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.
Local outbreaks of the plague are grouped into three plague pandemics, whereby the respective start and end dates and the assignment of some outbreaks to either pandemic are still subject to discussion. The pandemics were: the first plague pandemic from 541 to ~750, spreading from Egypt to the Mediterranean (starting with the Plague of Justinian) and northwestern Europe the second plague pandemic from ~1331 to ~1855, spreading from Central Asia to the Mediterranean and Europe (starting with the Black Death), and probably also to China the third plague pandemic from 1855 to 1960, spreading from China to various places around the world, notably India and the West Coast of the United States. However, the late medieval Black Death (roughly 1331 to 1353) is sometimes seen not as the start of the second, but as the end of the first pandemic – in that case, the first pandemic ended in around 1353, and the second pandemic's start would be about 1361. Also various end dates of the second pandemic are given in the literature, ranging from about 1840 to 1890.
Antiquity
The word plague is believed to come from the Latin word plāga ("blow, wound") and plangere ("to strike, or to strike down"), via the German Plage ("infestation").
Some authors have suggested that the plague was responsible for the Neolithic decline. That is supported by the discovery of a tomb in modern-day Sweden containing 79 corpses buried within a short time, in which the authors discovered fragments of a unique strain of the plague pathogen Yersinia pestis.
Plasmids of Y. pestis have been detected in archaeological samples of the teeth of seven Bronze Age individuals from 5000 years ago (3000 BC), in the Afanasievo culture in Siberia, the Corded Ware culture in Estonia, the Sintashta culture in Russia, the Unetice culture in Poland and the Andronovo culture in Siberia. Y. pestis existed over Eurasia during the Bronze Age. Estimates of the age of the most recent common ancestor of all Y. pestis is estimated at 5,783 years Before Present.
The Yersinia murine toxin (ymt) allows the bacteria to infect fleas, which can then transmit bubonic plague. Early ancestral versions of Y. pestis did not have the ymt gene, which was only detected in a 951 calibrated BC sample.
The Amarna letters and the Plague Prayers of Mursili II describe an outbreak of a disease among the Hittites."Plague Prayers of Mursilis" Pritchard, J. B. 1969. Ancient Near Eastern Texts. Princeton: Princeton University Press. The First Book of SamuelI Samuel 5:6; "But the hand of Yahweh was heavy on them of Ashdod, and he destroyed them, and struck them with "sores"/"tumors"/"Hemorrhoids", even Ashdod and its borders."The LXX and Vulgate include "And mice multiplied in their land, and the terror of death was throughout the entire city." describes a possible plague outbreak in Philistia, and the Septuagint version says it was caused by a "ravaging of mice".
In the second year of the Peloponnesian War (430 BC), Thucydides described an epidemic disease which was said to have begun in Ethiopia, passed through Egypt and Libya, then come to the Greek world. In the Plague of Athens, the city lost possibly one third of its population, including Pericles. Modern historians disagree on whether the plague was a critical factor in the loss of the war. Although this epidemic has long been considered an outbreak of plague, many modern scholars believe that typhus, smallpox, or measles may better fit the surviving descriptions. A recent study of DNA found in the dental pulp of plague victims suggests that typhoid was actually responsible.
In the first century AD, Rufus of Ephesus, a Greek anatomist, refers to an outbreak of plague in Libya, Egypt, and Syria. He records that Alexandrian doctors named Dioscorides and Posidonius described symptoms including acute fever, pain, agitation, and delirium. Buboes—large, hard, and non-suppurating—developed behind the knees, around the elbows, and "in the usual places." The death toll of those infected was very high. Rufus also wrote that similar buboes were reported by a Dionysius Curtus, who may have practiced medicine in Alexandria in the third century BC. If this is correct, the eastern Mediterranean world may have been familiar with bubonic plague at that early date.Simpson, W. J. A Treatise on Plague. Cambridge, England: Cambridge University Press, 1905.Patrick, Adam. "Disease in Antiquity: Ancient Greece and Rome," in Diseases in Antiquity, editors: Don Brothwell and A. T. Sandison. Springfield, Illinois; Charles C. Thomas, 1967.
In the second century, the Antonine Plague, named after Marcus Aurelius' family name of Antoninus and also known as the Plague of Galen, who had first hand knowledge of the disease, may in fact have been smallpox. Galen was in Rome when it struck in 166 AD, and was also present in the winter of 168–69 during an outbreak among troops stationed at Aquileia; he had experience with the epidemic, referring to it as very long lasting, and describes its symptoms and his treatment of it, though his references are scattered and brief. According to Barthold Georg NiebuhrNiebuhr, 1873. Lectures on the history of Rome, p 733. "this pestilence must have raged with incredible fury; it carried off innumerable victims. The ancient world never recovered from the blow inflected upon it by the plague which visited it in the reign of M. Aurelius." The mortality rate of the plague was 7–10 percent; the outbreak in 165/6–168 would have caused approximately 3.5 to 5 million deaths. Otto Seek believes that over half the population of the empire perished. J. F. Gilliam believes that the Antonine plague probably caused more deaths than any other epidemic during the empire before the mid-3rd century.
First pandemic: Early Middle Ages
The Plague of Justinian in AD 541–542 is the first known attack on record, and marks the first firmly recorded pattern of bubonic plague. This disease is thought to have originated in China. It then spread to Africa from where the huge city of Constantinople imported massive amounts of grain, mostly from Egypt, to feed its citizens. The grain ships were the source of contagion for the city, with massive public granaries nurturing the rat and flea population. At its peak, Procopius said the plague was killing 10,000 people in Constantinople every day. The real number was more likely close to 5,000 a day.Procopius. History of the Wars, Books I and II (The Persian War). Trans. H. B. Dewing. Vol. 1. Cambridge: Loeb-Harvard UP, 1954.—Chapters XXII and XXIII of Book II (pp. 451–73) are Procopius's famous description of the Plague of Justinian. This includes the famous statistic of 10,000 people per day dying in Constantinople (p. 465). The plague ultimately killed perhaps 40% of the city's inhabitants, and then continued to kill up to a quarter of the human population of the eastern Mediterranean.
In AD 588 a second major wave of plague spread through the Mediterranean into what is now France. It is estimated that the Plague of Justinian killed as many as people across the world. It caused Europe's population to drop by around 50% between 541 and 700. It also may have contributed to the success of the Arab conquests. An outbreak of it in the AD 560s was described in AD 790 as causing "swellings in the glands ... in the manner of a nut or date" in the groin "and in other rather delicate places followed by an unbearable fever". While the swellings in this description have been identified by some as buboes, there is some contention as to whether the pandemic should be attributed to the bubonic plague, Yersinia pestis, known in modern times.
Second pandemic: from 14th century to 19th century
From 1331 to 1351, the Black Death, a massive and deadly pandemic, spread along the Silk Road and swept through Asia, Europe and Africa. It may have reduced the world's population from to between 350 and . China lost around half of its population, from around to around ; Europe around one third of its population, from about to about ; and Africa approximately of its population, from around to (mortality rates tended to be correlated with population density so Africa, being less dense overall, had the lowest death rate). This makes the Black Death the largest death toll from any known non-viral epidemic. Although accurate statistical data does not exist, it is thought that 1.4 million died in England ( of England's 4.2 million people), while an even higher percentage of Italy's population was likely wiped out. On the other hand, north-eastern Germany, Bohemia, Poland and Hungary are believed to have suffered less, and there are no estimates available for Russia or the Balkans. It is conceivable that Russia may not have been as affected due to its very cold climate and large size, hence often less close contact with the contagion.
The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. According to Biraben, plague was present somewhere in Europe in every year between 1346 and 1671. The Second Pandemic was particularly widespread in the following years: 1360–1363; 1374; 1400; 1438–1439; 1456–1457; 1464–1466; 1481–1485; 1500–1503; 1518–1531; 1544–1548; 1563–1566; 1573–1588; 1596–1599; 1602–1611; 1623–1640; 1644–1654; and 1664–1667; subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century). According to Geoffrey Parker, "France alone lost almost a million people to plague in the epidemic of 1628–31."
In England, in the absence of census figures, historians propose a range of pre-incident population figures from as high as 7 million to as low as 4 million in 1300,The Black Death in Egypt and England: A Comparative Study, Stuart J. Borsch, Austin: University of Texas and a postincident population figure as low as 2 million.Secondary sources such as the Cambridge History of Medieval England often contain discussions of methodology in reaching these figures that are necessary reading for anyone wishing to understand this controversial episode in more detail. By the end of 1350, the Black Death subsided, but it never really died out in England. Over the next few hundred years, further outbreaks occurred in 1361–62, 1369, 1379–83, 1389–93, and throughout the first half of the 15th century. An outbreak in 1471 took as much as 10–15% of the population, while the death rate of the plague of 1479–80 could have been as high as 20%. The most general outbreaks in Tudor and Stuart England seem to have begun in 1498, 1535, 1543, 1563, 1589, 1603, 1625, and 1636, and ended with the Great Plague of London in 1665.