Black Death pandemic in medieval Europe -- prevention?

[Aidyan]

TL;DR Summary

What could have been a prevention at those times?

We are told that the Black Death, pandemic that ravaged Europe between 1347 and 1351 was caused by the bacterium Yersinia pestis with rats as the main vehicle of transmission and transmitted to human by the bites of fleas. At those time there were no vaccines, of course. So, what would have been the best counter measures as **prevention of the disease** (NOT prevention of its spread or treatment)? I don't mean preventions as killing all rats, quarantine, etc. I mean what could have possibly avoided the the plague (at those times, not nowadays) to come into existence in the first place? What I find are only vague explanations such as that people of the Medieval Ages were uneducated about diseases and cleanliness. Can someone be more specific or eventually point to an article, link, paper that discusses this in more detail?

 

[jim mcnamara]

The reason you cannot find much is that historians tend to overlook biology in favor of some other factors.

Rats->Fleas are only one vector.

Pneumonic plague (a form of plague) spreads like influenza or Covid-19. It develops in the lungs of some individuals and then takes off rapidly into surrounding people. So everything you've read about sterilization, masks, and so on for Covid-19 applies here as well.
Plague vaccines work well, too.
https://www.cdc.gov/mmwr/preview/mmwrhtml/00041848.htm

Also note that so many people died over repeated waves of pandemics that Europeans and Asia Minor folks have some immunity to disease, even today.

There were several waves of plague over time. Example: there was the earlier Plague of Justinian, it was Yersinia pestis too. -- https://en.wikipedia.org/wiki/First_plague_pandemic

Important: there are links at the bottom of the wiki page, so a google search with "NIH [name of the paper or reference]" will get more technical information. Lose the brackets and quotes.

Read the pneumonic plague section, transmission rates are highest with airborne bacteria form of the disease a general treatment:
https://emergency.cdc.gov/agent/plague/factsheet.asp

Plague is still common in rodent populations in the American Southwest for example. It is not a thing of the past.

 

[Vanadium 50]

Plague is still common in rodent populations in the American Southwest for example. It is not a thing of the past.

I've been vaccinated against plague myself.

 

[russ_watters]

So, what would have been the best counter measures as **prevention of the disease** (NOT prevention of its spread or treatment)? I don't mean preventions as killing all rats, quarantine, etc. I mean what could have possibly avoided the the plague (at those times, not nowadays) to come into existence in the first place?

It kind of sounds like you are asking how we could have prevented a specific bacterium species from coming into existence? If that's what you mean, it's an odd question, but the obvious answer is; we can't.

 

[Aidyan]

Ok, I try to rephrase: could the spread from animal to human be avoided? Or, could it be at least limited? Say by using more hygiene, keep distance from rats, wild animals, measures to avoid outbreak of fleas, etc.? Or would that have been useless anyway?

 

[BWV]

Supposedly central Asian marmots were the source of the more virulent pneumatic plague strain that caused the black death and spread down the silk road (cant find a good link, but in Kelly, John (2006). The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of All Time )

Also the famines that killed 10-15% of Europe's population due to the cooling climate in the early 14th century may have created susceptibility to the disease

 

[jim mcnamara]

https://en.wikipedia.org/wiki/A_Distant_Mirror Is another good reference by a historian.

 

[Evo]

Ok, I try to rephrase: could the spread from animal to human be avoided? Or, could it be at least limited? Say by using more hygiene, keep distance from rats, wild animals, measures to avoid outbreak of fleas, etc.? Or would that have been useless anyway?

Yes, the Pope was sequestered and he didn't catch it, a lot of the nobility that quickly moved to their uninfected country homes fared better than those that stayed in the area of possible infestation.

Edited to add, that doesn't mean that they knew it would help or why, it was just to get away.

 

[jim mcnamara]

@Aidyan yes, it could have been mediated. But nobody had a useful understanding of what was happening.
So how could they take effective measures? Why do we still die from cancer? You do realize that imposing 21st Century understanding on past events can allow us understanding how things got so bad. But we know how to deal with it reasonably well now. But you answered your own question.

 

[Vanadium 50]

,keep distance from rats...measures to avoid outbreak of fleas

Gosh, Theodoric, you know what this place needs?
Why no, Aelfred, what?
More rats. There just aren't enough rats here.
Rats? I think we could stand some more fleas myself.

 

[pinball1970]

Ok, I try to rephrase: could the spread from animal to human be avoided? Or, could it be at least limited? Say by using more hygiene, keep distance from rats, wild animals, measures to avoid outbreak of fleas, etc.? Or would that have been useless anyway?

There are a 500 hundred years between the plague and the publication of germ theory of disease so its worth considering how people thought about disease and what caused it in the 14thC

Isolation was probably the only thing that would have made sense after traditional medicines, prayer had failed and anyone trying to attend to the sick died as well.

An example in the UK here below self-isolation of an entire village for over a year. Comparisons to COVID and implications to HIV immunity in this article.

One remedy according to legend from the link was drinking bacon fat (mistaken for water)

https://www.bbc.co.uk/news/uk-england-derbyshire-51904810

 

[Laroxe]

Despite the fact that people didn't understand the cause they quickly recognised the idea of contagion and they took some very serious steps to contain the disease. Ships that arrived from ports known to have plague or with people sick on board were barred entry for a period of 40 days, the word quarantine comes from this. If someone in a household became infected, the whole family were prevented from leaving the house (the doors were nailed shut and guards posted). Even these measures had a limited effect, it does seem that this was a new highly aggressive strain, which for some reason has now disappeared.
The village of Eyam in Derbyshire isolated itself when people became infected in an attempt to prevent it spreading across England, they were trying to protect others and suffered high casualties because of it. Now we can't even get people to wear masks.

 

[Astronuc]

DNA analysis reveals source of Black Death​

https://www.cnn.com/2022/06/15/health/black-death-plague-source-identified-scn/index.html

(CNN) - Tombstones in what’s now Kyrgyzstan have revealed tantalizing details about the origins of the Black Death, the world’s most devastating plague outbreak that is estimated to have killed half of Europe’s population in the space of seven years during the Middle Ages.

The source of that pandemic has been debated by historians for centuries, but the inscribed tombstones – some of which referred to a mysterious pestilence – and genetic material from bodies exhumed from two grave sites that date back to the 13th century have provided some concrete answers to this long-standing question.

Researchers first excavated the burial sites in the 1880s. The tombstone inscriptions, written in the Syriac language, were painstakingly reexamined in 2017 by historian Phil Slavin, an associate professor at the University of Stirling in Scotland. He noticed that of the 467 burials that were precisely dated, a disproportionate number – 118 – were from just two years: 1338 and 1339. It’s a revelation he described as “astonishing.”

“When you have one or two years with excess mortality, it means that something was going on. But another thing that really caught my attention is the fact that it wasn’t any year – because it was just seven or eight years before the (plague) actually came to Europe,” Slavin told a news briefing.

In 1347, plague first entered the Mediterranean via trade ships transporting goods from territories around the Black Sea. The disease then spread across Europe, the Middle East and northern Africa, claiming up to 60% of the population, according to the study that published in the journal Nature on Wednesday.

The source of the Black Death in fourteenth-century central Eurasia​

https://www.nature.com/articles/s41586-022-04800-3

 

[jim mcnamara]

I was going to add the link... good find.

 

[Laroxe]

There are a 500 hundred years between the plague and the publication of germ theory of disease so its worth considering how people thought about disease and what caused it in the 14thC

Isolation was probably the only thing that would have made sense after traditional medicines, prayer had failed and anyone trying to attend to the sick died as well.

An example in the UK here below self-isolation of an entire village for over a year. Comparisons to COVID and implications to HIV immunity in this article.

One remedy according to legend from the link was drinking bacon fat (mistaken for water)

https://www.bbc.co.uk/news/uk-england-derbyshire-51904810

It's interesting to look at attempts to study the history of disease and the beliefs about causes and management. Despite our confidence in the germ theory, epidemiology and genetics, things keep changing and really, it's debatable how application of these ideas have helped, at least initially.

Plague is a good example and the desire to identify the source, does seem reminiscent of the debates over the source of Covid 19, there seems to be a natural resistance to the idea of circumstances coming together that allows a pathogen to spread, that puts us at the mercy of the fates. There is however some evidence that in some rural areas in China, outbreaks of a Covid 19 like illness have been occurring for some time but the Coronavirus involved was unknown, rather like most of them.

However, there is reasonable evidence that humans have experienced epidemics / pandemics of plague since the bronze age. The Black Death is estimated to have killed around 25 million people but over time it may have killed some 200 million. It seems a bit strange that rats got the blame, the plague bacillus kills both rats and their flea's, in fact a noticeable increase in rat deaths was considered a harbinger of an outbreak. It's now considered that it was primarily spread by human fleas and possibly by contaminated grain. It seems, rodents are their primary reservoir in nature and it remains common in rodent populations, across Africa and Asia and even in the USA.

Despite having no knowledge of germs, the primary containment methods are instantly recognisable, public gathering places were closed, the infected were isolated, their possessions, and even their homes were burned and animals were killed. These measures were enforced with extreme brutality, there were no appeals to individual rights, well none that worked, anyway. The few Drs that would deal with people, designed their own PPE, it might even be the case that some of the herbs they used acted as insect replants, they certainly protected from any liquid contamination. The people collecting corpses, who couldn't afford such luxury, had to be well paid and were often people who had recovered.

Remember, that as Alexander's armies marched towards Asia, his medics could predict, based on the Miasma theories, personnel losses to disease, based on the local geography, with considerable accuracy. If you marched through swampy lowlands, the poison miasma rising from the ground would kill quite a few, while the fresh mountain air was far healthier, so no change there either. These ideas might have been wrong but they were not adopted randomly, they often worked. The control of sinful behaviour, which usually meant sex, limited close intimate contact, this and the ability to persecute minorities served to give the majority people to blame. It may have been that only when international trade had been virtually shut down and the population density reduced that a sufficient reduction in the rate of infection (the R number) allowed the epidemic to die down.

https://www.pnas.org/doi/10.1073/pnas.1715640115
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7513766/

 

[Astronuc]

Bubonic plague came to the US for the first time in history in 1899.
https://www.pbs.org/wgbh/americanexperience/films/plague-golden-gate/#part01

 

[BWV]

Bubonic plague came to the US for the first time in history in 1899.
https://www.pbs.org/wgbh/americanexperience/films/plague-golden-gate/#part01

although it may have been part of the cocktail of pathogens that nearly eradicated the native population of the Americas in the 16th and 17th centuries

https://theconversation.com/how-pla...land-before-the-mayflower-even-arrived-137570