Editorial 70: The pandemic of the fifth century before our era
2,451 years ago, in 430 BC, in two countries of the Eastern Mediterranean, an epidemic outbreak took place that sowed death, economic ruin and despair
2,451 years ago, in 430 BC, in two countries of the Eastern Mediterranean, an epidemic outbreak took place that sowed death, economic ruin and despair. It began in the Achaemenid Empire, corresponding to a territory between present-day India, Ethiopia, Libya and Turkey, extending to the City of Athens. From the study of these facts, we can obtain lessons that guide us today and in the future.
Artaxerxes ruled the Achaemenid Empire for 30 years. His country had fought three Medical Wars against Greece that had weakened his population. Between 435 to 430 BC, in Cush (Ethiopia), several epidemics were originated that spread to areas of the Achaemenid empire such as Egypt, Libya, Assyria. In 430 BC they reached the island of Lemnos, in the Aegean, and from there to the port of Piraeus, near Athens, following routes of transport of goods and passengers.
On the other hand, the previous year, Greece, ruled by Pericles, had started the Peloponnesian war against the Spartans ruled by Archidamus II.
The arrival of the epidemic in Athens coincides with special conditions for its inhabitants, derived from the war events, leading to the so-called plague of Athens.
Indeed, as described by Thucydides, in his History of the Peloponnesian War, and later Aristophanes, in his Hippeis, the Athenians lived in unsanitary conditions due to overcrowding caused by immigration. In front of the Spartan attack and by decision of Pericles, the inhabitants of the Attica region abandoned their crops and accumulated inside Athens walls and in the interior space of the long walls that linked Athens with the ports of Piraeus and Faleron.
The epidemic appeared in the summer of 430 BC, lasted 4 years and caused the death of a third of the population, including the ruler Pericles in 429 BC, affecting all ages and social classes equally. According to Thucydides, the epidemic was a health problem for the 300 richest citizens of Athens, while, for the lower classes and immigrants, it was a health problem and economic ruin.
Thucydides’ detailed description of the symptoms has allowed current pathologists to propose that it was an infection with Salmonella enteric serotype typhi, which causes typhoid fever. However, other pathologists have proposed alternative arbovirus or bubonic plague infections. Faced with the impossibility of the essential autopsies, pathologists are inclined to typhoid fever, of zoonotic origin. Thucydides points out that another symptom, which we would currently classify as psychological, was the despair of being ill or fearing ill.
After a time of relative calm, the epidemic reappeared with a second wave in the summer of 429 BC. and, a third wave, in the winter between 427 and 426 BC During all these years the refugees were the most affected.
It is of interest to consider the role of Hippocrates and others who cared for the sick in controlling and appeasing the epidemic. Thus, the annotation of symptoms, recommendations such as avoiding direct contact, sleeping, exercising, maintaining a positive attitude and a varied diet, were of great help.
Thucydides and many others survived the disease (quote: “The same man was never attacked twice, never at least fatally”) thus introducing the immunological information. Although in the year 430 BC, they did not have vaccines against typhoid fever, it is interesting to analyze what happened to them in the last century and in present.
Ralph W.G. Wyckoff spent 4 years of research (1939-1943) in the industry to develop, for the first time, a vaccine against typhoid fever with live attenuated bacteria, which is currently not marketable due to its side effects. Subsequent research has made it possible to have two vaccines that achieve 70 to 80% protection.
At Veterinaria Digital we consider that the actions of Thucydides, Hippocrates and R. Wyckoff, in addition to the criteria of W. Far, R. Koch and C. Flugge (editorial numbers 67-68-69) and the practices carried out by veterinarians in the poultry and swine industry (example of mass population management in search of the target “Higia pecoris, salus populi”) could serve as a reference to avoid similar situations.
Finally, we want to emphasize that Thucydides never uses the words epidemic or plague, and says that the events of 430 BC were “pónos” work or fatigue; “nosos” suffering or “loimós” suffering, and therefore the disease had, not only a physical origin, but also a moral origin. Thus, social and territorial imbalances, ignorance, incompetence and corruption caused overcrowding, poverty and hunger among the population, allowing bacteria and viruses, coming from humans or animals, to unleash fatigue, suffering and epidemics in weakened societies physically and morally.
Photo: La peste de Atenas, el fin del gobernar de Pericles – Oscar Hugo Montagno Ortega