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Infected animals (rats) and people were the main vectors of Bubonic Plague in the middle ages. There was an active trading system even then with ships and cargo going from different parts of the world to multiple destinations. As there was no restrictions on peoples movement (barring access to transport) and the geographical places (for example the Americas) were relatively newly discovered the disease could spread around the world as the people moved. I don't think anyone knows for sure where the plague originated but it was probably from outside Europe and when it arived back to Western Europe due to the people having low resistance levels to the illness (much like the native Americans in the US) there was a serious loss of life.

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