 1 to 7 days to appear after initial infection.

Repurcussion was very, very rare, as most who contracted the plague died from it.

Treatment
Medieval treatments for the plague were not too effective. Bleeding was popular, but this only served to further spread the plague. Other remedies included an infusion of sulfur and burning incense and aromatic oils. Today, treatments are much more effective. The patient is given a strong dose of antibiotics, including streptomycin. The modern-day mortality rates, when treatment is given, are as follows: bubonic, minimal; septicemic, 100%; pnemonic, 5-10%. However, in 1997 researchers discovered a strain of the plague that is immune to most antibiotics used to treat it.

Prevention
In the Middle Ages, some people believed that the disease was transmitted through the air, so they took to carrying cloths infused with aromatic oils such as rosemary, camphor, and laurel to cover their faces when they went out. One particular drawing from the Middle Ages shows a contraption meant to keep physicians from contracting the disease: it is a mask shaped like a bird's head, with a long, hollow beak fitting over the mouth; the beak is to be filled with aromatic herbs. Other people tried to scare away the plague with sound, by ringing bells or blasting cannons. Talismans and spells were also quite popular. Milan and Venice both took measures to quarantine the ill, and their efforts paid off.

Today, there are still sporadic outbreaks of plague. There was a major outbreak in San Francisco from 1900-1909. In 1996, five people in the Southwest region of the United States died of plague, and periodic outbreaks are not uncommon in the Indian Penninsula and in Africa. Prevention measures include improving sanitary conditions, killing rats and burning their corpses, and using insecticide to kill fleas. In 1999, researchers announced that they were ready to test a vaccine against the plague.

Self-Assessment
Just in case you ever ask yourself, "Do I have the plague?", I am offering a self-assessment test to help you determine whether you do.

1. Do I have a fever? Yes or No
2. Do I have a horrible, hacking cough? Do I feel like I have needles in my chest? Am I coughing up blood? Yes or No
3. Do I have swollen lymph nodes on my neck, under my armpits, or near my crotch? Are they swollen to the size of a walnut or larger, turning black, becoming hot to the touch, or turning hard? Yes or No
4. Am I delirious? (This is hard to self-diagnose; it's better to phone a friend and ask them.) Yes or No
5. Am I confused? Example: If you've been thinking, "Dan Quayle might not be such a bad president," you are confused and might have the plague. Yes or No
6. Do I have an enlarged liver and/or spleen? (Again, this is tough to self-diagnose. Performing exploratory surgery on yourself is not recommended.) Yes or No
7. Am I vomiting up a viscuous black bile streaked with blood? (This is okay to self-diagnose.) Yes or No
8. Am I crawling with fleas? Although this does not necessarily mean that you have the plague, if the fleas are accompanied by symptoms of the plague, you might be a little more worried. Yes or No
9. Am I surrounded by dead rats? Yes or No
10. Am I in the Middle Ages?

If you exhibit more than a few of these symptoms, it's probably a good idea to call your doctor and quarantine yourself until you find out what's wrong. This has been a public health service provided by SueZVudu!