Tournament of Pandemics - Plague vs Malaria - Part One

by Alanna Shaikh · 2009-03-16 09:55:00 UTC
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(photo credit: hans s)

This is the fourth match-up in March's Tournament of Pandemics.

Plague

Plague is pretty famous. By "pretty famous" I mean that it strikes fear into the human heart and still causes nightmares. It's mentioned in Shakespeare's plays, by the ancient Greeks, and in Stephen King novels.  Plague is a metaphor, a euphemism; the essence of threat. It has earned this reputation. Outbreaks of plague punctuate human history with horror. For example, bubonic plague killed seventy-five million people in the middle ages.

And bubonic isn't even the scariest kind of plague. There's a lot of kinds of plague. Bubonic plague, pneumonic plague, and Septicaemic plague. Bubonic plague causes the big swollen lumps that break open into lesions. Septicaemic plague is a blood infection. Pneumonic plague spreads through inhaling fine droplets of aerosolized droplets.

Pneumonic is the truly terrifying form of plague. Bubonic plague is controllable; it's spread by fleas and we've got plenty of insecticides that kill fleas. We know how to control an outbreak. We've got it down to a death rate of about 2000 people a year.

But pneumonic plague could spread directly from person to person, by a cough or a sneeze. It requires strict isolation procedures to control it. Without treatment, the mortality rate is about 100%. Health care providers need antibiotics just to treat people with pneumonic plague. We've already seen pneumonic plague outbreaks in India in 2002, and in Uganda in 2004.  We're just starting to see what it can do.

Right know, we treat plague with streptomycin and tetracycline, regular first-line antibiotics. Nothing to difficult and experimental. More cases of plague, though, would lead pretty quickly to antibiotic resistant strains of the infection.

Alanna Shaikh
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