Might the first recorded Ebola outbreak have occurred not in Africa less than 40 years ago but, rather, more than 2,400 years ago, in ancient Greece? That’s what one professor of infectious diseases and history now suggests.
Most researchers say that the first outbreak of Ebola happened in 1976, in the Democratic Republic of Congo, then known as Zaire. In the current outbreak of the virus in West Africa — which began in early 2014 and is the largest to date — more than 27,000 people have been infected and nearly 11,200 people have died, according to the World Health Organization.
However, the Ebola virus is apparently quite old; previous research discovered remnants of identical Ebola DNA in several species of rodents, including the mouse and the Norway rat. This led scientists to speculate that Ebola infected the ancestors of these species at least 20 million years ago.
The ancient nature of the disease “raises the question of whether Ebola may have spilled over from its animal reservoir to humans well before scientists first identified it in 1976,” said Powel Kazanjian, a professor of history and infectious diseases at the University of Michigan.
In a new paper, Kazanjian suggests that an Ebola virus may have been the culprit in the Plague of Athens, a five-year epidemic that began in 430 B.C., whose cause has long been a matter of conjecture. Not only was the famed historian Thucydides, who chronicled the Peloponnesian War between Athens and Sparta, a witness to the Athenian disease, he also contracted it himself and survived.
“The Athenian epidemic in 430 B.C. has had a fascinating attraction for researchers of communicable diseases for a long period of time,” said William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Nashville.
The illness, also called Thucydides syndrome, began with an abrupt onset of fever, headache, fatigue and pain in the stomach and extremities, accompanied by furious vomiting. Those who survived seven days of illness also experienced severe diarrhea. Additional symptoms included reddened eyes, hiccups and bleeding from the mouth. Some individuals endured coughing, seizures, confusion, rashes, pustules, ulcers and even loss of fingers and toes, possibly due to gangrene.
As the disease progressed, Thucydides noted that people became so dehydrated that some plunged themselves into wells in futile attempts to quench their unceasing thirst. The disease often ended in death, typically within seven to nine days. Medical treatment was useless.
“Thucydides’s vivid description allows present-day historians and clinicians to speculate about the cause of prior epidemics and the historical roots of our epidemics we know about today,” Kazanjian said.
The Athenian disease began south of Egypt in a region Thucydides called “Aethiopia,” a term that ancient Greeks used to refer to regions in sub-Saharan Africa, where modern Ebola outbreaks have occurred, Kazanjian said. In the ancient world, sub-Saharan Africans migrated to Greece to work as farmers or servants, thereby providing a potential human vector for Ebola.
Kazanjian argued that the symptoms, mortality rate and sub-Saharan Africa origin that characterize the Plague of Athens are consistent with Ebola. He added that physicians were among the first victims of the Athenian disease in Thucydides’s account, just as modern health-care workers have proven especially vulnerable to Ebola, with nearly 500 having died from the virus as of January, according to the World Health Organization.
“Diseases like Ebola, which we sometimes lump into the category of a new or emerging disease, may actually be much older than we realize,” Kazanjian said. His paper was published June 1 in the journal Clinical Infectious Diseases.
A number of other possible causes of Thucydides syndrome have been suggested over the years, including typhus, smallpox, measles, anthrax, bubonic plague and toxic shock syndrome. Kazanjian argued that no other disease matches the features of the Athenian disease as well as Ebola does; however, he said, “my study does not answer this question definitively.”
“We may never know what caused the Athenian epidemic,” said Schaffner, who did not take part in Kazanjian’s paper. “I think it’s a bit far-fetched that the Plague of Athens was Ebola, but I think it’s great fun that new people have become engaged in what I call studious speculation of the subject.”
Kazanjian added that the ancient, panic-stricken response to the plague holds lessons for the modern world. Thucydides noted that fear compounded the damage caused by the disease itself, often leading people to abandon their responsibilities to others. Fear also exacerbated the spread of the disease by causing people to crowd together, he wrote.
This historical account gives perspective “to today’s observations about how fear and panic about Ebola” hamper efforts “to control the spread of the disease,” Kazanjian said.