The quick onset, rapid spread and early mortality of the illness afflicting the Philistines suggests that the 'tumours' were inflammatory rather than neoplastic. The weight of evidence[1] implicates Yersinia pestis as the pathogen, making this probably the earliest recorded outbreak of bubonic plague in human history. The disease is transmitted to humans through the bite of infected ectoparasites (especially the rat flea) and is characterised by abrupt hyperpyrexia, regional lymph node enlargement (Buboes or tumours), bacteremia and often secondary pneumonia. Respiratory transmission contributes to rapid spread and untreated the mortality rate is 50 to 90%. Before the antibiotic era, the pneumonic, septicaemic and meningitic forms were almost invariably fatal within a few days. [1 Sam 5:6,11,12;6:5]
Differential Diagnosis 3
There are two historical accounts of the death of Herod Agrippa 1. Luke describes it as follows: '...because Herod did not give praise to God, an angel of the Lord struck him down, and he was eaten by worms and died' (Acts 12:23). The Jewish historian Joseph us in recording the same event does not mention worms, but says the king was suddenly seized and after suffering severe and tormenting pain in the bowels, died within five days (Antiq. Jud. xix, c, viii, sec.2). Given the evidence what was the most likely mechanism of death?
Luke's opinion in next issue.
