When a teenager in Idaho contracted the bubonic plague in early June, it made a few headlines because it was the first case in Idaho in 26 years. Half a millennium after it killed an estimated 60% of the European population, the specter of the Black Death still looms large in Western consciousness — gangrene, swollen lymph nodes, seizures — a horrific relic of days long past. But actually, although the bubonic plague has long been understood, it has never been eradicated.
In fact, outbreaks of the bubonic plague have been fairly common across the US since the early 20th Century. The last widespread outbreak happened in Los Angeles in late 1924, when 30 people who lived within a few blocks of each other contracted the bubonic plague, which developed into pneumonic plague, as it virtually always does when left untreated. Altogether, 24 people died in that outbreak, though newspapers at the time referred to it as a strain of pneumonia to prevent panic — and possibly anti-racist sentiment as the neighborhood affected was home to a large population of Mexican immigrants, including Patient 0. Antibiotics, which are still very effective against the bubonic plague, did not come into widespread use until the 1950s. Before that development, outbreaks were not unusual throughout the west, particularly in California, New Mexico, Arizona and Oregon.
When we hear “Bubonic Plague,” Europe in the Middle Ages may come to mind. From 1347 to 1350, the Bubonic Plague or the “Black Death” spread across the continent, killing approximately 50 million people, which at the time accounted for more than one-third of Europe’s population. However, the disease is still very much with us, with roughly 600 cases diagnosed annually across the globe.
The countries currently experiencing the largest incidents of plague include Peru, the Republic of Congo, and Madagascar. In the United States, incidents of Plague are largely confined to rural parts of the country, such as a recent report of a child with Bubonic Plague in Idaho.
You may think of scarlet fever as one of those Victorian illnesses, now thankfully eradicated with modern medicine, which afflicted the consumption-weakened people of the era. In fact, scarlet fever is the result of a common bacterial infection gone untreated. The culprit is Group A streptococcus, which typically resides on our faces and in our throats, and is responsible for scarlet fever, strep throat, and impetigo.
While the infection has been controlled through better hygiene practices and antibiotics, reducing its incidences, it’s been making a dramatic comeback in the past couple years, leaving scientists scrambling to understand why.
Our best medicines are losing their power. Since the 1940s, antibiotics have stopped infections from turning deadly, saving millions of lives around the world. Prior to the discovery of antibiotics, surgery was more dangerous, now-curable diseases like STDs and tuberculosis killed millions, and a paper cut could be fatal. However, overuse and misuse of these drugs have led to the rise of antibiotic-resistant strains of “superbugs.” Older types of antibiotics have been rendered useless by these powerful bacteria, compelling researchers to develop new generations of stronger varieties. Now those newer drugs are losing their effectiveness as well, and the World Health Organization has raised the alarm: We are running out of cures.
"Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine," said Dr. Tedros Adhanom Ghebreyesus, Director General of WHO. "There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery."
There are two kinds of STDs: those that can be successfully treated and those that cannot. Now gonorrhea, a sexually transmitted disease that has typically been cured through a course of antibiotics, is moving into the untreatable camp. Neisseria gonorrhoeae, the bacterium that causes gonorrhea, is developing resistance to the only antibiotics that can treat it.
The World Health Organization has issued new guidelines for the treatment of gonorrhea after many new antibiotic-resistant strains have emerged around the world. The WHO recommends doctors use cephalosporins instead of quinolones (both of which are classes of antibiotics), changing the protocol for gonorrhea treatment for the first time since 2003.