Digitizing Historical Plague

TO THE EDITOR– Outbreaks of bubonic plague initiated by the flea-borne bacterium Yersinia pestis have repeatedly afflicted the Old World since the onset of the ‘Justinian Plague’ in 541 AD [1]. The second European pandemic, the ‘Black Death’ rapidly killed around half of the population during 1347–1353 AD. Both pandemics then persisted with recurrent local outbreaks over several centuries. The reason for the eventual cessation of each pandemic remains mysterious [1], particularly in light of continued activity in Asia [2] where the infection is enzootic in its natural rodent hosts [3]. Socio-political influences have often compounded the complexity of plague ecology, likely increasing the spillover of infection into human populations [1–3]. The threat from the plague bacillus, which still induces several thousand human cases annually, may well increase under projected climate change [1] – and, ominously, within the context of bioterrorism [4]. Knowledge of plague ecology, epidemiology, and pathophysiology is,