One of the most devastating pandemics in human history. The Black Death resulting estimated 75 to 200 milion people death in Europe in the years of 1346 to 1353.  No medical knowledge existed in Medieval England to cope with the disease. The Black Death is the name given to a deadly plague (often called bubonic plague, but is more likely to be pneumonic plague) which was rampant during the Fourteenth Century. It was believed to have arrived from Asia in late 1348 and caused more than one epidemic in that century.

By the following August, the plague had spread as far north as England, where people called it "The Black Death" because of the black spots it produced on the skin. A terrible killer was loose across Europe, and Medieval medicine had nothing to combat it.

In winter the disease seemed to disappear, but only because fleas--which were now helping to carry it from person to person are dormant then. Each spring, the plague attacked again, killing new victims. After five years 25 million people were dead,one-third of Europe's people.

Even when the worst was over, smaller outbreaks continued, not just for years, but for centuries. The survivors lived in constant fear of the plague's return, and the disease did not disappear until the 1600s.

Medieval society never recovered from the results of the plague. So many people had died that there were serious labor shortages all over Europe. This led workers to demand higher wages, but landlords refused those demands. By the end of the 1300s peasant revolts broke out in England, France, Belgium and Italy.

Hawar (Plague)

Hawar
Hawar merupakan penyakit berjangkit yang merbahaya yang disebabkan bakteria Yersinia Pestis. Hawar banyak merebak melalui satu tikus yang kotor ke yang lain melalui kutu. Penyakit ini banyak berlaku di seluruh benua kecuali Australia.

Cara Jangkitan

• Titisan - Bersin atau batuk
• Sentuhan - Bersentuhan dengan orang yang telah berjangkit (termasuk sentuhan seksual)
• Sentuhan lain - Bersentuhan dengan tanah ataupun permukaan yang telah tercemar
• Udara - Jika bakteria tersebut berada di udara
• Binatang perosak - bawaan serangga atau binatang perosak yang lain

Tanda & Gejala

• Demam
• Batuk
• Bengkak di badan seperti di peha, leher dan lengan
• Muntah
• Loya

Terdapat 3 jenis hawar : - 

Hawar Bubonik

Apabila kutu mengigit manusia dan mencemarkan darah luka, bakteria mula masuk kedalam tisu. Bakteria Yersinia Pestis boleh membiak dan menghasilkan semua sel sel di dalam. Apabila bakteria memasuki sistem limpa, bakteria itu melepaskan toksin. Akibatnya, bengkak yang sakit di badan dan akan bernanah. 

Hawar Septisemik

Berlaku selepas hawar bubonik, bakteria boleh memasuki salur darah dan boleh berjalan ke serata tubuh badan. Jangkitan ini boleh menyebabkan kerandangan di selaput otak dan renjatan endotoksid serta pendarahan yang teruk akibat gumpalan darah.

Hawar Pneumonik

Hawar pneumonik mula timbul akibat daripada jangkitan paru paru yang boleh menyebabkan batuk dan bersin yang menghasilkan titisan mengandungi bakteria yang boleh menjangkiti sesiapa sahaja yang menghidunya.

Pencegahan

• Basmi tikus dan elakkan memegang tikus yang kotor sama ada yang hidup mahupun yang mati
• Elakkan tempat yang dipenuhi orang
• Basmi kutu
• Jika mempunyai hubungan dengan orang yang dijangkiti, elakkan daripada menyentuhi cecair tubuh pesakit dan dapatkan rawatan awal
• Simpan makanan ataupun lupuskan makanan dengan cara yang betul supaya tidak dicerobohi tikus.

Melioidosis

Melioidosis or also as known as Whitmore's disease is an infectious disease caused by Burkholderia pseudomallei which can be found in soil and water. Melioidosis can infect humans or animals. Melioidosis were frequently reported in climate area especially in  SEA (South East Asia), North Australia, West Africa and South America. Melioidosis infection commonly involves the lungs and also similar to glander disease, which is passed to humans from infected domestic animals. The bacterium that causes the disease is found in the soil, rice paddies, and stagnant waters of the area. People acquire the disease by inhaling dust contaminated by the bacteria and when the contaminated soil and the infection most commonly occurs during rainy season.

It is very rare for people to get the disease from another person. While a few cases have been documented, contaminated soil and surface water remain the primary way in which people become infected.

Besides humans, many animal species are susceptible to melioidosis such as sheep, goats, swine, horses, cats, dogs and cattle.

• Symptoms
• Melioidosis has many range of signs and symptoms and usually can be mistaken for other disease such as tuberculosis or pneumonia.
• Localized pain or swelling, fever, ulceration, abscess, cough, chest pain, high fever, massive headace, anorexia, respiratory disease, abdominal discomfort, joint pain, muscle tenderness, disorientation, weight loss, stomach or chest pain, muscle or joint pain, headache, seizures.
• Major risk factors to from Melioidosis 
• Diabetes
• Liver disease
• Thalassemia
• Chronic Lung disease 
• Cancer or another immune-suppressing condition other than HIV

Melioidosis were greatly reported in Thailand, Malaysia and Singapore.

Melioidosis can be diagnose with microscopic evaluation of a blood,urine sputum or skin-lesion test sample in the laboratory and blood test is useful to detect early acute cases of melioidosis.

• Prevention
• Persons with open skin wounds or diabetes or chronic renal disease should prevent themselves by avoiding contact with soil and standing water.
• Agricultural workers or health care workers should wear PPE (Personal Protective Equipment) such as boots, gloves, mask to prevent infection through skin and inhalation.

Epidermiology Triangle Concept of Leptospirosis

Host

• Mode of transmission
• Leptospirosis can effect human by direct or indirectly through exposure of animal urine of the carrier. Genus Leptospira bacteria enter the bloodstream through wounds, cuts, bruised skin and mucus membranes such as eyes, nose and mouth.
• Also can be spread by the semen of infected animals. Butcher and slaughterer also can be infected through contact with body fluids and blood.
• Human can be infected through exposure of water, food or soil containing urine from infected animals bacteria. May happen by swallowing contaminated food or water or by contact with the skin.
• Pets owner can be infected by the dog's saliva if the dog already infected by licking the rodents bacteria.

• Prevention
• By not swimming in the contaminated water.
• Not in contact with animals that have been exposed to infection.
• Wear PPE or protective clothing or footwear.
• Frequent medical checkups.
• Frequent visit to vet clinic for animal vaccine for pets.
• Antibiotics such as doxycyline and pennicilin.
• Extra cautions on handling animal's urine or blood.
• Always wash your hands with anti-bacterial cleaning solution.