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Did the Ancient Greeks Get Ebola?

A new paper from Dr. Powel Kazanjian theorizes that the famous Plague of Athens was caused by the same virus that has decimated West Africa in recent years.

by Mike Pearl
Jun 19 2015, 10:26pm

Etruscan relief via Wikimedia Commons

In 430 BC, an incredibly nasty plague hit Athens. Dubbed "the Plague of Athens" by relatively unimaginative historians, the epidemic gave citizens red skin, diarrhea, and high fever, among other symptoms. Modern-day academics have no idea what actually caused all this suffering, though they've guessed it could have been Typhus, measles, smallpox, or even toxic shock syndrome.

But Powel Kazanjian, a professor of medicine at the University of Michigan, has his own theory about the culprit: According to him, it's none other than our old friend Ebola.

"The clinical features of the plague resemble Ebola at least as well as the other conditions historians have considered," Kazanjian, whose paper "Ebola in Antiquity" was published in Clinical Infectious Diseases earlier this month, told VICE. According to him, this connection can be made thanks to fresh information about the epidemiology of Ebola gathered from the horrific outbreak in West Africa.

Like most scientists, he's quick to point out that his conclusions aren't the only possible answer, however. "At the end of the day, the answer is that Ebola is a possible cause, as are the other conditions that historians have speculated," Kazanjian said.

We know about the Plague of Athens's symptoms mostly because the most famous historian of all time, Thucydides, reported live from the hot zone, providing firsthand coverage of the horror show. He said the disease originated in "Ethiopia," which is what the Ancient Greeks called Sub-Saharan Africa, and got to Greece through Egypt. Modern cases of Ebola originate in Sub-Sarahan Africa as well, with two simultaneous outbreaks in Sudan and Democratic Republic of Congo appearing in 1976.

Thucydides himself survived a bout with the deadly disease, allowing him to describe it in gut-wrenching detail in The History of the Peloponnesian War (available in bookstores everywhere, or just download it for free because it's over 2,000 years old and therefore in the public domain).

Here are the Ebola-ish early stages of the disease as described by Thucydides:

People in good health were all of a sudden attacked by violent heats in the head, and redness and inflammation in the eyes, the inward parts, such as the throat or tongue, becoming bloody and emitting an unnatural and fetid breath

[...]

Discharges of bile of every kind named by physicians ensued, accompanied by very great distress. In most cases also an ineffectual retching followed, producing violent spasms, which in some cases ceased soon after, in others much later.

This matches nicely with the symptoms laid out in the CDC's fact sheet on Ebola: "Fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain."

Kazanjian's paper points out that in cases of both Ebola and the Plague of Athens, those who survived the plague became indispensable as nurses. From Thucydides:

It was with those who had recovered from the disease that the sick and the dying found most compassion. These knew what it was from experience, and had now no fear for themselves; for the same man was never attacked twice—never at least fatally. And such persons not only received the congratulations of others, but themselves also, in the elation of the moment, half entertained the vain hope that they were for the future safe from any disease whatsoever.

Another similarity is the compounding effect of fear on both plagues. Fear not only "intensified the disruption of society and damage to the individual, " according to Kazanjian, but it also "amplified the spread of disease." During the plague of Athens, Thucydides wrote, "if they were afraid to visit each other, they perished from neglect; indeed many houses were emptied of their inmates for want of a nurse."

But there are also dissimilarities. For instance, victims of the Plague of Athens lost their fingers, toes, and genitals to what sounds like gangrene, an atypical symptom of Ebola. "The loss of digits that Thucydides mentions could be due to lack of blood flow or 'ischemia' from low blood pressure (hypotension) or bleeding/clotting complications from Ebola," Kazanjian said. He pointed out that the Plague of Athens also included "coughing and chest pain, which can occur about a third of the time with Ebola," but the sneezing that Thucydides describes, "would not be compatible with any of the possible causes of the Plague that historians have entertained, including Ebola."

But, Kazanjian added, one of the reasons to study diseases from the past is that viruses and bacteria don't stay the same. "Clinical and epidemiologic features of a particular disease can change over time, as they have for ebola outbreaks from 1976 to today," said Kazanjian, pointing out shifting percentages of Ebola patients who experience bleeding and changes in the mortality rate. Syphilis is another case, he said, since it no longer causes the kinds of blisters first described in the 1490s.

But more importantly, he said looking back shows us that "fear and panic do not help to control the spread of epidemic diseases." Studying earlier epidemics injects some valuable perspective into our contemporary views on Ebola—and "AIDS in the early phase of the epidemic," he was quick to point out. Fear and panic always just make things worse.

"In other words," he said, "there are worthwhile reasons to study prior epidemics, even if we never know the cause for sure."

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