Document Detail

The Eyam plague revisited: did the village isolation change transmission from fleas to pulmonary?
MedLine Citation:
PMID:  15488668     Owner:  NLM     Status:  MEDLINE    
Back in the 17th century the Derbyshire village of Eyam fell victim to the Black Death, which is thought to have arrived from London in some old clothes brought by a travelling tailor. The village population was 350 at the commencement of plague, of which only 83 survived. Led by the church leaders, the village community realized that the whole surrounding region was at risk from the epidemic, and therefore decided to seal themselves off from the other surrounding villages. In the first 275 days of the outbreak, transmission was predominantly from infected fleas to susceptible humans. From then onward, mortality sharply increased, which indicates a changing in transmission pattern. We hypothesize that the confinement facilitated the spread of the infection by increasing the contact rate through direct transmission among humans. This would be more consistent with pulmonary plague, a deadlier form of the disease. In order to test the above hypothesis we designed a mathematical model for plague dynamics, incorporating both the indirect (fleas-rats-humans) and direct (human-to-human) transmissions of the infection. Our results show remarkable agreement between data and the model, lending support to our hypotheses. The Eyam plague episode is celebrated as a remarkable act of collective self-sacrifice. However, to the best of our knowledge, there were no evidence before that the confinement actually increased the burden payed by the commoners. In the light of our results, it can be said that the hypothesis that confinement facilitated the spread of the infection by increasing the contact rate through direct transmission is plausible.
E Massad; F A B Coutinho; M N Burattini; L F Lopez
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Historical Article; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medical hypotheses     Volume:  63     ISSN:  0306-9877     ISO Abbreviation:  Med. Hypotheses     Publication Date:  2004  
Date Detail:
Created Date:  2004-10-18     Completed Date:  2005-03-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  911-5     Citation Subset:  IM    
School of Medicine, University of São Paulo, Medical Informatics, Av. Dr. Arnaldo, 455, CEP 01246-903, Sao Paulo, SP, Brazil.
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MeSH Terms
Communicable Diseases / history,  mortality,  parasitology,  transmission
Computer Simulation
Diagnosis, Differential
Disease Outbreaks / history
England / epidemiology
Fleas / pathogenicity*
History, 18th Century
History, Ancient
Models, Biological*
Plague / mortality,  parasitology*,  transmission*
Social Isolation*
Yersinia pseudotuberculosis Infections / mortality,  parasitology*,  transmission*

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