How I survived the bubonic plague (sort of)
By Frederic Friedel
Once a year we try to make it to California, for a two or three week carefree stay. It’s a wonderful deal: our oldest and dearest friends, Ken and Bonnie, cannot for some reason get enough of us; they have a beautiful house in San José; and an even more beautiful one in Sea Ranch, north of San Francisco, right on the edge of the Pacific. We go flying around with Ken in his Cessna, one time over the Sierra, Vegas, Grand Canyon, Monument Valley, Zion, Bryce, Lake Powell, where we got to see some of the geologically most exciting places on Earth, from a thousand feet up. And finally, Ken works for Google, or he did until a heart problem forced him into a kind of retirement. But he still has full access and takes us to The Campus in Mountain View.
So we have a really great time. But recently, just two days before we were due to fly back home, I broke out in boils down my arm and hand. What on earth??
A little googling gave me an idea what it might be: bubonic plague! Apparently the plague is still endemic: in Africa, Bhutan — and in the American West, more specifically in San José and Mountain View. I had been taking long walks with Ingrid in the surrounding hills, and seen many squirrels and wild rodents scurry around. So cute and delightful, but also sometimes infected with plague. Here is a list of contemporary distribution of animal plague. Had I been bitten by a flea and contracted it?
You know what plague meant for Europe in antiquity and medieval times. The first major pandemic started in the sixth century in Egypt; the second and biggest one in the fourteenth century, and the third in the nineteenth century. That second one came from China, which lost half its population (about sixty million people died), and spread along the Silk Road to the rest of Asia, Europe and Africa. In Europe about one third (some estimate half) of the population perished, when all the medical cures known at the time — blood letting, prayer, self-flagellation, killing Jews — all proved to be worthless.
If you really feel up to it, you should read Daniel Defoe’s harrowing description of the Great Plague that hit London in the 17th century. It contains close to a hundred references to God, and a similar number to divine power, divine justice, divine vengeance, etc.; but as far as I can tell just one single mention of rats (people laid rat poison after the destruction of 40,000 dogs and five times as many cats had led to a proliferation of the rat population), and no mention whatsoever of fleas. Google has scanned the book so you can read it here on your screen; or you can use the HTML version at Gutenberg here.
So Europe and China kept losing tens of millions of people to the plague, periodically up to half of their entire population. And the people died in abject misery, in full ignorance of what was causing the catastrophe. Things have changed since that time. Today we know that plague is caused by a bacterium called Yersinia pestis, which is passed to humans by flea bites with regurgitated blood being injected into the tissue. And we have a real cure.
In 1994 a pneumonic plague epidemic broke out in the slums of Surat, India, precipitated by heavy monsoon rain and clogged sewers. Absolutely terrifying, really. This outbreak resulted in 52 (fifty-two) deaths — doctors armed with syringes of antibiotics put a stop to the disease as fast as they could reach the affected population. Compare the stats: fifty-two individuals vs a hundred million in medieval times.
I must add a note: Madagascar, off the coast of Africa, is the country most severely affected today. The World Health Organization reports that since 2010 it has been the site of over half (and one year, 90 percent) of worldwide incidents of the plague! Last year, 63 people died in Madagascar, out of a total of 275 cases. Mind you the numbers are so high because in remote areas sometimes people do not get antibiotics, or do not take them by volition, preferring to rely on native doctors who massage the boils. That makes them smaller, but it also helps to spread Yersinia throughout the body faster. And it is also an excruciatingly painful procedure.
But back to my case of bubonic plague, contracted in California. I called a doctor friend who essentially said: “I doubt it is plague, but even if it is, take two Aspirins and come see me in the morning.” I didn’t, and flew back to Germany, where I went to a specialist doctor immediately on arrival. She was disconcertingly young and attractive (initially I thought she was a helper), and after looking at my boils, and hearing my theory, she said: “This is definitely not Yersinia. Unfortunately, it is much worse: shingles.”
Shingles is a painful skin rash, caused by the varicella zoster virus. It usually appears in a band, a strip, or a small area on one side of the face or body. My doctor recognized it, she told me, because it followed the path of an artery down my arm. Shingles is caused by a reactivation of varicella that had invaded, usually a number of decades previously, with chickenpox. When the body has overcome that infection the virus remains inactive in nerve cells, and re-emerges as shingles in old age or people whose immune function has been weakened. It is a dangerous condition, causing a fair number of deaths — by suicide, since patients sometimes cannot bear the pain that comes with it.
Well, my doctor wanted to send me to a hospital for immediate infusion, but when she consulted her boss, a professor of dermatology, he said: “Let’s try this new medication: Acyclovir. It makes infusions superfluous.” So I went home and started taking a few pills, three or four times a day. And my “bubonic plague” quickly disappeared. That is how far we have come with modern clinical medicine.