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“Coronavirus is Scary. But The World's First Pandemic Might Have Killed 50 Million People. - The National Interest Online” plus 2 more

“Coronavirus is Scary. But The World's First Pandemic Might Have Killed 50 Million People. - The National Interest Online” plus 2 more


Coronavirus is Scary. But The World's First Pandemic Might Have Killed 50 Million People. - The National Interest Online

Posted: 29 Feb 2020 05:33 AM PST

Justinian I was a man with a mission. The son of Thracian peasants (modern-day Albania), he rose through the ranks due to a combination of merit and family connections to become Emperor of the Byzantine Empire in 527AD. He ordered the construction of the iconic Hagia Sophia cathedral in Constantinople and wrote a Code of Law that's considered a foundational document in Western legal tradition. But his greatest ambition was nothing less than reuniting the shattered remnants of the Roman Empire.

Back in the year 285AD, Emperor Diocletian divided the Roman Empire into Western and Eastern branches to ease administrative burdens. But while the Western Roman Empire would fragment and fall before barbarian invasions, the eastern Byzantine Empire proved more robust.

Justinian's forces at first seemed unstoppable in their reconquest of former Roman territories. Led by General Belisarius, they crushed the barbarian Vandals at Tricamarum in North Africa in 535AD, drove Goths out of Rome, and successfully defended the iconic city against a lengthy Goth siege. Meanwhile, Justinian bought peace with the neighboring Sassanid (neo-Persian) empire through generous tribute.

But Byzantium's deadliest foe proved not to be Vandals, Goths, or Persians, but fleas born on the backs of Mediterranean black rats infesting grain-storage warehouses in Egypt. The rat-borne fleas then infected humans with yersinia pestis—better known as the bubonic plague, or Black Death.

Archaeology suggests the first strains of the bubonic plague originated in China or Central Asia hundreds, or even thousands, of years earlier. Though not known to have triggered any large-scale epidemics, the disease wound it way westward to Africa, perhaps shepherded by nomadic peoples like the Huns, and found its ways to Ethiopia and Egypt. Finally, an epidemic broke out in Egypt in 540AD, reportedly starting in Pelusium (close to modern Port Said), and spreading from there to Alexandria.

While neither rats nor fleas are normally inclined to travel far from their homes, they do travel far when their homes are the boats ferrying grain from Alexandria to Constantinople. In 542AD, the plague hit Constantinople like a hammer—and not even Justiniancould escape its effects. 

Unlike the notorious influenza pandemic that ravaged the globe in 1918, the bubonic plague didn't simply kill people quickly and cleanly—it psychologically traumatized the infected and uninfected alike. Within hours, newly infected individuals would first develop a fever then sprout black, pus-filled blisters. Bacteria transmitted via the lymphatic system caused huge grapefruit-sized bulges (buboes) to erupt from victim's genitals, armpits, and behind-ear areas. Some of the afflicted would simply fall into a coma and die within a day or two. But others would rant and rave, afflicted by delusions and nightmares. Justinian was one of the lucky survivors of an infection, which had a fatality rate ranging between 40 and 70 percent.

Procopius, the great Byzantine chronicler of the age, claimed that a four-month wave of pestilent death resulted in between 5,000 and 10,000 deaths per day in the Byzantine capital at its peak, eventually killing 40 percent of the population. 

The dead were so numerous, graveyards overflowed. The army was ordered to clear the streets of corpses, which were tossed into pits and trenches, thrown into the sea, packed into death ships and set adrift, or stuffed into towers that were sealed away. Citizens who braved the streets carried name tags with them so that their families could be notified should they become afflicted and die.

The few trained physicians lacked effective treatments. The average person was relegated to superstitious rituals and even exorcisms. Only officially ordered quarantines, and paranoia-induced shunning, may have controlled the spread of the illness.

As Constantinople was the nerve center of a multinational empire, the disease exploded into the world's first recorded pandemic, afflicting the entire Mediterranean region and Western Europe. Traders from Egypt may also have directly transmitted the disease to the Romano-British peoples inhabiting England. The decimation of their population may have contributed to the success of Saxon invaders later immortalized in Arthurian legend.

As so many people were either dying from the plague or refusing to leave home, agricultural output declined precipitously, adding food shortages and economic recession to everyone's woes.

Justinian did his best to continue his ambitious civil and military projects, but his armies suddenly suffered manpower shortages and urgently needed reinforcements simply became unavailable. 

Goth armies recaptured Rome in 546AD. Though Justinian's forces soon recaptured it, the city would continue see-saw in and out of control for years. Justinian finally secured Italy again in the mid-550s by relying heavily on barbarian mercenaries, including over 6,000 Lombards to make up for lack of personnel. He even subsequently established a toehold in Spain. But then the Germanic Lombards turned on him in 568AD, overwhelming the small Byzantine force holding northern Italy to establish their own kingdom, permanently ending the dream of reunifying the Roman Empire.

Even though the plague hit Constantinople hardest in 542AD, it then lingered and returned multiple times over the next two centuries, first returning to the Byzantine capital in 558AD. Recurring outbreaks may have especially weakened Byzantine Empire's hold on its Middle Eastern territories, possibly leading to defeats starting in 629AD facing the military campaigns of the Prophet Mohamed.

Just a year before, it was claimed Sasanid Western Persia lost half its population to the plague. The last outbreak didn't take place until around 750AD.

The plague's total death toll is estimated to lie between 25 and 50 million—in other words, between one out of every eight, and one out of every four humans then living on Earth. A second bubonic pandemic followed 600 years later in the fourteenth century (the infamous Medieval black death. The disease resurged for a third and hopefully final pandemic in mid-nineteenth century China and India.

The historical narrative recounted above suggests the plague of Justinian was an inflection point that sealed the fate of the Age of Antiquity and ushered in the Middle Ages. This interpretation is most popularly advanced in the ambitious Justinian's Flea: The First Great Plague and the End of the Roman Empire by William Rosen (you can read a review here).

However, scholars have recently questioned this narrative. In an article by environmental historians Lee Mordechai and Merle Eisenberg, they argue that evidence of the plague's severity is over-reliant on a small number of unreliable sources: "Few direct pieces of evidence exist for the supposed catastrophe outside a handful of famous literary accounts."

Texts that do refer to the plague, they argue, are clearly at times exaggerated or unreliable. For example, a mention of the plague by Bishop Gregory of Tours in France is enumerated alongside fantastical items such as reports of prophetic comets and blood raining in Paris. Many other sources from the era fail to mention the plague entirely, contrary to expectations.

While Mordechai doesn't deny a deadly pandemic occurred, he argues the evidence that it was on such a scale as to doom the Byzantine Empire by itself is inadequate, and that Procopius' narrative has been uncritically seized upon by modern scholars because it fits with a dramatic catastrophist narrative about how plagues can lead to the collapse of empires.

Whether you're persuaded more by either maximalist or minimalist interpretations of the Justinian plague's impact, it certainly wise to remain mindful of the difficulties interpreting a limited pool of historical data, and the natural tendency to impose sweeping narratives on potentially more complicated events.

But even by the least severe estimates, the Justinian plague killed millions, and perhaps illustrated as never before how relatively prosperous multi-national polities bound by commercial, political and military ties could inadvertently facilitate the transmission of deadly diseases

Sébastien Roblin holds a master's degree in conflict resolution from Georgetown University and served as a university instructor for the Peace Corps in China. He has also worked in education, editing, and refugee resettlement in France and the United States. He currently writes on security and military history for War Is Boring.

Bubonic plague in Galveston recalled in its centennial year - TMC News - Texas Medical Center News

Posted: 24 Feb 2020 11:00 AM PST

In the summer of 1920, the Bubonic plague arrived on Galveston Island.

The infectious disease that had killed large portions of the European population struck fear in residents and challenged scientists in the Texas port city 100 years ago.

The lifesaving efforts of professionals at the University of Texas Medical Branch at Galveston (UTMB), who addressed the epidemiology of disease, are being recalled in this centennial year.

"It was not a big surprise to have the plague in Galveston," said Vladimir L. Motin, Ph.D., professor of pathology in the Department of Microbiology and Immunology at the UTMB. "In 1920, there was a pandemic going on so many port cities would get the plague from infected rats on steamboats."

San Francisco, Seattle and other port cities also were dealing with cases of the plague caused by rats who hitchhiked on ships and quickly spread the disease by infecting fleas that were attached to the livestock aboard.

Cases of the plague are incredibly rare and symptoms often present like the flu at first. According to the Centers for Disease Control and Prevention, the bacteria that cause plague—Yersinia pestis—maintain their existence in a cycle involving rodents and fleas. The plague can be transmitted in one of three ways: flea bites, coming into contact with contaminated fluid or tissue and by cough droplets spewing into the air.

Over a two-year period, 18 Galvestonians were infected with the plague. Of those, 12 died and 67 plague-infected rats were identified.

"When the first person died, they set up a plague laboratory downtown and they encouraged people to catch rats, label them and bring them to the lab," said Paula Summerly, Ph.D., research project manager for the John P. McGovern Academy of Oslerian Medicine at the Old Red Medical Museum at UTMB.

The city of Galveston declared a "Poison the Rat!" campaign to efficiently stop the plague from spreading, Motin said.

"Rat-proofing was introduced after the outbreak of the plague," Summerly said. "There were rat trappers employed by the city and fumigation of buildings."

By killing the rats, city and health officials knew they would be able to break the epidemiological chain of the outbreak. From June to November of 1920, more than 6,000 rat traps were set and 40 rat trappers were hired.

Trappers combed the city—tearing down dilapidated sheds, rooting out rat shelters and fumigating structures as well as rat-proofing buildings and ships. Hundreds of rats were captured daily for a six-month tally of 46,623.

"They cleaned the entire city out," Motin said. "This obviously helped, but they also looked at how an outbreak spreads—which was very important."

Black Death Quarantine: How Did We Try To Contain The Deadly Disease? - BBC History Magazine

Posted: 14 Feb 2020 12:00 AM PST

The outbreak and spread of coronavirus has seen cities locked down as people across the globe are quarantined in hospitals, houses, and even on a cruise ship. But the practice of quarantine is nothing new. Historian Helen Carr explores how it was used alongside other measures in the 14th century to curb the disease that became known as the Black Death…

The effects of the disease known as the Black Death

In the autumn of 1348 a ship glided into the port of Southampton in England, carrying a disease from the east that had already ravaged the western world. It had killed men, women and children in their thousands quickly and mercilessly. This was the bubonic plague, identified by the blackening 'buboes' that formed within the joint area of an infected person – the groin or armpit were the most common places. These were accompanied by bodily aches, cold, lethargy and a high fever. When the infection got into the blood stream it effectively poisoned the blood, leading to probable death. Some survived the infection but most people died within days, sometimes hours. This wave of bubonic plague became known then as the Pestilence – or later, the Black Death.

By November 1348 the disease had reached London, and by New Year's Day 1349 around 200 bodies a day were being piled into mass graves outside the city. Henry Knighton, an Augustinian monk, witnessed the devastation of the Black Death in England: "there was a general mortality throughout the world… sheep and oxen strayed through the fields and among the crops and there was none to drive them off or collect them, but they perished in uncounted numbers… for lack of shepherds… After the Pestilence many buildings fell into total ruin for lack of inhabitants; similarly many small villages and hamlets became desolate and no homes were left in them, for all those who had dwelt anthem (sic) were dead."

In the autumn of 1348 a ship glided into the port of Southampton in England, carrying a disease from the east that had already ravaged the western world. It had killed men, women and children in their thousands quickly and mercilessly. This was the bubonic plague, identified by the blackening 'buboes' that formed within the joint area of an infected person – the groin or armpit were the most common places. These were accompanied by bodily aches, cold, lethargy and a high fever. When the infection got into the blood stream it effectively poisoned the blood, leading to probable death. Some survived the infection but most people died within days, sometimes hours. This wave of bubonic plague became known then as the Pestilence – or later, the Black Death.

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By November 1348 the disease had reached London, and by New Year's Day 1349 around 200 bodies a day were being piled into mass graves outside the city. Henry Knighton, an Augustinian monk, witnessed the devastation of the Black Death in England: "there was a general mortality throughout the world… sheep and oxen strayed through the fields and among the crops and there was none to drive them off or collect them, but they perished in uncounted numbers… for lack of shepherds… After the Pestilence many buildings fell into total ruin for lack of inhabitants; similarly many small villages and hamlets became desolate and no homes were left in them, for all those who had dwelt anthem (sic) were dead."

The countryside went to ruin, with crops, livestock and produce dying for lack of people to tend to them. Towns were abandoned, left only with the dead to occupy them, and war with France – the first part of the later-named Hundred Years' War – was put on hold. England and the rest of Europe was forced to come to terms with an epidemic of an apocalyptic nature that drastically changed the landscape of society.

In a bid to take control of the epidemic, Edward III, king of England as the time, was forced to turn his attention to domestic matters. Before the outbreak in England, his daughter Princess Joan had contracted plague after her ship docked in Bordeaux. She was on her way to marry Peter of Castile as part of a diplomatic marriage alliance between the two kingdoms. She never reached Castile and, upon discovery that the plague had taken hold of Bordeaux, she took refuge in a small village called Loremo, where she died alongside a large part of her entourage.

Clothes infected by the Black Death are burned in medieval Europe
Clothes infected by the Black Death are burned in medieval Europe, c1340. (Photo by Hulton Archive/Getty Images)

The king was devastated by the news and acted quickly and decisively to try to curb the outbreak in England. The 1349 January parliament was postponed until Easter (however, when spring came parliament was still empty.) Officials fled to their homes in the country and sheriffs refused to conduct their business for fear of their lives. The country was in lockdown and the people looked to the king to support them in the crisis.

Edward's response was rational: he suspected that poor public hygiene was responsible for the epidemic. In a bid to tackle the spread of infection, he opposed the idea of digging a burial pit for the plague victims in East Smithfield – it being in close proximity to the Tower of London and surrounding residential areas. Pits were dug further away, the largest one in Smithfield. In 1349 Edward III wrote to the Mayor of London directing him to have the streets thoroughly cleaned, for they were "foul with human faeces, and the air of the city poisioned (sic) to the great danger of men passing, especially in this time of infectious disease".

Overseas, further precautions were taken. In Italy in 1347, almost a year before the plague reached England, ports began to turn away ships, fearful that they carried the deadly disease. By March 1348, these protective measures were formalised and Venice became the first city to close its ports to incoming vessels. Those they did admit were subjected to 30 days of isolation, later raised to 40, which eventually lead to the birth of the term 'quarantine', for ships were forced to wait in the middle of the Venetian lagoon before they were permitted to disembark. Remote cemeteries were dug and in a later outbreak, the Venetians even went as far as establishing a quarantine island on Lazzaretto Vecchio, a small island in the Venetian Lagoon. An excavation in 2007 revealed more than 1,500 skeletons, all supposedly victims of bubonic plague. Thousands more are believed to remain below ground on the island.

The Venetians even went as far to establish a quarantine island

However, these measures were too little too late. Plague still took hold in Venice – as it did globally – killing an estimated 100,000 people, a catastrophic proportion of the Venetian population.

The Triumph of Death
The Triumph of Death, by 16th century painter, Bruegel the Elder. (Photo by: PHAS/Universal Images Group via Getty Images)

Which parts of England were affected by plague?

England shared the same fate. In 1300 the population had reached around five million, and by 1377 this was reduced to 2.5 million. Plague had claimed half of the population, wiping out entire families, villages and even towns such as Bristol. The measures that were taken to hinder the spread of the first Black Death epidemic were powerless, but there were contingency plans for future outbreaks later in history.

Saint Francois praying during a plague epidemic.
Saint Francois praying during a plague epidemic. (Photo by: Christophel Fine Art/Universal Images Group via Getty Images)

In 1563, when plague struck again (as the disease did most years, although some outbreaks were more severe than others), the lord mayor ordered that blue crosses should be attached to doors of houses that held anyone infected with plague over the past week. Inhabitants were to stay indoors for one month after the death or infection of anyone in the building. Only one uninfected person was allowed out of the house, in order to buy provisions for the sick or healing. To mark their health they were meant to carry a white rod, which if they forgot would incur a fine or even imprisonment. In 1539 plague struck London again and houses were to be incarcerated for 40 days – the typical quarantine period stipulated in 14th-century Venice. By 1580 shipping was heavily monitored, and crews and passengers were quarantined either on board their vessels or in the port where they had disembarked. Merchants were kept at the port of Rye and were prohibited from entering the city, and all goods were to be aired in order not to transport infection. Movement was also monitored within the country – travellers into London from outside counties were prohibited if there was known to be plague in their area.

Outbreaks of plague continued into the 17th century, the most savage and famous being the 1665–56 epidemic. In 1630, quarantine measures were taken in London, with the Privy Council ordering that again houses were shut up when those inside were infected. However, to enforce the order, guards were to be stationed outside the infected house. This was soon replaced with the order that the people inside were to be sent to the Pest House (an enclosed hospital for those suffering from the plague) while the house was closed up. More famously, the village of Eyam in Derbyshire bravely imposed a self-quarantine in order to prevent the spread of infection into other villages, losing 260 villagers in the process.

The mass burials that took place during the Great Plague of 1665
A broadsheet illustrates the mass burials that took place during the Great Plague of 1665. (Image by Alamy)

Over four centuries, plague devastated the lives of millions, and despite the best efforts of the authorities, there was little to be done in order to control the spread of such virulent infection. People blamed themselves, usually in the belief that they were being punished by God for their sins – some even believed that the epidemic was an apocalypse.

Although today plague has generally ceased to exist, there was an outbreak in the US in 1924, and in India as late as 1994, killing 52 people and causing mass panic as people fled out of fear of infection. However, we do not tend to experience the rate of mortality seen in the 14th, 15th, 16th and 17th centuries. With the advancement of modern medicine and practical contingency, we hope that bio-medical disaster remains as history.

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Helen Carr is a historian, writer and producer.

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