Occasionally, however, the disease becomes endemic, killing off large numbers of rats. When this happens, the rat flea,
Xenopsylla cheopis, which normally feeds on rodent hosts, turns to people instead. Their bite transmits the plague from infected rat to man.
In medieval times, plague was most often carried by the common black rat, Rattus rattus, which lived among the populace, feeding on grain stores and other foodstuffs. Some historians argue that the human flea, Pulex irritans, may also have played a significant role in transmitting the disease, as it will feed on any available blood source, moving indiscriminately between rats and humans.
Symptoms of plague develop quickly after infection. In man, the disease takes one of three forms: bubonic (involving the lymphatic system), pneumonic (centered in the respiratory system), and septicemic (involving the blood-stream).
The best-known symptom of bubonic plague were buboes—hard, extremely painful, swollen lymph nodes—which filled with blood and pus, turned black, and often burst, giving the disease its common name. The buboes were accompanied by a high fever, headache, chills, body aches, and sensitivity to light. At least half the people who contracted this form of the plague died.
Those who suffered from pneumonic plague usually had no buboes, but their lungs filled with fluid and blood, and they too endured raging fevers, sweats, and pain.
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