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The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Taubenberger). People were struck with illness on the street and died rapid deaths. One anectode shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza (Hoagg). Others told stories of people on their way to work suddenly developing the flu and dying within hours (Henig). One physician writes that patients with seemingly ordinary influenza would rapidly "develop the most viscous type of pneumonia that has ever been seen" and later when cyanosis appeared in the patients, "it is simply a struggle for air until they suffocate," (Grist, 1979). Another physician recalls that the influenza patients "died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth," (Starr, 1976). The physicians of the time were helpless against this powerful agent of influenza. In 1918 children would skip rope to the rhyme (Crawford):

The origins of this influenza variant is not precisely known. It is thought to have originated in China in a rare genetic shift of the influenza virus. The recombination of its surface proteins created a virus novel to almost everyone and a loss of herd immunity. Recently the virus has been reconstructed from the tissue of a dead soldier and is now being genetically characterized. The name of Spanish Flu came from the early affliction and large mortalities in Spain (BMJ,10/19/1918) where it allegedly killed 8 million in May (BMJ, 7/13/1918). However, a first wave of influenza appeared early in the spring of 1918 in Kansas and in military camps throughout the US. Few noticed the epidemic in the midst of the war. Wilson had just given his 14 point address. There was virtually no response or acknowledgment to the epidemics in March and April in the military camps. It was unfortunate that no steps were taken to prepare for the usual recrudescence of the virulent influenza strain in the winter. The lack of action was later criticized when the epidemic could not be ignored in the winter of 1918 (BMJ, 1918). These first epidemics at training camps were a sign of what was coming in greater magnitude in the fall and winter of 1918 to the entire world.

The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years.

"The 1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man's destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all--infectious disease," (12/28/1918).

riers, along trade routes and shipping lines. Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific (Taubenberger). In India the mortality rate was extremely high at around 50 deaths from influenza per 1,000 people (Brown).

With the military patients coming home from the war with battle wounds and mustard gas burns, hospital facilities and staff were taxed to the limit. This created a shortage of physicians, especially in the civilian sector as many had been lost for service with the military. Since the medical practitioners were away with the troops, only the medical students were left to care for the sick. Third and forth year classes were closed and the students assigned jobs as interns or nurses (Starr,1976). One article noted that "depletion has been carried to such an extent that the practitioners are brought very near the breaking point," (BMJ, 11/2/1918). The shortage was further confounded by the added loss of physicians to the epidemic. In the U.S., the Red Cross had to recruit more volunteers to contribute to the new cause at home of fighting the influenza epidemic. To respond with the fullest utilization of nurses, volunteers and medical supplies, the Red Cross created a National Committee on Influenza. It was involved in both military and civilian sectors to mobilize all forces to fight Spanish influenza (Crosby, 1989). In some areas of the US, the nursing shortage was so acute that the Red Cross had to ask local businesses to allow workers to have the day off if they volunteer in the hospitals at night (Deseret News). Emergency hospitals were created to take in the patients from the US and those arriving sick from overseas.

    George Thompson, the owner of the house, was particularly worried, concerned that no well-to-do New Yorkers would be of a mind to rent his home the following season if it was associated with disease. The house was very large, and expensive to run. Thompson himself, though the owner of four other homes, could not afford to live there. If the house lay vacant, it would mean disaster. Desperate, he called in experts to track down the source of the contagion, hoping it came from outside the property and eager for someone to prove it.     Drinking water was analyzed. The single indoor toilet, the cesspool, manure pit, and outhouse were all examined and ultimately rejected as the possible source of infection.

    Dairy products were inspected.     An old woman who lived on the beach was considered a likely suspect. She had offered the family clams for sale, and these were scrutinized minutely, but no one else in th

e town who had eaten shellfish from the same source had fallen ill.

    Thompson, unsatisfied with the inconclusive results from local health authorities on the scene and from his hired experts, reached out to friends in New York City, looking for someone, anyone, to help him with his embarrassing problem.     Salvation didn't exactly ride in on a white horse. Nor was Dr. George Soper hero material exactly. Dr. Soper was not even in fact a medical doctor. He was a sanitary engineer — as one newspaper described him: `a doctor to sick cities.'     Called into the fray, he took the train out to Oyster Bay from the city and set immediately to work. After reviewing the findings of the first medical men on the scene, as well as those of earlier experts who had scrutinized the drinking water, trash and sewage, he began questioning members of the household, inquiring about visitors, ultimately receiving a comprehensive list going back an impressive ten years. To the best of his ability, Soper examined the medical histories of each of these individuals, eventually ruling all of them out as possible sources.

    Soper now uncovered `other episodes', as he called them. Provocatively, there was a two-year period for which there were no records available at all for Ms. Mallon's employment — the period between the Gilsey family incident and Mary's arrival in Oyster Bay.     The two-year blank was tantalizing to Soper. Where had Mary been? Who had she been cooking for? She must have been cooking somewhere ... The sanitary engineer's mind teemed with disturbing images. He no doubt pictured the cook stirring soup in some unknown and very busy cellar kitchen, barehanded, unknowing, infecting untold multitudes of solid citizens with potentially deadly bacilli.     Dr. Soper's breathless, self-serving, yet ultimately unreliable accounts to newspapers give a sense of how excited he was, how exhilarated by the thrill of the chase and the tantalizing prospect of being onto something really important. At first he had anticipated a case that might last only a few weeks — a little sea air, a few bowls of steamers, some resolution, and back to the city — but now he found himself further drawn into a quest which had already occupied him for a full four months. The Warrens were long gone — back home with the other summer renters. The weather had turned colder, the house now stood empty.

    He went over the facts of the case as they had presented themselves to him. Here he had an unexplained outbreak of typhoid in an area where no typhoid of any kind had been previously. The home was immaculate, clean from top to bottom. All other possible sources of infection had been examined and ruled out. The only new element introduced into the household had been a cook. The cook handled food, which all the afflicted members of the household had eaten. The disease broke out, and the cook was now gone. Had she left under different circumstances, say, the disappearance of a diamond necklace, the cops — or any investigator — would have been looking very hard in her direction.     Soper got a description of the suspect: a woman of about forty, tall, with a buxom build, blond hair, blue eyes, and a firm mouth and jaw. It was remarked that she was `a pretty good cook', though she was observed by some interviewees in retrospect as bein

`not particularly clean' in her work habits and `difficult to talk to'.     Writing later, Soper describes what he did next:

    This was frustrating. Things usually went pretty quickly in cases like this. Feces in the water supply, contaminated milk, a sickly visitor, and case closed. Not so at the Thompson house. Soper began to `walk the cat backward' in search of an answer.     Typhoid's incubation period was known to be ten to fourteen days long, so he focused on a time on or before August 20. Soper was intrigued by the news that on the fourth of the month, the Warrens had seen fit to change cooks. More significantly, the new cook, a Mary Mallon, was now missing, having left without notice or explanation some three weeks after the sickness began.     A missing cook! It was the kind of lead that criminal investigators find almost too easy, too good to be true; evidence of a kind that prosecutors like to present to jurors as indicating `guilty knowledge', the kind of red flag that Miss Marple or Hercule Poirot would disregard automatically as being just too obvious. Look at it: A murder or some other felony is committed in a household or place of business, and someone who used to be there is suddenly no longer there. It doesn't take an investigative mastermind to deduce who to go looking for first. It was circumstantial evidence of the most provocative kind, and Soper was well acquainted with the old saw about circumstantial evidence: `It's like finding a goldfish in your milk. It doesn't prove anything — but it's mighty suspicious'.

    Carriers were a very hot concept in the new world of epidemiology, a theory unproven in the United States. In Germany, however, the respected bacteriologist Dr. Robert Koch had recently investigated repeated outbreaks of typhoid in a Strasbourg bakeshop. The bakery was clean. The water supply was uncorrupted. Yet well-heeled customers were getting sick. Dr. Koch questioned the proprietor and found that she had, years earlier, contracted typhoid, but had survived the experience and was now, seemingly, fully recovered. After testing her, Koch found that even though she was devoid of symptoms and to all outward appearances a healthy person capable of working and going about her tasks like everyone else, she was in fact still teeming with typhoid germs, exuding them through her bowel movements and spreading them with improperly cleaned hands. This was a revolutionary discovery, and news of it had found its way to New York, where it was discussed with interest. Soper had read the transcript of a speech Koch had given on the subject a couple of years previous.     Dr. Soper had learned of seemingly clean and affluent homes in Mary Mallon's past being struck with typhoid after her employment. Now he was confronted with similar circumstances in yet another place she had worked. Given that no human carrier such as Koch's bakery proprietor had ever been identified in America, Soper was suddenly very, very interested in getting his hands on the mysterious Mary Mallon.

    That she was evidently not interested in being found only piqued the good doctor's interest to even greater pitch:

    At this point, Soper already seems to have formed in his mind a picture of Mary as some kind of Moriarty-esque nemesis, an elusive and crafty adversary with the answer to all his questions, but always just out of reach.     He wanted her badly. His day-to-day work, by this time, had become closer to a detective's than a microbe-hunter's, interviewing witnesses, poring over records. He felt good. He was going to make his bones with this case. He foresaw himself as the poster boy for epidemiologists and health professionals, an honored and much-sought-after speaker at all the medical societies, a hero to the afflicted, a newspaper personality, idol to generations of aspiring sanitary engineers.     Furthermore, he knew that his work was important. Typhoid was lethal and, especially in 1906 and 1907, no joke.

    These were boom times. It was a new century and a new world that Soper lived in. The 1900 Chicago World's Fair had once and for all convinced Americans that they lived in a great country, a major world power, on a par — at least — with the European monarchies. Any inferiority complex New Yorkers and Americans might once have felt was rapidly disappearing in the light of an increasingly powerful, worldwide naval presence, a national construction explosion, the emergence of a newly affluent and pleasure-seeking middle class, the recent developments of subway systems, mass-produced automobiles, a tunnel under the Hudson River, new entertainments, libraries, an exuberantly sensationalistic press, and the warm glow of having recently drubbed the Spanish in Cuba and the Philippines. Great strides had been made in the fighting of disease and the word `epidemic' was now an embarrassment to a city. An earlier epidemic of typhoid and cholera had had New York and Philadelphia pointing fingers at one another, each claiming the other was responsible for the outbreak, both mortified that something so closely associated with the squalor of the old world would be blamed on their fair metropolis.     Soper's description of an earlier experience with a typhoid epidemic gives a flavor of what a man in his position saw as his responsibility, of what he perceived himself to be up against:

These were the stakes as Soper saw them. Confusion, suspicion, contagion, neighbor pitted against neighbor, panic in the streets, and ultimately, chaos and death.     Epidemics — especially unexplained ones — tended to bring out the worst in people, and the `carrier' theory, however fearful its implications, was far preferable to some of the alternatives. In the past citizens thought to be contagious — particularly if they were members of the minority or underclass — had hardly been taken to the bosom of their communities. Instead the usual outcome was for mob rule to win out. It was not unheard of for those thought to be infected to be run out of town on a rail or set adrift in the Long Island Sound — often at the point of a gun — or worse still. As Soper saw it, he needed a quick and tidy solution to the Oyster Bay problem.     Looking at pictures of Soper — a serious, narrow-faced, whippetlike man with a neat mustache and a receding hairline — one gets the impression of not so much the dogged detective he might have liked to see himself as, but of a timid, fastidious scientist, a man ensconced in reasoned practice and methodology. That he might have been racist, sexist, and far too influenced by the prejudices of his class — as has been suggested by revisionist accounts — a flawed, ambitious fellow who looked for the first likely Irish woman he could clap the manacles on — does not present itself through photography. Nor do we get much of that from his work later in life: tomes with titles such as: The Air and Ventilation of Subways (1908), Modern Methods of Street Cleaning

(1909), Further Studies of European Methods of Street Cleaning and Waste Disposal With Suggestions (1930), and of course, what proved his masterwork, the story for which he became best known, the pamphlet with a title like a Victorian detective story's The Curious Case of Typhoid Mary (1939).     George Soper looks from his photographs not to be a nice guy. He looks like someone who was bullied in high school, a nerd, a geek, an apple-polishing dirt-wonk with an unseemly interest in filth and how to make it go away.     It was not for a good many more months, not until March of 1907, that Soper finally came face to face with Mary Mallon. It was then that reports reached him that a family on Park Avenue in New York City had been stricken with typhoid. Two cases had initially been reported. A maid was ill, and a daughter of the people who owned the house, a beautiful young woman in her twenties, was lying on her deathbed. The family were reportedly beside themselves with grief. The girl died two days later, and soon the nurse who had attended her became str

icken as well.     The details of the case as they reached Soper were indeed tragic, another example of bad things happening to people to whom bad things are not supposed to happen; but what particularly excited Soper, got that Sherlock Holmes mojo working again, was the news that there was a new cook fitting the description of Mary Mallon still employed by the stricken family.

    The cook in question, and indeed it was Mary Mallon, did not quite share the good doctor's enthusiasm. She showed true displeasure when Soper, who rushed over to the Park Avenue address immediately upon receiving the news, suddenly showed up at her job, accusing her in no uncertain terms of causing the typhoid which right then was draining the life from one member of her employer's family.

    To his dismay, Mary did not see Soper as the answer to some long-troubling question about the series of odd and unpleasant coincidences that had long followed her. He stood an accuser, and she reacted thus, and her reaction seems to have come as a complete surprise to him.     Here, at this first meeting between pursuer and pursued, is where things began to go terribly wrong — at least for Mary Mallon and any future she might have had. What was said here, and how it was said, would set the tone for everything that happened after.

“The Black Death” Even before the “death ships” pulled into port at Messina, many Europeans had heard rumors about a “Great Pestilence” that was carving a deadly path across the trade routes of the Near and Far East. (Early in the 1340s, the disease had struck China, India, Persia, Syria and Egypt.) However, they were scarcely equipped for the horrible reality of the Black Death. “In men and women alike,” the Italian poet Giovanni Boccaccio wrote, “at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.” Blood and pus seeped out of these strange swellings, which were followed by a host of other unpleasant symptoms–fever, chills, vomiting, diarrhea, terrible aches and pains–and then, in short order, death. The Black Death was terrifyingly, indiscriminately contagious: “the mere touching of the clothes,” wrote Boccaccio, “appeared to itself to communicate the malady to the toucher.” The disease was also terrifyingly efficient. People who were perfectly healthy when they went to bed at night could be dead by morning. Did You Know? Many scholars think that the nursery rhyme “Ring around the Rosy” was written about the symptoms of the Black Death.

The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey through the Black Sea. The people who gathered on the docks to greet the ships were met with a horrifying surprise: Most of the sailors aboard the ships were dead, and those who were still alive were gravely ill. They were overcome with fever, unable to keep food down and delirious from pain. Strangest of all, they were covered in mysterious black boils that oozed blood and pus and gave their illness its name: the “Black Death.” The Sicilian authorities hastily ordered the fleet of “death ships” out of the harbor, but it was too late: Over the next five years, the mysterious Black Death would kill more than 20 million people in Europe–almost one-third of the continent’s population.

Meanwhile, in a panic, healthy people did all they could to avoid the sick. Doctors refused to see patients; priests refused to administer last rites. Shopkeepers closed stores. Many people fled the cities for the countryside, but even there they could not escape the disease: It affected cows, sheep, goats, pigs and chickens as well as people. In fact, so many sheep died that one of the consequences of the Black Death was a European wool shortage. And many people, desperate to save themselves, even abandoned their sick and dying loved ones. “Thus doing,” Boccaccio wrote, “each thought to secure immunity for himself.”

Contents “The Black Death” Understanding the Black Death God’s Punishment? Facebook Twitter Google Print Cite Article Details: Black Death Author History.com Staff Website Name History.com Year Published 2010 Title Black Death URL http://www.history.com/topics/black-death Access Date April 16, 2014 Publisher A+E Networks Introduction The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey thro

the Black Sea

Even before the “death ships” pulled into port at Messina, many Europeans had heard rumors about a “Great Pestilence” that was carving a deadly path across the trade routes of the Near and Far East.

The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey through the Black Sea.

Strangest of all, they were covered in mysterious black boils that oozed blood and pus and gave their illness its name: the “Black Death.”

Blood and pus seeped out of these strange swellings, which were followed by a host of other unpleasant symptoms–fever, chills, vomiting, diarrhea, terrible aches and pains–and then, in short order, death.

“In men and women alike,” the Italian poet Giovanni Boccaccio wrote, “at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.”

The people who gathered on the docks to greet the ships were met with a horrifying surprise: Most of the sailors aboard the ships were dead, and those who were still alive were gravely ill.

Some people coped with the terror and uncertainty of the Black Death epidemic

Some upper-class men joined processions of flagellants that traveled from town to town and engaged in public displays of penance and punishment: They would beat themselves and one another with heavy leather straps studded with sharp pieces of metal while the townspeople looked on. For 33 1/2 days, the flagellants repeated this ritual three times a day. Then they would move on to the next town and begin the process over again

African Americans played a vital role in the epidemic of 1793. Rush pleaded for the help of Philadelphia’s free black community, believing that African Americans were immune to the disease. African Americans worked tirelessly with the sick and dying as nurses, cart drivers, coffin makers, and grave diggers. Absalom Jones and Richard Allen, religious leaders who would later go on to found the first black churches of Philadelphia, African Episcopal Church of St. Thomas, and African Methodist Episcopal Church, respectively, described their experience as volunteers in 1793: “at this time the dread that prevailed over people’s minds was so general, that it was a rare instance to see one neighbor visit another, and even friends when they met in the streets were afraid of each other, much less would they admit into their houses.” This was not the only horror that Absalom Jones and Richard Allen observed. They observed horrendous behavior from the fearful citizens of Philadelphia: “[Many white people]…have acted in a manner that would make humanity shudder.” Despite Dr. Rush’s theory, 240 African Americans died of Yellow Fever.

There is no specific treatment for those with yellow fever beyond good nursing and supportive care. The disease, however, is completely preventable. People can be rendered immune to the virus through vaccination, and outbreaks can be contained by eliminating or controlling mosquito populations. Thanks to such measures, the great yellow fever epidemics of the late 19th and early 20th centuries are no more. Nevertheless, the disease is still present in tropical Africa and South America, where access to vaccine is sometimes lacking

An infectious disease, yellow fever infects humans, all species of monkeys, and certain other small mammals. The virus is transmitted from animals to humans and among humans by several species of

An infectious disease, yellow fever infects humans, all species of monkeys, and certain other small mammals. The virus is transmitted from animals to humans and among humans by several species of mosquitoes. Yellow fever is one of the great epidemic diseases of the tropical world, and in earlier centuries it was one of the great plagues of the New World. At one time the tropical and subtropical regions of the Americas were subjected to devastating epidemics, and serious outbreaks occurred not only as far north as Philadelphia, New York, and Boston but also as far away as Spain, France, England, and Italy.

tious disease, yellow fever infects humans, all species of monkeys, and certain other small mammals. The virus is transmitted from animals to humans and among humans by several species of

called the Black Death because one of the symptoms produced a blackening of the skin around the swellings.

Key Dates relating to the event: This terrible plague started in Europe in 1328 and lasted until 1351 although there were outbreaks for the next sixty years

buboes were red at first, but later turned a dark purple, or black.

spread of the Black Death followed all of the Trade Routes to every country

Nearly one third of the population of died - about 200 million people in Europe The 1328 outbreak in China caused the population to drop from 125 million to 90 million in just fifty years7500 victims of the disease were dying every day

Some four million men were mobilized in the U.S. Armed Forces. Training camps and stations were often overcrowded. Soldiers and sailors routinely were packed on to passenger trains and sent to training stations and bases around the nation

When influenza struck the United States in the fall of 1918, it almost universally appeared in military populations before hitting civilian communities. Medical officers attempted to contain the epidemic through a host of measures, including nasal-pharyngeal sprays for all troops, quarantine of new arrivals, and isolation of cases in camp hospitals or special emergency

As the influenza epidemic raged, scientists and physicians struggled to isolate the causative microbe and to develop an effective vaccine against it.

Quacks and naysayers, on the other hand, advocated a host of alternatives such as raw onions rubbed on the chest, creosote baths, and the consumption of large quantities of brown sugar. Some—including several city health officers—claimed that a clean heart, clean bowels, or warm feet were all that was needed to stave off influenza.

Health officers, mayors, and city councils ordered theaters, movie houses, dance halls, saloons, schools, churches, and other places of public gathering to close for the duration of the epidemic.

In the three decades after 1890, nearly 24 million immigrants arrived on the shores of the United States

Seattle saw a drastic drop-off in the number of marriage license applications during the epidemic (although, interestingly, the number of divorce filings increased).5

World War I did not just affect soldiers, sailors, and Marines. On the home front, civilians were expected to contribute to the war effort as well by self-rationing food, fabric, gasoline, and other goods, and by purchasing Liberty bonds.

people in close proximity to one another. In the East, where the deadly fall wave

American Red Cross, the Visiting Nurse Association, the Blue Circle Nurses, the Public Health Nurses, and others played a vital role during the influenza epidemic, providing nursing care to the ill, staffing emergency hospitals, organizing volunteers, coordinating relief efforts, assembling gauze face masks, and operating ambulances. Communities across the nation were overwhelmed by the

magnitude of the crisis,

Local courts, on the other hand, had more flexibility in how they met the crisis

The 1918 influenza pandemic took a horrible toll of death and destruction in the United States

Outbreaks of the flu occurred in nearly every inhabited part of the world, first in ports, then spreading from city to city along the main transportation routes. India is believed to have suffered at least 12,500,000 deaths during the pandemic, and the disease reached distant islands in the South Pacific, including New Zealand and Samoa. In the United States about 550,000 people died. Altogether an estimated 25,000,000 persons throughout the world perished, most during the brutal second and third waves. Other outbreaks of Spanish influenza occurred in the 1920s, but with declining virulence

footprints were spotted leading from the house to a chair placed next to a fence. Over the fence was a neighbor's property. They spent five hours searching both properties, until, finally, they found "a tiny scrap of blue calico caught in the door of the areaway closet under the high outside stairway leading to the front door."4

Mary was on the lookout and peered out, a long kitchen fork in her hand like a rapier. As she lunged at me with the fork, I stepped back, recoiled on the policeman and so confused matters that, by the time we got through the door, Mary had disappeared. 'Disappear' is too matter-of-fact a word; she had completely vanished.3

Mallon, now extremely suspicious of these health officials, refused to listen to Baker, Baker returned with the aid of five police officers and an ambulance. Mallon was prepared this time. Baker describes the scene:

After a trial and then a short run from health officials, Typhoid Mary was recaptured and forced to live in relative seclusion upon North Brother Island off New York. Who was Mary Mallon and how did she spread typhoid fever? An Investigation

For the summer of 1906, New York banker Charles Henry Warren wanted to take his family on vacation. They rented a summer home from George Thompson and his wife in Oyster Bay, Long Island. Also for the summer, the Warrens hired Marry Mallon to be their cook.

On August 27, one of the Warren's daughters became ill with typhoid fever. Soon, Mrs. Warren and two maids became ill; followed by the gardener and another Warren daughter. In total, six of the eleven people in the house came down with typhoid. Since the common way typhoid spread was through water or food sources, the owners of the home feared they would not be able to rent the property again without first discovering the source of the outbreak. The Thompsons first hired investigators to find the cause, but they were unsuccessful. Then the Thompsons hired George Soper, a civil engineer with experience in typhoid fever outbreaks. It was Soper who believed the recently hired cook, Mary Mallon, was the cause. Mallon had left the Warren's approximately three weeks after the outbreak. Soper began to research her employment history for more clues. Mary Mallon was born on September 23, 1869 in Cookstown, Ireland. According to what she told friends, Mallon emigrated to America around the age of 15. Like most Irish immigrant women, Mallon found a job as a domestic servant. Finding she had a talent for cooking, Mallon became a cook, which paid better wages than many other domestic service positions. Soper was able to trace Mallon's employment history back to 1

900. He found that typhoid outbreaks had followed Mallon from job to job. From 1900 to 1907, Soper found that Mallon had worked at seven jobs in which 22 people had become ill, including one young girl who died, with typhoid fever shortly after Mallon had come to work for them.1 Soper was satisfied that this was much more than a coincidence; yet, he needed stool and blood samples from Mallon to scientifically prove she was the carrier.

first symptoms

skin blackene

inspiration for “Dance of Death” rituals

nervous system collapsed, causing extreme pain and bizarre neurological disorders

Once infected, people can infect others by coughing, sneezing, or close talking

“pocket full of posies,” that people carried with them and held near their faces to ward off the horrid odor

uncharacteristically cremated—the “ashes, ashes,”—and finally, death would come, and we would “all fall down.”

Fleas feeding on infected rodents can transmit the disease to people as well

the skin blackened, giving rise to “The Black Death.

The origin of “The Black Death” dates to an outbreak in China during the 1330s

Unlike smallpox, the plague is still a threat in some parts of the world. Yersinia pestis, the bacterium that causes bubonic plague, is transmitted through rat-tainted fleabites in densely populated cities and in countries with poor hygiene, or in the open country from infected wild rodents. The most common form of human plague is a swollen and painful lymph gland that forms buboes.

Pneumonic plague is more difficult to treat, and even with antibiotics, victims can die from it. Pneumonic plague occurs when the infectious bacteria infects the lungs. The first signs of illness in pneumonic plague are fever, headache, weakness, and a cough that produces blood or watery sputum. The pneumonia progresses over two to four days and, without early treatment, death ensues.

Plague vaccines have been used since the late nineteenth century, but their effectiveness is uncertain. Vaccination reduces the incidence and severity of disease resulting from the bite of infected fleas, but it isn't 100 percent effective. The plague vaccine is licensed for use in the United States and is available for adults at high risk—people who live in the western United States, people who will be in parts of the world where plague is still endemic, and people who are around rodents. Severe inflammatory reactions are common, and plague vaccine should not be given to anyone with a known hypersensitivity to beef protein, soya, casein, or phenol. Finally, the vaccination routine is complex and requires frequent boosters to maintain its effectiveness.

Bubonic Plague

When, for instance, a stranger called Andrew Hogson died from plague on his arrival in Penrith in 1597, and the next plague case followed twenty-two days later, this corresponded to the first phase of the development of an epidemic of bubonic plague. And Hobson was, of course, not the only fugitive from a plague-stricken town or area arriving in various communities in the region with infective rat fleas in their clothing or luggage. This pattern of spread is called ‘spread by leaps’ or ‘metastatic spread’. Thus, plague soon broke out in other urban and rural centres, from where the disease spread into the villages and townships of the surrounding districts by a similar process of leaps.

other two strains are the septicaemic plague, which infects the circulatory system in victims, and the pneumonic plague

the traders carried the bacterium yersinia pestis in the rats on board as well as in some of the sailors themselves. The Black Death had arrived in Europe.

Once the flea bites a human, infected blood from the rat is introduced to the healthy blood of the human, and the bacteria spreads. Death occurs in less than a week for humans. A high fever, aching limbs, and fatigue mark the early stages of infection. Eventually, the lymph nodes of the neck, groin, and armpit areas swell and turn black. Those black swellings on victims are what give the Black Death its name. The victim begins to vomit blood and in some instances suffer hysteria from fever and terror. Exposure to any body fluids means exposure to the bacterium, and thus spreading the disease is very easy through coughing victims. The victim dies shortly after the lymph nodes swell until bursting within the body.

As winter approached, colder temperatures killed fleas and caused rats to seek dormancy

disease was not gone, it was simply dormant for a few month

bubonic plague is actually the weakest strain of known plagues.

Black Death was solely caused by the bubonic strain of plague has been questioned

which infects the respiratory system

was the spread eastward to China

Black Death killed virtually all infected people raises doub

bubonic plague is not as fatal compared to the other two strains (which have mortality rates close to 100%)

the site of the first plague cases in Italy, Messina:

Soon the boils grew to the size of a walnut, then to that of a hen's egg or a goose's egg,

There was not nearly enough consecrated ground for each victim to have an individual plot, and so enormous trenches were dug into which layer upon layer of dead bodies were lain. The trench was topped off with a small layer of soil,

Pope Clement VI even consecrated the entire Rhone river so that corpses could be thrown into it for lack of earth.

people, and considered it to be a punishment from an angry God. Some peasants resorted to magic spells, charms, and talismans.

Some people burned incense or other herbs as they believed that they overpowering smell of the dead victims was the source of the disease.

Some people even tried to "drive the disease away" with sound from church bells and canon fire

Churchmen, and public officials considered the disease to be just that; a disease.

The Italian writer Boccaccio said victims often "ate lunch with their friends, and ate dinner with their ancestors in paradise."

The Europeans often ate stale or diseased meat because refrigeration had not yet been invented.

Europeans were susceptible to disease because many people lived in crowded surroundings in an era when personal hygiene was not considered important.

Cities began to build hospitals and enforce standards for sanitation.

The devastation of the plague led to advances in medicine.

People were advised to not bathe because open skin pores might let in the disease.

Some Europeans believed the plague was a sign from God. Groups known as flagellants tried to atone for the sins of the world by inflicting punishments upon themselves. The flagellants also had a tendency to persecute Jews and even clergymen who spoke out against them. Eccentric and unusual people were often charged with witchcraft and sorcery. Pope Clement VI condemned the flagellants, but they continued to reappear in times of plague.