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Measles: the plague that ruined Rome

Rome wasn’t built in a day, but from 165-180 CE, up to 2,000 of its citizens were killed per day.

The Antonine Plague, also known as the Plague of Galen (after the doctor who described it), decimated the Roman Empire. It was brought to Rome by armies returning from western Asia, causing fevers, skin sores, diarrhea and sore throats.

This plague, and the Plague of Cyprian that occurred about 70 years later, are generally thought to be due to smallpox and measles. The Roman citizens at this time would not had been exposed to either virus and thus would have had no immunity, which could explain the mass casualties seen (the first plague had a mortality rate of 25%).

While smallpox has not been seen clinically since 1977, measles still kills upwards of 85,000 people every year, despite being vaccine preventable. While the measles virus is most famous for causing the red rash that begins at the hairline and slowly spreads over the entire body, it can also cause fevers, sore throats, nausea and diarrhea. Perhaps just as distinctive, if not as noticeable, are the tiny white Koplik spots that may appear inside a victim’s mouth. The good news is that the rash actually signals the end of the viral infection, and the skin usually flakes off as the rash goes away.

Most of our readers are safe from the Romans’ fate, as measles was officially eliminated from the Americas in 2016. However, this elimination is conditional on travellers not bringing the virus back from their vacations and causing an outbreak. That’s why the MMR vaccine, which provides immunity against measles, mumps, and rubella, is recommended for all, travellers and home bodies alike.

In 2014 a group of unvaccinated Amish missionaries brought measles back from the Philippines. It rapidly spread through their largely unvaccinated communities, resulting in 383 cases of measles across 9 countries. Luckily, thanks to modern medicine, no one died. We’ve come a long way from the plague that wiped out one third of the Roman Empire, and thanks to vaccines, we’ve got no plans for a measles plague of our own.


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