The past present and future of the bubonic plague Sharon N. DeWitte

Imagine if half the people
in your neighborhood, your city,

or even your whole country were wiped out.

It might sound like something out of
an apocalyptic horror film,

but it actually happened
in the 14th century

during a disease outbreak
known as the Black Death.

Spreading from China through Asia,
the Middle East, Africa and Europe,

the devastating epidemic destroyed
as much as 1/5 of the world’s population,

killing nearly 50% of Europeans
in just four years.

One of the most fascinating
and puzzling things abut the Black Death

is that the illness itself
was not a new phenomenon

but one that has affected
humans for centuries.

DNA analysis of bone
and tooth samples from this period,

as well as an earlier epidemic known as
the Plague of Justinian in 541 CE,

has revealed that both were caused
by Yersinia pestis,

the same bacterium that causes
bubonic plague today.

What this means is that the same disease
caused by the same pathogen

can behave and spread
very differently throughout history.

Even before the use of antibiotics,
the deadliest oubreaks in modern times,

such as the ones that occurred
in early 20th century India,

killed no more than 3% of the population.

Modern instances of plague
also tend to remain localized,

or travel slowly,
as they are spread by rodent fleas.

But the medieval Black Death,
which spread like wildfire,

was most likely communicated directly
from one person to another.

And because genetic comparisons of ancient
to modern strains of Yersinia pestis

have not revealed any significantly
functional genetic differences,

the key to why the earlier outbreak
was so much deadlier

must lie not in the parasite but the host.

For about 300 years during
the High Middle Ages,

a warmer climate
and agricultural improvements

had led to explosive population growth
throughout Europe.

But with so many new mouths to feed,

the end of this warm period spelled disaster.

High fertility rates
combined with reduced harvest,

meant the land could no longer
support its population,

while the abundant supply
of labor kept wages low.

As a result, most Europeans
in the early 14th century

experienced a steady decline
in living standards,

marked by famine, poverty and poor health,
leaving them vulnerable to infection.

And indeed, the skeletal remains
of Black Death victims found in London

show telltale signs of
malnutrition and prior illness.

The destruction caused by the Black Death
changed humanity in two important ways.

On a societal level,
the rapid loss of population

led to important changes in
Europe’s economic conditions.

With more food to go around,

as well as more land and better pay
for the surviving farmers and workers,

people began to eat better and live longer
as studies of London cemeteries have shown.

Higher living standards also brought
an increase in social mobility,

weakening feudalism,
and eventually leading to political reforms.

But the plague also had an important
biological impact.

The sudden death of so many of
the most frail and vulnerable people

left behind a population with
a significantly different gene pool,

including genes that may have helped
survivors resist the disease.

And because such mutations
often confer immunities

to multiple pathogens
that work in similar ways,

research to discover the genetic
consequences of the Black Death

has the potential to be hugely beneficial.

Today, the threat of an epidemic
on the scale of the Black Death

has been largely eliminated
thanks to antibiotics.

But the bubonic plague continues to kill a
few thousand people worldwide every year,

and the recent emergence of a
drug-resistant strain

threatens the return of darker times.

Learning more about the causes and effects
of the Black Death is important,

not just for understanding how
our world has been shaped by the past.

It may also help save us from
a similar nightmare in the future.

想象一下,如果
你所在的社区、你的城市

甚至你的整个国家有一半的人被消灭了。

这听起来
像是世界末日恐怖电影中的情节,

但它实际上发生
在 14 世纪

的一场被称为黑死病的疾病爆发期间
。 这场毁灭性的流行病

从中国蔓延到亚洲
、中东、非洲和欧洲,在短短四年内

摧毁
了多达 1/5 的世界人口,

造成近 50% 的欧洲人死亡
。 黑死病

最令人着迷
和令人费解的事情之一

是,这种疾病本身
并不是一种新现象,

而是已经影响了
人类几个世纪。


这一时期的骨骼和牙齿样本的 DNA 分析,

以及
在公元 541 年被称为查士丁尼瘟疫的早期流行病

表明,两者都是
由鼠疫耶尔森菌引起的

,这种细菌是今天引起腺鼠疫的同一种细菌

这意味着由同一种病原体引起的同一种疾病

在历史上的表现和传播方式可能大不相同。

甚至在使用抗生素之前
,现代最致命的爆发

,例如发生
在 20 世纪初印度的爆发,

杀死的人口不超过 3%。

现代鼠疫实例
也倾向于保持局部化,

或传播缓慢,
因为它们是通过啮齿动物跳蚤传播的。

但是像野火一样蔓延的中世纪黑死病

很可能是直接
从一个人传播给另一个人的。

而且由于
古代和现代鼠疫耶尔森菌菌株的基因比较

没有发现任何显着的
功能遗传差异,

所以早期
爆发如此致命的关键

一定不在于寄生虫,而在于宿主。

在中世纪盛期的大约 300 年里

,气候变暖
和农业

改善导致整个欧洲人口爆炸式增长

但是有这么多新的嘴巴要喂养,

这个温暖时期的结束意味着灾难。

高生育率
加上收成减少,

意味着土地不再能
养活人口,

而充足
的劳动力供应使工资保持在低位。

结果,大多数欧洲人
在 14 世纪初

经历了生活水平的稳步下降
,其

特点是饥荒、贫困和健康状况不佳,
使他们容易受到感染。

事实上,
在伦敦发现的黑死病受害者的骨骼遗骸

显示出
营养不良和先前疾病的明显迹象。

黑死病造成的破坏
在两个重要方面改变了人类。

在社会层面,
人口的迅速减少

导致
欧洲经济状况发生重大变化。 正如对伦敦墓地的研究所表明的那样

,随着更多的食物可供食用,

以及更多的土地和更好的工资
给幸存的农民和工人,

人们开始吃得更好,寿命更长

更高的生活水平也带来
了社会流动性的增加,

削弱了封建主义,
并最终导致了政治改革。

但瘟疫也产生了重要的
生物学影响。

许多最脆弱和最脆弱的人突然死亡,

留下了
一个基因库明显不同的人群,

其中包括可能帮助
幸存者抵抗疾病的基因。

而且由于这种突变
通常赋予

以相似方式起作用的多种病原体的免疫力,

因此发现黑死病遗传后果的研究

有可能产生巨大的益处。

今天,由于抗生素的使用,
黑死病规模的流行病威胁

已基本消除

但腺鼠疫每年继续在
全世界造成数千人死亡

,最近出现的
耐药菌株

威胁着黑暗时代的回归。

更多地了解黑死病的原因和
影响很重要,

而不仅仅是为了了解
我们的世界是如何被过去塑造的。

它还可能帮助我们
在未来摆脱类似的噩梦。