The World Health Organization has often warned that plagues and epidemics are only one plane-ride away. This was certainly true for AIDS thirty years ago, and has also been the case with SARS. Talking about plagues and diseases is not the pleasantest thing to read on a lovely Santa Cruz summer day, but there are good reasons for understanding the prospects for us today and in the near future.

The economics of epidemics alone are alarming. Both China and Canada have lost tourism in the millions of dollars, not to mention business arrangements that they both need. Also, with all epidemics in human history, the health facilities may be quickly overwhelmed, and people lose faith in their authorities—from governments to religions. Law and order break down as the people tasked with these duties become ill. While none of these things have occurred yet in the United States, you can be certain that our governments—local, state, and federal—are trying to prepare for these possibilities. As we now know, after the disaster of September 11, 2001, there are people out there who would be quite willing to use biological warfare against their perceived enemies—us. So we need to consider the risks to us from both natural and man-made epidemics, and we may find some answers from a historic tour of plagues in the past. The fact that you and I are here today means that we had ancestors who survived bad times and kept mankind going.

But one more note before we look to the past. We have some new and different plagues to try to manage today. The first, AIDS, is a disease that is thought to be a crossover from Africa's forest animals to humans. This disease, we learned, is transmissible through sexual activity and through needle-drug sharing. It is not like the medieval Black Death that was lethally infectious by all sorts of human contact, but AIDS is lethal in Africa and rural India, where economies and medical systems are in crisis, and where behavior is resistant to change or modification. (More about this later.) The Caribbean, China, and Russia are the next candidates.

Some older plagues are returning with AIDS—primarily tuberculosis, which is proving lethal in Africa, and we are seeing drug-resistent Malaria and other tropical diseases.

SARS, the newest surprise disease that seems to be a crossover from animals, seems to have originated in China, as have most human epidemics throughout history, and has begun its move across the globe. Hopefully this one will be amenable to a vaccine or some other treatment that will reduce its lethality.

Sources for plagues. We have two plague sources: the first is the result of globalization and gross overpopulation, which provides the human congestion that breeds disease and the travel and trade that propel it around the world. The second is the possibility of a deadly epidemic deliberately produced by a terrorist enemy. This was one of the reasons for going to war in Iraq, and is not a figment of the Bush Administration’s imagination. We are having a preview right now of a relative of smallpox: the Monkey-Pox virus. Imagine the real thing!

Plagues have a very old history among human beings, and they all follow a common track. This may well be nature's system of checks and balances when certain human behaviors get out of line. (I am not substituting "Nature" for the older notion of "God's punishment" here, but am really looking at cause and effect, which seems to me much more in line with reality.)

Our first hunter/gatherer ancestors who emerged out of Africa were a hearty lot--they had to be or they did not survive at all. Babies often died before reaching five, but those who survived the vicissitudes of infancy were tough and made it through reproduction and what passed for an old age of 40 or so. We know this through forensic anthropology (examining ancient bodies for what they can tell us about the person's life, injuries, and diseases) and through studying the remnant of hunter/gatherers still living in the fringes of our world today. Hunting was a dangerous enterprise, and despite the growing skill and weapons of early hunters, breaking bones or becoming the food of some other hunter (animal or human) was always possible. Jared Diamond (Guns, Germs, and Steel) notes that we spent much longer as a species being hunted for some beast's dinner than being the hunters ourselves. There is even today a subliminal fear of being eaten or attacked by dogs, big cats, or sharks.

However, there does not seem to have been much of a history of communicable diseases among the hunter/gatherers. This did not happen until the first food revolution: the development of herding and agriculture. Herding may well have come first--and it may surprise you to learn that the first deliberately cultivated livestock was snails! The French have simply continued a primeval business, it seems. In the campsites and caves of our most ancient ancestors, there are literally mountains of snail shells. No garlic that we know of, and no butter yet, but snails. (You can explore this further in Near a Thousand Tables: A History of Food, by Felipe Fernandez-Armesto.)

But before long, other animals were tamed and the industry of herding was born. It was much better to have animals at your doorstep than to have to hunt them. Besides, one could also get milk; learn to make yogurt and cheese; use the hides for clothing, footwear, and shelter; and use antlers and horns as tools or receptacles. Herding was followed by the discovery of grains and grasses that could be planted and harvested, not just gathered. Around the world, wheat, barley, millet, maize (corn), and rice provided enough storable food to support communities that grew in size and wealth.

Along with this wealth came its companions, greed and violence. There were always people who did not want to do the work but wanted the goods, and the people who did the work had to learn how to protect what they had. Organized warfare was born. In addition to warfare came private property and social inequality. Slavery of both captives and all women came with this package--along with civilization, cities, arts, architecture, and organized religions. It is a package of mixed merit at times. Life was good for a minority and wretched for most, a problem that persists to our own day.

This "agricultural revolution" brought with it the two elements that made epidemics and plagues possible. In herding animals, human beings were exposed to a number of diseases (bacteria and viruses) that crossed over from our animals to their tenders. The tenders, like the milkmaids of 18th century France, picked up these diseases but developed inoculation-like immunities to them. Unfortunately, others in their communities did not. Also, the increasing density of population centers that emerged from the wealth and the calories of grains, provided a perfect breeding and transmission ground for contagion. People died in massive numbers--and had no idea why. In ancient times, such horrors were attributed to the anger of their gods, who somehow had to be placated.

According to William H. McNeill (Plagues and Peoples), most of the distinctive infectious diseases of civilization came to human populations from their animal herds. "Measles, for example, is probably related to rinderpest and/or canine distemper; smallpox is certainly connected closely with cowpox and with a cluster of other animal infections; influenza is shared by humans and hogs." Even today, we share 26 diseases with poultry, 32 with rats and mice, 35 with horses, 42 with pigs, 46 with sheep and goats, 50 with cattle, and 65 with dogs. (The paperback edition of this work was printed in 1976, long before Mad Cow Disease got our attention.)

The point is that in antiquity most of the major epidemic diseases afflicted all the peoples of Europe and Asia (Eurasia), coming from the congested cities of China and India and traveling to the west by caravan and ship. Diseases such as measles, for example, were deadly when they first arrived, but over time became only childhood diseases that were not necessarily lethal. Because Europe, Asia, and North Africa were one giant trading and traveling region, our ancestors developed considerable immunity. However, the people of the New World had never developed resistance to these diseases, and this alone conquered and broke them much more than the Spanish Conquistadors or Pilgrim fathers.

Plagues and Kings. Three ancient stories come to mind, all of them written about the same time. The first is the Athenian story of Oedipus, a king who came out of nowhere to be offered the crown of Thebes when their king died mysteriously at a crossroad. Oedipus took up the crown and married the young widowed queen, having four children by her. Then a plague nearly leveled Thebes. The wise man of the city pinpointed Oedipus as the cause. The man he killed at the crossroads was (unknown to him) his father and the woman he married (unknown to him) was his mother. Oedipus plucked out his eyes in self-punishment and exiled himself from Thebes.. The plague ceased. This was enough cause and effect to satisfy the locals.

The second story is about King David, another ancient king, this time Hebrew, who lusted after a married woman and sent her husband to the front lines in war. Plague came to his city and did not cease until he confessed and asked God's forgiveness.

The third and most awesome story appears in Exodus, when God inflicts the Egyptians with a terrible plague because of the actions of their Pharaoh. Again, the plague abated when the Pharaoh let the Hebrew slaves leave the country.

Elsewhere in the ancient world, desperate people dealt with plagues by resorting to human sacrifice. The notorious stories about casting virgins into volcanoes illustrate the method. The gods must have liked the gift because the plague eventually stopped.

Plagues and Evil Eye. It took several thousand years before we understood any of the real causes and effects of disease transmission. During all those centuries, the kings grew smarter and deflected blame for plagues onto others. Frequent targets were women (witches) and strangers or marginalized and helpless people. During the first bouts of Black Death during the Middle Ages, rampaging German peasants threw Jews into wells or burned them in their synagogues because they believed that these people brought the plague upon Christians but did not die from it themselves. Before long, when the wells were full and contaminated, they finally observed that plague was equal opportunity. (The book to see is James Carrol’s Constantine’s Sword.)

Females and witchcraft became the next group to be accused of "bringing on plagues." This was not just a European problem, but has also been big in Black Africa—to this very day-- as well. During periods of disaster, "sniffers" (priests) would go around sniffing out witchcraft, and the people so identified would be impaled on stakes. In Southeast Africa today, numerous "witches" are identified and slaughtered because of lightning strikes on village thatch roofs. And, of course, another mindless superstition has lured men with AIDS to have intercourse with very young and small virgin girls--believing that this will cure their disease. They are undeterred by the death of the little girls, as well as the death of their rapists.

Plagues and Governments. One of the best recorded early plagues hit Rome in AD 165, and cut a great swath throughout Roman territories, killing a quarter or one-third of the entire Roman Empire. The disease seems to have been an ancestor of smallpox. It seems to have been brought to the Mediterranean by Roman troops who had been campaigning in Mesopotamia, (today’s Iraq). Again, we see an east to west track of diseases.

The chaos and despair that accompanies a great epidemic has brought down governments and brought about changes in religion. The Romans, when confronting a plague, were not at their best. Despite the fine intellect of Roman society, there was a powerful undertow of superstition and a horror of blood not deliberately shed in battle. In Rome, the sick and dying were shunned. A new religion that was emerging in Rome during the first centuries of the millennium, Christianity, preached charity for the sick and needy, and ailing Romans turned to them. This can account for the swelling of Christian numbers and the disdain for the old and impotent Roman gods and goddesses. (By the way, the Navajos have the same horror of blood that the Romans had. Curious, eh?)

Six centuries later, when the Muslims emerged on the scene, they too had principles about caring for the sick, orphaned, and widowed. The Muslim Golden Age, from Baghdad to Spain, began with health clinics that became the central pillars of universities and scientific research and investigation. The care of the sick was a very good selling point for conversion.

Plagues in the New World, brought to the great Aztec and Inca empires by mere handfuls of Spanish Conquistadors, not only wiped out whole armies and depopulated whole cities, but also turned the people against their old gods who seemed impotent to help them. The Spanish conquest of the New World was less due to naked courage than to the lack of immunity of the natives. As Jared Diamond tells us, the Eurasian continent provided thousands of years of contact, exposure to diseases, and gradually developing some immunities that the New World did not have.

Hawaii was hit by a measles epidemic brought by western sailors that nearly wiped out the native population. The unfortunate Hawaiians could not defend their independence against the Western interlopers.

The two worst plagues. It may be that we know as much as we do about the first recurring plague, the Bubonic (or Black Death), because the record keeping was amazingly good for that time and place, and population density was sufficient to make the plague visibly devastating. This disease arrived in Europe from either northeastern India or Yemen, and it ravaged the Mediterranean world. Then there was a break until 542 AD, after which it raged intermittently until 750. Europe recovered, population exploded, and the older agricultural lands began to show signs of exhaustion, producing endemic famines. The weakened population was then confronted with the new arrival of Bubonic Plague that had been ravaging China and India for some years.

The plague arrived aboard a ship that drifted into an Italian harbor in 1346, everybody on board dead, except for the black rats who disembarked, bringing with them the fleas that carried the disease. As the rats died, the fleas migrated to human beings, who began dying in alarming numbers along the riverways and trade routes of Europe. This plague came back again and again, killing entire communities and leaving Europe’s population greatly reduced. (See Robert S. Gottfried’s The Black Death, and again, McNeill’s Plagues and Peoples.)

The second plague that probably killed more human beings than any other disease was the Spanish Flu that followed the horrors of World War I. This was the first totally modern epidemic that traveled with lightning speed from Asia to every heavily populated part of the world. It is estimated that 25 million people perished in that one year, 1918-19.

We have had nothing this alarming since then, with the exception of AIDS and polio, which leaves us very vulnerable to whatever will come next. Our parents and grandparents lived in a world with death-dealing diseases, some of them epidemic, which made them less anxious than we are today. But today we know so much more about such epidemics than ever before in the past.

Things to watch out for. The rodents who live in the high plateaus of Central Asia and the high deserts of America have long had endemic diseases of their own that keeps their numbers in line. The native tribes in Mongolia who knew about these furry rodents (much like our own Prairie Dogs) had taboos about hunting them. They kept their distance. But then as the Chinese expanded into this area (as they are doing once more), the Chinese merchants saw the fur as something marketable. They had the rodents hunted and the furs brought to China—which started the Bubonic Plagues (or Black Death). The plague virus was carried by fleas, in furs and trade goods from China, by boat and by caravan. The first deliberate biological warfare incident happened during this plague. When the Mongols were attacking the Russian Crimean city of Kaffa, which was a Genoa trading outpost, they catapulted plague victims over the walls. A modern terrorist could dispatch an infected agent who would be willing to die for his religion to a convention in New York, and those exposed could bring the disease back home everywhere in the United States.

Chinese custom has once more presented a problem. In the southern province of Guangzhou, every sort of animal that walks, crawls, or flies is for sale for food. The civet cat as one of these, is being investigated as one of the animal carriers or a virus crossover to humans, in the outbreak of SARS. Once such a thing gets into the human population, it spreads on its own. The Chinese authorities are having a terrible time convincing the food merchants to cease and desist, and we are once more seeing a government that is losing credibility with its population because of what is perceived as mismanagement of a plague.

India’s customs are also playing a role—as they always have—in epidemic diseases. It is thought that one of the original reasons for the Caste System was the fear that the Aryan invaders had of the local population. The Aryans came from the highlands and cool mountains, whereas India was a giant hot incubator of every kind of disease, much of it deadly to humans. India still is such an incubator, and customs are not helping. The Ganges River is a great cesspool of dead animals, the ashes of the dead, and the bathing of the pious. It is amazing that there is not more sickness than there is.

The latest problem is the campaign to eradicate polio. India is the last breeding ground of this terrible disease in the world. Health workers are fanning out among the Muslim villages of India and are having difficulty convincing mothers to have their babies and children take the drops. Someone has planted the notion that these medicines have been designed to render Muslim children impotent and thus are a plot to commit genocide on them. It is very difficult to overcome such stupidity and paranoia, and the result may well be that a new strain of polio will emerge.

Africa, of course, is the most current source of new diseases, crossovers from the jungle animals whose habitat is being ever more encroached upon by an incredible population explosion. Despite famines, savage warfare, and not only AIDS, but also TB and a range of venereal diseases, the population in Africa continues to grow beyond the continent’s ability to sustain it. This has to be blamed on human perversity and stubborn custom, which we can all hope will be addressed by education and better leadership. This is only a hope.

I also have hope that Jerry Fallwell and his religious right movement will also be moved to reconsider their notion that AIDS is God’s punishment for homosexuality. They are a real obstacle to distributing condoms and clean needles not only here, but in Africa as well.

Conclusions. As my late mother-in-law said, better to be lucky than good. We are lucky to be living in a developed society, and lucky to have customs that can change when we find them outdated. The rest of the world has yet to reach this level, and will suffer terribly until it does.

We can also look to the political ramifications of a plague on certain societies. The Chinese government is facing more internal (currently small) demonstrations, but those are reflective of a loss of faith in the government which may be very broadly based. This has them very concerned, as they well should be. I would hope this would concern them enough to stop their program of peopling Central Asia and replacing native populations, who have specific knowledge, with urban Chinese. Not a good idea.

India will need to develop better government if they want to avoid the chaos that will come from the AIDS plague and other epidemics that could be avoided. The growing muscle of Fundamentalist Hinduism (Hindu Nationalism) is very dangerous to the future of India’s modernization and economic development. The mistrust of village Muslims in their government’s intentions is bad news.

The West, with its ever-evolving medical knowledge, is the only shield we have from another global epidemic as deadly as those of past history. I put my trust there. Throwing virgins into volcanoes will no longer cut it.

© 2003 Laina Farhat-Holzman