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Volume 16, Number 10—October 2010
Letter

Body Lice, Yersinia pestis Orientalis, and Black Death

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To the Editor: A scientific debate with public health implications wages: What caused the medieval European plague epidemics known as Black Death? Recent articles note inconsistencies between a rat flea–borne pandemic of Yersinia pestis (the bacterium that causes bubonic plague) and the documented characteristics of Black Death (1, among others). Ayyadurai et al. (2) acknowledge that a rat flea–only hypothesis does not fit Black Death observations, but they resolve theoretical transmission inconsistencies through a louse-borne hypothesis. Ayyadurai et al. base their surety of fact—that medieval “plagues” were caused by Y. pestis infection—on a 2007 study (3) in which 5 of 36 teeth of “plague” victims, none of which were dated to the Black Death era (1347–1351), contained biological evidence of Y. pestis. The 3 locations in that study were all port cities: 2 on the Mediterranean Sea and 1 on the Rhone River. As Duncan and Scott (4) note, bubonic plague most likely existed endemically near ship-borne trade, unlike the fast-moving epidemic fronts exhibited by medieval “plagues.” Moreover, Gilbert et al. (5) found no Y. pestis DNA in 61 skeletons from primarily nonport locations in England, France, and Denmark.

We do not dispute the authors’ claim that Y. pestis might have been present in some skeletons from port cities in France, or that body lice might, under certain circumstances, transmit the Orientalis biotype of Y. pestis; their work appears careful and considered. However, given the differences mentioned above and improved knowledge on the rapidity of virus mutation and worldwide transmission potential, we merely argue that the simplest explanation for medieval plagues has yet to be ruled out: that they may have resulted from a human-to-human transmitted virus. Adding complexity to an already complicated etiologic theory, and stating such as historical fact based on limited geography and sample size, does not seem congruent with Occam’s razor.

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Mark Welford and Brian Bossak

Author affiliations: Author affiliation: Georgia Southern University, Statesboro, Georgia, USA

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References

  1. Welford  MR, Bossak  BH. Validation of inverse seasonal peak mortality in medieval plagues, including the Black Death, in comparison to modern Yersinia pestis–variant diseases. PLoS ONE. 2009;4:e8401. DOIPubMed
  2. Ayyadurai  S, Sebbane  F, Raoult  D, Drancourt  M. Body lice, Yersinia pestis Orientalis, and Black Death. Emerg Infect Dis. 2010;16:8923.PubMed
  3. Drancourt  M, Signoli  M, Vu Dang  L, Bizot  B, Roux  V, Tzortzis  S, Yersinia pestis Orientalis in remains of ancient plague patients. Emerg Infect Dis. 2007;13:3323. DOIPubMed
  4. Duncan  CJ, Scott  S. What caused the Black Death? Postgrad Med J. 2005;81:31520. DOIPubMed
  5. Gilbert  MT, Cuccui  J, White  W, Lynnerup  N, Titball  RW, Cooper  A, Absence of Yersinia pestis–specific DNA in human teeth from five European excavations of putative plague victims. Microbiology. 2004;150:34154. DOIPubMed

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Cite This Article

DOI: 10.3201/eid1610.100683

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Table of Contents – Volume 16, Number 10—October 2010

Page created: September 08, 2011
Page updated: September 08, 2011
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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