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Antonine Plague
The Antonine Plague of 165–180 AD—also known as the Plague of Galen, a Greek physician living in the Roman Empire who described it—was an ancient pandemic brought back to the Roman Empire by troops returning from campaigns in the Near East. It has been suspected to have been either smallpox〔H. Haeser's conclusion, in ''Lehrbuch der Geschichte der Medicin und der epidemischen Krankenheiten'' III:24–33 (1882), followed by Zinsser in 1935.〕 or measles,〔"There is not enough evidence satisfactorily to identify the disease or diseases" concluded J. F. Gilliam in his summary (1961) of the written sources, with inconclusive Greek and Latin inscriptions, two groups of papyri and coinage.〕 but the true cause remains undetermined. The epidemic may have claimed the life of Roman emperor Lucius Verus, who died in 169 and was the co-regent of Marcus Aurelius Antoninus, whose family name, Antoninus, was given to the epidemic. The disease broke out again nine years later, according to the Roman historian Dio Cassius, and caused up to 2,000 deaths a day in Rome, one quarter of those who were affected, making the disease have a mortality rate of about twenty five percent (25%).〔Dio Cassius, LXXII 14.3–4; his book that would cover the plague under Marcus Aurelius is missing; this later outburst was the greatest of which the historian had knowledge.〕 The total deaths have been estimated at five million,〔("Past pandemics that ravaged Europe" ), BBC News, November 7, 2005〕 and the disease killed as much as one-third of the population in some areas and devastated the Roman army.〔(Plague in the Ancient World )〕
Ancient sources agree that the epidemic appeared first during the Roman siege of Seleucia in the winter of 165–166.〔Martin Sicker, (2000). "The Struggle over the Euphrates Frontier". ''The Pre-Islamic Middle East.'' (Greenwood) 2000:p.169 ISBN 0-275-96890-1.〕 Ammianus Marcellinus reports that the plague spread to Gaul and the legions along the Rhine. Eutropius asserts that a large population died throughout the Empire.〔Eutropius XXXI, 6.24.〕
== Epidemiology ==
In 166, during the epidemic, the Greek physician and writer Galen traveled from Rome to his home in Asia Minor. He returned to Rome in 168 when summoned by the two Augusti; he was present at the outbreak among troops stationed at Aquileia in the winter of 168/69. Galen briefly records observations and a description of the epidemic in the treatise ''Methodus Medendi'', and his other references to it are scattered among his voluminous writings. He describes the plague as "great" and of long duration and mentions fever, diarrhea, and pharyngitis, as well as a skin eruption—sometimes dry and sometimes pustular—appearing on the ninth day of the illness. The information provided by Galen does not clearly define the nature of the disease, but scholars have generally preferred to retrospectively diagnose it as smallpox.〔See McLynn, Frank, ''Marcus Aurelius, Warrior, Philosopher, Emperor'', Vintage Books, London, 2009.〕
Historian William McNeill〔McNeill, W.H. 1976 Plagues and Peoples. New York Anchor Press. ISBN 0-385-11256-4〕 asserts that the Antonine Plague and the later Plague of Cyprian (251–ca.270) were outbreaks of two different diseases, one of smallpox and one of measles, although not necessarily in that order. The severe devastation to the European population from the two plagues may indicate that people had no previous exposure to either disease, which brought immunity to survivors. Other historians believe that both outbreaks involved smallpox.〔D. Ch. Stathakopoulos ''Famine and Pestilence in the late Roman and early Byzantine Empire'' (2007) 95〕 This latter view seems more likely to be correct given that molecular estimates place the evolution of measles sometime after 500 AD.〔Furuse Y, Suzuki A, Oshitani H (2010) Origin of measles virus: divergence from rinderpest virus between the 11th and 12th centuries. Virol J. 7:52.〕
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