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.

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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.

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As bad as this year’s flu epidemic has been, at least in the United States, most of us rest easy knowing that deadlier and nastier mass-murdering pathogens such as bubonic plague and smallpox live mostly in our collective memory. Or do they? As climate change melts longstanding permafrost, some scientists fear that “zombie pathogens,” which have been slumbering for centuries, might be waking up, threatening to overtake humanity again.

Permafrost refers to a layer of permanently frozen earth—it has to be frozen for a minimum of two years to qualify—found primarily in most continually frosty parts of the world such as the Arctic Circle, Greenland, Alaska and Siberia. According to National Geographic, there are some 22.8 million square miles of permafrost in the world. Research has shown that Earth's permafrost heated up by 6 degrees Celsius during the 20th century and scientists predict even more dramatic melting by 2100. Not only will this raise ocean levels and exacerbate erosion, it may also mean a release of pathogens better left frozen.

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People carry a body wrapped in a sheet as they take part in a funerary tradition called the Famadihana in the village of Ambohijafy, a few kilometres from Antananarivo, on September 23, 2017. During the Famadihana, which can be translated as "turning of the bones", several crypts are opened and people take the bodies of their ancestors from the family crypts and rewrap them in fresh cloth, then dance with the corpses in their arms at the pace of traditional Malagasy band's music. The Famadihana is a pillar in the Malagasy ancestor's worship and is celebrated each three, five or seven years. / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)

Experts worry a recent outbreak of the plague on the island of Madagascar is being spread by a sacred, ancient funerary ritual practiced by a native ethnic group.

Famadihana (pronounced fa-ma-dee-an), also known as “turning of the bones,” is a tradition practiced by many Malagasy people that dates back to the 17th century. In short, it requires exhuming the deceased bodies of loved ones, wrapping them in a fresh shroud, and dancing with the corpses through the streets to singing and music before reburying them.

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