The Plague! The (Athenian) Plague!

Modern science weighs in on the old debate about which disease afflicted the Athenians at the start of the Peloponnesian War. DNA tests on material extracted from skeletons found in a mass grave dating to 430 BCE point to… Typhoid Fever.

From the Journal of Infectious Diseases:

BACKGROUND: Until now, in the absence of direct microbiological evidence, the cause of the Plague of Athens has remained a matter of debate among scientists who have relied exclusively on Thucydides’ narrations to introduce several possible diagnoses. A mass burial pit, unearthed in the Kerameikos ancient cemetery of Athens and dated back to the time of the plague outbreak (around 430 BC), has provided the required skeletal material for the investigation of ancient microbial DNA.

OBJECTIVE: To determine the probable cause of the Plague of Athens.

METHOD: Dental pulp was our material of choice, since it has been proved to be an ideal DNA source of ancient septicemic microorganisms through its good vascularization, durability and natural sterility. RESULTS: Six DNA amplifications targeted at genomic parts of the agents of plague (Yersinia pestis), typhus (Rickettsia prowazekii), anthrax (Bacillus anthracis), tuberculosis (Mycobacterium tuberculosis), cowpox (cowpox virus) and cat-scratch disease (Bartonella henselae) failed to yield any product in ‘suicide’ reactions of DNA samples isolated from three ancient teeth. On the seventh such attempt, DNA sequences of Salmonella enterica serovar Typhi were identified providing clear evidence for the presence of that microorganism in the dental pulp of teeth recovered from the Kerameikos mass grave.

CONCLUSION: The results of this study clearly implicate typhoid fever as a probable cause of the Plague of Athens.

The symptoms of Typhoid Fever (from MedicineNet):

The incubation period is usually 1-2 weeks and the duration of the illness is about 4-6 weeks. The patient experiences:

  • poor appetite,
  • headaches,
  • generalized aches and pains,
  • fever,
  • lethargy,
  • [the CDC adds: “in some cases, patients have a rash of flat, rose-colored spots”]

Persons with typhoid fever usually have a sustained fever as high as 103 to 104 degrees Fahrenheit (39 to 40 degrees Centigrade).

Chest congestion develops in many patients and abdominal pain and discomfort are common. The fever becomes constant. Improvement occurs in the third and fourth week in those without complications. About 10% of patients have recurrent symptoms (relapse) after feeling better for one to two weeks.

How does this compare with Thucydides’ description of the plague?

As a rule, however, there was no ostensible cause; but people in good health were all of a sudden attacked by violent heats in the head, and redness and inflammation in the eyes, the inward parts, such as the throat or tongue, becoming bloody and emitting an unnatural and fetid breath. These symptoms were followed by sneezing and hoarseness, after which the pain soon reached the chest, and produced a hard cough. When it fixed in the stomach, it upset it; and discharges of bile of every kind named by physicians ensued, accompanied by very great distress. In most cases also an ineffectual retching followed, producing violent spasms, which in some cases ceased soon after, in others much later. Externally the body was not very hot to the touch, nor pale in its appearance, but reddish, livid, and breaking out into small pustules and ulcers. But internally it burned so that the patient could not bear to have on him clothing or linen even of the very lightest description; or indeed to be otherwise than stark naked. What they would have liked best would have been to throw themselves into cold water; as indeed was done by some of the neglected sick, who plunged into the rain-tanks in their agonies of unquenchable thirst; though it made no difference whether they drank little or much. Besides this, the miserable feeling of not being able to rest or sleep never ceased to torment them. The body meanwhile did not waste away so long as the distemper was at its height, but held out to a marvel against its ravages; so that when they succumbed, as in most cases, on the seventh or eighth day to the internal inflammation, they had still some strength in them. But if they passed this stage, and the disease descended further into the bowels, inducing a violent ulceration there accompanied by severe diarrhoea, this brought on a weakness which was generally fatal. For the disorder first settled in the head, ran its course from thence through the whole of the body, and, even where it did not prove mortal, it still left its mark on the extremities; for it settled in the privy parts, the fingers and the toes, and many escaped with the loss of these, some too with that of their eyes. Others again were seized with an entire loss of memory on their first recovery, and did not know either themselves or their friends (Thuc. 2. 48ff.).

Of course, just because these poor individuals died of Typhoid Fever during the Plague (thus the mass grave), the does not mean that the Plague was (only) the result of Typhoid. Note that Thucydides attributes all disease during the Plague Years to the Plague. I wonder if one cause was assigned to what, in fact, was a witch’s brew of diseases that assailed the population of Athens?

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