La Peste (1695) wax sculpture, Gaetano Zumbo, Museum of Specola, Florence

The Black Death: the Plague that Sowed Terror and Death in Medieval Europe - Part 2

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The average time between infection and the onset of symptoms is around 2 to 8 days, but in the case of pneumonic plague it may be only one day. The three most common forms of plague are bubonic plague, pneumonic plague, and septicemic plague.

Bubonic plague is an infection of the lymph nodes. Its symptoms usually appear suddenly, after 2-5 days of exposure to the bacteria. Its main symptoms include chills, fever, malaise, headache, muscle pain, seizures, and formation of bubones (painful swollen lymph nodes), armpit or neck.

Pneumonic plague is a lung infection and its symptoms also appear suddenly, normally within 2 to 3 days after exposure. Symptoms of the pneumonic plague include severe coughing, difficulty breathing, coughing or expulsion of blood and/or bloody/foamy mucus, and chest pain when breathing deeply.

The formation of buboes is one of the main symptoms of bubonic plague. Illustration Toggenburg Bible (1411)

The formation of buboes is one of the main symptoms of bubonic plague. Illustration Toggenburg Bible (1411) ( Wikimedia Commons )

Septicemic plague, which is an infection of the blood, can cause death even before showing symptoms. If symptoms do occur they often include abdominal pain, bleeding due to problems with blood clotting, diarrhea, fever, nausea, and vomiting.

People infected with the plague need immediate treatment. If it is not received within 24 hours of the onset of initial symptoms, the victim of the disease will likely die. To fight the disease, antibiotics such as streptomycin, gentamicin, doxycycline or ciprofloxacin are used today. The use of oxygen, intravenous fluids, and respiratory support is often also necessary.

In addition, patients suffering from pneumonic plague must be isolated from caregivers and other patients. Also, people who have had contact with someone infected with pneumonic plague must be monitored closely and receive antibiotics as a preventive measure.

What if it wasn’t Black Rats?

According to the findings of a new study by Nils Stenseth, a researcher at the University of Oslo, we may have to rewrite part of the story of the Plague because black rats may not be to blame for the outbreak of the bubonic plague in Europe after all.

According to the research team in charge of the study, repeated plague epidemics were caused by another rodent: the gerbilino or gerbil (Gerbillinae) from Asia.

A Mongolian gerbil, perhaps the true flea-bearers that caused the plague epidemics in Europe.

A Mongolian gerbil, perhaps the true flea-bearers that caused the plague epidemics in Europe. ( Wikimedia Commons )

After comparing the tree rings in Europe where the worst outbreaks of the plague took place, it was noted that the weather conditions were not optimal for rats to be the culprits. The team wrote in their report:

“We showed that there were good conditions for gerbils and fleas in Central Asia, and the bacteria appeared a few years later in European port cities and then expanded across the continent. For that warm summers were needed, without much rainfall - dry but not too dry. We looked at the broad spectrum of climatic indices and saw no relationship between the onset of fever and climate.”

The team believes that the specific weather conditions in Asia may have caused the increase in the gerbil population, what they claim were the real transmitters of the disease.

Burned houses in China during the plague of 1890.

Burned houses in China during the plague of 1890. ( Wikimedia Commons )

Stenseth’s team now plans to analyze the DNA of the plague bacteria obtained from former European skeletons. If the genetic material shows a lot of variations, it may indicate that the theory is correct because it would suggest different waves of Plague arrivals from Asia - showing more than a single strain which is thought to arise from one main rat invasion.

The plague disappeared from Europe in the nineteenth century. However, even today, cases are still recorded around the world.

Featured image: La Peste (1695) wax sculpture, Gaetano Zumbo, Museum of Specola, Florence ( Wikimedia Commons )

Author: Mariló TA

This article was first published in Spanish at and has been translated with permission.


California investigates possible second case of plague visited Yosemite. Artículo/19-08-2015.

The Black Death, the epidemic more mortífera.

What caused the Black Death in Europe?

Medical Encyclopedia. Death.

Stories of our history. The Black Death.

Causes and consequences of the plague negra

Cats, witches and black plague.

Ole J. Benedictow. (2011). The Black Death, 1346-1353: The Complete History.

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