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Although the plague has practically disappeared from Europe since the beginning of the 20th century, it is still present in everyone's memory. Owing to three pandemics, it has left an indelible mark on mankind and has given rise to many popular phrases, paintings, books or more recently movies and video games. After a brief description of the plague as a disease, we will try to trace the history of the plague through some of the works of art it inspired and then to show how the plague is still haunting our collective memory., (Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.)

Bubonic plague has caused three deadly pandemics in human history: from the mid-sixth to mid-eighth century, from the mid-fourteenth to the mid-eighteenth century and from the end of the nineteenth until the mid-twentieth century. Between the second and the third pandemics, plague was causing sporadic outbreaks in only a few countries in the Middle East, including Egypt. Little is known about this historical phase of plague, even though it represents the temporal, geographical and phylogenetic transition between the second and third pandemics. Here we analysed in detail an outbreak of plague that took place in Cairo in 1801, and for which epidemiological data are uniquely available thanks to the presence of medical officers accompanying the Napoleonic expedition into Egypt at that time. We propose a new stochastic model describing how bubonic plague outbreaks unfold in both rat and human populations, and perform Bayesian inference under this model using a particle Markov chain Monte Carlo. Rat carcasses were estimated to be infectious for approximately 4 days after death, which is in good agreement with local observations on the survival of infectious rat fleas. The estimated transmission rate between rats implies a basic reproduction number R 0 of approximately 3, causing the collapse of the rat population in approximately 100 days. Simultaneously, the force of infection exerted by each infected rat carcass onto the human population increases progressively by more than an order of magnitude. We also considered human-to-human transmission via pneumonic plague or human specific vectors, but found this route to account for only a small fraction of cases and to be significantly below the threshold required to sustain an outbreak., (© 2017 The Author(s).)

This paper examined whether the preventive measures taken by the Hong Kong's colonial authorities were legitimate during the 1894 Hong Kong plague epidemic, and illuminated the correlation between the plague epidemic and hospital space in Hong Kong in the late 19th century. The quarantine measures taken by the colonial authorities were neither a clear-cut victory for Western medicine nor for a rational quarantine based on scientific medical knowledge. Hong Kong's medical officials based on the miasma theory, and focused only on house-to-house inspections and forced quarantine or isolation, without encouraging people to wear masks and without conducting disinfection. Even after Hong Kong plague spread, the Hong Kong's colonial authorities were not interested in what plague bacilli were, but in where they were to be found and how to prevent and control an outbreak of the disease. The germ theory brought significant changes to the disease classification system. Until the 1890s, Hong Kong's colonial authority had classified cause of death mainly on the basis of symptoms, infectious diseases, parts of the body and diseases of systems. Microbiological analysis of the cause of death in Hong Kong was started by Hunter, a bacteriologist, in 1902. He used bacteriological tests with a microscope to analyze the cause of death. New disease recognition and medical recognition brought large changes to hospital space as well. In particular, from the 1880s to the early 1900s, Western medical circles witnessed shifts from miasma theory to the germ theory, thereby influencing Hong Kong's hospital spaces. As the germ theory took ground in Hong Kong in 1894, the bacteriological laboratory and isolation ward became inevitable facilities, and hospital space were reorganized accordingly. However, the colonial authorities and local elites' strategy was different. As a government bacteriologist, Hunter established a central facility to unify several laboratories and to manage urban space from ouside the hospital. On the contrary, the Tungwah Hospital tried to transform hospital space with isolation ward and Receiving Ward System as the eclectic form of Chinese and Western medicine. The 1894 Hong Kong plague promoted the introduction of germ theory and the reorganization of hospital space.

Infectious diseases are potential catalysts for exploring 'engaged citizen' or socioscientific themes given their interwoven economic, political, scientific and social dimensions. This article describes how an undergraduate course on the history of infectious diseases was modified to explore the impact of two 'engaged citizen' themes (poverty and technology), and to consider the ramifications of those themes on past, present and future infectious disease outbreaks. Four outbreaks were used as the foundation for the course: plague (1350s), puerperal fever (1840s), cholera (1850s) and syphilis (1930s). The first part of the article describes the general course structure and the role of university-wide 'engaged citizen' themes in its semester-specific construction. The second part of the article demonstrates how poverty and technology 'threads' were explored in each of the four historical contexts, and subsequently how they were considered in current and future contexts; appendices with lesson suggestions are provided. The third and final part of the article discusses how this specific model might be more broadly applied to other microbiology instructional contexts., (© FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Though written amid an atmosphere of unprecedented medical advance in both diagnosis and therapeutics, Karel Čapek's The White Plague takes a starkly critical stance against overconfidence in medical science and its dubious ethical orbit. This article explores Čapek's censure of those who would privilege scientific interest in disease over the holistic plight of the sufferer. Provocatively, Čapek achieves this not only via the play's content, but also-prefiguring aspects of contemporary live art practice by several decades-by placing audience members in worrying proximity to abject ill bodies. Čapek proposes a sort of theatrical homeopathy, suggesting that limited exposure to the threat of disease might spur spectators toward empathy for those who suffer and promote a healthier, more compassionate society.

This article traces a seven-hundred-year history of one puzzling treatment for plague buboes that used the rumps of chickens to draw out the bubo's poisons. It traces the origin of the recipe to Avicenna's Canon and explores how medieval and early modern physicians altered the treatment and explained its workings up to the early eighteenth century. Much of the analysis focuses on the variants of the recipe that German physicians created as they adapted or elaborated on older recipes. This article argues that most variations of the treatment likely resulted from physicians trying ideas on paper, rather than in practice, as they attempted to unlock the mysteries of the plague's underlying poisons. Starting in the sixteenth century, however, evidence suggests that practice began to play an important role in the adaptation and interpretation of the "live chicken" recipes.

Immune heterogeneity in wild host populations indicates that disease-mediated selection is common in nature. However, the underlying dynamic feedbacks involving the ecology of disease transmission, evolutionary processes, and their interaction with environmental drivers have proven challenging to characterize. Plague presents an optimal system for interrogating such couplings: Yersinia pestis transmission exerts intense selective pressure driving the local persistence of disease resistance among its wildlife hosts in endemic areas. Investigations undertaken in colonial India after the introduction of plague in 1896 suggest that, only a decade after plague arrived, a heritable, plague-resistant phenotype had become prevalent among commensal rats of cities undergoing severe plague epidemics. To understand the possible evolutionary basis of these observations, we developed a mathematical model coupling environmentally forced plague dynamics with evolutionary selection of rats, capitalizing on extensive archival data from Indian Plague Commission investigations. Incorporating increased plague resistance among rats as a consequence of intense natural selection permits the model to reproduce observed changes in seasonal epidemic patterns in several cities and capture experimentally observed associations between climate and flea population dynamics in India. Our model results substantiate Victorian era claims of host evolution based on experimental observations of plague resistance and reveal the buffering effect of such evolution against environmental drivers of transmission. Our analysis shows that historical datasets can yield powerful insights into the transmission dynamics of reemerging disease agents with which we have limited contemporary experience to guide quantitative modeling and inference., Competing Interests: The authors declare no conflict of interest.

The recent use of next-generation sequencing methods to investigate historical disease outbreaks has provided us with an unprecedented ability to address important and long-standing questions in epidemiology, pathogen evolution, and human history. In this review, we present major findings that illustrate how microbial genomics has provided new insights into the nature and etiology of infectious diseases of historical importance, such as plague, tuberculosis, and leprosy. Sequenced isolates collected from archaeological remains also provide evidence for the timing of historical evolutionary events as well as geographic spread of these pathogens. Elucidating the genomic basis of virulence in historical diseases can provide relevant information on how we can effectively understand the emergence and re-emergence of infectious diseases today and in the future., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Plague, a deadly zoonose caused by the bacterium Yersinia pestis, has been firmly documented in 39 historical burial sites in Eurasia that date from the Bronze Age to two historical pandemics spanning the 6th to 18th centuries. Palaeomicrobiologic data, including gene and spacer sequences, whole genome sequences and protein data, confirmed that two historical pandemics swept over Europe from probable Asian sources and possible two-way-ticket journeys back from Europe to Asia. These investigations made it possible to address questions regarding the potential sources and routes of transmission by completing the standard rodent and rodent-flea transmission scheme. This suggested that plague was transmissible by human ectoparasites such as lice, and that Y. pestis was able to persist for months in the soil, which is a source of reinfection for burrowing mammals. The analyses of seven complete genome sequences from the Bronze Age indicated that Y. pestis was probably not an ectoparasite-borne pathogen in these populations. Further analyses of 14 genomes indicated that the Justinian pandemic strains may have formed a clade distinct from the one responsible for the second pandemic, spanning in Y. pestis branch 1, which also comprises the third pandemic strains. Further palaeomicrobiologic studies must tightly connect with historical and anthropologic studies to resolve questions regarding the actual sources of plague in ancient populations, alternative routes of transmission and resistance traits. Answering these questions will broaden our understanding of plague epidemiology so we may better face the actuality of this deadly infection in countries where it remains epidemic., (Copyright © 2016. Published by Elsevier Ltd.)

Infectious diseases have become a rising challenge to mankind in a globalizing world. Yet, little is known about the inland transmission of infectious diseases in history. In this study, we based on the spatio-temporal information of 5559 plague (Yersinia pestis) outbreaks in Europe and its neighboring regions in AD1347-1760 to statistically examine the connection between navigable rivers and plague outbreak. Our results showed that 95.5% of plague happened within 10 km proximity of navigable rivers. Besides, the count of plague outbreak was positively correlated with the width of river and negatively correlated with the distance between city and river. This association remained robust in different regression model specifications. An increase of 100 m in the width of river and a shortening of 1 km distance between city and river resulted in 9 and 0.96 more plague outbreaks in our study period, respectively. Such relationship shows a declining trend over our study period due to the expansion of city and technological advancement in overland transportation. This study elucidates the key role of navigable river in the dissemination of plague in historical Europe.

The digitisation of historical disease images and their widespread availability on the internet have been a boon to education and research, but with unintended consequences, including the misrepresentation of infectious diseases in the past and the viral spread of misinformation. Many medieval images containing scenes of infectious disease come from non-medical sources and are not meant to convey any medical meaning. Erroneous modern captions have led to the publication of several historical images labelled as depictions of the plague, although artistic and textual evidence shows that they are not. Mislabelled images lose their intended historical narrative, and their use creates a distorted view of the past and of the disease in question. Scholars should give the same careful consideration to an image's evidentiary context that they would insist on giving to all other forms of evidence., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

We have been involved in the field of paleomicrobiology since 1998, when we used dental pulp to identify Yersinia pestis as the causative agent of the great plague of Marseille (1720). We recently designed a specific technique, "suicide PCR," that can prevent contamination. A controversy arose between two teams, with one claiming that DNA must be altered to amplify it and the other group claiming that demographic data did not support the role of Y. pestis in the Black Death (i.e., the great plague of the Middle Ages). These controversies led us to evaluate other epidemiological models and to propose the body louse as the vector of this pandemic. This proposal was substantiated by experimental models, the recovery of Y. pestis from lice in the Congo, and the identification of epidemics involving both Y. pestis and Bartonella quintana (the agent of trench fever, transmitted by the body louse) in ancient corpses from mass graves. Paleomicrobiology has led to a re-evaluation of plague pandemics.

The analysis of biological parameters such as age and sex is particularly relevant to the interpretation of ancient skeletal assemblages related to abrupt mortality crises, and more particularly epidemics. In such a context, the mechanisms of selection within a population or part of a population differ according to the pathogen involved. They may also vary depending on the period and location in which the population lived. Here, we illustrate the specificity of plague mortality through the study of several European burial sites contemporary with the first and second plague pandemics. The paleodemographic patterns obtained for different plague outbreaks from the 6th to the 16th centuries reveal some constant features over time and space as well as some differences that suggest a possible evolution in the epidemiological characteristics of the disease.

Objectives: Plague remains a public health concern worldwide, particularly in old foci. Multiple epidemics of this disease have been recorded throughout the history of Iran. Despite the long-standing history of human plague in Iran, it remains difficult to obtain an accurate overview of the history and current status of plague in Iran., Methods: In this review, available data and reports on cases and outbreaks of human plague in the past and present in Iran and in neighboring countries were collected, and information was compiled regarding when, where, and how many cases occurred., Results: This paper considers the history of plague in Persia (the predecessor of today's Iran) and has a brief review of plague in countries in the World Health Organization Eastern Mediterranean Region, including a range of countries in the Middle East and North Africa., Conclusions: Since Iran has experienced outbreaks of plague for several centuries, neighboring countries have reported the disease in recent years, the disease can be silent for decades, and the circulation of Yersinia pestis has been reported among rodents and dogs in western Iran, more attention should be paid to disease monitoring in areas with previously reported human cases and in high-risk regions with previous epizootic and enzootic activity., Competing Interests: The authors have no conflicts of interest to declare for this study.

Ancient DNA analysis has revealed an involvement of the bacterial pathogen Yersinia pestis in several historical pandemics, including the second plague pandemic (Europe, mid-14(th) century Black Death until the mid-18(th) century AD). Here we present reconstructed Y. pestis genomes from plague victims of the Black Death and two subsequent historical outbreaks spanning Europe and its vicinity, namely Barcelona, Spain (1300-1420 cal AD), Bolgar City, Russia (1362-1400 AD), and Ellwangen, Germany (1485-1627 cal AD). Our results provide support for (1) a single entry of Y. pestis in Europe during the Black Death, (2) a wave of plague that traveled toward Asia to later become the source population for contemporary worldwide epidemics, and (3) the presence of an historical European plague focus involved in post-Black Death outbreaks that is now likely extinct., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Vampirism has been a component of Central European and Balkan folklore since the Middle Ages and was often believed to be responsible for the transmission of serious infectious diseases such as plague and tuberculosis/consumption. Vampirism was believed to be spread within the same family or village and if the rite of the so-called second burial after death was not performed. The practice of "second burial" entailed exhumation of the body and the removal of the shroud from the mouth of the corpse, and a search for evidence if the corpse had chewed the cloth. If the shroud was chewed, a handful of earth or a brick was put into the body's mouth so that the vampire could no longer harm others. In some cases, the corpse was decapitated and an awl, made of ash, was thrust into its chest. Furthermore, the limbs were nailed down to prevent its movements. Remarkably, these beliefs were not restricted to the popular classes, but were also debated by theologians, political scientists at the height of the eighteenth century (Enlightenment). In the Habsburg Empire, this question attained such important political, social as well as health connotations as to force the Empress Maria Theresa to entrust an ad hoc study to her personal physician Gerard van Swieten with a view to determining what was true about the apparitions of vampires that occurred throughout central Europe and in the Balkans. The result of this investigation led to a ban on the "second burial" rites. Despite this prohibition, the practice of necrophilia on the bodies of suspected people continued, and both a cultured and popular literature on vampirism continued to flourish well into the nineteenth century.

Introduction: Plague has been responsible for two major historic pandemics (6th-8th century CE; 14th-19th century CE) and a modern one. The recent Malagasy plague outbreaks raised new concerns on the deadly potential of the plague-causing bacteria Yersinia pestis. Between September 2014 and April 2015, outbreaks of bubonic and pneumonic plague hit the Malagasy population. Two hundred and sixty-three cases, including 71 deaths, have been reported in 16 different districts with a case fatality rate of 27%. The scope of our study was to ascertain whether the risk factors for health in modern-day populations exposed to plague and in ancient populations that faced the two historic pandemics varied or remained substantially unaltered., Methodology: The risk of mortality of the Malagasy population with those obtained from the reconstruction of three samples of European populations exposed to the historic pandemics was contrasted., Results: The evidence shows that the risks of death are not uniform across age neither in modern nor in historic populations exposed to plague and shows precise concentrations in specific age groups (children between five and nine years of age and young adults)., Conclusions: Although in the post-antibiotic era, the fatality rates have drastically reduced, both modern and historic populations were exposed to the same risk factors that are essentially represented by a low standard of environmental hygiene, poor nutrition, and weak health systems.

Plague, caused by the bacterium Yersinia pestis, is one of the deadliest infectious diseases in human history, and still causes worrying outbreaks in Africa and South America. Despite the historical and current importance of plague, several questions remain unanswered concerning its transmission routes and infection risk factors. The plague outbreak that started in September 1665 in the Derbyshire village of Eyam claimed 257 lives over 14 months, wiping out entire families. Since previous attempts at modelling the Eyam plague, new data have been unearthed from parish records revealing a much more complete record of the disease. Using a stochastic compartmental model and Bayesian analytical methods, we found that both rodent-to-human and human-to-human transmission played an important role in spreading the infection, and that they accounted, respectively, for a quarter and three-quarters of all infections, with a statistically significant seasonality effect. We also found that the force of infection was stronger for infectious individuals living in the same household compared with the rest of the village. Poverty significantly increased the risk of disease, whereas adulthood decreased the risk. These results on the Eyam outbreak contribute to the current debate on the relative importance of plague transmission routes., (© 2016 The Authors.)

The Swiss-born medical researcher Karl Friedrich Meyer (1884-1974) is best known as a 'microbe hunter' who pioneered investigations into diseases at the intersection of animal and human health in California in the 1920s and 1930s. In particular, historians have singled out Meyer's 1931 Ludwig Hektoen Lecture in which he described the animal kingdom as a 'reservoir of disease' as a forerunner of 'one medicine' approaches to emerging zoonoses. In so doing, however, historians risk overlooking Meyer's other intellectual contributions. Developed in a series of papers from the mid-1930s onwards, these were ordered around the concept of latent infections and sought to link microbial behavior to broader bio-ecological, environmental, and social factors that impact hostpathogen interactions. In this respect Meyer-like the comparative pathologist Theobald Smith and the immunologist Frank Macfarlane Burnet-can be seen as a pioneer of modern ideas of disease ecology. However, while Burnet's and Smith's contributions to this scientific field have been widely acknowledged, Meyer's have been largely ignored. Drawing on Meyer's published writings and private correspondence, this paper aims to correct that lacuna while contributing to a reorientation of the historiography of bacteriological epidemiology. In particular I trace Meyer's intellectual exchanges with Smith, Burnet and the animal ecologist Charles Elton, over brucellosis, psittacosis and plague-exchanges that not only showed how environmental and ecological conditions could 'tip the balance' in favor of parasites but which transformed Meyer thinking about resistance to infection and disease.

On 2 July 1637 43-year-old Elizabeth Burgess, from Canterbury, was buried at Birchington, Kent, having died of the plague in the hamlet of Wood in that parish. She was the first victim of an outbreak of plague in 1637. This article firstly examines that outbreak in Birchington in detail; then it considers how far the parish's experience matched that in nearby Faversham and Sandwich. It finally discusses the extent to which the infection spread to the surrounding area.

Histories of the Third Plague Pandemic, which diffused globally from China in the 1890s, have tended to focus on colonial efforts to regulate the movement of infected populations, on the state's draconian public health measures, and on the development of novel bacteriological theories of disease causation. In contrast, this article focuses on the plague epidemic in Hong Kong and examines colonial preoccupations with Chinese "things" as sources of likely contagion. In the 1890s, laboratory science invested plague with a new identity as an object to be collected, cultivated, and depicted in journals. At the same time, in the increasingly vociferous anti-opium discourse, opium was conceived as a contagious Chinese commodity: a plague. The article argues that rethinking responses to the plague through the history of material culture can further our understanding of the political consequences of disease's entanglement with economic and racial categories, while demonstrating the extent to which colonial agents "thought through things."

Nathaniel Hodges was the son of Thomas Hodges (1605-1672), an influential Anglican preacher and reformer with strong connections in the political life of Carolingian London. Educated at Westminster School, Trinity College Cambridge and Christ Church College, Oxford, Nathaniel established himself as a physician in Walbrook Ward in the City of London. Prominent as one of a handful of medical men who remained in London during the time of the Great Plague of 1665, he wrote the definitive work on the outbreak. His daily precautions against contracting the disease included fortifying himself with Théodore de Mayerne's antipestilential electuary and the liberal consumption of Sack. Hodges' approach to the treatment of plague victims was empathetic and based on the traditional Galenic method rather than Paracelsianism although he was pragmatic in the rejection of formulae and simples which he judged from experience to be ineffective. Besieged by financial problems in later life, his practice began to fail in the 1680s and he eventually died in a debtor's prison., (© The Author(s) 2014.)

The 14th-18th century pandemic of Yersinia pestis caused devastating disease outbreaks in Europe for almost 400 years. The reasons for plague's persistence and abrupt disappearance in Europe are poorly understood, but could have been due to either the presence of now-extinct plague foci in Europe itself, or successive disease introductions from other locations. Here we present five Y. pestis genomes from one of the last European outbreaks of plague, from 1722 in Marseille, France. The lineage identified has not been found in any extant Y. pestis foci sampled to date, and has its ancestry in strains obtained from victims of the 14th century Black Death. These data suggest the existence of a previously uncharacterized historical plague focus that persisted for at least three centuries. We propose that this disease source may have been responsible for the many resurgences of plague in Europe following the Black Death.

Ancient DNA (aDNA) recovered from plague victims of the second plague pandemic (14th to 17th century), excavated from two different burial sites in Germany, and spanning a time period of more than 300 years, was characterized using single nucleotide polymorphism (SNP) analysis. Of 30 tested skeletons 8 were positive for Yersinia pestis-specific nucleic acid, as determined by qPCR targeting the pla gene. In one individual (MP-19-II), the pla copy number in DNA extracted from tooth pulp was as high as 700 gene copies/μl, indicating severe generalized infection. All positive individuals were identical in all 16 SNP positions, separating phylogenetic branches within nodes N07_N10 (14 SNPs), N07_N08 (SNP s19) and N06_N07 (s545), and were highly similar to previously investigated plague victims from other European countries. Thus, beside the assumed continuous reintroduction of Y. pestis from central Asia in multiple waves during the second pandemic, long-term persistence of Y. pestis in Europe in a yet unknown reservoir host has also to be considered.

Plague caused by Yersinia pestis is a zoonotic infection, i.e., it is maintained in wildlife by animal reservoirs and on occasion spills over into human populations, causing outbreaks of different entities. Large epidemics of plague, which have had significant demographic, social, and economic consequences, have been recorded in Western European historical documents since the sixth century. Plague has remained in Europe for over 1400 years, intermittently disappearing, yet it is not clear if there were reservoirs for Y. pestis in Western Europe or if the pathogen was rather reimported on different occasions from Asian reservoirs by human agency. The latter hypothesis thus far seems to be the most plausible one, as it is sustained by both ecological and climatological evidence, helping to interpret the phylogeny of this bacterium.

Three plague pandemics plus several epidemics have ravaged the world. The three pandemics were characterised by the role shipping played in spreading of the plague. The third pandemic, which began in southern China in the 1850s, was carried out of Hong Kong in 1894 to all continents by steamships. The oldest known documents mentioning quarantine as a precaution against epidemics dates back to 1127 in Venice. During the second pandemic, the Black Death, quarantine was systematised. During the third pandemic gassing of the ships was introduced by burning sulphur. Later hydrogen cyanide, carbon monoxide and other toxic gasses have been applied. In many harbours the use of rat shields were made compulsory in the beginning of the 20th century. The French bacteriologist Alexandre Emile Jean Yersin isolated in 1894 and identified Yersinia pestis as the contagious agent in Hong Kong despite obstructions from the British authorities who favoured Shibasaburo Kitasato from Japan. Four years later the French scientist Paul-Louis Simond established the rat flee, Xenopsylla cheopis, as the vector transferring the bacteria from rats to humans. This discovery was, however, not recognized until 1903 and another five years passed until clinical consequences were taken during the plague epidemic in India 1908. Each pandemic lasted several centuries due to reintroduction of Y pestis from local reservoirs in rodent populations in addition to reintroduction from the original Asiatic reservoirs.

The paper gives the results of a comparative analysis of the prerequisites for the emergence and spread of epidemics of particularly dangerous infections, by using plague in Manchuria (1910-1911) and Ebola virus disease in West Africa (2014-2015) as examples. Analysis of literature and archival data and online information could reveal a number of common factors and conditions, which substantially contributed to the epidemics. Organization of anti-epidemic (preventive) measures in cases of the threatening epidemic spread, of particularly dangerous diseases must be based on the minimization, of the influence of the specific factors and conditions, which facilitate disease transmission in a given area in a given time.

As a prototype of the antiplague costume can be considered a special clothing, which physicians in medieval Europe wear for protection in plague nidus. Inventor of the first antiplague costume is considered to be a French doctor Charles de Lorme (1619). Much later, in 1878, a Russian professor Pashutin V V offered to use a costume, which looked like a hermetically sealed "bag" with a special breathing device aimed at protection of medical staff. Later, professor O.I. Dogel's respirator became well-known (1889). At the beginning of 20th century as part of the antiplague costume was used a charcoal filter mask, invented by Zelinsky N.D. Requirements to order the use of modern means of individual protection when working in nidus of especially dangerous infections identified sanitary-epidemiological rules, which reflect issues of laboratory workers working and protective clothing, respiratory protection, and view, especially operation, the procedure of putting on, removing and disinfecting antiplague costumes, pneumocostumes, pneumohelmets, isolation suits, gas-protection boxes, etc.

Plague resulted in three pandemics in history; however, its causative pathogen was isolated until the third pandemic in Hong Kong in 1894. At that time, two famous researchers, Dr. Alexandre Yersin and Dr. Shibasaburo Kitasato, went to HK, in order to identify the pathogen. The two great researchers had done a lot of work to isolate and identify the causative pathogen. However, Dr. Alexandre Yersin reported the real pathogen for plague, and we now acknowledge his work by nominating the pathogen's genus as Yersinia. In this chapter, we discussed the lessons learned from the two researchers' experience on isolation and identification of plague pathogen.

Objectives: This work was designed to adapt Geographical Information System-based spatial analysis to the study of historical epidemics. We mapped "plague" deaths during three epidemics of the early 15th century, analyzed spatial distributions by applying the Kulldorff's method, and determined their relationships with the distribution of socio-professional categories in the city of Dijon., Materials and Methods: Our study was based on a database including 50 annual tax registers (established from 1376 to 1447) indicating deaths and survivors among the heads of households, their home location, tax level and profession. The households of the deceased and survivors during 6 years with excess mortality were individually located on a georeferenced medieval map, established by taking advantage of the preserved geography of the historical center of Dijon. We searched for clusters of heads of households characterized by shared tax levels (high-tax payers, the upper decile; low-tax payers, the half charged at the minimum level) or professional activities and for clusters of differential mortality., Results: High-tax payers were preferentially in the northern intramural part, as well as most wealthy or specialized professionals, whereas low-tax payers were preferentially in the southern part. During two epidemics, in 1400-1401 and 1428, areas of higher mortality were found in the northern part whereas areas of lower mortality were in the southern one. A high concentration of housing and the proximity to food stocks were common features of the most affected areas, creating suitable conditions for rats to pullulate. A third epidemic, lasting from 1438 to 1440 had a different and evolving geography: cases were initially concentrated around the southern gate, at the confluence of three rivers, they were then diffuse, and ended with residual foci of deaths in the northern suburb., Conclusion: Using a selected historical source, we designed an approach allowing spatial analysis of urban medieval epidemics. Our results fit with the view that the 1400-1401 epidemic was a Black Death recurrence. They suggest that this was also the case in 1428, whereas in 1438-1440 a different, possibly waterborne, disease was involved.

A little-known effort to conduct biological warfare occurred during the 17th century. The incident transpired during the Venetian–Ottoman War, when the city of Candia (now Heraklion, Greece) was under siege by the Ottomans (1648–1669). The data we describe, obtained from the Archives of the Venetian State, are related to an operation organized by the Venetian Intelligence Services, which aimed at lifting the siege by infecting the Ottoman soldiers with plague by attacking them with a liquid made from the spleens and buboes of plague victims. Although the plan was perfectly organized, and the deadly mixture was ready to use, the attack was ultimately never carried out. The conception and the detailed cynical planning of the attack on Candia illustrate a dangerous way of thinking about the use of biological weapons and the absence of reservations when potential users, within their religious framework, cast their enemies as undeserving of humanitarian consideration.

Objectives: The 14(th) -century Black Death was one of the most devastating epidemics in human history, killing tens of millions of people in a short period of time. It is not clear why mortality rates during the epidemic were so high. One possibility is that the affected human populations were particularly stressed in the 14(th) century, perhaps as a result of repeated famines in areas such as England. This project examines survival and mortality in two pre-Black Death time periods, 11-12(th) centuries vs 13(th) century CE, to determine if demographic conditions were deteriorating before the epidemic occurred., Materials and Methods: This study is done using a sample of individuals from several London cemeteries that have been dated, in whole or in part, either to the 11-12(th) centuries (n = 339) or 13(th) century (n = 258). Temporal trends in survivorship and mortality are assessed via Kaplan-Meier survival analysis and by modeling time period as a covariate affecting the Gompertz hazard of adult mortality., Results: The age-at-death distributions from the two pre-Black Death time periods are significantly different, with fewer older adults in 13(th) century. The results of Kaplan-Meier survival analysis indicate reductions in survival before the Black Death, with significantly lower survival in the 13(th) century (Mantel Cox p < 0.001). Last, hazard analysis reveals increases in mortality rates before the Black Death., Conclusions: Together, these results suggest that health in general was declining in the 13(th) century, and this might have led to high mortality during the Black Death. This highlights the importance of considering human context to understand disease in past and living human populations., (© 2015 Wiley Periodicals, Inc.)

The bacteria Yersinia pestis is the etiological agent of plague and has caused human pandemics with millions of deaths in historic times. How and when it originated remains contentious. Here, we report the oldest direct evidence of Yersinia pestis identified by ancient DNA in human teeth from Asia and Europe dating from 2,800 to 5,000 years ago. By sequencing the genomes, we find that these ancient plague strains are basal to all known Yersinia pestis. We find the origins of the Yersinia pestis lineage to be at least two times older than previous estimates. We also identify a temporal sequence of genetic changes that lead to increased virulence and the emergence of the bubonic plague. Our results show that plague infection was endemic in the human populations of Eurasia at least 3,000 years before any historical recordings of pandemics., (Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.)

This article discusses the medicinal remedies consumed at the court of the Yorkist kings of England in the light of a lawsuit in the court of common pleas (edited in an appendix) between John Clerk, king's apothecary to Edward IV, and Katherine Neville, Duchess of Norfolk, over the partial non-payment of the apothecary's bills. It argues that the consumption of apothecaries' wares in large quantities was not merely a direct result of the excessive diet of the late medieval aristocracy, but in itself represented a facet of the conspicuous consumption inherent in the lifestyle of this particular social class. The remedies supplied by Clerk over a period of several years and listed in the legal record are set in the context of contemporary collections of medical recipes, particularly a 'dispensary' in the British Library's Harleian collection generally attributed to the king's apothecary.

Manuscripts written on white pages or margins of ancient books often present some interest for the historian. Here is studied the handwritten inscription on the page facing the frontispiece of the Pharmacopée des dogmatiques by Joseph du Chesne. It referred to the opinion of traditional doctors such as Guy Patin or Jean Riolan about Joseph du Chesne and chemical medicine issued from the theories of Paracelsus. A special interest was given to the pills against plague.