the Black Plague and Comparison between Past and Today’s Pandemic

Complete Guide about the Black Plague and Comparison between Past and Today’s Pandemic

Before moving on to Black Plague and Comparison between Past and Today’s Pandemic, you should know about Pandemic, so let’s start with!

What is Pandemic?

A Pandemic is defined as “an epidemic usually affecting a large proportion of population occurring over a wide geographical area such as the selection of nation, the entire nation, and the continent of the world, i.e., In 1871, Cholera Pandemic Outreached in India.

Black Plague

Black Plague is also known as the Black Death. The black Plague was the deadliest pandemic that was recorded in human history. The black Plague pandemic resulted in the death of up to 75 to 200 million folks in Eur & Asia and North Africa peaking in Europe from 1347 to 1351. Plague illness is occurred by the bacterium pestis. It was an infectious disease of animals (Zoonosis), Particularly, wild and domestic rodents.

According to the Estimation, 25 million people almost third of the country’s population over the world are killed by Black Plague.

Ways of Transmission:

Below are the some ways of transmission of the Black Plague

  • The bite of an affected flea
  • Straight contact with the tissues of affected animals
  • Droplet infection from the causes of pneumonic plague
  • Black Plague Transmission Cycle:

At least five basic types of transmission cycle in Black Plague.

  • Commensal Rat  Rat fleas  Man
  • Wild Rodentswild Rodent fleas or direct contact  Man
  • Wild Rodents, peri-domestic rodent, commensal rodents wild rodents fleas Man
  • Man Human flea Man
  • ManMan

Black Plague Symptoms:

  • swollen lymph glands
  • A high concentration of lymph nodes: The groin, underarms, and neck
  • Fever,, hemorrhaging, bloody sputum, chills, headaches, shortness of breath, vomiting, and delirium.

Measures for the Prevention of Transmission of Plague:

  1. Control of Cases
  • Early diagnosis
  • Notification
  • Isolation
  • Treatment
  • Disinfection
  1. Control of Fleas

The most prominent method to break the chain of spreading (rodentfleaMan) is the destruction of Rat fleas by appropriate application of an affected insecticide. In general DDT and BHC should be used as dust containing 10% and 3% of active ingredient respectively about 2 or 3 gram of insecticide formulation will be needed for each square meter of surface recurring treatment.

  • Control of Rodents
  • Vaccination

Immunization with plague vaccine is a remarkable measure for avoidance of plague vaccination is done by plague vaccine in two doses of 0.5 to 1ml at a period of 1 week and it is given below the skin. Boosten dose is also necessary Immunity lasts for 6 months.

  • Chemoprophylaxis
  • Surveillance
  • Health Education

Past Pandemics:

  1. The Bubonic Plague or Black Plague (1346-1353)

By studying the bubonic plague, we gain insight into the origins of quarantine. We have discussed it already in the above section.

  1. Cholera ( 1817 )

Cholera is a terrible incisive gastrointestinal infection occurred by vibrio cholera. During the 19th century, Cholera spread across the globe from its real reservoir in the Ganges delta in India. Six Subsequent pandemics killed millions of people across all over the continents. Then the current (seventh) pandemic started in South Asia in 1961 and reached Africa in 1971 and America in 1991 then it also outbreaks in various countries.

Since, the year 2000 – 2016, countries reporting to the WHO have recorded a total of 3.4 million Cholera cases and 65,600 deaths.

Cholera is called the “father of public health”. An English Epidemiologist John Snow studied the epidemiology of cholera in London and established the role of polluted drinking water spread of cholera then came the demand for clean water from the people. As the principle activities of public health are the improvement of sanitation and provide safe drinking water.

Clinical features of Cholera:

Typical features of Cholera are shown below:

  1. Stage of Evacuation

The onset is abrupt with profuse, painless, watery diarrhea followed by vomiting. The patient may pass off many as 40 stools in a day. The stools may have a “rice water” appearance.

  1. Stages of Collapse
  • Dehydration
  • Sunken Eye
  • Hollow cheeks
  • Scaphoid abdomen
  • Subnormal temperature
  • Washerman’s hands and feet
  • Absent pulse
  • Unaccordable blood pressure
  • Loss of skin elasticity
  • Shallow and quick respiration
  • The output of urine decreases
  • Restless
  • Death may occur due to dehydration and acidosis resulting in diarrhea.
  1. Stage of Recovery:

If death does not occur, the patient begins to show signs of clinical improvement.

Sanitation Measures to control Cholera outbreak

  • Water Control
  • Excreta Disposal
  • Food sanitation
  • Disinfection of patients, stool, and vomit, etc.
  1. The Spanish Flu (1918-1919)

The Spanish Flu also known as the Flu pandemic, was an unusually deadly influenza pandemic caused by H1N1 influenza A Virus. It was started from the last of February 1918 to April 1920, it infected 500 million people about a third of the world’s population at that time.

Clinical Features

Respiratory Symptoms, fever, chills, and fatigue.

Prevention measures of Spanish Flu :

  • Using masks and gloves
  • Frequent washing of the hands
  • Maintain personal hygiene and maintain social distance
  • Avoid touching your own eyes, nose, and mouth
  • Avoid Gathering
  • The use of the vaccines on swine flu to prevent infection is a major method of limiting swine to human transmission.
  1. SARS (2002-2004) AND MERS (2012-2016)

SARS stands for Severe Acute Respiratory Syndrome and MARS stands for Middle East Respiratory Syndrome was a communicable viral disease, which differs considerably in genetic structure from the previously recognized pandemic.

Clinical Features:

  • Fever
  • Malaise
  • Chills
  • Headache
  • Dizziness
  • Cough
  • Sore throat
  • Nose Running
  • Chest X-ray finding typically begin with a small, unilateral patchy shadowing and progress over 1-2 days become bilateral and generalized with confluent infiltration
  • Adult respiratory syndrome ( at the end stage)

Mode of Transmission:

  • Close contact with an infected patient
  • Close contact with infected material via, eyes, mouth, and nose with infectious respiratory droplets

Epidemiological Aspect:

Maximum virus excretion from the respiratory tract occurs on about 10 days of illness and then declines.

  1. AIDS Pandemic(1981-present day)

AIDS ( Acquired Immunodeficiency Syndrome) is a fatal illness caused by a retrovirus known as the human immunodeficiency virus (HIV), which breaks down the body’s immune system, leaving the victim vulnerable to a host of life to threaten opportunistic infections, neurological disorders, or unusual malignancies.

It has claimed an estimated 35 million lives since it was first identified. HIV crossed from Chimps to Humans in the 1920s in what now the Democratic Republic of Congo.

Host Factors

Age: Mostly 20-49 years, children under 15 years make up less than 3% of cases.

Sex: Both male and female particularly homosexual and bisexual male.

Immunology: HIV selectively infects T-helper cells

High-Risk Group

  • Male Homosexual and bisexual
  • Prostitutes
  • Intravenous drug abusers
  • Transfusion recipients of blood and blood products
  • Hemophiliac and client of Sexually transmitted disease (STD)

Mode of transmission

  • Sexual transmission
  • Contaminated blood
  • Any skin piercing
  • IV drug Abuse
  • Shared razor, toothbrushes, and combs
  • Maternal-fetal transmission (Mother to child transmission)

HIV may pass from an infected mother to her fetus through the placenta or to her infant during delivery by breastfeeding

Clinical Manifestation of HIV Infection

Initial Infection: Most HIV-infected people have no symptoms for the first five years. But there may be a generally mild illness like fever, sore throat, and rash in 70% of people in the first few weeks.

Asymptomatic carrier state: Infected people have antibodies but no overt signs of disease, except persistent generalized lymphadenopathy.

AIDS-related Complex (ARC): A person with ARC has illness caused by damage of Immune System, but without opportunistic infections and cancers associated with AIDS but they exhibit one or more of the following clinical signs. These signs are mentioned below:

  • Unexplained diarrhea longer than a month
  • Fatigue
  • Malaise
  • Loss of more than 10 percent body weight
  • Fever
  • Other mid opportunistic infections such as; oral thrush, generalized lymph-adenopathy on the enlarged spleen

Major Signs of AIDS

  • Weight loss of more than 10 percent
  • Chronic diarrhea more than 1 month
  • Prolong fever more than 1 month
  • Control of measure of AIDS

Today’s Pandemic:

Today’s Pandemic is a communicable Zoonotic Airborne disease, it is caused by the newly discovered virus. The first patient of today’s pandemic was found in China’s Wuhan City in 2019.

Mode of Transmission of Today’s Pandemic:

  • It started by infecting our upper respiratory tract which is the airways from our nose to just above our vocal cords
  • Direct contact like touching, kissing, or close contacts
  • Droplet infection like coughing, sneezing, and droplets of Saliva

Risk Factors:

  • Over 65 years old people
  • Children
  • Smokers
  • The poor immune system of young people

Signs and Symptoms produced by Today’s Pandemic:

  • Fever
  • Dry cough
  • Pneumonia
  • Chest pain
  • Nose running
  • Diarrhea
  • Breathless
  • Sore throat
  • Fatigue
  • Headache
  • Nausea and vomiting


  • Supportive care
  • Medication in a clinical trial


  • Frequently hand wash at least for 25 seconds
  • Drink more hot water
  • Avoid direct contact with the suspected patient
  • Avoid touching face and mouth
  • Use sanitizer, face mask, and gloves

Comparison between Past Pandemic and Today’s Pandemic:

Below is the comparison between the Past Pandemic and Today’s Pandemic.

Above those past pandemic diseases, we can see 20th and 21st centuries have either been caused by influenza or the current virus . But the 2003 SARS pandemic had a much smaller impact than today’s pandemic and the number of people’s death (1.8 Million) more comparable with the previous Flu pandemic.

Both today’s pandemic and previous flu pandemic spread via respiratory droplets, but their agent factors are quite different. The previous pandemic, the Spanish Flu pandemic is also noted for having had two waves an initial one in the spring of 1918, and a devastating resurgence in the fall of that year.

SARS and MERS provide the closest parallels to days pandemic for several reasons. First SARS, MERS, and SARS COV-2 are all like today’s pandemic viruses that passed to humans from animals. All three viruses were infected people who were admitted to hospitals with severe Pneumonia.

Mortality of Today’s Pandemic appears higher than the previous swine Flu Pandemic because today’s pandemic can lead to organ damage and long-term symptoms, but it is not seen in a previous swine Flu pandemic. Sign Symptoms produced by today’s pandemic are closely related to SARS and MARS. But the swine Flu Pandemic sign symptoms are a little bit different because diarrhea and vomiting are not much markable in this pandemic.

Apart from the devastating loss of life, the disruption to normal life means pandemics have long been predicted to damage the economy. Yet each successive pandemic seems to affect the economy more largely response to previous pandemics relied on hygiene and sanitation measures such as handwashing but not on lockdowns, Physical distancing on other measures that disrupt economies.

About half of all jobs in Africa have been wiped out as a result of the current pandemic and routine immunization disrupted, as well as access to treatment for malaria, HIV, tuberculosis, and family planning.

The number of hungry people is set to double, which means that aside from the immediate effect of the potential of today’s pandemic infection. The resulting shockwaves from the lockdown could reverberate for many years to come, especially for the most marginalized communities.

Risk factors of today’s pandemic are mostly SARS and MARS. Today’s pandemic mostly killed people older than 65. Spanish Flu pandemic was different in case of deaths regarding today’s pandemic. It infected young and healthy people particularly hard half of everyone, the age of died people lies between 20-40 years and 99% were younger than 65 years.

Similarly, 87% of deaths in 2009 caused by the Swine Flu pandemic were in those younger than 65 years. While today’s pandemic disease spread more quickly because of its new to humans. Humans have no way to prepare for it and their immune systems are not ready to fight it. This result is the virus causing more cellular damage and producing more inflammatory cells.

The vaccine is available for all the previous pandemic but still, the vaccine is not available for today’s pandemic. So, need supportive care and medication in a clinical trial and for prevention need to maintain some rules that have been mentioned in the above sections.

The speed of transmission is one of the most significant factors of difference between the past and Today’s pandemic. Past pandemics have a shorter incubation time( the period from infection to visibility of symptoms) and a little serial time( the interval between successive point cases) than Today’s Pandemic. The serial period for Today’s Pandemic is approximately to be 5-6 days, while for the influenza pandemic, the serial period is estimated at 3 days which shows that influenza can spread faster than Today’s pandemic.

Children are the core drivers of influenza pandemic spread in the community. For Today’s pandemic , At the starting of Today’s pandemic, data shows that children are little infected than Grownups. The Chinese report shows that Children are affected by adults instead of vice versa.

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