Two Spots and a Bubo

• Return of the Black Death: The World’s Greatest Serial Killer by Susan Scott and Christopher Duncan
  Wiley, 310 pp, £16.99, May 2004, ISBN 0 470 09000 6
• The Great Plague: The Story of London’s Most Deadly Year by Lloyd Moote and Dorothy Moote
  Johns Hopkins, 357 pp, £19.95, April 2004, ISBN 0 8018 7783 0
• Plague: The Mysterious Past and Terrifying Future of the World’s Most Dangerous Disease by Wendy Orent
  Free Press, 276 pp, £17.99, May 2004, ISBN 0 7432 3685 8

Well over three hundred years have gone by since the plague died out as an indigenous disease in Britain. It lingers on only as a rare rural infection in Madagascar, Tanzania, Kenya, Zaire, Botswana, Uganda, Bolivia, Brazil, Peru, the US, Vietnam, China, Mongolia, Kazakhstan and Burma. Worldwide, the annual number of human cases rarely exceeds a couple of thousand. As the Oxford Textbook of Medicine says: ‘The major animal reservoirs are urban rats as well as rural rodents including ground squirrels and prairie dogs. The Oriental rat flea Xenopsylla cheopis is the most efficient vector. When bitten by a rodent flea humans become an accidental host and play no role in disease transmission except in rare epidemics of pneumonic plague.’