324249, PI, BB. In addition, from the middle of the twentieth century, the number of pests and parasites was reduced by the introduction of insecticides like dichlorodiphenyltrichloroethane (DDT), which was used heavily in many places like Malta from 1946 onwards . In some cases, it appears that infected vectors transmitted the disease between people in close contact. We see that cases were mainly notified in large cities and ports, which had more traffic from trade but also may have had more resources and established practices for detecting infectious diseases. (Only locations with multiple plague outbreaks are shown (see also the electronic supplementary material, table S1). This article explores how plague—as an idea—became an ahistorical independent agent of historical change. Figure 2. Case records and outbreak reports for the Third Pandemic are numerous and have improved our understanding of the historical epidemiology and distribution of plague. By Josh Sanburn Tuesday, Oct. 26, 2010. Even in Malta, where the environment is much more favourable to rodent reproduction , Barnett observed that ‘plague outbreaks always come to an end even if nothing is done to kill rats or their fleas’ [67, p. 17]. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, Oslo, Norway, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy, Division of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway. We declare we have no competing interests. [36,63]) (electronic supplementary material, table S1). It passed through Libya, Ethiopia, and Egypt, and it reached Athens as the Spartans laid siege. " An epidemic is an event in which a disease is actively spreading. We review published research on previous pandemics to historicize pandemic othering and blame, and enumerate some of the consequences for politics, policy, and public health. 10–16. designed research; B.B. It was noted by Proust that, ‘As in the previous meeting about cholera, it was decided that the treatment applicable to ships must be regulated by their sanitary condition at the arrival and not by the state of the port of provenance which gives only indications, which may be valuable indications but which are only indications. Indeed, infected ectoparasites in clothing, rags, grain sacks and other textiles could explain the appearances of plague even in the absence of infected rats (e.g. Plague epidemics in Europe during the First and Second Pandemics, including the Black Death, are infamous for their widespread mortality and lasting social and economic impact. Bubonic plague symptoms and signs include painful and enlarged or swollen lymph nodes (an enlarged lymph node due to plague is called a bubo), chills, ... causing the death of 60% of the entire population. For plague, detailed records of cases and deaths appear in the Public Health Reports beginning in 1899 (electronic supplementary material, table S1). There were 1692 cases and 457 deaths from plague reported in Europe between 1899 and 1947 (figure 1; electronic supplementary material, table S1), with the largest number of cases in the years 1899 and 1920. Published by the Royal Society under the terms of the Creative Commons Attribution License CC BY 4.0. A recent paper , which analysed plague cases reported since the end of the last century, has proposed classifying plague as a re-emerging disease. International conferences were held in Venice in 1892, in Dresden in 1893 and in Paris in 1894 . Nevertheless, over-reporting may have occurred if cases were misdiagnosed as plague. Europe is also the only region for which we have extended records and accounts on the previous plague pandemics, in particular those of the Second Pandemic. These symptoms include fever, headaches, and vomiting. Although the existence of a rodent reservoir for plague in the past is heavily debated [8,14,17,56,82–84], there is no evidence that plague is endemic to Europe today or was at any time during the Third Pandemic. The lack of a rodent reservoir in Europe is the fundamental reason why plague is no longer a public health threat today on the continent. At the end of the nineteenth century, the newly established discipline of microbiology found causative relationships between germs and diseases. Recent outbreaks of plague in Liverpool and Glasgow, Taranto fra guerra e dopoguerra. Infectiousness of any disease is measured by the reproduction number (R0, or. Il minamento della Rada di Mar Grande (1943) e l'episodio epidemico di peste bubbonica (1945), Control of plague in Taranto, Italy, 1945/1946: an account of a successful programme of rodent extermination, The last epidemic of plague in England? Despite the regulations in place, Europe experienced several outbreaks of plague during the Third Pandemic, but the vast majority of these outbreaks were small (electronic supplementary material, table S1). Thus, having documented outbreaks of the Third Pandemic can enable comparisons with historical ones, especially considering that the Third Pandemic in Europe was restricted to the pre-antibiotic era. Examination of rats for plague-infection, 1900–1907, The scarcity of rats and the Black Death: an ecological history, Rats cannot have been intermediate hosts for, Ethologische Unterschiede zwischen Hausratte und Wanderratte. Here, we compile the reported plague cases for Europe during the Third Pandemic from digitized records of notifiable diseases, previous studies and grey literature. This is the new principle underlying modern international prophylaxis' [21, p. vi]. While plague clearly has a long history in Europe, there are no known reservoirs for the disease today , which has generated debate surrounding how the ecology and epidemiology of plague has changed over time [13,14]. Although published in 1947 and a piece of fiction, The Plague by Albert Camus still eerily reflects how we reacted to the COVID-19 pandemic today as if it is a pattern that we need to recognize. In 1945, they found only two rats tested positive  and, in 1946, none were infected . While early bacteriological methods were used to identify plague in some instances, to our knowledge, most of the cases in the electronic supplementary material, table S1 were not confirmed. [21,35]). Scheube wrote that, ‘The development and spread of plague is influenced in a great measure by the unfavorable hygienic conditions, essentially connected with social misery’ [75, p. 12]. The pandemic is believed to have originated in Africa and then spread to Europe through infected rats on merchant ships. There were two species of commensal rats present in Europe during the Third Pandemic, the black rat (Rattus rattus), also called the ship rat or the roof rat, and the brown rat (Rattus norvegicus), also called the sewage rat. Authorities also issued a third-level alert, the second lowest in a four-level system, warning people against hunting, eating or transporting potentially infected animals, particularly marmots, and to report any dead or diseased rodents. The original use of the word Quarantine was the act of anchoring a ship arrived in Venice, Italy, for 40 days before landing. If the address matches an existing account you will receive an email with instructions to reset your password. Figure 1. We present these raw data in the electronic supplementary material, table S1 (1899–1927 in blue, 1927–1947 in green), with the highest resolution available from the reports. Using supplemental literature, we summarize the potential sources of plague in Europe and the transmission of the disease, including the role of rats. In addition to rats, the authorities found some ferrets, cats and rabbits that died of plague . Ancient DNA studies have identified Yersinia pestis, the aetiological agent of the Third Pandemic, as the cause of the previous plague pandemics: the First Pandemic (sixth to eighth centuries) [1–3] and the Second Pandemic (fourteen to nineteenth centuries) [4–8]. For instance, the last outbreak in Taranto in 1945, with 30 cases and 15 deaths, was hidden owing to military reasons, and possibly, other cases were not reported in times of war. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited. At the beginning of the Third Pandemic, physicians and scientists used new methods to increase their knowledge of plague, including microbiological and experimental techniques . Plague has a long history on the European continent, with evidence of the disease dating back to the Stone Age. From a comparison with the grey literature summarized in the electronic supplementary material, it is evident that not all cases have been reported in the Public Health Reports. The low numbers of plague-infected rats found during European outbreaks suggest that they played a relatively minor role in plague transmission. Bubonic plague | With the news that there was a suspected case in China, questions were raised about what it could mean as we fight with the Covid-19 pandemic. and L.W. Rats were also examined during and after outbreaks in East Suffolk [36,44], Malta [67–69], Italy , Corsica , Spain  and France  (see the electronic supplementary material). An epidemic is a broad term used to describe any problem that is actively spreading and has grown out of control. especially those outbreaks associated with the second pandemic (14th to 19th centuries) in Europe and Asia (1, 3–5), and have inspired many theoretical studies of the ecology and evolution of infectious disease (6–13). Swollen and painful lymph nodes occur in the area closest to where the bacteria entered the skin. This necessitated the development of adequate measures to prevent the introduction and spread of infectious diseases to Europe. There are also accounts of bubonic plague transmission without a clear association with rats, probably from infected vectors (e.g. B.B. Even in this modern era, outbreaks are nearly constant, though not every outbreak reaches pandemic level as the COVID-19 has. The American zoologist Davis  described similar differences in articles from the mid-1950s. As it is still the case for today, vermin infestations back then were associated with poverty and unhygienic living conditions (e.g. Is bubonic plague still lurking in the City of Glasgow? The largest rat epizootic found in Marseille occurred in the poor downtown areas in 1930, where 42 infected rats were discovered out of the 7275 that were examined . wrote the paper with contribution of the other authors. The third pandemic of plague (in its bubonic and pneumonic clinical forms) struck the globe between 1894 and 1959. After a small outbreak of plague in Taranto, Italy, in 1945, there was a large-scale anti-rodent campaign, which killed around 5000 rats . Plague in Africa from 1935 to 1949: a survey of wild rodents in African territories, Rapport sur une missione médicale en Russie; La peste du gouvernement d'Astrakhan, Medieval and modern bubonic plague: some clinical continuities, A commentary on recent plague investigations in Transbaikalia and southern Russia, Simla, India: Printed at the Government Central Print Office, Dr. Wu Lien Teh, plague fighter and father of the Chinese public health system, The past, present, and future of public health surveillance, Plague: modern preventive measures in ships and ports, Prevalence of disease: foreign and insular. Over the next few years, plague spread to many cities around the world: Bombay, Singapore, Alexandria, Buenos Aires, Rio de Janeiro, Honolulu, San Francisco and Sidney, among others . This was the third major bubonic plague outbreak to hit European society. Image courtesy of Wellcome Collection. Indeed, in the last years, the frequency of plague outbreaks in developing countries in Africa should not be overlooked; industrialized countries must react promptly to plague outbreaks as well as other epidemic diseases, in order to inform the population and help fight against them. Over the next 20 years, rats carried the infectious fleas responsible for the disease to Hong Kong and port cities around the world. A summary of the history and a survey of the present distribution of the disease. The recommendations of the conference to governments resulted in a complex system of regulations that controlled carriers coming by land and sea from infected regions . http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited. The reports consisted of primary accounts, secondary accounts and scientific reports, which are mainly found in grey literature. The plague returned in waves but was not as severe as this one. [39,63,72]). A pandemic is a disease occurring in epidemic form throughout the entire population of a country, a people, or the world. Despite the independency of these strains, the clinical symptoms were similar during the first and second pandemics. The pattern of recurrent cases in East Suffolk led researchers John and Dorothy Black to assume that plague was endemic in this region . [36,37,55], see also the electronic supplementary material). See also the electronic supplementary material, table S1. [36,63,64,67,74]), often in the poorest quarters of cities, where the majority of cases were found during outbreaks such as Oporto (1899), Glasgow (1900) and Marseille (1900–1921). Pneumonic plague occurs when plague infects the lungs, either primarily by the spread of infectious droplets or secondarily as a complication of bubonic plague. The lack of any respiratory symptoms in the account of the Plague of Cyprian is a strike against the identification. plague usually develop acute febrile disease with other non-specific systemic symptoms after an incubation period of one to seven days Indeed, from the 1950s, the introduction of baths in the majority of European dwellings, and the use of vacuum cleaners and washing machines, strongly enhanced personal hygiene and that of the domestic environment (e.g. Electronic supplementary material is available online at http://dx.doi.org/10.6084/m9.figshare.c.4454687. Of these, 60% were R. norvegicus and 40% were R. rattus in the docks, while all of the rats in the city were black rats. 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