Category Archives: Diseases

Invalidation of early-phase transmission as an epizootic and epidemiological theory

Dear colleagues,

New plague research has just been published with particular importance for the discussion of the early-phase transmission and transmission by proventricular blockage. B.J. Hinnebusch, Senior Investigator at the Laboratory of Zoonotic Pathogens, NIH, NIAID, Rocky Mountain Laboratories, has long been one of the sharpest critics of the early-phase theory of transmission, see, for instance, his article “Biofilm-Dependent and Bio-Film-Independent Mechanisms of using Transmission of Yersinia pestis by Fleas”, Advances in Experimental Medicine and Biology, 954; 2012:  237‒243. In these days, he publishes with co-authors an evidently crucial article on this topic: Hinnebusch, B.J. Bland, D.M., Bosio, C.F., Jarrett, C.O., “Comparative Ability of Oropsylla montana and Xenopylla cheopis Fleas to transmitt Yersinia pestis by two Different Mechanisms” PLOS Neglected Tropical Diseases | DOI: 10…1371/journal.pntd.0005276 January 12, 2017: 1-15.

They used fleas of Oropsylla montana provided by two of the central advocates of the early-phase theory, which excludes that different strains of this flea could affect the outcome. The conventional vector of plague ‘par excellence’, Xenopsylla cheopis, was used for comparison. Contrary to earlier assertions by the advocates of the early-phase theory that Oropsylla montana rarely develop proventricular blockage, it was shown to block earlier and surviving longer after becoming blocked than X. Cheopis, and that transmission by blockage was as good as or better than observed for X. cheopis. This (re)confirmed earlier research on the vector capacity of this species of flea (see, e.g., the fully referenced comments in my monograph The Black Death and Later Plague Epidemic in the Scandinavian Countries, 2016: 377, 403, 630, 658).

In this article, the early-phase theory is dismantled as an important or significant means or mechanism of transmission of plague. In a personal communication by email of 01.03.17, Hinnebusch states that “In fact, I think early-phase transmission only has a role in very special circumstances, such as during an epizootic of plague in a dense [rodent] population that is both highly susceptible (LD50< 10) and that routinely develops very high bacteremia levels (>108 to 109 Y. pestis/ml) before death.  High flea density is also a likely precondition, as intermittent challenges from just a few fleas at a time would frequently lead to resistance rather than productive, transmissible disease (bacteremia).”

This also means that early-phase transmission is of no significance in plague epidemics, except perhaps, at the individual level, the occasional transmission of immunity-inducing tiny doses of plague bacteria (that will be easily dealt with by the human immune apparatus). It will also become clear that Hinnebusch et al. corroborate and deepen earlier plague research: it is pointed out that this type of early-phase transmission was identified by the Indian Plague Research Commission (IPRC) in 1907 and that the pioneering studies of Bacot of the IPRC on blockage in fleas IPRC 1914 and 1915, are still tenable and relevant. The bibliography contains studies from the entire 1900s, not least 1940s, which have kept their value as fine research.

Finally, I will point out that my recently published monograph contains a long study of early-phase transmission in Chapter 12: 625-655 (with bibliographic references included in the General Bibliography). Its conclusions and basic analysis agree with this recent study by Hinnebusch et al.

Kind regards,

Ole J. Benedictow,

Emeritus Professor

The Bronze Age Plague

A new study refers to the presence of yersinia pestis in Europe during the late neolithic/early bronze age:

  • Simon Rasmussen/ Morten Erik Allentoft/ Kasper Nielsen/ Ludovic Orlando/ Martin Sikora/ Karl-Göran Sjögren/ Anders Gorm Pedersen/ Mikkel Schubert/ Alex Van Dam/ Christian Moliin Outzen Kapel/ Henrik Bjørn Nielsen/ Søren Brunak/ Pavel Avetisyan/ Andrey Epimakhov/ Mikhail Viktorovich Khalyapin/ Artak Gnuni/ Aivar Kriiska/ Irena Lasak/ Mait Metspalu/ Vyacheslav Moiseyev/ Andrei Gromov/ Dalia Pokutta/ Lehti Saag/ Liivi Varul/ Levon Yepiskoposyan/ Thomas Sicheritz-Pontén/ Robert A. Foley/ Marta Mirazón Lahr/ Rasmus Nielsen/ Kristian Kristiansen/ Eske Willerslev: Early Divergent Strains of Yersinia pestis in Eurasia 5,000 Years Ago. Cell 163/3, 2015, 571–582 (22.10.2015). – DOI: – open access!

If these hypothesis of a y.p. as a major trigger of the cultural and demographic changes at the end of the neolithic can be verified, comparisons with the 14th c. crisis will be of some interest. Prehistoric archaeology should check for indications e.g. of wheather extremes, the reorganisation of land use practices and increasing soil erosion in the time before the outbreak of the plague. Furthermore it should be tested, whether the health of the population was probably weak at that time.   However, by now neither the chronological nor the spatial framework of this postulated outbreak is clear.



Rainer Schreg

archaeologist researcher at Römisch-Germanisches Zentralmuseum Mainz - lecturer at Tübingen university

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Lepra in the Middle Ages

A new genetic study dealing with Lepra:
V. J. Schuenemann, P. Singh, T. A. Mendum, B. Krause-Kyora, G. Jäger et al., Genome-Wide Comparison of Medieval and Modern Mycobacterium leprae. Science (online 13.6.2013)

There have been several media reports in Germany. E.g. FAZ (19.6.2013)

Rainer Schreg

archaeologist researcher at Römisch-Germanisches Zentralmuseum Mainz - lecturer at Tübingen university

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Rats cannot have been intermediate hosts for Yersinia pestis during medieval plague epidemics in Northern Europe

Journal of Archaeological Science

Volume 40, Issue 4, April 2013, Pages 1752–1759

Rats cannot have been intermediate hosts for Yersinia pestis during medieval plague epidemics in Northern Europe

  • a University Museum of Bergen, University of Bergen, Norway
  • b Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1103 Blindern, N-0317 Oslo, Norway


The commonly accepted understanding of modern human plague epidemics has been that plague is a disease of rodents that is transmitted to humans from black rats, with rat fleas as vectors. Historians have assumed that this transmission model is also valid for the Black Death and later medieval plague epidemics in Europe. Here we examine information on the geographical distribution and population density of the black rat (Rattus rattus) in Norway and other Nordic countries in medieval times. The study is based on older zoological literature and on bone samples from archaeological excavations. Only a few of the archaeological finds from medieval harbour towns in Norway contain rat bones. There are no finds of black rats from the many archaeological excavations in rural areas or from the inland town of Hamar. These results show that it is extremely unlikely that rats accounted for the spread of plague to rural areas in Norway. Archaeological evidence from other Nordic countries indicates that rats were uncommon there too, and were therefore unlikely to be responsible for the dissemination of human plague. We hypothesize that the mode of transmission during the historical plague epidemics was from human to human via an insect ectoparasite vector.

Julia Gamble – Bioarchaeologist

I am a doctoral candidate based at the University of Manitoba, Canada.

I am currently undertaking the final stages of my doctoral research investigating patterns of health in two Danish cemetery populations dated from the mid-14th to the mid-16th centuries. This project has a number of facets. It involves a complete skeletal analysis of a sample of 167 individuals from these populations to identify age, sex, and other health dimensions (ex, stature and pathology). Through this, I am interested in changes in health across the period, particularly at the point bordering the mid-14th century. I am also considering the relationship between the two populations, one being rural and one being urban. Finally, I am conducting histological analysis of teeth from these individuals in order to on one level gain insight into the patterns of stress during development over time and on another level to consider the relationship between childhood stress and adult health.

My approach is bioarchaeological in nature – I am interested in looking at human health through the study of skeletal remains, but in the context of the socioeconomic and environmental context of the mid-14th century crises.

Islamic attidues to disasters in the Middle Ages: a comparison of earthquakes and plagues

A re-post from the blog of a 2007 article in Medieval History Journal (10) by Anna Akasoy:

Rainer Schreg

archaeologist researcher at Römisch-Germanisches Zentralmuseum Mainz - lecturer at Tübingen university

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Sickness, Hunger, War, and Religion

As open access available:
“Sickness, Hunger, War, and Religion: Multidisciplinary Perspectives.”
Rachel Carson Center Perspectives 2012, Issue 3
Edited by Michaela Harbeck, Kristin von Heyking, and Heiner Schwarzberg

A peste, fame et bello libera nos, Domine!” Disease, hunger, war, and religion have shaped human existence over many centuries. This volume presents exciting syntheses between research in the fields of archaeology, anthropology, and history; moving from prehistory to the medieval period, six chapters look at humanity’s struggles with subsistence, religious belief, ill-health, death, and warfare in a variety of global landscapes, and show how, by sharing expertise and combining methodological approaches, we can advance our understanding of our common past.

available as  pdf (pdf, 7.5 MB) (or printer-friendly version, pdf, 6.6 MB)

Rainer Schreg

archaeologist researcher at Römisch-Germanisches Zentralmuseum Mainz - lecturer at Tübingen university

More Posts - Website