But it is worth reading some observations of the 1918 pandemic. [4]). 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. Digest of recent observations on the epidemiology of plague, Great Britain: report from Glasgow. [36,44,63]) and the transportation of infected vectors (e.g. [36,39,43,63–68,70]). Published by the Royal Society under the terms of the Creative Commons Attribution License Beitrag zur Kenntnis der Verhaltensweise von Ratten vergleichend dargestellt bei, London, UK: Batsford Academic and Educational, Madrid, Spain: Comision Permanente de Investigaciones Sanitarias, Mesagne (Brindisi), Italy: Giordano Editore, Rat control in a plague outbreak in Malta, Epidemiology of a bubonic plague outbreak in Glasgow, Scotland in 1900, Between the Carlo R. and the Orleannais: public health and maritime prophylaxis in the description of two cases of ships transporting immigrants arriving in the port of Rio de Janeiro, 1893–1907, The French hygiene offensive of the 1950s: a critical moment in the history of manners, Immunity as a factor in the epidemiology of medieval plague, Metapopulation dynamics of bubonic plague, Plague persistence in western Europe: a hypothesis, Plague reappearance in Algeria after 50 years, 2003, Plague outbreak in Libya, 2009, unrelated to plague in Algeria, Globalization, international law, and emerging infectious diseases, Plague: a millenary infectious disease reemerging in the XXI century, Proceedings of the Royal Society B: Biological Sciences, http://dx.doi.org/10.6084/m9.figshare.c.4454687, http://creativecommons.org/licenses/by/4.0/, Climate drivers of plague epidemiology in British India, 1898–1949, 1913, 1915, 1919, 1920, 1925, 1926, 1927, 1928, 1899, 1910, 1914, 1920, 1921, 1922, 1923, 1924, 1926, 1928, 1901, 1905, 1908, 1912, 1914, 1916, 1919, 1920, 1926, 1902, 1903, 1907, 1919, 1920, 1924, 1925, 1926, 1930, 1932, 1933, 1935, 1936, 1913, 1914, 1915, 1916, 1919, 1920, 1921, 1922, 1925, 1926, 1927, 1929, 1930. 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. When plague was introduced to Europe during the Third Pandemic, rats were heavily scrutinized by European health authorities (figure 3) when plague cases were discovered (e.g. The third plague pandemic that started in 1855 in China. These reports are translated and summarized in the electronic supplementary material. 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). After a small outbreak of plague in Taranto, Italy, in 1945, there was a large-scale anti-rodent campaign, which killed around 5000 rats [42]. Credit: Wellcome Collection. We used narrative and scientific reports in four languages (English, French, Italian and German) to supplement the case data. Thucydides, in the History of the Peloponnesian War, paused in his narrative of the war to provide an extremely detailed description of the symptoms of those he observed to be afflicted; symptoms he shared as he too was struck by the illness. It was the first time that plague would reach and establish itself in all inhabited continents. [21,38,63]). Finally, we would like to thank three anonymous referees whose comments have improved our contribution. Cases of pneumonic plague were reported during many of the outbreaks in Europe (electronic supplementary material, table S1) and often spread within households and among close contacts [36,44]. Swollen and painful lymph nodes occur in the area closest to where the bacteria entered the skin. The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone. For example, in East Suffolk, a 9-year-old girl became ill with pneumonic plague and died in a cottage 5 miles from Ipswich on 13 September 1910 [36,44]. During the Third Pandemic, plague was transported around the world by black rats on ships. Even in Malta, where the environment is much more favourable to rodent reproduction [67], Barnett observed that ‘plague outbreaks always come to an end even if nothing is done to kill rats or their fleas’ [67, p. 17]. Electronic supplementary material is available online at http://dx.doi.org/10.6084/m9.figshare.c.4454687. In many places in Europe, this work included the destruction of slums, improvement of sewage systems and the widespread development of safe water supply systems [79]. Locations and years of reported plague outbreaks in Europe (1899–1950) from the Public Health Reports and electronic supplementary material. Two-thirds of the population died.The disease, suspected to have been typhoid fever, weakened the Athenians significantly and played a big role in their defeat by the Spartans. Perhaps the most extensive rat surveys carried out during the Third Pandemic in Europe were in and around East Suffolk, Britain, where cases appeared regularly from 1906 to 1918 [36,44]. (Only locations with multiple plague outbreaks are shown (see also the electronic supplementary material, table S1). Figure 3. Following the outbreak, the authorities trapped 148 rats, 14 were R. rattus and the rest were R. norvegicus, but they found no evidence of plague [70]. Contemporary scholars regarded cleaning and disinfecting as an essential part of plague control measurements [21,67,80]. 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. More than 40% of adults in four states – Illinois, Louisiana, Mississippi and Missouri – and Washington, D.C., had symptoms of anxiety or depression. Using supplemental literature, we summarize the potential sources of plague in Europe and the transmission of the disease, including the role of rats. Official reports and accounts of individual outbreaks such as those in Oporto, Glasgow and Taranto (summarized in the electronic supplementary material) offer more detailed information about case numbers, symptoms, transmission and mortality, which may differ from the information in the Public Health Reports and electronic supplementary material, table S1. Plague has a long history on the European continent, with evidence of the disease dating back to the Stone Age. However, a similar account for Europe is missing, making it difficult to compare local and global transmission patterns. Finally, we discuss the eventual disappearance of plague in Europe owing to increased hygiene and a lack of a long-term rodent reservoir. In bubonic plague infections, the patient’s lymph nodes swell, and the patient experiences fever, aches, and chills. The American zoologist Davis [56] described similar differences in articles from the mid-1950s. While plague clearly has a long history in Europe, there are no known reservoirs for the disease today [12], which has generated debate surrounding how the ecology and epidemiology of plague has changed over time [13,14]. For instance, when plague broke out in Glasgow in 1900 (see the electronic supplementary material), the Medical Officer of Health caught and examined 326 rats, but found no evidence of plague in the rat population [39,63]. We are now in the third pandemic (Modern Plague), with outbreaks continuing to occur in some parts of the world (14–18). 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]. Figure 1. The conference was chaired by Dr Wu Lien Teh, who had stopped the great epidemic of pneumonic plague in Manchuria and Mongolia (about 60 000 victims) by 1910 [33]. 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]. International Organization for Standardization (ISO) Country code in parentheses.). Cases were geographically widespread, although they were primarily found in coastal or inland port cities (figure 2). Overall, the connection between urban rodents and human plague in Europe during the Third Pandemic is less clear than for outbreaks in India and China [21,46,48–50,54,75–78]. During the later part of the nineteenth century, diseases such as cholera and later plague were spreading throughout the world, partly owing to the advent of steamships [26]. 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. These reports have been compiled and summarized for several regions: North America [22,23], South America [23,24], Africa [23,25] and Asia [23]. In 1894, plague reached Canton and then spread to Hong Kong, where Alexandre Yersin identified the bacterium. This necessitated the development of adequate measures to prevent the introduction and spread of infectious diseases to Europe. CC BY 4.0.Download figureOpen in new tabDownload powerPoint. Visuals Unlimited / Corbis. 1,9,12,15. Moreover, plague is currently present in 11 countries around the world [85]; at a time of globalization, characterized by the increased mobility of people and goods, diseases can easily spread from endemic or enzootic regions (i.e. Another key international plague conference was held in Shenyang (old name, Mukden) in April 1911, with epidemiologists and scientists from 11 countries (China, Japan, USA, Great Britain, France, Germany, Italy, Austria–Hungary, The Netherlands, Russia and Mexico) [33]. Plague is not a disease that is found in Europe today, and we found no mention of plague outbreaks after 1950. 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. The third, or modern, pandemic started in China in the 19th century and spread to many parts of the world in port cities. Plague was in Europe until the middle of the last century, just two generations ago. Finally, we discuss the international efforts aimed at prevention and intervention measures, namely improved hygiene and sanitation, that ultimately led to the disappearance of plague in Europe. Her mother also contracted the disease and died 3 days after her daughter's death, followed by her stepfather and a neighbour who nursed her mother. plague usually develop acute febrile disease with other non-specific systemic symptoms after an incubation period of one to seven days CC BY 4.0. It was then carried by ships to Japan, Singapore, Taiwan and the Indian subcontinent [18,19]. This pandemic affected the Eastern Roman Empire, specifically Constantinople and port cities along the Mediterranean sea. Other documented sources of plague in Europe were from direct human transmission of pneumonic plague (e.g. Surveys for plague were carried out over an area of more than 2000 km2 [36,44]. An epidemic is a broad term used to describe any problem that is actively spreading and has grown out of control. Image courtesy of Wellcome Collection. It reached the Byzantine capital of Constantinople in 541 A.D., and was soon claiming up to 10,000 lives per day—so many that unburied bodies were eventually stacked inside buildings or left in the open. China's Yunnan province was the setting for the third and last great plague pandemic, which began in the 1850s. We can still find some cases in the U.S. today. The earliest known European cases occurred in September and October 1896, when two sailors from Bombay died of plague on ships docked in London on the Thames [21]. During all three pandemics, distinct strains of Y. pestis were introduced to Europe causing epidemics of plague, including the infamous Black Death (1346–1353); the strains from the first two pandemics are now extinct. [39,63,72]). The Third Plague Pandemic. Ectoparasites were so abundant in Europe that the Third International Congress on School Hygiene held in Paris in 1910 advised to fight against them, because one out of every three children was infested [73]. B.B. The earliest cases popped up in the spring of 1665 and the death rate rose that summer. It was rumoured that dead rats were observed before the outbreak, but none were examined. One to seven days after exposure to the bacteria, flu-like symptoms develop. Despite the independency of these strains, the clinical symptoms were similar during the first and second pandemics. 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. Plague was reported in 11 countries, and many cities, including Lisbon, Marseille, Paris and Pireas, experienced multiple outbreaks (table 1). Image courtesy of Wellcome Collection. Epidemiology is the branch of medicine that handles the following: Two measurable factors mostly define the level of disease occurrence: As human civilizations rose, these pandemic diseases, from the bubonic plague to smallpox to influenza, struck them down. Third plague pandemic: | |Third Pandemic| is the designation of a major World Health Organization, the pandem... World Heritage Encyclopedia, the aggregation of the largest online encyclopedias available, and the most definitive collection ever assembled. Bubonic plague is one of three types of plague caused by the plague bacterium (Yersinia pestis). Figure 2. ‘Liverpool Port Sanitary Authority rat-catchers dipping rats in buckets of petrol to kill fleas for plague control. The pattern of recurrent cases in East Suffolk led researchers John and Dorothy Black to assume that plague was endemic in this region [36]. Here, we compile the reported plague cases for Europe during the Third Pandemic from digitized records of notifiable diseases, previous studies and grey literature. Map of reported plague cases in Europe (1899–1947) from the Public Health Reports and electronic supplementary material, including the number of outbreaks in each location (see also the electronic supplementary material, table S1). Owing to their different behaviour, black rats are living closer to humans than brown rats. A recent paper [89], which analysed plague cases reported since the end of the last century, has proposed classifying plague as a re-emerging disease. We excluded Russia because their reporting of cases internationally has been sparse and irregular. Some regions, such as the Nordics and Eastern Europe, did not report any case of plague. designed research; B.B. The local authorities concluded that the infected rats were most probably brought by grain ships which unloaded their cargo in the area to lighten their draught before continuing onwards [36,44]. In Taranto in 1945, the allied forces, contributed noticeably to the fight against the epidemic by spraying large quantities of DDT against ‘fleas, but also bugs, lice and ticks' [66, p. 167]. At the end of the nineteenth century, the newly established discipline of microbiology found causative relationships between germs and diseases. 336564 (PI Christos Lynteris, University of St Andrews). By Josh Sanburn Tuesday, Oct. 26, 2010. For plague, detailed records of cases and deaths appear in the Public Health Reports beginning in 1899 (electronic supplementary material, table S1). A summary of the history and a survey of the present distribution of the disease. We are indebted to Giovangualberto Carducci, who has provided us with valuable published and unpublished material about the plague in Taranto 1945, and to the project Visual Representations of the Third Plague Pandemic, funded by a European Research Council Starting Grant under the European Union's Seventh Framework Programme/ERC grant agreement no. At that time, the World Health Organization determined that the plague was no longer active. However, not all introductions of plague led to the formation of reservoirs, typically found in arid and semi-arid highlands [17], which are not present in Europe. It killed more than 50 … From the first reports of plague, European sanitary authorities actively searched for dead rats in cities [39,63–66], urban districts [36,44], isles [67–70] and on ships [19], and they used early bacteriological methods to test for the plague bacterium in the local black and brown rat populations (e.g. Is bubonic plague still lurking in the City of Glasgow? 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. The Third Cholera Pandemic (1852-1860) Death Toll: Approximately 1 million Cause: Cholera According to the WHO, there have been seven cholera epidemics. Yet, Europe still experienced plague outbreaks during the Third Pandemic, which began in China and spread globally at the end of the nineteenth century. The disappearance of plague in Europe during the Third Pandemic can be attributed to two main factors, improved hygiene and the lack of a present-day sylvatic reservoir for the disease. [81]). These sources state that the black rat is an efficient climber, which makes nests in the walls and roofs of buildings, while the brown rat may live outdoors in the European climate, is an efficient swimmer, and makes nests in borrows in the soil, in cellars or in sewage pipes [57,59]. Ships arriving in European ports, such as those in the UK, were checked for early signs of plague at arrival and filled out a ‘Declaration of Health’ [35]. Even in this modern era, outbreaks are nearly constant, though not every outbreak reaches pandemic level as the COVID-19 has. The disease has recurred in Algeria [86] and Lybia [87] less than a decade ago, in places that are less than 300 miles from European boarders. [36,37,55], see also the electronic supplementary material). The two species of rats carry the same species of fleas. We converted city and country data to latitudes and longitudes for mapping using GeoPy (https://geopy.readthedocs.io/en/stable/). Large datasets are available through Proceedings B's partnership with Dryad, Locations and years of reported plague outbreaks in Europe (1899–1950) from the, The Stone Age plague and its persistence in Eurasia, Emergence and spread of basal lineages of, A decade of plague in Mahajanga, Madagascar: insights into the global maritime spread of pandemic plague, 4 Epidemiology of the Black Death and successive waves of plague, Climate-driven introduction of the Black Death and successive plague reintroductions into Europe, Towards ‘the atlas of plague and its environment in the People's Republic of China’: idea, principle and methodology of design and research results, Plague: a disease which changed the path of human civilization, Epidemiology of human plague in the United States, 1900–2012, Plague studies: I. Figure 1. (Link) If a capstone ... "The symptoms were not the same as in the East, where a gush of blood from the nose was the plain second plague pandemic (14th–18th century). However, in the years following the outbreak, they found some evidence of plague in the rat population: in 1901 (122 of 1641), in 1902 (30 of 6492) and in 1907 (1 of 140) [55]. 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. An epidemic is defined as "an outbreak of a disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population. 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? That outbreak sparked the third global plague pandemic. They wrote after the outbreak that ‘inquiry failed to discover any evidence that rat mortality prevailed to an unusual extent’ [63, p. 26]. 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. It is possible that future ancient DNA studies will demonstrate that all of the different lineages of Y. pestis involved in historic outbreaks went extinct after their introduction into Europe (see also Namouchi et al. Specifically, we draw on lessons from smallpox outbreaks, the third bubonic plague, the 1918 influenza pandemic, and more recent pandemics, such as HIV/AIDS, SARS, and Ebola. The low number of human plague cases in Europe during the Third Pandemic could be explained by a low number of infected rats, but it could also be a reflection of effective public health intervention measures that reduced the contact between humans and infected vectors, such as isolation of patients and contacts, prohibition of gatherings and improved hygiene (e.g. Forms ) struck the globe between 1894 and 1959 records and outbreak reports for the Third pandemic are and... American zoologist Davis [ 56 ] described similar differences in his book on ‘ the death! Started in the spring of 1665 and the death rate rose that summer an idea—became an independent. That is actively spreading Sanitary Authority rat-catchers dipping rats in buckets of petrol to kill for! In Russia [ 21, p. vi ] association with rats, probably from infected vectors ( e.g Libya. Spillover of plague to Europe in the U.S. today that plague would reach and establish in. 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