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<span>Signs and symptoms</span> </div> </a> <ul id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-First_pandemic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#First_pandemic"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>First pandemic</span> </div> </a> <ul id="toc-First_pandemic-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Second_pandemic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Second_pandemic"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>Second pandemic</span> </div> </a> <ul id="toc-Second_pandemic-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Third_pandemic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Third_pandemic"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3</span> <span>Third pandemic</span> </div> </a> <ul id="toc-Third_pandemic-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Society and culture</span> </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Society and culture subsection</span> </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Biological_warfare" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Biological_warfare"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>Biological warfare</span> </div> </a> <ul id="toc-Biological_warfare-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Continued_research" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Continued_research"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.2</span> <span>Continued research</span> </div> </a> <ul id="toc-Continued_research-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Bubonic plague</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 55 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-55" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">55 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Builepes_in_Suid-Afrika" title="Builepes in Suid-Afrika – Afrikaans" lang="af" hreflang="af" data-title="Builepes in Suid-Afrika" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B7%D8%A7%D8%B9%D9%88%D9%86_%D8%AF%D9%85%D9%84%D9%8A" title="طاعون دملي – Arabic" lang="ar" hreflang="ar" data-title="طاعون دملي" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Peste_bub%C3%B3nica" title="Peste bubónica – Asturian" lang="ast" hreflang="ast" data-title="Peste bubónica" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target"><span>Asturianu</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Bubon_taunu" title="Bubon taunu – Azerbaijani" lang="az" hreflang="az" data-title="Bubon taunu" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A8%D9%88%D8%A8%D9%88%D9%86%DB%8C%DA%A9_%D8%B7%D8%A7%D8%B9%D9%88%D9%86%D9%88" title="بوبونیک طاعونو – South Azerbaijani" lang="azb" hreflang="azb" data-title="بوبونیک طاعونو" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AC%E0%A6%BF%E0%A6%89%E0%A6%AC%E0%A6%A8%E0%A6%BF%E0%A6%95_%E0%A6%AA%E0%A7%8D%E0%A6%B2%E0%A7%87%E0%A6%97" title="বিউবনিক প্লেগ – Bangla" lang="bn" hreflang="bn" data-title="বিউবনিক প্লেগ" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%91%D1%83%D0%B1%D0%BE%D0%BD%D0%BD%D0%B0%D1%8F_%D1%87%D1%83%D0%BC%D0%B0" title="Бубонная чума – Belarusian" lang="be" hreflang="be" data-title="Бубонная чума" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Bosenn_werblus" title="Bosenn werblus – Breton" lang="br" hreflang="br" data-title="Bosenn werblus" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target"><span>Brezhoneg</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Pesta_bub%C3%B2nica" title="Pesta bubònica – Catalan" lang="ca" hreflang="ca" data-title="Pesta bubònica" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/D%C3%BDm%C4%9Bjov%C3%BD_mor" title="Dýmějový mor – Czech" lang="cs" hreflang="cs" data-title="Dýmějový mor" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Pla_biwbonig" title="Pla biwbonig – Welsh" lang="cy" hreflang="cy" data-title="Pla biwbonig" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-de badge-Q70894304 mw-list-item" title=""><a href="https://de.wikipedia.org/wiki/Beulenpest" title="Beulenpest – German" lang="de" hreflang="de" data-title="Beulenpest" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-nv mw-list-item"><a href="https://nv.wikipedia.org/wiki/Dl%C3%B3%C3%B3%CA%BC_binaalniih" title="Dlóóʼ binaalniih – Navajo" lang="nv" hreflang="nv" data-title="Dlóóʼ binaalniih" data-language-autonym="Diné bizaad" data-language-local-name="Navajo" class="interlanguage-link-target"><span>Diné bizaad</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Peste_bub%C3%B3nica" title="Peste bubónica – Spanish" lang="es" hreflang="es" data-title="Peste bubónica" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Bubona_pesto" title="Bubona pesto – Esperanto" lang="eo" hreflang="eo" data-title="Bubona pesto" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Izurri_pneumoniko" title="Izurri pneumoniko – Basque" lang="eu" hreflang="eu" data-title="Izurri pneumoniko" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B7%D8%A7%D8%B9%D9%88%D9%86_%D8%AE%DB%8C%D8%A7%D8%B1%DA%A9%DB%8C" title="طاعون خیارکی – Persian" lang="fa" hreflang="fa" data-title="طاعون خیارکی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Peste_bubonique" title="Peste bubonique – French" lang="fr" hreflang="fr" data-title="Peste bubonique" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Pl%C3%A1_bh%C3%BAb%C3%B3nach" title="Plá bhúbónach – Irish" lang="ga" hreflang="ga" data-title="Plá bhúbónach" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Peste_bub%C3%B3nica" title="Peste bubónica – Galician" lang="gl" hreflang="gl" data-title="Peste bubónica" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B0%80%EB%9E%98%ED%86%B3%ED%8E%98%EC%8A%A4%ED%8A%B8" title="가래톳페스트 – Korean" lang="ko" hreflang="ko" data-title="가래톳페스트" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B2%D5%B8%D6%82%D5%A2%D5%B8%D5%B6%D5%A1%D5%B5%D5%AB%D5%B6_%D5%AA%D5%A1%D5%B6%D5%BF%D5%A1%D5%AD%D5%BF" title="Բուբոնային ժանտախտ – Armenian" lang="hy" hreflang="hy" data-title="Բուբոնային ժանտախտ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Bubonska_kuga" title="Bubonska kuga – Croatian" lang="hr" hreflang="hr" data-title="Bubonska kuga" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Pes_bubo" title="Pes bubo – Indonesian" lang="id" hreflang="id" data-title="Pes bubo" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Peste_bubonic" title="Peste bubonic – Interlingua" lang="ia" hreflang="ia" data-title="Peste bubonic" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target"><span>Interlingua</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/K%C3%BDlapest" title="Kýlapest – Icelandic" lang="is" hreflang="is" data-title="Kýlapest" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it badge-Q70894304 mw-list-item" title=""><a href="https://it.wikipedia.org/wiki/Peste_bubbonica" title="Peste bubbonica – Italian" lang="it" hreflang="it" data-title="Peste bubbonica" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%93%D7%91%D7%A8_%D7%94%D7%91%D7%9C%D7%95%D7%98%D7%95%D7%AA" title="דבר הבלוטות – Hebrew" lang="he" hreflang="he" data-title="דבר הבלוטות" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Pes_bubo" title="Pes bubo – Javanese" lang="jv" hreflang="jv" data-title="Pes bubo" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target"><span>Jawa</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Pestis_bubonica" title="Pestis bubonica – Latin" lang="la" hreflang="la" data-title="Pestis bubonica" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%91%D1%83%D0%B1%D0%BE%D0%BD%D1%81%D0%BA%D0%B0_%D1%87%D1%83%D0%BC%D0%B0" title="Бубонска чума – Macedonian" lang="mk" hreflang="mk" data-title="Бубонска чума" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%AC%E0%B5%8D%E0%B4%AF%E0%B5%82%E0%B4%AC%E0%B5%8B%E0%B4%A3%E0%B4%BF%E0%B4%95%E0%B5%8D_%E0%B4%AA%E0%B5%8D%E0%B4%B2%E0%B5%87%E0%B4%97%E0%B5%8D" title="ബ്യൂബോണിക് പ്ലേഗ് – Malayalam" lang="ml" hreflang="ml" data-title="ബ്യൂബോണിക് പ്ലേഗ്" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D8%B7%D8%A7%D8%B9%D9%88%D9%86_%D8%AF%D8%A8%D9%84%D9%89" title="طاعون دبلى – Egyptian Arabic" lang="arz" hreflang="arz" data-title="طاعون دبلى" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-mn mw-list-item"><a href="https://mn.wikipedia.org/wiki/%D0%A2%D0%B0%D1%80%D0%B2%D0%B0%D0%B3%D0%B0%D0%BD_%D1%82%D0%B0%D1%85%D0%B0%D0%BB" title="Тарваган тахал – Mongolian" lang="mn" hreflang="mn" data-title="Тарваган тахал" data-language-autonym="Монгол" data-language-local-name="Mongolian" class="interlanguage-link-target"><span>Монгол</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Builenpest" title="Builenpest – Dutch" lang="nl" hreflang="nl" data-title="Builenpest" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%85%BA%E3%83%9A%E3%82%B9%E3%83%88" title="腺ペスト – Japanese" lang="ja" hreflang="ja" data-title="腺ペスト" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Byllepest" title="Byllepest – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Byllepest" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Byllepest" title="Byllepest – Norwegian Nynorsk" lang="nn" hreflang="nn" 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mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%91%D1%83%D0%B1%D0%BE%D0%BD%D0%BD%D0%B0%D1%8F_%D1%87%D1%83%D0%BC%D0%B0" title="Бубонная чума – Russian" lang="ru" hreflang="ru" data-title="Бубонная чума" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Murtaja_bubonike" title="Murtaja bubonike – Albanian" lang="sq" hreflang="sq" data-title="Murtaja bubonike" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-scn mw-list-item"><a href="https://scn.wikipedia.org/wiki/Pesti_bubb%C3%B2nica" title="Pesti bubbònica – Sicilian" lang="scn" hreflang="scn" data-title="Pesti bubbònica" data-language-autonym="Sicilianu" data-language-local-name="Sicilian" class="interlanguage-link-target"><span>Sicilianu</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Bubonic_plague" title="Bubonic plague – Simple English" lang="en-simple" hreflang="en-simple" data-title="Bubonic plague" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%91%D1%83%D0%B1%D0%BE%D0%BD%D1%81%D0%BA%D0%B0_%D0%BA%D1%83%D0%B3%D0%B0" title="Бубонска куга – Serbian" lang="sr" hreflang="sr" data-title="Бубонска куга" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Bubonska_kuga" title="Bubonska kuga – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Bubonska kuga" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/B%C3%B6ldpest" title="Böldpest – Swedish" lang="sv" hreflang="sv" data-title="Böldpest" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Bubonik" title="Bubonik – Tagalog" lang="tl" hreflang="tl" data-title="Bubonik" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a 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.hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">This article is about the disease. For information about the medieval plague, see <a href="/wiki/Black_Death" title="Black Death">Black Death</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Bubonic plague</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Plague_-buboes.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Plague_-buboes.jpg/220px-Plague_-buboes.jpg" decoding="async" width="220" height="155" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Plague_-buboes.jpg/330px-Plague_-buboes.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Plague_-buboes.jpg/440px-Plague_-buboes.jpg 2x" data-file-width="2877" data-file-height="2028" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">A <i><a href="/wiki/Bubo" title="Bubo">bubo</a></i> on the upper thigh of a person infected with bubonic plague</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Fever" title="Fever">Fever</a>, <a href="/wiki/Headache" title="Headache">headaches</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Lymphadenopathy" title="Lymphadenopathy">swollen lymph nodes</a><sup id="cite_ref-WHO2014_1-0" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2012Sym_2-0" class="reference"><a href="#cite_note-CDC2012Sym-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data">Gangrene, meningitis<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">1–7 days after exposure<sup id="cite_ref-WHO2014_1-1" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Yersinia pestis</a></i> spread by <a href="/wiki/Fleas" class="mw-redirect" title="Fleas">fleas</a><sup id="cite_ref-WHO2014_1-2" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Finding the bacterium in the blood, <a href="/wiki/Sputum" title="Sputum">sputum</a>, or lymph nodes<sup id="cite_ref-WHO2014_1-3" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Antibiotics such as <a href="/wiki/Streptomycin" title="Streptomycin">streptomycin</a>, <a href="/wiki/Gentamicin" title="Gentamicin">gentamicin</a>, or <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a><sup id="cite_ref-Lancet2007_4-0" class="reference"><a href="#cite_note-Lancet2007-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2012Tx_5-0" class="reference"><a href="#cite_note-CDC2012Tx-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">650 cases reported a year<sup id="cite_ref-WHO2014_1-4" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">10% mortality with treatment<sup id="cite_ref-Lancet2007_4-1" class="reference"><a href="#cite_note-Lancet2007-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><br />30–90% if untreated<sup id="cite_ref-WHO2014_1-5" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Lancet2007_4-2" class="reference"><a href="#cite_note-Lancet2007-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Bubonic plague</b> is one of three types of <a href="/wiki/Plague_(disease)" title="Plague (disease)">plague</a> caused by the <a href="/wiki/Bacteria" title="Bacteria">bacterium</a> <i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Yersinia pestis</a></i>.<sup id="cite_ref-WHO2014_1-6" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> One to seven days after exposure to the bacteria, <a href="/wiki/Flu-like_symptoms" class="mw-redirect" title="Flu-like symptoms">flu-like symptoms</a> develop.<sup id="cite_ref-WHO2014_1-7" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> These symptoms include <a href="/wiki/Fever" title="Fever">fever</a>, <a href="/wiki/Headache" title="Headache">headaches</a>, and <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>,<sup id="cite_ref-WHO2014_1-8" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> as well as <a href="/wiki/Lymphadenopathy" title="Lymphadenopathy">swollen and painful lymph nodes</a> occurring in the area closest to where the bacteria entered the skin.<sup id="cite_ref-CDC2012Sym_2-1" class="reference"><a href="#cite_note-CDC2012Sym-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Acral_necrosis" title="Acral necrosis">Acral necrosis</a>, the dark discoloration of skin, is another symptom. Occasionally, swollen lymph nodes, known as "<a href="/wiki/Bubo" title="Bubo">buboes</a>", may break open.<sup id="cite_ref-WHO2014_1-9" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>The three types of plague are the result of the route of infection: bubonic plague, <a href="/wiki/Septicemic_plague" title="Septicemic plague">septicemic plague</a>, and <a href="/wiki/Pneumonic_plague" title="Pneumonic plague">pneumonic plague</a>.<sup id="cite_ref-WHO2014_1-10" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Bubonic plague is mainly spread by infected <a href="/wiki/Flea" title="Flea">fleas</a> from small <a href="/wiki/Animal" title="Animal">animals</a>.<sup id="cite_ref-WHO2014_1-11" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> It may also result from exposure to the body fluids from a dead plague-infected animal.<sup id="cite_ref-CDC2012Tran_6-0" class="reference"><a href="#cite_note-CDC2012Tran-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Mammals such as <a href="/wiki/Rabbit" title="Rabbit">rabbits</a>, <a href="/wiki/Hare" title="Hare">hares</a>, and some <a href="/wiki/Cat" title="Cat">cat</a> species are susceptible to bubonic plague, and typically die upon contraction.<sup id="cite_ref-:5_7-0" class="reference"><a href="#cite_note-:5-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> In the bubonic form of plague, the bacteria enter through the skin through a flea bite and travel via the <a href="/wiki/Lymphatic_vessels" class="mw-redirect" title="Lymphatic vessels">lymphatic vessels</a> to a <a href="/wiki/Lymph_node" title="Lymph node">lymph node</a>, causing it to swell.<sup id="cite_ref-WHO2014_1-12" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Diagnosis is made by finding the bacteria in the blood, <a href="/wiki/Sputum" title="Sputum">sputum</a>, or fluid from lymph nodes.<sup id="cite_ref-WHO2014_1-13" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>Prevention is through public health measures such as not handling dead animals in areas where plague is common.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WHO2014_1-14" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> While <a href="/wiki/Plague_vaccine" title="Plague vaccine">vaccines against the plague</a> have been developed, the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> recommends that only high-risk groups, such as certain laboratory personnel and health care workers, get inoculated.<sup id="cite_ref-WHO2014_1-15" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Several <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> are effective for treatment, including <a href="/wiki/Streptomycin" title="Streptomycin">streptomycin</a>, <a href="/wiki/Gentamicin" title="Gentamicin">gentamicin</a>, and <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a>.<sup id="cite_ref-Lancet2007_4-3" class="reference"><a href="#cite_note-Lancet2007-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2012Tx_5-1" class="reference"><a href="#cite_note-CDC2012Tx-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Without treatment, plague results in the death of 30% to 90% of those infected.<sup id="cite_ref-WHO2014_1-16" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Lancet2007_4-4" class="reference"><a href="#cite_note-Lancet2007-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Death, if it occurs, is typically within 10 days.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> With treatment, the risk of death is around 10%.<sup id="cite_ref-Lancet2007_4-5" class="reference"><a href="#cite_note-Lancet2007-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Globally between 2010 and 2015 there were 3,248 documented cases, which resulted in 584 deaths.<sup id="cite_ref-WHO2014_1-17" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The countries with the greatest number of cases are the <a href="/wiki/Democratic_Republic_of_the_Congo" title="Democratic Republic of the Congo">Democratic Republic of the Congo</a>, <a href="/wiki/Madagascar" title="Madagascar">Madagascar</a>, and <a href="/wiki/Peru" title="Peru">Peru</a>.<sup id="cite_ref-WHO2014_1-18" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>The plague is considered the likely cause of the <a href="/wiki/Black_Death" title="Black Death">Black Death</a> that <a href="/wiki/Black_Death_migration" title="Black Death migration">swept through Asia, Europe, and Africa</a> in the 14th century and killed an estimated 50 million people,<sup id="cite_ref-WHO2014_1-19" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> including about 25% to 60% of the European population.<sup id="cite_ref-WHO2014_1-20" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2012Hx_11-0" class="reference"><a href="#cite_note-CDC2012Hx-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Because the plague killed so many of the working population, wages rose due to the demand for labor.<sup id="cite_ref-CDC2012Hx_11-1" class="reference"><a href="#cite_note-CDC2012Hx-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Some historians see this as a turning point in <a href="/wiki/Economic_history_of_Europe" class="mw-redirect" title="Economic history of Europe">European economic development</a>.<sup id="cite_ref-CDC2012Hx_11-2" class="reference"><a href="#cite_note-CDC2012Hx-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> The disease is also considered to have been responsible for the <a href="/wiki/Plague_of_Justinian" title="Plague of Justinian">Plague of Justinian</a>, originating in the <a href="/wiki/Eastern_Roman_Empire" class="mw-redirect" title="Eastern Roman Empire">Eastern Roman Empire</a> in the 6th century CE, as well as the <a href="/wiki/Third_plague_pandemic" title="Third plague pandemic">third epidemic</a>, affecting <a href="/wiki/China" title="China">China</a>, <a href="/wiki/Mongolia" title="Mongolia">Mongolia</a>, and <a href="/wiki/India" title="India">India</a>, originating in the <a href="/wiki/Yunnan_Province" class="mw-redirect" title="Yunnan Province">Yunnan Province</a> in 1855.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> The term <i>bubonic</i> is derived from the Greek word <a href="https://en.wiktionary.org/wiki/%CE%B2%CE%BF%CF%85%CE%B2%CF%8E%CE%BD" class="extiw" title="wikt:βουβών">βουβών</a>, meaning <span class="gloss-quot">'</span><span class="gloss-text">groin</span><span class="gloss-quot">'</span>.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Flea_infected_with_yersinia_pestis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Flea_infected_with_yersinia_pestis.jpg/220px-Flea_infected_with_yersinia_pestis.jpg" decoding="async" width="220" height="166" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/c/c1/Flea_infected_with_yersinia_pestis.jpg 1.5x" data-file-width="250" data-file-height="189" /></a><figcaption>An <a href="/wiki/Oriental_rat_flea" title="Oriental rat flea">Oriental rat flea</a> (<i>Xenopsylla cheopis</i>) infected with the plague <a href="/wiki/Bacteria" title="Bacteria">bacterium</a> (<i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Yersinia pestis</a></i>), which appears as a dark mass in the gut. The foregut of this flea is blocked by a <i>Y. pestis</i> <a href="/wiki/Biofilm" title="Biofilm">biofilm</a>; when the flea attempts to feed on an uninfected <a href="/wiki/Host_(biology)" title="Host (biology)">host</a>, <i>Y. pestis</i> from the foregut is <a href="/wiki/Regurgitation_(digestion)" title="Regurgitation (digestion)">regurgitated</a> into the wound, causing <a href="/wiki/Infection" title="Infection">infection</a>.</figcaption></figure> <p>The bubonic plague is an infection of the <a href="/wiki/Lymphatic_system" title="Lymphatic system">lymphatic system</a>, usually resulting from the bite of an infected flea, <i>Xenopsylla cheopis</i> (the <a href="/wiki/Oriental_rat_flea" title="Oriental rat flea">Oriental rat flea</a>).<sup id="cite_ref-:1_14-0" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Several flea species carried the bubonic plague, such as <i>Pulex irritans</i> (the <a href="/wiki/Human_flea" title="Human flea">human flea</a>), <i>Xenopsylla cheopis</i>, and <i>Ceratophyllus fasciatus</i>.<sup id="cite_ref-:1_14-1" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> <i>Xenopsylla cheopis</i> was the most effective flea species for transmission.<sup id="cite_ref-:1_14-2" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>The flea is parasitic on house and field rats and seeks out other prey when its rodent host dies. Rats were an amplifying factor to bubonic plague due to their common association with humans as well as the nature of their blood.<sup id="cite_ref-:0_15-0" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> The rat's blood allows the rat to withstand a major <a href="/wiki/Concentration" title="Concentration">concentration</a> of the plague.<sup id="cite_ref-:0_15-1" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> The bacteria form aggregates in the gut of infected fleas, and this results in the flea regurgitating ingested blood, which is now infected, into the bite site of a rodent or human host. Once established, the bacteria rapidly spread to the <a href="/wiki/Lymph_node" title="Lymph node">lymph nodes</a> of the host and multiply. The fleas that transmit the disease only directly infect humans when the rat population in the area is wiped out from a mass infection.<sup id="cite_ref-:2_16-0" class="reference"><a href="#cite_note-:2-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Furthermore, in areas with a large population of rats, the animals can harbor low levels of the plague infection without causing human outbreaks.<sup id="cite_ref-:0_15-2" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> With no new rat inputs being added to the population from other areas, the infection only spread to humans in very rare cases of overcrowding.<sup id="cite_ref-:0_15-3" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Acral_necrosis_due_to_bubonic_plague.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0a/Acral_necrosis_due_to_bubonic_plague.jpg/220px-Acral_necrosis_due_to_bubonic_plague.jpg" decoding="async" width="220" height="335" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0a/Acral_necrosis_due_to_bubonic_plague.jpg/330px-Acral_necrosis_due_to_bubonic_plague.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/0/0a/Acral_necrosis_due_to_bubonic_plague.jpg 2x" data-file-width="331" data-file-height="504" /></a><figcaption><a href="/wiki/Tissue_necrosis" class="mw-redirect" title="Tissue necrosis">Necrosis</a> of the nose, the lips, and the fingers and residual <a href="/wiki/Ecchymosis" class="mw-redirect" title="Ecchymosis">bruising</a> over both forearms in a person recovering from bubonic plague that disseminated to the blood and the lungs. At one time, the person's entire body was <a href="/wiki/Ecchymotic" class="mw-redirect" title="Ecchymotic">bruised</a>.</figcaption></figure> <p>After being transmitted via the bite of an infected flea, the <i>Y. pestis</i> bacteria become localized in an inflamed <a href="/wiki/Lymph_node" title="Lymph node">lymph node</a>, where they begin to colonize and reproduce. Infected lymph nodes develop hemorrhages, which result in the death of tissue.<sup id="cite_ref-:4_17-0" class="reference"><a href="#cite_note-:4-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> <i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Y. pestis</a></i> <a href="/wiki/Bacilli" title="Bacilli">bacilli</a> can resist phagocytosis and even reproduce inside <a href="/wiki/Phagocyte" title="Phagocyte">phagocytes</a> and kill them. As the disease progresses, the lymph nodes can <a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">hemorrhage</a> and become swollen and <a href="/wiki/Necrosis" title="Necrosis">necrotic</a>. Bubonic plague can progress to lethal <a href="/wiki/Septicemic_plague" title="Septicemic plague">septicemic plague</a> in some cases. The plague is also known to spread to the lungs and become the disease known as the <a href="/wiki/Pneumonic_plague" title="Pneumonic plague">pneumonic plague</a>. Symptoms appear two to seven days after getting bitten and they include:<sup id="cite_ref-:1_14-3" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Chills" title="Chills">Chills</a></li> <li>General ill feeling (<a href="/wiki/Malaise" title="Malaise">malaise</a>)</li> <li>High <a href="/wiki/Fever" title="Fever">fever</a> >39 <a href="/wiki/Celsius" title="Celsius">°C</a> (102.2 <a href="/wiki/Fahrenheit" title="Fahrenheit">°F</a>)</li> <li>Muscle cramps<sup id="cite_ref-:4_17-1" class="reference"><a href="#cite_note-:4-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Seizures" class="mw-redirect" title="Seizures">Seizures</a></li> <li>Smooth, painful lymph gland swelling called a bubo, commonly found in the groin, but may occur in the armpits or neck, most often near the site of the initial infection (bite or scratch)</li> <li>Pain may occur in the area before the swelling appears</li> <li><a href="/wiki/Gangrene" title="Gangrene">Gangrene</a> of the extremities such as toes, fingers, lips, and tip of the nose.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup></li></ul> <p>The best-known symptom of bubonic plague is one or more infected, enlarged, and painful lymph nodes, known as <a href="/wiki/Buboes" class="mw-redirect" title="Buboes">buboes</a>. Buboes associated with the bubonic plague are commonly found in the armpits, upper femoral area, groin, and neck region. These buboes will grow and become more painful over time, often to the point of bursting.<sup id="cite_ref-Bubonic_Plague_2000_19-0" class="reference"><a href="#cite_note-Bubonic_Plague_2000-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Symptoms include heavy breathing, continuous vomiting of blood (<a href="/wiki/Hematemesis" title="Hematemesis">hematemesis</a>), aching limbs, coughing, and extreme pain caused by the decay or decomposition of the skin while the person is still alive. Additional symptoms include extreme fatigue, gastrointestinal problems, spleen inflammation, lenticulae (black dots scattered throughout the body), delirium, <a href="/wiki/Coma" title="Coma">coma</a>, organ failure, and death.<sup id="cite_ref-Echenberg_20-0" class="reference"><a href="#cite_note-Echenberg-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Organ failure is a result of the bacteria infecting organs through the bloodstream.<sup id="cite_ref-:1_14-4" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Other forms of the disease include <a href="/wiki/Septicemic_plague" title="Septicemic plague">septicemic plague</a> and <a href="/wiki/Pneumonic_plague" title="Pneumonic plague">pneumonic plague</a>, in which the bacterium reproduces in the person's blood and lungs respectively.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Yersinia_pestis_HHS.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/eb/Yersinia_pestis_HHS.jpg/208px-Yersinia_pestis_HHS.jpg" decoding="async" width="208" height="202" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/eb/Yersinia_pestis_HHS.jpg/312px-Yersinia_pestis_HHS.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/eb/Yersinia_pestis_HHS.jpg/416px-Yersinia_pestis_HHS.jpg 2x" data-file-width="700" data-file-height="680" /></a><figcaption>Gram-negative <i>Yersinia pestis</i> bacteria. The culture was grown over a 72-hour time period.</figcaption></figure> <p>Laboratory testing is required in order to <a href="/wiki/Medical_diagnosis" title="Medical diagnosis">diagnose</a> and confirm plague. Ideally, confirmation is through the identification of <i>Y. pestis</i> <a href="/wiki/Microbiological_culture" title="Microbiological culture">culture</a> from a patient sample. Confirmation of infection can be done by examining <a href="/wiki/Blood_serum" class="mw-redirect" title="Blood serum">serum</a> taken during the early and late stages of <a href="/wiki/Infection" title="Infection">infection</a>. To quickly screen for the <i>Y. pestis</i> <a href="/wiki/Antigen" title="Antigen">antigen</a> in patients, rapid <a href="/wiki/Dipstick" title="Dipstick">dipstick</a> tests have been developed for field use.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p>Samples taken for testing include:<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Buboes: Swollen lymph nodes (<a href="/wiki/Bubo" title="Bubo">buboes</a>) characteristic of bubonic plague, a fluid sample can be taken from them with a needle.</li> <li>Blood: <a href="/wiki/Blood_culture" title="Blood culture">blood cultures</a> test blood samples for bacteria to find source of infection<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup></li> <li>Lungs: <a href="/wiki/Spirometry" title="Spirometry">Spirometry</a> test are used to screen the lungs for diseases that affect the airways. Chest X-rays of the lungs are also used as an effective method of diagnosis.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2></div> <p>Bubonic plague outbreaks are controlled by pest control and modern sanitation techniques. This disease uses fleas commonly found on rats as a vector to jump from animals to humans. The mortality rate is highest in the summer and early fall.<sup id="cite_ref-Theilmann_26-0" class="reference"><a href="#cite_note-Theilmann-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> The successful control of rat populations in dense urban areas is essential to outbreak prevention. One example is the use of a machine called the <a href="/wiki/Sulfurozador" title="Sulfurozador">Sulfurozador</a>, used to deliver <a href="/wiki/Sulphur_dioxide" class="mw-redirect" title="Sulphur dioxide">sulphur dioxide</a> to eradicate the pest that spread the bubonic plague in Buenos Aires, Argentina during the early 18th century.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Targeted <a href="/wiki/Chemoprophylaxis" title="Chemoprophylaxis">chemoprophylaxis</a>, <a href="/wiki/Sanitation" title="Sanitation">sanitation</a>, and <a href="/wiki/Vector_control" title="Vector control">vector control</a> also played a role in controlling the 2003 <a href="/wiki/Oran" title="Oran">Oran</a> outbreak of the bubonic plague.<sup id="cite_ref-bertherat03_28-0" class="reference"><a href="#cite_note-bertherat03-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Another means of prevention in large European cities was a city-wide quarantine to not only limit interaction with people who were infected, but also to limit the interaction with the infected rats.<sup id="cite_ref-:3_29-0" class="reference"><a href="#cite_note-:3-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2></div> <p>Several classes of <a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">antibiotic</a> are effective in treating bubonic plague. These include <a href="/wiki/Aminoglycoside" title="Aminoglycoside">aminoglycosides</a> such as <a href="/wiki/Streptomycin" title="Streptomycin">streptomycin</a> and <a href="/wiki/Gentamicin" title="Gentamicin">gentamicin</a>, <a href="/wiki/Tetracycline" title="Tetracycline">tetracyclines</a> (especially <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a>), and the <a href="/wiki/Fluoroquinolone" class="mw-redirect" title="Fluoroquinolone">fluoroquinolone</a> <a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">ciprofloxacin</a>. Mortality associated with treated cases of bubonic plague is about 1–15%, compared to a mortality of 40–60% in untreated cases.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>People potentially infected with the plague need immediate treatment and should be given antibiotics within 24 hours of the first symptoms to prevent death. Other treatments include oxygen, intravenous fluids, and respiratory support. People who have had contact with anyone infected by pneumonic plague are given prophylactic antibiotics.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Using the broad-based antibiotic streptomycin has proven to be dramatically successful against the bubonic plague within 12 hours of infection.<sup id="cite_ref-autogenerated2002_32-0" class="reference"><a href="#cite_note-autogenerated2002-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Epidemiology_of_plague" class="mw-redirect" title="Epidemiology of plague">Epidemiology of plague</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:World_distribution_of_plague_1998.PNG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6b/World_distribution_of_plague_1998.PNG/310px-World_distribution_of_plague_1998.PNG" decoding="async" width="310" height="208" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6b/World_distribution_of_plague_1998.PNG/465px-World_distribution_of_plague_1998.PNG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6b/World_distribution_of_plague_1998.PNG/620px-World_distribution_of_plague_1998.PNG 2x" data-file-width="700" data-file-height="469" /></a><figcaption>Distribution of plague-infected animals, 1998</figcaption></figure> <p>Globally between 2010 and 2015, there were 3,248 documented cases, which resulted in 584 deaths.<sup id="cite_ref-WHO2014_1-21" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The countries with the greatest number of cases are the <a href="/wiki/Democratic_Republic_of_the_Congo" title="Democratic Republic of the Congo">Democratic Republic of the Congo</a>, <a href="/wiki/Madagascar" title="Madagascar">Madagascar</a>, and <a href="/wiki/Peru" title="Peru">Peru</a>.<sup id="cite_ref-WHO2014_1-22" class="reference"><a href="#cite_note-WHO2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>For over a decade since 2001, Zambia, India, Malawi, Algeria, China, Peru, and the Democratic Republic of the Congo had the most plague cases, with over 1,100 cases in the Democratic Republic of the Congo alone. From 1,000 to 2,000 cases are conservatively reported per year to the <a href="/wiki/World_Health_Organization" title="World Health Organization">WHO</a>.<sup id="cite_ref-Avoiding_the_Black_Plague_Today_33-0" class="reference"><a href="#cite_note-Avoiding_the_Black_Plague_Today-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> From 2012 to 2017, reflecting political unrest and poor hygienic conditions, Madagascar began to host regular epidemics.<sup id="cite_ref-Avoiding_the_Black_Plague_Today_33-1" class="reference"><a href="#cite_note-Avoiding_the_Black_Plague_Today-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p><p>Between 1900 and 2015, the United States had 1,036 human plague cases, with an average of 9 cases per year. In 2015, 16 people in the western United States developed plague, including 2 cases in <a href="/wiki/Yosemite_National_Park" title="Yosemite National Park">Yosemite National Park</a>.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> These US cases usually occur in rural northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon, and far western Nevada.<sup id="cite_ref-CDC_map_35-0" class="reference"><a href="#cite_note-CDC_map-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>In November 2017, the Madagascar Ministry of Health reported <a href="/wiki/2017_Madagascar_plague_outbreak" class="mw-redirect" title="2017 Madagascar plague outbreak">an outbreak</a> to the WHO (World Health Organization) with more cases and deaths than any recent outbreak in the country. Unusually, most of the cases were <a href="/wiki/Pneumonic_plague" title="Pneumonic plague">pneumonic</a> rather than bubonic.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>In June 2018, a child was confirmed to be the first person in <a href="/wiki/Idaho" title="Idaho">Idaho</a> to be infected by bubonic plague in nearly 30 years.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>A couple died in May 2019, in Mongolia, while hunting <a href="/wiki/Marmot" title="Marmot">marmots</a>.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Another two people in the province of Inner Mongolia, China, were treated in November 2019 for the disease.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Bubonic_plague-uk.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Bubonic_plague-uk.svg/220px-Bubonic_plague-uk.svg.png" decoding="async" width="220" height="250" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Bubonic_plague-uk.svg/330px-Bubonic_plague-uk.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Bubonic_plague-uk.svg/440px-Bubonic_plague-uk.svg.png 2x" data-file-width="696" data-file-height="790" /></a><figcaption>Spread of bubonic plague through time in Europe (2nd pandemic)</figcaption></figure> <p>In July 2020, in <a href="/wiki/Bayannur" title="Bayannur">Bayannur</a>, <a href="/wiki/Inner_Mongolia" title="Inner Mongolia">Inner Mongolia</a> of China, a human case of bubonic plague was reported. Officials responded by activating a city-wide plague-prevention system for the remainder of the year.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> Also in July 2020, in Mongolia, a teenager died from bubonic plague after consuming infected marmot meat.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2></div> <p><i>Yersinia pestis</i> has been discovered in archaeological finds from the Late Bronze Age (~3800 <a href="/wiki/YBP" class="mw-redirect" title="YBP">BP</a>).<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> The bacteria is identified by ancient DNA in human teeth from Asia and Europe dating from 2,800 to 5,000 years ago.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Some authors have suggested that the plague was responsible for the <a href="/wiki/Neolithic_decline" title="Neolithic decline">Neolithic decline</a>.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="First_pandemic">First pandemic</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/First_plague_pandemic" title="First plague pandemic">First plague pandemic</a> and <a href="/wiki/Plague_of_Justinian" title="Plague of Justinian">Plague of Justinian</a></div> <p>The first recorded epidemic affected the <a href="/wiki/Sasanian_Empire" title="Sasanian Empire">Sasanian Empire</a> and their arch-rivals, the <a href="/wiki/Byzantine_Empire" title="Byzantine Empire">Eastern Roman Empire (Byzantine Empire)</a> and was named the <a href="/wiki/Plague_of_Justinian" title="Plague of Justinian">Plague of Justinian</a> (541–549 AD) after emperor <a href="/wiki/Justinian_I" title="Justinian I">Justinian I</a>, who was infected but survived through extensive treatment.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> The pandemic resulted in the deaths of an estimated 25 million (6th century outbreak) to 50 million people (two centuries of recurrence).<sup id="cite_ref-Rosen_47-0" class="reference"><a href="#cite_note-Rosen-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-autogenerated1_48-0" class="reference"><a href="#cite_note-autogenerated1-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> The historian <a href="/wiki/Procopius" title="Procopius">Procopius</a> wrote, in Volume II of <i>History of the Wars</i>, of his personal encounter with the plague and the effect it had on the rising empire. </p><p>In the spring of 542, the plague arrived in Constantinople, working its way from port city to port city and spreading around the <a href="/wiki/Mediterranean_Sea" title="Mediterranean Sea">Mediterranean Sea</a>, later migrating inland eastward into Asia Minor and west into Greece and Italy. The Plague of Justinian is said to have been "completed" in the middle of the 8th century.<sup id="cite_ref-:0_15-4" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Because the infectious disease spread inland by the transferring of merchandise through Justinian's efforts in acquiring luxurious goods of the time and exporting supplies, his capital became the leading exporter of the bubonic plague. Procopius, in his work <i>Secret History</i>, declared that Justinian was a demon of an emperor who either created the plague himself or was being punished for his sinfulness.<sup id="cite_ref-autogenerated1_48-1" class="reference"><a href="#cite_note-autogenerated1-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Second_pandemic">Second pandemic</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Black_Death" title="Black Death">Black Death</a> and <a href="/wiki/Second_plague_pandemic" title="Second plague pandemic">Second plague pandemic</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Doutielt3.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/55/Doutielt3.jpg/220px-Doutielt3.jpg" decoding="async" width="220" height="132" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/55/Doutielt3.jpg/330px-Doutielt3.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/55/Doutielt3.jpg/440px-Doutielt3.jpg 2x" data-file-width="801" data-file-height="482" /></a><figcaption>Citizens of <a href="/wiki/Tournai" title="Tournai">Tournai</a> bury plague victims. Miniature from <i>The Chronicles of <a href="/wiki/Gilles_Li_Muisis" title="Gilles Li Muisis">Gilles Li Muisis</a></i> (1272–1352). Bibliothèque royale de Belgique, MS 13076–77, f. 24v.</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Bubonic_plague_victims-mass_grave_in_Martigues,_France_1720-1721.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Bubonic_plague_victims-mass_grave_in_Martigues%2C_France_1720-1721.jpg/290px-Bubonic_plague_victims-mass_grave_in_Martigues%2C_France_1720-1721.jpg" decoding="async" width="290" height="216" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Bubonic_plague_victims-mass_grave_in_Martigues%2C_France_1720-1721.jpg/435px-Bubonic_plague_victims-mass_grave_in_Martigues%2C_France_1720-1721.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Bubonic_plague_victims-mass_grave_in_Martigues%2C_France_1720-1721.jpg/580px-Bubonic_plague_victims-mass_grave_in_Martigues%2C_France_1720-1721.jpg 2x" data-file-width="600" data-file-height="447" /></a><figcaption>People who died of bubonic plague in a <a href="/wiki/Mass_grave" title="Mass grave">mass grave</a> from 1720 to 1721 in <a href="/wiki/Martigues" title="Martigues">Martigues</a>, France</figcaption></figure> <p>Medieval society's increasing population was put to deadly halt when, in the <a href="/wiki/Late_Middle_Ages" title="Late Middle Ages">Late Middle Ages</a>, Europe experienced the deadliest disease outbreak in history. They called it the Great Dying or The Great Pestilence, later coined The Black Death.<sup id="cite_ref-Bubonic_Plague_2000_19-1" class="reference"><a href="#cite_note-Bubonic_Plague_2000-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Lasting in potency for roughly six years, 1346–1352, the Black Death claimed one-third of the European human population, with mortality rates as high as 70%–80%.<sup id="cite_ref-Bubonic_Plague_2000_19-2" class="reference"><a href="#cite_note-Bubonic_Plague_2000-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Some historians believe that society subsequently became more violent as the mass mortality rate cheapened life and thus increased warfare, crime, popular revolt, waves of <a href="/wiki/Flagellant" title="Flagellant">flagellants</a>, and persecution.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> The Black Death originated in Central Asia and spread from Italy and then throughout other European countries. Arab historians Ibn Al-Wardni and Almaqrizi believed the Black Death originated in Mongolia. Chinese records also show a huge outbreak in <a href="/wiki/Yuan_Mongolia" class="mw-redirect" title="Yuan Mongolia">Mongolia</a> in the early 1330s.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p><p>In 2022, researchers presented evidence that the plague originated near Lake <a href="/wiki/Issyk-Kul" title="Issyk-Kul">Issyk-Kul</a> in <a href="/wiki/Kyrgyzstan" title="Kyrgyzstan">Kyrgyzstan</a>.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> The Mongols had cut the trade route (the <a href="/wiki/Silk_Road" title="Silk Road">Silk Road</a>) between China and Europe, which halted the spread of the Black Death from eastern Russia to Western Europe. The European epidemic may have begun with the <a href="/wiki/Siege_of_Caffa" title="Siege of Caffa">siege of Caffa</a>, an attack that <a href="/wiki/Mongol" class="mw-redirect" title="Mongol">Mongols</a> launched on the Italian merchants' last trading station in the region, <a href="/wiki/Caffa" class="mw-redirect" title="Caffa">Caffa</a>, in the <a href="/wiki/Crimean_Peninsula" class="mw-redirect" title="Crimean Peninsula">Crimea</a>.<sup id="cite_ref-autogenerated2002_32-1" class="reference"><a href="#cite_note-autogenerated2002-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>In late 1346, plague broke out among the <a href="/wiki/Siege" title="Siege">besiegers</a> and from them penetrated the town. The Mongol forces catapulted plague-infested corpses into Caffa as a form of attack, one of the first known instances of <a href="/wiki/Biological_warfare" title="Biological warfare">biological warfare</a>.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> When spring arrived, the Italian merchants fled on their ships, unknowingly carrying the Black Death. Carried by the fleas on rats, the plague initially spread to humans near the Black Sea and then outwards to the rest of Europe as a result of people fleeing from one area to another. Rats migrated with humans, traveling among grain bags, clothing, ships, wagons, and grain husks.<sup id="cite_ref-Echenberg_20-1" class="reference"><a href="#cite_note-Echenberg-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Continued research indicates that <a href="/wiki/Black_rat" title="Black rat">black rats</a>, those that primarily transmitted the disease, prefer grain as a primary meal.<sup id="cite_ref-:0_15-5" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Due to this, the major bulk grain fleets that transported major city's food shipments from Africa and <a href="/wiki/Alexandria" title="Alexandria">Alexandria</a> to heavily populated areas, and were then unloaded by hand, played a role in increasing the transmission effectiveness of the plague.<sup id="cite_ref-:0_15-6" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Third_pandemic">Third pandemic</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Third_plague_pandemic" title="Third plague pandemic">Third plague pandemic</a></div> <p>The plague resurfaced for a third time in the mid-19th century; this is also known as "the modern pandemic". Like the two previous outbreaks, this one also originated in <a href="/wiki/Eastern_Asia" class="mw-redirect" title="Eastern Asia">Eastern Asia</a>, most likely in <a href="/wiki/Yunnan" title="Yunnan">Yunnan</a>, a province of China, where there are several <a href="/wiki/Natural_reservoir" title="Natural reservoir">natural plague foci</a>.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> The initial <a href="/wiki/Third_plague_pandemic" title="Third plague pandemic">outbreaks</a> occurred in the second half of the 18th century.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> The disease remained localized in <a href="/wiki/Southwest_China" class="mw-redirect" title="Southwest China">Southwest China</a> for several years before spreading. In the city of <a href="/wiki/Guangzhou" title="Guangzhou">Canton</a>, beginning in January 1894, the disease had killed 80,000 people by June. Daily water traffic with the nearby city of <a href="/wiki/Hong_Kong" title="Hong Kong">Hong Kong</a> rapidly spread the plague there, killing over 2,400 within two months during the <a href="/wiki/1894_Hong_Kong_plague" title="1894 Hong Kong plague">1894 Hong Kong plague</a>.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> </p><p>The third pandemic spread the disease to port cities throughout the world in the second half of the 19th century and the early 20th century via shipping routes.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> The plague infected people in <a href="/wiki/Chinatown,_San_Francisco#Bubonic_plague" title="Chinatown, San Francisco">Chinatown in San Francisco</a> from 1900 to 1904,<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> and in the nearby locales of <a href="/wiki/Oakland,_California" title="Oakland, California">Oakland</a> and the <a href="/wiki/East_Bay" title="East Bay">East Bay</a> again from 1907 to 1909.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> During the former outbreak, in 1902, authorities made permanent the <a href="/wiki/Chinese_Exclusion_Act" title="Chinese Exclusion Act">Chinese Exclusion Act</a>, a law originally signed into existence by President <a href="/wiki/Chester_A._Arthur" title="Chester A. Arthur">Chester A. Arthur</a> in 1882. The Act was supposed to last for 10 years, but was renewed in 1892 with the <a href="/wiki/Geary_Act" title="Geary Act">Geary Act</a>, then followed by the 1902 decision. The last major outbreak in the United States occurred in Los Angeles in 1924,<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> though the disease is still present in wild rodents and can be passed to humans who come in contact with them.<sup id="cite_ref-CDC_map_35-1" class="reference"><a href="#cite_note-CDC_map-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> According to the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a>, the pandemic was considered active until 1959, when worldwide casualties dropped to 200 per year. In 1994, a <a href="/wiki/1994_plague_in_India" title="1994 plague in India">plague outbreak in five Indian states</a> caused an estimated 700 infections (including 52 deaths) and triggered a large migration of Indians within India as they tried to avoid the disease.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2021)">citation needed</span></a></i>]</sup> </p><p>It was during the 1894 Hong Kong plague outbreak that <a href="/wiki/Alexandre_Yersin" title="Alexandre Yersin">Alexandre Yersin</a> isolated the bacterium responsible (<i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Yersinia pestis</a></i>),<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> a few days after Japanese bacteriologist <a href="/wiki/Kitasato_Shibasabur%C5%8D" title="Kitasato Shibasaburō">Kitasato Shibasaburō</a> had isolated it.<sup id="cite_ref-FOOTNOTEPryor197566_62-0" class="reference"><a href="#cite_note-FOOTNOTEPryor197566-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FOOTNOTEHKMSSS200635–36_63-0" class="reference"><a href="#cite_note-FOOTNOTEHKMSSS200635–36-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> However, the latter's description was imprecise and also expressed doubts of its relation to the disease, and thus the bacterium is today only named after Yersin.<sup id="cite_ref-FOOTNOTEHKMSSS200635–36_63-1" class="reference"><a href="#cite_note-FOOTNOTEHKMSSS200635–36-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Black_Death_in_medieval_culture" title="Black Death in medieval culture">Black Death in medieval culture</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Marseille-peste-Serre.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/58/Marseille-peste-Serre.jpg/220px-Marseille-peste-Serre.jpg" decoding="async" width="220" height="170" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/58/Marseille-peste-Serre.jpg/330px-Marseille-peste-Serre.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/58/Marseille-peste-Serre.jpg/440px-Marseille-peste-Serre.jpg 2x" data-file-width="1419" data-file-height="1097" /></a><figcaption>Contemporary engraving of <a href="/wiki/Marseille" title="Marseille">Marseille</a> during the <a href="/wiki/Great_Plague_of_Marseille" title="Great Plague of Marseille">Great Plague</a> in 1720</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Paul_F%C3%BCrst,_Der_Doctor_Schnabel_von_Rom_(Holl%C3%A4nder_version).png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/57/Paul_F%C3%BCrst%2C_Der_Doctor_Schnabel_von_Rom_%28Holl%C3%A4nder_version%29.png/170px-Paul_F%C3%BCrst%2C_Der_Doctor_Schnabel_von_Rom_%28Holl%C3%A4nder_version%29.png" decoding="async" width="170" height="234" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/57/Paul_F%C3%BCrst%2C_Der_Doctor_Schnabel_von_Rom_%28Holl%C3%A4nder_version%29.png/255px-Paul_F%C3%BCrst%2C_Der_Doctor_Schnabel_von_Rom_%28Holl%C3%A4nder_version%29.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/57/Paul_F%C3%BCrst%2C_Der_Doctor_Schnabel_von_Rom_%28Holl%C3%A4nder_version%29.png/340px-Paul_F%C3%BCrst%2C_Der_Doctor_Schnabel_von_Rom_%28Holl%C3%A4nder_version%29.png 2x" data-file-width="1641" data-file-height="2260" /></a><figcaption>Copper <a href="/wiki/Engraving" title="Engraving">engraving</a> of a <a href="/wiki/Plague_doctor" title="Plague doctor">plague doctor</a> from the 17th century. This is one of the most well-known representations in art of the bubonic plague</figcaption></figure> <p>The scale of death and social upheaval associated with plague outbreaks has made the topic prominent in many historical and fictional accounts since the disease was first recognized. The <a href="/wiki/Black_Death" title="Black Death">Black Death</a> in particular is described and referenced in <a href="/wiki/Black_Death_in_medieval_culture" title="Black Death in medieval culture">numerous contemporary sources</a>, some of which, including works by <a href="/wiki/Geoffrey_Chaucer" title="Geoffrey Chaucer">Chaucer</a>, <a href="/wiki/Giovanni_Boccaccio" title="Giovanni Boccaccio">Boccaccio</a>, and <a href="/wiki/Petrarch" title="Petrarch">Petrarch</a>, are considered part of the <a href="/wiki/Western_canon" title="Western canon">Western canon</a>. <i><a href="/wiki/The_Decameron" title="The Decameron">The Decameron</a></i>, by Boccaccio, is notable for its use of a <a href="/wiki/Frame_story" title="Frame story">frame story</a> involving individuals who have fled Florence for a secluded villa to escape the Black Death. First-person, sometimes sensationalized or fictionalized, accounts of living through plague years have also been popular across centuries and cultures. For example, <a href="/wiki/Samuel_Pepys" title="Samuel Pepys">Samuel Pepys</a>'s diary makes several references to his first-hand experiences of the <a href="/wiki/Great_Plague_of_London" title="Great Plague of London">Great Plague of London</a> in 1665–66.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p><p>Later works, such as <a href="/wiki/Albert_Camus" title="Albert Camus">Albert Camus</a>'s novel <i><a href="/wiki/The_Plague_(novel)" title="The Plague (novel)">The Plague</a></i> or <a href="/wiki/Ingmar_Bergman" title="Ingmar Bergman">Ingmar Bergman</a>'s film <i><a href="/wiki/The_Seventh_Seal" title="The Seventh Seal">The Seventh Seal</a></i> have used bubonic plague in settings, such as quarantined cities in either medieval or modern times, as a backdrop to explore themes including the breakdown of society, institutions, and individuals during the plague; the cultural and psychological <a href="/wiki/Existentialism" title="Existentialism">existential</a> confrontation with mortality; and the plague as an allegory raising contemporary moral or spiritual questions.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Biological_warfare">Biological warfare</h3></div> <p>Some of the earliest instances of biological warfare were said to have been products of the plague, as armies of the 14th century were recorded catapulting diseased corpses over the walls of towns and villages to spread the pestilence. This was done by <a href="/wiki/Jani_Beg" title="Jani Beg">Jani Beg</a> when he attacked the city of <a href="/wiki/Feodosiya" class="mw-redirect" title="Feodosiya">Kaffa</a> in 1343.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> </p><p>Later, plague was used during the <a href="/wiki/Second_Sino-Japanese_War" title="Second Sino-Japanese War">Second Sino-Japanese War</a> as a <a href="/wiki/Bacteriological_warfare" class="mw-redirect" title="Bacteriological warfare">bacteriological weapon</a> by the <a href="/wiki/Imperial_Japanese_Army" title="Imperial Japanese Army">Imperial Japanese Army</a>. These weapons were provided by <a href="/wiki/Shir%C5%8D_Ishii" title="Shirō Ishii">Shirō Ishii</a>'s <a href="/wiki/Unit_731" title="Unit 731">units</a> and used in experiments on humans before being used in the field. For example, in 1940, the <a href="/wiki/Imperial_Japanese_Army_Air_Service" title="Imperial Japanese Army Air Service">Imperial Japanese Army Air Service</a> bombed <a href="/wiki/Ningbo" title="Ningbo">Ningbo</a> with fleas carrying the bubonic plague.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> During the <a href="/wiki/Khabarovsk_War_Crime_Trials" class="mw-redirect" title="Khabarovsk War Crime Trials">Khabarovsk War Crime Trials</a>, the accused, such as Major General Kiyoshi Kawashima, testified that, in 1941, 40 members of <a href="/wiki/Unit_731" title="Unit 731">Unit 731</a> air-dropped <a href="/wiki/Plague_(disease)" title="Plague (disease)">plague</a>-contaminated fleas on <a href="/wiki/Changde" title="Changde">Changde</a>. These operations caused epidemic plague outbreaks.<sup id="cite_ref-:3_29-1" class="reference"><a href="#cite_note-:3-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Continued_research">Continued research</h3></div> <p>Substantial research has been done regarding the origin of the plague and how it traveled through the continent.<sup id="cite_ref-:0_15-7" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Mitochondrial_DNA" title="Mitochondrial DNA">Mitochondrial DNA</a> of modern rats in Western Europe indicated that these rats came from two different areas, one being Africa and the other unclear.<sup id="cite_ref-:0_15-8" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> The research regarding this pandemic has greatly increased with technology.<sup id="cite_ref-:0_15-9" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Through archaeo-molecular investigation, researchers have discovered the DNA of plague bacillus in the dental core of those that fell ill to the plague.<sup id="cite_ref-:0_15-10" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Analysis of teeth of the deceased allows researchers to further understand both the demographics and mortuary patterns of the disease. For example, in 2013 in England, archeologists uncovered a burial mound to reveal 17 bodies, mainly children, who had died of the Bubonic plague. They analyzed these burial remains using <a href="/wiki/Radiocarbon_dating" title="Radiocarbon dating">radiocarbon dating</a> to determine they were from the 1530s, and dental core analysis revealed the presence of Yersinia pestis.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p><p>Other evidence for rats that are currently still being researched consists of gnaw marks on bones, predator <a href="/wiki/Pellets_(petrology)" title="Pellets (petrology)">pellets</a> and rat remains that were preserved in <a href="/wiki/In_situ" title="In situ">situ</a>.<sup id="cite_ref-:0_15-11" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> This research allows individuals to trace early rat remains to track the path traveled and in turn connect the impact of the Bubonic Plague to specific breeds of rats.<sup id="cite_ref-:0_15-12" class="reference"><a href="#cite_note-:0-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Burial sites, known as plague pits, offer archaeologists an opportunity to study the remains of people who died from the plague.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p><p>Another research study indicates that these separate pandemics were all interconnected.<sup id="cite_ref-:2_16-1" class="reference"><a href="#cite_note-:2-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> A current computer model indicates that the disease did not go away in between these pandemics.<sup id="cite_ref-:2_16-2" class="reference"><a href="#cite_note-:2-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> It rather lurked within the rat population for years without causing human epidemics.<sup id="cite_ref-:2_16-3" class="reference"><a href="#cite_note-:2-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2></div> <ul><li><a href="/wiki/List_of_cutaneous_conditions" class="mw-redirect" title="List of cutaneous conditions">List of cutaneous conditions</a></li> <li><a href="/wiki/List_of_epidemics" class="mw-redirect" title="List of epidemics">List of epidemics</a></li> <li><a href="/wiki/Miasma_theory" title="Miasma theory">Miasma theory</a></li> <li><a href="/wiki/Plague_(disease)" title="Plague (disease)">Plague (disease)</a></li> <li><a href="/wiki/Plague_doctor" title="Plague doctor">Plague doctor</a></li> <li><a href="/wiki/Hidradenitis_suppurativa" title="Hidradenitis suppurativa">Hidradenitis suppurativa</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol 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center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFWorld_Health_Organization2014" class="citation web cs1">World Health Organization (November 2014). <a rel="nofollow" class="external text" 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Dordrecht: Springer Netherlands. p. 390. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-9400710092" title="Special:BookSources/978-9400710092"><bdi>978-9400710092</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230114153348/https://books.google.com/books?id=61vuCAAAQBAJ&pg=PA390">Archived</a> from the original on 14 January 2023<span class="reference-accessdate">. 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</li> <li id="cite_note-52"><span class="mw-cite-backlink"><b><a href="#cite_ref-52">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWheelis2002" class="citation journal cs1">Wheelis M (2002). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732530">"Biological Warfare at the 1346 Siege of Caffa"</a>. <i><a href="/wiki/Emerging_Infectious_Diseases_(journal)" class="mw-redirect" title="Emerging Infectious Diseases (journal)">Emerging Infectious Diseases</a></i>. <b>8</b> (9): 971–975. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.3201%2Feid0809.010536">10.3201/eid0809.010536</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732530">2732530</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12194776">12194776</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Emerging+Infectious+Diseases&rft.atitle=Biological+Warfare+at+the+1346+Siege+of+Caffa&rft.volume=8&rft.issue=9&rft.pages=971-975&rft.date=2002&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2732530%23id-name%3DPMC&rft_id=info%3Apmid%2F12194776&rft_id=info%3Adoi%2F10.3201%2Feid0809.010536&rft.aulast=Wheelis&rft.aufirst=Mark&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2732530&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> <li id="cite_note-53"><span class="mw-cite-backlink"><b><a href="#cite_ref-53">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNicholas_Wade2010" class="citation news cs1"><a href="/wiki/Nicholas_Wade" title="Nicholas Wade">Nicholas Wade</a> (31 October 2010). <a rel="nofollow" class="external text" href="https://www.nytimes.com/2010/11/01/health/01plague.html">"Europe's Plagues Came From China, Study Finds"</a>. <i><a href="/wiki/The_New_York_Times" title="The New York Times">The New York Times</a></i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20101104083917/http://www.nytimes.com/2010/11/01/health/01plague.html">Archived</a> from the original on 4 November 2010<span class="reference-accessdate">. Retrieved <span class="nowrap">1 November</span> 2010</span>. <q>The great waves of plague that twice devastated Europe and changed the course of history had their origins in China, a team of medical geneticists reported Sunday, as did a third plague outbreak that struck less harmfully in the 19th century.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+York+Times&rft.atitle=Europe%27s+Plagues+Came+From+China%2C+Study+Finds&rft.date=2010-10-31&rft.au=Nicholas+Wade&rft_id=https%3A%2F%2Fwww.nytimes.com%2F2010%2F11%2F01%2Fhealth%2F01plague.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> <li id="cite_note-54"><span class="mw-cite-backlink"><b><a href="#cite_ref-54">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBenedict,_Carol1996" class="citation journal cs1">Benedict, Carol (1996). <a rel="nofollow" class="external text" href="https://archive.org/details/bubonicplagueinn00bene">"Bubonic plague in nineteenth-century China"</a>. <i>Modern China</i>. <b>14</b> (2). Stanford, Calif.: Stanford Univ. 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Retrieved <span class="nowrap">2 June</span> 2014</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+Hong+Kong+Branch+of+the+Royal+Asiatic+Society&rft.atitle=The+great+plague+of+Hong+Kong&rft.volume=15&rft.pages=61-70&rft.date=1975&rft_id=info%3Apmid%2F11614750&rft.aulast=Pryor&rft.aufirst=EG&rft_id=http%3A%2F%2Fhkjo.lib.hku.hk%2Farchive%2Ffiles%2F45de276ec2338bbab18a7bbb35a4d1de.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> <li id="cite_note-57"><span class="mw-cite-backlink"><b><a href="#cite_ref-57">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/plague/history/index.html">"History | Plague | CDC"</a>. <i>www.cdc.gov</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150821062557/http://www.cdc.gov/plague/history/index.html">Archived</a> from the original on 21 August 2015<span class="reference-accessdate">. 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Retrieved <span class="nowrap">31 August</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Samuel+Pepys+Diary&rft.atitle=Samuel+Pepys+Diary+%E2%80%93+Plague+extracts&rft.aulast=Pepys&rft.aufirst=S&rft_id=http%3A%2F%2Fwww.pepys.info%2F1665%2Fplague.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> <li id="cite_note-66"><span class="mw-cite-backlink"><b><a href="#cite_ref-66">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.britannica.com/event/Black-Death/Cause-and-outbreak">"Black Death –Origin and spread of the plague in Europe"</a>. <i>www.britannica.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">10 October</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.britannica.com&rft.atitle=Black+Death+%E2%80%93Origin+and+spread+of+the+plague+in+Europe&rft_id=https%3A%2F%2Fwww.britannica.com%2Fevent%2FBlack-Death%2FCause-and-outbreak&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> <li id="cite_note-67"><span class="mw-cite-backlink"><b><a href="#cite_ref-67">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20110912142325/http://www.independent.co.uk/news/world/asia/japan-triggered-bubonic-plague-outbreak-doctor-claims-704147.html">"Japan triggered bubonic plague outbreak, doctor claims - Asia, World - the Independent"</a>. <i>The Independent</i>. Archived from <a rel="nofollow" class="external text" href="https://www.independent.co.uk/news/world/asia/japan-triggered-bubonic-plague-outbreak-doctor-claims-704147.html">the original</a> on 12 September 2011.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=The+Independent&rft.atitle=Japan+triggered+bubonic+plague+outbreak%2C+doctor+claims+-+Asia%2C+World+-+the+Independent&rft_id=https%3A%2F%2Fwww.independent.co.uk%2Fnews%2Fworld%2Fasia%2Fjapan-triggered-bubonic-plague-outbreak-doctor-claims-704147.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span><sup class="noprint Inline-Template"><span style="white-space: nowrap;">[<i><a href="/wiki/Wikipedia:Link_rot" title="Wikipedia:Link rot"><span title=" Dead link tagged August 2023">dead link</span></a></i><span style="visibility:hidden; color:transparent; padding-left:2px">‍</span>]</span></sup></span> </li> <li id="cite_note-68"><span class="mw-cite-backlink"><b><a href="#cite_ref-68">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPinkowski2020" class="citation web cs1">Pinkowski J (18 February 2020). <a rel="nofollow" class="external text" href="https://www.nationalgeographic.com/history/article/black-death-discovery-rare-look-plague">"Black Death discovery offers rare new look at plague catastrophe"</a>. <i>National Geographic</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210507012653/https://www.nationalgeographic.com/history/article/black-death-discovery-rare-look-plague">Archived</a> from the original on 7 May 2021<span class="reference-accessdate">. Retrieved <span class="nowrap">5 December</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=National+Geographic&rft.atitle=Black+Death+discovery+offers+rare+new+look+at+plague+catastrophe&rft.date=2020-02-18&rft.aulast=Pinkowski&rft.aufirst=J&rft_id=https%3A%2F%2Fwww.nationalgeographic.com%2Fhistory%2Farticle%2Fblack-death-discovery-rare-look-plague&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> <li id="cite_note-69"><span class="mw-cite-backlink"><b><a href="#cite_ref-69">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAntoine2008" class="citation journal cs1">Antoine D (2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632866">"The archaeology of "plague"<span class="cs1-kern-right"></span>"</a>. <i>Medical History. Supplement</i>. <b>52</b> (27): 101–114. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1017%2FS0025727300072112">10.1017/S0025727300072112</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632866">2632866</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18575084">18575084</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medical+History.+Supplement&rft.atitle=The+archaeology+of+%22plague%22&rft.volume=52&rft.issue=27&rft.pages=101-114&rft.date=2008&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2632866%23id-name%3DPMC&rft_id=info%3Apmid%2F18575084&rft_id=info%3Adoi%2F10.1017%2FS0025727300072112&rft.aulast=Antoine&rft.aufirst=D&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2632866&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Alexander JT (2003) [First published 1980]. <i>Bubonic Plague in Early Modern Russia: Public Health and Urban Disaster</i>. Oxford, UK; New York: Oxford University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-19-515818-2" title="Special:BookSources/978-0-19-515818-2"><bdi>978-0-19-515818-2</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/50253204">50253204</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Bubonic+Plague+in+Early+Modern+Russia%3A+Public+Health+and+Urban+Disaster&rft.place=Oxford%2C+UK%3B+New+York&rft.pub=Oxford+University+Press&rft.date=2003&rft_id=info%3Aoclcnum%2F50253204&rft.isbn=978-0-19-515818-2&rft.aulast=Alexander&rft.aufirst=JT&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Batten-Hill D (2011). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130520124056/http://tsoy.co.uk/"><i>This Son of York</i></a>. Kendal, England: David Batten-Hill. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-78176-094-9" title="Special:BookSources/978-1-78176-094-9"><bdi>978-1-78176-094-9</bdi></a>. Archived from <a rel="nofollow" class="external text" href="http://www.tsoy.co.uk">the original</a> on 20 May 2013<span class="reference-accessdate">. Retrieved <span class="nowrap">27 August</span> 2018</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=This+Son+of+York&rft.place=Kendal%2C+England&rft.pub=David+Batten-Hill&rft.date=2011&rft.isbn=978-1-78176-094-9&rft.aulast=Batten-Hill&rft.aufirst=D&rft_id=http%3A%2F%2Fwww.tsoy.co.uk&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Biddle W (2002). <i>A Field Guide to Germs</i> (2nd Anchor Books ed.). New York: Anchor Books. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4000-3051-4" title="Special:BookSources/978-1-4000-3051-4"><bdi>978-1-4000-3051-4</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/50154403">50154403</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=A+Field+Guide+to+Germs&rft.place=New+York&rft.edition=2nd+Anchor+Books&rft.pub=Anchor+Books&rft.date=2002&rft_id=info%3Aoclcnum%2F50154403&rft.isbn=978-1-4000-3051-4&rft.aulast=Biddle&rft.aufirst=W&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Carol B (1996). <a rel="nofollow" class="external text" href="https://archive.org/details/bubonicplagueinn00bene"><i>Bubonic Plague in Nineteenth-Century China</i></a>. Stanford, CA: Stanford University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-8047-2661-0" title="Special:BookSources/978-0-8047-2661-0"><bdi>978-0-8047-2661-0</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/34191853">34191853</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Bubonic+Plague+in+Nineteenth-Century+China&rft.place=Stanford%2C+CA&rft.pub=Stanford+University+Press&rft.date=1996&rft_id=info%3Aoclcnum%2F34191853&rft.isbn=978-0-8047-2661-0&rft.aulast=Carol&rft.aufirst=B&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fbubonicplagueinn00bene&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1">Kool JL (April 2005). <a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F428617">"Risk of person-to-person transmission of pneumonic plague"</a>. <i>Clinical Infectious Diseases</i>. <b>40</b> (8): 1166–72. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F428617">10.1086/428617</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15791518">15791518</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Infectious+Diseases&rft.atitle=Risk+of+person-to-person+transmission+of+pneumonic+plague&rft.volume=40&rft.issue=8&rft.pages=1166-72&rft.date=2005-04&rft_id=info%3Adoi%2F10.1086%2F428617&rft_id=info%3Apmid%2F15791518&rft.aulast=Kool&rft.aufirst=JL&rft_id=https%3A%2F%2Fdoi.org%2F10.1086%252F428617&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Little LK (2007). <i>Plague and the End of Antiquity: The Pandemic of 541–750</i>. New York: Cambridge University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-521-84639-4" title="Special:BookSources/978-0-521-84639-4"><bdi>978-0-521-84639-4</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/65361042">65361042</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Plague+and+the+End+of+Antiquity%3A+The+Pandemic+of+541%E2%80%93750&rft.place=New+York&rft.pub=Cambridge+University+Press&rft.date=2007&rft_id=info%3Aoclcnum%2F65361042&rft.isbn=978-0-521-84639-4&rft.aulast=Little&rft.aufirst=LK&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Rosen W (2007). <a rel="nofollow" class="external text" href="https://archive.org/details/justiniansfleapl00rose"><i>Justinian's Flea: Plague, Empire and the Birth of Europe</i></a>. London: Viking Penguin. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-670-03855-8" title="Special:BookSources/978-0-670-03855-8"><bdi>978-0-670-03855-8</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Justinian%27s+Flea%3A+Plague%2C+Empire+and+the+Birth+of+Europe&rft.place=London&rft.pub=Viking+Penguin&rft.date=2007&rft.isbn=978-0-670-03855-8&rft.aulast=Rosen&rft.aufirst=W&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fjustiniansfleapl00rose&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1">Scott S, Duncan CJ (2001). <span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/biologyofplagues0000scot"><i>Biology of Plagues: Evidence from Historical Populations</i></a></span>. Cambridge, UK; New York: Cambridge University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-521-80150-8" title="Special:BookSources/978-0-521-80150-8"><bdi>978-0-521-80150-8</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/44811929">44811929</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Biology+of+Plagues%3A+Evidence+from+Historical+Populations&rft.place=Cambridge%2C+UK%3B+New+York&rft.pub=Cambridge+University+Press&rft.date=2001&rft_id=info%3Aoclcnum%2F44811929&rft.isbn=978-0-521-80150-8&rft.aulast=Scott&rft.aufirst=S&rft.au=Duncan%2C+CJ&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fbiologyofplagues0000scot&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABubonic+plague" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div> <ul><li><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Wikisource-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/15px-Wikisource-logo.svg.png" decoding="async" width="15" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/23px-Wikisource-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/30px-Wikisource-logo.svg.png 2x" data-file-width="410" data-file-height="430" /></a></span> Works related to <a href="https://en.wikisource.org/wiki/Philosophical_Transactions/Volume_54/An_Account_of_the_Plague_at_Constantinople" class="extiw" title="wikisource:Philosophical Transactions/Volume 54/An Account of the Plague at Constantinople">An Account of the Plague at Constantinople</a> at Wikisource</li></ul> <div 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style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q217519" class="extiw" title="d:Q217519">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1742025109">1B93.0</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/A20.0">A20.0</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=020.0">020.0</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb14226.htm">14226</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000596.htm">000596</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Pseudomonadota-associated_Gram-negative_bacterial_infections" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style 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abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Gram-negative_proteobacterial_diseases" title="Template:Gram-negative proteobacterial diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Gram-negative_proteobacterial_diseases" title="Template talk:Gram-negative proteobacterial diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Gram-negative_proteobacterial_diseases" title="Special:EditPage/Template:Gram-negative proteobacterial diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Pseudomonadota-associated_Gram-negative_bacterial_infections" style="font-size:114%;margin:0 4em"><a href="/wiki/Pseudomonadota" title="Pseudomonadota">Pseudomonadota</a>-associated <a href="/wiki/Gram-negative_bacterial_infection" class="mw-redirect" title="Gram-negative bacterial infection">Gram-negative bacterial infections</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alphaproteobacteria" title="Alphaproteobacteria">α</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Rickettsiales" title="Rickettsiales">Rickettsiales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Rickettsiaceae" title="Rickettsiaceae">Rickettsiaceae</a>/<br />(<a href="/wiki/Rickettsiosis" title="Rickettsiosis">Rickettsioses</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Typhus" title="Typhus">Typhus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_typhi" title="Rickettsia typhi">Rickettsia typhi</a></i> <ul><li><a href="/wiki/Murine_typhus" title="Murine typhus">Murine typhus</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_prowazekii" title="Rickettsia prowazekii">Rickettsia prowazekii</a></i> <ul><li><a href="/wiki/Epidemic_typhus" title="Epidemic typhus">Epidemic typhus</a>, <a href="/wiki/Brill%E2%80%93Zinsser_disease" title="Brill–Zinsser disease">Brill–Zinsser disease</a>, <a href="/wiki/Flying_squirrel_typhus" title="Flying squirrel typhus">Flying squirrel typhus</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Spotted_fever" title="Spotted fever">Spotted<br />fever</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Tick-borne_disease" title="Tick-borne disease">Tick-borne</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_rickettsii" title="Rickettsia rickettsii">Rickettsia rickettsii</a></i> <ul><li><a href="/wiki/Rocky_Mountain_spotted_fever" title="Rocky Mountain spotted fever">Rocky Mountain spotted fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_conorii" title="Rickettsia conorii">Rickettsia conorii</a></i> <ul><li><a href="/wiki/Boutonneuse_fever" title="Boutonneuse fever">Boutonneuse fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_japonica" title="Rickettsia japonica">Rickettsia japonica</a></i> <ul><li><a href="/wiki/Japanese_spotted_fever" title="Japanese spotted fever">Japanese spotted fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_sibirica" title="Rickettsia sibirica">Rickettsia sibirica</a></i> <ul><li><a href="/wiki/North_Asian_tick_typhus" title="North Asian tick typhus">North Asian tick typhus</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_australis" title="Rickettsia australis">Rickettsia australis</a></i> <ul><li><a href="/wiki/Queensland_tick_typhus" title="Queensland tick typhus">Queensland tick typhus</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_honei" title="Rickettsia honei">Rickettsia honei</a></i> <ul><li><a href="/wiki/Flinders_Island_spotted_fever" title="Flinders Island spotted fever">Flinders Island spotted fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_africae" title="Rickettsia africae">Rickettsia africae</a></i> <ul><li><a href="/wiki/African_tick_bite_fever" title="African tick bite fever">African tick bite fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_parkeri" title="Rickettsia parkeri">Rickettsia parkeri</a></i> <ul><li><a href="/wiki/American_tick_bite_fever" class="mw-redirect" title="American tick bite fever">American tick bite fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_aeschlimannii" class="mw-redirect" title="Rickettsia aeschlimannii">Rickettsia aeschlimannii</a></i> <ul><li><a href="/wiki/Rickettsia_aeschlimannii_infection" title="Rickettsia aeschlimannii infection"><i>Rickettsia aeschlimannii</i> infection</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Mite#Clinical_significance" title="Mite">Mite-borne</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_akari" title="Rickettsia akari">Rickettsia akari</a></i> <ul><li><a href="/wiki/Rickettsialpox" title="Rickettsialpox">Rickettsialpox</a></li></ul></li> <li><i><a href="/wiki/Orientia_tsutsugamushi" title="Orientia tsutsugamushi">Orientia tsutsugamushi</a></i> <ul><li><a href="/wiki/Scrub_typhus" title="Scrub typhus">Scrub typhus</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Flea#Fleas_as_a_vector" title="Flea">Flea-borne</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_felis" title="Rickettsia felis">Rickettsia felis</a></i> <ul><li><a href="/wiki/Flea-borne_spotted_fever" title="Flea-borne spotted fever">Flea-borne spotted fever</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Anaplasmataceae" class="mw-redirect" title="Anaplasmataceae">Anaplasmataceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ehrlichiosis" title="Ehrlichiosis">Ehrlichiosis</a>: <i><a href="/wiki/Anaplasma_phagocytophilum" title="Anaplasma phagocytophilum">Anaplasma phagocytophilum</a></i> <ul><li><a href="/wiki/Human_granulocytic_anaplasmosis" title="Human granulocytic anaplasmosis">Human granulocytic anaplasmosis</a>, <a href="/wiki/Anaplasmosis" title="Anaplasmosis">Anaplasmosis</a></li></ul></li> <li><i><a href="/wiki/Ehrlichia_chaffeensis" title="Ehrlichia chaffeensis">Ehrlichia chaffeensis</a></i> <ul><li><a href="/wiki/Human_monocytotropic_ehrlichiosis" title="Human monocytotropic ehrlichiosis">Human monocytotropic ehrlichiosis</a></li></ul></li> <li><i><a href="/wiki/Ehrlichia_ewingii" title="Ehrlichia ewingii">Ehrlichia ewingii</a></i> <ul><li><a href="/wiki/Ehrlichiosis_ewingii_infection" title="Ehrlichiosis ewingii infection">Ehrlichiosis ewingii infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Hyphomicrobiales" title="Hyphomicrobiales">Hyphomicrobiales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Brucellaceae" title="Brucellaceae">Brucellaceae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Brucella_abortus" title="Brucella abortus">Brucella abortus</a></i> <ul><li><a href="/wiki/Brucellosis" title="Brucellosis">Brucellosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Bartonella" title="Bartonella">Bartonellaceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bartonellosis" title="Bartonellosis">Bartonellosis</a>: <i><a href="/wiki/Bartonella_henselae" title="Bartonella henselae">Bartonella henselae</a></i> <ul><li><a href="/wiki/Cat-scratch_disease" title="Cat-scratch disease">Cat-scratch disease</a></li></ul></li> <li><i><a href="/wiki/Bartonella_quintana" title="Bartonella quintana">Bartonella quintana</a></i> <ul><li><a href="/wiki/Trench_fever" title="Trench fever">Trench fever</a></li></ul></li> <li>Either <i>B. henselae</i> or <i>B. quintana</i> <ul><li><a href="/wiki/Bacillary_angiomatosis" title="Bacillary angiomatosis">Bacillary angiomatosis</a></li></ul></li> <li><i><a href="/wiki/Bartonella_bacilliformis" title="Bartonella bacilliformis">Bartonella bacilliformis</a></i> <ul><li><a href="/wiki/Carrion%27s_disease" title="Carrion's disease">Carrion's disease</a>, <a href="/wiki/Verruga_peruana" class="mw-redirect" title="Verruga peruana">Verruga peruana</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Betaproteobacteria" title="Betaproteobacteria">β</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Neisseriaceae" title="Neisseriaceae">Neisseriales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Maltose" title="Maltose">M+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Neisseria_meningitidis" title="Neisseria meningitidis">Neisseria meningitidis/meningococcus</a></i> <ul><li><a href="/wiki/Meningococcal_disease" title="Meningococcal disease">Meningococcal disease</a>, <a href="/wiki/Waterhouse%E2%80%93Friderichsen_syndrome" title="Waterhouse–Friderichsen syndrome">Waterhouse–Friderichsen syndrome</a>, <a href="/wiki/Meningococcal_septicaemia" class="mw-redirect" title="Meningococcal septicaemia">Meningococcal septicaemia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Maltose" title="Maltose">M−</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae">Neisseria gonorrhoeae/gonococcus</a></i> <ul><li><a href="/wiki/Gonorrhea" title="Gonorrhea">Gonorrhea</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i>ungrouped:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Eikenella_corrodens" title="Eikenella corrodens">Eikenella corrodens</a></i>/<i><a href="/wiki/Kingella_kingae" title="Kingella kingae">Kingella kingae</a></i> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul></li> <li><i><a href="/wiki/Chromobacterium_violaceum" title="Chromobacterium violaceum">Chromobacterium violaceum</a></i> <ul><li><a href="/wiki/Chromobacteriosis_infection" title="Chromobacteriosis infection">Chromobacteriosis infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Burkholderiales" title="Burkholderiales">Burkholderiales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Burkholderia_pseudomallei" title="Burkholderia pseudomallei">Burkholderia pseudomallei</a></i> <ul><li><a href="/wiki/Melioidosis" title="Melioidosis">Melioidosis</a></li></ul></li> <li><i><a href="/wiki/Burkholderia_mallei" title="Burkholderia mallei">Burkholderia mallei</a></i> <ul><li><a href="/wiki/Glanders" title="Glanders">Glanders</a></li></ul></li> <li><i><a href="/wiki/Burkholderia_cepacia_complex" title="Burkholderia cepacia complex">Burkholderia cepacia complex</a></i></li> <li><i><a href="/wiki/Bordetella_pertussis" title="Bordetella pertussis">Bordetella pertussis</a>/<a href="/wiki/Bordetella_parapertussis" title="Bordetella parapertussis">Bordetella parapertussis</a></i> <ul><li><a href="/wiki/Pertussis" class="mw-redirect" title="Pertussis">Pertussis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gammaproteobacteria" title="Gammaproteobacteria">γ</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Enterobacteriaceae" title="Enterobacteriaceae">Enterobacteriales</a><br />(<a href="/wiki/Oxidase_test#OX−" title="Oxidase test">OX−</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/MacConkey_agar#Lac+" title="MacConkey agar">Lac+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Klebsiella_pneumoniae" title="Klebsiella pneumoniae">Klebsiella pneumoniae</a></i> <ul><li><a href="/wiki/Rhinoscleroma" title="Rhinoscleroma">Rhinoscleroma</a>, <a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a></li></ul></li> <li><i><a href="/wiki/Klebsiella_granulomatis" title="Klebsiella granulomatis">Klebsiella granulomatis</a></i> <ul><li><a href="/wiki/Granuloma_inguinale" title="Granuloma inguinale">Granuloma inguinale</a></li></ul></li> <li><i><a href="/wiki/Klebsiella_oxytoca" title="Klebsiella oxytoca">Klebsiella oxytoca</a></i></li></ul> <ul><li><i><a href="/wiki/Escherichia_coli" title="Escherichia coli">Escherichia coli</a></i>: <a href="/wiki/Enterotoxigenic_Escherichia_coli" title="Enterotoxigenic Escherichia coli">Enterotoxigenic</a></li> <li><a href="/wiki/Enteroinvasive_Escherichia_coli" title="Enteroinvasive Escherichia coli">Enteroinvasive</a></li> <li><a href="/wiki/Verotoxin-producing_Escherichia_coli" class="mw-redirect" title="Verotoxin-producing Escherichia coli">Enterohemorrhagic</a></li> <li><a href="/wiki/Escherichia_coli_O157:H7" title="Escherichia coli O157:H7">O157:H7</a></li> <li><a href="/wiki/Escherichia_coli_O104:H4" title="Escherichia coli O104:H4">O104:H4</a> <ul><li><a href="/wiki/Hemolytic-uremic_syndrome" class="mw-redirect" title="Hemolytic-uremic syndrome">Hemolytic-uremic syndrome</a></li></ul></li></ul> <ul><li><i><a href="/wiki/Enterobacter_aerogenes" class="mw-redirect" title="Enterobacter aerogenes">Enterobacter aerogenes</a>/<a href="/wiki/Enterobacter_cloacae" title="Enterobacter cloacae">Enterobacter cloacae</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/MacConkey_agar#Slow" title="MacConkey agar">Slow/weak</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Serratia_marcescens" title="Serratia marcescens">Serratia marcescens</a></i> <ul><li><a href="/wiki/Serratia_infection" class="mw-redirect" title="Serratia infection"><i>Serratia</i> infection</a></li></ul></li> <li><i><a href="/wiki/Citrobacter_koseri" title="Citrobacter koseri">Citrobacter koseri</a></i>/<i><a href="/wiki/Citrobacter_freundii" title="Citrobacter freundii">Citrobacter freundii</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/MacConkey_agar#Lac−" title="MacConkey agar">Lac−</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Bismuth_sulfite_agar" title="Bismuth sulfite agar">H2S+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Salmonella_enterica" title="Salmonella enterica">Salmonella enterica</a></i> <ul><li><a href="/wiki/Typhoid_fever" title="Typhoid fever">Typhoid fever</a>, <a href="/wiki/Paratyphoid_fever" title="Paratyphoid fever">Paratyphoid fever</a>, <a href="/wiki/Salmonellosis" title="Salmonellosis">Salmonellosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue">H2S−</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Shigella_dysenteriae" title="Shigella dysenteriae">Shigella dysenteriae</a>/<a href="/wiki/Shigella_sonnei" title="Shigella sonnei">sonnei</a>/<a href="/wiki/Shigella_flexneri" title="Shigella flexneri">flexneri</a>/<a href="/wiki/Shigella_boydii" title="Shigella boydii">boydii</a></i> <ul><li><a href="/wiki/Shigellosis" title="Shigellosis">Shigellosis</a>, <a href="/wiki/Bacillary_dysentery" title="Bacillary dysentery">Bacillary dysentery</a></li></ul></li> <li><i><a href="/wiki/Proteus_mirabilis" title="Proteus mirabilis">Proteus mirabilis</a></i>/<i><a href="/wiki/Proteus_vulgaris" title="Proteus vulgaris">Proteus vulgaris</a></i></li> <li><i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Yersinia pestis</a></i> <ul><li><a href="/wiki/Plague_(disease)" title="Plague (disease)">Plague</a>/<a class="mw-selflink selflink">Bubonic plague</a></li></ul></li> <li><i><a href="/wiki/Yersinia_enterocolitica" title="Yersinia enterocolitica">Yersinia enterocolitica</a></i> <ul><li><a href="/wiki/Yersiniosis" title="Yersiniosis">Yersiniosis</a></li></ul></li> <li><i><a href="/wiki/Yersinia_pseudotuberculosis" title="Yersinia pseudotuberculosis">Yersinia pseudotuberculosis</a></i> <ul><li><a href="/wiki/Far_East_scarlet-like_fever" title="Far East scarlet-like fever">Far East scarlet-like fever</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Pasteurellaceae" title="Pasteurellaceae">Pasteurellales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i><a href="/wiki/Haemophilus" title="Haemophilus">Haemophilus</a>:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Haemophilus_influenzae" title="Haemophilus influenzae">H. influenzae</a></i> <ul><li><a href="/wiki/Haemophilus_meningitis" title="Haemophilus meningitis"><i>Haemophilus</i> meningitis</a></li> <li><a href="/wiki/Brazilian_purpuric_fever" title="Brazilian purpuric fever">Brazilian purpuric fever</a></li></ul></li> <li><i><a href="/wiki/Haemophilus_ducreyi" title="Haemophilus ducreyi">H. ducreyi</a></i> <ul><li><a href="/wiki/Chancroid" title="Chancroid">Chancroid</a></li></ul></li> <li><i><a href="/wiki/Haemophilus_parainfluenzae" title="Haemophilus parainfluenzae">H. parainfluenzae</a></i> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i><a href="/wiki/Pasteurella_multocida" title="Pasteurella multocida">Pasteurella multocida</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pasteurellosis" title="Pasteurellosis">Pasteurellosis</a></li> <li><i><a href="/wiki/Actinobacillus" title="Actinobacillus">Actinobacillus</a></i> <ul><li><a href="/wiki/Actinobacillosis" title="Actinobacillosis">Actinobacillosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i><a href="/wiki/Aggregatibacter_actinomycetemcomitans" title="Aggregatibacter actinomycetemcomitans">Aggregatibacter actinomycetemcomitans</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Legionellales" title="Legionellales">Legionellales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Legionella_pneumophila" title="Legionella pneumophila">Legionella pneumophila</a>/<a href="/wiki/Legionella_longbeachae" title="Legionella longbeachae">Legionella longbeachae</a></i> <ul><li><a href="/wiki/Legionnaires%27_disease" title="Legionnaires' disease">Legionnaires' disease</a></li></ul></li> <li><i><a href="/wiki/Coxiella_burnetii" title="Coxiella burnetii">Coxiella burnetii</a></i> <ul><li><a href="/wiki/Q_fever" title="Q fever">Q fever</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Thiotrichales" title="Thiotrichales">Thiotrichales</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Francisella_tularensis" title="Francisella tularensis">Francisella tularensis</a></i> <ul><li><a href="/wiki/Tularemia" title="Tularemia">Tularemia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Vibrionaceae" title="Vibrionaceae">Vibrionaceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i> <ul><li><a href="/wiki/Cholera" title="Cholera">Cholera</a></li></ul></li> <li><i><a href="/wiki/Vibrio_vulnificus" title="Vibrio vulnificus">Vibrio vulnificus</a></i></li> <li><i><a href="/wiki/Vibrio_parahaemolyticus" title="Vibrio parahaemolyticus">Vibrio parahaemolyticus</a></i></li> <li><i><a href="/wiki/Vibrio_alginolyticus" title="Vibrio alginolyticus">Vibrio alginolyticus</a></i></li> <li><i><a href="/wiki/Plesiomonas_shigelloides" title="Plesiomonas shigelloides">Plesiomonas shigelloides</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Pseudomonadales" title="Pseudomonadales">Pseudomonadales</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Pseudomonas_aeruginosa" title="Pseudomonas aeruginosa">Pseudomonas aeruginosa</a></i> <ul><li><a href="/wiki/Pseudomonas_infection" title="Pseudomonas infection"><i>Pseudomonas</i> infection</a></li></ul></li> <li><i><a href="/wiki/Moraxella_catarrhalis" title="Moraxella catarrhalis">Moraxella catarrhalis</a></i></li> <li><i><a href="/wiki/Acinetobacter_baumannii" title="Acinetobacter baumannii">Acinetobacter baumannii</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Xanthomonadaceae" title="Xanthomonadaceae">Xanthomonadaceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Stenotrophomonas_maltophilia" title="Stenotrophomonas maltophilia">Stenotrophomonas maltophilia</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Cardiobacteriaceae" title="Cardiobacteriaceae">Cardiobacteriaceae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Cardiobacterium_hominis" title="Cardiobacterium hominis">Cardiobacterium hominis</a></i> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Aeromonadales" title="Aeromonadales">Aeromonadales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Aeromonas_hydrophila" title="Aeromonas hydrophila">Aeromonas hydrophila</a>/<a href="/wiki/Aeromonas_veronii" title="Aeromonas veronii">Aeromonas veronii</a></i> <ul><li><a href="/wiki/Aeromonas_infection" title="Aeromonas infection"><i>Aeromonas</i> infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Campylobacterota" title="Campylobacterota">ε</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Campylobacterales" scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Campylobacterales" title="Campylobacterales">Campylobacterales</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Campylobacter_jejuni" title="Campylobacter jejuni">Campylobacter jejuni</a></i> <ul><li><a href="/wiki/Campylobacteriosis" title="Campylobacteriosis">Campylobacteriosis</a>, <a href="/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome" title="Guillain–Barré syndrome">Guillain–Barré syndrome</a></li></ul></li> <li><i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a></i> <ul><li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic ulcer</a>, <a href="/wiki/MALT_lymphoma" title="MALT lymphoma">MALT lymphoma</a>, <a href="/wiki/Gastric_cancer" class="mw-redirect" title="Gastric cancer">Gastric cancer</a></li></ul></li> <li><i><a href="/wiki/Helicobacter_cinaedi" title="Helicobacter cinaedi">Helicobacter cinaedi</a></i> <ul><li><a href="/wiki/Helicobacter_cellulitis" title="Helicobacter cellulitis"><i>Helicobacter</i> cellulitis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> 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