Dread Diseases of the Past: Treatable Today?

I understand that leprosy is still around (and that the Biblical “leprosy” probably isn’t what we call “leprosy”) in small pockets. ISTR that Bubonic Plague exists in a secure lab somewhere, as does smallpox.

Anyway, are these diseases treatable with modern, readily-accessible antibiotics? If I came down with leprosy, could some Amoxycillin from Walgreen’s do the trick? If the Bubonic Plague were to break out in Sangamon County, is the cure on the shelves at my local CVS? And what about other diseases of yore that I’m failing to remember at the moment?

*By the way, are Black Plague, Bubonic Plage, and the Black Death all the same thing?

The big thing with Bubonic plague is it has to be caught early for anti-biotics to be effective. There was a famous case (in the scientific community, at least, reported via my Dad who is a biological scientist) where a scientist in the UK who was researching plague ignored various safety protocols, including the one that said you have to report all illnesses to your superiors, he came down with the plague (which he thought was just a cold), didn’t report it, and just stayed at home for a few sick days. By the time anyone realized what was going wrong it was too late, and he died.

Plague still exists in the wild; the last major outbreak was in 1994-1995 in India. Don’t think you’re safe in the US, either. According to the Centers for Disease Control:

Fortunately, the plague bacterium Yersinia pestis responds well to standard antibiotics.

Leprosy, aka Hansen’s disease, is a tougher nut to crack as the bacterium quickly evolved antibiotic resistance. Current treatment is through multi-drug therapy.

Yersinia pestis, the probable causative agent of bubonic plague, is not kept in secure labs. I got a job my freshman year of college in the microbiology department. One of the duties I had was subculturing bacteria to keep cultures alive. *Yersinia pestis * was one of them. No special procedures were used.

The bubonic plague is one of three forms of the plague. The other two are pneumonic and septicemic. The Black Plague and Black Death are nicknames for the plague. The “White Plague” is a nickname for tuberculosis.

Yersinia pestis is alive and well in prairie dog populations in the southwestern US. You only get 10-20 human cases a year, though.

The eradicated but for the high-security lab samples disease that comes to mind is smallpox. It’s a virus, so antibiotics wouldn’t be effective against it (but might against secondary bacterial infections that might result from infection). There is at least one antiviral agent that might work but it has serious potential side effects; the only other option would be a smallpox vaccination which actually does have an effect if given soon after infection. However, almost no one these days gets smallpox vaccinations (pre-exposure) unless they’re expected to be shipped off to the Middle East or working with it in a lab, so it’s not exactly in common supply.

Plague is alive and well in northern New Mexico. But if you do get it, the odds are still pretty good:

According to the state of New Mexico, streptomycin is the best treatment, but “may be difficult to obtain”.

Rabies is another one of those diseases like leprosy that’s still as scary as it used to be - as far as I know only one person has survived without pre-outbreak treatment.

There are, as described, three forms of the plague, the result of infection by Yersinia pestis. The form is largely depend on the route of infection. However, it is not clear that the pandemics of the Black Death of Medieval Europe (and related outbreaks in Asia, the Middle East, and Mediterranean Africa) were all caused by Y. pestis. While some descriptions of the ravaging effects of the Black Death have some resemblance to the bubonic form of the plague, there are numerous discrepancies in both detail symptoms and the dispersion patterns of the Black Death as opposed to those from the plague. One of the most significant discrepancies is in acquired immunity; while infection from Y. pestis doesn’t offer immunity from future infection, and there is no statistical basis that European and Central Asians are more resistant than other isolated populations from infection by the plague, survivors of the Black Death often enjoyed an acquired immunity. This has led some immunologists to speculate that Black Death may have been due to one or more epidemics Poxviridae, Paramyxoviridae, or Herpesviridae that crossed from domesticated animals that later became the “childhood diseases” of Europe and Asia which so devastated the unadapted inhabitants of the Americas upon contact.

Aside from the Black Death, there were a number of other smaller pandemics which devastated Western Europe and/or the British Isles and Ireland, most notably the English Sweats. And global epidemics of influenza were not uncommon until the development of effective vaccination reduced their spread.


Some other dread diseases off the top of my head:

Tuberculosis (aka consumption) - one-third of the world’s current population may be infected; new infections occur at the rate of one per second; responds to antibiotics; risk of evolving antibiotic resistance

Cholera - rears its ugly head wherever hygiene is poor; primary treatment is through oral rehydration therapy; control achieved through improved sanitation

Polio - now only endemic in Nigeria, India, Pakistan, and Afghanistan; may be well on the road to eradication, joining smallpox as a disease of the past

Malaria - still a widespread problem through the tropics and subtropics; no vaccine exists; primary control is through eradication of the mosquito vector

Polio, smallpox and measles are caused by viruses. Antibiotics can help with secondary infections, but won’t affect the course of the disease.

Diptheria and tetanus are caused by bacteria. However, the real damage is from toxins produced by the bacteria. Antibiotics will kill the bacteria, but not stop the damage caused by the toxins.

Pertussis (whooping cough) and cholera do respond to antibiotics. However, severe cholera can kill in less than a day, which makes the diagnosis and treatment window pretty short.

I’m old enough to remember the last major polio epidemics in the 1950s (and to have had several classmates who were crippled by it.) Parents wouldn’t let their kids go outside, let alone think there was a cure at the local pharmacy.