Introduction

The Roman physician Galen coined the term ‘plague’ to describe any quickly spreading fatal
disease. Epidemics of all kinds have been described as plagues, but the bubonic plague is a very
specific disease that first spread around the world in the 1300s.In 430 BC, a plague struck the
city of Athens, which was then under siege by Sparta during the Peloponnesian War (431-404
BC). In the next 3 years, most of the population was infected, and perhaps as many as 75,000 to
100,000 people, 25% of theCity’s population, died. Plague pandemics hit the world in three
waves from the 1300s to the 1900s and killed millions of people. The first wave, called the Black
Death in Europe, was in 14th century.The worst outbreak of plague in England since the black
death. London lost roughly 15% of its population. While 68,596 deaths were recorded in the city,
the true number was probably over 100,000. Other parts of the country also suffered.
The Plague of Athens
In 430 BC, a plague struck the city of Athens, whichwas then under siege by Sparta during the
Peloponnesian War (431-404 BC). In the next 3 years,most of the population was infected, and
perhapsas many as 75,000 to 100,000 people, 25% of thecity’s population, died. The Athenian
general andhistorian Thucydides left an eye-witness account ofthis plague and a detailed
description to allow futuregenerations to identify the disease should it breakout again. Because of
the importance of Thucydidesand Athens in Western history and culture, thePlague of Athens
has taken a prominent positionin the history of the West for the past 2500 years.The war, along
with the plague, had serious effects on Athens' society. This resulted in a lack of adherence to
laws and religious belief; in response, laws became stricter, resulting in the punishment of non-
citizens claiming to be Athenian. Among the victims of the plague was Pericles, the leader of
Athens.The plague returned in the winter of 427/426 BC. Some 30 pathogens have been
suggested as having caused the plague.Thucydides claims that the plague spread from Ethiopia to
Athens. The plague first emerged in the port of Piraeus from ships with plague infected
passengers. From there it spread to Athens via the Long Walls where refugees would camp out.
The small space and poor hygiene of the people living in the Long Walls led to a significant
spread of the plague.
The plague affected certain groups over others, however, there is a lack of details of how the
plague spread among inbreeds and certain working members. Physicians and health care workers
were at a higher risk to catch the plague due to the exposure of other diseases. Higher-ranking
members of society were at a lower risk of catching the plague due to better living standards and
better hygiene. Lack of food was not an issue for Athens, for they had plenty of grain storage.
Athens lacked vitamin C due to their mainly grain diet. The lack of vitamin C caused a lower
immunity. The lower immunity left Athenians more susceptible to diseases. The Plague of
Athens was most likely caused by a reservoir disease or respiratory disease, though neither has
been confirmed. If the plague was caused by a reservoir disease, it would be very similar to
arboviral diseases or typhus as later mentioned. If it was a respiratory disease, it would most
likely be similar to smallpox.
According to Thucydides, the illness began by showing symptoms in the head as it worked its
way through the rest of the body. He also described in detail the symptoms that victims of the
plague experienced.
  Fever
 Redness and inflammation in the eyes
 Sore throats leading to bleeding and bad breath
 Sneezing
 Loss of voice
 Coughing
 Vomiting
 Pustules and ulcers on the body
 Extreme thirst
 Insomnia
 Diarrhea
 Convulsions
 Gangrene
Historians have long tried to identify the disease behind the Plague of Athens. The disease
has traditionally been considered an outbreak of the bubonic plague in its many forms, but a
reconsideration of the reported symptoms and epidemiology have led scholars to advance
alternative explanations. These include typhus, smallpox, measles, and toxic shock
syndrome. Based upon striking descriptive similarities with recent outbreaks in Africa, as
well as the fact that the Athenian plague itself came from Africa (as Thucydides recorded),
Ebola or a related viral hemorrhagic fever has been considered.
Given the possibility that profiles of a known disease may have changed over time, or that
the plague was caused by a disease that no longer exists, the exact nature of the Athenian
plague may never be known. In addition, crowding caused by the influx of refugees into the
city led to inadequate food and water supplies and a probable proportionate increase in
insects, lice, rats, and waste. These conditions would have encouraged more than one
epidemic disease during the outbreak.
Black Death ( 1346 – 1353 )
The Black Death was a bubonic plague pandemic occurring in Europe from 1346 to 1353. The
Black Death is widely believed to have been the result of plague, caused by infection with
the bacterium Yersinia pestis.. Hence, the origin of modern plague epidemics lies in
the medieval period. Bubonic plague is one type of plague. It gets its name from the swollen
lymph nodes (buboes) caused by the disease. The nodes in the armpit, groin and neck can
become as large as eggs and can ooze pus.
The Black Death was the second great natural disaster to strike Europe during the Late Middle
Ages and is estimated to have killed 30% to 60% of the European population, as well as
approximately 33% of the population of the Middle East. There were further outbreaks
throughout the Late Middle Ages and, also due to other contributing factors (the Crisis of the
Late Middle Ages), the European population did not regain its 14th century level until the 16th
century. Outbreaks of the plague recurred around the world until the early 19th century.In
English prior to the 18th century, the event was called the "pestilence" or "great pestilence",
"the plague" or the "great death".
There have been other episodes of bubonic plague in world history apart from the Black Death
years (1346-1353). Bubonic plague still occurs throughout the world and in the U.S., with cases
in Africa, Asia, South America and the western areas of North America. About seven cases of
plague happen in the U.S. every year on average. Half of the U.S. cases involve people aged 12
to 45 years.Bubonic plague symptoms include: Sudden high fever and chills, Pains in the
areas of the abdomen, arms and legs,Headaches, Large and swollen lumps in the lymph
nodes (buboes) that can develop and leak pus.
Bubonic plague is a type of infection caused by the yersinia pestis bacterium which is spread
mostly by fleas on rodents and other animals. Humans who are bitten by the fleas then can come
down with plague. It’s an example of a disease that can spread between animals and people (a
zoonotic disease).Bubonic plague can be fatal if it’s not treated. It can create infection throughout the
body (septicemic plague) and / or infect your lungs (pneumonic plague.) Without treatment, septicemic
plague and pneumonic plague are both fatal. Antibiotics that can traet bubonic plague are
Ciprofloxacin, levofloxacin and moxifloxacin, Gentamicin and Doxycycline.
London Plague ( 1665 – 1666 )
The Great Plague of London, lasting from 1665 to 1666, was the last major epidemic of
the bubonic plague to occur in England. It happened within the centuries-long Second Pandemic,
a period of intermittent bubonic plague epidemics that originated in Central Asia in 1331 (the
first year of the Black Death), and included related diseases such as pneumonic
plague and septicemic plague, which lasted until 1750.
The Great Plague killed an estimated 100,000 people—almost a quarter of London's population
—in 18 months. The plague was caused by the Yersinia pestis bacterium, which is usually
transmitted to a human by the bite of a flea or louse. The 1665–66 epidemic was on a much
smaller scale than the earlier Black Death pandemic. It became known afterwards as the "great"
plague mainly because it was the last widespread outbreak of bubonic plague in England during
the 400-year Second Pandemic.
Symptoms of great plague include; fever, delirium, vomitings, muscle cramps, painful
swellings of lymph nodes.
Plague usually resulted in death, normally within a week of the first symptoms. The first few
days though were without symptom and someone fleeing the dead could be a good carrier. The
plague was actually caused by infected fleas carried by black rats, although this would not be
known for centuries to come. Rats were particularly prevalent in the cramped and dirty streets of
capital occupied by the poorest residents. The plague in London largely affected the poor, as the
rich were able to leave the city by either retiring to their country estates or residing with kin in
other parts of the country.