Abstract:
During the fourteenth century, the bubonic plague or Black Death killed more than one third of Europe or 25 million people. Those afflicted died quickly and horribly from an unseen menace, spiking high fevers with suppurative buboes (swellings). Its causative agent is Yersinia pestis, creating recurrent plague cycles from the Bronze Age into modern-day California and Mongolia. Plague remains endemic in Madagascar, Congo, and Peru. This history of medicine review highlights plague events across the centuries. Transmission is by fleas carried on rats, although new theories include via human body lice and infected grain. We discuss symptomatology and treatment options. Pneumonic plague can be weaponized for bioterrorism, highlighting the importance of understanding its clinical syndromes. Carriers of recessive familial Mediterranean fever (FMF) mutations have natural immunity against Y. pestis. During the Black Death, Jews were blamed for the bubonic plague, perhaps because Jews carried FMF mutations and died at lower plague rates than Christians. Blaming minorities for epidemics echoes across history into our current coronavirus pandemic and provides insightful lessons for managing and improving its outcomes.
摘要:
在14世纪,黑死病或黑死病杀死了欧洲三分之一以上或2500万人。那些受苦的人迅速而可怕地死于看不见的威胁,尖刺高烧具化脓性长袍(肿胀)。它的病原体是鼠疫耶尔森氏菌,从青铜时代到现代的加利福尼亚和蒙古,创造了反复发生的鼠疫周期。瘟疫仍然是马达加斯加的地方病,刚果,秘鲁。这篇医学历史回顾强调了几个世纪以来的鼠疫事件。通过老鼠身上的跳蚤传播,尽管新理论包括通过人体虱子和受感染的谷物。我们讨论症状学和治疗方案。肺鼠疫可以被武器化用于生物恐怖主义,强调了解其临床综合征的重要性。隐性家族性地中海热(FMF)突变的携带者具有针对鼠疫耶尔森氏菌的天然免疫。在黑死病期间,犹太人被指责为鼠疫,也许是因为犹太人携带FMF突变,死于低于基督徒的瘟疫率。将少数群体归咎于流行病在历史上呼应了我们当前的冠状病毒大流行,并为管理和改善其结果提供了深刻的教训。