This is a timeline of plague , describing major epidemics and key medical developments.
|Time period||Key developments|
|3500–3000 BC (circa)||In 2018 a Swedish tomb was excavated and discovered to harbor evidence of Yersinia pestis within the interred human remains. The estimated date of this individual's death is correlated to a period of European history known as the Neolithic decline; the presence of plague in the remains is evidence for the plague as a potential cause of this event.|
|541–750 (circa)||The first plague pandemic spreads from Egypt to the Mediterranean (starting with the Plague of Justinian) and Northwestern Europe.|
|1346–1840||The second plague pandemic spreads from China (questionable) to the Mediterranean and Europe. The Black Death of 1346–1353 is considered to be unparalleled in human history. From 1347 to 1665, the Black Death is responsible for about a million of deaths in Europe.|
|1866–1960s||The third plague pandemic, which originated in China, results in about 2.2 million deaths. The plague spread to India and killed a total of 22.5 million people under the British rule. Haffkine develops the first vaccine against bubonic plague. Antibiotic drugs are developed in the 1940s which dramatically reduce the death rate from plague.|
|1950–2000||Plague cases are massively reduced during the second half of the 20th century. However, outbreaks would still occur, especially in developing countries. Between 1954 and 1997, human plague is reported in 38 countries, making the disease a remerging threat to human health. Also, between 1987 and 2001, 36,876 confirmed cases of plague with 2,847 deaths are reported to the World Health Organization.|
|Recent years||In the 21st century, fewer than 200 people die of the plague worldwide each year, mainly due to lack of treatment. Plague is considered to be endemic in 26 countries around the world, with most cases found in remote areas of Africa. The three most endemic countries are Madagascar, the Democratic Republic of the Congo and Peru.|
|Year/Period||Event type||Event||Present-day geographic location|
|430 BC||Epidemic||Plague of Athens devastates the city's population. The outbreak originated in Ethiopia and spread to the Mediterranean region through Egypt and Libya.||Greece, Mediterranean basin|
|224 BC||Plague infection is first recorded in China.||China|
|165–180 AD||Epidemic||Antonine Plague, also known as the plague of Galen, the Greek physician living in the Roman Empire who described it. It is suspected to have been smallpox or measles. The total deaths have been estimated at five million and the disease killed as much as one-third of the population in some areas and devastated the Roman army.||Iraq, Italy, France, Germany|
|250–270 AD||Epidemic||Plague of Cyprian breaks out in Rome. It is estimated to kill about 5000 people a day.||Italy|
|540 AD||Epidemic||Plague epidemic originates in Ethiopia spreads to Pelusium in Egypt.||Ethiopia, Egypt|
|541–542 AD||Epidemic||The Plague of Justinian, considered the first recorded pandemic, breaks out and develops as an extended epidemic in the Mediterranean basin. According to some, frequent outbreaks over the next two hundred years would eventually kill an estimated 25 million people. This number has recently been disputed.||Mediterranean Basin|
|542 AD||Epidemic||The plague arrives in Constantinople (now Istanbul). By spring of 542, about 5,000 deaths per day in the city are calculated, although some estimates vary to 10,000 per day. The epidemic would go on to kill over a third of the city's population.||Turkey|
|543 AD||Epidemic||After passing from Italy to Syria, Palestine, and Iraq, plague reaches Iran.||Iran|
|627 AD||Epidemic||A large epidemic of plague breaks out in Ctesiphon, the capital of the Sasanian Empire, killing more than 100,000 people.||Iran|
|1334||Epidemic||The second plague pandemic breaks out in China (questionable). Widely known as the "Black Death" or the Great Plague, it is regarded as one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people in Eurasia.||Eurasia|
|1338–1339||Bubonic plague is reported in central Asia.|
|1345||Plague occurs in southern Russia, around the lower Volga River basin.||Russia|
|1346||Epidemic||Bubonic plague breaks out in India (questionable).||China, India|
|1347||Epidemic||The plague spreads to Constantinople, a major port city. It also infects the Black Sea port of Kaffa down from southern Russia.||Turkey, Ukraine|
|1347||Epidemic||Italian traders bring the plague in rat-infested ships from Constantinople to Sicily, which becomes the first place in Europe to suffer the Black death epidemic. The same year, Venice is also hit.||Italy|
|1347–1350||Medical development||During the 1347–1350 outbreak, doctors are completely unable to prevent or cure the plague. Some of the cures they try include cooked onions, ten-year-old treacle, arsenic, crushed emeralds, sitting in the sewers, sitting in a room between two enormous fires, fumigating the house with herbs, trying to stop God punishing the sick for their sin. Flagellants would go on processions whipping themselves.||Europe|
|1348||Medical development||Italian writer Giovanni Boccaccio in his book Decameron writes a description of symptoms of the plague.||Italy|
|1348–1350||Epidemic||The Black Death arrives at Melcombe Regis in the south of England. Over the next year, the plague spreads into Northern England, Wales and Ireland. By 1350, the plague reaches Scotland. The estimated death toll for the British Isles is calculated at 3.2 million.||United Kingdom, Ireland|
|1349||Genocide||Black Death Jewish persecutions. A rumor rises claiming that Jews are responsible for the plague as an attempt to kill Christians and dominate the world. Supported by a widely distributed report of the trial of Jews who supposedly had poisoned wells in Switzerland, the rumor spreads quickly. As a result, a wave of pogroms against Jews breaks out. Christians start to attack Jews in their communities, burning their homes, and murder them with clubs and axes. In the Strasbourg massacre, it is estimated that people locked up and burned 900 Jews alive. Finally, Pope Clement VI issues a religious order to stop the violence against the Jews, claiming that the plague is "the result of an angry God striking at the Christian people for their sins."||France, Switzerland|
|1351||Epidemic||Black Death epidemic reaches Russia, attacking Novgorod and reaching Pskov, before being temporarily suppressed by the Russian winter.||Russia|
|1352||Epidemic||The plague reaches Moscow.||Russia|
|1361–1364||Medical development||During an outbreak, doctors learn how to help the patient recover by bursting the buboes.|
|1374||Epidemic||Black Death epidemic re-emerges in Europe. In Venice, various public health controls such as isolating victims from healthy people and preventing ships with disease from landing at port are instituted.||Europe|
|1377||Program launch||The Republic of Ragusa establishes a landing station for vessels far from the city and harbour in which travellers suspected to have the plague must spend thirty days, to see whether they became ill and died or whether they remained healthy and could leave.||Croatia|
|1403||After finding thirty days isolation to be too short, Venice dictates that travellers from the Levant in the eastern Mediterranean be isolated in a hospital for forty days, the quarantena or quaranta giorni, from which the term quarantine is derived.||Italy|
|1582–1583||Epidemic||A new outbreak of bubonic plague occurs, in the Canary Islands, mainly affecting the city of San Cristóbal de La Laguna on the island of Tenerife. Between 5,000 and 9,000 people die, a considerable number considering that the population of the island at the time was less than 20,000 inhabitants.||Spain|
|1629–1631||Epidemic||The Italian plague of 1629–1631 develops as a series of outbreaks of bubonic plague. About 280,000 people are estimated to be killed in Lombardy and other territories of Northern Italy. The Italian plague is estimated to have claimed between 35 and 69 percent of the local population.||Italy|
|1637||Epidemic||Plague breaks out in Andalusia, killing about 20,000 people in less than four months.||Spain|
|1647–1652||Epidemic||Plague ravages Spain. About 30,000 die in Valencia. The great Plague of Seville breaks out.||Spain|
|1665–1666||Epidemic||Great Plague of London. 100,000 people are killed within 18 months.||United Kingdom|
|1679||Epidemic||The Great Plague of Vienna kills at least 76,000 people.||Austria|
|1720||Epidemic||The Great Plague of Marseille kills more than 100,000 people in the French city of Marseille.||Marseille, France|
|1722||Publication||Daniel Defoe publishes A Journal of the Plague Year , a fictional account of the Great Plague of London in 1665. This novel is often read as non-fiction.||United Kingdom|
|1738||Epidemic||Great Plague of 1738 kills at least 36,000 people.||Romania, Hungary, Ukraine, Serbia, Croatia, Austria|
|1772–1850||Epidemic||The human plague is reported intermittently in the Chinese province of Yunnan, where the third plague pandemic would begin in the 1860s.||China|
|1867||Epidemic||The plague spreads from Yunnan Province to Beihai on the Chinese coastline.||China|
|1869||Epidemic||The plague is observed in Taiwan.||Taiwan|
|1894||Epidemic||The plague spreads to Guangdong and results in the death of about 70,000 people.||China|
|1894||Scientific development||Working independently, both French bacteriologist Alexandre Yersin and Japanese bacteriologist Shibasaburo Kitasato isolate the bacterium that causes bubonic plague. Yersin discovers that rodents are the mode of infection. The bacterium is named yersinia pestis after Yersin.|
|1896–1897||Medical development||Russian bacteriologist Waldemar Haffkine successfully protects rabbits against an inoculation of virulent plague microbes, by treating them previously with a subcutaneous injection of a culture of the microbes in broth. The first vaccine for bubonic plague is developed. The rabbits treated in this way become immune to plague. In the next year, Haffkine causes himself to be inoculated with a similar preparation, thus proving in his own person the harmlessness of the fluid. This is considered the first vaccine against bubonic plague.||India (Bombay)|
|1899||Epidemic||Plague is first introduced in Latin America in Paraguay, followed by Brazil and Argentina in the same year.||Paraguay, Brazil, Argentina|
|1901||Epidemic||Plague infection is first reported in Uruguay.||Uruguay|
|1902||Epidemic||Plague infection is first reported in Mexico.||Mexico|
|1903||Epidemic||Plague infection is first reported in Chile and Peru.||Chile, Peru|
|1905||Epidemic||Plague infection is first reported in Panama.||Panama|
|1908||Epidemic||Plague infection is first reported in Ecuador and Venezuela.||Ecuador, Venezuela|
|1910||Epidemic||Manchurian plague breaks out, killing about 60,000 people over the course of a year.||China|
|1912||Epidemic||Plague infection is first reported in Cuba and Puerto Rico.||Cuba, Puerto Rico|
|1921||Epidemic||Plague infection is first reported in Bolivia.||Bolivia|
|1924–1925||Epidemic||Plague breaks out in Los Angeles. 32 people get infected and only 2 survive. It is the last rat-borne epidemic occurring in the United States.||United States|
|1928||Medical development||Antibiotics developed||United Kingdom|
|1947||Publication||French novelist Albert Camus publishes The Plague , a novel about a fictional outbreak of plague in Oran, Algeria. The book helps to show the effects the plague has on a populace.||France|
|1994||Epidemic||Plague in India. The country experiences a large outbreak of pneumonic plague after 30 years with no reports of the disease. 693 suspected bubonic or pneumonic plague cases are reported.||India|
|1995–1998||Epidemic||From 1995 to 1998, annual outbreaks of plague were witnessed in Mahajanga, Madagascar.||Madagascar|
|2003||Epidemic||An outbreak of plague is reported in Algeria, in an area considered plague-free for 50 years.||Algeria|
|2006||Epidemic||In June 2006, one hundred deaths resulting from pneumonic plague were reported in Ituri district of the eastern Democratic Republic of the Congo. Control of the plague was proving difficult due to the ongoing conflict.||Democratic Republic of the Congo|
|2009||Infection||Plague is reported in Libya, after 25 years without a case of the disease.||Libya|
|2014||Scientific development||Researchers at Duke University School of Medicine and Duke-NUS Medical School Singapore find the Yersinia pestis bacteria to hitchhike on immune cells in the lymph nodes and eventually ride into the lungs and the blood stream, thus spreading bubonic plague effectively to others.||Singapore|
|2014–2018||Epidemic||Outbreaks in Madagascar||Madagascar|
The Black Death was the deadliest pandemic recorded in human history. The Black Death resulted in the deaths of up to 75–200 million people in Eurasia and North Africa, peaking in Europe from 1347 to 1351. Plague, the disease caused by the bacterium Yersinia pestis, was the cause; Y. pestis infection most commonly results in bubonic plague, but can cause septicaemic or pneumonic plagues.
Plague is an infectious disease caused by the bacterium Yersinia pestis. Symptoms include fever, weakness and headache. Usually this begins one to seven days after exposure. In the bubonic form there is also swelling of lymph nodes, while in the septicemic form tissues may turn black and die, and in the pneumonic form shortness of breath, cough and chest pain may occur.
A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people. A widespread endemic disease with a stable number of infected people is not a pandemic. Widespread endemic diseases with a stable number of infected people such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.
Yersinia pestis is a gram-negative, non-motile, rod-shaped, coccobacillus bacterium, with no spores. It is a facultative anaerobic organism that can infect humans via the Oriental rat flea. It causes the disease plague, which takes three main forms: pneumonic, septicemic, and bubonic.
Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by severe acute respiratory syndrome coronavirus, the first-identified strain of the SARS coronavirus species severe acute respiratory syndrome-related coronavirus (SARSr-CoV). The syndrome caused the 2002–2004 SARS outbreak. In late 2017, Chinese scientists traced the virus through the intermediary of Asian palm civets to cave-dwelling horseshoe bats in Yunnan.
The Plague of Justinian or Justinianic Plague was the beginning of the first plague pandemic, the first Old World pandemic of plague, the contagious disease caused by the bacterium Yersinia pestis. The disease afflicted the entire Mediterranean Basin, Europe, and the Near East, severely affecting the Sasanian Empire and the Roman Empire and especially its capital, Constantinople. The plague is named for the Roman emperor in Constantinople, Justinian I, who according to his court historian Procopius contracted the disease and recovered in 542, at the height of the epidemic which killed about a fifth of the population in the imperial capital. The contagion arrived in Roman Egypt in 541 and spread around the Mediterranean Sea until 544; in Northern Europe and the Arabian Peninsula, persisting until 549.
Ovine rinderpest, also commonly known as peste des petits ruminants (PPR), is a contagious disease primarily affecting goats and sheep; however, camels and wild small ruminants can also be affected. PPR is currently present in North, Central, West and East Africa, the Middle East, and South Asia. It is caused by small ruminants morbillivirus in the genus Morbillivirus, and is closely related to, among others, rinderpest morbillivirus, measles morbillivirus, and canine morbillivirus. The disease is highly contagious, and can have an 80–100% mortality rate in acute cases in an epidemic setting. This virus does not infect humans.
Globalization, the flow of information, goods, capital, and people across political and geographic boundaries, allows infectious diseases to rapidly spread around the world, while also allowing the alleviation of factors such as hunger and poverty, which are key determinants of global health. The spread of diseases across wide geographic scales has increased through history. Early diseases that spread from Asia to Europe were bubonic plague, influenza of various types, and similar infectious diseases.
Bubonic plague is one of three types of plague caused by bacterium Yersinia pestis. One to seven days after exposure to the bacteria, flu-like symptoms develop. These symptoms include fever, headaches, and vomiting. Swollen and painful lymph nodes occur in the area closest to where the bacteria entered the skin. Occasionally, the swollen lymph nodes may break open.
In public health, social distancing, also called physical distancing, is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious disease by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. It typically involves keeping a certain distance from others and avoiding gathering together in large groups.
John S Marr is an American physician, epidemiologist, and author. His professional life has concerned outbreaks of infectious disease and thus his subsequent writing career has focused on that topic, particularly historical epidemics.
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Globally about 600 cases of plague are reported a year. In 2017 and November 2019 the countries with the most cases include the Democratic Republic of the Congo, Madagascar, and Peru.
Several epidemics from the plague struck Malta from the medieval era until 1945, claiming almost 20,000 victims in at least ten epidemics over 350 years. After the first epidemics, preventive measures were installed, including a very active lazaret which issued patents of non-contagion for many ships plying the Mediterranean.
The Manchurian plague was a pneumonic plague that occurred between 1910 and 1911. It mainly hit the area of Manchuria, although some cases were reported in other places like Peking and Tianjin. Since there was no vaccine, the plague was very deadly, with estimates that it killed around 60,000 people, including doctors and nurses.
Human-to-human transmission (HHT) is a particularly problematic epidemiologic vector, especially in case the disease is borne by individuals known as superspreaders. In these cases, the basic reproduction number of the virus, which is the average number of additional people that a single case will infect without any preventative measures, can be as high as 3.9. Interhuman transmission is a synonym for HHT.