Insufficient phylogenetic analysis may not exclude candidacy of typhoid fever as a probable cause of the Plague of Athens (reply to Shapiro et al.)

Papagrigorakis, Manolis J.; Yapijakis, Christos; Synodinos, Philippos N.; Baziotopoulou-Valavani, Effie

doi:10.1016/j.ijid.2006.02.005

Cited by 12 publications

(7 citation statements)

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“…96 Moreover, it is generally agreed that Athens was probably suffering from outbreaks of multiple diseases, and there is no proof that typhoid fever was the disease associated with the ''plague'' outbreak. 97,98 Pathogens evolve, as does host response, and other critics argue that the epidemiology of the epidemic is inconsistent with typhoid fever, 99 although possible differences between the ancient and modern strains of the pathogen might make it hard to rely too much on analogies to modern epidemiologic patterns.…”

Section: ''Primitive'' Warfarementioning

confidence: 99%

The History of Biological Weapons Use: What We Know and What We Don't

Carus

2015

Health Security

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This article critically reviews the literature on the history of biological warfare, bioterrorism, and biocrimes. The first serious effort to review this entire history, made in 1969, had numerous limitations. In recent decades, several authors have filled many of the gaps in our understanding of the past use of biological agents (including both pathogens and toxins), making it possible to reconstruct that history with greater fidelity than previously possible. Nevertheless, there are numerous remaining gaps, and closer inspection indicates that some supposed uses of biological weapons never took place or are poorly substantiated. Topics requiring additional research are identified.

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Section: ''Primitive'' Warfarementioning

confidence: 99%

The History of Biological Weapons Use: What We Know and What We Don't

Carus

2015

Health Security

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“…El descubrimiento de una fosa común en los terrenos del muy antiguo cementerio Kerameikos (Figura 2), durante la excavación de una estación de metro mientras Atenas se preparaba para las olimpíadas del 2004, reveló los restos de unos 150 niños, mujeres y hombres, enterrados en forma progresivamente apresurada y desordenada, sin evidencia del cuidadoso ceremonial fúnebre como era la costumbre de los atenienses, y con cerámica votiva estimada del año 430 a.C. De la pulpa dentaria de tres osamentas se aisló ADN que fue identifi cado como Salmonella enterica serovar Typhi. Los autores concluyen que este podría ser el agente causal de la peste [28][29][30] . El hallazgo y sus conclusiones han sido controvertidos 31 , y no han sido replicados hasta ahora.…”

Section: Diagnóstico Diferencialunclassified

¿Qué fue la plaga de Atenas?

2011

Rev. chil. infectol.

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In the year 430 B.C., at the beginning of the second year of the Peloponessian War, a terrible epidemic fell upon Athens and the most populous cities in Attica. It would last for just over four years and it would kill 100.000 people, a quarter to a third of the population. We know about it through the masterly description made by Thucydides in his History of the Peloponnesian War. His narrative has withstood twenty fi ve centuries due to its medical interest and, above all, its great dramatic force. The description of symptoms and signs, their evolution, and the consequences upon persons and moral and social order has captivated physicians, philologists and classical historians ever since. It has inspired literary works and hundreds of medical articles, with no agreement having been reached upon its cause or consequences, or if it is history or tragedy, or even if there is a single answer to these alternatives.Key words: Plague, epidemics, Thucydides, history of Medicine. Palabras clave: Plaga, epidemias, Tucídides, historia de la Medicina. Pontificia UniversidadCatólica de Chile. Facultad de MedicinaDivisión de Anestesiología y Programa de Estudios MédicosHumanísticos.No hay conflictos de interés. Recibido: 7 de mayo de 2011Correspondencia a:Jorge Dagnino Sepúlveda jdagnino@med.puc.cl E sparta, que lideraba la liga del Peloponeso invadió Ática en el año 431 a.C iniciando así una brutal lucha fraticida que duraría veintisiete años y cambiaría irreversiblemente el mundo griego y la civilización antigua 1 (Figura 1). Apenas habían transcurrido cincuenta años desde las épicas batallas en las Termópilas, y luego en Salamina y Platea, donde los griegos entonces unidos enfrentaron y derrotaron al enorme ejército persa invasor en la segunda de las guerras médicas. Esta improbable victoria ante fuerzas inmensamente superiores en número fue seguida por décadas de gran desarrollo económico y cultural, particularmente en Atenas, con seminales avances en las artes, las ciencias y la medicina. Entre los líderes atenienses sobresale Pericles, cuya habilidad política y militar facilitaría el desarrollo del imperio ateniense en el siglo que lleva su nombre. Al desatarse las hostilidades, Pericles, consciente de la superioridad de los hoplitas espartanos en el combate terrestre, impuso la estrategia de dejar los campos a merced del ejército invasor, protegiendo a la población en Atenas y su puerto, el Pireo. Estas ciudades estaban amuralladas y se encontraban unidas por un largo corredor defendido por las Murallas Largas que Temístocles había erigido al retirarse el ejército persa (Figura 2). Este complejo fortifi cado constituía una posición inexpugnable para las posibilidades bélicas de la época, mientras que la conexión marítima y la hegemonía ateniense en el mar aseguraban el abastecimiento indefi nido de la población y permitían desarrollar ataques en las costas del territorio enemigo. A consecuencias de esta estrategia, la población de Atenas se había cuadruplicado con los refugiados, muchos de los cuales vivían hacinados ...

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“…Shapiro et al further suggested that the sequence might have come from soil surrounding the burial and that the analysis is therefore compromised. Papagrigorakis et al 45 responded that soil wash was used as a negative control and that there was no contamination, a phylogenetic analysis of only 1 gene might be insufficient or misleading, and Salmonella species do not survive for long in soil. A DNA analysis of the skeletal materials is an intriguing start that one could anticipate will lead to new information about paleopathology and the plague years.…”

Section: Paleopathologymentioning

confidence: 99%

The Plague of Athens: Epidemiology and Paleopathology

Littman

2009

Mount Sinai J Medicine

115

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In 430 BC, a plague struck the city of Athens, which was then under siege by Sparta during the Peloponnesian War (431-404 BC). In the next 3 years, most of the population was infected, and perhaps as many as 75,000 to 100,000 people, 25% of the city's population, died. The Athenian general and historian Thucydides left an eye-witness account of this plague and a detailed description to allow future generations to identify the disease should it break out again. Because of the importance of Thucydides and Athens in Western history and culture, the Plague of Athens has taken a prominent position in the history of the West for the past 2500 years. Despite Thucydides' careful description, in the past 100 years, scholars and physicians have disagreed about the identification of the disease. Based on clinical symptoms, 2 diagnoses have dominated the modern literature on the Athenian plague: smallpox and typhus. New methodologies, including forensic anthropology, demography, epidemiology, and paleopathogy, including DNA analysis, have shed new light on the problem. Mathematical modeling has allowed the examination of the infection and attack rates and the determination of how long it takes a disease to spread in a city and how long it remains endemic. The highly contagious epidemic exhibited a pustular rash, high fever, and diarrhea. Originating in Ethiopia, it spread throughout the Mediterranean. It spared no segment of the population, including the statesman Pericles. The epidemic broke in early May 430 BC, with another wave in the summer of 428 BC and in the winter of 427-426 BC, and lasted 4.5 to 5 years. Thucydides portrays a virgin soil epidemic with a high attack rate and an unvarying course in persons of different ages, sexes, and nationalities.The epidemiological analysis excludes common source diseases and most respiratory diseases. The plague can be limited to either a reservoir diseases (zoonotic or vector-borne) or one of the respiratory diseases associated with an unusual means of persistence, either environmental/fomite persistence or adaptation to indolent transmission among dispersed rural populations. The first category includes typhus, arboviral diseases, and plague, and the second category includes smallpox. Both measles and explosive streptococcal disease appear to be much less likely candidates.In 2001, a mass grave was discovered that belonged to the plague years. Ancient microbial typhoid (Salmonella enterica serovar Typhi) DNA was extracted from 3 skeletons. Because typhoid was endemic in the Greek world, it is not the likely cause of this sudden epidemic. Mt Sinai J Med 76:456-467, 2009. (c) 2009 Mount Sinai School of Medicine.

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Insufficient phylogenetic analysis may not exclude candidacy of typhoid fever as a probable cause of the Plague of Athens (reply to Shapiro et al.)

Cited by 12 publications

References 14 publications

The History of Biological Weapons Use: What We Know and What We Don't

The History of Biological Weapons Use: What We Know and What We Don't

¿Qué fue la plaga de Atenas?

The Plague of Athens: Epidemiology and Paleopathology

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