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Tandem repeat

In genetics , tandem repeats occur in DNA when a pattern of one or more nucleotides is repeated and the repetitions are directly adjacent to each other. Several protein domains also form tandem repeats within their amino acid primary structure , such as armadillo repeats . However, in proteins, perfect tandem repeats are unlikely in most in vivo proteins, and most known repeats are in proteins which have been designed. An example would be: in which the sequence ATTCG is repeated three times.All tandem repeat arrays are classifiable as satellite DNA , a name originating from the fact that tandem DNA repeats, by nature of repeating the same nucleotide sequences repeatedly, have a unique ratio of the two possible nucleotide base pair combinations, conferring them a specific mass density that allows them to be separated from the rest of the genome with density-based laboratory techniques, thus appearing as "satellite bands." Albeit, a tandem repeat array could not show up as a satellite band if it had a nucleotide composition close to the average of the genome. [ citation needed ] When exactly two nucleotides are repeated, it is called a dinucleotide repeat (for example: ACACACAC...). The microsatellite instability in hereditary nonpolyposis colon cancer most commonly affects such regions. When three nucleotides are repeated, it is called a trinucleotide repeat (for example: CAGCAGCAGCAG...), and abnormalities in such regions can give rise to trinucleotide repeat disorders . When between 10 and 60 nucleotides are repeated, it is called a minisatellite . Those with fewer are known as microsatellites or short tandem repeats . When much larger lengths of nucleotides are repeated, on the order of 1,000 nucleotides, it is called a macrosatellite . When the repeat unit copy number is variable in the population being considered, it is called a variable number tandem repeat (VNTR). MeSH classifies variable number tandem repeats under minisatellites. Tandem repeats can occur through different mechanisms. For example, slipped strand mispairing (SSM), (also known as replication slippage ), is a mutation process which occurs during DNA replication. It involves denaturation and displacement of the DNA strands, resulting in mispairing of the complementary bases. Slipped strand mispairing is one explanation for the origin and evolution of repetitive DNA sequences. Other mechanisms include unequal crossover and gene conversion .Tandem repeat describes a pattern that helps determine an individual's inherited traits. Tandem repeats can be very useful in determining parentage . Short tandem repeats are used for certain genealogical DNA tests . DNA is examined from microsatellites within the chromosomal DNA. Parentage can be determined through the similarity in these regions. Polymorphic tandem repeats (alias VNTRs) are also present in microorganisms and can be used to trace the origin of an outbreak. The corresponding assay in which a collection of VNTRs is typed to characterize a strain is most often called MLVA (Multiple Loci VNTR Analysis). Using tandem repeat polymorphism, recombination has been reported in the natural transmission of monkeypox ( mpox ) virus genome during 2022 pandemic. In the field of computer science , tandem repeats in strings (e.g., DNA sequences) can be efficiently detected using suffix trees or suffix arrays . Studies in 2004 linked the unusual genetic plasticity of dogs to mutations in tandem repeats. Nested tandem repeats are described as repeating unit lengths that are variable or unknown and frequently include an asymmetric hierarchy of smaller repeating units. These repeats are constructed from distinct groups of homologous-length monomers. An algorithm known as NTRprism was created by Oxford Nanopore Technologies researchers to enable for the annotation of repetitive structures in built satellite DNA arrays. The algorithm NTRprism is developed to find and display the satellite repeating periodicity.

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Bundeswehr Institute of Microbiology

The Bundeswehr Institute of Microbiology (IMB, military abbreviation InstMikroBioBw) in Munich is the German Armed Forces' scientific competence center in the field of medical defense against biological warfare agents and other dangerous pathogens or biotoxins . The institute provides procedures and methods for the rapid and unambiguous identification and verification of allegations of the use of biological warfare agents, conducts specialized training, and participates in the development of medical biodefense concepts and strategies.Provide expertise, specialized diagnostic capabilities, principles, concepts, guidelines, and procedures for preserving/restoring the health of populations and individuals exposed to biological warfare agents. Deployment of specialized, rapidly deployable military response teams in biological threat situations, investigation of unexplained outbreaks of infectious diseases, and medical verification of biological agent use. Research on the epidemiology, epidemic management, pathomechanisms, prevention, diagnostics, and treatment of diseases caused by biological warfare agents. Advising the German Ministry of Defense and other federal agencies on scientific and medical issues related to bioweapons disarmament and arms control.1984–1994: Colonel Dr. med. vet. Ahrens 1994–2008: Colonel Dr. med. Ernst-Jürgen Finke 2008–2019: Colonel Prof. Dr. med. Lothar Zöller Since 2019: Colonel Prof. Dr. med. Roman WölfelThe institute was established in 1966 as the Microbiology Laboratory Group at the Medical Corps School of the Bundeswehr (now: Bundeswehr Medical Academy ) in Munich. In 1984, today's Bundeswehr Institute of Microbiology was officially founded as an independent military unit. It has been stationed in the Ernst-von-Bergmann barracks in the north of Munich ever since. In response to the September 11 attacks in 2001, the German Council of Science and Humanities recommended that the Bundeswehr Institute of Microbiology be developed into a national military competence center for biodefense. The institute provides medical diagnostics for biological warfare agents and naturally occurring infectious agents of military importance for all members of the Bundeswehr. These services include infectious agents of biological risk groups 3 and 4 and are also available to civilian healthcare facilities. In September 2012, the Central Diagnostic Department (ZBD) of the Institute was flexibly accredited by the German Accreditation Body according to ISO 15189 . In August 2002, along with the Bundeswehr Institute of Radiobiology and the Bundeswehr Institute of Pharmacology and Toxicology, the institute became an independent entity under the Central Medical Service of the Bundeswehr and was placed under the supervision of the Bundeswehr Medical Office. Since 2012, all three institutes have once again been under the military command of the Medical Academy, but now as independent military units at battalion level. Since 2010, the institute, together with the Technical University of Munich , the Ludwig Maximilian University of Munich , and the Helmholtz Zentrum München , forms the partner site in Munich of the German Center for Infection Research (DZIF). In February 2013, the cooperation with the Institute of Microbiology, Immunology, and Hygiene and the Institute of Virology of the TU Munich began. In 2016, a cooperation agreement was signed with the University of Stuttgart-Hohenheim . Since 2009, the Medical Biodefense Conference has been organized in the format of an international conference. The Bundeswehr Institute for Microbiology has been leading the development of a modular and rapidly deployable mobile laboratory system for the German Armed Forces since 2007. The institute's mobile lab systems are crafted to deliver a prompt response to sudden disease outbreaks, featuring adaptable configurations and cutting-edge biosafety measures. The incorporation of a collapsible glove box with sturdy polycarbonate walls ensures a secure working environment for handling highly infectious samples. Leveraging diagnostic technologies like qPCR, ELISA , and NGS , the system aims for expeditious turnaround times in sample analysis. With minimal infrastructure requirements, it can be rapidly deployed worldwide and utilized across diverse environments. Following initial deployments in the Balkans, the mobile laboratory seamlessly integrated into the European Mobile Lab Project (EMLab) from 2013. Remarkably, these systems played a pivotal role during the 2014 Ebola outbreak in West Africa and are now acknowledged as a global technical standard for diagnostic field operations in combating disease outbreaks. The Bundeswehr Institute of Microbiology reached a significant milestone during the COVID-19 pandemic . On January 27, 2020, researchers at the institute diagnosed the first cases of illness caused by the SARS-CoV-2 virus in Germany, marking a pivotal early detection in the laboratory. Notably, the institute successfully cultured the virus in cell cultures, achieving a feat previously only accomplished by Australian researchers outside of China. Furthermore, the research group sequenced the genome of SARS-CoV-2, providing comprehensive insights beyond the partial information available from Chinese online transmissions. The institute offered the initial description of the replication of SARS-CoV-2 in the nasal and throat cavity and the excretion of the virus in the stool. On May 19, 2022, amidst the largest outbreak of mpox in Europe to date, the Bundeswehr Institute of Microbiology confirmed the first case of mpox in Germany. The mpox virus was diagnosed in a patient with characteristic skin lesions using PCR and cell culture. Significantly, scientists at the institute detected the mpox virus in blood and, notably, for the first time, in semen. This breakthrough contributes substantially to the understanding and management of mpox outbreaks. [ citation needed ]

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Dimie Ogoina

Dimie Ogoina is a Nigerian infectious disease physician-scientist . He is a professor of medicine at the Niger Delta University and chief medical director at its teaching hospital. He is president of the Nigerian Infectious Diseases Society.Ogoina attended high school in Lagos , Nigeria. He completed a Bachelor of Medicine, Bachelor of Surgery at Ahmadu Bello University where he studied under mentors Laszlo Egler and Geoffrey Onyemelukwe. After his residency, Ogoina worked as a lecturer and consultant physician at the HIV/AIDS clinic at Bingham University Teaching Hospital in Jos . He then joined Niger Delta University (NDU) and the NDU Teaching Hospital where he has served in several roles including head of department, provost of the college of medicine, chair of the medical advisory committee, and chief medical director. He is a professor of medicine. Ogoina researches HIV/AIDS and antimicrobial resistance . In 2017, he presented on Mpox in Nigeria . As of 2023, he is the current president of the Nigerian Infectious Diseases Society. In April 2023, Ogoina was named to the Time 100 list of the most influential people in the world for his scientific contributions and global health equity efforts.

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Mpox

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2022–2023 mpox outbreak in Colombia

The 2022–2023 mpox outbreak in Colombia is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus . The outbreak reached Colombia on 23 June 2022. Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. In May 2022, the World Health Organization (WHO) made an emergency announcement of the existence of a multi-country outbreak of mpox , a viral disease then commonly known as "monkeypox" . The initial cluster of cases was found in the United Kingdom , where the first case was detected in London on 6 May 2022 in a patient with a recent travel history from Nigeria (where the disease is endemic ). On 16 May, the UK Health Security Agency ( UKHSA ) confirmed four new cases with no link to travel to a country where mpox is endemic. Subsequently, cases have been reported from many countries and regions. The outbreak marked the first time mpox had spread widely outside Central and West Africa . There is evidence that the disease had been circulating and evolving in human hosts over a number of years prior to the outbreak. The outbreak was of the Clade IIb variant of the virus. As of May, the Colombian Ministry of Health was taking follow-up and control measures. The Director of Epidemiology and Demography of the Ministry of Health, Claudia Cuellar, informed the Colombian population about how mpox is spread through people, and she spoke about the clinical presentation of the virus and international health regulations. Health authorities in the Department of Norte de Santander have been on alert, since the department is a border area where people pass between Colombia and Venezuela. On June 23, 2022, the Colombian Ministry of Health confirmed three cases of mpox, specifically two in the city of Bogotá and one in Medellín . The two cases reported in Bogota were of people who had traveled to Europe. The first case identified in Medellin was a person who had been infected while traveling to the European city of Barcelona in Spain. On July 8, the National Institute of Health confirmed a new case of the disease in Bogota from a person who had been in contact with an infected person from Italy when they had traveled to Europe. On July 23, following the follow-up of several cases, health authorities began an extensive surveillance phase. On the same day, the National Institute of Health confirmed that the number of cases in the country reached 10. On July 25, the first case of a person who had been in Argentina was reported in the department of Cundinamarca , specifically in the municipality of Cajicá . On July 29, the first case was detected in Pereira , capital of the department of Risaralda . On July 30, the National Institute of Health confirmed the first case in the department of Valle del Cauca , specifically in the city of Cartago located in the north of the department. On August 1, the Mayor's Office of Cali City opened a hotline to receive information when a person reports suspected cases of this disease. On August 3, the first case was confirmed in the Department of La Guajira of a man who had traveled to Bogotá. The case was detected in the municipality of Albania , which is located in the center of the department. After the first case was detected in La Guajira, health authorities in the neighboring department of Cesar increased their alert. The department's health secretary, Guillermo Girón, indicated that prevention measures should be increased due to the proximity to La Guajira. On August 4, the first case was confirmed in the city of Bucaramanga , capital of the department of Santander . On the same day, the first case was registered in the department of Tolima , specifically in the capital city of Ibagué , of a person who had traveled to the United States. On August 5, the first case was confirmed in the capital of the department of Bolívar , Cartagena . On August 11, the first case of this disease was detected in Popayán , capital of the Cauca department . On August 12, the first case of mpox in Riohacha , capital of La Guajira, was confirmed. On August 15, the first case was confirmed in the city of Cúcuta , capital of the department of Norte de Santander , in a man who had traveled to Mexico and the United States. On the same day, the first case was reported in Barranquilla , capital city of the Atlántico department . On August 16, the first case was reported in Cali, capital city of the Valle del Cauca department. On August 17, the first case was confirmed in the capital of the department of Quindío , Armenia . On August 20, the first case was reported in the city of Villavicencio, capital of the Meta department . On August 31, the José María Córdova airport carried out the first simulation in the country in order to deal with contagions of the disease. On August 26, the first one was confirmed in the department of Sucre , specifically in the municipality of Tolú in the western part of the department. On August 29, the first case was confirmed in Tunja , capital of the department of Boyacá . On September 7, the health authorities of the department of Cesar confirmed the first case in the department, specifically in Valledupar . On September 9, the first case was confirmed in the capital of Putumayo , Mocoa, according to Adriana Medicis, health secretary of the departmental government, explained that the case was a person residing in Mocoa . Also on the same day, the first case was confirmed in the city of Neiva , the capital of the Huila department . As of May, the Colombian Ministry of Health was taking follow-up and control measures. The Director of Epidemiology and Demography of the Ministry of Health, Claudia Cuellar, informed the Colombian population about how mpox is spread through people, and she spoke about the clinical presentation of the virus and international health regulations. Health authorities in the Department of Norte de Santander have been on alert, since the department is a border area where people pass between Colombia and Venezuela. On June 23, 2022, the Colombian Ministry of Health confirmed three cases of mpox, specifically two in the city of Bogotá and one in Medellín . The two cases reported in Bogota were of people who had traveled to Europe. The first case identified in Medellin was a person who had been infected while traveling to the European city of Barcelona in Spain. On July 8, the National Institute of Health confirmed a new case of the disease in Bogota from a person who had been in contact with an infected person from Italy when they had traveled to Europe. On July 23, following the follow-up of several cases, health authorities began an extensive surveillance phase. On the same day, the National Institute of Health confirmed that the number of cases in the country reached 10. On July 25, the first case of a person who had been in Argentina was reported in the department of Cundinamarca , specifically in the municipality of Cajicá . On July 29, the first case was detected in Pereira , capital of the department of Risaralda . On July 30, the National Institute of Health confirmed the first case in the department of Valle del Cauca , specifically in the city of Cartago located in the north of the department. On August 1, the Mayor's Office of Cali City opened a hotline to receive information when a person reports suspected cases of this disease. On August 3, the first case was confirmed in the Department of La Guajira of a man who had traveled to Bogotá. The case was detected in the municipality of Albania , which is located in the center of the department. After the first case was detected in La Guajira, health authorities in the neighboring department of Cesar increased their alert. The department's health secretary, Guillermo Girón, indicated that prevention measures should be increased due to the proximity to La Guajira. On August 4, the first case was confirmed in the city of Bucaramanga , capital of the department of Santander . On the same day, the first case was registered in the department of Tolima , specifically in the capital city of Ibagué , of a person who had traveled to the United States. On August 5, the first case was confirmed in the capital of the department of Bolívar , Cartagena . On August 11, the first case of this disease was detected in Popayán , capital of the Cauca department . On August 12, the first case of mpox in Riohacha , capital of La Guajira, was confirmed. On August 15, the first case was confirmed in the city of Cúcuta , capital of the department of Norte de Santander , in a man who had traveled to Mexico and the United States. On the same day, the first case was reported in Barranquilla , capital city of the Atlántico department . On August 16, the first case was reported in Cali, capital city of the Valle del Cauca department. On August 17, the first case was confirmed in the capital of the department of Quindío , Armenia . On August 20, the first case was reported in the city of Villavicencio, capital of the Meta department . On August 31, the José María Córdova airport carried out the first simulation in the country in order to deal with contagions of the disease. On August 26, the first one was confirmed in the department of Sucre , specifically in the municipality of Tolú in the western part of the department. On August 29, the first case was confirmed in Tunja , capital of the department of Boyacá . On September 7, the health authorities of the department of Cesar confirmed the first case in the department, specifically in Valledupar . On September 9, the first case was confirmed in the capital of Putumayo , Mocoa, according to Adriana Medicis, health secretary of the departmental government, explained that the case was a person residing in Mocoa . Also on the same day, the first case was confirmed in the city of Neiva , the capital of the Huila department . In August 2022, the Colombian government requested from the Pan American Health Organization the vaccines to immunize the country's population. Doctor Gina Tambini, who is Colombia's representative for both the World Health Organization and the Pan American Health Organization, explained about the vaccination scheme that will be implemented in the country, which will first prioritize people who have presented symptoms of the disease or have been close to positive cases.

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Epidemic

An epidemic (from Greek ἐπί epi "upon or above" and δῆμος demos "people") is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections , an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic. Epidemics of infectious disease are generally caused by several factors including a change in the ecology of the host population (e.g., increased stress or increase in the density of a vector species), a genetic change in the pathogen reservoir or the introduction of an emerging pathogen to a host population (by movement of pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium and the transmission threshold is exceeded. An epidemic may be restricted to one location; however, if it spreads to other countries or continents and affects a substantial number of people, it may be termed as a pandemic . : §1:72 The declaration of an epidemic usually requires a good understanding of a baseline rate of incidence ; epidemics for certain diseases, such as influenza , are defined as reaching some defined increase in incidence above this baseline. A few cases of a very rare disease may be classified as an epidemic, while many cases of a common disease (such as the common cold ) would not. An epidemic can cause enormous damage through financial and economic losses in addition to impaired health and loss of life. [ citation needed ]The United States Centers for Disease Control and Prevention defines epidemic broadly: "Epidemic refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area." The term "outbreak" can also apply, but is usually restricted to smaller events. : §1:72 Any sudden increase in disease prevalence may generally be termed an epidemic. This may include contagious disease (i.e. easily spread between persons) such as influenza ; vector-borne diseases such as malaria ; water-borne diseases such as cholera ; and sexually transmitted diseases such as HIV/AIDS . The term can also be used for non-communicable health issues such as obesity . The term epidemic derives from a word form attributed to Homer 's Odyssey , which later took its medical meaning from the Epidemics , a treatise by Hippocrates . Before Hippocrates, epidemios , epidemeo , epidamos , and other variants had meanings similar to the current definitions of "indigenous" or " endemic ". Thucydides ' description of the Plague of Athens is considered one of the earliest accounts of a disease epidemic. By the early 17th century, the terms endemic and epidemic referred to contrasting conditions of population-level disease, with the endemic condition a " common sicknesse " and the epidemic " hapning in some region, or countrey, at a certaine time, ....... producing in all sorts of people, one and the same kind of sicknesse ". The term "epidemic" is often applied to diseases in non-human animals, although " epizootic " is technically preferable. There are several factors that may contribute (individually or in combination) to causing an epidemic. There may be changes in a pathogen , in the population that it can infect, in the environment, or in the interaction between all three. Factors include the following: : §1:72 An antigen is a protein on the virus' surface that host antibodies can recognize and attack. Changes in the antigenic characteristics of the agent make it easier for the changed virus to spread throughout a previously immune population. There are two natural mechanisms for change - antigenic drift and antigenic shift. Antigenic drift arises over a period of time as an accumulation of mutations in the virus genes , possibly through a series of hosts, and eventually gives rise to a new strain of virus which can evade existing immunity. Antigenic shift is abrupt - in this, two or more different strains of a virus , coinfecting a single host, combine to form a new subtype having a mixture of characteristics of the original strains. The best known and best documented example of both processes is influenza . SARS-CoV2 has demonstrated antigenic drift and possibly shift as well. Antibiotic resistance applies specifically to bacteria that become resistant to antibiotics . Resistance in bacteria can arise naturally by genetic mutation , or by one species acquiring resistance from another through horizontal gene transfer . Extended use of antibiotics appears to encourage selection for mutations which can render antibiotics ineffective. This is especially true of tuberculosis , with increasing occurrence of multiple drug-resistant tuberculosis (MDR-TB) worldwide. Pathogen transmission is a term used to describe the mechanisms by which a disease-causing agent (virus, bacterium, or parasite) spreads from one host to another. Common modes of transmission include: - The first three of these require that pathogen must survive away from its host for a period of time; an evolutionary change which increases survival time will result in increased virulence. Another possibility, although rare, is that a pathogen may adapt to take advantage of a new mode of transmission Seasonal diseases arise due to the change in the environmental conditions, especially such as humidity and temperature, during different seasons. Many diseases display seasonality , This may be due to one or more of the following underlying factors: - Changes in behaviour can affect the likelihood or severity of epidemics. The classic example is the 1854 Broad Street cholera outbreak , in which a cholera outbreak was mitigated by removing a supply of contaminated water - an event now regarded as the foundation of the science of epidemiology . Urbanisation and overcrowding (e.g. in refugee camps ) increase the likelihood of disease outbreaks. A factor which contributed to the initial rapid increase in the 2014 Ebola virus epidemic was ritual bathing of (infective) corpses; one of the control measures was an education campaign to change behaviour around funeral rites. The level of immunity to a disease in a population - herd immunity - is at its peak after a disease outbreak or a vaccination campaign. In the following years, immunity will decline, both within individuals and in the population as a whole as older individuals die and new individuals are born. Eventually, unless there is another vaccination campaign, an outbreak or epidemic will recur. It's also possible for disease which is endemic in one population to become epidemic if it is introduced into a novel setting where the host population is not immune. An example of this was the introduction European diseases such as smallpox into indigenous populations during the 16th century. A zoonosis is an infectious disease of humans caused by a pathogen that can jump from a non-human host to a human. Major diseases such as Ebola virus disease and salmonellosis are zoonoses. HIV was a zoonotic disease transmitted to humans in the early part of the 20th century, though it has now evolved into a separate human-only disease. Some strains of bird flu and swine flu are zoonoses; these viruses occasionally recombine with human strains of the flu and can cause pandemics such as the 1918 Spanish flu or the 2009 swine flu . An antigen is a protein on the virus' surface that host antibodies can recognize and attack. Changes in the antigenic characteristics of the agent make it easier for the changed virus to spread throughout a previously immune population. There are two natural mechanisms for change - antigenic drift and antigenic shift. Antigenic drift arises over a period of time as an accumulation of mutations in the virus genes , possibly through a series of hosts, and eventually gives rise to a new strain of virus which can evade existing immunity. Antigenic shift is abrupt - in this, two or more different strains of a virus , coinfecting a single host, combine to form a new subtype having a mixture of characteristics of the original strains. The best known and best documented example of both processes is influenza . SARS-CoV2 has demonstrated antigenic drift and possibly shift as well. Antibiotic resistance applies specifically to bacteria that become resistant to antibiotics . Resistance in bacteria can arise naturally by genetic mutation , or by one species acquiring resistance from another through horizontal gene transfer . Extended use of antibiotics appears to encourage selection for mutations which can render antibiotics ineffective. This is especially true of tuberculosis , with increasing occurrence of multiple drug-resistant tuberculosis (MDR-TB) worldwide. Pathogen transmission is a term used to describe the mechanisms by which a disease-causing agent (virus, bacterium, or parasite) spreads from one host to another. Common modes of transmission include: - The first three of these require that pathogen must survive away from its host for a period of time; an evolutionary change which increases survival time will result in increased virulence. Another possibility, although rare, is that a pathogen may adapt to take advantage of a new mode of transmission Seasonal diseases arise due to the change in the environmental conditions, especially such as humidity and temperature, during different seasons. Many diseases display seasonality , This may be due to one or more of the following underlying factors: - Changes in behaviour can affect the likelihood or severity of epidemics. The classic example is the 1854 Broad Street cholera outbreak , in which a cholera outbreak was mitigated by removing a supply of contaminated water - an event now regarded as the foundation of the science of epidemiology . Urbanisation and overcrowding (e.g. in refugee camps ) increase the likelihood of disease outbreaks. A factor which contributed to the initial rapid increase in the 2014 Ebola virus epidemic was ritual bathing of (infective) corpses; one of the control measures was an education campaign to change behaviour around funeral rites. The level of immunity to a disease in a population - herd immunity - is at its peak after a disease outbreak or a vaccination campaign. In the following years, immunity will decline, both within individuals and in the population as a whole as older individuals die and new individuals are born. Eventually, unless there is another vaccination campaign, an outbreak or epidemic will recur. It's also possible for disease which is endemic in one population to become epidemic if it is introduced into a novel setting where the host population is not immune. An example of this was the introduction European diseases such as smallpox into indigenous populations during the 16th century. A zoonosis is an infectious disease of humans caused by a pathogen that can jump from a non-human host to a human. Major diseases such as Ebola virus disease and salmonellosis are zoonoses. HIV was a zoonotic disease transmitted to humans in the early part of the 20th century, though it has now evolved into a separate human-only disease. Some strains of bird flu and swine flu are zoonoses; these viruses occasionally recombine with human strains of the flu and can cause pandemics such as the 1918 Spanish flu or the 2009 swine flu . In a common source outbreak epidemic, the affected individuals had an exposure to a common agent. If the exposure is singular and all of the affected individuals develop the disease over a single exposure and incubation course, it can be termed as a point source outbreak. If the exposure was continuous or variable, it can be termed as a continuous outbreak or intermittent outbreak, respectively. : 56 In a propagated outbreak, the disease spreads person-to-person. Affected individuals may become independent reservoirs leading to further exposures. : 56 Many epidemics will have characteristics of both common source and propagated outbreaks (sometimes referred to as mixed outbreak ). [ citation needed ] For example, secondary person-to-person spread may occur after a common source exposure or an environmental vector may spread a zoonotic diseases agent. : 56–58In a common source outbreak epidemic, the affected individuals had an exposure to a common agent. If the exposure is singular and all of the affected individuals develop the disease over a single exposure and incubation course, it can be termed as a point source outbreak. If the exposure was continuous or variable, it can be termed as a continuous outbreak or intermittent outbreak, respectively. : 56In a propagated outbreak, the disease spreads person-to-person. Affected individuals may become independent reservoirs leading to further exposures. : 56 Many epidemics will have characteristics of both common source and propagated outbreaks (sometimes referred to as mixed outbreak ). [ citation needed ] For example, secondary person-to-person spread may occur after a common source exposure or an environmental vector may spread a zoonotic diseases agent. : 56–58Preparations for an epidemic include having a disease surveillance system; the ability to quickly dispatch emergency workers, especially local-based emergency workers; and a legitimate way to guarantee the safety and health of health workers. Effective preparations for a response to a pandemic are multi-layered. The first layer is a disease surveillance system. Tanzania , for example, runs a national lab that runs testing for 200 health sites and tracks the spread of infectious diseases. The next layer is the actual response to an emergency. According to U.S.-based columnist Michael Gerson in 2015, only the U.S. military and NATO have the global capability to respond to such an emergency. Still, despite the most extensive preparatory measures, a fast-spreading pandemic may easily exceed and overwhelm existing health-care resources. Consequently, early and aggressive mitigation efforts, aimed at the so-called "epidemic curve flattening" need to be taken. Such measures usually consist on non-pharmacological interventions such as social/physical distancing, aggressive contact tracing, "stay-at-home" orders, as well as appropriate personal protective equipment (i.e., masks, gloves, and other physical barriers to spread).

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Bushmeat

Bushmeat is meat from wildlife species that are hunted for human consumption. Bushmeat represents a primary source of animal protein and a cash-earning commodity in poor and rural communities of humid tropical forest regions of the world. The numbers of animals killed and traded as bushmeat in the 1990s in West and Central Africa were thought to be unsustainable. By 2005, commercial harvesting and trading of bushmeat was considered a threat to biodiversity . As of 2016, 301 terrestrial mammals were threatened with extinction due to hunting for bushmeat including primates , even-toed ungulates , bats , diprotodont marsupials , rodents and carnivores occurring in developing countries . Bushmeat provides increased opportunity for transmission of several zoonotic viruses from animal hosts to humans, such as Ebolavirus and HIV . The term 'bushmeat' is originally an African term for wildlife species that are hunted for human consumption, and usually refers specifically to the meat of African wildlife. In October 2000, the IUCN World Conservation Congress passed a resolution on the unsustainable commercial trade in wild meat . Affected countries were urged to recognize the increasing ramifications of the bushmeat trade, to strengthen and enforce legislation, and to develop action programmes to mitigate the consequences of the trade. Donor organisations were requested to provide funding for the implementation of such programmes. Wildlife hunting for food is important for the livelihood security of and supply of dietary protein for poor people. It can be sustainable when carried out by traditional hunter-gatherers in large landscapes for their own consumption. Due to the extent of bushmeat hunting for trade in markets, the survival of those species that are large-bodied and reproduce slowly is threatened. The term bushmeat crisis was coined in 2007 and refers to this dual threat of depleting food resources and wildlife extinctions , both entailed by the bushmeat trade. Globally, more than 1,000 animal species are estimated to be affected by hunting for bushmeat. Bushmeat hunters use mostly leg-hold snare traps to catch any wildlife, but prefer to kill large species, as these provide a greater amount of meat than small species. The volume of the bushmeat trade in West and Central Africa was estimated at 1–5 million tonnes (980,000–4,920,000 long tons; 1,100,000–5,500,000 short tons) per year at the turn of the 21st century. In 2002, it was estimated that species weighing more than 10 kg (22 lb) contribute 177.7 ± 358.4 kg/km 2 (1,015 ± 2,046 lb/sq mi) of meat per year to the bushmeat extracted in the Congo Basin , based on 24 individuals. Species weighing less than 10 kg (22 lb) were estimated to contribute 35.4 ± 72.2 kg/km 2 (202 ± 412 lb/sq mi) , also based on 24 individuals. Bushmeat extraction in the Amazon rainforest was estimated to be much lower, at 3.69 ± 3.9 kg/km 2 (21.1 ± 22.3 lb/sq mi) in the case of species weighing more than 10 kg and 0.6 ± 0.9 kg/km 2 (3.4 ± 5.1 lb/sq mi) in the case of species weighing less than 10 kg, based on 3 individuals. [ better source needed ] Based on these estimates, a total of 2,200,000 t (2,200,000 long tons; 2,400,000 short tons) bushmeat is extracted in the Congo Basin per year, ranging from 12,938 t (12,734 long tons; 14,262 short tons) in Equatorial Guinea to 1,665,972 t (1,639,661 long tons; 1,836,420 short tons) in the Democratic Republic of the Congo . The 301 mammal species threatened by hunting for bushmeat comprise 126 primates, 65 even-toed ungulates, 27 bats, 26 diprotodont marsupials, 21 rodents, 12 carnivores and all pangolin species. Primate species offered fresh and smoked in 2009 at a wildlife market by Liberia's Cavally River included chimpanzee ( Pan troglodytes ), Diana monkey ( Cercopithecus diana ), putty-nosed monkey ( C. nictitans ), lesser spot-nosed monkey ( C. petaurista ), Campbell's mona monkey ( C. campbelli ), sooty mangabey ( Cercocebus atys ), king colobus ( Colobus polykomos ), olive colobus ( Procolobus verus ), western red colobus ( P. badius ). Duiker species constituted more than half of the total 723 animals offered. In 2012, the bushmeat trade was surveyed in three villages in the Sassandra Department , Ivory Coast . During six months, nine restaurants received 376 mammals and eight reptiles, including dwarf crocodile ( Osteolaemus tetraspis ), harnessed bushbuck ( Tragelaphus scriptus ), Maxwell's duiker ( Philantomba maxwellii ), bay duiker ( Cephalophus dorsalis ), Campbell's mona monkey, lesser spot-nosed monkey, potto ( Perodicticus potto ), tree pangolin ( Phataginus tricuspis ), long-tailed pangolin ( P. tetradactyla ), African brush-tailed porcupine ( Atherurus africanus ), giant pouched rat ( Cricetomys gambianus ), greater cane rat ( Thryonomys swinderianus ), striped ground squirrel ( Xerus erythropus ) and western tree hyrax ( Dendrohyrax dorsalis ). About 128,400 straw-coloured fruit bats ( Eidolon helvum ) were estimated in 2011 to be traded as bushmeat every year in four cities in southern Ghana. In 2006, it was estimated that about 1,437,458 animals are killed every year in the Nigerian and Cameroon parts of the Cross-Sanaga-Bioko coastal forests , including about 43,880 Emin's pouched rats ( Cricetomys emini ), 41,800 tree pangolins, 39,700 putty-nosed monkeys, 22,500 Mona monkeys ( Cercopithecus mona ), 3,500 red-eared guenons ( C. erythrotis ), 20,300 drills ( Mandrillus leucophaeus ), 15,300 African civets ( Civettictis civetta ), 11,900 common kusimanses ( Crossarchus obscurus ), more than 7,600 African palm civets ( Nandinia binotata ), 26,760 Nile monitors ( Varanus niloticus ) and 410 African forest elephants ( Loxodonta cyclotis ). Between 1983 and 2002, the Gabon populations of western gorilla ( Gorilla gorilla ) and common chimpanzee ( Pan troglodytes ) were estimated to have declined by 56%. This decline was primarily caused by the commercial hunting, which was facilitated by the extended infrastructure for logging purposes. Marsh mongoose ( Atilax paludinosus ) and long-nosed mongoose ( Herpestes naso ) are the most numerous small carnivores offered in rural bushmeat markets in the country. In the late 1990s, fresh and smoked bonobo ( Pan paniscus ) carcasses were observed in Basankusu in the Province of Équateur in the Congo Basin. The main species killed by bushmeat hunters in Tanzania's Katavi - Rukwa Region include impala ( Aepyceros melampus ), common duiker ( Sylvicapra grimmia ), warthog ( Phacocherus africanus ), Cape buffalo ( Syncerus caffer ), harnessed bushbuck, red river hog ( Potamochoerus porcus ) and plains zebra ( Equus quagga ). A survey in a rural area in southwestern Madagascar revealed that bushmeat hunters target bushpig ( Potamochoerus larvatus ), ring-tailed lemur ( Lemur catta ), Verreaux's sifaka ( Propithecus verreauxi ), Hubbard's sportive lemur ( Lepilemur hubbardorum ), fat-tailed dwarf lemur ( Cheirogaleus medius ), common tenrec ( Tenrec ecaudatus ), grey mouse lemur ( Microcebus murinus ), reddish-gray mouse lemur ( M. griseorufus ), Madagascan fruit bat ( Eidolon dupreanum ) and Madagascan flying fox ( Pteropus rufus ). Logging concessions operated by companies in African forests have been closely linked to the bushmeat trade. Because they provide roads, trucks and other access to remote forests, they are the primary means for the transportation of hunters and meat between forests and urban centres. Some, including the Congolaise Industrielle du Bois (CIB) in the Republic of Congo , partnered with governments and international conservation organizations to regulate the bushmeat trade within the concessions where they operate. Numerous solutions are needed; because each country has different circumstances, traditions and laws, no one solution will work in every location. Bushmeat can be an important source of micronutrients and macronutrients . A study of South Americans in the Tres Fronteras region found that those who consumed bushmeat were at a lower risk of anemia and chronic health conditions, as their diets included more iron , zinc , and vitamin C than those who did not eat bushmeat. In Ghana , international illegal over-exploitation of African fishing grounds has increased demand for bushmeat. Both European Union -subsidized fleets and local commercial fleets have depleted fish stocks, leaving local people to supplement their diets with animals hunted from nature reserves. Over 30 years of data link sharp declines in both mammal populations and the biomass of 41 wildlife species with a decreased supply of fish. Consumption of fish and of bushmeat is correlated: the decline of one resource drives up the demand and price for the other. Transhumant pastoralists from the border area between Sudan and the Central African Republic are accompanied by armed merchants who also engage in poaching large herbivores . The decline of giant eland , Cape buffalo, hartebeest and waterbuck in the Chinko area between 2012 and 2017 is attributed to their poaching activities. They use livestock to transport bushmeat to markets. Logging concessions operated by companies in African forests have been closely linked to the bushmeat trade. Because they provide roads, trucks and other access to remote forests, they are the primary means for the transportation of hunters and meat between forests and urban centres. Some, including the Congolaise Industrielle du Bois (CIB) in the Republic of Congo , partnered with governments and international conservation organizations to regulate the bushmeat trade within the concessions where they operate. Numerous solutions are needed; because each country has different circumstances, traditions and laws, no one solution will work in every location. Bushmeat can be an important source of micronutrients and macronutrients . A study of South Americans in the Tres Fronteras region found that those who consumed bushmeat were at a lower risk of anemia and chronic health conditions, as their diets included more iron , zinc , and vitamin C than those who did not eat bushmeat. In Ghana , international illegal over-exploitation of African fishing grounds has increased demand for bushmeat. Both European Union -subsidized fleets and local commercial fleets have depleted fish stocks, leaving local people to supplement their diets with animals hunted from nature reserves. Over 30 years of data link sharp declines in both mammal populations and the biomass of 41 wildlife species with a decreased supply of fish. Consumption of fish and of bushmeat is correlated: the decline of one resource drives up the demand and price for the other. Transhumant pastoralists from the border area between Sudan and the Central African Republic are accompanied by armed merchants who also engage in poaching large herbivores . The decline of giant eland , Cape buffalo, hartebeest and waterbuck in the Chinko area between 2012 and 2017 is attributed to their poaching activities. They use livestock to transport bushmeat to markets. Animal sources may have been the cause for infectious diseases such as tuberculosis , leprosy , cholera , smallpox , measles , influenza , and syphilis acquired by early agrarians. The emergence of HIV-1 , AIDS , Ebola virus disease , and Creutzfeldt-Jakob disease are attributed to animal sources today. Thomas's rope squirrel ( Funisciurus anerythrus ) and red-legged sun squirrel ( Heliosciurus rufobrachium ) were identified as reservoirs of the mpox virus in the Democratic Republic of the Congo in the 1980s. Outbreaks of the Ebola virus in the Congo Basin and in Gabon in the 1990s have been associated with the butchering and consumption of chimpanzees and bonobos . Bushmeat hunters in Central Africa infected with the human T-lymphotropic virus were closely exposed to wild primates. Anthrax can be transmitted when butchering and eating ungulates. The risk of bloodborne diseases to be transmitted is higher when butchering a carcass than when transporting, cooking and eating it. Many hunters and traders are not aware of zoonosis and the risks of disease transmissions. An interview survey in rural communities in Nigeria revealed that 55% of the respondents knew of zoonoses , but their education and cultural traditions are important drivers for hunting and eating bushmeat despite the risks involved. Results of research on wild chimpanzees in Cameroon indicate that they are naturally infected with the simian foamy virus and constitute a reservoir of HIV-1, a precursor of the acquired immunodeficiency syndrome (AIDS) in humans . There are several distinct strains of HIV, indicating that this cross-species transfer has occurred several times. Simian immunodeficiency virus present in chimpanzees is reportedly derived from older strains of the virus present in the collared mangabey ( Cercocebus torquatus ) and the putty-nosed monkey. It is likely that HIV was initially transferred to humans after having come into contact with infected bushmeat. The natural reservoirs of ebolaviruses are unknown. Possible reservoirs include non-human primates , megabats , rodents, shrews, carnivores, and ungulates. Between October 2001 and December 2003, five Ebola virus outbreaks occurred in the border area between Gabon and Republic of Congo. Autopsies of wildlife carcasses showed that chimpanzees, gorillas and bay duikers were infected with the virus. The Ebola virus has been linked to bushmeat, with some researchers hypothesizing that megabats are a primary host of at least some variants of Ebola virus. Between the first recorded outbreak in 1976 and the largest in 2014, the virus has transferred from animals to humans only 30 times, despite large numbers of bats being killed and sold each year. Bats drop partially eaten fruits and pulp, then terrestrial mammals such as gorillas and duikers feed on these fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations. The suspected index case for the Ebola virus epidemic in West Africa in 2014 was a two-year-old boy in Meliandou in south-eastern Guinea, who played in a hollow tree harbouring a colony of Angolan free-tailed bats ( Mops condylurus ). Results of a study conducted during the Ebola crisis in Liberia showed that socio-economic conditions affected bushmeat consumption. During the crisis, there was a decrease in bushmeat consumption and daily meal frequency. In addition, preferences for bushmeat species stayed the same. In Cameroon, 15 primate species were examined for gastrointestinal parasites . Bushmeat primates were infected with Trichuris , Entamoeba , Ascaris , Capillaria , pinworms , Bertiella and Endolimax nana . A large proportion of Bitis vipers sold at rural bushmeat markets in the Democratic Republic of the Congo are infected by Armillifer grandis , which represent a threat to public health. Results of research on wild chimpanzees in Cameroon indicate that they are naturally infected with the simian foamy virus and constitute a reservoir of HIV-1, a precursor of the acquired immunodeficiency syndrome (AIDS) in humans . There are several distinct strains of HIV, indicating that this cross-species transfer has occurred several times. Simian immunodeficiency virus present in chimpanzees is reportedly derived from older strains of the virus present in the collared mangabey ( Cercocebus torquatus ) and the putty-nosed monkey. It is likely that HIV was initially transferred to humans after having come into contact with infected bushmeat. The natural reservoirs of ebolaviruses are unknown. Possible reservoirs include non-human primates , megabats , rodents, shrews, carnivores, and ungulates. Between October 2001 and December 2003, five Ebola virus outbreaks occurred in the border area between Gabon and Republic of Congo. Autopsies of wildlife carcasses showed that chimpanzees, gorillas and bay duikers were infected with the virus. The Ebola virus has been linked to bushmeat, with some researchers hypothesizing that megabats are a primary host of at least some variants of Ebola virus. Between the first recorded outbreak in 1976 and the largest in 2014, the virus has transferred from animals to humans only 30 times, despite large numbers of bats being killed and sold each year. Bats drop partially eaten fruits and pulp, then terrestrial mammals such as gorillas and duikers feed on these fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations. The suspected index case for the Ebola virus epidemic in West Africa in 2014 was a two-year-old boy in Meliandou in south-eastern Guinea, who played in a hollow tree harbouring a colony of Angolan free-tailed bats ( Mops condylurus ). Results of a study conducted during the Ebola crisis in Liberia showed that socio-economic conditions affected bushmeat consumption. During the crisis, there was a decrease in bushmeat consumption and daily meal frequency. In addition, preferences for bushmeat species stayed the same. In Cameroon, 15 primate species were examined for gastrointestinal parasites . Bushmeat primates were infected with Trichuris , Entamoeba , Ascaris , Capillaria , pinworms , Bertiella and Endolimax nana . A large proportion of Bitis vipers sold at rural bushmeat markets in the Democratic Republic of the Congo are infected by Armillifer grandis , which represent a threat to public health. Suggestions for reducing or halting bushmeat harvest and trade include: As an alternative to bushmeat, captive breeding of species traditionally harvested from the wild is sometimes feasible. Captive breeding efforts must be closely monitored, as there is risk they can be used to launder and legitimize individuals captured from the wild, similar to the laundering of wild green tree pythons in Indonesia for the pet trade.

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2023 in science

The following scientific events occurred in 2023 .

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Bang Lamung district

Bang Lamung ( Thai : บางละมุง , pronounced [ bāːŋ lā.mūŋ ] ) is a district ( amphoe ) in the southern part of Chonburi province , Thailand .Mueang Bang Lamung was formerly in Ban Bang Lamung, Tambon Bang Lamung. However, the government downgraded Bang Lamung to a district, with the district office on the banks of Khlong Nok Yang. In 1909, the district head, Phraya Sattaya Nukun (Choem) , moved the district office to the seacoast in Tambon Na Kluea. On 21 October 1952 the district office was completely destroyed by a storm. The office set up temporarily in Bang Lamung School, Sukhumvit Road . The following year the Thai government approved building a new district office near the school. It is still in use today. During September 2023, the district experienced a surge in dengue fever , recording two deaths. Along with dengue fever, Bang Lamung is also experiencing a surge in Mpox cases, with the district recording 26 cases September 6. Neighboring districts are (from the north clockwise) Si Racha of Chonburi Province, Pluak Daeng , Nikhom Phatthana , Ban Chang of Rayong province , Sattahip of Chonburi Province and the Gulf of Thailand . The islands of Ko Lan and Ko Phai are in this district.The district is divided into eight sub-districts ( tambons ), which are further subdivided into 61 villages ( mubans ). The city of Pattaya is a special municipal area which covers the whole tambon Nong Prue and Na Kluea and parts of Huai Yai and Nong Pla Lai. There are a further two townships ( thesaban tambon ): Bang Lamung and Laem Chabang . Laem Chabang covers parts of tambon Bang Lamung, and of neighboring Si Racha the complete tambon Bueng, Sura Sak, Thung Su Khla and parts of Nong Kham. Bang Lamung covers parts of the tambon Bang Lamung, Nong Pla Lai, and Takhian Tia. The non-municipal area is administrated by five tambon administrative organizations (TAO).

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Index of Singapore-related articles

This is a list of Singapore -related articles by alphabetical order . To learn quickly what Singapore is, see Outline of Singapore . Those interested in the subject can monitor changes to the pages by clicking on Related changes in the sidebar. A list of to do topics can be found here .

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2022–2023 mpox outbreak in Belgium

The 2022–2023 mpox outbreak in Belgium is part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus . Belgium was the fifth country, outside of the African countries with endemic mpox, to experience an outbreak in 2022. The first case was documented in Antwerp , Belgium , on 19 May 2022. As of 10 August, Belgium has 546 cases and 1 suspected case. Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. An ongoing outbreak of mpox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic ), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak. The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May, but it has been suggested that cases were already spreading in Europe in the previous months. A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria , the Democratic Republic of the Congo as well as central and western Africa . It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis , gonorrhea , chlamydia , and herpes . The first two known cases were detected in on 19 May 2022. The first infected person was diagnosed in Antwerp , and the second from a region called Flemish Brabant . Both had gone to the same party, and thus began the mpox outbreak in Belgium. It is unknown what hospital they went to, although it is very likely that the first infected person went to an Antwerp hospital, and the second infected person went to a Flemish Brabant region hospital. There, they both tested positive for mpox, becoming the first cases in Belgium. A day after both tested positive, there was another case reported in a man of unknown age who was relatively healthy but had bullous lesions on his hands. More and more cases were reported in Belgium days later and more continue to be reported. As of 10 August, there are 546 cases and 1 suspected case. On 5 July the Office of European Commissioner for Health, Stella Kyriakides , told Belga News Agency that 3,040 mpox vaccines were shipped to Belgium on 7 July. According to the Cypriot commissioner, these deliveries will "protect Belgian citizens and respond to this outbreak." She also praised the European Health Emergency Response and Preparedness Authority 's (HERA) quick response. Kyriakides concluded that more doses will be delivered to Belgium in the following weeks. Hospitals have also begun making their own preparations to help control the current mpox outbreak, including screening patients, increasing decontamination and cleaning procedures, and wearing appropriate safety gear ( Personal protective equipment / Medical gown ) when interacting with infected patients. Belgium also introduced a mandatory 21-day quarantine for infected mpox patients in hopes of containing the disease in the country. Close contacts are not required to self-isolate but are encouraged to remain vigilant, especially if in contact with vulnerable people.

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Pox

Pox may refer to:

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Kathleen Rubins

Kathleen Hallisey "Kate" Rubins (born October 14, 1978) is an American microbiologist and NASA astronaut . She became the 60th woman to fly in space when she launched on a Russian Soyuz spacecraft to the International Space Station (ISS) on July 7, 2016. She returned to Earth in Kazakhstan on October 30, 2016, aboard a Soyuz. She was a crew member of Expedition 48 / 49 and Expedition 63 / 64 of the ISS. Rubins has spent a total of 300 days, 1 hour, and 31 minutes in space which is the fourth most days in space by a U.S female astronaut. Rubins was born in Farmington, Connecticut , and raised in Napa, California . She did chores around the house to help her fund a trip to Space Camp in seventh grade. The camp inspired her to take more math and science classes in school. In July 2016, Rubin became the third female Space Camp alumna to fly in space. Her father, Jim, still resides in Napa and her mother, Ann Hallisey, lives in Davis, California . Kathleen Rubins graduated from Vintage High School in Napa, California , in 1996. She received a Bachelor of Science degree in molecular biology from the University of California, San Diego , and a Ph.D. degree in cancer biology from Stanford University Medical School Biochemistry Department and Microbiology and Immunology Department. She was a member of the Kappa Lambda chapter of the Chi Omega sorority while attending UC San Diego. For as long as she can remember, Rubins had always wanted to be an astronaut. Her initial understanding was that she would have to become a fighter pilot first and progress from there, but after getting involved with public health HIV prevention in high school she developed an interest in viruses and microbiology and decided to pursue that first instead. Some of her hobbies include flying airplanes and jumping out of them, scuba diving, and entering triathlons, in which she was a member of the Stanford triathlon team. Rubins conducted her undergraduate research on HIV-1 integration in the Infectious Diseases Laboratory at the Salk Institute for Biological Studies. She analyzed the mechanism of HIV integration, including several studies of HIV-1 Integrase inhibitors and genome-wide analyses of HIV integration patterns into host genomic DNA. She obtained her Ph.D. from Stanford University and, with the U.S. Army Medical Research Institute of Infectious Diseases and the Centers for Disease Control and Prevention , Rubins (who was responsible for building its underlying microarray ) and colleagues developed the first model of smallpox infection. She also developed a complete map of the poxvirus transcriptome and studied virus-host interactions using both in-vitro and animal model systems. Rubins accepted a Fellow/Principal Investigator position at the Whitehead Institute for Biomedical Research (MIT/Cambridge, Massachusetts) and headed a lab of researchers studying viral diseases that primarily affect Central and West Africa. Work in the Rubins Lab focused on poxviruses and host-pathogen interaction as well as viral mechanisms for regulating host cell mRNA transcription, translation and decay. In addition, she conducted research on transcriptome and genome sequencing of Ebolavirus , Marburgvirus , and Lassa mammarenavirus , and collaborative projects with the U.S. Army to develop therapies for Ebola and Lassa. Dr. Rubins also conducted research regarding space radiation and its effects on astronauts. The authors of this study investigated whether or not the Risk of Exposure-Induced Death (REID) that NASA had accepted was accurate enough. Much of the radiation in space is from ion exposure and solar cycle activity. The authors of the Nature paper concluded that although there are limitations in estimating the radiation levels that astronauts are exposed to while in space, more research needs to be done on the subject. Another study that Dr. Rubins was involved with was the life-cycle analysis of a family of viruses including the smallpox virus. The researchers utilized fluorescent protein-based reporters to monitor and analyze the function of the Vaccinia virus. This study was important in starting to work on treatment for diseases like mpox. The mpox is a zoonotic disease originating from the rainforest around Central and West Africa . One can contract mpox when coming in contact with the virus from an animal, human, or any material that has been infected with the virus. In 2003, there was a small mpox outbreak in the United States, which provided more motivation for the study to be conducted. The results of this study provided useful information for the tracking of viral activity and replication. As of January 2023 [ update ] , there is still no cure for mpox, but it can be controlled. Rubins was a part of the research team that investigated the effects of microgravity on RNA isolation and PCR analysis. The experiments occurred between April 19 and May 3, 2017. Operations required the use of the WetLab-2 hardware suite consisting of microgravity-compatible STT (ACT2 or Finger Loop syringe), SPM, bubble-removing Pipette Loader (PL), reaction tube centrifugation rotor and a Cepheid SmartCycler® for thermocycling/fluorescence readout. This study was conducted while on board the International Space Station (ISS). The experiment performed was one of the first successful ones in the WetLab-2, a research station built for microbiology in space. The results of this study were incredibly valuable for the future of space exploration and analysis of space environment samples.Rubins was selected in July 2009 as one of 14 members of NASA Astronaut Group 20 . She graduated from Astronaut Candidate Training, where her training included International Space Station (ISS) systems, Extravehicular Activity (EVA), robotics, physiological training, T-38 flight training and water and wilderness survival training. She also participated in the fourth edition of the ESA PANGAEA training program (September and November 2021). Together with the ESA astronaut Andreas Mogensen , Rubins went to the Italian Dolomites, to the Ries Crater in Germany and the volcanic landscapes of Lanzarote, Spain. ESA's Pangaea program prepares astronauts and space engineers to identify planetary geological features for future missions to the Moon, Mars and asteroids. She became the 60th woman in space when she launched on Soyuz MS-01 in July 2016. She was inspired by learning the constellations with her dad and going to local "star-gazing" gatherings and science museums as early as she could remember as a young child. She had always been fascinated with science and exploring the world. Rubins left Earth for the first time on July 7, 2016, on board the new Soyuz MS spacecraft alongside Russian cosmonaut Anatoli Ivanishin and JAXA astronaut Takuya Onishi . In August 2016, Rubins became the first person to sequence DNA in space. Rubins and the other astronauts were conducting research on how to diagnose an illness, or identify microbes growing in the International Space Station and determine whether or not they represent a health threat. San Diego graduate, Kate Rubins, used a commercially available machine to sequence mouse, virus and bacteria DNA. Aboard the ISS, she used a hand-held, USB -powered DNA sequencer called the MinION made by Oxford Nanopore Technologies to determine the DNA sequences of mouse, E. coli bacteria, and lambda phage virus. It was a part of the Biomolecule Sequencer experiment, the goal of which was "to provide evidence that DNA sequencing in space is possible, which holds the potential to enable the identification of microorganisms, monitor changes in microbes and humans in response to spaceflight, and possibly aid in the detection of DNA-based life elsewhere in the universe." During her first stay in space, she also spent 12 hours and 46 minutes outside the station on two separate spacewalks . She made these two spacewalks with veteran spacewalker Jeffrey Williams . During her first spacewalk, Dr. Rubins successfully installed the first International Docking Adapter, which allows U.S. commercial spacecraft to dock. On her second spacewalk, Rubins installed new, high definition cameras. Rubins also captured the SpaceX Dragon commercial resupply spacecraft and sent back experiment samples to Earth. Rubins returned to Earth on October 30, 2016, after 115 days in space. Rubins launched on her second mission on October 14, 2020 (her 42nd birthday) with Russian cosmonauts Sergey Ryzhikov and Sergey Kud-Sverchkov aboard Soyuz MS-17 . She returned to Earth on April 17, 2021, at 10:55 AM local (Kazakhstan) time, following the launch of Soyuz MS-18 . Rubins was on the ISS at the time of the 2020 United States elections and cast her absentee ballot from the station. During her second stay in space, she made her third career spacewalk with Victor J. Glover , and her fourth with Soichi Noguchi in March 2021. While on the ISS during her most recent trip, Rubins continued research for the Cardinal Heart experiment which included cancer therapies and heart conditions. Microgravity significantly affects heart tissues that perform work and exert an opposite force to gravity and is known to cause molecular and structural abnormalities in cells and tissues that can lead to disease. The investigation could provide new understanding of similar heart issues on Earth and help identify new treatments. This study was analyzing the effects of low-gravity on heart muscles. Dr. Rubins and other scientists generated 3D engineered heart tissue. This research could provide important information for heart problems not only for astronauts returning home, but also for any citizen on Earth.Rubins left Earth for the first time on July 7, 2016, on board the new Soyuz MS spacecraft alongside Russian cosmonaut Anatoli Ivanishin and JAXA astronaut Takuya Onishi . In August 2016, Rubins became the first person to sequence DNA in space. Rubins and the other astronauts were conducting research on how to diagnose an illness, or identify microbes growing in the International Space Station and determine whether or not they represent a health threat. San Diego graduate, Kate Rubins, used a commercially available machine to sequence mouse, virus and bacteria DNA. Aboard the ISS, she used a hand-held, USB -powered DNA sequencer called the MinION made by Oxford Nanopore Technologies to determine the DNA sequences of mouse, E. coli bacteria, and lambda phage virus. It was a part of the Biomolecule Sequencer experiment, the goal of which was "to provide evidence that DNA sequencing in space is possible, which holds the potential to enable the identification of microorganisms, monitor changes in microbes and humans in response to spaceflight, and possibly aid in the detection of DNA-based life elsewhere in the universe." During her first stay in space, she also spent 12 hours and 46 minutes outside the station on two separate spacewalks . She made these two spacewalks with veteran spacewalker Jeffrey Williams . During her first spacewalk, Dr. Rubins successfully installed the first International Docking Adapter, which allows U.S. commercial spacecraft to dock. On her second spacewalk, Rubins installed new, high definition cameras. Rubins also captured the SpaceX Dragon commercial resupply spacecraft and sent back experiment samples to Earth. Rubins returned to Earth on October 30, 2016, after 115 days in space. Rubins launched on her second mission on October 14, 2020 (her 42nd birthday) with Russian cosmonauts Sergey Ryzhikov and Sergey Kud-Sverchkov aboard Soyuz MS-17 . She returned to Earth on April 17, 2021, at 10:55 AM local (Kazakhstan) time, following the launch of Soyuz MS-18 . Rubins was on the ISS at the time of the 2020 United States elections and cast her absentee ballot from the station. During her second stay in space, she made her third career spacewalk with Victor J. Glover , and her fourth with Soichi Noguchi in March 2021. While on the ISS during her most recent trip, Rubins continued research for the Cardinal Heart experiment which included cancer therapies and heart conditions. Microgravity significantly affects heart tissues that perform work and exert an opposite force to gravity and is known to cause molecular and structural abnormalities in cells and tissues that can lead to disease. The investigation could provide new understanding of similar heart issues on Earth and help identify new treatments. This study was analyzing the effects of low-gravity on heart muscles. Dr. Rubins and other scientists generated 3D engineered heart tissue. This research could provide important information for heart problems not only for astronauts returning home, but also for any citizen on Earth.While on the ISS during her most recent trip, Rubins continued research for the Cardinal Heart experiment which included cancer therapies and heart conditions. Microgravity significantly affects heart tissues that perform work and exert an opposite force to gravity and is known to cause molecular and structural abnormalities in cells and tissues that can lead to disease. The investigation could provide new understanding of similar heart issues on Earth and help identify new treatments. This study was analyzing the effects of low-gravity on heart muscles. Dr. Rubins and other scientists generated 3D engineered heart tissue. This research could provide important information for heart problems not only for astronauts returning home, but also for any citizen on Earth.NASA has announced the next group of astronauts to be a part of the Artemis program that will put the first American woman on the Moon. Dr. Rubins is among the astronauts announced on the Artemis Team. The Artemis program aims to not only place an American woman on the Moon but also survey the entire surface of the Moon to gain a better understanding for the possibility of human life on Mars.Rubins has a total of 5 honors and awards so far in her career. She received Popular Science's Brilliant Ten (2009), National Science Foundation Predoctoral Fellowship (2000), Stanford Graduate Fellowship - Gabilan Fellow (2000), UCSD Emerging Leader of the Year (1998), Order of Omega Honor Society Scholarship Award (1998).

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Mpox

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2022–2023 mpox outbreak in the Republic of Ireland

The 2022-2023 mpox outbreak in the Republic of Ireland is part of the larger ongoing global outbreak of human mpox caused by Clade II of the monkeypox virus . The first case in the Republic was confirmed on 27 May 2022. Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria , the Democratic Republic of the Congo as well as central and western Africa . It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis , an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis , gonorrhea , chlamydia , and herpes . As of 28 June 2023, the Health Protection Surveillance Centre (HPSC) had been notified of 228 cases of mpox, no deaths have been recorded so far. Median age: 35; Mean age: 37; Total = 228 Total = 228

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Mpox

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Basic reproduction number

In epidemiology , the basic reproduction number , or basic reproductive number (sometimes called basic reproduction ratio or basic reproductive rate ), denoted R 0 {\displaystyle R_{0}} (pronounced R nought or R zero ), of an infection is the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection. The definition assumes that no other individuals are infected or immunized (naturally or through vaccination ). Some definitions, such as that of the Australian Department of Health , add the absence of "any deliberate intervention in disease transmission". The basic reproduction number is not necessarily the same as the effective reproduction number R {\displaystyle R} (usually written R t {\displaystyle R_{t}} [ t for time], sometimes R e {\displaystyle R_{e}} ), which is the number of cases generated in the current state of a population, which does not have to be the uninfected state. R 0 {\displaystyle R_{0}} is a dimensionless number (persons infected per person infecting) and not a time rate, which would have units of time −1 , or units of time like doubling time . R 0 {\displaystyle R_{0}} is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population. R 0 {\displaystyle R_{0}} values are usually estimated from mathematical models, and the estimated values are dependent on the model used and values of other parameters. Thus values given in the literature only make sense in the given context and it is not recommended to compare values based on different models. R 0 {\displaystyle R_{0}} does not by itself give an estimate of how fast an infection spreads in the population. The most important uses of R 0 {\displaystyle R_{0}} are determining if an emerging infectious disease can spread in a population and determining what proportion of the population should be immunized through vaccination to eradicate a disease. In commonly used infection models , when R 0 > 1 {\displaystyle R_{0}>1} the infection will be able to start spreading in a population, but not if R 0 1 {\displaystyle R_{0}>1} , the outbreak will expand. In some cases, for some models, values of R 0 < 1 {\displaystyle R_{0}<1} can still lead to self-perpetuating outbreaks. This is particularly problematic if there are intermediate vectors between hosts (as is the case for zoonoses ), such as malaria . Therefore, comparisons between values from the "Values of R 0 {\displaystyle R_{0}} of well-known contagious diseases" table should be conducted with caution. Although R 0 {\displaystyle R_{0}} cannot be modified through vaccination or other changes in population susceptibility, it can vary based on a number of biological, sociobehavioral, and environmental factors. It can also be modified by physical distancing and other public policy or social interventions, although some historical definitions exclude any deliberate intervention in reducing disease transmission, including nonpharmacological interventions. And indeed, whether nonpharmacological interventions are included in R 0 {\displaystyle R_{0}} often depends on the paper, disease, and what if any intervention is being studied. This creates some confusion, because R 0 {\displaystyle R_{0}} is not a constant; whereas most mathematical parameters with "nought" subscripts are constants. R {\displaystyle R} depends on many factors, many of which need to be estimated. Each of these factors adds to uncertainty in estimates of R {\displaystyle R} . Many of these factors are not important for informing public policy. Therefore, public policy may be better served by metrics similar to R {\displaystyle R} , but which are more straightforward to estimate, such as doubling time or half-life ( t 1 / 2 {\displaystyle t_{1/2}} ). Methods used to calculate R 0 {\displaystyle R_{0}} include the survival function , rearranging the largest eigenvalue of the Jacobian matrix , the next-generation method , calculations from the intrinsic growth rate, existence of the endemic equilibrium, the number of susceptibles at the endemic equilibrium, the average age of infection and the final size equation. Few of these methods agree with one another, even when starting with the same system of differential equations . Even fewer actually calculate the average number of secondary infections. Since R 0 {\displaystyle R_{0}} is rarely observed in the field and is usually calculated via a mathematical model, this severely limits its usefulness. Despite the difficulties in estimating R 0 {\displaystyle R_{0}} mentioned in the previous section, estimates have been made for a number of genera , and are shown in this table. Each genus may be composed of many species , strains , or variants . Estimations of R 0 {\displaystyle R_{0}} for species, strains, and variants are typically less accurate than for genera, and so are provided in separate tables below for diseases of particular interest ( influenza and COVID-19 ). Estimates for strains of influenza . Estimates for variants of SARS-CoV-2 . In the 2011 film Contagion , a fictional medical disaster thriller, a blogger's calculations for R 0 {\displaystyle R_{0}} are presented to reflect the progression of a fatal viral infection from isolated cases to a pandemic.

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Mpox

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2020s

The 2020s (pronounced "twenty-twenties"; shortened to " the '20s " and also known as " The Twenties ") is the current decade . It began on January 1, 2020, and will end on December 31, 2029. The 2020s began with the COVID-19 pandemic . The first reports of the virus were published on December 31, 2019, though the first cases are said to have appeared nearly a month earlier. The pandemic led to a global economic recession , a sustained rise in global inflation for the first time since the 1970s , and a global supply chain crisis . Several anti-government demonstrations and revolts occurred in the late 2010s and early 2020s, including a continuation of those in Hong Kong against extradition legislation ; protests against certain local, state and national responses to the COVID-19 pandemic; others around the world , particularly in the United States , against racism and police brutality ; one in India against agriculture and farming acts ; one in Israel against judicial reforms ; another in Indonesia against the omnibus law on jobs ; ongoing protests and strikes in France against pension reform ; an ongoing political crisis in Peru , Armenia , and Thailand ; and many in Belarus , Eswatini , Myanmar , Afghanistan , Sri Lanka , Iran , China , and Russia against various forms of governmental jurisdiction, corruption and authoritarianism ; along with citizen riots in the United States and Brazil in an attempt to overturn election results. The world population grew to over 8 billion people, and in 2023, India overtook China as the most populous country in the world. Ongoing military conflicts include the Myanmar civil war , the Ethiopian civil conflict , the Kivu conflict , the Mali War , the Yemeni civil war , the Somali Civil War , the Syrian civil war , the Russo-Ukrainian War , and the Israel–Hamas war . The Russian invasion of Ukraine became the largest conventional military offensive in Europe since World War II , and resulting in a refugee crisis , disruptions to global trade , and an exacerbation of economic inflation . In 2023, a Hamas-led attack marked the first invasion of Israel since 1948 , triggering a swift Israeli response with an invasion into Gaza . This conflict has led to the displacement of nearly all 2.3 million Gaza residents, raising international concerns about a humanitarian crisis and sparking global protests against Israel's actions in the war. Smaller conflicts include the insurgency in the Maghreb , the Iraq insurgency , the Philippine drug war , and the Mexican drug war . The year 2021 saw the withdrawal of U.S. troops from Afghanistan and the fall of Kabul to the Taliban , ending twenty years of war in that country, and leading to the republican loyalist uprising against the new emirate government . With many extreme weather events magnifying in the early 2020s, several world leaders have called it the "decisive decade" for climate action as ecological crises continue to escalate. In February 2023, a series of powerful earthquakes killed up to 62,000 people in Turkey and Syria ; this event fell within the top five deadliest earthquakes of the 21st century . There were significant improvements in the complexity of artificial intelligence , with American companies, universities, and research labs pioneering advances in the field. Generative AI-based applications such as ChatGPT and DALL-E have accumulated billions of users, and allow users to instantly generate complex texts, images, art, and video, comparable to the sophistication of human work. Other technological advances have also been made, impacting many, such as the widespread use of teleconferencing , online learning , streaming services , e-commerce and food delivery services to compensate for lockdowns ordered by governments around the world during the early months of the COVID-19 pandemic. 5G networks have launched around the globe at the start of the decade as well, and became prevalent in smartphones . Research into outer space greatly accelerated in the 2020s, with the United States and India mainly dominating space exploration , including the James Webb Space Telescope , Ingenuity helicopter , Lunar Gateway , and Artemis program from the United States and Chandrayaan-3 from India . The prominent wars of the decade include: 6 May 2021 7 October 2023 21 May 2021 Ongoing 27 September 2020 19 September 2023 10 November 2020 20 September 2023 7 October 2001 20 March 2003 30 August 2021 Ongoing 24 February 2022 Ongoing 7 September 2021 Ongoing 6 February 2023 Ongoing 3 November 2020 9 April 2023 3 November 2022 Ongoing Successful revolutions and otherwise major protests of the decade include, but are not limited to: 6 January 2021 16 September 2022 – present 8 January 2023 Note: To be included, entries must be notable (have a stand-alone article) and described by a consensus of reliable sources as "terrorism". They also must have 100 or more fatalities reported. The most prominent terrorist attacks committed against civilian populations during the decade include, but are not limited to: Having suffered decline in the years after the Great Recession , the centre-left politics and the 1990s political model (like progressivism , liberalism , social democracy , and third way policies) experienced a resurgence across Europe and the Anglosphere in the early 2020s, with New Statesman suggesting various causes, including natural shifts in the electoral cycle and conservatives' unpopularity among university graduates and voters under the age of 40. Sitting leaders that died in office: In 2020 : Sheik Sabah al-Sabah , Sultan Qaboos bin Said , and Pierre Nkurunziza . In 2021 : Idriss Déby , John Magufuli , and Jovenel Moïse . In 2022 : Khalifa bin Zayed Al Nahyan and Elizabeth II In 2023 : Nawaf Al-Ahmad Al-Jaber Al-Sabah In 2024 : Hage Geingob Former world leaders who died: In 2020 : Hosni Mubarak , Valéry Giscard d'Estaing , John Turner , Daniel arap Moi , Pranab Mukherjee , Amadou Toumani Touré , Jerry Rawlings , Mamadou Tandja , Tabaré Vázquez , Javier Pérez de Cuéllar , Pierre Buyoya , John Cremona , Sidi Ould Cheikh Abdallahi , Kuniwo Nakamura , Litokwa Tomeing , Moussa Traoré , Pascal Lissouba , Branko Kostić , Lee Teng-hui , Benjamin Mkapa , Miloš Jakeš , Rafael Leonardo Callejas Romero , Abdul Halim Khaddam , Joachim Yhombi-Opango , Manuel Serifo Nhamadjo , Mike Moore , and Janez Stanovnik . In 2021 : Gustavo Noboa , Ali Mahdi Muhammad , Moudud Ahmed , Didier Ratsiraka , Bonfoh Abass , Mamnoon Hussain , Arturo Armando Molina , Hissène Habré , Jorge Sampaio , Abdelkader Bensalah , Kenneth Kaunda , Anerood Jugnauth , Abdelaziz Bouteflika , Enrique Bolaños , Roh Tae-woo , Chun Doo-hwan , Benigno Aquino III , Carlos Menem , F. W. de Klerk , James Fitz-Allen Mitchell , Norodom Ranariddh , Kinza Clodumar , and Karolos Papoulias . In 2022 : Toshiki Kaifu , Ernest Shonekan , Ibrahim Boubacar Keïta , Christos Sartzetakis , Amos Sawyer , Rupiah Banda , Karl Offmann , Shahabuddin Ahmed , Ayaz Mutallibov , Dušan Čkrebić , Mwai Kibaki , Leonid Kravchuk , Ciriaco De Mita , Stanislav Shushkevich , Romeo Morri , Bujar Nishani , Evaristo Carvalho , Jacob Nena , Shinzo Abe , José Eduardo dos Santos , Luis Echeverría , Francisco Morales Bermúdez , Fidel V. Ramos , Mikhail Gorbachev , Balakh Sher Mazari , Karmenu Mifsud Bonnici , Jiang Zemin , Adolfas Šleževičius , Edgar Savisaar and Pope Benedict XVI . In 2023 : Abdelsalam Majali , Constantine II of Greece , Álvaro Colom , Sherif Ismail , Pervez Musharraf , Lubomír Štrougal , Ivan Silayev , Sergey Tereshchenko , Hans Modrow , Ahmed Qurei , Gérard Latortue , Pōhiva Tuʻiʻonetoa , Pascoal Mocumbi , Sir Rabbie Namaliu , Mudar Badran , Nikica Valentić , Rifat Rastoder , Silvio Berlusconi , Sir Lloyd Erskine Sandiford , Sir Tapley Seaton , Milan Milutinović , Arnaldo Forlani , Rachid Sfar , Jean-Jacques Honorat , Surat Huseynov , Henri Konan Bédié , Mircea Snegur , Abdul Ati al-Obeidi , Giorgio Napolitano , Marouf al-Bakhit , László Sólyom , Martti Ahtisaari , Bill Hayden , Li Keqiang , Henri Lopes , Antoni Martí , Rahim Huseynov , Faustin Twagiramungu , Paulin Obame-Nguema and Sir Michael Hardie Boys . In 2024 : Basdeo Panday , Dries van Agt , John Bruton , Sebastián Piñera , Edward Lowassa , Anfinn Kallsberg , Nikolai Ryzhkov , Ali Hassan Mwinyi , Brian Mulroney , Agbéyomé Kodjo , Mahammed Dionne and Josip Manolić . Coups d'état against ruling governments during the decade include: The event has been condemned by foreign governments, the political opposition, and human rights organizations and is considered the first major political crisis in the country since the conclusion of the Salvadoran Civil War in 1992 and has been referred to as a coup attempt .The prominent wars of the decade include: 6 May 2021 7 October 2023 21 May 2021 Ongoing 27 September 2020 19 September 2023 10 November 2020 20 September 2023 7 October 2001 20 March 2003 30 August 2021 Ongoing 24 February 2022 Ongoing 7 September 2021 Ongoing 6 February 2023 Ongoing 3 November 2020 9 April 2023 3 November 2022 Ongoing6 May 2021 7 October 2023 21 May 2021 Ongoing 27 September 2020 19 September 2023 10 November 2020 20 September 2023 7 October 2001 20 March 2003 30 August 2021 Ongoing 24 February 2022 Ongoing7 September 2021 Ongoing 6 February 2023 Ongoing 3 November 2020 9 April 2023 3 November 2022 OngoingSuccessful revolutions and otherwise major protests of the decade include, but are not limited to: 6 January 2021 16 September 2022 – present 8 January 2023Note: To be included, entries must be notable (have a stand-alone article) and described by a consensus of reliable sources as "terrorism". They also must have 100 or more fatalities reported. The most prominent terrorist attacks committed against civilian populations during the decade include, but are not limited to:Having suffered decline in the years after the Great Recession , the centre-left politics and the 1990s political model (like progressivism , liberalism , social democracy , and third way policies) experienced a resurgence across Europe and the Anglosphere in the early 2020s, with New Statesman suggesting various causes, including natural shifts in the electoral cycle and conservatives' unpopularity among university graduates and voters under the age of 40. Sitting leaders that died in office: In 2020 : Sheik Sabah al-Sabah , Sultan Qaboos bin Said , and Pierre Nkurunziza . In 2021 : Idriss Déby , John Magufuli , and Jovenel Moïse . In 2022 : Khalifa bin Zayed Al Nahyan and Elizabeth II In 2023 : Nawaf Al-Ahmad Al-Jaber Al-Sabah In 2024 : Hage Geingob Former world leaders who died: In 2020 : Hosni Mubarak , Valéry Giscard d'Estaing , John Turner , Daniel arap Moi , Pranab Mukherjee , Amadou Toumani Touré , Jerry Rawlings , Mamadou Tandja , Tabaré Vázquez , Javier Pérez de Cuéllar , Pierre Buyoya , John Cremona , Sidi Ould Cheikh Abdallahi , Kuniwo Nakamura , Litokwa Tomeing , Moussa Traoré , Pascal Lissouba , Branko Kostić , Lee Teng-hui , Benjamin Mkapa , Miloš Jakeš , Rafael Leonardo Callejas Romero , Abdul Halim Khaddam , Joachim Yhombi-Opango , Manuel Serifo Nhamadjo , Mike Moore , and Janez Stanovnik . In 2021 : Gustavo Noboa , Ali Mahdi Muhammad , Moudud Ahmed , Didier Ratsiraka , Bonfoh Abass , Mamnoon Hussain , Arturo Armando Molina , Hissène Habré , Jorge Sampaio , Abdelkader Bensalah , Kenneth Kaunda , Anerood Jugnauth , Abdelaziz Bouteflika , Enrique Bolaños , Roh Tae-woo , Chun Doo-hwan , Benigno Aquino III , Carlos Menem , F. W. de Klerk , James Fitz-Allen Mitchell , Norodom Ranariddh , Kinza Clodumar , and Karolos Papoulias . In 2022 : Toshiki Kaifu , Ernest Shonekan , Ibrahim Boubacar Keïta , Christos Sartzetakis , Amos Sawyer , Rupiah Banda , Karl Offmann , Shahabuddin Ahmed , Ayaz Mutallibov , Dušan Čkrebić , Mwai Kibaki , Leonid Kravchuk , Ciriaco De Mita , Stanislav Shushkevich , Romeo Morri , Bujar Nishani , Evaristo Carvalho , Jacob Nena , Shinzo Abe , José Eduardo dos Santos , Luis Echeverría , Francisco Morales Bermúdez , Fidel V. Ramos , Mikhail Gorbachev , Balakh Sher Mazari , Karmenu Mifsud Bonnici , Jiang Zemin , Adolfas Šleževičius , Edgar Savisaar and Pope Benedict XVI . In 2023 : Abdelsalam Majali , Constantine II of Greece , Álvaro Colom , Sherif Ismail , Pervez Musharraf , Lubomír Štrougal , Ivan Silayev , Sergey Tereshchenko , Hans Modrow , Ahmed Qurei , Gérard Latortue , Pōhiva Tuʻiʻonetoa , Pascoal Mocumbi , Sir Rabbie Namaliu , Mudar Badran , Nikica Valentić , Rifat Rastoder , Silvio Berlusconi , Sir Lloyd Erskine Sandiford , Sir Tapley Seaton , Milan Milutinović , Arnaldo Forlani , Rachid Sfar , Jean-Jacques Honorat , Surat Huseynov , Henri Konan Bédié , Mircea Snegur , Abdul Ati al-Obeidi , Giorgio Napolitano , Marouf al-Bakhit , László Sólyom , Martti Ahtisaari , Bill Hayden , Li Keqiang , Henri Lopes , Antoni Martí , Rahim Huseynov , Faustin Twagiramungu , Paulin Obame-Nguema and Sir Michael Hardie Boys . In 2024 : Basdeo Panday , Dries van Agt , John Bruton , Sebastián Piñera , Edward Lowassa , Anfinn Kallsberg , Nikolai Ryzhkov , Ali Hassan Mwinyi , Brian Mulroney , Agbéyomé Kodjo , Mahammed Dionne and Josip Manolić .Having suffered decline in the years after the Great Recession , the centre-left politics and the 1990s political model (like progressivism , liberalism , social democracy , and third way policies) experienced a resurgence across Europe and the Anglosphere in the early 2020s, with New Statesman suggesting various causes, including natural shifts in the electoral cycle and conservatives' unpopularity among university graduates and voters under the age of 40. Sitting leaders that died in office: In 2020 : Sheik Sabah al-Sabah , Sultan Qaboos bin Said , and Pierre Nkurunziza . In 2021 : Idriss Déby , John Magufuli , and Jovenel Moïse . In 2022 : Khalifa bin Zayed Al Nahyan and Elizabeth II In 2023 : Nawaf Al-Ahmad Al-Jaber Al-Sabah In 2024 : Hage Geingob Former world leaders who died: In 2020 : Hosni Mubarak , Valéry Giscard d'Estaing , John Turner , Daniel arap Moi , Pranab Mukherjee , Amadou Toumani Touré , Jerry Rawlings , Mamadou Tandja , Tabaré Vázquez , Javier Pérez de Cuéllar , Pierre Buyoya , John Cremona , Sidi Ould Cheikh Abdallahi , Kuniwo Nakamura , Litokwa Tomeing , Moussa Traoré , Pascal Lissouba , Branko Kostić , Lee Teng-hui , Benjamin Mkapa , Miloš Jakeš , Rafael Leonardo Callejas Romero , Abdul Halim Khaddam , Joachim Yhombi-Opango , Manuel Serifo Nhamadjo , Mike Moore , and Janez Stanovnik . In 2021 : Gustavo Noboa , Ali Mahdi Muhammad , Moudud Ahmed , Didier Ratsiraka , Bonfoh Abass , Mamnoon Hussain , Arturo Armando Molina , Hissène Habré , Jorge Sampaio , Abdelkader Bensalah , Kenneth Kaunda , Anerood Jugnauth , Abdelaziz Bouteflika , Enrique Bolaños , Roh Tae-woo , Chun Doo-hwan , Benigno Aquino III , Carlos Menem , F. W. de Klerk , James Fitz-Allen Mitchell , Norodom Ranariddh , Kinza Clodumar , and Karolos Papoulias . In 2022 : Toshiki Kaifu , Ernest Shonekan , Ibrahim Boubacar Keïta , Christos Sartzetakis , Amos Sawyer , Rupiah Banda , Karl Offmann , Shahabuddin Ahmed , Ayaz Mutallibov , Dušan Čkrebić , Mwai Kibaki , Leonid Kravchuk , Ciriaco De Mita , Stanislav Shushkevich , Romeo Morri , Bujar Nishani , Evaristo Carvalho , Jacob Nena , Shinzo Abe , José Eduardo dos Santos , Luis Echeverría , Francisco Morales Bermúdez , Fidel V. Ramos , Mikhail Gorbachev , Balakh Sher Mazari , Karmenu Mifsud Bonnici , Jiang Zemin , Adolfas Šleževičius , Edgar Savisaar and Pope Benedict XVI . In 2023 : Abdelsalam Majali , Constantine II of Greece , Álvaro Colom , Sherif Ismail , Pervez Musharraf , Lubomír Štrougal , Ivan Silayev , Sergey Tereshchenko , Hans Modrow , Ahmed Qurei , Gérard Latortue , Pōhiva Tuʻiʻonetoa , Pascoal Mocumbi , Sir Rabbie Namaliu , Mudar Badran , Nikica Valentić , Rifat Rastoder , Silvio Berlusconi , Sir Lloyd Erskine Sandiford , Sir Tapley Seaton , Milan Milutinović , Arnaldo Forlani , Rachid Sfar , Jean-Jacques Honorat , Surat Huseynov , Henri Konan Bédié , Mircea Snegur , Abdul Ati al-Obeidi , Giorgio Napolitano , Marouf al-Bakhit , László Sólyom , Martti Ahtisaari , Bill Hayden , Li Keqiang , Henri Lopes , Antoni Martí , Rahim Huseynov , Faustin Twagiramungu , Paulin Obame-Nguema and Sir Michael Hardie Boys . In 2024 : Basdeo Panday , Dries van Agt , John Bruton , Sebastián Piñera , Edward Lowassa , Anfinn Kallsberg , Nikolai Ryzhkov , Ali Hassan Mwinyi , Brian Mulroney , Agbéyomé Kodjo , Mahammed Dionne and Josip Manolić .Coups d'état against ruling governments during the decade include: The event has been condemned by foreign governments, the political opposition, and human rights organizations and is considered the first major political crisis in the country since the conclusion of the Salvadoran Civil War in 1992 and has been referred to as a coup attempt .Coups d'état against ruling governments during the decade include:The event has been condemned by foreign governments, the political opposition, and human rights organizations and is considered the first major political crisis in the country since the conclusion of the Salvadoran Civil War in 1992 and has been referred to as a coup attempt .Prominent assassinations, targeted killings, and assassination attempts include:Note: This table is a chronological list of earthquakes reported with 7.5 M w or greater or that have reported at least 100 fatalities. Several southern provinces in the Philippines were inundated and devastated by the typhoon. A total of 410 people died + 80 missing, of which a full 409 died in the Philippines and only 1 died in Vietnam .The damage amounts to up to $720 million. Note: This section reports only floods with 200 or more deaths and avalanches and landslides involving 30 or more deaths. Beginning in 2019 until 2022, a huge swarm of desert locusts threatened to engulf massive portions of the Middle East , Africa and Asia . Note: This table is a chronological list of earthquakes reported with 7.5 M w or greater or that have reported at least 100 fatalities. Several southern provinces in the Philippines were inundated and devastated by the typhoon. A total of 410 people died + 80 missing, of which a full 409 died in the Philippines and only 1 died in Vietnam .The damage amounts to up to $720 million. Note: This section reports only floods with 200 or more deaths and avalanches and landslides involving 30 or more deaths. Beginning in 2019 until 2022, a huge swarm of desert locusts threatened to engulf massive portions of the Middle East , Africa and Asia . Note: This table is a chronological list of earthquakes reported with 7.5 M w or greater or that have reported at least 100 fatalities.Several southern provinces in the Philippines were inundated and devastated by the typhoon. A total of 410 people died + 80 missing, of which a full 409 died in the Philippines and only 1 died in Vietnam .The damage amounts to up to $720 million. Note: This section reports only floods with 200 or more deaths and avalanches and landslides involving 30 or more deaths.Beginning in 2019 until 2022, a huge swarm of desert locusts threatened to engulf massive portions of the Middle East , Africa and Asia . The World Trade Organization reported that trade growth had stagnated and that trade restrictions were increasing as the decade began. The sectors most affected by import restrictions were mineral and fuel oils (17.7%), machinery and mechanical appliances (13%), electrical machinery and parts (11.7%), and precious metals (6%). Regional trade agreements were also found to be increasing. The World Trade Organization reported that trade growth had stagnated and that trade restrictions were increasing as the decade began. The sectors most affected by import restrictions were mineral and fuel oils (17.7%), machinery and mechanical appliances (13%), electrical machinery and parts (11.7%), and precious metals (6%). Regional trade agreements were also found to be increasing. 2020sMedical experts advised, and local authorities often mandated stay-at-home orders to prevent gatherings of any size. Such gatherings could be replaced by teleconferencing , or in some cases with unconventional attempts to maintain social distancing with activities such as a balcony sing-along for a concert, or a "birthday parade" for a birthday party . Replacements for gatherings were seen as significant to mental health during the crisis . Social isolation among alcohol users also adopted a trend towards Kalsarikänni or " pantsdrunking ", a Finnish antisocial drinking culture . Low-income individuals were more likely to contract the coronavirus and to die from it. In both New York City and Barcelona, low-income neighborhoods were disproportionately hit by coronavirus cases. Hypotheses for why this was the case included that poorer families were more likely to live in crowded housing and work in low-skill jobs, such as supermarkets and elder care, which were deemed essential during the crisis. In the United States, millions of low-income people may lack access to health care due to being uninsured or underinsured . Millions of Americans lost their health insurance after losing their jobs. Many low-income workers in service jobs became unemployed. The coronavirus pandemic was followed by a concern for a potential spike in suicides, exacerbated by social isolation due to quarantine and social-distancing guidelines, fear, and unemployment and financial factors. Many countries reported an increase in domestic violence and intimate partner violence attributed to lockdowns amid the COVID-19 pandemic. Financial insecurity, stress, and uncertainty led to increased aggression at home, with abusers able to control large amounts of their victims' daily life. Midlife crisis is a major concern in domestic violence, social implications and suicides for middle-aged adults amid the pandemic. UN Secretary-General António Guterres called for a domestic violence and midlife crisis "ceasefire". The murder of George Floyd led to civil unrest and protests across the United States and internationally in 2020. 24.3% of all national parliamentarians were women as of February 2019. 11 women were serving as head of state and 12 as head of government in June 2019. 20.7% of government ministers were women as of January 2019. There are wide regional variations in the average percentages of women parliamentarians. As of February 2019, these were: Nordic countries, 42.5%; Americas, 30.6%; Europe excluding Nordic countries, 27.2; sub-Saharan Africa, 23.9; Asia, 19.8%; Arab States, 19%; and the Pacific, 16.3%. Rwanda has the highest number of women parliamentarians worldwide, 61.3% of seats in the lower house. About 26% of elected local parliamentarians are women. Many states swore in their first female leaders during the 2020s including Presidents Katerina Sakellaropoulou ( Greece ), Samia Suluhu Hassan ( Tanzania ), Sandra Mason ( Barbados ), Xiomara Castro ( Honduras ), Katalin Novák ( Hungary ), Dina Boluarte ( Peru ), Nataša Pirc Musar ( Slovenia ), Prime Ministers Rose Christiane Raponda ( Gabon ), Victoire Tomegah Dogbé ( Togo ), Kaja Kallas ( Estonia ), Fiamē Naomi Mata'afa ( Samoa ), Robinah Nabbanja ( Uganda ), Najla Bouden ( Tunisia ), Magdalena Andersson ( Sweden ), Giorgia Meloni ( Italy ), and Chairwoman Borjana Krišto ( Bosnia and Herzegovina ). Medical experts advised, and local authorities often mandated stay-at-home orders to prevent gatherings of any size. Such gatherings could be replaced by teleconferencing , or in some cases with unconventional attempts to maintain social distancing with activities such as a balcony sing-along for a concert, or a "birthday parade" for a birthday party . Replacements for gatherings were seen as significant to mental health during the crisis . Social isolation among alcohol users also adopted a trend towards Kalsarikänni or " pantsdrunking ", a Finnish antisocial drinking culture . Low-income individuals were more likely to contract the coronavirus and to die from it. In both New York City and Barcelona, low-income neighborhoods were disproportionately hit by coronavirus cases. Hypotheses for why this was the case included that poorer families were more likely to live in crowded housing and work in low-skill jobs, such as supermarkets and elder care, which were deemed essential during the crisis. In the United States, millions of low-income people may lack access to health care due to being uninsured or underinsured . Millions of Americans lost their health insurance after losing their jobs. Many low-income workers in service jobs became unemployed. The coronavirus pandemic was followed by a concern for a potential spike in suicides, exacerbated by social isolation due to quarantine and social-distancing guidelines, fear, and unemployment and financial factors. Many countries reported an increase in domestic violence and intimate partner violence attributed to lockdowns amid the COVID-19 pandemic. Financial insecurity, stress, and uncertainty led to increased aggression at home, with abusers able to control large amounts of their victims' daily life. Midlife crisis is a major concern in domestic violence, social implications and suicides for middle-aged adults amid the pandemic. UN Secretary-General António Guterres called for a domestic violence and midlife crisis "ceasefire".The murder of George Floyd led to civil unrest and protests across the United States and internationally in 2020.24.3% of all national parliamentarians were women as of February 2019. 11 women were serving as head of state and 12 as head of government in June 2019. 20.7% of government ministers were women as of January 2019. There are wide regional variations in the average percentages of women parliamentarians. As of February 2019, these were: Nordic countries, 42.5%; Americas, 30.6%; Europe excluding Nordic countries, 27.2; sub-Saharan Africa, 23.9; Asia, 19.8%; Arab States, 19%; and the Pacific, 16.3%. Rwanda has the highest number of women parliamentarians worldwide, 61.3% of seats in the lower house. About 26% of elected local parliamentarians are women. Many states swore in their first female leaders during the 2020s including Presidents Katerina Sakellaropoulou ( Greece ), Samia Suluhu Hassan ( Tanzania ), Sandra Mason ( Barbados ), Xiomara Castro ( Honduras ), Katalin Novák ( Hungary ), Dina Boluarte ( Peru ), Nataša Pirc Musar ( Slovenia ), Prime Ministers Rose Christiane Raponda ( Gabon ), Victoire Tomegah Dogbé ( Togo ), Kaja Kallas ( Estonia ), Fiamē Naomi Mata'afa ( Samoa ), Robinah Nabbanja ( Uganda ), Najla Bouden ( Tunisia ), Magdalena Andersson ( Sweden ), Giorgia Meloni ( Italy ), and Chairwoman Borjana Krišto ( Bosnia and Herzegovina ). Development in global goals and issues – including goals or progress related to the largest causes of human death – during the decade, according to reports that systematically track, quantify or review associated progress .Wearing a decorative mask to prevent the disease COVID-19 from spreading was a fashion trend in the early 2020s. [ further explanation needed ] The fashion of the early 2020s was characterized by a variety of styles and influences from different eras. During this period, the trend towards individuality and self-expression in clothing continued. Generation Z has witnessed a notable resurgence of fashion styles from the 1990s and 2000s in the fashion industry. A prominent example of this is the revival of trends such as crop tops , baggy jeans , and elements from the Y2K aesthetic. Sustainable fashion practices gained significance, with an increased awareness of environmentally friendly materials and production processes. Influences from social media culture were also unmistakable, as influencers and celebrities exerted a strong influence on fashion trends. The popularity of online platforms like Instagram and TikTok contributed to the rapid spread of trends, while simultaneously allowing niche styles and subcultures to flourish. Popular brands in the Anglosphere ( Australia , New Zealand , Canada , the United Kingdom , and the United States ) during this era include Adidas , Fila , Nike , New Balance , Globe International , Vans , Hurley , Kappa , Tommy Hilfiger , Asics , Ellesse , Ralph Lauren , Forever 21 , Playboy , and The North Face . The COVID-19 pandemic heavily impacted film releases especially early in the decade, resulting in a drastic drop in box office revenue as well as many films postponing their release or shifting it to a streaming services . Avatar: The Way of Water is the highest-grossing film of the decade so far, and currently the third-highest-grossing film of all time . Other financially successful films at the box office include Top Gun: Maverick , No Time to Die , Jurassic World Dominion and Oppenheimer . Superhero films mostly continued to do well financially, with Spider-Man: No Way Home being the second-highest-grossing of the decade. Other successful superhero films include The Batman as well as most of Marvel Studios ' " Multiverse Saga of the MCU ". However, DC Studios ' " DC Extended Universe " films began to generally underperform at the box office . Nintendo and Mattel made their own big-budget theatrical releases, resulting in the massive successes of The Super Mario Bros. Movie and Barbie . These films became the highest-grossing movies of 2023 internationally. Critically successful films nominated for awards include Nomadland , CODA , Everything Everywhere All at Once , Marcel the Shell with Shoes On , Licorice Pizza and The Fabelmans . Animated films such as Guillermo del Toro's Pinocchio , Soul , Encanto , Luca , Puss in Boots: The Last Wish , and Spider-Man: Across the Spider-Verse have also been highly acclaimed. Film reboots regained popularity as many were released on streaming services and in theaters. Some of these film remakes, reboots and returns to older franchises include: Clerks III , Bill & Ted Face the Music , Space Jam: A New Legacy , Beavis and Butt-Head Do the Universe , Ghostbusters: Afterlife , Top Gun: Maverick , Mean Girls , He's All That , A Christmas Story Christmas , Scream , The Little Mermaid , Indiana Jones and the Dial of Destiny , Good Burger 2 , Wonka , Snow White and Coming 2 America . The 2020s started off with streaming services like Netflix , Amazon Prime Video , Binge , Max , Showtime , Hulu , and Disney+ . Additional streaming services such as Discovery+ , Paramount+ , and Peacock were released as well. Streaming television such as Pluto TV and YouTube TV also became more popular. New and critically acclaimed adult animated shows like Midnight Gospel , Invincible , and Smiling Friends launched in the 2020s, as well as Disney animated shows such as Amphibia and The Owl House . [ citation needed ] Japanese anime continued to rise in global popularity and appeal during the decade due its wide distribution on movie theaters and streaming services, with works such as Jujutsu Kaisen , Demon Slayer: Kimetsu no Yaiba , Chainsaw Man , Cyberpunk: Edgerunners , Spy x Family , Suzume , The Boy and the Heron , Oshi no Ko , Frieren: Beyond Journey's End , Attack on Titan and One Piece reaching large international audiences. A variety of shows on streaming services such as Squid Game , Never Have I Ever , Tulsa King , Ted Lasso , Extraordinary Attorney Woo , Wednesday , and Tiger King gained popularity. Many different shows on many different competing streaming services resulted in what has been called the "streaming wars" of the early 2020s. TV show reboots also became increasingly popular, with Frasier , That '90s Show , and Friends: The Reunion appearing on streaming. Matthew Perry passed away in 2023, following Friends: The Reunion . Billions of people watched the death and state funeral of Elizabeth II , speculated to be the most watched television event in history. By 2020, TikTok , an online video service , had become extremely popular as a music platform on social media. Users on streaming platforms such as Spotify , YouTube Music , Amazon Music and Apple Music have increased due to the COVID-19 pandemic. Festivals such as Coachella were cancelled because of the virus. The COVID-19 pandemic devastated the touring business. Pop , hip hop , K-pop , R&B , nu disco and synthpop all dominated the early part of the decade, with the most popular artists being Ariana Grande , Billie Eilish , Lizzo , Lil Nas X , Drake , Megan Thee Stallion , Dua Lipa , Jack Harlow , The Weeknd , Justin Bieber , Taylor Swift , BTS , Doja Cat , Olivia Rodrigo , Blackpink , Harry Styles , Bad Bunny , Ed Sheeran , Cardi B , Beyoncé , the Kid Laroi and more. The early 20s also saw the one-off return of The Beatles and The Rolling Stones with a new song and album , respectively, which topped out the charts immediately upon release. The ninth generation of consoles began in 2020. The industry remains dominated by Nintendo , Sony , and Microsoft with the release of the Xbox Series X/S and the PlayStation 5 , while the Nintendo Switch continues to be popular from the previous decade. Technological advancements in consoles included support for real-time ray tracing graphics and output for 4K or even 8K resolution . Physical media continued to be replaced by online distribution of games, with the Xbox Series S and the PlayStation 5 Digital Edition lacking an optical drive. The Steam Deck was released in 2022 as Valve 's attempt to bring PC-level gaming to a Nintendo Switch-style handheld format. Critically successful games such as Elden Ring , Ghost of Tsushima , God of War Ragnarök , and The Last of Us Part II were released and won multiple best game of the year awards , signaling a shift towards narrative-driven and single-played focused gaming compared with the end of the 2010s where popularity of multiplayer gaming dominated. Nonetheless, widely successful multiplayer games includes Fall Guys , Fortnite , Genshin Impact , It Takes Two , Minecraft , Overwatch 2 , Valorant , and Warzone . The detective-party game Among Us surged in popularity in 2020 and became a global sensation, largely attributed in to global stay-at-home orders during the COVID-19 pandemic . Nintendo continued to successfully produce games for the Nintendo Switch, with Animal Crossing: New Horizons selling over 40 million copies, and making it the second-best-selling game on the console. The Nintendo Switch's sales remained strong in the 2020s due in part to games such as Super Mario 3D All-Stars , Bowser's Fury , Metroid Dread , Pokémon Legends: Arceus , Kirby and the Forgotten Land , Nintendo Switch Sports , Xenoblade Chronicles 3 , Splatoon 3 , Bayonetta 3 , Pokémon Scarlet and Violet , The Legend of Zelda: Tears of the Kingdom , Pikmin 4 , Super Mario Bros. Wonder , and Princess Peach: Showtime! . The Nintendo Switch's best-selling game Mario Kart 8 Deluxe has received additional tracks with the " Booster Course Pass ", releasing across 2022 and 2023, while Super Smash Bros. Ultimate received a second DLC pass from 2020 to 2021, including characters such as Steve from Minecraft and Sora from Kingdom Hearts . High-budget remakes of video games became much more widespread in the 2020s, with notable examples including Resident Evil 3 and 4 , Final Fantasy VII Remake and its sequels, Live A Live , The Last of Us Part I , Dead Space , Super Mario RPG , Metal Gear Solid Delta: Snake Eater , and Silent Hill 2 being notable examples of older games that received full graphical and modernized remakes. Video game film and television adaptations became more financially and critically successful compared with previous decades. Film releases include The Super Mario Bros. Movie , Sonic the Hedgehog , Five Nights at Freddy's and Uncharted ; as well as the video game-themed Tetris , Ready Player Two and Free Guy . Television adaptations include Arcane: League of Legends , Carmen Sandiego , Castlevania , Cyberpunk: Edgerunners , Dota: Dragon's Blood , Dragon Age: Absolution , Sonic Prime , The Last of Us , and The Witcher ; in addition with the table-top game adaptation The Legend of Vox Machina . There is a revival in expressionist architecture . The SoFi Stadium was completed on 8 September 2020 and is a component of Hollywood Park , a master-planned neighborhood in development in Inglewood, California . The stadium serves as a home to the Los Angeles Rams and the Los Angeles Chargers . SoFi Stadium hosted Super Bowl LVI in February 2022. The stadium is also set to host the opening and closing ceremonies, soccer and archery in the 2028 Summer Olympics , which will be hosted in Los Angeles, California , United States of America. The Unity Tower was finally completed on 30 September 2020. The construction of the building originally started in 1975, but stopped permanently in 1981 because of economic constraints and political unrest at the time. Due to the unfinished building's resemblance to a skeleton , it was nicknamed after Skeletor , the arch-villain in He-Man and the Masters of the Universe , which was popular in Poland at the time construction began. The COVID-19 pandemic leads to the cancellation or rescheduling of numerous sporting events globally: The 2020 Summer Olympics and Paralympics were postponed to July–August 2021. This was the first Olympic Games to be postponed rather than cancelled in history. The 2020 T20 Cricket World Cup , originally scheduled to take place in Australia , was rescheduled to occur in India in 2021. Which was then rescheduled to United Arab Emirates and Oman . Sporting leagues such as the North American National Hockey League Major League Baseball and National Basketball Association , and the English Premier League adapt their seasons and championship play around COVID-19 by placing players in "bubbles" and televising games played in empty arenas and stadiums. Food delivery apps such as DoorDash , Instacart , Menulog , Uber Eats , Grubhub and Just Eat Takeaway flourished due to the COVID-19 pandemic. Indoor dining was also closed in many countries due to the COVID-19 pandemic, and upon re-opening the usage of QR codes and other technologies in the restaurant industry increased compared to the 2010s in order to comply with pandemic restrictions. Due to the COVID-19 restrictions , online grocery shopping has substantially grown and in the first few months of the pandemic, online grocery shopping increased by 300%. Before the pandemic occurred, food shopping activity accounted for 9% of the market, now 63 percent of consumers worldwide has purchased more groceries online after the outbreak than they did before they were socially isolated. Books published throughout the decade include The Vanishing Half , Leave the World Behind , Transcendent Kingdom , I'm Glad My Mom Died , The Glass Hotel , Memorial and The City We Became . Recent releases on this decade include How to Prevent the Next Pandemic by Bill Gates , Meet Me by the Fountain: An Inside History of the Mall by Alexandra Lange, Wikipedia @ 20 by Joseph M. Reagle Jr. and Jackie Koerner, It's OK to Be Angry About Capitalism by Bernie Sanders , and The Candy House . Over a year after Friends: The Reunion , Matthew Perry released Friends, Lovers, and the Big Terrible Thing (which had a foreword written by Lisa Kudrow). The book became a New York Times best-seller . [ citation needed ] [ further explanation needed ]Wearing a decorative mask to prevent the disease COVID-19 from spreading was a fashion trend in the early 2020s. [ further explanation needed ] The fashion of the early 2020s was characterized by a variety of styles and influences from different eras. During this period, the trend towards individuality and self-expression in clothing continued. Generation Z has witnessed a notable resurgence of fashion styles from the 1990s and 2000s in the fashion industry. A prominent example of this is the revival of trends such as crop tops , baggy jeans , and elements from the Y2K aesthetic. Sustainable fashion practices gained significance, with an increased awareness of environmentally friendly materials and production processes. Influences from social media culture were also unmistakable, as influencers and celebrities exerted a strong influence on fashion trends. The popularity of online platforms like Instagram and TikTok contributed to the rapid spread of trends, while simultaneously allowing niche styles and subcultures to flourish. Popular brands in the Anglosphere ( Australia , New Zealand , Canada , the United Kingdom , and the United States ) during this era include Adidas , Fila , Nike , New Balance , Globe International , Vans , Hurley , Kappa , Tommy Hilfiger , Asics , Ellesse , Ralph Lauren , Forever 21 , Playboy , and The North Face . The COVID-19 pandemic heavily impacted film releases especially early in the decade, resulting in a drastic drop in box office revenue as well as many films postponing their release or shifting it to a streaming services . Avatar: The Way of Water is the highest-grossing film of the decade so far, and currently the third-highest-grossing film of all time . Other financially successful films at the box office include Top Gun: Maverick , No Time to Die , Jurassic World Dominion and Oppenheimer . Superhero films mostly continued to do well financially, with Spider-Man: No Way Home being the second-highest-grossing of the decade. Other successful superhero films include The Batman as well as most of Marvel Studios ' " Multiverse Saga of the MCU ". However, DC Studios ' " DC Extended Universe " films began to generally underperform at the box office . Nintendo and Mattel made their own big-budget theatrical releases, resulting in the massive successes of The Super Mario Bros. Movie and Barbie . These films became the highest-grossing movies of 2023 internationally. Critically successful films nominated for awards include Nomadland , CODA , Everything Everywhere All at Once , Marcel the Shell with Shoes On , Licorice Pizza and The Fabelmans . Animated films such as Guillermo del Toro's Pinocchio , Soul , Encanto , Luca , Puss in Boots: The Last Wish , and Spider-Man: Across the Spider-Verse have also been highly acclaimed. Film reboots regained popularity as many were released on streaming services and in theaters. Some of these film remakes, reboots and returns to older franchises include: Clerks III , Bill & Ted Face the Music , Space Jam: A New Legacy , Beavis and Butt-Head Do the Universe , Ghostbusters: Afterlife , Top Gun: Maverick , Mean Girls , He's All That , A Christmas Story Christmas , Scream , The Little Mermaid , Indiana Jones and the Dial of Destiny , Good Burger 2 , Wonka , Snow White and Coming 2 America . The 2020s started off with streaming services like Netflix , Amazon Prime Video , Binge , Max , Showtime , Hulu , and Disney+ . Additional streaming services such as Discovery+ , Paramount+ , and Peacock were released as well. Streaming television such as Pluto TV and YouTube TV also became more popular. New and critically acclaimed adult animated shows like Midnight Gospel , Invincible , and Smiling Friends launched in the 2020s, as well as Disney animated shows such as Amphibia and The Owl House . [ citation needed ] Japanese anime continued to rise in global popularity and appeal during the decade due its wide distribution on movie theaters and streaming services, with works such as Jujutsu Kaisen , Demon Slayer: Kimetsu no Yaiba , Chainsaw Man , Cyberpunk: Edgerunners , Spy x Family , Suzume , The Boy and the Heron , Oshi no Ko , Frieren: Beyond Journey's End , Attack on Titan and One Piece reaching large international audiences. A variety of shows on streaming services such as Squid Game , Never Have I Ever , Tulsa King , Ted Lasso , Extraordinary Attorney Woo , Wednesday , and Tiger King gained popularity. Many different shows on many different competing streaming services resulted in what has been called the "streaming wars" of the early 2020s. TV show reboots also became increasingly popular, with Frasier , That '90s Show , and Friends: The Reunion appearing on streaming. Matthew Perry passed away in 2023, following Friends: The Reunion . Billions of people watched the death and state funeral of Elizabeth II , speculated to be the most watched television event in history.By 2020, TikTok , an online video service , had become extremely popular as a music platform on social media. Users on streaming platforms such as Spotify , YouTube Music , Amazon Music and Apple Music have increased due to the COVID-19 pandemic. Festivals such as Coachella were cancelled because of the virus. The COVID-19 pandemic devastated the touring business. Pop , hip hop , K-pop , R&B , nu disco and synthpop all dominated the early part of the decade, with the most popular artists being Ariana Grande , Billie Eilish , Lizzo , Lil Nas X , Drake , Megan Thee Stallion , Dua Lipa , Jack Harlow , The Weeknd , Justin Bieber , Taylor Swift , BTS , Doja Cat , Olivia Rodrigo , Blackpink , Harry Styles , Bad Bunny , Ed Sheeran , Cardi B , Beyoncé , the Kid Laroi and more. The early 20s also saw the one-off return of The Beatles and The Rolling Stones with a new song and album , respectively, which topped out the charts immediately upon release. The ninth generation of consoles began in 2020. The industry remains dominated by Nintendo , Sony , and Microsoft with the release of the Xbox Series X/S and the PlayStation 5 , while the Nintendo Switch continues to be popular from the previous decade. Technological advancements in consoles included support for real-time ray tracing graphics and output for 4K or even 8K resolution . Physical media continued to be replaced by online distribution of games, with the Xbox Series S and the PlayStation 5 Digital Edition lacking an optical drive. The Steam Deck was released in 2022 as Valve 's attempt to bring PC-level gaming to a Nintendo Switch-style handheld format. Critically successful games such as Elden Ring , Ghost of Tsushima , God of War Ragnarök , and The Last of Us Part II were released and won multiple best game of the year awards , signaling a shift towards narrative-driven and single-played focused gaming compared with the end of the 2010s where popularity of multiplayer gaming dominated. Nonetheless, widely successful multiplayer games includes Fall Guys , Fortnite , Genshin Impact , It Takes Two , Minecraft , Overwatch 2 , Valorant , and Warzone . The detective-party game Among Us surged in popularity in 2020 and became a global sensation, largely attributed in to global stay-at-home orders during the COVID-19 pandemic . Nintendo continued to successfully produce games for the Nintendo Switch, with Animal Crossing: New Horizons selling over 40 million copies, and making it the second-best-selling game on the console. The Nintendo Switch's sales remained strong in the 2020s due in part to games such as Super Mario 3D All-Stars , Bowser's Fury , Metroid Dread , Pokémon Legends: Arceus , Kirby and the Forgotten Land , Nintendo Switch Sports , Xenoblade Chronicles 3 , Splatoon 3 , Bayonetta 3 , Pokémon Scarlet and Violet , The Legend of Zelda: Tears of the Kingdom , Pikmin 4 , Super Mario Bros. Wonder , and Princess Peach: Showtime! . The Nintendo Switch's best-selling game Mario Kart 8 Deluxe has received additional tracks with the " Booster Course Pass ", releasing across 2022 and 2023, while Super Smash Bros. Ultimate received a second DLC pass from 2020 to 2021, including characters such as Steve from Minecraft and Sora from Kingdom Hearts . High-budget remakes of video games became much more widespread in the 2020s, with notable examples including Resident Evil 3 and 4 , Final Fantasy VII Remake and its sequels, Live A Live , The Last of Us Part I , Dead Space , Super Mario RPG , Metal Gear Solid Delta: Snake Eater , and Silent Hill 2 being notable examples of older games that received full graphical and modernized remakes. Video game film and television adaptations became more financially and critically successful compared with previous decades. Film releases include The Super Mario Bros. Movie , Sonic the Hedgehog , Five Nights at Freddy's and Uncharted ; as well as the video game-themed Tetris , Ready Player Two and Free Guy . Television adaptations include Arcane: League of Legends , Carmen Sandiego , Castlevania , Cyberpunk: Edgerunners , Dota: Dragon's Blood , Dragon Age: Absolution , Sonic Prime , The Last of Us , and The Witcher ; in addition with the table-top game adaptation The Legend of Vox Machina .There is a revival in expressionist architecture . The SoFi Stadium was completed on 8 September 2020 and is a component of Hollywood Park , a master-planned neighborhood in development in Inglewood, California . The stadium serves as a home to the Los Angeles Rams and the Los Angeles Chargers . SoFi Stadium hosted Super Bowl LVI in February 2022. The stadium is also set to host the opening and closing ceremonies, soccer and archery in the 2028 Summer Olympics , which will be hosted in Los Angeles, California , United States of America. The Unity Tower was finally completed on 30 September 2020. The construction of the building originally started in 1975, but stopped permanently in 1981 because of economic constraints and political unrest at the time. Due to the unfinished building's resemblance to a skeleton , it was nicknamed after Skeletor , the arch-villain in He-Man and the Masters of the Universe , which was popular in Poland at the time construction began. The COVID-19 pandemic leads to the cancellation or rescheduling of numerous sporting events globally: The 2020 Summer Olympics and Paralympics were postponed to July–August 2021. This was the first Olympic Games to be postponed rather than cancelled in history. The 2020 T20 Cricket World Cup , originally scheduled to take place in Australia , was rescheduled to occur in India in 2021. Which was then rescheduled to United Arab Emirates and Oman . Sporting leagues such as the North American National Hockey League Major League Baseball and National Basketball Association , and the English Premier League adapt their seasons and championship play around COVID-19 by placing players in "bubbles" and televising games played in empty arenas and stadiums.The COVID-19 pandemic leads to the cancellation or rescheduling of numerous sporting events globally: The 2020 Summer Olympics and Paralympics were postponed to July–August 2021. This was the first Olympic Games to be postponed rather than cancelled in history. The 2020 T20 Cricket World Cup , originally scheduled to take place in Australia , was rescheduled to occur in India in 2021. Which was then rescheduled to United Arab Emirates and Oman . Sporting leagues such as the North American National Hockey League Major League Baseball and National Basketball Association , and the English Premier League adapt their seasons and championship play around COVID-19 by placing players in "bubbles" and televising games played in empty arenas and stadiums.Food delivery apps such as DoorDash , Instacart , Menulog , Uber Eats , Grubhub and Just Eat Takeaway flourished due to the COVID-19 pandemic. Indoor dining was also closed in many countries due to the COVID-19 pandemic, and upon re-opening the usage of QR codes and other technologies in the restaurant industry increased compared to the 2010s in order to comply with pandemic restrictions. Due to the COVID-19 restrictions , online grocery shopping has substantially grown and in the first few months of the pandemic, online grocery shopping increased by 300%. Before the pandemic occurred, food shopping activity accounted for 9% of the market, now 63 percent of consumers worldwide has purchased more groceries online after the outbreak than they did before they were socially isolated. Books published throughout the decade include The Vanishing Half , Leave the World Behind , Transcendent Kingdom , I'm Glad My Mom Died , The Glass Hotel , Memorial and The City We Became . Recent releases on this decade include How to Prevent the Next Pandemic by Bill Gates , Meet Me by the Fountain: An Inside History of the Mall by Alexandra Lange, Wikipedia @ 20 by Joseph M. Reagle Jr. and Jackie Koerner, It's OK to Be Angry About Capitalism by Bernie Sanders , and The Candy House . Over a year after Friends: The Reunion , Matthew Perry released Friends, Lovers, and the Big Terrible Thing (which had a foreword written by Lisa Kudrow). The book became a New York Times best-seller . [ citation needed ] [ further explanation needed ]

Wiki

Mpox

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2022–2023 mpox outbreak in South Africa

The 2022–2023 mpox outbreak in South Africa is a part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus . South Africa was the forty-seventh country, outside of the African countries with endemic mpox, to experience an outbreak in 2022. The first case of mpox in South Africa was on June 23, 2022. Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. An ongoing outbreak of mpox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic ), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak. The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May, but it has been suggested that cases were already spreading in Europe in the previous months. A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria , the Democratic Republic of the Congo as well as central and western Africa . It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis , an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis , gonorrhea , chlamydia , and herpes . The first known case of mpox in South Africa was detected on Thursday, 23 June 2022 declared by the health minister of South Africa Joe Phaahla . The first victim was a 30-year-old man who had no recent travel history, meaning that he has not contacted the disease outside the country. 5 days later on the 28th of June, South Africa confirmed its second case of mpox. The victim also had no recent travel history. On 11 July 2022 South Africa confirmed third case of mpox, the 42 year old is a tourist from Switzerland who came to South Africa to enjoy his holidays. On the second week of August 2022 Minister of Health South Africa announced the 4th case of mpox in South Africa the victim recently arrived from Spain .

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Mpox

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2022–2023 mpox outbreak in Chile

The 2022–2023 mpox outbreak in Chile is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak reached Chile on 17 June 2022. Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. An ongoing outbreak of mpox was confirmed on May 6, 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic ), presented symptoms consistent with mpox on April 29, 2022. The resident returned to the United Kingdom on May 4, creating the country's index case of the outbreak. The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May, but it has been suggested that cases were already spreading in Europe in the previous months. A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria , the Democratic Republic of the Congo as well as central and western Africa . It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis , gonorrhea , chlamydia , and herpes . The first case of infection was recorded on June 17 in Santiago de Chile after an adult with a history of travel to Europe presented symptoms

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Mpox

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2023 in the United Nations

Events in the year 2023 in the United Nations .

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Mpox

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Zoonosis

A zoonosis ( / z oʊ ˈ ɒ n ə s ɪ s , ˌ z oʊ ə ˈ n oʊ s ɪ s / ; plural zoonoses ) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium , virus , parasite , or prion ) that can jump from a non-human (usually a vertebrate ) to a human and vice versa. Major modern diseases such as Ebola and salmonellosis are zoonoses. HIV was a zoonotic disease transmitted to humans in the early part of the 20th century, though it has now evolved into a separate human-only disease. Human infection with animal influenza viruses is rare, as they do not transmit easily to or among humans. However, avian and swine influenza viruses in particular possess high zoonotic potential, and these occasionally recombine with human strains of the flu and can cause pandemics such as the 2009 swine flu . Taenia solium infection is one of the neglected tropical diseases with public health and veterinary concern in endemic regions. Zoonoses can be caused by a range of disease pathogens such as emergent viruses , bacteria, fungi and parasites; of 1,415 pathogens known to infect humans, 61% were zoonotic. Most human diseases originated in non-humans; however, only diseases that routinely involve non-human to human transmission, such as rabies , are considered direct zoonoses. Zoonoses have different modes of transmission. In direct zoonosis the disease is directly transmitted from non-humans to humans through media such as air (influenza) or bites and saliva (rabies). In contrast, transmission can also occur via an intermediate species (referred to as a vector ), which carry the disease pathogen without getting sick. When humans infect non-humans, it is called reverse zoonosis or anthroponosis. The term is from Greek : ζῷον zoon "animal" and νόσος nosos "sickness". Host genetics plays an important role in determining which non-human viruses will be able to make copies of themselves in the human body. Dangerous non-human viruses are those that require few mutations to begin replicating themselves in human cells. These viruses are dangerous since the required combinations of mutations might randomly arise in the natural reservoir . The emergence of zoonotic diseases originated with the domestication of animals. Zoonotic transmission can occur in any context in which there is contact with or consumption of animals, animal products, or animal derivatives. This can occur in a companionistic (pets), economic (farming, trade, butchering, etc.), predatory (hunting, butchering, or consuming wild game), or research context. Recently, there has been a rise in frequency of appearance of new zoonotic diseases. "Approximately 1.67 million undescribed viruses are thought to exist in mammals and birds, up to half of which are estimated to have the potential to spill over into humans", says a study led by researchers at the University of California, Davis . According to a report from the United Nations Environment Programme and International Livestock Research Institute a large part of the causes are environmental like climate change , unsustainable agriculture, exploitation of wildlife, and land use change . Others are linked to changes in human society such as an increase in mobility. The organizations propose a set of measures to stop the rise. The most significant zoonotic pathogens causing foodborne diseases are Escherichia coli O157:H7 , Campylobacter , Caliciviridae , and Salmonella . In 2006 a conference held in Berlin focused on the issue of zoonotic pathogen effects on food safety , urging government intervention and public vigilance against the risks of catching food-borne diseases from farm-to-table dining. Many food-borne outbreaks can be linked to zoonotic pathogens. Many different types of food that have an animal origin can become contaminated. Some common food items linked to zoonotic contaminations include eggs, seafood, meat, dairy, and even some vegetables. Outbreaks involving contaminated food should be handled in preparedness plans to prevent widespread outbreaks and to efficiently and effectively contain outbreaks. Contact with farm animals can lead to disease in farmers or others that come into contact with infected farm animals. Glanders primarily affects those who work closely with horses and donkeys. Close contact with cattle can lead to cutaneous anthrax infection, whereas inhalation anthrax infection is more common for workers in slaughterhouses , tanneries , and wool mills . Close contact with sheep who have recently given birth can lead to infection with the bacterium Chlamydia psittaci , causing chlamydiosis (and enzootic abortion in pregnant women), as well as increase the risk of Q fever , toxoplasmosis , and listeriosis , in the pregnant or otherwise immunocompromised . Echinococcosis is caused by a tapeworm, which can spread from infected sheep by food or water contaminated by feces or wool. Avian influenza is common in chickens, and, while it is rare in humans, the main public health worry is that a strain of avian influenza will recombine with a human influenza virus and cause a pandemic like the 1918 Spanish flu . [ citation needed ] In 2017, free-range chickens in the UK were temporarily ordered to remain inside due to the threat of avian influenza. Cattle are an important reservoir of cryptosporidiosis , which mainly affects the immunocompromised. Reports have shown mink can also become infected. In Western countries, hepatitis E burden is largely dependent on exposure to animal products, and pork is a significant source of infection, in this respect. Veterinarians are exposed to unique occupational hazards when it comes to zoonotic disease. In the US, studies have highlighted an increased risk of injuries and lack of veterinary awareness of these hazards. Research has proved the importance for continued clinical veterinarian education on occupational risks associated with musculoskeletal injuries, animal bites, needle-sticks, and cuts. A July 2020 report by the United Nations Environment Programme stated that the increase in zoonotic pandemics is directly attributable to anthropogenic destruction of nature and the increased global demand for meat and that the industrial farming of pigs and chickens in particular will be a primary risk factor for the spillover of zoonotic diseases in the future. Habitat loss of viral reservoir species has been identified as a significant source in at least one spillover event . The wildlife trade may increase spillover risk because it directly increases the number of interactions across animal species, sometimes in small spaces. The origin of the ongoing COVID-19 pandemic is traced to the wet markets in China . Zoonotic disease emergence is demonstrably linked to the consumption of wildlife meat, exacerbated by human encroachment into natural habitats and amplified by the unsanitary conditions of wildlife markets. These markets, where diverse species converge, facilitate the mixing and transmission of pathogens, including those responsible for outbreaks of HIV-1, Ebola, and mpox , and potentially even the COVID-19 pandemic. Notably, small mammals often harbor a vast array of zoonotic bacteria and viruses, yet endemic bacterial transmission among wildlife remains largely unexplored. Therefore, accurately determining the pathogenic landscape of traded wildlife is crucial for guiding effective measures to combat zoonotic diseases and documenting the societal and environmental costs associated with this practice. Pets can transmit a number of diseases. Dogs and cats are routinely vaccinated against rabies . Pets can also transmit ringworm and Giardia , which are endemic in both animal and human populations. Toxoplasmosis is a common infection of cats; in humans it is a mild disease although it can be dangerous to pregnant women. Dirofilariasis is caused by Dirofilaria immitis through mosquitoes infected by mammals like dogs and cats. Cat-scratch disease is caused by Bartonella henselae and Bartonella quintana , which are transmitted by fleas that are endemic to cats. Toxocariasis is the infection of humans by any of species of roundworm , including species specific to dogs ( Toxocara canis ) or cats ( Toxocara cati ). Cryptosporidiosis can be spread to humans from pet lizards, such as the leopard gecko . Encephalitozoon cuniculi is a microsporidial parasite carried by many mammals, including rabbits, and is an important opportunistic pathogen in people immunocompromised by HIV/AIDS , organ transplantation , or CD4+ T-lymphocyte deficiency. Pets may also serve as a reservoir of viral disease and contribute to the chronic presence of certain viral diseases in the human population. For instance, approximately 20% of domestic dogs, cats, and horses carry anti-hepatitis E virus antibodies and thus these animals probably contribute to human hepatitis E burden as well. For non-vulnerable populations (e.g., people who are not immunocompromised) the associated disease burden is, however, small. [ citation needed ] Furthermore, the trade of non domestic animals such as wild animals as pets can also increase the risk of zoonosis spread. Outbreaks of zoonoses have been traced to human interaction with, and exposure to, other animals at fairs , live animal markets , petting zoos , and other settings. In 2005, the Centers for Disease Control and Prevention (CDC) issued an updated list of recommendations for preventing zoonosis transmission in public settings. The recommendations, developed in conjunction with the National Association of State Public Health Veterinarians , include educational responsibilities of venue operators, limiting public animal contact, and animal care and management. Hunting involves humans tracking, chasing, and capturing wild animals, primarily for food or materials like fur. However, other reasons like pest control or managing wildlife populations can also exist. Transmission of zoonotic diseases, those leaping from animals to humans, can occur through various routes: direct physical contact, airborne droplets or particles, bites or vector transport by insects, oral ingestion, or even contact with contaminated environments. Wildlife activities like hunting and trade bring humans closer to dangerous zoonotic pathogens, threatening global health. According to the Center for Diseases Control and Prevention (CDC) hunting and consuming wild animal meat ("bushmeat") in regions like Africa can expose people to infectious diseases due to the types of animals involved, like bats and primates. Unfortunately, common preservation methods like smoking or drying aren't enough to eliminate these risks. Although bushmeat provides protein and income for many, the practice is intricately linked to numerous emerging infectious diseases like Ebola, HIV, and SARS , raising critical public health concerns. A review published in 2022 found evidence that zoonotic spillover linked to wildmeat consumption has been reported across all continents. Kate Jones , Chair of Ecology and Biodiversity at University College London , says zoonotic diseases are increasingly linked to environmental change and human behavior. The disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanization, and population growth is bringing people into closer contact with animal species they may never have been near before. The resulting transmission of disease from wildlife to humans, she says, is now "a hidden cost of human economic development". In a guest article, published by IPBES , President of the EcoHealth Alliance and zoologist Peter Daszak , along with three co-chairs of the 2019 Global Assessment Report on Biodiversity and Ecosystem Services , Josef Settele, Sandra Díaz , and Eduardo Brondizio, wrote that "rampant deforestation, uncontrolled expansion of agriculture, intensive farming , mining and infrastructure development, as well as the exploitation of wild species have created a 'perfect storm' for the spillover of diseases from wildlife to people." Joshua Moon, Clare Wenham, and Sophie Harman said that there is evidence that decreased biodiversity has an effect on the diversity of hosts and frequency of human-animal interactions with potential for pathogenic spillover. An April 2020 study, published in the Proceedings of the Royal Society ' s Part B journal, found that increased virus spillover events from animals to humans can be linked to biodiversity loss and environmental degradation , as humans further encroach on wildlands to engage in agriculture, hunting, and resource extraction they become exposed to pathogens which normally would remain in these areas. Such spillover events have been tripling every decade since 1980. An August 2020 study, published in Nature , concludes that the anthropogenic destruction of ecosystems for the purpose of expanding agriculture and human settlements reduces biodiversity and allows for smaller animals such as bats and rats, which are more adaptable to human pressures and also carry the most zoonotic diseases, to proliferate. This in turn can result in more pandemics. In October 2020, the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services published its report on the 'era of pandemics' by 22 experts in a variety of fields and concluded that anthropogenic destruction of biodiversity is paving the way to the pandemic era and could result in as many as 850,000 viruses being transmitted from animals – in particular birds and mammals – to humans. The increased pressure on ecosystems is being driven by the "exponential rise" in consumption and trade of commodities such as meat, palm oil , and metals, largely facilitated by developed nations, and by a growing human population . According to Peter Daszak, the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic, or of any modern pandemic. The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment." According to a report from the United Nations Environment Programme and International Livestock Research Institute , entitled "Preventing the next pandemic – Zoonotic diseases and how to break the chain of transmission", climate change is one of the 7 human-related causes of the increase in the number of zoonotic diseases. The University of Sydney issued a study, in March 2021, that examines factors increasing the likelihood of epidemics and pandemics like the COVID-19 pandemic. The researchers found that "pressure on ecosystems, climate change and economic development are key factors" in doing so. More zoonotic diseases were found in high-income countries . A 2022 study dedicated to the link between climate change and zoonosis found a strong link between climate change and the epidemic emergence in the last 15 years, as it caused a massive migration of species to new areas, and consequently contact between species which do not normally come in contact with one another. Even in a scenario with weak climatic changes, there will be 15,000 spillover of viruses to new hosts in the next decades. The areas with the most possibilities for spillover are the mountainous tropical regions of Africa and southeast Asia. Southeast Asia is especially vulnerable as it has a large number of bat species that generally do not mix, but could easily if climate change forced them to begin migrating. A 2021 study found possible links between climate change and transmission of COVID-19 through bats. The authors suggest that climate-driven changes in the distribution and robustness of bat species harboring coronaviruses may have occurred in eastern Asian hotspots (southern China, Myanmar, and Laos), constituting a driver behind the evolution and spread of the virus. The most significant zoonotic pathogens causing foodborne diseases are Escherichia coli O157:H7 , Campylobacter , Caliciviridae , and Salmonella . In 2006 a conference held in Berlin focused on the issue of zoonotic pathogen effects on food safety , urging government intervention and public vigilance against the risks of catching food-borne diseases from farm-to-table dining. Many food-borne outbreaks can be linked to zoonotic pathogens. Many different types of food that have an animal origin can become contaminated. Some common food items linked to zoonotic contaminations include eggs, seafood, meat, dairy, and even some vegetables. Outbreaks involving contaminated food should be handled in preparedness plans to prevent widespread outbreaks and to efficiently and effectively contain outbreaks. Contact with farm animals can lead to disease in farmers or others that come into contact with infected farm animals. Glanders primarily affects those who work closely with horses and donkeys. Close contact with cattle can lead to cutaneous anthrax infection, whereas inhalation anthrax infection is more common for workers in slaughterhouses , tanneries , and wool mills . Close contact with sheep who have recently given birth can lead to infection with the bacterium Chlamydia psittaci , causing chlamydiosis (and enzootic abortion in pregnant women), as well as increase the risk of Q fever , toxoplasmosis , and listeriosis , in the pregnant or otherwise immunocompromised . Echinococcosis is caused by a tapeworm, which can spread from infected sheep by food or water contaminated by feces or wool. Avian influenza is common in chickens, and, while it is rare in humans, the main public health worry is that a strain of avian influenza will recombine with a human influenza virus and cause a pandemic like the 1918 Spanish flu . [ citation needed ] In 2017, free-range chickens in the UK were temporarily ordered to remain inside due to the threat of avian influenza. Cattle are an important reservoir of cryptosporidiosis , which mainly affects the immunocompromised. Reports have shown mink can also become infected. In Western countries, hepatitis E burden is largely dependent on exposure to animal products, and pork is a significant source of infection, in this respect. Veterinarians are exposed to unique occupational hazards when it comes to zoonotic disease. In the US, studies have highlighted an increased risk of injuries and lack of veterinary awareness of these hazards. Research has proved the importance for continued clinical veterinarian education on occupational risks associated with musculoskeletal injuries, animal bites, needle-sticks, and cuts. A July 2020 report by the United Nations Environment Programme stated that the increase in zoonotic pandemics is directly attributable to anthropogenic destruction of nature and the increased global demand for meat and that the industrial farming of pigs and chickens in particular will be a primary risk factor for the spillover of zoonotic diseases in the future. Habitat loss of viral reservoir species has been identified as a significant source in at least one spillover event . The wildlife trade may increase spillover risk because it directly increases the number of interactions across animal species, sometimes in small spaces. The origin of the ongoing COVID-19 pandemic is traced to the wet markets in China . Zoonotic disease emergence is demonstrably linked to the consumption of wildlife meat, exacerbated by human encroachment into natural habitats and amplified by the unsanitary conditions of wildlife markets. These markets, where diverse species converge, facilitate the mixing and transmission of pathogens, including those responsible for outbreaks of HIV-1, Ebola, and mpox , and potentially even the COVID-19 pandemic. Notably, small mammals often harbor a vast array of zoonotic bacteria and viruses, yet endemic bacterial transmission among wildlife remains largely unexplored. Therefore, accurately determining the pathogenic landscape of traded wildlife is crucial for guiding effective measures to combat zoonotic diseases and documenting the societal and environmental costs associated with this practice.Pets can transmit a number of diseases. Dogs and cats are routinely vaccinated against rabies . Pets can also transmit ringworm and Giardia , which are endemic in both animal and human populations. Toxoplasmosis is a common infection of cats; in humans it is a mild disease although it can be dangerous to pregnant women. Dirofilariasis is caused by Dirofilaria immitis through mosquitoes infected by mammals like dogs and cats. Cat-scratch disease is caused by Bartonella henselae and Bartonella quintana , which are transmitted by fleas that are endemic to cats. Toxocariasis is the infection of humans by any of species of roundworm , including species specific to dogs ( Toxocara canis ) or cats ( Toxocara cati ). Cryptosporidiosis can be spread to humans from pet lizards, such as the leopard gecko . Encephalitozoon cuniculi is a microsporidial parasite carried by many mammals, including rabbits, and is an important opportunistic pathogen in people immunocompromised by HIV/AIDS , organ transplantation , or CD4+ T-lymphocyte deficiency. Pets may also serve as a reservoir of viral disease and contribute to the chronic presence of certain viral diseases in the human population. For instance, approximately 20% of domestic dogs, cats, and horses carry anti-hepatitis E virus antibodies and thus these animals probably contribute to human hepatitis E burden as well. For non-vulnerable populations (e.g., people who are not immunocompromised) the associated disease burden is, however, small. [ citation needed ] Furthermore, the trade of non domestic animals such as wild animals as pets can also increase the risk of zoonosis spread. Outbreaks of zoonoses have been traced to human interaction with, and exposure to, other animals at fairs , live animal markets , petting zoos , and other settings. In 2005, the Centers for Disease Control and Prevention (CDC) issued an updated list of recommendations for preventing zoonosis transmission in public settings. The recommendations, developed in conjunction with the National Association of State Public Health Veterinarians , include educational responsibilities of venue operators, limiting public animal contact, and animal care and management.Hunting involves humans tracking, chasing, and capturing wild animals, primarily for food or materials like fur. However, other reasons like pest control or managing wildlife populations can also exist. Transmission of zoonotic diseases, those leaping from animals to humans, can occur through various routes: direct physical contact, airborne droplets or particles, bites or vector transport by insects, oral ingestion, or even contact with contaminated environments. Wildlife activities like hunting and trade bring humans closer to dangerous zoonotic pathogens, threatening global health. According to the Center for Diseases Control and Prevention (CDC) hunting and consuming wild animal meat ("bushmeat") in regions like Africa can expose people to infectious diseases due to the types of animals involved, like bats and primates. Unfortunately, common preservation methods like smoking or drying aren't enough to eliminate these risks. Although bushmeat provides protein and income for many, the practice is intricately linked to numerous emerging infectious diseases like Ebola, HIV, and SARS , raising critical public health concerns. A review published in 2022 found evidence that zoonotic spillover linked to wildmeat consumption has been reported across all continents. Kate Jones , Chair of Ecology and Biodiversity at University College London , says zoonotic diseases are increasingly linked to environmental change and human behavior. The disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanization, and population growth is bringing people into closer contact with animal species they may never have been near before. The resulting transmission of disease from wildlife to humans, she says, is now "a hidden cost of human economic development". In a guest article, published by IPBES , President of the EcoHealth Alliance and zoologist Peter Daszak , along with three co-chairs of the 2019 Global Assessment Report on Biodiversity and Ecosystem Services , Josef Settele, Sandra Díaz , and Eduardo Brondizio, wrote that "rampant deforestation, uncontrolled expansion of agriculture, intensive farming , mining and infrastructure development, as well as the exploitation of wild species have created a 'perfect storm' for the spillover of diseases from wildlife to people." Joshua Moon, Clare Wenham, and Sophie Harman said that there is evidence that decreased biodiversity has an effect on the diversity of hosts and frequency of human-animal interactions with potential for pathogenic spillover. An April 2020 study, published in the Proceedings of the Royal Society ' s Part B journal, found that increased virus spillover events from animals to humans can be linked to biodiversity loss and environmental degradation , as humans further encroach on wildlands to engage in agriculture, hunting, and resource extraction they become exposed to pathogens which normally would remain in these areas. Such spillover events have been tripling every decade since 1980. An August 2020 study, published in Nature , concludes that the anthropogenic destruction of ecosystems for the purpose of expanding agriculture and human settlements reduces biodiversity and allows for smaller animals such as bats and rats, which are more adaptable to human pressures and also carry the most zoonotic diseases, to proliferate. This in turn can result in more pandemics. In October 2020, the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services published its report on the 'era of pandemics' by 22 experts in a variety of fields and concluded that anthropogenic destruction of biodiversity is paving the way to the pandemic era and could result in as many as 850,000 viruses being transmitted from animals – in particular birds and mammals – to humans. The increased pressure on ecosystems is being driven by the "exponential rise" in consumption and trade of commodities such as meat, palm oil , and metals, largely facilitated by developed nations, and by a growing human population . According to Peter Daszak, the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic, or of any modern pandemic. The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment." According to a report from the United Nations Environment Programme and International Livestock Research Institute , entitled "Preventing the next pandemic – Zoonotic diseases and how to break the chain of transmission", climate change is one of the 7 human-related causes of the increase in the number of zoonotic diseases. The University of Sydney issued a study, in March 2021, that examines factors increasing the likelihood of epidemics and pandemics like the COVID-19 pandemic. The researchers found that "pressure on ecosystems, climate change and economic development are key factors" in doing so. More zoonotic diseases were found in high-income countries . A 2022 study dedicated to the link between climate change and zoonosis found a strong link between climate change and the epidemic emergence in the last 15 years, as it caused a massive migration of species to new areas, and consequently contact between species which do not normally come in contact with one another. Even in a scenario with weak climatic changes, there will be 15,000 spillover of viruses to new hosts in the next decades. The areas with the most possibilities for spillover are the mountainous tropical regions of Africa and southeast Asia. Southeast Asia is especially vulnerable as it has a large number of bat species that generally do not mix, but could easily if climate change forced them to begin migrating. A 2021 study found possible links between climate change and transmission of COVID-19 through bats. The authors suggest that climate-driven changes in the distribution and robustness of bat species harboring coronaviruses may have occurred in eastern Asian hotspots (southern China, Myanmar, and Laos), constituting a driver behind the evolution and spread of the virus. During most of human prehistory groups of hunter-gatherers were probably very small. Such groups probably made contact with other such bands only rarely. Such isolation would have caused epidemic diseases to be restricted to any given local population, because propagation and expansion of epidemics depend on frequent contact with other individuals who have not yet developed an adequate immune response . To persist in such a population, a pathogen either had to be a chronic infection, staying present and potentially infectious in the infected host for long periods, or it had to have other additional species as reservoir where it can maintain itself until further susceptible hosts are contacted and infected. In fact, for many "human" diseases, the human is actually better viewed as an accidental or incidental victim and a dead-end host . Examples include rabies, anthrax, tularemia, and West Nile fever. Thus, much of human exposure to infectious disease has been zoonotic. Many diseases, even epidemic ones, have zoonotic origin and measles , smallpox , influenza , HIV, and diphtheria are particular examples. Various forms of the common cold and tuberculosis also are adaptations of strains originating in other species. [ citation needed ] Some experts have suggested that all human viral infections were originally zoonotic. Zoonoses are of interest because they are often previously unrecognized diseases or have increased virulence in populations lacking immunity. The West Nile virus first appeared in the United States in 1999 , in the New York City area. Bubonic plague is a zoonotic disease, as are salmonellosis , Rocky Mountain spotted fever , and Lyme disease . A major factor contributing to the appearance of new zoonotic pathogens in human populations is increased contact between humans and wildlife. This can be caused either by encroachment of human activity into wilderness areas or by movement of wild animals into areas of human activity. An example of this is the outbreak of Nipah virus in peninsular Malaysia, in 1999, when intensive pig farming began within the habitat of infected fruit bats. The unidentified infection of these pigs amplified the force of infection, transmitting the virus to farmers, and eventually causing 105 human deaths. Similarly, in recent times avian influenza and West Nile virus have spilled over into human populations probably due to interactions between the carrier host and domestic animals. [ citation needed ] Highly mobile animals, such as bats and birds, may present a greater risk of zoonotic transmission than other animals due to the ease with which they can move into areas of human habitation. Because they depend on the human host for part of their life-cycle, diseases such as African schistosomiasis , river blindness , and elephantiasis are not defined as zoonotic, even though they may depend on transmission by insects or other vectors . The first vaccine against smallpox by Edward Jenner in 1800 was by infection of a zoonotic bovine virus which caused a disease called cowpox . Jenner had noticed that milkmaids were resistant to smallpox. Milkmaids contracted a milder version of the disease from infected cows that conferred cross immunity to the human disease. Jenner abstracted an infectious preparation of 'cowpox' and subsequently used it to inoculate persons against smallpox. As a result of vaccination, smallpox has been eradicated globally, and mass inoculation against this disease ceased in 1981. There are a variety of vaccine types, including traditional inactivated pathogen vaccines, subunit vaccines , live attenuated vaccines . There are also new vaccine technologies such as viral vector vaccines and DNA/RNA vaccines , which include many of the COVID-19 vaccines .

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Mpox

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2022–2023 mpox outbreak in Mexico

The 2022–2023 mpox outbreak in Mexico is part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus . Mexico is the twenty-fourth country outside of Africa to experience an endemic mpox outbreak. The first case was reported in Mexico City , Mexico , on May 28, 2022. As of December 8th 2022, Mexico had confirmed a total of 3455 cases in all 32 states and 4 deaths.Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. An ongoing outbreak of mpox was confirmed on May 6, 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic ), presented symptoms consistent with mpox on April 29, 2022. The resident returned to the United Kingdom on May 4, creating the country's index case of the outbreak. The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May, but it has been suggested that cases were already spreading in Europe in the previous months. A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria , the Democratic Republic of the Congo as well as central and western Africa . It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis , gonorrhea , chlamydia , and herpes . The first known case was detected in on May 28, 2022, in a 50-year-old male who resides permanently in the city of New York City , New York . He was diagnosed and hospitalized in Mexico City . There, he tested positive for mpox, becoming the first case in Mexico. On June 14, 4 more cases were reported in Mexico in the course of a week which brought the total number of cases in the country up to 5. There were 4 cases reported in Mexico City and 1 confirmed in Jalisco . On July 5, over the course of 3 weeks, 22 more cases were reported, which brought the total number of cases in the country up to 27. The only counties that reported cases were Mexico City and Jalisco . Other counties were not affected at the time. On July 27, after 3 weeks, 33 more infections were confirmed, which increased the total number of cases in the country up to 60. Cases had been reported across 11 regions in Mexico. On August 2, after 1 week, 31 more cases were confirmed, which rose the total number of cases from 60 to 91. Cases had been reported in 4 more regions, which brought the overall number of regions and territories affected by mpox up to 15. On August 9, over the course of 1 week, 56 more mpox cases were reported, which brought the total number of cases in the country up to 147. Cases had been reported in 3 more regions, which rose the overall number of regions and territories affected by mpox up to 18. On August 15, in the course of just 6 days, 105 greater mpox cases had been confirmed, which rose the overall number of infections from 147 to 252. Mpox infections had been reported in 2 more regions, which brought the total number of regions and territories affected by mpox up to 20. As of August 18, there is currently 252 confirmed cases with 107 suspected cases in the country. Hospitals have also begun making their own preparations to help control the current mpox outbreak, including screening patients, increasing decontamination and cleaning procedures, and wearing appropriate safety gear ( Personal protective equipment / Medical gown ) when interacting with infected patients. Mexico has also responded to the outbreak. Mexican health authorities have posted notices in clinics and hospitals for the purpose of identifying suspected cases and infections in the country. In addition, the Ministry of Health has issued an epidemiological alert on 26 May 2022.

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Mpox

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Herd immunity

Herd immunity (also called herd effect , community immunity , population immunity , or mass immunity ) is a form of indirect protection that applies only to contagious diseases . It occurs when a sufficient percentage of a population has become immune to an infection, whether through previous infections or vaccination , thereby reducing the likelihood of infection for individuals who lack immunity. Once the herd immunity has been reached, disease gradually disappears from a population and may result in eradication or permanent reduction of infections to zero if achieved worldwide. Herd immunity created via vaccination has contributed to the reduction of many diseases. Some individuals either cannot develop immunity after vaccination or for medical reasons cannot be vaccinated. Newborn infants are too young to receive many vaccines, either for safety reasons or because passive immunity renders the vaccine ineffective. Individuals who are immunodeficient due to HIV/AIDS , lymphoma , leukemia , bone marrow cancer, an impaired spleen , chemotherapy , or radiotherapy may have lost any immunity that they previously had and vaccines may not be of any use for them because of their immunodeficiency. A portion of those vaccinated may not develop long-term immunity. Vaccine contraindications may prevent certain individuals from being vaccinated. In addition to not being immune, individuals in one of these groups may be at a greater risk of developing complications from infection because of their medical status, but they may still be protected if a large enough percentage of the population is immune. High levels of immunity in one age group can create herd immunity for other age groups. Vaccinating adults against pertussis reduces pertussis incidence in infants too young to be vaccinated, who are at the greatest risk of complications from the disease. This is especially important for close family members, who account for most of the transmissions to young infants. In the same manner, children receiving vaccines against pneumococcus reduces pneumococcal disease incidence among younger, unvaccinated siblings. Vaccinating children against pneumococcus and rotavirus has had the effect of reducing pneumococcus - and rotavirus -attributable hospitalizations for older children and adults, who do not normally receive these vaccines. Influenza (flu) is more severe in the elderly than in younger age groups, but influenza vaccines lack effectiveness in this demographic due to a waning of the immune system with age. The prioritization of school-age children for seasonal flu immunization, which is more effective than vaccinating the elderly, however, has been shown to create a certain degree of protection for the elderly. For sexually transmitted infections (STIs), high levels of immunity in heterosexuals of one sex induces herd immunity for heterosexuals of both sexes. Vaccines against STIs that are targeted at heterosexuals of one sex result in significant declines in STIs in heterosexuals of both sexes if vaccine uptake in the target sex is high. Herd immunity from female vaccination does not, however, extend to males who have sex with males. High-risk behaviors make eliminating STIs difficult because, even though most infections occur among individuals with moderate risk, the majority of transmissions occur because of individuals who engage in high-risk behaviors. For this reason, in certain populations it may be necessary to immunize high-risk individuals regardless of sex. Herd immunity itself acts as an evolutionary pressure on pathogens, influencing viral evolution by encouraging the production of novel strains, referred to as escape mutants, that are able to evade herd immunity and infect previously immune individuals. The evolution of new strains is known as serotype replacement, or serotype shifting, as the prevalence of a specific serotype declines due to high levels of immunity, allowing other serotypes to replace it. At the molecular level, viruses escape from herd immunity through antigenic drift , which is when mutations accumulate in the portion of the viral genome that encodes for the virus's surface antigen , typically a protein of the virus capsid , producing a change in the viral epitope . Alternatively, the reassortment of separate viral genome segments, or antigenic shift , which is more common when there are more strains in circulation, can also produce new serotypes . When either of these occur, memory T cells no longer recognize the virus, so people are not immune to the dominant circulating strain. For both influenza and norovirus , epidemics temporarily induce herd immunity until a new dominant strain emerges, causing successive waves of epidemics. As this evolution poses a challenge to herd immunity, broadly neutralizing antibodies and "universal" vaccines that can provide protection beyond a specific serotype are in development. Initial vaccines against Streptococcus pneumoniae significantly reduced nasopharyngeal carriage of vaccine serotypes (VTs), including antibiotic-resistant types, only to be entirely offset by increased carriage of non-vaccine serotypes (NVTs). This did not result in a proportionate increase in disease incidence though, since NVTs were less invasive than VTs. Since then, pneumococcal vaccines that provide protection from the emerging serotypes have been introduced and have successfully countered their emergence. The possibility of future shifting remains, so further strategies to deal with this include expansion of VT coverage and the development of vaccines that use either killed whole-cells , which have more surface antigens, or proteins present in multiple serotypes. If herd immunity has been established and maintained in a population for a sufficient time, the disease is inevitably eliminated – no more endemic transmissions occur. If elimination is achieved worldwide and the number of cases is permanently reduced to zero, then a disease can be declared eradicated. Eradication can thus be considered the final effect or end-result of public health initiatives to control the spread of contagious disease. In cases in which herd immunity is compromised, on the contrary, disease outbreaks among the unvaccinated population are likely to occur. The benefits of eradication include ending all morbidity and mortality caused by the disease, financial savings for individuals, health care providers, and governments, and enabling resources used to control the disease to be used elsewhere. To date, two diseases have been eradicated using herd immunity and vaccination: rinderpest and smallpox . Eradication efforts that rely on herd immunity are currently underway for poliomyelitis , though civil unrest and distrust of modern medicine have made this difficult. Mandatory vaccination may be beneficial to eradication efforts if not enough people choose to get vaccinated. Some individuals either cannot develop immunity after vaccination or for medical reasons cannot be vaccinated. Newborn infants are too young to receive many vaccines, either for safety reasons or because passive immunity renders the vaccine ineffective. Individuals who are immunodeficient due to HIV/AIDS , lymphoma , leukemia , bone marrow cancer, an impaired spleen , chemotherapy , or radiotherapy may have lost any immunity that they previously had and vaccines may not be of any use for them because of their immunodeficiency. A portion of those vaccinated may not develop long-term immunity. Vaccine contraindications may prevent certain individuals from being vaccinated. In addition to not being immune, individuals in one of these groups may be at a greater risk of developing complications from infection because of their medical status, but they may still be protected if a large enough percentage of the population is immune. High levels of immunity in one age group can create herd immunity for other age groups. Vaccinating adults against pertussis reduces pertussis incidence in infants too young to be vaccinated, who are at the greatest risk of complications from the disease. This is especially important for close family members, who account for most of the transmissions to young infants. In the same manner, children receiving vaccines against pneumococcus reduces pneumococcal disease incidence among younger, unvaccinated siblings. Vaccinating children against pneumococcus and rotavirus has had the effect of reducing pneumococcus - and rotavirus -attributable hospitalizations for older children and adults, who do not normally receive these vaccines. Influenza (flu) is more severe in the elderly than in younger age groups, but influenza vaccines lack effectiveness in this demographic due to a waning of the immune system with age. The prioritization of school-age children for seasonal flu immunization, which is more effective than vaccinating the elderly, however, has been shown to create a certain degree of protection for the elderly. For sexually transmitted infections (STIs), high levels of immunity in heterosexuals of one sex induces herd immunity for heterosexuals of both sexes. Vaccines against STIs that are targeted at heterosexuals of one sex result in significant declines in STIs in heterosexuals of both sexes if vaccine uptake in the target sex is high. Herd immunity from female vaccination does not, however, extend to males who have sex with males. High-risk behaviors make eliminating STIs difficult because, even though most infections occur among individuals with moderate risk, the majority of transmissions occur because of individuals who engage in high-risk behaviors. For this reason, in certain populations it may be necessary to immunize high-risk individuals regardless of sex. Herd immunity itself acts as an evolutionary pressure on pathogens, influencing viral evolution by encouraging the production of novel strains, referred to as escape mutants, that are able to evade herd immunity and infect previously immune individuals. The evolution of new strains is known as serotype replacement, or serotype shifting, as the prevalence of a specific serotype declines due to high levels of immunity, allowing other serotypes to replace it. At the molecular level, viruses escape from herd immunity through antigenic drift , which is when mutations accumulate in the portion of the viral genome that encodes for the virus's surface antigen , typically a protein of the virus capsid , producing a change in the viral epitope . Alternatively, the reassortment of separate viral genome segments, or antigenic shift , which is more common when there are more strains in circulation, can also produce new serotypes . When either of these occur, memory T cells no longer recognize the virus, so people are not immune to the dominant circulating strain. For both influenza and norovirus , epidemics temporarily induce herd immunity until a new dominant strain emerges, causing successive waves of epidemics. As this evolution poses a challenge to herd immunity, broadly neutralizing antibodies and "universal" vaccines that can provide protection beyond a specific serotype are in development. Initial vaccines against Streptococcus pneumoniae significantly reduced nasopharyngeal carriage of vaccine serotypes (VTs), including antibiotic-resistant types, only to be entirely offset by increased carriage of non-vaccine serotypes (NVTs). This did not result in a proportionate increase in disease incidence though, since NVTs were less invasive than VTs. Since then, pneumococcal vaccines that provide protection from the emerging serotypes have been introduced and have successfully countered their emergence. The possibility of future shifting remains, so further strategies to deal with this include expansion of VT coverage and the development of vaccines that use either killed whole-cells , which have more surface antigens, or proteins present in multiple serotypes. If herd immunity has been established and maintained in a population for a sufficient time, the disease is inevitably eliminated – no more endemic transmissions occur. If elimination is achieved worldwide and the number of cases is permanently reduced to zero, then a disease can be declared eradicated. Eradication can thus be considered the final effect or end-result of public health initiatives to control the spread of contagious disease. In cases in which herd immunity is compromised, on the contrary, disease outbreaks among the unvaccinated population are likely to occur. The benefits of eradication include ending all morbidity and mortality caused by the disease, financial savings for individuals, health care providers, and governments, and enabling resources used to control the disease to be used elsewhere. To date, two diseases have been eradicated using herd immunity and vaccination: rinderpest and smallpox . Eradication efforts that rely on herd immunity are currently underway for poliomyelitis , though civil unrest and distrust of modern medicine have made this difficult. Mandatory vaccination may be beneficial to eradication efforts if not enough people choose to get vaccinated. Herd immunity is vulnerable to the free rider problem . Individuals who lack immunity, including those who choose not to vaccinate, free ride off the herd immunity created by those who are immune. As the number of free riders in a population increases, outbreaks of preventable diseases become more common and more severe due to loss of herd immunity. Individuals may choose to free ride or be hesitant to vaccinate for a variety of reasons, including the belief that vaccines are ineffective, or that the risks associated with vaccines are greater than those associated with infection, mistrust of vaccines or public health officials, bandwagoning or groupthinking , social norms or peer pressure , and religious beliefs. Certain individuals are more likely to choose not to receive vaccines if vaccination rates are high enough to convince a person that he or she may not need to be vaccinated, since a sufficient percentage of others are already immune. Individuals who are immune to a disease act as a barrier in the spread of disease, slowing or preventing the transmission of disease to others. An individual's immunity can be acquired via a natural infection or through artificial means, such as vaccination. When a critical proportion of the population becomes immune, called the herd immunity threshold (HIT) or herd immunity level (HIL), the disease may no longer persist in the population, ceasing to be endemic . The theoretical basis for herd immunity generally assumes that vaccines induce solid immunity, that populations mix at random, that the pathogen does not evolve to evade the immune response, and that there is no non-human vector for the disease. The critical value, or threshold, in a given population, is the point where the disease reaches an endemic steady state , which means that the infection level is neither growing nor declining exponentially . This threshold can be calculated from the effective reproduction number R e , which is obtained by taking the product of the basic reproduction number R 0 , the average number of new infections caused by each case in an entirely susceptible population that is homogeneous, or well-mixed, meaning each individual is equally likely to come into contact with any other susceptible individual in the population, and S , the proportion of the population who are susceptible to infection, and setting this product to be equal to 1: [ citation needed ] S can be rewritten as (1 − p ), where p is the proportion of the population that is immune so that p + S equals one. Then, the equation can be rearranged to place p by itself as follows: [ citation needed ] With p being by itself on the left side of the equation, it can be renamed as p c , representing the critical proportion of the population needed to be immune to stop the transmission of disease, which is the same as the "herd immunity threshold" HIT. R 0 functions as a measure of contagiousness, so low R 0 values are associated with lower HITs, whereas higher R 0 s result in higher HITs. For example, the HIT for a disease with an R 0 of 2 is theoretically only 50%, whereas a disease with an R 0 of 10 the theoretical HIT is 90%. When the effective reproduction number R e of a contagious disease is reduced to and sustained below 1 new individual per infection, the number of cases occurring in the population gradually decreases until the disease has been eliminated. If a population is immune to a disease in excess of that disease's HIT, the number of cases reduces at a faster rate, outbreaks are even less likely to happen, and outbreaks that occur are smaller than they would be otherwise. If the effective reproduction number increases to above 1, then the disease is neither in a steady state nor decreasing in incidence , but is actively spreading through the population and infecting a larger number of people than usual. An assumption in these calculations is that populations are homogeneous, or well-mixed, meaning that every individual is equally likely to come into contact with any other individual, when in reality populations are better described as social networks as individuals tend to cluster together, remaining in relatively close contact with a limited number of other individuals. In these networks, transmission only occurs between those who are geographically or physically close to one another. The shape and size of a network is likely to alter a disease's HIT, making incidence either more or less common. Mathematical models can use contact matrices to estimate the likelihood of encounters and thus transmission. In heterogeneous populations, R 0 is considered to be a measure of the number of cases generated by a "typical" contagious person, which depends on how individuals within a network interact with each other. Interactions within networks are more common than between networks, in which case the most highly connected networks transmit disease more easily, resulting in a higher R 0 and a higher HIT than would be required in a less connected network. In networks that either opt not to become immune or are not immunized sufficiently, diseases may persist despite not existing in better-immunized networks. The cumulative proportion of individuals who get infected during the course of a disease outbreak can exceed the HIT. This is because the HIT does not represent the point at which the disease stops spreading, but rather the point at which each infected person infects fewer than one additional person on average. When the HIT is reached, the number of additional infections does not immediately drop to zero. The excess of the cumulative proportion of infected individuals over the theoretical HIT is known as the overshoot . The cumulative proportion of individuals who get infected during the course of a disease outbreak can exceed the HIT. This is because the HIT does not represent the point at which the disease stops spreading, but rather the point at which each infected person infects fewer than one additional person on average. When the HIT is reached, the number of additional infections does not immediately drop to zero. The excess of the cumulative proportion of infected individuals over the theoretical HIT is known as the overshoot . The primary way to boost levels of immunity in a population is through vaccination. Vaccination is originally based on the observation that milkmaids exposed to cowpox were immune to smallpox, so the practice of inoculating people with the cowpox virus began as a way to prevent smallpox. Well-developed vaccines provide protection in a far safer way than natural infections, as vaccines generally do not cause the diseases they protect against and severe adverse effects are significantly less common than complications from natural infections. The immune system does not distinguish between natural infections and vaccines, forming an active response to both, so immunity induced via vaccination is similar to what would have occurred from contracting and recovering from the disease. To achieve herd immunity through vaccination, vaccine manufacturers aim to produce vaccines with low failure rates, and policy makers aim to encourage their use . After the successful introduction and widespread use of a vaccine, sharp declines in the incidence of diseases it protects against can be observed, which decreases the number of hospitalizations and deaths caused by such diseases. Assuming a vaccine is 100% effective, then the equation used for calculating the herd immunity threshold can be used for calculating the vaccination level needed to eliminate a disease, written as V c . Vaccines are usually imperfect however, so the effectiveness, E , of a vaccine must be accounted for: From this equation, it can be observed that if E is less than (1 − 1/ R 0 ), then it is impossible to eliminate a disease, even if the entire population is vaccinated. Similarly, waning vaccine-induced immunity, as occurs with acellular pertussis vaccines , requires higher levels of booster vaccination to sustain herd immunity. If a disease has ceased to be endemic to a population, then natural infections no longer contribute to a reduction in the fraction of the population that is susceptible. Only vaccination contributes to this reduction. The relation between vaccine coverage and effectiveness and disease incidence can be shown by subtracting the product of the effectiveness of a vaccine and the proportion of the population that is vaccinated, p v , from the herd immunity threshold equation as follows: It can be observed from this equation that, all other things being equal (" ceteris paribus "), any increase in either vaccine coverage or vaccine effectiveness, including any increase in excess of a disease's HIT, further reduces the number of cases of a disease. The rate of decline in cases depends on a disease's R 0 , with diseases with lower R 0 values experiencing sharper declines. Vaccines usually have at least one contraindication for a specific population for medical reasons, but if both effectiveness and coverage are high enough then herd immunity can protect these individuals. Vaccine effectiveness is often, but not always, adversely affected by passive immunity, so additional doses are recommended for some vaccines while others are not administered until after an individual has lost his or her passive immunity. Individual immunity can also be gained passively, when antibodies to a pathogen are transferred from one individual to another. This can occur naturally, whereby maternal antibodies, primarily immunoglobulin G antibodies, are transferred across the placenta and in colostrum to fetuses and newborns. Passive immunity can also be gained artificially, when a susceptible person is injected with antibodies from the serum or plasma of an immune person. Protection generated from passive immunity is immediate, but wanes over the course of weeks to months, so any contribution to herd immunity is temporary. For diseases that are especially severe among fetuses and newborns, such as influenza and tetanus, pregnant women may be immunized in order to transfer antibodies to the child. In the same way, high-risk groups that are either more likely to experience infection, or are more likely to develop complications from infection, may receive antibody preparations to prevent these infections or to reduce the severity of symptoms. The primary way to boost levels of immunity in a population is through vaccination. Vaccination is originally based on the observation that milkmaids exposed to cowpox were immune to smallpox, so the practice of inoculating people with the cowpox virus began as a way to prevent smallpox. Well-developed vaccines provide protection in a far safer way than natural infections, as vaccines generally do not cause the diseases they protect against and severe adverse effects are significantly less common than complications from natural infections. The immune system does not distinguish between natural infections and vaccines, forming an active response to both, so immunity induced via vaccination is similar to what would have occurred from contracting and recovering from the disease. To achieve herd immunity through vaccination, vaccine manufacturers aim to produce vaccines with low failure rates, and policy makers aim to encourage their use . After the successful introduction and widespread use of a vaccine, sharp declines in the incidence of diseases it protects against can be observed, which decreases the number of hospitalizations and deaths caused by such diseases. Assuming a vaccine is 100% effective, then the equation used for calculating the herd immunity threshold can be used for calculating the vaccination level needed to eliminate a disease, written as V c . Vaccines are usually imperfect however, so the effectiveness, E , of a vaccine must be accounted for: From this equation, it can be observed that if E is less than (1 − 1/ R 0 ), then it is impossible to eliminate a disease, even if the entire population is vaccinated. Similarly, waning vaccine-induced immunity, as occurs with acellular pertussis vaccines , requires higher levels of booster vaccination to sustain herd immunity. If a disease has ceased to be endemic to a population, then natural infections no longer contribute to a reduction in the fraction of the population that is susceptible. Only vaccination contributes to this reduction. The relation between vaccine coverage and effectiveness and disease incidence can be shown by subtracting the product of the effectiveness of a vaccine and the proportion of the population that is vaccinated, p v , from the herd immunity threshold equation as follows: It can be observed from this equation that, all other things being equal (" ceteris paribus "), any increase in either vaccine coverage or vaccine effectiveness, including any increase in excess of a disease's HIT, further reduces the number of cases of a disease. The rate of decline in cases depends on a disease's R 0 , with diseases with lower R 0 values experiencing sharper declines. Vaccines usually have at least one contraindication for a specific population for medical reasons, but if both effectiveness and coverage are high enough then herd immunity can protect these individuals. Vaccine effectiveness is often, but not always, adversely affected by passive immunity, so additional doses are recommended for some vaccines while others are not administered until after an individual has lost his or her passive immunity. Individual immunity can also be gained passively, when antibodies to a pathogen are transferred from one individual to another. This can occur naturally, whereby maternal antibodies, primarily immunoglobulin G antibodies, are transferred across the placenta and in colostrum to fetuses and newborns. Passive immunity can also be gained artificially, when a susceptible person is injected with antibodies from the serum or plasma of an immune person. Protection generated from passive immunity is immediate, but wanes over the course of weeks to months, so any contribution to herd immunity is temporary. For diseases that are especially severe among fetuses and newborns, such as influenza and tetanus, pregnant women may be immunized in order to transfer antibodies to the child. In the same way, high-risk groups that are either more likely to experience infection, or are more likely to develop complications from infection, may receive antibody preparations to prevent these infections or to reduce the severity of symptoms. Herd immunity is often accounted for when conducting cost–benefit analyses of vaccination programs. It is regarded as a positive externality of high levels of immunity, producing an additional benefit of disease reduction that would not occur had no herd immunity been generated in the population. Therefore, herd immunity's inclusion in cost–benefit analyses results both in more favorable cost-effectiveness or cost–benefit ratios, and an increase in the number of disease cases averted by vaccination. Study designs done to estimate herd immunity's benefit include recording disease incidence in households with a vaccinated member, randomizing a population in a single geographic area to be vaccinated or not, and observing the incidence of disease before and after beginning a vaccination program. From these, it can be observed that disease incidence may decrease to a level beyond what can be predicted from direct protection alone, indicating that herd immunity contributed to the reduction. When serotype replacement is accounted for, it reduces the predicted benefits of vaccination. Herd immunity was recognized as a naturally occurring phenomenon in the 1930s when it was observed that after a significant number of children had become immune to measles , the number of new infections temporarily decreased. Mass vaccination to induce herd immunity has since become common and proved successful in preventing the spread of many contagious diseases. Opposition to vaccination has posed a challenge to herd immunity, allowing preventable diseases to persist in or return to populations with inadequate vaccination rates. The exact herd immunity threshold (HIT) varies depending on the basic reproduction number of the disease. An example of a disease with a high threshold was the measles, with a HIT exceeding 95%. The term "herd immunity" was first used in 1894 by American veterinary scientist and then Chief of the Bureau of Animal Industry of the US Department of Agriculture Daniel Elmer Salmon to describe the healthy vitality and resistance to disease of well-fed herds of hogs. In 1916 veterinary scientists inside the same Bureau of Animal Industry used the term to refer to the immunity arising following recovery in cattle infected with brucellosis, also known as "contagious abortion." By 1923 it was being used by British bacteriologists to describe experimental epidemics with mice, experiments undertaken as part of efforts to model human epidemic disease. By the end of the 1920s the concept was used extensively - particularly among British scientists - to describe the build up of immunity in populations to diseases such as diphtheria, scarlet fever, and influenza. Herd immunity was recognized as a naturally occurring phenomenon in the 1930s when A. W. Hedrich published research on the epidemiology of measles in Baltimore , and took notice that after many children had become immune to measles, the number of new infections temporarily decreased, including among susceptible children. In spite of this knowledge, efforts to control and eliminate measles were unsuccessful until mass vaccination using the measles vaccine began in the 1960s. Mass vaccination, discussions of disease eradication, and cost–benefit analyses of vaccination subsequently prompted more widespread use of the term herd immunity . In the 1970s, the theorem used to calculate a disease's herd immunity threshold was developed. During the smallpox eradication campaign in the 1960s and 1970s, the practice of ring vaccination , to which herd immunity is integral, began as a way to immunize every person in a "ring" around an infected individual to prevent outbreaks from spreading. Since the adoption of mass and ring vaccination, complexities and challenges to herd immunity have arisen. Modeling of the spread of contagious disease originally made a number of assumptions, namely that entire populations are susceptible and well-mixed, which is not the case in reality, so more precise equations have been developed. In recent decades, it has been recognized that the dominant strain of a microorganism in circulation may change due to herd immunity, either because of herd immunity acting as an evolutionary pressure or because herd immunity against one strain allowed another already-existing strain to spread. Emerging or ongoing fears and controversies about vaccination have reduced or eliminated herd immunity in certain communities, allowing preventable diseases to persist in or return to these communities.

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Ashwin Vasan

Ashwin Vasan (born November 15, 1980) is an American physician and epidemiologist serving as the 44th commissioner of the New York City Department of Health and Mental Hygiene . Vasan is also a public health professor and practicing primary care doctor at Columbia University, and was recently the president and CEO of Fountain House, a national mental health nonprofit. A native of Chicago, with roots in Chennai, India, Vasan earned a Bachelor of Arts in Economics from the University of California, Los Angeles in 2001, a Master of Science from the Harvard School of Public Health in 2004. He graduated from University of Michigan Medical School in 2011 and completed a PhD from the London School of Hygiene & Tropical Medicine in 2015, and completed his medical training in internal medicine at NewYork-Presbyterian Hospital .Ashwin Vasan started his career in global health, working on HIV/AIDS, specifically, access to antiretroviral therapy in developing countries. He worked with Partners In Health in Boston, before moving to the Department of HIV/AIDS at the World Health Organization , where he worked under Dr. Jim Yong Kim on the "3by5" Initiative to expand access to HIV treatment, spending time in Switzerland , rural Uganda , Lesotho and Rwanda with PIH once again. After completing his internal medicine training at NewYork-Presbyterian Hospital, in 2014 Vasan joined the faculty of the Columbia University Mailman School of Public Health , and the Department of Medicine at Columbia's Vagelos College of Physicians & Surgeons, where he works as an assistant professor of clinical population and family health and medicine. Vasan practices primary care medicine at Columbia University Irving Medical Center . In 2016, Vasan was appointed to serve as the founding executive director of the New York City Department of Health and Mental Hygiene 's Health Access Equity Unit, a city-wide initiative aimed at improving the health and social welfare of marginalized communities in New York City . In 2019, Vasan was named president and CEO of Fountain House, a national mental health nonprofit that provides employment, education, housing, health and wellness programs to the mentally ill. Fountain House is notable for creating the Clubhouse model of psychosocial rehabilitation , which has been replicated in over 300 locations in 30 countries. During his tenure, Vasan grew the organization from a local New York-based nonprofit to a national organization, supporting eight markets, and establishing a policy office based in Washington, DC, working on mental health reform, including funding for community based mental health systems and mental health crisis response. During his tenure the organization nearly doubled in revenue including transformative new gifts from MacKenzie Scott and the Ford Foundation , amongst others. As Commissioner, Vasan has led a re-envisioning of the Department and the City's public health planning, focusing on stopping and reversing declines in life expectancy in NYC , which have been severe in NYC and the nation the wake of COVID-19 and parallel pandemics, culminating with the launch of HealthyNYC , the city's population health agenda aiming to reach its highest life expectancy of 83 years by 2030 . A local law was passed to ensure HealthyNYC is a permanent feature of citywide planning, spanning across administrations and updated every five years. In doing so he has centered mental health (focusing on youth, SMI, and overdoses) leading the creation of a comprehensive citywide mental health agenda Care, Community, Action: A Mental Health Plan for NYC and restructured the Agency around other key strategic priorities and contributors to declining life expectancy (chronic diseases, women's health and birth equity, violence prevention, and climate change), while shifting the agency culture and process towards response readiness, preparedness, managing health emergencies, especially infectious diseases and strengthening its data systems . Vasan began his tenure toward the end of the Omicron wave of COVID-19, during which he served as the Senior Public Health Advisor in City Hall and steered administration strategy on vaccination, testing, and new treatments, where the city developed the first-in-the-nation telehealth and home delivery program for Paxlovid . Early in his tenure as Commissioner, Vasan faced protests over COVID-19 related mandates and restrictions put in place under previous leadership. On the evening of April 4, 2022, around two dozen protesters carrying anti- Joe Biden flags and anti-COVID-19 vaccine mandate posters assembled around Vasan's house in Brooklyn , chanting "We! The People! Will Not Comply!". A group of the protesters later climbed the front steps of his house, banged on the front door, and screamed racial epithets and death threats. One of the protesters was carrying a hammer . The April 4 protest occurred after New York City Mayor Eric Adams delayed the removal of COVID-19 mask mandates for schoolchildren under the age of 5, citing rising cases of COVID-19 and delayed approval of the under-5 vaccine by the CDC. During another protest, one of the protesters was carrying a baseball bat . The protests, which continued regularly for six months, resulted in Vasan needing daily police protection from the New York City Police Department (NYPD). Despite this protection, protesters still occasionally show up at Vasan's house. Vasan led NYC's response to the mpox outbreak in summer 2022, with the city the epicenter of the North American outbreak. The Health Department was the first in the nation to launch MPOX vaccination clinics in June 2022 for "extended Pre-Exposure Prophylaxis", doing so under extreme national vaccine supply constraints . These clinics, and the close partnership with community leaders, advocates, and providers, led the nation and pushed the federal government to launch a national mpox response and vaccination strategy just a few weeks later in early July 2022. New York City vaccinated over 100,000 people in the 2022 mpox outbreak, and within weeks cases dramatically declined and the end of the outbreak was eventually declared in early 2023 . Under Vasan's leadership the Department has also led a response to reproductive health after the Supreme Court's ruling in the Dobbs case, launching the nation's first public sector Abortion Access Hub , where people from all across the U.S. and especially in states in new restrictions on abortion, can call and be navigated and supported to attain necessary reproductive health and abortion care in New York City, and becoming the first city to offer medication abortion at its public health clinics , in addition to telehealth access. Vasan's writing and quotations as a public health and mental health expert in national and international publications including CNN , The New York Times , NPR , CBS News , USA Today , The Guardian , Forbes , WNYC , Al Jazeera , today.com , and Insider . He was also the subject of a Lancet profile outlining his agenda for improving health in NYC. Vasan was also a member of the City & State advisory board until assuming his current role as NYC Health Commissioner. He has also served on the boards of Transportation Alternatives, inseparable, and Forward Majority. He has worked on multiple local, state, and national political campaigns as a health policy advisor.Vasan lives in Brooklyn with his wife and three kids.

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34th GLAAD Media Awards

The 34th GLAAD Media Awards is the 2023 annual presentation of the GLAAD Media Awards by GLAAD honoring 2022 films, television shows, video games, musicians and works of journalism that fairly, accurately and inclusively represent the LGBT community and issues relevant to the community. As in previous years, the awards were presented in two groups at two separate ceremonies, which for this awards edition took place on March 30, 2023 in Los Angeles and on May 13, 2023 in New York City. The eligibility period for the 34th GLAAD Media Awards ran from January 1, 2022 to December 31, 2022 and the nominations were announced on January 18, 2023 by RuPaul's Drag Race stars Sasha Colby and Salina EsTittes on the GLAAD YouTube channel. For the 34th ceremony, GLAAD announced the introduction of two new categories: Outstanding Podcast and Outstanding Live TV Journalism - Segment or Special. They also revealed changes to the Outstanding Reality Program category, which was split into Outstanding Reality Program and Outstanding Reality Program - Competition, and the Outstanding Kids and Family Programming category, which was split into Live Action and Animated categories. In addition, the Outstanding Film – Wide Release category featured ten nominees for the first time and separate category for streaming films and TV movies was introduced. Finally, a new category for Outstanding Children's Programming was introduced to honor content made for younger children. Children's Programming Mombian Charlotte's Web Thoughts Holy Bullies and Headless Monsters My Fabulous Disease The Reckoning Charlotte's Web Thoughts Holy Bullies and Headless Monsters My Fabulous Disease The ReckoningChildren's ProgrammingMombian Charlotte's Web Thoughts Holy Bullies and Headless Monsters My Fabulous Disease The Reckoning Charlotte's Web Thoughts Holy Bullies and Headless Monsters My Fabulous Disease The Reckoning

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Health in Afghanistan

Health in Afghanistan remains poor but steadily improving. It has been negatively affected by the nation's environmental issues and the decades of war since 1978 . The Ministry of Public Health (MoPH) oversees all matters concerning the health of the country's residents. The Human Rights Measurement Initiative finds that Afghanistan is fulfilling 72.5% of what it should be fulfilling for the right to health based on its level of income. Afghanistan is generally considered a poor and least developed country . From 2001 to 2021, Afghanistan experienced improvements in health, with life expectancy increasing from 56 to 64 years. Maternal mortality rate was reduced by half, with the rate estimated at 638 deaths/100,000 live births and its infant mortality rate estimated at 106 per 1,000 live births in 2021. Nearly 90% of residents living in cities had access to clean water in 2021, compared to 16% in 2001. Afghanistan is one of the only two remaining countries that has not eradicated polio . Around 16,000 people die annually from various forms of cancer . Around 1,000 or more die in traffic collision each year. Around 380 children die from measles . Afghanistan became a member of the World Health Organization (WHO) on April 19, 1948. It has an estimated population of around 40 million people. Of this, approximately 35 million are in the country while the remaining 5 million or so reside in Iran , Pakistan and elsewhere around the world . Afghanistan in 2016 had the second lowest health worker density in the Eastern Mediterranean Region (EMR), with a ratio of 4.6 medical doctors, nurses and midwives per 10,000 people, considerably below the threshold for critical shortage of 23 health care professionals per 10,000. Afghanistan's health workforce shortage is a result of the continues war in the country since 1978 , including the historic under-investment in education and training, migration, lack of infrastructure and equipment and poor remuneration. Other challenges also include lack of opportunities for career advancement, staff absenteeism, moonlighting, and weak management. Cultural and socio-economic barriers have also contributed to the overall shortage as well as gender and geographic imbalances in the health workforce. As per the global pattern, many health workers (especially specialists and female doctors) prefer to work in Kabul and other large cities for a notably better standard of life. In addition, policies limiting girls' education affecting health workforce production are still felt and encountered today, especially in more rural provinces. The shortage of female healthcare providers has long been seen as an access and comfort issue for female patients in Afghanistan. The shortage of such providers is also a quality of care issue for female patients. Female healthcare providers in Afghanistan may be more sensitive to the needs of female patients, and adult females can interact freely with each other, whereas sex discordant adults face constraints in their interactions that may hinder the ability of a provider to deliver high quality care. Hospitals and clinics can be found in most districts of Afghanistan but what quality of healthcare they provide is not fully known. Older surveys show that 57 percent of Afghans say they have good or very good access to clinics or hospitals, and Afghans themselves pay approximately 75% of health care costs directly. On 18 January 2022, UNICEF warned that up to 1 million children in Afghanistan were at risk of death from malnutrition . According to the World Food Programme , more than half the population faced acute hunger, with nearly 9 million one step away from famine. Also due to an unprecedented food crisis, drought and disruptions to vital health and nutrition services, children across Afghanistan were increasingly vulnerable to disease and illness. Around 16,000 people die annually from various types of cancer . Covid-19 has killed nearly 8,000 people in Afghanistan since early 2020. Crimean–Congo hemorrhagic fever (or simply Congo fever) has been reported in the country in recent years. According to MoPH, around 1,000 people die annually from diabetes . In 2023, up to 6,000 people with hepatitis have been treated in Afghanistan. Hepatitis A Sanitation issues place the Afghanistan population at risk of contracting hepatitis A through the consumption of food and water that has been contaminated by fecal material. Hepatitis A works by inhibiting the liver from functioning properly. Symptoms generally include jaundice, fatigue, loss of appetite, while some victims may experience diarrhea. Furthermore, symptoms will appear 2–6 weeks after an individual has come into contact with the hepatitis A virus. Hepatitis C Hepatitis C virus (HCV) is a blood-borne pathogen associated with several morbidities and mortality. HCV prevalence in the population at large in Afghanistan appears to be around 1%. HCV prevalence among people who inject drugs is substantial with evidence of regional and temporal variation. HCV prevention efforts in Afghanistan should focus on expanding access to and coverage of harm reduction services among people who inject drugs and prisoners. As of 2023, more than 12,000 people are living with HIV in the country. According to Afghanistan's National Aids Control Program (NACP), 504 cases of HIV/AIDS were documented in late 2008. By the end of 2012, the number reached 1,327. Health officials stated that most of the HIV patients were among intravenous drug users and that 70% of them were men, 25% women, and the remaining 5% children. They belonged to Kabul, Kandahar and Herat, the provinces from where people make the most trips to neighboring or other foreign countries. Regarding Kandahar, 22 cases were reported in 2012. AIDS Prevention department head Dr Hamayoun Rehman said 1,320 blood samples were examined and 21 were positive. Among the 21 patients, 18 were males and three were females who contracted the deadly virus from their husbands. He said four people had reached a critical stage while three had died. The main source of the disease was the use of syringes used by drug addicts. There are approximately 23,000 addicts in the country who inject drugs into their bodies using syringes. Leishmaniasis is estimated to cause the ninth largest disease burden among infectious diseases worldwide and it is not preventable by vaccination or chemoprophylaxis, but only by personal protective measures preventing bites of infectious arthropod vectors. Four Leishmania species are considered endemic in northern Afghanistan, of which Leishmania tropica, L. major, and L. donovani can produce skin lesions while L. donovani and L. infantum visceralize. Visceral leishmaniasis infections are often recognised by fever, swelling of the liver and spleen, and anemia . They are known by many local names, of which the most common is probably Kala azar . A total of 21 cases of VL acquired in Afghanistan, all in the 1980s according to CDC reporting. Despite anti-leprosy initiatives by Leprosy Control (LEPCO) dating to 1984, leprosy is present in Afghanistan, with 231 cases reported in the 2001-2007 period. Just over three-quarters of the cases were the MB-type, with the rest PB-type. Leprosy has been reported in the central Hindu Kush mountain area of the country. Mainly in the provinces of Bamyan , Ghazni and Balkh . More than half of Afghan girls and boys experience permanent mental and physical damage because they are poorly nourished in the crucial first two years of life. High levels of malnutrition in Children is rate of stunting 60.5%, One third of children (33.7%) underweight, Anaemia 50% in children 6–24 months, High iodine deficiency: 72%(school age) and also the high levels of Malnutrition in Women is Iron deficiency: 48.4%, non-pregnant and Iodine deficiency 75%.and high levels of chronic energy deficiency are 20.9% low BMI. Supporting the Implementation of Nutrition (and Health)-Specific Interventions through BPHS and EPHS. The Ministry of Public Health , World Bank and WFP have been working together for ensuring that mothers are healthy before they become pregnant and throughout pregnancy, promoting appropriate Infant and Young Child Feeding Practices, ensuring that children receive adequate health care to prevent growth faltering resulting from illness and early treatment of acute malnutrition and Promote appropriate hygiene practices. Afghanistan has long been one of the countries that deal with high maternal mortality cases. Initially, having one of the highest maternal mortality rates in the world at 1640 per 100,000 in 1980 to 400 per 100,000 in 2013. Measles killed over 380 children in Afghanistan in 2022. Approximately 75,000 people suffer from the disease. Vaccinations against the disease is ongoing. Two suspected cases of mpox (monkeypox) have been reported in Nimruz Province in 2022, which later proved to be negative. In Afghanistan, the mortality ratio for children <5 years of age is 90 deaths/1,000 live births, twice the global average; 20% of deaths are from pneumonia . Although Afghanistan is considered 1 of the 5 countries with the highest level of childhood deaths from pneumonia, studies of the risk factors for death and etiology of pneumonia among children in Afghanistan are lacking. The CFR for children <5 years of age with pneumonia admitted to a regional hospital in Afghanistan was 12.1%, compared with only 7.6% for the full WHO Eastern Mediterranean region. Most deaths occurred within 2 days of hospitalization. Factors that may have contributed to the high mortality rate were delays in presentation to healthcare facilities, inability to identify severe symptoms in children, and delayed referral from primary care. These issues could be addressed by strengthening the Integrated Management of Childhood Illness program of WHO, introduced in Afghanistan in 2004. In 2023 a total of 6 cases of polio were reported in Afghanistan. All were in Nangarhar Province . Two were recorded in the previous year. Afghanistan and Pakistan remain the only countries where the transmission of endemic wild poliovirus type 1 (WPV1) continues. Government agencies have been working together to eliminate polio in the country. Wild poliovirus is present in Afghanistan, though in limited areas. Reported cases were on the decline, from 63 in 1999 to 17 in 2007, until increased violence in 2008 impeded vaccination efforts, causing cases to climb up for the first nine months of 2009. Tuberculosis is endemic in Afghanistan, with over 76,000 cases reported per year. The United States Agency for International Development (USAID) has been engaged in promulgating DOTS ( directly observed therapy, short course ) treatments, as well as TB awareness and prevention. BRAC is a development organization that focuses on the alleviation of poverty through the empowerment of the poor to improve their lives. BRAC Afghanistan has been involved in assisting Afghan Ministry of Public Health in the implementation of the Basic Package of Health Services (BPHS) in Kabul, Badghis , Balkh and Nimroz . This implementation was mainly funded by the World Bank and the USAID-REACH (United States Agency for International Development - Rural Expansion of Afghanistan Community-based Healthcare). Tuberculosis is a serious public health problem in Afghanistan. In 2007, 8,200 people in the country died from tuberculosis and, in the WHO's Global Tuberculosis Control Report 2009, an annual estimated figure of 46,000 new cases of tuberculosis were in Afghanistan. As such, Afghanistan is ranked 22nd in amongst highly affected Tuberculosis countries. To help control tuberculosis, BRAC Afghanistan started the community-based TB DOTS under the Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB (FIDELIS) project in 2006. In the first phase of this programme, diagnostic facilities for tuberculosis were expanded through the setting up of 50 TB microscopy centres. This phase lasted from January 2006 and up to March 2007. Over the next two years, facilities were further expanded and 92 more Tuberculosis Microscopy Centres were set up under the FIDELIS programme. The Tuberculosis Control Assistance Programme (TB CAP) was another project taken up between BRAC Afghanistan, World Health Organization (WHO) and Management Sciences for Health (MSH) in a bid to fight TB in Afghanistan. In this project, BRAC Afghanistan supported the BPHS (Basic Package of Health Services) project by replicating the CB-DOTS model into health systems of four provinces: Baghlan , Jawzjan , Badakshan and Herat . BRAC Afghanistan was selected as Principal Recipient (PR) for malaria and TB components of the Global Fund 8. In 2009, 2,143,354 patients received treatment under the health programs mentioned. As of August 2010, BRAC Afghanistan had covered 388 districts and 25 million of the total population are under the BRAC Afghanistan Health Program. Health facilities also include six District Hospitals, 26 Comprehensive Health Centres, 53 Basic Health Centres, 18 Sub Health Centres as well as 533 Mobile Clinics every month. Being the 15th least developed country in the world, Afghanistan faces difficulties in sanitation . In urban areas 40% of the population have unimproved access to sanitation facilities. Because of this many Afghanistan natives are forced to combat typhoid fever . Typhoid fever is one of Afghanistan's major infectious diseases in terms of food/waterborne diseases. This infectious disease occurs when fecal material comes into contact with food or water. Symptoms vary from case to case but often mild fever is present and if left untreated death may occur. According to the Afghan Red Crescent Society , as much as 11,000 children are affected by the treatable disease known as ventricular septal defect , which is commonly referred to as hole in the heart . Most patients are treated in Afghanistan. Around 16,000 people die annually from various types of cancer . Covid-19 has killed nearly 8,000 people in Afghanistan since early 2020.Crimean–Congo hemorrhagic fever (or simply Congo fever) has been reported in the country in recent years. According to MoPH, around 1,000 people die annually from diabetes . In 2023, up to 6,000 people with hepatitis have been treated in Afghanistan. Hepatitis A Sanitation issues place the Afghanistan population at risk of contracting hepatitis A through the consumption of food and water that has been contaminated by fecal material. Hepatitis A works by inhibiting the liver from functioning properly. Symptoms generally include jaundice, fatigue, loss of appetite, while some victims may experience diarrhea. Furthermore, symptoms will appear 2–6 weeks after an individual has come into contact with the hepatitis A virus. Hepatitis C Hepatitis C virus (HCV) is a blood-borne pathogen associated with several morbidities and mortality. HCV prevalence in the population at large in Afghanistan appears to be around 1%. HCV prevalence among people who inject drugs is substantial with evidence of regional and temporal variation. HCV prevention efforts in Afghanistan should focus on expanding access to and coverage of harm reduction services among people who inject drugs and prisoners. As of 2023, more than 12,000 people are living with HIV in the country. According to Afghanistan's National Aids Control Program (NACP), 504 cases of HIV/AIDS were documented in late 2008. By the end of 2012, the number reached 1,327. Health officials stated that most of the HIV patients were among intravenous drug users and that 70% of them were men, 25% women, and the remaining 5% children. They belonged to Kabul, Kandahar and Herat, the provinces from where people make the most trips to neighboring or other foreign countries. Regarding Kandahar, 22 cases were reported in 2012. AIDS Prevention department head Dr Hamayoun Rehman said 1,320 blood samples were examined and 21 were positive. Among the 21 patients, 18 were males and three were females who contracted the deadly virus from their husbands. He said four people had reached a critical stage while three had died. The main source of the disease was the use of syringes used by drug addicts. There are approximately 23,000 addicts in the country who inject drugs into their bodies using syringes. Leishmaniasis is estimated to cause the ninth largest disease burden among infectious diseases worldwide and it is not preventable by vaccination or chemoprophylaxis, but only by personal protective measures preventing bites of infectious arthropod vectors. Four Leishmania species are considered endemic in northern Afghanistan, of which Leishmania tropica, L. major, and L. donovani can produce skin lesions while L. donovani and L. infantum visceralize. Visceral leishmaniasis infections are often recognised by fever, swelling of the liver and spleen, and anemia . They are known by many local names, of which the most common is probably Kala azar . A total of 21 cases of VL acquired in Afghanistan, all in the 1980s according to CDC reporting. Despite anti-leprosy initiatives by Leprosy Control (LEPCO) dating to 1984, leprosy is present in Afghanistan, with 231 cases reported in the 2001-2007 period. Just over three-quarters of the cases were the MB-type, with the rest PB-type. Leprosy has been reported in the central Hindu Kush mountain area of the country. Mainly in the provinces of Bamyan , Ghazni and Balkh . More than half of Afghan girls and boys experience permanent mental and physical damage because they are poorly nourished in the crucial first two years of life. High levels of malnutrition in Children is rate of stunting 60.5%, One third of children (33.7%) underweight, Anaemia 50% in children 6–24 months, High iodine deficiency: 72%(school age) and also the high levels of Malnutrition in Women is Iron deficiency: 48.4%, non-pregnant and Iodine deficiency 75%.and high levels of chronic energy deficiency are 20.9% low BMI. Supporting the Implementation of Nutrition (and Health)-Specific Interventions through BPHS and EPHS. The Ministry of Public Health , World Bank and WFP have been working together for ensuring that mothers are healthy before they become pregnant and throughout pregnancy, promoting appropriate Infant and Young Child Feeding Practices, ensuring that children receive adequate health care to prevent growth faltering resulting from illness and early treatment of acute malnutrition and Promote appropriate hygiene practices.Afghanistan has long been one of the countries that deal with high maternal mortality cases. Initially, having one of the highest maternal mortality rates in the world at 1640 per 100,000 in 1980 to 400 per 100,000 in 2013. Measles killed over 380 children in Afghanistan in 2022. Approximately 75,000 people suffer from the disease. Vaccinations against the disease is ongoing. Two suspected cases of mpox (monkeypox) have been reported in Nimruz Province in 2022, which later proved to be negative. In Afghanistan, the mortality ratio for children <5 years of age is 90 deaths/1,000 live births, twice the global average; 20% of deaths are from pneumonia . Although Afghanistan is considered 1 of the 5 countries with the highest level of childhood deaths from pneumonia, studies of the risk factors for death and etiology of pneumonia among children in Afghanistan are lacking. The CFR for children <5 years of age with pneumonia admitted to a regional hospital in Afghanistan was 12.1%, compared with only 7.6% for the full WHO Eastern Mediterranean region. Most deaths occurred within 2 days of hospitalization. Factors that may have contributed to the high mortality rate were delays in presentation to healthcare facilities, inability to identify severe symptoms in children, and delayed referral from primary care. These issues could be addressed by strengthening the Integrated Management of Childhood Illness program of WHO, introduced in Afghanistan in 2004. In 2023 a total of 6 cases of polio were reported in Afghanistan. All were in Nangarhar Province . Two were recorded in the previous year. Afghanistan and Pakistan remain the only countries where the transmission of endemic wild poliovirus type 1 (WPV1) continues. Government agencies have been working together to eliminate polio in the country. Wild poliovirus is present in Afghanistan, though in limited areas. Reported cases were on the decline, from 63 in 1999 to 17 in 2007, until increased violence in 2008 impeded vaccination efforts, causing cases to climb up for the first nine months of 2009.Tuberculosis is endemic in Afghanistan, with over 76,000 cases reported per year. The United States Agency for International Development (USAID) has been engaged in promulgating DOTS ( directly observed therapy, short course ) treatments, as well as TB awareness and prevention. BRAC is a development organization that focuses on the alleviation of poverty through the empowerment of the poor to improve their lives. BRAC Afghanistan has been involved in assisting Afghan Ministry of Public Health in the implementation of the Basic Package of Health Services (BPHS) in Kabul, Badghis , Balkh and Nimroz . This implementation was mainly funded by the World Bank and the USAID-REACH (United States Agency for International Development - Rural Expansion of Afghanistan Community-based Healthcare). Tuberculosis is a serious public health problem in Afghanistan. In 2007, 8,200 people in the country died from tuberculosis and, in the WHO's Global Tuberculosis Control Report 2009, an annual estimated figure of 46,000 new cases of tuberculosis were in Afghanistan. As such, Afghanistan is ranked 22nd in amongst highly affected Tuberculosis countries. To help control tuberculosis, BRAC Afghanistan started the community-based TB DOTS under the Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB (FIDELIS) project in 2006. In the first phase of this programme, diagnostic facilities for tuberculosis were expanded through the setting up of 50 TB microscopy centres. This phase lasted from January 2006 and up to March 2007. Over the next two years, facilities were further expanded and 92 more Tuberculosis Microscopy Centres were set up under the FIDELIS programme. The Tuberculosis Control Assistance Programme (TB CAP) was another project taken up between BRAC Afghanistan, World Health Organization (WHO) and Management Sciences for Health (MSH) in a bid to fight TB in Afghanistan. In this project, BRAC Afghanistan supported the BPHS (Basic Package of Health Services) project by replicating the CB-DOTS model into health systems of four provinces: Baghlan , Jawzjan , Badakshan and Herat . BRAC Afghanistan was selected as Principal Recipient (PR) for malaria and TB components of the Global Fund 8. In 2009, 2,143,354 patients received treatment under the health programs mentioned. As of August 2010, BRAC Afghanistan had covered 388 districts and 25 million of the total population are under the BRAC Afghanistan Health Program. Health facilities also include six District Hospitals, 26 Comprehensive Health Centres, 53 Basic Health Centres, 18 Sub Health Centres as well as 533 Mobile Clinics every month. Being the 15th least developed country in the world, Afghanistan faces difficulties in sanitation . In urban areas 40% of the population have unimproved access to sanitation facilities. Because of this many Afghanistan natives are forced to combat typhoid fever . Typhoid fever is one of Afghanistan's major infectious diseases in terms of food/waterborne diseases. This infectious disease occurs when fecal material comes into contact with food or water. Symptoms vary from case to case but often mild fever is present and if left untreated death may occur. According to the Afghan Red Crescent Society , as much as 11,000 children are affected by the treatable disease known as ventricular septal defect , which is commonly referred to as hole in the heart . Most patients are treated in Afghanistan.

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Leana Wen

Leana Sheryle Wen ( Chinese : 温麟衍 ; born Wen Linyan ; January 27, 1983) is an American physician, author, professor, speaker, consultant, newspaper columnist and television commentator. She is former health commissioner for the city of Baltimore and former president of Planned Parenthood . She has written two books based on her experiences as a medical professional. Wen has served as a public health communicator during the COVID-19 pandemic and 2022 mpox outbreak , appearing frequently on CNN as an on-air medical analyst. Wen was asked to testify four times to Congress during the COVID-19 pandemic, including twice to the Select Subcommittee on the Coronavirus Crisis. Currently, Wen serves as a public health professor at George Washington University and is a nonresident senior fellow at the Brookings Institution . She is also a columnist for The Washington Post and a medical analyst for CNN. Born Wen Linyan ( 温麟衍 ) in Shanghai , China on January 27, 1983, to Ying Sandy Zhang and Xiaolu Wen, Wen moved with her parents to the U.S. when she was eight, by then having the English name Leana Sheryle Wen. Granted political asylum , the Wen family lived in East Los Angeles and Compton , California. In 2003, Wen and her family became U.S. citizens. Wen's mother, who died of breast cancer in 2010, first worked as a hotel room cleaner and video store clerk before becoming an elementary school teacher. Her father delivered newspapers and was a dishwasher, later serving as technology manager for The Chinese Daily News in Los Angeles. Wen married South Africa native Sebastian Neil Walker in Boston in February 2012, after a blessing ceremony in Cape Town in November 2011. They have two children: a son born in 2017 and a daughter born in 2020. As a result of her own asthma attacks as a child and seeing a neighbor's child die of an asthma attack, Wen decided that she wanted to become an emergency room physician. Attending the Early Entrance Program (EEP) at California State University, Los Angeles starting at age 13, Wen graduated summa cum laude at age 18 with a bachelor's degree in biochemistry, in 2001. She received a Doctor of Medicine from Washington University School of Medicine and has two master's degrees, one in Economic and Social History and another in Modern Chinese Studies, both from the Merton College, Oxford in England where she was a Rhodes Scholar . She also met her future husband, Sebastian Walker, during her time in England. In 2005, Wen took a one-year leave of absence from medical school to serve as the national president of the American Medical Student Association , where she led campaigns to increase healthcare access, decrease health disparities , and combat conflicts of interest between physicians and the pharmaceutical companies who notoriously use attractive sales representatives and free gifts to influence doctors, especially young interns and medical residents. Wen became involved in U.S. and international health policy during medical school, serving in Geneva, Switzerland as a fellow for the World Health Organization and in Rwanda as a fellow for the U.S. Department of Defense . In addition, she advised the U.S. Congress on physician workforce and medical education through her appointment on the Council on Graduate Medical Education by the U.S. Secretary of Health and Human Services . Following medical school, Wen completed a residency at Brigham and Women's Hospital (BWH) and Massachusetts General Hospital (Mass General) and a clinical fellowship at Harvard Medical School in Boston . She is board certified in emergency medicine. Wen started working in emergency medicine at BWH and Mass General before moving to the ER at the George Washington University (GW) in Washington, DC , where she became a professor in emergency and health policy, and the Director of Patient-Centered Care Research. She served as a consultant to the Brookings Institution and the China Medical Board , and conducted international health systems research including in South Africa, Slovenia, Nigeria, Singapore, and China. From December 2014 until October 2018, Wen served as the health commissioner for Baltimore City under two mayors. She was first appointed by Mayor Stephanie Rawlings-Blake ; in December 2016, she was reappointed by Mayor Catherine Pugh . She resigned in 2018, when she was appointed head of the Planned Parenthood Federation of America. In her role as commissioner, Wen oversaw the Baltimore City Health Department , an agency of 1,100 employees and $130her million annual budget with wide-ranging responsibilities, including management of acute communicable diseases, animal control, chronic disease prevention, emergency preparedness, food service inspections, HIV/AIDS and other sexually transmitted diseases, maternal-child health, school health, senior services, and youth violence issues. She directed the city's public health recovery efforts after the 2015 Baltimore riots , including ensuring prescription medication access to seniors after the closure of 13 pharmacies, and developing the Mental Health/Trauma Recovery Plan, with 24-hour crisis counseling, and healing circles and group counseling in schools, community groups, and churches. Following the riots, the Baltimore City Health Department team launched numerous campaigns, including a citywide trauma response plan, youth health and wellness strategy, violence prevention programs, B'Healthy in B'More blog, and B'More Health Talks, a biweekly town hall and podcast series on health disparities. In March 2018, on behalf of Wen and the Baltimore City Health Department, the City of Baltimore sued the Trump administration for cutting teen pregnancy prevention funds, which resulted in a federal judge ordering the Trump administration to restore $5 million in grant funding to two Baltimore-based teen pregnancy prevention programs. She wrote an opinion editorial criticizing proposed changes to the Title X program which would affect health clinics in Baltimore providing reproductive health care for low income women. This court decision was later reversed by the 9th Circuit court, enabling the Trump administration to withhold Title X funding for abortion. Wen has led implementation of the Baltimore opioid overdose prevention and response plan, which includes a blanket prescription for the opioid antidote, naloxone; "hotspotting" and street outreach teams to target individuals most at risk; training family/friends on naloxone use; and launching a new public education campaign. [ citation needed ] Wen testified to the U.S. Senate HELP Committee and U.S. House Oversight Committee on Baltimore's overdose prevention efforts. She led a group of state and city health officials to petition the Food and Drug Administration (FDA) on adding black box warnings to opioids and benzodiazepines . In March 2016, she was invited by the White House to join President Barack Obama and CNN's Dr. Sanjay Gupta on a panel discussion, where she spoke about Baltimore's response. She convened doctors and public health leaders to sign the Baltimore Statement on the Importance of Childhood Vaccinations and to successfully advocate to ban the sale of powdered alcohol in Maryland and synthetic drugs in Baltimore. Congressman Elijah Cummings cited Wen's efforts to combat the opioid epidemic in Baltimore and sought her help in creating national legislation to change how the United States fights it. In 2018, the National Association of County and City Health Officials awarded the Baltimore City Health Department the Local Health Department of the Year. On September 18, 2018, Wen was appointed president of Planned Parenthood Federation of America. She was the first medical doctor to serve in the role in nearly 50 years and was the first woman doctor ever to do so. In an interview with Elle magazine, Wen described her excitement to be at the helm of the organization where both she and her mother had received significant medical care many years prior. Wen envisioned a new direction for discourse surrounding Planned Parenthood, endeavoring to frame abortion access as an issue of healthcare rather than politics. She also wanted to expand the services provided by Planned Parenthood clinics to include treatment for medical concerns unrelated to reproduction, especially treatment for opioid addiction and easy access to Naloxone (in keeping with her former work as Health Commissioner in Baltimore). In an op-ed for the New York Times after her departure from the organization, she described her initial goal as "finding common ground with the large majority of Americans who can unite behind the goal of improving the health and well-being of women and children." Wen's appointment and proposed strategic plan received mixed reviews, with commentators on both sides of the political spectrum both praising her novel approach and criticizing it as "backing away from the fight [for abortion access]." Wen's tenure at Planned Parenthood saw many major events with implications for reproductive healthcare, starting with the confirmation hearings and appointment to the Supreme Court of Brett Kavanaugh , and ending with the implementation of the nationwide Title X gag rule under the Trump-Pence administration . This legislation prevented medical providers who received funding from Title X from referring patients for abortion services and also prohibited the performance of abortions in the same facility as providers who received Title X funding (the rule was later overturned in 2021 by the Biden-Harris administration ). The period also saw a marked increase in the number of laws passed at the state level that restricted access to abortions. As president of Planned Parenthood, Wen worked to expand non-abortion services like maternal health and mental health services and to rebrand Planned Parenthood from its image as an abortion rights advocacy group to a comprehensive women's health organization that serves women and families. She spoke out about her own experiences as a cervical cancer survivor who struggled with infertility, and about a miscarriage she suffered while in the role. In July 2019, Wen was forced to resign from her position after only 8 months. The board gave no reason, but sources cited a dispute over management and organizational philosophy. Other sources alluded to Wen's incompatibilities with the organization on an interpersonal level, citing organization members' difficulty adapting to her leadership style. In a letter to Planned Parenthood affiliates, Wen claimed philosophical differences in the direction of the organization. On July 19, 2019, Wen published an opinion editorial in The New York Times which set forth the circumstances underlying her departure from Planned Parenthood. She attributed her sudden departure more specifically to disagreements over the centrality of abortion in the mission of Planned Parenthood and stated her view that "As one of the few national health care organizations with a presence in all 50 states, Planned Parenthood's mandate should be to promote reproductive health care as part of a wide range of policies that affect women's health and public health." Echoing her earlier statements, she described her goal to focus on the more holistic elements of the organization, while the board instead wanted to focus on the political debate surrounding abortion rights. In August 2019, it was announced that Wen would join the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University (GW) as a visiting professor of health policy and management. She was also named a distinguished fellow in the Fitzhugh Mullan Institute for Health Workforce Equity (Mullan Institute), where she focused on advancing "interdisciplinary research and education, participating in the trainings of the Mullan Institute's fellowship programs and enhancing the school's educational opportunities in the areas of maternal and child health, women's health and health equity.". She is also a nonresident senior fellow at the Brookings Institution. Wen started writing for The Washington Post as a contributing op-ed writer in 2019. Her role as a columnist became formalized in 2020, and she began anchoring a weekly newsletter on public health and healthcare called The Checkup with Dr. Wen . Her commentaries for the Post started with a heavy focus on COVID-19 and have touched on a range of other issues, including the nursing shortage, the opioid epidemic, reemergence of polio, cancer, mental health, obesity, marijuana, and other public health and policy topics. In 2023, Wen received attention for a piece claiming that Covid deaths were being over counted, with some claiming vindication after claims of over counting deaths were decried as conspiracy theories years earlier. Wen has appeared frequently on CNN during the COVID-19 pandemic and 2022 monkeypox outbreak as an on-air medical analyst. In 2013, St. Martin's Press published her book, When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests with coauthor Joshua Kosowsky. It is about how patients can take control of their health to advocate for better care for themselves. Wen wrote a blog, The Doctor is Listening. She was a regular contributor to the Huffington Post and Psychology Today on patient empowerment and healthcare reform. She was also an advisor to the then-newly established Patient-Centered Outcomes Research Institute , and an advisor to the Lown Institute and the Medical Education Futures Study. She was the founder of Who's My Doctor, an international campaign that called for transparency in medicine. Wen is a frequent keynote speaker on healthcare reform, education, and leadership, and has given several TED Talks . Her TED talk on transparency in medicine has been viewed over 1.9 million times. Wen's evolving views on the COVID-19 pandemic have garnered support and controversy from both sides of the political spectrum. A Texas man pleaded guilty to threatening her due to her advocacy for COVID-19 vaccines and was sentenced in federal court to six months in prison. In a June 2021 interview, Wen summarized her thinking on what was learned during the pandemic in three main points: The importance of a having a national plan in place to avoid ineffective piecemeal approaches How much public health depends on trust between scientists and government officials to avoid politicization of needed preventive measures like masks and vaccinations The underlying health care system disparities based on ethnicity and income that were exposed by COVID Following medical school, Wen completed a residency at Brigham and Women's Hospital (BWH) and Massachusetts General Hospital (Mass General) and a clinical fellowship at Harvard Medical School in Boston . She is board certified in emergency medicine. Wen started working in emergency medicine at BWH and Mass General before moving to the ER at the George Washington University (GW) in Washington, DC , where she became a professor in emergency and health policy, and the Director of Patient-Centered Care Research. She served as a consultant to the Brookings Institution and the China Medical Board , and conducted international health systems research including in South Africa, Slovenia, Nigeria, Singapore, and China. From December 2014 until October 2018, Wen served as the health commissioner for Baltimore City under two mayors. She was first appointed by Mayor Stephanie Rawlings-Blake ; in December 2016, she was reappointed by Mayor Catherine Pugh . She resigned in 2018, when she was appointed head of the Planned Parenthood Federation of America. In her role as commissioner, Wen oversaw the Baltimore City Health Department , an agency of 1,100 employees and $130her million annual budget with wide-ranging responsibilities, including management of acute communicable diseases, animal control, chronic disease prevention, emergency preparedness, food service inspections, HIV/AIDS and other sexually transmitted diseases, maternal-child health, school health, senior services, and youth violence issues. She directed the city's public health recovery efforts after the 2015 Baltimore riots , including ensuring prescription medication access to seniors after the closure of 13 pharmacies, and developing the Mental Health/Trauma Recovery Plan, with 24-hour crisis counseling, and healing circles and group counseling in schools, community groups, and churches. Following the riots, the Baltimore City Health Department team launched numerous campaigns, including a citywide trauma response plan, youth health and wellness strategy, violence prevention programs, B'Healthy in B'More blog, and B'More Health Talks, a biweekly town hall and podcast series on health disparities. In March 2018, on behalf of Wen and the Baltimore City Health Department, the City of Baltimore sued the Trump administration for cutting teen pregnancy prevention funds, which resulted in a federal judge ordering the Trump administration to restore $5 million in grant funding to two Baltimore-based teen pregnancy prevention programs. She wrote an opinion editorial criticizing proposed changes to the Title X program which would affect health clinics in Baltimore providing reproductive health care for low income women. This court decision was later reversed by the 9th Circuit court, enabling the Trump administration to withhold Title X funding for abortion. Wen has led implementation of the Baltimore opioid overdose prevention and response plan, which includes a blanket prescription for the opioid antidote, naloxone; "hotspotting" and street outreach teams to target individuals most at risk; training family/friends on naloxone use; and launching a new public education campaign. [ citation needed ] Wen testified to the U.S. Senate HELP Committee and U.S. House Oversight Committee on Baltimore's overdose prevention efforts. She led a group of state and city health officials to petition the Food and Drug Administration (FDA) on adding black box warnings to opioids and benzodiazepines . In March 2016, she was invited by the White House to join President Barack Obama and CNN's Dr. Sanjay Gupta on a panel discussion, where she spoke about Baltimore's response. She convened doctors and public health leaders to sign the Baltimore Statement on the Importance of Childhood Vaccinations and to successfully advocate to ban the sale of powdered alcohol in Maryland and synthetic drugs in Baltimore. Congressman Elijah Cummings cited Wen's efforts to combat the opioid epidemic in Baltimore and sought her help in creating national legislation to change how the United States fights it. In 2018, the National Association of County and City Health Officials awarded the Baltimore City Health Department the Local Health Department of the Year. Wen has led implementation of the Baltimore opioid overdose prevention and response plan, which includes a blanket prescription for the opioid antidote, naloxone; "hotspotting" and street outreach teams to target individuals most at risk; training family/friends on naloxone use; and launching a new public education campaign. [ citation needed ] Wen testified to the U.S. Senate HELP Committee and U.S. House Oversight Committee on Baltimore's overdose prevention efforts. She led a group of state and city health officials to petition the Food and Drug Administration (FDA) on adding black box warnings to opioids and benzodiazepines . In March 2016, she was invited by the White House to join President Barack Obama and CNN's Dr. Sanjay Gupta on a panel discussion, where she spoke about Baltimore's response. She convened doctors and public health leaders to sign the Baltimore Statement on the Importance of Childhood Vaccinations and to successfully advocate to ban the sale of powdered alcohol in Maryland and synthetic drugs in Baltimore. Congressman Elijah Cummings cited Wen's efforts to combat the opioid epidemic in Baltimore and sought her help in creating national legislation to change how the United States fights it. In 2018, the National Association of County and City Health Officials awarded the Baltimore City Health Department the Local Health Department of the Year. On September 18, 2018, Wen was appointed president of Planned Parenthood Federation of America. She was the first medical doctor to serve in the role in nearly 50 years and was the first woman doctor ever to do so. In an interview with Elle magazine, Wen described her excitement to be at the helm of the organization where both she and her mother had received significant medical care many years prior. Wen envisioned a new direction for discourse surrounding Planned Parenthood, endeavoring to frame abortion access as an issue of healthcare rather than politics. She also wanted to expand the services provided by Planned Parenthood clinics to include treatment for medical concerns unrelated to reproduction, especially treatment for opioid addiction and easy access to Naloxone (in keeping with her former work as Health Commissioner in Baltimore). In an op-ed for the New York Times after her departure from the organization, she described her initial goal as "finding common ground with the large majority of Americans who can unite behind the goal of improving the health and well-being of women and children." Wen's appointment and proposed strategic plan received mixed reviews, with commentators on both sides of the political spectrum both praising her novel approach and criticizing it as "backing away from the fight [for abortion access]." Wen's tenure at Planned Parenthood saw many major events with implications for reproductive healthcare, starting with the confirmation hearings and appointment to the Supreme Court of Brett Kavanaugh , and ending with the implementation of the nationwide Title X gag rule under the Trump-Pence administration . This legislation prevented medical providers who received funding from Title X from referring patients for abortion services and also prohibited the performance of abortions in the same facility as providers who received Title X funding (the rule was later overturned in 2021 by the Biden-Harris administration ). The period also saw a marked increase in the number of laws passed at the state level that restricted access to abortions. As president of Planned Parenthood, Wen worked to expand non-abortion services like maternal health and mental health services and to rebrand Planned Parenthood from its image as an abortion rights advocacy group to a comprehensive women's health organization that serves women and families. She spoke out about her own experiences as a cervical cancer survivor who struggled with infertility, and about a miscarriage she suffered while in the role. In July 2019, Wen was forced to resign from her position after only 8 months. The board gave no reason, but sources cited a dispute over management and organizational philosophy. Other sources alluded to Wen's incompatibilities with the organization on an interpersonal level, citing organization members' difficulty adapting to her leadership style. In a letter to Planned Parenthood affiliates, Wen claimed philosophical differences in the direction of the organization. On July 19, 2019, Wen published an opinion editorial in The New York Times which set forth the circumstances underlying her departure from Planned Parenthood. She attributed her sudden departure more specifically to disagreements over the centrality of abortion in the mission of Planned Parenthood and stated her view that "As one of the few national health care organizations with a presence in all 50 states, Planned Parenthood's mandate should be to promote reproductive health care as part of a wide range of policies that affect women's health and public health." Echoing her earlier statements, she described her goal to focus on the more holistic elements of the organization, while the board instead wanted to focus on the political debate surrounding abortion rights. In August 2019, it was announced that Wen would join the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University (GW) as a visiting professor of health policy and management. She was also named a distinguished fellow in the Fitzhugh Mullan Institute for Health Workforce Equity (Mullan Institute), where she focused on advancing "interdisciplinary research and education, participating in the trainings of the Mullan Institute's fellowship programs and enhancing the school's educational opportunities in the areas of maternal and child health, women's health and health equity.". She is also a nonresident senior fellow at the Brookings Institution. Wen started writing for The Washington Post as a contributing op-ed writer in 2019. Her role as a columnist became formalized in 2020, and she began anchoring a weekly newsletter on public health and healthcare called The Checkup with Dr. Wen . Her commentaries for the Post started with a heavy focus on COVID-19 and have touched on a range of other issues, including the nursing shortage, the opioid epidemic, reemergence of polio, cancer, mental health, obesity, marijuana, and other public health and policy topics. In 2023, Wen received attention for a piece claiming that Covid deaths were being over counted, with some claiming vindication after claims of over counting deaths were decried as conspiracy theories years earlier. Wen has appeared frequently on CNN during the COVID-19 pandemic and 2022 monkeypox outbreak as an on-air medical analyst. Wen started writing for The Washington Post as a contributing op-ed writer in 2019. Her role as a columnist became formalized in 2020, and she began anchoring a weekly newsletter on public health and healthcare called The Checkup with Dr. Wen . Her commentaries for the Post started with a heavy focus on COVID-19 and have touched on a range of other issues, including the nursing shortage, the opioid epidemic, reemergence of polio, cancer, mental health, obesity, marijuana, and other public health and policy topics. In 2023, Wen received attention for a piece claiming that Covid deaths were being over counted, with some claiming vindication after claims of over counting deaths were decried as conspiracy theories years earlier. Wen has appeared frequently on CNN during the COVID-19 pandemic and 2022 monkeypox outbreak as an on-air medical analyst. In 2013, St. Martin's Press published her book, When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests with coauthor Joshua Kosowsky. It is about how patients can take control of their health to advocate for better care for themselves. Wen wrote a blog, The Doctor is Listening. She was a regular contributor to the Huffington Post and Psychology Today on patient empowerment and healthcare reform. She was also an advisor to the then-newly established Patient-Centered Outcomes Research Institute , and an advisor to the Lown Institute and the Medical Education Futures Study. She was the founder of Who's My Doctor, an international campaign that called for transparency in medicine. Wen is a frequent keynote speaker on healthcare reform, education, and leadership, and has given several TED Talks . Her TED talk on transparency in medicine has been viewed over 1.9 million times. Wen's evolving views on the COVID-19 pandemic have garnered support and controversy from both sides of the political spectrum. A Texas man pleaded guilty to threatening her due to her advocacy for COVID-19 vaccines and was sentenced in federal court to six months in prison. In a June 2021 interview, Wen summarized her thinking on what was learned during the pandemic in three main points: The importance of a having a national plan in place to avoid ineffective piecemeal approaches How much public health depends on trust between scientists and government officials to avoid politicization of needed preventive measures like masks and vaccinations The underlying health care system disparities based on ethnicity and income that were exposed by COVID

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Gambian_pouched_rat/html

Gambian pouched rat

The Gambian pouched rat ( Cricetomys gambianus ), also commonly known as the African giant pouched rat , is a species of nocturnal pouched rat of the giant pouched rat genus Cricetomys , in the family Nesomyidae . It is among the largest muroids in the world, growing to about 0.9 m (3 ft) long, including the tail, which makes up half of its total length. It is widespread in sub-Saharan Africa , ranging from Senegal to Kenya and from Angola to Mozambique (although it is absent from much of the Democratic Republic of the Congo , where Emin's pouched rat is present) from sea level to 2,000 m (6,600 ft) . The Gambian pouched rat is sometimes kept as a pet, but some have escaped from captivity and become an invasive species in Florida . In the United States, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) now ban the importation of this species because it is blamed for the 2003 outbreak of monkeypox .The Gambian pouched rat has very poor eyesight , so it depends on its senses of smell and hearing . Its name comes from the large, hamster -like pouches in its cheeks. It is not a true rat , but is part of an African branch of muroid rodents . It typically weighs between 1.0 and 1.4 kg (2.2 and 3.1 lb) . In its native Africa, the pouched rat lives in colonies of up to 20, usually in forests and thickets, but also commonly in termite mounds. It is omnivorous , feeding on vegetables , insects , crabs , snails , and other items, but apparently prefers palm fruits and palm kernels. [ citation needed ] Its cheek pouches allow it to gather up several kilograms of nuts per night for storage underground. It has been known to stuff its pouches so full of date palm nuts so as to be hardly able to squeeze through the entrance of its burrow. [ citation needed ] The burrow consists of a long passage with side alleys and several chambers, one for sleeping and the others for storage. The Gambian pouched rat reaches sexual maturity at 5–7 months of age. It has up to four litters every nine months, with up to six offspring in each litter. Males are territorial and tend to be aggressive when they encounter one another.A Tanzanian social enterprise founded by two Belgians, APOPO ("Anti-Personnel Landmines Removal Product Development" in English), trains the closely related southern giant pouched rats ( Cricetomys ansorgei ) to detect land mines and tuberculosis with their highly developed sense of smell. The trained pouched rats are called HeroRATS . The rats are far cheaper to train than mine-detecting dogs; a rat requires US$7,300 for nine months of training, whereas a dog costs about $25,000 for training, but lives about twice as long. In 2020, a Hero Rat named Magawa (2013–2022) received a People's Dispensary for Sick Animals Gold Medal , the animal equivalent of the George Cross , becoming the first rat to receive the award since the charity began honouring animals in 2003. Before retiring in 2021, Magawa detected 71 landmines and 38 items of unexploded ordnance, clearing over 2,421,880 sq ft (225,000 m 2 ) of land in Cambodia , preventing many injuries and deaths, in his 5-year career. Magawa died from natural causes at the age of 8 in 2022. The Gambian pouched rat is currently being used in experiments at Cornell University to investigate its usefulness in the detection of tuberculosis in human sputum samples. Reports that they are also being used in Mozambique and Tanzania to check tuberculosis test results have proven mildly incorrect: Genetic testing by Watkins shows APOPO 's workers are C. ansorgei . Gambian pouched rats have become an invasive species on Grassy Key in the Florida Keys , after a private breeder allowed the animals to escape in the 1990s. Starting in 2007, Florida wildlife officials have tried to eradicate it from Grassy Key, but it was still present as of 2014 [ update ] , and has been sighted nearby on Key Largo and in Marathon , Florida. This outsized African rodent is also believed to be responsible for the 2003 Midwest monkeypox outbreak in the United States, after spreading it to prairie dogs that were purchased as pets. In 2003, the CDC and FDA issued an order preventing the importation of the rodents following the first reported outbreak of monkeypox . Around 20 individuals were affected.

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/List_of_notable_disease_outbreaks_in_the_United_States/html

List of notable disease outbreaks in the United States

This is a list of notable disease outbreaks in the United States :

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/List_of_The_Daily_Show_episodes_(2022)/html

List of The Daily Show episodes (2022)

This is a list of episodes for The Daily Show with Trevor Noah , Comedy Central's nightly satirical news program, in 2022. This is the final year of The Daily Show to be hosted by Trevor Noah , who announced on September 29, 2022, that he would depart the show by the end of the year. Noah's final episode aired on December 8. For the first three months of 2022, The Daily Show taped its episodes in a studio One Astor Plaza , the Times Square headquarters of Comedy Central parent ViacomCBS ; the show had moved to the temporary, audience-free home in September 2021 as part of COVID-19 pandemic precautions (before then, and after the pandemic began in March 2020, Noah taped episodes from his apartment). On April 11, the show returned to its longtime, revamped home at NEP Studio 52 in Manhattan's Hell's Kitchen district.

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/COVID-19_pandemic_in_Canada/html

COVID-19 pandemic in Canada

Vaccinated : 32,320,750 (83.00%): - One dose only: 137,295 (0.35%) - Two doses only: 12,868,886 (33.05%) - Three doses only: 13,746,054 (35.30%) - Four doses: 5,568,515 (14.30%) Non-vaccinated : 6,619,913 (17.00%) * On November 12, 2022, the Government of Canada transitioned to a new system of collecting data on vaccinated persons. This data is much less detailed and no overview exists that would provide a clear picture of how many persons have had one, two, three, or four doses (or more), so this data will no longer be updated. The COVID-19 pandemic in Canada is part of the ongoing worldwide pandemic of coronavirus disease 2019 ( COVID-19 ). It is caused by severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ). Most cases over the course of the pandemic have been in Ontario , Quebec , British Columbia and Alberta . Confirmed cases have been reported in all of Canada's provinces and territories. The virus was confirmed to have reached Canada on January 25, 2020, after an individual who had returned to Toronto from Wuhan , Hubei, China, tested positive. The first case of community transmission in Canada was confirmed in British Columbia on March 5. In March 2020, as cases of community transmission were confirmed, all of Canada's provinces and territories declared states of emergency. Provinces and territories implemented, to varying degrees, school and daycare closures, prohibitions on gatherings, closures of non-essential businesses and restrictions on entry. Canada severely restricted its border access, barring travelers from all countries with some exceptions. The federal Minister of Health invoked the Quarantine Act , introduced following the 2002–2004 SARS outbreak . For the first time in its legislative history, the act was used, legally requiring all travelers (excluding essential workers) returning to the country to self-isolate for 14 days, until rules were changed to accommodate fully vaccinated travelers. Between July and November, the four Atlantic provinces By mid to late summer of 2020, the country saw a steady decline in active cases until the beginning of late summer. In July, the four Atlantic provinces formed the Atlantic Bubble , which allowed unrestricted movement for provincial residents. Through autumn, there was a resurgence of cases in all provinces and territories. On September 23, 2020, Prime Minister Trudeau declared that Canada was experiencing a "second wave" of the virus. New restrictions from provincial governments were put in place once again as cases increased, including variations of regional lockdowns . In late November, the Atlantic Bubble was disbanded because of the second wave. The federal government passed legislation to approve further modified economic aid for businesses and individuals. Nation-wide cases, hospitalizations and deaths spiked during and after the Christmas and holiday season in December, 2020 and January, 2021. Alarmed by hospital capacity issues, fatalities and new cases, heavy restrictions (such as lockdowns and curfews) were put in place in affected areas (primarily Ontario, Quebec, and Alberta) and across the country. These lockdowns caused active cases to steadily decline, reaching a plateau in active cases in mid-February 2021. During a third wave of the virus, cases began rising across most provinces west of Atlantic Canada in mid-March, prompting further lockdowns and restrictions in the most populous provinces of Ontario and Quebec. Due to a relatively low volume of cases in the Atlantic provinces, the travel-restricted Atlantic Bubble was planned to reopen; however, in late April, the third wave had spread to the Atlantic provinces. In response, Newfoundland and Labrador, Prince Edward Island, and Nova Scotia reinstated travel bans toward the rest of the country. Following Health Canada 's approval of the Pfizer–BioNTech COVID-19 vaccine , and later the mRNA-1273 vaccine developed by Moderna , mass vaccinations began nationwide on December 14, 2020. On February 26, 2021, Health Canada approved the Oxford–AstraZeneca COVID-19 vaccine for use, and on March 5, 2021, they additionally approved the Janssen COVID-19 vaccine for a total of four approved vaccines in the nation. However, most provinces discontinued first doses of Oxford-AstraZeneca by May 12, 2021, while the administration of the Janssen vaccine was determined unnecessary. Canada became one of the most vaccinated countries in the world, with a continually high uptake of the vaccine. Despite high general uptake of the vaccine, cases began to surge particularly amongst the unvaccinated population in provinces like Alberta, which had removed nearly all pandemic restrictions. [ citation needed ] Near the end of summer 2021, cases began to surge across Canada, notably in the provinces of British Columbia , Alberta , Quebec and Ontario , particularly amongst the unvaccinated population. During this fourth wave of the virus, return to pandemic restrictions such as mask mandates were reinstated in provinces like British Columbia and Alberta. The surge in cases was largely deemed to be a "pandemic of the unvaccinated" and resulted in the introduction of vaccine passports , for all provinces and two of the territories. Federally, Prime Minister Justin Trudeau instated requirements for vaccination in order to partake in air travel, as well as those who ride Via Rail and Rocky Mountaineer trains as of October 30, 2021. Additionally, the mandate included any federally regulated workers. In January 2022, all of Canada's provinces and territories were experiencing record-level case numbers, primarily driven by the SARS-CoV-2 Omicron variant , which caused provincial and territorial governments to reintroduce restrictions surrounding travel and isolation. However, in mid-February active caseloads and hospitalizations began to decrease and towards the end of February 2022, almost all provinces and territories had announced plans to lift restrictions by early March or mid-March 2022, if epidemiology remained favorable. On January 12, 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, reported to the WHO on December 31, 2019. The case fatality ratio for COVID-19 was much lower than SARS of 2003, but the transmission was significantly greater, with a significant death toll. On January 1, 2020, the WHO set up the IMST (Incident Management Support Team) across all three levels of the organization: headquarters, regional headquarters and country-level, putting the organization on an emergency footing for dealing with the outbreak. On January 7, when it appeared that there was a health crisis emerging in Wuhan, Public Health Canada advised travelers to China to avoid contact with animals, noting that they were very carefully monitoring the situation. Still there was no evidence of what caused the illness, or how it spread. On January 15, the federal government activated its Emergency Operations Centre. On January 17, the Canada Border Services Agency (CBSA) indicated plans were in progress "to implement signage" in the Montreal , Toronto , and Vancouver airports to raise awareness of the virus. An additional health screening question added to the electronic kiosks for passengers arriving from central China. The agency noted the overall risk to Canadians was low, and there were no direct flights from Wuhan to Canada. The CBSA said it would not be, at that time, implementing extra screening measures, but would "monitor the situation closely". On January 23, the federal Minister of Health , Patty Hajdu , said they were monitoring five or six people for signs of the virus. That same day, the chief public health officer of Canada, Theresa Tam , was a member of the WHO committee that broadcast that it was too early to declare a Public Health Emergency of International Concern . Initially, Canada faced a shortage of personal protective equipment , as the Trudeau government had reduced PPE funding as a cost-cutting measure in previous years. Health Canada is responsible for approval and regulation of vaccines (and other pharmaceuticals), while the Public Health Agency of Canada (PHAC) is responsible for public health, emergency preparedness and response, and infectious and chronic disease control and prevention. Vaccines are authorized by Health Canada, purchased by the Government of Canada and distributed by PHAC to individual provinces and territories in tranches based on various factors such as population size and prioritized peoples. The National Advisory Committee on Immunization (NACI) has also issued recommendations on how vaccines should be distributed, in what intervals and to which populations. NACI has also been involved in recommendations on the use or disuse of vaccines to certain ages or populations.On December 26, 2020, Ontario announced that two cases of the B.1.1.7 variant had been found in Durham. On January 8, 2021, the Public Health Agency of Canada announced that the first case of the South African variant had been found in Alberta. On February 8, CTV reported that the first case of the P.1 variant out of Brazil had been detected in Toronto. On April 21, the B.C. Ministry of Health announced that they had seen cases of B.1.617 as early as April 4. On May 14, Canada added B.1.617 (including what is now known as Delta ) to its variants of concern. On May 31, 2021, WHO announced that the variant B.1.1.7 was being renamed Alpha , P.1 Gamma , B.1.617.2 Delta and B.1.351 Beta . Early evidence out of Alberta suggested that the Pfizer and Moderna vaccines would continue to be effective against death or hospitalization from the Alpha and Gamma variants. A study in Ontario found that the Pfizer vaccine was 95% effective to prevent hospitalization or death from the Alpha, Beta and Gamma variants 7 days after the second dose. Moderna was 94% effective against Alpha 7 days after the 2nd dose. Moderna appeared to be highly effective against Delta. A preprint study from epidemiologists David Fisman and Ashleigh Tuite, at the University of Toronto, found that the Delta variant had a 120% greater risk of hospitalization, 287% greater risk of ICU admission and 137% greater risk of death compared to non-variant of concern strains of SARS-COV-2. As the people of Canada experience profound and rapid changes to their lives, we are all concerned about the future. It may be difficult to remain hopeful when faced with loss and uncertainty, but Canadians have many reasons for optimism, even in the most trying times. Across Canada, countless people continue to care for the most vulnerable and to provide essential services for their fellow citizens. I am thankful for their dedication and for the hope it offers. In the coming weeks and months, the people of Canada will need to continue to work together to ensure the health and vitality of our communities. I know that Canadians will remain optimistic and will rise to the challenges ahead. My thoughts and prayers are with the people of Canada at this time." Elizabeth II , Queen of Canada , April 5, 2020 The federal government activated its Emergency Operations Centre on January 15, 2020. The federal government's pandemic response was based on two primary documents: the Canadian Pandemic Influenza Preparedness planning guidelines, which outlines risks and measures to address a viral disease, and the Federal/Provincial/Territorial Public Health Response Plan for Biological Events , which includes identifying, tracking, and ensuring rapid access to medical care. By February 27, the response plan was at level 3 (escalated). On March 18, the federal Minister of Health , Patty Hajdu , announced that the federal government had signed an interim order to speed up access to COVID-19 test kits that would allow provincial labs to increase testing. The test kits were made by Switzerland-based Roche Molecular Systems and Thermo Fisher Scientific . Several research projects were provided federal funding to develop and implement measures to detect, manage, and reduce the transmission of COVID-19. On March 11, Trudeau annonced $275 million in funding for 47 projects. On March 19, the federal government announced funding for an additional 49 projects to bring the total to 96. On March 20, Trudeau stated that the National Research Council would work with small- and medium-sized companies on health research to fight the virus, as part of the announcement on Canada's industrial strategy (see below). On March 23, Theresa Tam began appearing in public service announcements on radio and television, urging personal hygiene, social distancing, and against unnecessary travel. On April 6, Tam began to suggest that the use of non-medical face masks in public could be an "additional measure" of protection. She stated to "protect others around you in situations where physical distancing is difficult to maintain", but that this is not proven to protect the wearer and is considered complementary to all existing health guidance issued thus far. In response to backlogs in COVID-19 testing , especially provinces like Ontario , Health Canada approved new rapid testing for the virus. On November 3, the Public Health Agency of Canada started recommended that people wear non-medical masks with three layers including a filter. Tam said that " living with COVID-19 is something that we have to do because it's not going to immediately disappear and the population doesn't have much immunity", and went on to say that "If cases do occur and accelerate in a community, then you have to get at it early because if you let it, the virus and the numbers accelerate and keep accelerating...you will then end up with more widespread closures. So, I think as cities or hotspots cool down, if you like, the restart needs to be carefully thought of." Long-term care homes were impacted heavily by the pandemic. On April 13, Tam reported that at least half of COVID-19 deaths in Canada were linked to long-term care homes (with the exact number varying by province), and that those deaths would continue to increase even as the transmission rate decreased. Tam cited factors such as outside visitors, communal living spaces, and staff being transferred among multiple facilities as particular vulnerabilities. The pandemic exacerbated pre-existing staffing issues at some facilities, including underpaid staff and being understaffed in general. On April 28, Tam stated that as many as 79 percent of Canada's COVID-19 fatalities occurred in long-term care homes. Health Canada issued recommendations for long-term care homes. They were encouraged to restrict outside visitors and volunteers, restrict employees from being transferred between multiple facilities, provide personal protective equipment , enforce physical distancing during meals, screen staff and essential visitors. On April 15, Trudeau announced that the federal government planned to provide additional pay to long-term care workers. In April 2020, the Department of National Defence gave the provinces the option to get Canadian Armed Forces assistance in combating the pandemic in long-term care facilities. Quebec was the first to act, with military personnel arriving on April 17. Ontario responded next, with Premier Doug Ford requesting military aid on April 22. On March 14, Canada recommended against any international travel and advised those returning from outside of Canada, except for essential workers (such as flight crew), to self-isolate for 14 days. The Quarantine Act was invoked by Hajdu on March 26, making self-isolation a legal mandate for travelers (excluding essential workers) returning to the country. It also prohibits those who are symptomatic from using public transit as transport to their place of self-isolation, and prohibiting self-isolation in settings where they may come in contact with those who are vulnerable (people with pre-existing conditions and the elderly). Starting March 16, only Canadian citizens and their immediate families, permanent residents, and U.S. citizens were allowed to enter the country. The only exceptions were flight crews, diplomats, and trade and commerce. Travellers showing COVID-19 symptoms were not allowed to board flights into Canada, regardless of their citizenship. International flights to Canada from outside the Caribbean, Mexico, and the U.S. were instructed to land at either Calgary International Airport , Montréal–Trudeau International Airport , Toronto Pearson International Airport , or Vancouver International Airport . From March 20, Canada and the United States temporarily restricted all non-essential travel across their land border . The U.S. did not restrict non-essential air travel into the country by Canadians, but Americans were prohibited from boarding flights into Canada per U.S. restrictions—a non-reciprocal restriction that was criticized as being contradictory. On April 16, Trudeau stated that the Canada/U.S. border restrictions would remain in place "for a significant amount of time". The next day, Canada and the United States agreed to extend their entry restrictions, which were to expire on April 21, for an additional 30 days beyond that date. On April 20, the federal government introduced the " ArriveCAN " mobile app , which is used to conduct entry screenings and submit documentation; use of the app became mandatory in November. Since March 30, individuals showing COVID-19 symptoms were to be refused boarding on domestic flights (10 seats or more) and passenger trains. However, it excluded buses and intercity passenger rail services. From April 20, all travellers were required to wear face masks while departing and arriving on air travel, including during security screenings. Those who did not comply were prevented from proceeding. As the land border with the United States continued to be closed to non-essential travel, the Canadian government announced plans in October to allow family members to reunite under compassionate terms. Within the country, the Canadian provinces of New Brunswick, Prince Edward Island, Nova Scotia and Newfoundland and Labrador established the Atlantic Bubble , restricting travel from other provinces but allowing free movement amongst residents of the member provinces. On January 6, 2021, the federal government announced that all incoming travellers must present proof of a negative COVID-19 PCR test conducted within 72 hours of their departure time to board flights into Canada. On January 29, 2021, due to concerns surrounding SARS-CoV-2 variants , Trudeau announced a series of new travel restrictions. Travellers arriving in Canada would be required to receive a COVID-19 PCR test on arrival and must quarantine at an "approved hotel" at their own expense. At the same time, they awaited test results or recovery and were subject to "increased surveillance" during the remainder of the mandatory 14-day quarantine period. Foreign flights were only allowed to land in Calgary, Montreal, Toronto, or Vancouver. To discourage non-essential travel, the major airlines agreed to suspend all flights to the Caribbean and Mexico until April 30, 2021. On February 12, it was announced a third PCR test would also be required at the end of the 14-day quarantine period. The new rules for international travel went into effect on February 22. In July 2021, the government lifted the quarantine requirement for Canadian citizens and permanent residents re-entering the country, provided they submit proof of vaccination via the ArriveCAN app or website. On August 9, 2021, Canada reopened its land border to American citizens and permanent residents that are fully-vaccinated. However, the U.S. land border remained closed to Canadians entering the United States until November 8, 2021, when the U.S. began to allow non-essential land travel into the country, with a vaccine mandate for residents 18 and over (enforced via random checks). However, as with air travel, anyone re-entering the country was required to present proof of a negative COVID-19 PCR test conducted within 72 hours of their arrival; this test could alternatively be obtained in Canada if the traveler had been in the country for less than 72 hours. On October 6, 2021, it was announced that all passengers of federally-regulated transportation over the age of 12 (including air travel, cruises, and Via Rail or Rocky Mountaineer trains) would be required to be fully-vaccinated beginning October 30, 2021. Until November 30, 2021, a recent negative test was also accepted. Beginning January 15, 2022, international truckers entering the country were required to be fully-vaccinated; this decision instigated a protest convoy —backed largely by supporters of alt-right and far-right movements—which culminated in a multi-day occupation of downtown Ottawa , and evolved into a general protest against all COVID-19 vaccine mandates. Beginning April 1, 2022, pre-entry PCR testing requirements were dropped for fully-vaccinated travelers entering the country. However, air travelers were still subject to random testing as part of surveillance for variants (which would not require self-isolation). On September 26, 2022, it was announced that all remaining COVID-19-related travel restrictions and mandates would be dropped effective October 1, 2022; this includes vaccine requirements, masking requirements, random tests, and the requirement to submit documentation via ArriveCAN. However, on December 31, 2022, the government announced that mandatory testing would be reinstated for travellers entering from China beginning January 5, 2023. A First Ministers' meeting scheduled for March 12 and 13 was cancelled after Trudeau and his wife Sophie Grégoire entered self-isolation. The Canadian House of Commons was suspended between March 14 and April 20, immediately after passing the new North American free trade deal. The federal budget, previously scheduled for March 20, was also suspended. In March 2020, the Bank of Canada twice lowered its overnight rate target by 50 basis points—first to 1.25 percent on March 4, and then to 0.75 percent on March 13. It cited the "negative shocks to Canada's economy arising from the COVID-19 pandemic and the recent sharp drop in oil prices" in explaining the move. On March 27, the Bank lowered the rate a third time to 0.25 percent, citing "serious consequences for Canadians and for the economy" due to the COVID-19 pandemic. The Bank also launched a program to "alleviate strains in the short-term funding markets" and another program to acquire Government of Canada securities at a minimum of $5 billion per week. On March 18, the federal government announced an $82-billion response package with a variety of measures. On March 25, the COVID-19 Emergency Response Act received royal assent from Governor General Julie Payette . The measures in this first package included: The CERB launched on April 6. On April 15, Trudeau announced an extension to the CERB to workers making up to $1,000 per month and that the government planned to work with the provinces to implement salary top-ups for essential workers who make less than $2,500 per month. The Canada Emergency Wage Subsidy (CEWS) was announced on April 1, an expanded version of the temporary business wage subsidy. The Parliament reconvened on April 11 to pass the COVID-19 Emergency Response Act, No. 2 on division. It implemented the CEWS, allowing eligible companies to receive a 75 percent subsidy on each of their employees' wages (up to their first $58,700) for 12 weeks retroactive to March 15. Trudeau introduced new financial aid programs on April 10, including the Canada Emergency Business Account (CEBA), which offers loans, interest-free until the end of 2022, of up to $40,000 for small- and medium-sized businesses. The CEBA was expanded on April 16 to make more businesses eligible. [ how? ] Trudeau announced the Canada Emergency Student Benefit (CESB) on April 22. On April 30, Parliamentary Budget Officer Yves Giroux issued a report projecting the federal deficit for the fiscal year 2020 could be in excess of $252 billion, based on nearly $146 billion in spending on federal aid measures. On October 12, 2020, the federal government rolled out a new income support program after the ending of CERB, the Canada Recovery Benefit (CRB). Another program, the Canada Recovery Caregiving Benefit (CRCB), supports Canadians working but have to take a break to care for dependents (a child below 12 years of age or a disabled family member). The benefit only applies if schools and care centres are closed or the dependent fell sick or contracted COVID-19. On March 20, 2020, the government announced a plan to ramp up production of medical equipment, switching assembly lines to produce ventilators, masks, and other personal protective gear. Companies will be able to access funds through the government's Strategic Innovation Fund . The PM stated that Canadian medical supply firms Thornhill Medical, Medicom and Spartan Bioscience were looking to expand production. The government also contracted Sterling Industries , a medical device manufacturer, to facilitate the production of over 15 million medical face shields (PPE) in response to the COVID-19 pandemic. To address shortages and supply-chain disruption, Canada passed emergency legislation that waived patent protection, giving the government, companies or organizations that it selects the right to produce patented products without permission from the patent holder. According to Innovation, Science and Industry minister Navdeep Bains , "the country's entire industrial policy will be refocused to prioritize the fight against COVID-19". During the COVID-19 pandemic , 34% of people consulted their doctors over the phone. In May 2020, Justin Trudeau announced an investment of $240.5 million to support the growth of virtual care and mental health tools in Canada. On March 12, Quebec declared a public health emergency, requiring international travellers to self-isolate for 14 days and banning gatherings of 250 people. Extending the ban to all gatherings outside workplaces and retail. On March 16, Prince Edward Island declared a public health emergency. Alberta and Ontario declared emergencies on March 17, followed by British Columbia, Newfoundland and Labrador, the Northwest Territories, Nunavut, Saskatchewan, and Yukon on March 18. New Brunswick, Manitoba, and Nova Scotia declared emergencies on March 19, March 20, and March 22 respectively. These emergencies allowed provinces to ban gatherings and require international travellers to self-isolate. On March 25, mandatory self-isolation was imposed federally, making it a legal requirement for all provinces that had not done so already. New Brunswick, the Northwest Territories, Nunavut, Prince Edward Island and have all restricted entry through interprovincial borders, prohibiting the entry of non-residents without a valid reason. Quebec has additionally restricted travel into 9 of its 18 regions and parts of 3 other regions. The borders of Nova Scotia and Newfoundland and Labrador are being screened, while also requiring travellers to self-isolate for 14 days upon entering the province. Public schools (under Provincial control) across the country quickly followed suit and closed. Schools in the Toronto District School Board were closed under a 2-week class-free quarantine beginning on the week after the regularly scheduled March Break. Virtual learning was implemented in the week following the quarantine and extended until the beginning of the next school year, giving students the option of going in-person with restrictions or continuing virtual learning. March Break was pushed back to the week of April 11. Laurentian University in Greater Sudbury was the first to voluntarily suspended classes and moved to online instruction on March 12. This was quickly followed by many other universities across the country. Bars, restaurants, cinemas, and other businesses were ordered closed by provinces, territories, and municipalities across the country. Initially, some jurisdictions allowed restaurants or bars to stay open with reduced capacity and social distancing. Takeout and delivery orders were largely still permitted. Jurisdictions differed on daycare closures. In particular, British Columbia and Saskatchewan faced criticism for allowing daycares to remain open while closing schools, bars, and restaurants. Ontario, Quebec, and Saskatchewan mandated the closure of all businesses not deemed essential by the provinces. Essential businesses included grocery stores, takeout and delivery restaurants, pharmacies, transportation, manufacturing, food production, energy, and healthcare. Liquor and cannabis stores mostly remained open across the country, with governments reversing their closure orders due to alcohol withdrawal syndrome concerns. Alberta, British Columbia, New Brunswick, Prince Edward Island, and Manitoba all offered one-time payments that aimed to bridge the gap before implementing the federal Canada Emergency Response Benefit . Quebec's Temporary Aid for Workers Program provided up to four weeks of payments for those who do not qualify for federal assistance. Prince Edward Island also provided payments to those who kept their jobs but worked reduced hours. Many provinces and territories increased payments for those already receiving income supports. Courts across the country instituted measures to reduce public contact while maintaining access to the courts. The Supreme Court of Canada building was closed to public tours while maintaining the ability to file documents for cases electronically. It also adjourned appeals which were to be heard in March, to dates in June. Other courts prioritized the cases that would be heard, giving priority to ongoing criminal trials and trials in family and child protection matters while adjourning most pending cases to later dates. On March 19, the Pimicikamak Cree Nation in northern Manitoba restricted entry to essential travellers, and Chief David Monias said the Sayisi Dene and others are doing the same. As of March 19, the Council of the Haida Nation said it was discouraging all non-resident travel to the islands "for the time being." On March 27, Wasauksing First Nation declared a state of emergency with Gimaa (chief) Wally Tabobondung announcing the creation of a response team and the state of emergency via YouTube video. In an update posted on May 16, the chief and council announced they had installed cameras with facial and licence plate recognition technology at local checkpoints to identify outsiders entering the territory. Cottagers leasing property on the territory had been barred from entering until June 6. As of June 6, anyone entering the Wasauksing must have a tag issued by the band government and provide information for a centralized registry. Re-opening occurred in phases. As of an update posted on June 21, the state of emergency had been extended an additional 90 days. On October 1, in anticipation of the "Second Wave," Tk'emlups te Secwepemc Secwépemc First Nation instituted a mandatory face mask policy in indoor spaces where physical distancing was not possible, including hallways, staircases, and shared vehicles. As of October 8, the infection rate in Indigenous communities had been one-third of the infection rate in non-Indigenous communities, according to an update from Indigenous Services Minister Marc Miller . Miller praised Indigenous leadership and with Indigenous Services Canada's Chief Medical Officer Dr. Tim Wong, encouraging Indigenous people to remain vigilant and safe. First Nations communities were prioritized amongst others in the first phase of vaccinations against the virus. As the people of Canada experience profound and rapid changes to their lives, we are all concerned about the future. It may be difficult to remain hopeful when faced with loss and uncertainty, but Canadians have many reasons for optimism, even in the most trying times. Across Canada, countless people continue to care for the most vulnerable and to provide essential services for their fellow citizens. I am thankful for their dedication and for the hope it offers. In the coming weeks and months, the people of Canada will need to continue to work together to ensure the health and vitality of our communities. I know that Canadians will remain optimistic and will rise to the challenges ahead. My thoughts and prayers are with the people of Canada at this time." Elizabeth II , Queen of Canada , April 5, 2020 The federal government activated its Emergency Operations Centre on January 15, 2020. The federal government's pandemic response was based on two primary documents: the Canadian Pandemic Influenza Preparedness planning guidelines, which outlines risks and measures to address a viral disease, and the Federal/Provincial/Territorial Public Health Response Plan for Biological Events , which includes identifying, tracking, and ensuring rapid access to medical care. By February 27, the response plan was at level 3 (escalated). On March 18, the federal Minister of Health , Patty Hajdu , announced that the federal government had signed an interim order to speed up access to COVID-19 test kits that would allow provincial labs to increase testing. The test kits were made by Switzerland-based Roche Molecular Systems and Thermo Fisher Scientific . Several research projects were provided federal funding to develop and implement measures to detect, manage, and reduce the transmission of COVID-19. On March 11, Trudeau annonced $275 million in funding for 47 projects. On March 19, the federal government announced funding for an additional 49 projects to bring the total to 96. On March 20, Trudeau stated that the National Research Council would work with small- and medium-sized companies on health research to fight the virus, as part of the announcement on Canada's industrial strategy (see below). On March 23, Theresa Tam began appearing in public service announcements on radio and television, urging personal hygiene, social distancing, and against unnecessary travel. On April 6, Tam began to suggest that the use of non-medical face masks in public could be an "additional measure" of protection. She stated to "protect others around you in situations where physical distancing is difficult to maintain", but that this is not proven to protect the wearer and is considered complementary to all existing health guidance issued thus far. In response to backlogs in COVID-19 testing , especially provinces like Ontario , Health Canada approved new rapid testing for the virus. On November 3, the Public Health Agency of Canada started recommended that people wear non-medical masks with three layers including a filter. Tam said that " living with COVID-19 is something that we have to do because it's not going to immediately disappear and the population doesn't have much immunity", and went on to say that "If cases do occur and accelerate in a community, then you have to get at it early because if you let it, the virus and the numbers accelerate and keep accelerating...you will then end up with more widespread closures. So, I think as cities or hotspots cool down, if you like, the restart needs to be carefully thought of." Long-term care homes were impacted heavily by the pandemic. On April 13, Tam reported that at least half of COVID-19 deaths in Canada were linked to long-term care homes (with the exact number varying by province), and that those deaths would continue to increase even as the transmission rate decreased. Tam cited factors such as outside visitors, communal living spaces, and staff being transferred among multiple facilities as particular vulnerabilities. The pandemic exacerbated pre-existing staffing issues at some facilities, including underpaid staff and being understaffed in general. On April 28, Tam stated that as many as 79 percent of Canada's COVID-19 fatalities occurred in long-term care homes. Health Canada issued recommendations for long-term care homes. They were encouraged to restrict outside visitors and volunteers, restrict employees from being transferred between multiple facilities, provide personal protective equipment , enforce physical distancing during meals, screen staff and essential visitors. On April 15, Trudeau announced that the federal government planned to provide additional pay to long-term care workers. In April 2020, the Department of National Defence gave the provinces the option to get Canadian Armed Forces assistance in combating the pandemic in long-term care facilities. Quebec was the first to act, with military personnel arriving on April 17. Ontario responded next, with Premier Doug Ford requesting military aid on April 22. On March 14, Canada recommended against any international travel and advised those returning from outside of Canada, except for essential workers (such as flight crew), to self-isolate for 14 days. The Quarantine Act was invoked by Hajdu on March 26, making self-isolation a legal mandate for travelers (excluding essential workers) returning to the country. It also prohibits those who are symptomatic from using public transit as transport to their place of self-isolation, and prohibiting self-isolation in settings where they may come in contact with those who are vulnerable (people with pre-existing conditions and the elderly). Starting March 16, only Canadian citizens and their immediate families, permanent residents, and U.S. citizens were allowed to enter the country. The only exceptions were flight crews, diplomats, and trade and commerce. Travellers showing COVID-19 symptoms were not allowed to board flights into Canada, regardless of their citizenship. International flights to Canada from outside the Caribbean, Mexico, and the U.S. were instructed to land at either Calgary International Airport , Montréal–Trudeau International Airport , Toronto Pearson International Airport , or Vancouver International Airport . From March 20, Canada and the United States temporarily restricted all non-essential travel across their land border . The U.S. did not restrict non-essential air travel into the country by Canadians, but Americans were prohibited from boarding flights into Canada per U.S. restrictions—a non-reciprocal restriction that was criticized as being contradictory. On April 16, Trudeau stated that the Canada/U.S. border restrictions would remain in place "for a significant amount of time". The next day, Canada and the United States agreed to extend their entry restrictions, which were to expire on April 21, for an additional 30 days beyond that date. On April 20, the federal government introduced the " ArriveCAN " mobile app , which is used to conduct entry screenings and submit documentation; use of the app became mandatory in November. Since March 30, individuals showing COVID-19 symptoms were to be refused boarding on domestic flights (10 seats or more) and passenger trains. However, it excluded buses and intercity passenger rail services. From April 20, all travellers were required to wear face masks while departing and arriving on air travel, including during security screenings. Those who did not comply were prevented from proceeding. As the land border with the United States continued to be closed to non-essential travel, the Canadian government announced plans in October to allow family members to reunite under compassionate terms. Within the country, the Canadian provinces of New Brunswick, Prince Edward Island, Nova Scotia and Newfoundland and Labrador established the Atlantic Bubble , restricting travel from other provinces but allowing free movement amongst residents of the member provinces. On January 6, 2021, the federal government announced that all incoming travellers must present proof of a negative COVID-19 PCR test conducted within 72 hours of their departure time to board flights into Canada. On January 29, 2021, due to concerns surrounding SARS-CoV-2 variants , Trudeau announced a series of new travel restrictions. Travellers arriving in Canada would be required to receive a COVID-19 PCR test on arrival and must quarantine at an "approved hotel" at their own expense. At the same time, they awaited test results or recovery and were subject to "increased surveillance" during the remainder of the mandatory 14-day quarantine period. Foreign flights were only allowed to land in Calgary, Montreal, Toronto, or Vancouver. To discourage non-essential travel, the major airlines agreed to suspend all flights to the Caribbean and Mexico until April 30, 2021. On February 12, it was announced a third PCR test would also be required at the end of the 14-day quarantine period. The new rules for international travel went into effect on February 22. In July 2021, the government lifted the quarantine requirement for Canadian citizens and permanent residents re-entering the country, provided they submit proof of vaccination via the ArriveCAN app or website. On August 9, 2021, Canada reopened its land border to American citizens and permanent residents that are fully-vaccinated. However, the U.S. land border remained closed to Canadians entering the United States until November 8, 2021, when the U.S. began to allow non-essential land travel into the country, with a vaccine mandate for residents 18 and over (enforced via random checks). However, as with air travel, anyone re-entering the country was required to present proof of a negative COVID-19 PCR test conducted within 72 hours of their arrival; this test could alternatively be obtained in Canada if the traveler had been in the country for less than 72 hours. On October 6, 2021, it was announced that all passengers of federally-regulated transportation over the age of 12 (including air travel, cruises, and Via Rail or Rocky Mountaineer trains) would be required to be fully-vaccinated beginning October 30, 2021. Until November 30, 2021, a recent negative test was also accepted. Beginning January 15, 2022, international truckers entering the country were required to be fully-vaccinated; this decision instigated a protest convoy —backed largely by supporters of alt-right and far-right movements—which culminated in a multi-day occupation of downtown Ottawa , and evolved into a general protest against all COVID-19 vaccine mandates. Beginning April 1, 2022, pre-entry PCR testing requirements were dropped for fully-vaccinated travelers entering the country. However, air travelers were still subject to random testing as part of surveillance for variants (which would not require self-isolation). On September 26, 2022, it was announced that all remaining COVID-19-related travel restrictions and mandates would be dropped effective October 1, 2022; this includes vaccine requirements, masking requirements, random tests, and the requirement to submit documentation via ArriveCAN. However, on December 31, 2022, the government announced that mandatory testing would be reinstated for travellers entering from China beginning January 5, 2023. A First Ministers' meeting scheduled for March 12 and 13 was cancelled after Trudeau and his wife Sophie Grégoire entered self-isolation. The Canadian House of Commons was suspended between March 14 and April 20, immediately after passing the new North American free trade deal. The federal budget, previously scheduled for March 20, was also suspended. In March 2020, the Bank of Canada twice lowered its overnight rate target by 50 basis points—first to 1.25 percent on March 4, and then to 0.75 percent on March 13. It cited the "negative shocks to Canada's economy arising from the COVID-19 pandemic and the recent sharp drop in oil prices" in explaining the move. On March 27, the Bank lowered the rate a third time to 0.25 percent, citing "serious consequences for Canadians and for the economy" due to the COVID-19 pandemic. The Bank also launched a program to "alleviate strains in the short-term funding markets" and another program to acquire Government of Canada securities at a minimum of $5 billion per week. On March 18, the federal government announced an $82-billion response package with a variety of measures. On March 25, the COVID-19 Emergency Response Act received royal assent from Governor General Julie Payette . The measures in this first package included: The CERB launched on April 6. On April 15, Trudeau announced an extension to the CERB to workers making up to $1,000 per month and that the government planned to work with the provinces to implement salary top-ups for essential workers who make less than $2,500 per month. The Canada Emergency Wage Subsidy (CEWS) was announced on April 1, an expanded version of the temporary business wage subsidy. The Parliament reconvened on April 11 to pass the COVID-19 Emergency Response Act, No. 2 on division. It implemented the CEWS, allowing eligible companies to receive a 75 percent subsidy on each of their employees' wages (up to their first $58,700) for 12 weeks retroactive to March 15. Trudeau introduced new financial aid programs on April 10, including the Canada Emergency Business Account (CEBA), which offers loans, interest-free until the end of 2022, of up to $40,000 for small- and medium-sized businesses. The CEBA was expanded on April 16 to make more businesses eligible. [ how? ] Trudeau announced the Canada Emergency Student Benefit (CESB) on April 22. On April 30, Parliamentary Budget Officer Yves Giroux issued a report projecting the federal deficit for the fiscal year 2020 could be in excess of $252 billion, based on nearly $146 billion in spending on federal aid measures. On October 12, 2020, the federal government rolled out a new income support program after the ending of CERB, the Canada Recovery Benefit (CRB). Another program, the Canada Recovery Caregiving Benefit (CRCB), supports Canadians working but have to take a break to care for dependents (a child below 12 years of age or a disabled family member). The benefit only applies if schools and care centres are closed or the dependent fell sick or contracted COVID-19. On March 20, 2020, the government announced a plan to ramp up production of medical equipment, switching assembly lines to produce ventilators, masks, and other personal protective gear. Companies will be able to access funds through the government's Strategic Innovation Fund . The PM stated that Canadian medical supply firms Thornhill Medical, Medicom and Spartan Bioscience were looking to expand production. The government also contracted Sterling Industries , a medical device manufacturer, to facilitate the production of over 15 million medical face shields (PPE) in response to the COVID-19 pandemic. To address shortages and supply-chain disruption, Canada passed emergency legislation that waived patent protection, giving the government, companies or organizations that it selects the right to produce patented products without permission from the patent holder. According to Innovation, Science and Industry minister Navdeep Bains , "the country's entire industrial policy will be refocused to prioritize the fight against COVID-19". During the COVID-19 pandemic , 34% of people consulted their doctors over the phone. In May 2020, Justin Trudeau announced an investment of $240.5 million to support the growth of virtual care and mental health tools in Canada. The federal government activated its Emergency Operations Centre on January 15, 2020. The federal government's pandemic response was based on two primary documents: the Canadian Pandemic Influenza Preparedness planning guidelines, which outlines risks and measures to address a viral disease, and the Federal/Provincial/Territorial Public Health Response Plan for Biological Events , which includes identifying, tracking, and ensuring rapid access to medical care. By February 27, the response plan was at level 3 (escalated). On March 18, the federal Minister of Health , Patty Hajdu , announced that the federal government had signed an interim order to speed up access to COVID-19 test kits that would allow provincial labs to increase testing. The test kits were made by Switzerland-based Roche Molecular Systems and Thermo Fisher Scientific . Several research projects were provided federal funding to develop and implement measures to detect, manage, and reduce the transmission of COVID-19. On March 11, Trudeau annonced $275 million in funding for 47 projects. On March 19, the federal government announced funding for an additional 49 projects to bring the total to 96. On March 20, Trudeau stated that the National Research Council would work with small- and medium-sized companies on health research to fight the virus, as part of the announcement on Canada's industrial strategy (see below). On March 23, Theresa Tam began appearing in public service announcements on radio and television, urging personal hygiene, social distancing, and against unnecessary travel. On April 6, Tam began to suggest that the use of non-medical face masks in public could be an "additional measure" of protection. She stated to "protect others around you in situations where physical distancing is difficult to maintain", but that this is not proven to protect the wearer and is considered complementary to all existing health guidance issued thus far. In response to backlogs in COVID-19 testing , especially provinces like Ontario , Health Canada approved new rapid testing for the virus. On November 3, the Public Health Agency of Canada started recommended that people wear non-medical masks with three layers including a filter. Tam said that " living with COVID-19 is something that we have to do because it's not going to immediately disappear and the population doesn't have much immunity", and went on to say that "If cases do occur and accelerate in a community, then you have to get at it early because if you let it, the virus and the numbers accelerate and keep accelerating...you will then end up with more widespread closures. So, I think as cities or hotspots cool down, if you like, the restart needs to be carefully thought of." Long-term care homes were impacted heavily by the pandemic. On April 13, Tam reported that at least half of COVID-19 deaths in Canada were linked to long-term care homes (with the exact number varying by province), and that those deaths would continue to increase even as the transmission rate decreased. Tam cited factors such as outside visitors, communal living spaces, and staff being transferred among multiple facilities as particular vulnerabilities. The pandemic exacerbated pre-existing staffing issues at some facilities, including underpaid staff and being understaffed in general. On April 28, Tam stated that as many as 79 percent of Canada's COVID-19 fatalities occurred in long-term care homes. Health Canada issued recommendations for long-term care homes. They were encouraged to restrict outside visitors and volunteers, restrict employees from being transferred between multiple facilities, provide personal protective equipment , enforce physical distancing during meals, screen staff and essential visitors. On April 15, Trudeau announced that the federal government planned to provide additional pay to long-term care workers. In April 2020, the Department of National Defence gave the provinces the option to get Canadian Armed Forces assistance in combating the pandemic in long-term care facilities. Quebec was the first to act, with military personnel arriving on April 17. Ontario responded next, with Premier Doug Ford requesting military aid on April 22. On March 14, Canada recommended against any international travel and advised those returning from outside of Canada, except for essential workers (such as flight crew), to self-isolate for 14 days. The Quarantine Act was invoked by Hajdu on March 26, making self-isolation a legal mandate for travelers (excluding essential workers) returning to the country. It also prohibits those who are symptomatic from using public transit as transport to their place of self-isolation, and prohibiting self-isolation in settings where they may come in contact with those who are vulnerable (people with pre-existing conditions and the elderly). Starting March 16, only Canadian citizens and their immediate families, permanent residents, and U.S. citizens were allowed to enter the country. The only exceptions were flight crews, diplomats, and trade and commerce. Travellers showing COVID-19 symptoms were not allowed to board flights into Canada, regardless of their citizenship. International flights to Canada from outside the Caribbean, Mexico, and the U.S. were instructed to land at either Calgary International Airport , Montréal–Trudeau International Airport , Toronto Pearson International Airport , or Vancouver International Airport . From March 20, Canada and the United States temporarily restricted all non-essential travel across their land border . The U.S. did not restrict non-essential air travel into the country by Canadians, but Americans were prohibited from boarding flights into Canada per U.S. restrictions—a non-reciprocal restriction that was criticized as being contradictory. On April 16, Trudeau stated that the Canada/U.S. border restrictions would remain in place "for a significant amount of time". The next day, Canada and the United States agreed to extend their entry restrictions, which were to expire on April 21, for an additional 30 days beyond that date. On April 20, the federal government introduced the " ArriveCAN " mobile app , which is used to conduct entry screenings and submit documentation; use of the app became mandatory in November. Since March 30, individuals showing COVID-19 symptoms were to be refused boarding on domestic flights (10 seats or more) and passenger trains. However, it excluded buses and intercity passenger rail services. From April 20, all travellers were required to wear face masks while departing and arriving on air travel, including during security screenings. Those who did not comply were prevented from proceeding. As the land border with the United States continued to be closed to non-essential travel, the Canadian government announced plans in October to allow family members to reunite under compassionate terms. Within the country, the Canadian provinces of New Brunswick, Prince Edward Island, Nova Scotia and Newfoundland and Labrador established the Atlantic Bubble , restricting travel from other provinces but allowing free movement amongst residents of the member provinces. On January 6, 2021, the federal government announced that all incoming travellers must present proof of a negative COVID-19 PCR test conducted within 72 hours of their departure time to board flights into Canada. On January 29, 2021, due to concerns surrounding SARS-CoV-2 variants , Trudeau announced a series of new travel restrictions. Travellers arriving in Canada would be required to receive a COVID-19 PCR test on arrival and must quarantine at an "approved hotel" at their own expense. At the same time, they awaited test results or recovery and were subject to "increased surveillance" during the remainder of the mandatory 14-day quarantine period. Foreign flights were only allowed to land in Calgary, Montreal, Toronto, or Vancouver. To discourage non-essential travel, the major airlines agreed to suspend all flights to the Caribbean and Mexico until April 30, 2021. On February 12, it was announced a third PCR test would also be required at the end of the 14-day quarantine period. The new rules for international travel went into effect on February 22. In July 2021, the government lifted the quarantine requirement for Canadian citizens and permanent residents re-entering the country, provided they submit proof of vaccination via the ArriveCAN app or website. On August 9, 2021, Canada reopened its land border to American citizens and permanent residents that are fully-vaccinated. However, the U.S. land border remained closed to Canadians entering the United States until November 8, 2021, when the U.S. began to allow non-essential land travel into the country, with a vaccine mandate for residents 18 and over (enforced via random checks). However, as with air travel, anyone re-entering the country was required to present proof of a negative COVID-19 PCR test conducted within 72 hours of their arrival; this test could alternatively be obtained in Canada if the traveler had been in the country for less than 72 hours. On October 6, 2021, it was announced that all passengers of federally-regulated transportation over the age of 12 (including air travel, cruises, and Via Rail or Rocky Mountaineer trains) would be required to be fully-vaccinated beginning October 30, 2021. Until November 30, 2021, a recent negative test was also accepted. Beginning January 15, 2022, international truckers entering the country were required to be fully-vaccinated; this decision instigated a protest convoy —backed largely by supporters of alt-right and far-right movements—which culminated in a multi-day occupation of downtown Ottawa , and evolved into a general protest against all COVID-19 vaccine mandates. Beginning April 1, 2022, pre-entry PCR testing requirements were dropped for fully-vaccinated travelers entering the country. However, air travelers were still subject to random testing as part of surveillance for variants (which would not require self-isolation). On September 26, 2022, it was announced that all remaining COVID-19-related travel restrictions and mandates would be dropped effective October 1, 2022; this includes vaccine requirements, masking requirements, random tests, and the requirement to submit documentation via ArriveCAN. However, on December 31, 2022, the government announced that mandatory testing would be reinstated for travellers entering from China beginning January 5, 2023. A First Ministers' meeting scheduled for March 12 and 13 was cancelled after Trudeau and his wife Sophie Grégoire entered self-isolation. The Canadian House of Commons was suspended between March 14 and April 20, immediately after passing the new North American free trade deal. The federal budget, previously scheduled for March 20, was also suspended. In March 2020, the Bank of Canada twice lowered its overnight rate target by 50 basis points—first to 1.25 percent on March 4, and then to 0.75 percent on March 13. It cited the "negative shocks to Canada's economy arising from the COVID-19 pandemic and the recent sharp drop in oil prices" in explaining the move. On March 27, the Bank lowered the rate a third time to 0.25 percent, citing "serious consequences for Canadians and for the economy" due to the COVID-19 pandemic. The Bank also launched a program to "alleviate strains in the short-term funding markets" and another program to acquire Government of Canada securities at a minimum of $5 billion per week. On March 18, the federal government announced an $82-billion response package with a variety of measures. On March 25, the COVID-19 Emergency Response Act received royal assent from Governor General Julie Payette . The measures in this first package included: The CERB launched on April 6. On April 15, Trudeau announced an extension to the CERB to workers making up to $1,000 per month and that the government planned to work with the provinces to implement salary top-ups for essential workers who make less than $2,500 per month. The Canada Emergency Wage Subsidy (CEWS) was announced on April 1, an expanded version of the temporary business wage subsidy. The Parliament reconvened on April 11 to pass the COVID-19 Emergency Response Act, No. 2 on division. It implemented the CEWS, allowing eligible companies to receive a 75 percent subsidy on each of their employees' wages (up to their first $58,700) for 12 weeks retroactive to March 15. Trudeau introduced new financial aid programs on April 10, including the Canada Emergency Business Account (CEBA), which offers loans, interest-free until the end of 2022, of up to $40,000 for small- and medium-sized businesses. The CEBA was expanded on April 16 to make more businesses eligible. [ how? ] Trudeau announced the Canada Emergency Student Benefit (CESB) on April 22. On April 30, Parliamentary Budget Officer Yves Giroux issued a report projecting the federal deficit for the fiscal year 2020 could be in excess of $252 billion, based on nearly $146 billion in spending on federal aid measures. On October 12, 2020, the federal government rolled out a new income support program after the ending of CERB, the Canada Recovery Benefit (CRB). Another program, the Canada Recovery Caregiving Benefit (CRCB), supports Canadians working but have to take a break to care for dependents (a child below 12 years of age or a disabled family member). The benefit only applies if schools and care centres are closed or the dependent fell sick or contracted COVID-19. On March 20, 2020, the government announced a plan to ramp up production of medical equipment, switching assembly lines to produce ventilators, masks, and other personal protective gear. Companies will be able to access funds through the government's Strategic Innovation Fund . The PM stated that Canadian medical supply firms Thornhill Medical, Medicom and Spartan Bioscience were looking to expand production. The government also contracted Sterling Industries , a medical device manufacturer, to facilitate the production of over 15 million medical face shields (PPE) in response to the COVID-19 pandemic. To address shortages and supply-chain disruption, Canada passed emergency legislation that waived patent protection, giving the government, companies or organizations that it selects the right to produce patented products without permission from the patent holder. According to Innovation, Science and Industry minister Navdeep Bains , "the country's entire industrial policy will be refocused to prioritize the fight against COVID-19". During the COVID-19 pandemic , 34% of people consulted their doctors over the phone. In May 2020, Justin Trudeau announced an investment of $240.5 million to support the growth of virtual care and mental health tools in Canada. On March 12, Quebec declared a public health emergency, requiring international travellers to self-isolate for 14 days and banning gatherings of 250 people. Extending the ban to all gatherings outside workplaces and retail. On March 16, Prince Edward Island declared a public health emergency. Alberta and Ontario declared emergencies on March 17, followed by British Columbia, Newfoundland and Labrador, the Northwest Territories, Nunavut, Saskatchewan, and Yukon on March 18. New Brunswick, Manitoba, and Nova Scotia declared emergencies on March 19, March 20, and March 22 respectively. These emergencies allowed provinces to ban gatherings and require international travellers to self-isolate. On March 25, mandatory self-isolation was imposed federally, making it a legal requirement for all provinces that had not done so already. New Brunswick, the Northwest Territories, Nunavut, Prince Edward Island and have all restricted entry through interprovincial borders, prohibiting the entry of non-residents without a valid reason. Quebec has additionally restricted travel into 9 of its 18 regions and parts of 3 other regions. The borders of Nova Scotia and Newfoundland and Labrador are being screened, while also requiring travellers to self-isolate for 14 days upon entering the province. Public schools (under Provincial control) across the country quickly followed suit and closed. Schools in the Toronto District School Board were closed under a 2-week class-free quarantine beginning on the week after the regularly scheduled March Break. Virtual learning was implemented in the week following the quarantine and extended until the beginning of the next school year, giving students the option of going in-person with restrictions or continuing virtual learning. March Break was pushed back to the week of April 11. Laurentian University in Greater Sudbury was the first to voluntarily suspended classes and moved to online instruction on March 12. This was quickly followed by many other universities across the country. Bars, restaurants, cinemas, and other businesses were ordered closed by provinces, territories, and municipalities across the country. Initially, some jurisdictions allowed restaurants or bars to stay open with reduced capacity and social distancing. Takeout and delivery orders were largely still permitted. Jurisdictions differed on daycare closures. In particular, British Columbia and Saskatchewan faced criticism for allowing daycares to remain open while closing schools, bars, and restaurants. Ontario, Quebec, and Saskatchewan mandated the closure of all businesses not deemed essential by the provinces. Essential businesses included grocery stores, takeout and delivery restaurants, pharmacies, transportation, manufacturing, food production, energy, and healthcare. Liquor and cannabis stores mostly remained open across the country, with governments reversing their closure orders due to alcohol withdrawal syndrome concerns. Alberta, British Columbia, New Brunswick, Prince Edward Island, and Manitoba all offered one-time payments that aimed to bridge the gap before implementing the federal Canada Emergency Response Benefit . Quebec's Temporary Aid for Workers Program provided up to four weeks of payments for those who do not qualify for federal assistance. Prince Edward Island also provided payments to those who kept their jobs but worked reduced hours. Many provinces and territories increased payments for those already receiving income supports.Public schools (under Provincial control) across the country quickly followed suit and closed. Schools in the Toronto District School Board were closed under a 2-week class-free quarantine beginning on the week after the regularly scheduled March Break. Virtual learning was implemented in the week following the quarantine and extended until the beginning of the next school year, giving students the option of going in-person with restrictions or continuing virtual learning. March Break was pushed back to the week of April 11. Laurentian University in Greater Sudbury was the first to voluntarily suspended classes and moved to online instruction on March 12. This was quickly followed by many other universities across the country.Bars, restaurants, cinemas, and other businesses were ordered closed by provinces, territories, and municipalities across the country. Initially, some jurisdictions allowed restaurants or bars to stay open with reduced capacity and social distancing. Takeout and delivery orders were largely still permitted. Jurisdictions differed on daycare closures. In particular, British Columbia and Saskatchewan faced criticism for allowing daycares to remain open while closing schools, bars, and restaurants. Ontario, Quebec, and Saskatchewan mandated the closure of all businesses not deemed essential by the provinces. Essential businesses included grocery stores, takeout and delivery restaurants, pharmacies, transportation, manufacturing, food production, energy, and healthcare. Liquor and cannabis stores mostly remained open across the country, with governments reversing their closure orders due to alcohol withdrawal syndrome concerns.Alberta, British Columbia, New Brunswick, Prince Edward Island, and Manitoba all offered one-time payments that aimed to bridge the gap before implementing the federal Canada Emergency Response Benefit . Quebec's Temporary Aid for Workers Program provided up to four weeks of payments for those who do not qualify for federal assistance. Prince Edward Island also provided payments to those who kept their jobs but worked reduced hours. Many provinces and territories increased payments for those already receiving income supports.Courts across the country instituted measures to reduce public contact while maintaining access to the courts. The Supreme Court of Canada building was closed to public tours while maintaining the ability to file documents for cases electronically. It also adjourned appeals which were to be heard in March, to dates in June. Other courts prioritized the cases that would be heard, giving priority to ongoing criminal trials and trials in family and child protection matters while adjourning most pending cases to later dates.On March 19, the Pimicikamak Cree Nation in northern Manitoba restricted entry to essential travellers, and Chief David Monias said the Sayisi Dene and others are doing the same. As of March 19, the Council of the Haida Nation said it was discouraging all non-resident travel to the islands "for the time being." On March 27, Wasauksing First Nation declared a state of emergency with Gimaa (chief) Wally Tabobondung announcing the creation of a response team and the state of emergency via YouTube video. In an update posted on May 16, the chief and council announced they had installed cameras with facial and licence plate recognition technology at local checkpoints to identify outsiders entering the territory. Cottagers leasing property on the territory had been barred from entering until June 6. As of June 6, anyone entering the Wasauksing must have a tag issued by the band government and provide information for a centralized registry. Re-opening occurred in phases. As of an update posted on June 21, the state of emergency had been extended an additional 90 days. On October 1, in anticipation of the "Second Wave," Tk'emlups te Secwepemc Secwépemc First Nation instituted a mandatory face mask policy in indoor spaces where physical distancing was not possible, including hallways, staircases, and shared vehicles. As of October 8, the infection rate in Indigenous communities had been one-third of the infection rate in non-Indigenous communities, according to an update from Indigenous Services Minister Marc Miller . Miller praised Indigenous leadership and with Indigenous Services Canada's Chief Medical Officer Dr. Tim Wong, encouraging Indigenous people to remain vigilant and safe. First Nations communities were prioritized amongst others in the first phase of vaccinations against the virus. The COVID-19 pandemic had a deep impact on the Canadian economy , leading it into a recession . The government's social distancing rules had the effect of limiting economic activity in the country. Companies started mass layoffs of workers, and Canada's unemployment rate was 13.5 percent in May 2020, the highest it has been since 1976. Many large-scale events that planned to take place in 2020 in Canada were cancelled or delayed. This includes all major sporting and artistic events. Canada's tourism and air travel sectors were hit especially hard due to travel restrictions. Some farmers feared a labour shortfall and bankruptcy. Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan YukonCOVID-19 testing can be used to track the prevalence and spread, to diagnose individuals for treatment, to identify infections for isolation and contact tracing, to screen at-risk populations, to clear exposed healthcare workers to return to work, and to identify individuals with potential immunity. The World Health Organization says that jurisdictions should aim to test every suspected case of COVID-19. Since health care is under provincial jurisdiction, almost all testing is conducted by the provinces and territories rather than the federal government. On April 23, Trudeau identified broader testing as key to reopening the country, mentioning the target of 60,000 tests per day set by Dr. Theresa Tam, but warned that up to 120,000 per day may be required. As of late April, approximately 20,000 tests per day were being performed in Canada. Total numbers of tests conducted for the provinces and Canada show that over 800,000 Canadians have been tested as of early May 2020. The displayed chart shows the testing rates per capita in the provinces and territories from March to May 2020. Only COVID-19 tests approved by Health Canada can be imported or sold in Canada. Since this is usually a lengthy process, on March 18, the Minister of Health Hajdu issued an interim order to allow expedited access to COVID-19-related medical devices for use by healthcare providers, including diagnostic test kits. The same day, the first commercial tests were approved, RT-PCR tests from Roche and Thermo Fisher . Another 13 diagnostic products have since been approved, all based on Nucleic Acid tests. As of April 30, 21 diagnostic device applications were listed as submitted by Health Canada. Canada's National Microbiology Lab in Winnipeg performs diagnostic testing for and research into COVID-19. Samples from suspected cases early in the pandemic were sent by provinces and territories to this national lab for testing, either as the sole test or as a check of an in-province test result. The lab diagnosed the first confirmed case in Canada on January 27, 2020. Since then, provinces and territories have established their own testing capacity but have occasionally sent samples to the national lab for a second test as a check. Provinces faced COVID-19 testing backlogs due to a shortage of supplies, including the chemical reagents required to complete the tests. In late April, the federal government arranged for a cargo flight from China that delivered the equivalent of about six to nine months of production for one particular raw material for the 20-odd raw materials needed by supplier LuminUltra to supply reagent kits for RT-PCR machines. Health Canada identified nucleic acid-based testing as "the gold standard used in Canada and abroad, for the diagnosis of active COVID-19 infection in patients with symptoms." The predominant type of testing is used in RT-PCR . They use a carefully produced and validated swab to collect a sample from a person's throat, back of the nose, or front of the nose. The swab is put inside a sealed container containing a medium that preserves the virus, which is sent to test-processing centres in the corresponding province or territory. At the centres, highly skilled technicians use large commercial machines from a variety of manufactures to process tens to hundreds batches of samples at a time. The test chemically strips the RNA from the sample then mixes it with a test kit containing chemical reagents designed to detect RNA signatures of SARS-CoV-2. The sample is cycled between a set of temperatures to amplify the chemical RNA signature. This leads to processing times that range from 4 to 24 hours. The actual RT-PCR test is 99 percent accurate. However, false-negative results are estimated to occur 8 to 10 percent of the time due to poor swabbing technique. They may be as high as 30 percent, depending on how long after symptom onset the test was performed. LuminUltra Technologies Ltd. of Fredericton produced reagent test kits to use with automated RT-PCR machines. On April 15, Trudeau announced that the company would be "ramping up production ... to meet the weekly demand in all provinces." The company announced the same day that it would provide "500,000 urgently needed COVID-19 tests per week to the Canadian federal government for use across Canada." Spartan Bioscience of Ottawa signed contracts with the federal government and the provinces of Alberta, Quebec, and Ontario to supply virus-RNA testing systems that process a single swab sample in 30 to 60 minutes. Together the contracts were for over one million swab test kits, and at least 250 handheld devices. On April 13, Health Canada approved this test, but on May 3 the test was recalled due to unreliable results. Precision Biomonitoring of Guelph signed a Letter of Intent on March 31 with the federal government to co-develop a novel point-of-care test kit for COVID-19, which is now pending an authorization from Health Canada. Their 1.2 kg battery-operated mobile device performs nine tests per hour and takes 60 minutes to produce a result. Bio-ID Diagnostics of Edmonton developed a direct 24-hour virus test that could be scaled to 20,000 samples per day. Since it is based on sequencing DNA it avoids false positives, and it detects a low concentration of the virus, substantially reducing false negatives in asymptomatic individuals. On October 5, Health Canada approved a portable PCR test – the Hyris bCUBE —which was based on technology developed at the University of Guelph and can process tests in 90 minutes. These blood tests look for antibodies to the SARS-CoV-2 virus and range in complexity from laboratory tests to at-home kits similar to pregnancy tests. Antibodies do not form immediately upon infection, so these tests are not well-suited for detecting a current infection. However, they can potentially identify those who have been infected in the past. Health Canada has been evaluating several antibody tests. Health Canada deemed that "Serological tests are not appropriate for early diagnosis of COVID-19, largely due variability in the time required after infection to develop antibodies." On May 12, 2020, Health Canada announced the first antibody test approved for use, a laboratory test from DiaSorin, an Italian multinational biotechnology company. Health Canada wrote that the trial would "contribute to a better understanding of whether people who have been infected are immune to the virus." Health Canada posts "studies will be required to determine how long the antibodies remain detectable, whether for weeks, months or years" and "the relationship between antibodies and immunity to future viral infection." Nonetheless, many countries are conducting or planning large-scale testing to determine the population's proportion that are potentially immune. As of April 20, the WHO estimated that the most affected countries had at most 2 to 3 percent of people infected. On April 23, 2020, Trudeau created a COVID-19 Immunity Task Force of researchers, including Dr. Tam, Dr. David Naylor , and Dr. Mona Nemer , to coordinate monitoring of immunity and vulnerability to COVID-19 in the Canadian population. The taskforce will oversee national antibody surveys over the next two years in which will test one million Canadians. Researchers at Sinai Health's Lunenfeld-Tanenbaum Research Institute in Toronto are developing a robotic system that can process mass numbers of antibody tests. MedMira of Halifax developed one of the first rapid detection kits for HIV and has now developed a COVID-19 antibody test that takes three minutes from taking the blood drop specimen. Plantform Corp. of Guelph applied for funding from the National Research Council to develop an antibody test for COVID-19. Tests for antigens, proteins that are part of the virus's surface, were first approved by Health Canada on October 6, when it approved and ordered 20.5 million units of one manufactured by Abbott Laboratories as a point-of-care test. They can produce results faster than PCR tests (around 20 minutes) but are generally less accurate than PCR tests. Abbott states that they are designed for preliminary results and not intended "as the sole basis for treatment or other management decisions." Deputy Chief Public Health Officer Howard Njoo stated these tests could be deployed in workplaces and communal living environments. Sona Nanotech of Halifax was developing point-of-care COVID-19 antigen test kits that provide results in 5–15 minutes with an anticipating cost to be less than $50. If successful, the project will yield 20,000 test kits available per week, with the potential to scale up to 1 million test kits per week. Only COVID-19 tests approved by Health Canada can be imported or sold in Canada. Since this is usually a lengthy process, on March 18, the Minister of Health Hajdu issued an interim order to allow expedited access to COVID-19-related medical devices for use by healthcare providers, including diagnostic test kits. The same day, the first commercial tests were approved, RT-PCR tests from Roche and Thermo Fisher . Another 13 diagnostic products have since been approved, all based on Nucleic Acid tests. As of April 30, 21 diagnostic device applications were listed as submitted by Health Canada. Canada's National Microbiology Lab in Winnipeg performs diagnostic testing for and research into COVID-19. Samples from suspected cases early in the pandemic were sent by provinces and territories to this national lab for testing, either as the sole test or as a check of an in-province test result. The lab diagnosed the first confirmed case in Canada on January 27, 2020. Since then, provinces and territories have established their own testing capacity but have occasionally sent samples to the national lab for a second test as a check. Provinces faced COVID-19 testing backlogs due to a shortage of supplies, including the chemical reagents required to complete the tests. In late April, the federal government arranged for a cargo flight from China that delivered the equivalent of about six to nine months of production for one particular raw material for the 20-odd raw materials needed by supplier LuminUltra to supply reagent kits for RT-PCR machines. Only COVID-19 tests approved by Health Canada can be imported or sold in Canada. Since this is usually a lengthy process, on March 18, the Minister of Health Hajdu issued an interim order to allow expedited access to COVID-19-related medical devices for use by healthcare providers, including diagnostic test kits. The same day, the first commercial tests were approved, RT-PCR tests from Roche and Thermo Fisher . Another 13 diagnostic products have since been approved, all based on Nucleic Acid tests. As of April 30, 21 diagnostic device applications were listed as submitted by Health Canada. Canada's National Microbiology Lab in Winnipeg performs diagnostic testing for and research into COVID-19. Samples from suspected cases early in the pandemic were sent by provinces and territories to this national lab for testing, either as the sole test or as a check of an in-province test result. The lab diagnosed the first confirmed case in Canada on January 27, 2020. Since then, provinces and territories have established their own testing capacity but have occasionally sent samples to the national lab for a second test as a check. Provinces faced COVID-19 testing backlogs due to a shortage of supplies, including the chemical reagents required to complete the tests. In late April, the federal government arranged for a cargo flight from China that delivered the equivalent of about six to nine months of production for one particular raw material for the 20-odd raw materials needed by supplier LuminUltra to supply reagent kits for RT-PCR machines. Health Canada identified nucleic acid-based testing as "the gold standard used in Canada and abroad, for the diagnosis of active COVID-19 infection in patients with symptoms." The predominant type of testing is used in RT-PCR . They use a carefully produced and validated swab to collect a sample from a person's throat, back of the nose, or front of the nose. The swab is put inside a sealed container containing a medium that preserves the virus, which is sent to test-processing centres in the corresponding province or territory. At the centres, highly skilled technicians use large commercial machines from a variety of manufactures to process tens to hundreds batches of samples at a time. The test chemically strips the RNA from the sample then mixes it with a test kit containing chemical reagents designed to detect RNA signatures of SARS-CoV-2. The sample is cycled between a set of temperatures to amplify the chemical RNA signature. This leads to processing times that range from 4 to 24 hours. The actual RT-PCR test is 99 percent accurate. However, false-negative results are estimated to occur 8 to 10 percent of the time due to poor swabbing technique. They may be as high as 30 percent, depending on how long after symptom onset the test was performed. LuminUltra Technologies Ltd. of Fredericton produced reagent test kits to use with automated RT-PCR machines. On April 15, Trudeau announced that the company would be "ramping up production ... to meet the weekly demand in all provinces." The company announced the same day that it would provide "500,000 urgently needed COVID-19 tests per week to the Canadian federal government for use across Canada." Spartan Bioscience of Ottawa signed contracts with the federal government and the provinces of Alberta, Quebec, and Ontario to supply virus-RNA testing systems that process a single swab sample in 30 to 60 minutes. Together the contracts were for over one million swab test kits, and at least 250 handheld devices. On April 13, Health Canada approved this test, but on May 3 the test was recalled due to unreliable results. Precision Biomonitoring of Guelph signed a Letter of Intent on March 31 with the federal government to co-develop a novel point-of-care test kit for COVID-19, which is now pending an authorization from Health Canada. Their 1.2 kg battery-operated mobile device performs nine tests per hour and takes 60 minutes to produce a result. Bio-ID Diagnostics of Edmonton developed a direct 24-hour virus test that could be scaled to 20,000 samples per day. Since it is based on sequencing DNA it avoids false positives, and it detects a low concentration of the virus, substantially reducing false negatives in asymptomatic individuals. On October 5, Health Canada approved a portable PCR test – the Hyris bCUBE —which was based on technology developed at the University of Guelph and can process tests in 90 minutes. These blood tests look for antibodies to the SARS-CoV-2 virus and range in complexity from laboratory tests to at-home kits similar to pregnancy tests. Antibodies do not form immediately upon infection, so these tests are not well-suited for detecting a current infection. However, they can potentially identify those who have been infected in the past. Health Canada has been evaluating several antibody tests. Health Canada deemed that "Serological tests are not appropriate for early diagnosis of COVID-19, largely due variability in the time required after infection to develop antibodies." On May 12, 2020, Health Canada announced the first antibody test approved for use, a laboratory test from DiaSorin, an Italian multinational biotechnology company. Health Canada wrote that the trial would "contribute to a better understanding of whether people who have been infected are immune to the virus." Health Canada posts "studies will be required to determine how long the antibodies remain detectable, whether for weeks, months or years" and "the relationship between antibodies and immunity to future viral infection." Nonetheless, many countries are conducting or planning large-scale testing to determine the population's proportion that are potentially immune. As of April 20, the WHO estimated that the most affected countries had at most 2 to 3 percent of people infected. On April 23, 2020, Trudeau created a COVID-19 Immunity Task Force of researchers, including Dr. Tam, Dr. David Naylor , and Dr. Mona Nemer , to coordinate monitoring of immunity and vulnerability to COVID-19 in the Canadian population. The taskforce will oversee national antibody surveys over the next two years in which will test one million Canadians. Researchers at Sinai Health's Lunenfeld-Tanenbaum Research Institute in Toronto are developing a robotic system that can process mass numbers of antibody tests. MedMira of Halifax developed one of the first rapid detection kits for HIV and has now developed a COVID-19 antibody test that takes three minutes from taking the blood drop specimen. Plantform Corp. of Guelph applied for funding from the National Research Council to develop an antibody test for COVID-19. Tests for antigens, proteins that are part of the virus's surface, were first approved by Health Canada on October 6, when it approved and ordered 20.5 million units of one manufactured by Abbott Laboratories as a point-of-care test. They can produce results faster than PCR tests (around 20 minutes) but are generally less accurate than PCR tests. Abbott states that they are designed for preliminary results and not intended "as the sole basis for treatment or other management decisions." Deputy Chief Public Health Officer Howard Njoo stated these tests could be deployed in workplaces and communal living environments. Sona Nanotech of Halifax was developing point-of-care COVID-19 antigen test kits that provide results in 5–15 minutes with an anticipating cost to be less than $50. If successful, the project will yield 20,000 test kits available per week, with the potential to scale up to 1 million test kits per week. Health Canada identified nucleic acid-based testing as "the gold standard used in Canada and abroad, for the diagnosis of active COVID-19 infection in patients with symptoms." The predominant type of testing is used in RT-PCR . They use a carefully produced and validated swab to collect a sample from a person's throat, back of the nose, or front of the nose. The swab is put inside a sealed container containing a medium that preserves the virus, which is sent to test-processing centres in the corresponding province or territory. At the centres, highly skilled technicians use large commercial machines from a variety of manufactures to process tens to hundreds batches of samples at a time. The test chemically strips the RNA from the sample then mixes it with a test kit containing chemical reagents designed to detect RNA signatures of SARS-CoV-2. The sample is cycled between a set of temperatures to amplify the chemical RNA signature. This leads to processing times that range from 4 to 24 hours. The actual RT-PCR test is 99 percent accurate. However, false-negative results are estimated to occur 8 to 10 percent of the time due to poor swabbing technique. They may be as high as 30 percent, depending on how long after symptom onset the test was performed. LuminUltra Technologies Ltd. of Fredericton produced reagent test kits to use with automated RT-PCR machines. On April 15, Trudeau announced that the company would be "ramping up production ... to meet the weekly demand in all provinces." The company announced the same day that it would provide "500,000 urgently needed COVID-19 tests per week to the Canadian federal government for use across Canada." Spartan Bioscience of Ottawa signed contracts with the federal government and the provinces of Alberta, Quebec, and Ontario to supply virus-RNA testing systems that process a single swab sample in 30 to 60 minutes. Together the contracts were for over one million swab test kits, and at least 250 handheld devices. On April 13, Health Canada approved this test, but on May 3 the test was recalled due to unreliable results. Precision Biomonitoring of Guelph signed a Letter of Intent on March 31 with the federal government to co-develop a novel point-of-care test kit for COVID-19, which is now pending an authorization from Health Canada. Their 1.2 kg battery-operated mobile device performs nine tests per hour and takes 60 minutes to produce a result. Bio-ID Diagnostics of Edmonton developed a direct 24-hour virus test that could be scaled to 20,000 samples per day. Since it is based on sequencing DNA it avoids false positives, and it detects a low concentration of the virus, substantially reducing false negatives in asymptomatic individuals. On October 5, Health Canada approved a portable PCR test – the Hyris bCUBE —which was based on technology developed at the University of Guelph and can process tests in 90 minutes. LuminUltra Technologies Ltd. of Fredericton produced reagent test kits to use with automated RT-PCR machines. On April 15, Trudeau announced that the company would be "ramping up production ... to meet the weekly demand in all provinces." The company announced the same day that it would provide "500,000 urgently needed COVID-19 tests per week to the Canadian federal government for use across Canada." Spartan Bioscience of Ottawa signed contracts with the federal government and the provinces of Alberta, Quebec, and Ontario to supply virus-RNA testing systems that process a single swab sample in 30 to 60 minutes. Together the contracts were for over one million swab test kits, and at least 250 handheld devices. On April 13, Health Canada approved this test, but on May 3 the test was recalled due to unreliable results. Precision Biomonitoring of Guelph signed a Letter of Intent on March 31 with the federal government to co-develop a novel point-of-care test kit for COVID-19, which is now pending an authorization from Health Canada. Their 1.2 kg battery-operated mobile device performs nine tests per hour and takes 60 minutes to produce a result. Bio-ID Diagnostics of Edmonton developed a direct 24-hour virus test that could be scaled to 20,000 samples per day. Since it is based on sequencing DNA it avoids false positives, and it detects a low concentration of the virus, substantially reducing false negatives in asymptomatic individuals. On October 5, Health Canada approved a portable PCR test – the Hyris bCUBE —which was based on technology developed at the University of Guelph and can process tests in 90 minutes. These blood tests look for antibodies to the SARS-CoV-2 virus and range in complexity from laboratory tests to at-home kits similar to pregnancy tests. Antibodies do not form immediately upon infection, so these tests are not well-suited for detecting a current infection. However, they can potentially identify those who have been infected in the past. Health Canada has been evaluating several antibody tests. Health Canada deemed that "Serological tests are not appropriate for early diagnosis of COVID-19, largely due variability in the time required after infection to develop antibodies." On May 12, 2020, Health Canada announced the first antibody test approved for use, a laboratory test from DiaSorin, an Italian multinational biotechnology company. Health Canada wrote that the trial would "contribute to a better understanding of whether people who have been infected are immune to the virus." Health Canada posts "studies will be required to determine how long the antibodies remain detectable, whether for weeks, months or years" and "the relationship between antibodies and immunity to future viral infection." Nonetheless, many countries are conducting or planning large-scale testing to determine the population's proportion that are potentially immune. As of April 20, the WHO estimated that the most affected countries had at most 2 to 3 percent of people infected. On April 23, 2020, Trudeau created a COVID-19 Immunity Task Force of researchers, including Dr. Tam, Dr. David Naylor , and Dr. Mona Nemer , to coordinate monitoring of immunity and vulnerability to COVID-19 in the Canadian population. The taskforce will oversee national antibody surveys over the next two years in which will test one million Canadians. Researchers at Sinai Health's Lunenfeld-Tanenbaum Research Institute in Toronto are developing a robotic system that can process mass numbers of antibody tests. MedMira of Halifax developed one of the first rapid detection kits for HIV and has now developed a COVID-19 antibody test that takes three minutes from taking the blood drop specimen. Plantform Corp. of Guelph applied for funding from the National Research Council to develop an antibody test for COVID-19. Health Canada posts "studies will be required to determine how long the antibodies remain detectable, whether for weeks, months or years" and "the relationship between antibodies and immunity to future viral infection." Nonetheless, many countries are conducting or planning large-scale testing to determine the population's proportion that are potentially immune. As of April 20, the WHO estimated that the most affected countries had at most 2 to 3 percent of people infected. On April 23, 2020, Trudeau created a COVID-19 Immunity Task Force of researchers, including Dr. Tam, Dr. David Naylor , and Dr. Mona Nemer , to coordinate monitoring of immunity and vulnerability to COVID-19 in the Canadian population. The taskforce will oversee national antibody surveys over the next two years in which will test one million Canadians. Researchers at Sinai Health's Lunenfeld-Tanenbaum Research Institute in Toronto are developing a robotic system that can process mass numbers of antibody tests. MedMira of Halifax developed one of the first rapid detection kits for HIV and has now developed a COVID-19 antibody test that takes three minutes from taking the blood drop specimen. Plantform Corp. of Guelph applied for funding from the National Research Council to develop an antibody test for COVID-19. Tests for antigens, proteins that are part of the virus's surface, were first approved by Health Canada on October 6, when it approved and ordered 20.5 million units of one manufactured by Abbott Laboratories as a point-of-care test. They can produce results faster than PCR tests (around 20 minutes) but are generally less accurate than PCR tests. Abbott states that they are designed for preliminary results and not intended "as the sole basis for treatment or other management decisions." Deputy Chief Public Health Officer Howard Njoo stated these tests could be deployed in workplaces and communal living environments. Sona Nanotech of Halifax was developing point-of-care COVID-19 antigen test kits that provide results in 5–15 minutes with an anticipating cost to be less than $50. If successful, the project will yield 20,000 test kits available per week, with the potential to scale up to 1 million test kits per week. Sona Nanotech of Halifax was developing point-of-care COVID-19 antigen test kits that provide results in 5–15 minutes with an anticipating cost to be less than $50. If successful, the project will yield 20,000 test kits available per week, with the potential to scale up to 1 million test kits per week. Alberta British Columbia Saskatchewan Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Northwest Territories Yukon NunavutAlberta British Columbia Saskatchewan Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Northwest Territories Yukon Nunavut

Wiki

Mpox

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2022–2023 mpox outbreak in Peru

The 2022–2023 mpox outbreak in Peru is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus . The outbreak reached Peru on 26 June 2022. Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and a wide range of other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes . The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. In May 2022, the World Health Organization (WHO) made an emergency announcement of the existence of a multi-country outbreak of mpox , a viral disease then commonly known as "monkeypox" . The initial cluster of cases was found in the United Kingdom , where the first case was detected in London on 6 May 2022 in a patient with a recent travel history from Nigeria (where the disease is endemic ). On 16 May, the UK Health Security Agency ( UKHSA ) confirmed four new cases with no link to travel to a country where mpox is endemic. Subsequently, cases have been reported from many countries and regions. The outbreak marked the first time mpox had spread widely outside Central and West Africa . There is evidence that the disease had been circulating and evolving in human hosts over a number of years prior to the outbreak. The outbreak was of the Clade IIb variant of the virus. The first suspected case of infection in the country was reported on 30 May 2022, when health authorities in the department of Piura reported the identification of a 70-year-old patient who presented symptoms compatible with mpox and was isolated in the intensive care unit (ICU) of the Santa Rosa Hospital ( Piura ).

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/LGB_Alliance/html

LGB Alliance

The LGB Alliance is a British nonprofit advocacy group founded in 2019, in opposition to the policies of LGBT rights charity Stonewall on transgender issues. Its founders are Bev Jackson, Kate Harris, Allison Bailey , Malcolm Clark and Ann Sinnott. The organisation has said that lesbians are facing "extinction" because of the "disproportionate" focus on transgender identities in schools. The LGB Alliance describes its objective as "asserting the right of lesbians, bisexuals and gay men to define themselves as same-sex attracted", and states that such a right is threatened by "attempts to introduce confusion between biological sex and the notion of gender ". The group has opposed a ban on conversion therapy for trans people in the UK, opposed the use of puberty blockers for children, and opposed gender recognition reform. The LGB Alliance has been described by the Labour Campaign for Trans Rights as transphobic , in a statement signed by a number of Labour MPs, and by articles in four scholarly journals as "trans-exclusionary" or "anti-trans". Hope not Hate and the Trades Union Congress have described the group as anti-trans. It has also been described by several members of parliament, journalists, and LGBT organisations and activists as a hate group . The group has received support from a number of UK politicians, including Boris Johnson . The LGB Alliance was granted charitable status by the Charity Commission for England and Wales in April 2021, which was controversial with LGBT groups in the UK, fifty of whom signed an open letter condemning it. A hearing for an appeal against its charitable status started in the First-tier Tribunal in September 2022. The appeal was dismissed in July 2023. It found that Mermaids , which had made the appeal, did not have legal standing to challenge the decision made by the Charity Commission. The judges also said they had been unable to reach agreement on whether LGB Alliance qualified for charitable status and therefore had not ruled on that matter. In September 2019, twenty-two people signed an open letter to The Sunday Times accusing leading UK gay-rights charity Stonewall of having "undermined women's sex-based rights and protections" through its policy on transgender issues. It further stated that twelve months earlier, a group had asked Stonewall to commit to "fostering an atmosphere of respectful debate" with those who wished to question its transgender policies, but that Stonewall had refused to allow any such dialogue, and that "if Stonewall remains intransigent, there must surely now be an opening for a new organisation committed both to freedom of speech and to fact instead of fantasy." One month after the publication of the open letter, it was announced that a new group called the LGB Alliance had been launched. The group was co-founded by Bev Jackson, Kate Harris, Allison Bailey , Malcolm Clark, and Ann Sinnott, with the support of Simon Fanshawe , who spoke at the initial meeting on 22 October 2019 along with Miranda Yardley and Charlie Evans. [ improper synthesis? ] Harris stated that: The main difference is that lesbians, gays, and bisexuals have something in common because of our sexual orientation, that has nothing to do with being trans. We welcome the support of anyone — gay, straight or trans — as long as they support our commitment to freedom of speech and biological definitions of sex. So we are a very broad and accepting group. We will be called transphobic, but we're not. In October 2020, Ann Sinnott, a director of the LGB Alliance at the time, initiated a legal case calling for a judicial review of the Equality and Human Rights Commission 's guidance on the Equality Act 2010 , crowdfunding almost £100,000 for legal fees. The LGB Alliance believed that the specifics of the Equality Act 2010 have been "misrepresented" by some organisations. In May 2021 the case was found by the court to be unarguable , Justice Henshaw stating that "the claimant has shown no arguable reason to believe the Code has misled or will mislead service providers about their responsibilities under the Act." In June 2021, the LGB Alliance announced the appointment of five new trustees in addition to Harris, Jackson and documentary producer Malcolm Clark: co-founder of Shed Productions Eileen Gallagher OBE, strategy consultant Conrad Roebar, professor of philosophy Kathleen Stock OBE, professor of human rights law Robert Wintemute and Labour peer Lord Young of Norwood Green . At the same time, Ann Sinnott announced her resignation as a director. In October 2021, the organisation had a stand at the Conservative Party Conference , which reportedly cost £6,000. Later that month, the organisation hosted its own conference, with guests including MPs Joanna Cherry (SNP), Jackie Doyle-Price (Conservative) and Rosie Duffield (Labour), as well as the television comedy writer and anti-trans activist Graham Linehan . A protest against LGB Alliance was held outside the conference venue, attended by Daniel Lismore and the King's College London LGBT+ Society. On 30 March 2022, the London Community Foundation awarded the LGB Alliance a grant as part of the Arts Council England Let's Create Jubilee Fund, for a film Queens — 70 Years of Queer History . It withdrew the grant in April 2022, after being made aware of the legal challenge against the LGB Alliance's charitable status. The film was retitled "Very British Gays" and first shown in March 2023. On 10 June 2022, the organisation announced that it had received a grant from the National Lottery Community Fund to create a helpline "for young lesbian, gay and bisexual people and their families and friends." In March 2020, the LGB Alliance submitted an application for charitable status to the Charity Commission for England and Wales . Bev Jackson, a founder of the LGB Alliance in a speech stated "We're applying for charitable status and building an organisation to challenge the dominance of those who promote the damaging theory of gender identity." A petition set up against the application received 30,000 signatures. The application was granted in April 2021. After LGB Alliance was granted the status of charity, the UK Pride Organisers Network released an open letter signed by more than 50 LGBT+ Pride groups across the UK condemning the decision. In June 2021, a number of groups, including transgender youth charity Mermaids and the Good Law Project , appealed against the decision to grant charitable status, on the basis that it did not "meet the threshold tests to be registered as a charity". They say that the LGB Alliance does not meet two key criteria for charitable status under the Charities Act 2011 : that a charity should "give rise to tangible, legally recognised benefits that outweigh any associated harms", and that they "benefit the public or a sufficient section of the public". The Charity Commission reaffirmed its role "to decide whether an organisation's purposes fall within the legal definition of charity" and that objections to the LGB Alliance's application had been "carefully considered" in its original decision to grant charitable status. Lui Asquith, director of legal and policy at Mermaids, said "LGB Alliance purports to be an organisation that supports lesbian, gay and bisexual people, but it doesn't. Many trans people are LGB and LGB Alliance actively works to oppose the advancement of rights of trans individuals." Mermaids were supported in this appeal by the Good Law Project, the LGBT+ Consortium , Gendered Intelligence, Trans Actual, and the LGBT Foundation . A First-tier Tribunal sat from 9 to 16 September 2022 and from 7 to 8 November 2022, with Mermaids, the Charity Commission and the LGB Alliance represented in court. Judgment was reserved until a later date, which was expected to be early 2023. The appeal was dismissed in July 2023 on the grounds that "the law does not permit Mermaids to challenge the decision made by the Charity Commission to register LGB Alliance as a charity". There was no finding made on the question of whether LGB Alliance should have been given charitable status, with the two judges unable to reach an agreement. The Charity Commission welcomed the result and repeated its position, that it "applied the law carefully and properly in registering LGB Alliance as a charity". In August 2021, the Charity Commission announced that it would be engaging with LGB Alliance trustees after the LGB Alliance posted a Tweet stating that "adding the + to LGB gives the green light to paraphilias like bestiality – and more – to all be part of one big happy 'rainbow family'" which was subsequently removed by Twitter for violating the social media platform's rules. [ needs update ] On 7 September 2022, the LGB Alliance was found by the Fundraising Regulator to have broken its Code of Fundraising Practice in two ways. Firstly by making a "false and misleading" claim that it was the only charity representing lesbian, gay, and bisexual interests. Secondly, it failed to deal correctly with a complaint made about this claim. In August 2021, the Charity Commission announced that it would be engaging with LGB Alliance trustees after the LGB Alliance posted a Tweet stating that "adding the + to LGB gives the green light to paraphilias like bestiality – and more – to all be part of one big happy 'rainbow family'" which was subsequently removed by Twitter for violating the social media platform's rules. [ needs update ] On 7 September 2022, the LGB Alliance was found by the Fundraising Regulator to have broken its Code of Fundraising Practice in two ways. Firstly by making a "false and misleading" claim that it was the only charity representing lesbian, gay, and bisexual interests. Secondly, it failed to deal correctly with a complaint made about this claim. LGB Alliance states it "promotes and defends the rights of LGB people" with the caveat that these rights "are rooted in simple, clear definitions of biology, i.e. that there are only two sexes, male and female, not some multitude of genders on a gender spectrum." They regard the promotion of the concept of gender identity as a threat to LGB rights. The organisation believes the "conflict between trans rights and the rights of LGB people – and women's rights" stems from the "extraordinary widening of the definition of trans". This, they argue, used to mean "a transsexual who has gone through some actual physical process to become more like their 'chosen' sex" but now includes "almost any man" who "declare[s] he is a woman" and "cross-dressers". Co-founder Bev Jackson said that lesbians are in danger of extinction due to disproportionate focus on transgender issues in schools: "At school, in university, it is so uncommon, it is the bottom of the heap. Becoming trans is now considered the brave option." She also voiced concern that "If you do not accept that everyone has a gender identity then you are automatically labelled transphobic which means you can no longer discuss women's lives and what's happening to lesbians. We are increasingly discovering that lesbians are no longer welcome in the LGBTQ+ world, which is astonishing." Jackson has said, "Lesbians don't have penises. A lesbian is a biological woman who is attracted to another biological woman. That's obvious. Or at least it was obvious until a few years ago." LGB Alliance has stated that the repeal of Section 28 (a law that prohibited the "promotion of homosexuality" by local authorities ) and the introduction of same-sex marriage were "landmark victories". In January 2023, their trustee, Robert Wintemute, represented LGB Alliance in a legal campaign at the European Court of Human Rights to require Russia and 16 other states that are member states of the Council of Europe to "grant same-sex couples equal access to legal marriage". LGB Alliance has opposed the inclusion of transgender people in legislation banning conversion therapy. The LGB Alliance claims that affirmation-based therapy for transgender youth is gay conversion therapy and that campaigns to ban conversion therapy for transgender people are "being used as political cover to promote an affirmation-only approach to gender identity". LGB Alliance opposed legislation in the Scottish Parliament to change the process of legal recognition of gender to be "based only on self-identification rather than biological sex", and reduce the age of access from 18 to 16. The group took out adverts in Scotland to campaign against the Scottish government's plan to reform the Gender Recognition Act, stating that the reform would create a "gender free-for-all" and is "a law that could be exploited by predatory men who wish to hurt women and girls". Following a number of complaints to the Advertising Standards Authority over the adverts, the ASA issued the group with an "Advice Notice", advising that the messages could be "potentially misleading" because "the legislation it refers to is still under consultation". Bev Jackson accused the Tavistock and Portman NHS Foundation Trust , which offers Gender Identity Development Services (GIDS) to children, of "transing out the gay". She also referred to studies which showed that children who identified as transgender were more likely to be autistic , saying she had spoken with a teacher at an SEN (special educational needs) school who told her there were "24 trans kids, one non binary, but no gays and lesbians." In November 2020, Jackson was quoted in a BBC story about children experiencing delays in access to gender reassignment treatment, saying "We don't think children should be allowed to self-diagnose any medical condition." The next month, Jackson welcomed the High Court verdict in the Bell vs. Tavistock trial, which ruled that children should not be given puberty blockers without court approval. In September 2021, the verdict was overturned by the Court of Appeal. LGB Alliance states it "promotes and defends the rights of LGB people" with the caveat that these rights "are rooted in simple, clear definitions of biology, i.e. that there are only two sexes, male and female, not some multitude of genders on a gender spectrum." They regard the promotion of the concept of gender identity as a threat to LGB rights. The organisation believes the "conflict between trans rights and the rights of LGB people – and women's rights" stems from the "extraordinary widening of the definition of trans". This, they argue, used to mean "a transsexual who has gone through some actual physical process to become more like their 'chosen' sex" but now includes "almost any man" who "declare[s] he is a woman" and "cross-dressers". Co-founder Bev Jackson said that lesbians are in danger of extinction due to disproportionate focus on transgender issues in schools: "At school, in university, it is so uncommon, it is the bottom of the heap. Becoming trans is now considered the brave option." She also voiced concern that "If you do not accept that everyone has a gender identity then you are automatically labelled transphobic which means you can no longer discuss women's lives and what's happening to lesbians. We are increasingly discovering that lesbians are no longer welcome in the LGBTQ+ world, which is astonishing." Jackson has said, "Lesbians don't have penises. A lesbian is a biological woman who is attracted to another biological woman. That's obvious. Or at least it was obvious until a few years ago." LGB Alliance has stated that the repeal of Section 28 (a law that prohibited the "promotion of homosexuality" by local authorities ) and the introduction of same-sex marriage were "landmark victories". In January 2023, their trustee, Robert Wintemute, represented LGB Alliance in a legal campaign at the European Court of Human Rights to require Russia and 16 other states that are member states of the Council of Europe to "grant same-sex couples equal access to legal marriage". LGB Alliance has opposed the inclusion of transgender people in legislation banning conversion therapy. The LGB Alliance claims that affirmation-based therapy for transgender youth is gay conversion therapy and that campaigns to ban conversion therapy for transgender people are "being used as political cover to promote an affirmation-only approach to gender identity". LGB Alliance opposed legislation in the Scottish Parliament to change the process of legal recognition of gender to be "based only on self-identification rather than biological sex", and reduce the age of access from 18 to 16. The group took out adverts in Scotland to campaign against the Scottish government's plan to reform the Gender Recognition Act, stating that the reform would create a "gender free-for-all" and is "a law that could be exploited by predatory men who wish to hurt women and girls". Following a number of complaints to the Advertising Standards Authority over the adverts, the ASA issued the group with an "Advice Notice", advising that the messages could be "potentially misleading" because "the legislation it refers to is still under consultation". Bev Jackson accused the Tavistock and Portman NHS Foundation Trust , which offers Gender Identity Development Services (GIDS) to children, of "transing out the gay". She also referred to studies which showed that children who identified as transgender were more likely to be autistic , saying she had spoken with a teacher at an SEN (special educational needs) school who told her there were "24 trans kids, one non binary, but no gays and lesbians." In November 2020, Jackson was quoted in a BBC story about children experiencing delays in access to gender reassignment treatment, saying "We don't think children should be allowed to self-diagnose any medical condition." The next month, Jackson welcomed the High Court verdict in the Bell vs. Tavistock trial, which ruled that children should not be given puberty blockers without court approval. In September 2021, the verdict was overturned by the Court of Appeal. According to journalist Gaby Hinsliff , "The Alliance is seen by many in the LGBT sector as a fringe organisation at best, and at worst a hate group." It has been described as a hate group by Pride in London , Pride in Surrey, the LGBT+ Liberal Democrats , the Labour Campaign for Trans Rights , the Independent Workers' Union of Great Britain , barrister Jolyon Maugham , Green Party of England and Wales co-leader Carla Denyer , journalist Owen Jones and Natacha Kennedy, co-chair of the Feminist Gender Equality Network. Broadcaster India Willoughby has described the group as "baddies masquerading as the good guys." The group has also been described as "anti-trans" by the Trades Union Congress and Hope not Hate . Paul Roberts OBE, CEO of LGBT Consortium said of LGB Alliance "they exist to oppose free, safe and empowered trans lives". In November 2020, the gay men's magazine Boyz retweeted Twitter posts from the LGB Alliance and responded to criticism by suggesting that people not jump to conclusions about the organisation and instead "hear them out". Companies that advertised in Boyz or stocked the magazine were targeted with threats of boycotts, and at least one venue, the cabaret club Royal Vauxhall Tavern , stopped distributing it. The magazine eventually apologised "for the publicity we have given the LGB Alliance." The Spectator writer Brendan O'Neill wrote a defence of the LGB Alliance after the Boyz controversy, arguing the group was being targeted by left-wing activists who had deprived it of opportunities to raise money by getting it removed from crowdfunding websites and that activists had lobbied to have gay rights activist and LGB Alliance co-founder Allison Bailey investigated by her employers for transphobia. In December 2020, John Nicolson, Member of Parliament for Ochil and South Perthshire , described the group as "sinister" and said that it was absurd for the BBC to rely on "transphobic groups like the so-called LGB Alliance" to give balance on reports about trans issues, saying "you would never do a report on racism, for example, and call in a racist organisation to say that they don't think black people have a right to equality". In October 2021, Labour Shadow Minister for Women and Equalities Taiwo Owatemi argued that LGB Alliance "should be rejected by all those who believe in equality," saying that LGB Alliance "opposes LGBT+ inclusive education," disregards Gillick competence , and has opposed conversion therapy bans. The group has been condemned by several MPs, including SNP MP Mhairi Black, Liberal Democrat MP Jamie Stone , and Labour MP Charlotte Nichols . A statement from the Labour Campaign for Trans Rights group calling LGB Alliance transphobic and trans-exclusionist was signed by two of the three candidates in the 2020 party leadership elections , Rebecca Long-Bailey and Lisa Nandy , as well as candidates for deputy leader Dawn Butler and Angela Rayner , the latter being elected deputy leader. LGB Alliance has received support from a number of UK politicians, including Boris Johnson (Conservative), Rosie Duffield (Labour), Baroness Sarah Ludford (Liberal Democrats), Joanna Cherry (SNP) and Neale Hanvey (Alba). In July 2020, the group met with Conservative Minister for Women and Equalities Kemi Badenoch . The LGB Alliance has been described as trans-exclusionary in articles published in the journals Metaphilosophy and the Journal of Gender Studies . A 2021 article in the International Journal of Sociology listed LGB Alliance among "UK lobby groups [that] are successfully pushing a radical agenda to deny the basic rights of trans people." Mike Homfray of the University of Liverpool has argued that "there is ample evidence that the LGB Alliance ... has as a central aim [trans people's] isolation and separation from LGB people." Dame Melanie Dawes , chief executive of Ofcom , responding to a comment from MP John Nicolson asking why "transphobic groups like the so-called LGB Alliance" should appear on BBC programming, said quoting anti-trans pressure groups in order to bring balance "can be extremely inappropriate". Gary Powell, who participated in the LGB Alliance's pre-launch meetings and was involved in the promotion of its launch, has been criticised for speaking at events organised by the Heritage Foundation and writing for the Witherspoon Institute , both American conservative think tanks which have campaigned against LGBT rights. Bev Jackson, one of the founders of the LGB Alliance, has been criticised for saying that "working with the Heritage Foundation is sometimes the only possible course of action" since "the leftwing silence on gender in the US is even worse than in the UK". Malcolm Clark, a co-founder of the LGB Alliance, has been criticised for arguing against LGBT+ clubs in schools , saying that he "[doesn't] see the point of LGBT clubs in schools" and citing a risk of "predatory gay teachers". He stated, "There should never, of course, be bullying. But the vast majority of children have not settled on a sexual orientation. Suggesting they do have a sexual orientation is fraught with dangers – for kids" and "Having clubs where kids explore on school grounds …their sexual orientation seems to be unnecessary and potentially dangerous". In June 2020, LGB Alliance said in a tweet "To those people saying it is "homophobic" not to be in favour of gay marriage have a look at the statistics. It seems it's rather a small minority who have made their wedding vows.", along with a chart showing that most lesbian, gay and bisexual people are single. The tweet was swiftly deleted after a Twitter backlash that included actor David Paisley , Scottish MP Mhairi Black , and journalist Owen Jones . They wrote in a further tweet: "That same-sex marriage tweet was very badly formulated! The introduction of same-sex marriage was a great breakthrough for gay people. But support for it wasn't universal among LGB activists: many saw it as a sellout - joining the establishment. A minority still view it that way." James Greig has argued that LGB Alliance has, like the writers Brendan O'Neill (former editor of Spiked magazine who has defended LGB Alliance) and Helen Joyce (director of advocacy for campaign group Sex Matters and author of Trans: When Ideology Meets Reality ), attempted to rewrite history. Greig proposes that, unlike the gay and lesbian rights movement , trans activists are depicted as "uniquely demanding, dogmatic and extreme". As evidence, Greig cites a now-deleted tweet where LGB Alliance wrote "In our historical gay and lesbian rights movement, we never demanded that society change its laws, its activities and its language to accommodate us. We never cursed people who disagreed with us or tried to get them fired. We always built bridges." LGB Alliance received criticism after giving controversial conservative social media personality Andy Ngo a press pass to their October 2021 conference and saying that "whatever his other work in the past, his work on the Wi Spa controversy was extraordinary and important." The former UK Conservative MP Ben Howlett has described how the LGB Alliance and Sex Matters lobbied Conservative Party members of parliament in private: "I think one of the core reasons why issues surrounding trans people are going high up the agenda is that there's a lot of Machiavellian stuff going on behind the scenes". On 5 November 2021, MP John Nicolson said that the Speaker of the House of Commons had referred "abuse and obsessive behaviour" from the LGB Alliance to the House of Commons security as part of a review following the murder of David Amess . LGB Alliance had previously run a fundraising campaign for itself where it pledged that "make a donation to us IN HIS [Nicholson's] NAME and we will tweet out your message," subsequently tweeting a number of statements attacking Nicolson, including one that called him a "rape-enabling politician". The fundraiser had been removed from the JustGiving and GoFundMe crowdfunding platforms for violating their rules. In May 2022, the organisation urged the closure of all sex venues for one month, including saunas , leather bars and dark rooms , in response to the 2022-2023 mpox outbreak . In November 2022, the group was criticised for excluding the trans victims of the Colorado Springs nightclub shooting in their social media condolences, after which it tweeted: "We stand in solidarity – as LGB people – against all violence and extend our thoughts to ALL the victims of such horror". In December 2022, Twitch removed the LGB Alliance from its approved list of charities because its "anti-transgender advocacy" violated the platform's policies against hateful content; over 16,000 people voted for it to be removed. That same month, it was reported that LGB Alliance had office space at 55 Tufton Street , a building also occupied by several controversial right-wing groups promoting climate change denial and anti-immigration politics. The LGB Alliance denied having links to the groups, stating "the office was chosen because it's handy, flexible, and that it became available at the right time". A number of LGB groups have been formed internationally with similar objectives. In October 2020, a group called LGB Alliance Ireland was launched on Twitter. A number of Irish LGBT+ activists said that group was based in the UK and was mainly composed of British supporters. This was disputed by the group, which stated that "all our committee members are living in Ireland, with representation in each of the four provinces". In November 2020, LGB Alliance Ireland faced criticism after calling for schools to ignore LGBT youth organisation BeLonG To 's Stand Up Awareness Week. In August 2022, the Global Project against Hate and Extremism released a report in which it classified LGB Alliance Ireland as a far-right anti-transgender hate group. In September 2020, a linked group was launched in Iceland, named LBG teymið , with Iva Marín Adrichem as a co-founder. Þorbjörg Þorvaldsdóttir , director of Icelandic national queer organisation Samtökin '78 , condemned the group. The Icelandic group later rebranded as Samtökin 22 . In August 2022, LGB Alliance Australia filed an application with Equal Opportunity Tasmania , part of the Tasmanian Department of Justice , for permission to hold drag shows from which trans women would be banned from attending. Tasmania's anti-discrimination commissioner rejected the request. In October 2022, the Global Project against Hate and Extremism released a report in which it classified LGB Alliance Australia as a far-right anti-transgender hate group. LGB Alliance Australia responded that it believed GPAHE had misrepresented it. In 2023, the group published its support for Sall Grover 's stance defending a legal challenge concerning a women's only mobile app. In November 2020, LGB Alliance Canada submitted a brief in opposition to a proposed ban on conversion therapy. In October 2020, a group called LGB Alliance Ireland was launched on Twitter. A number of Irish LGBT+ activists said that group was based in the UK and was mainly composed of British supporters. This was disputed by the group, which stated that "all our committee members are living in Ireland, with representation in each of the four provinces". In November 2020, LGB Alliance Ireland faced criticism after calling for schools to ignore LGBT youth organisation BeLonG To 's Stand Up Awareness Week. In August 2022, the Global Project against Hate and Extremism released a report in which it classified LGB Alliance Ireland as a far-right anti-transgender hate group. In September 2020, a linked group was launched in Iceland, named LBG teymið , with Iva Marín Adrichem as a co-founder. Þorbjörg Þorvaldsdóttir , director of Icelandic national queer organisation Samtökin '78 , condemned the group. The Icelandic group later rebranded as Samtökin 22 . In August 2022, LGB Alliance Australia filed an application with Equal Opportunity Tasmania , part of the Tasmanian Department of Justice , for permission to hold drag shows from which trans women would be banned from attending. Tasmania's anti-discrimination commissioner rejected the request. In October 2022, the Global Project against Hate and Extremism released a report in which it classified LGB Alliance Australia as a far-right anti-transgender hate group. LGB Alliance Australia responded that it believed GPAHE had misrepresented it. In 2023, the group published its support for Sall Grover 's stance defending a legal challenge concerning a women's only mobile app. In November 2020, LGB Alliance Canada submitted a brief in opposition to a proposed ban on conversion therapy.

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Notifiable_diseases_in_the_United_Kingdom/html

Notifiable diseases in the United Kingdom

A notifiable disease is one which the law requires to be reported to government authorities. In England and Wales, notification of infectious diseases is a statutory duty for registered medical practitioners and laboratories, under the Public Health (Control of Disease) Act 1984 and (in England) the Health Protection (Notification) Regulations 2010. Similar provision, albeit with a different list of diseases, is made for Wales in the Health Protection (Notification) (Wales) Regulations 2010. Medical practitioners are required to notify their local authority of diseases on the list in writing within three days, or if the situation is urgent, by telephone within 24 hours. For Scotland, similar provision is made by the Public Health etc. (Scotland) Act 2008 . The diseases notifiable in England to local authorities under the Health Protection (Notification) Regulations 2010 are: The causative organisms which the laboratories shall notify to the proper authority under the Health Protection (Notification) Regulations 2010 are: [ citation needed ]

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Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Gérard_Krause/html

Gérard Krause

Gérard Krause (born 1965 ) is a German epidemiologist . He is currently based at the Helmholtz Centre for Infection Research (HZI) in Braunschweig . After obtaining a doctoral degree in tropical medicine at the University of Heidelberg and several stints as medical doctor and specialist in tropical medicine, Krause moved in 2000 to the Robert Koch Institute , where he worked as an epidemiologist. In 2005 he obtained his habilitation at the Charité in the fields of epidemiology and hygiene . He participated in the successful containment of the Western African Ebola virus epidemic of 2014/2015. As of 2017, he led the SORMAS (Surveillance, Outbreak Response Management and Analysis System) project at the HZI. SORMAS is an open source software for early recording of infectious diseases (that is, surveillance) and the steering of subsequent pandemic protection measures. It was later rolled out in other countries including France , Switzerland and Fiji , performing infection surveillance for more than 270 million people. The SORMAS software was extended during the COVID-19 pandemic in Germany by a module specifically tailored to the disease, and was expected to help reduce the effort in contact tracing and follow-up of infection chains by health authorities at the district level. During the COVID-19 pandemic in Germany , Krause joined the advisory committee of the federal government and state premiers. During that time, he became known to a wider audience through his contact with the media. The weekly Der Spiegel described him in January 2021 as an advocate of very targeted measures. Krause repeatedly called for better protection of the elderly from the disease. He has been a critic of the threshold value of 50 infections per 100,000 residents in the past seven days as indicator for anti-pandemic measures, and called for the inclusion of other indicators, such as the number of available beds in intensive care. In an August 2020 interview with Deutschlandfunk , at a time when cases in Germany began to rise again, Krause called for particular attention to the degree of increase in serious cases and deaths, and for adequate protection of those particularly likely to become serious ill from the disease; public attention to this matter was, in his eyes, highly insufficient. Commenting in Der Spiegel on the decision of the German government on 28 October to impose a partial lockdown for November, Krause said that the protection of high-risk groups posed a challenge which society had to be ready to meet. On 19 April 2021, he doubted the benefits of the night curfew from 9:00 p.m. to 5:00 a.m. that was mulled by the federal government, citing the situation in France, where the curfew had been sidestepped through overnight stays after visits outside of the curfew times. He opined against the loosening of the vaccination prioritization before the vaccination of high-risk groups. Instead of the number of reported infections as indicator for pandemic measures, as favored by the federal and state governments, he proposed to use the number of those who fell ill – in particular those requiring intensive care –, arguing that the number of reported infections was bound to increase anyway due to the desirable ramping up of coronavirus testing. In November 2021, Krause said that COVID-19 vaccination in the healthcare sector should be taken "for granted" to protect patients, and that it was "regrettable" that a government vaccine mandate for the sector had been necessary to achieve this. In an expert discussion session on 27 May 2022 on research regarding the monkeypox virus which had triggered the 2022–2023 mpox outbreak in Europe , Krause called for the identification of risk groups within the general population. He warned against them being stigmatized, also given that this would make it harder to collect information from some countries. He said that research on monkeypox in Nigeria , in which he had participated, was only conditionally transferable to the situation in Europe, due to the greater prevalence of animal-to-human transmission, the less well equipped health system, and the lower vaccination rate in the African country.

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Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Virological.org/html

Virological.org

Virological.org is a discussion forum for the pre-publication sharing and discussion of pathogenic virus sequence data. The forum was launched in November 2014 by Andrew Rambaut . Scientists have often used the forum to publicly share the first available outbreak sequences, e.g. during the SARS-CoV-2 pandemic, the 2022–2023 mpox outbreak , and the Ebola virus epidemic in Guinea . Virological.org is used for rapid pre-publication dissemination of public health related information by a community of virologists, phylogeneticists and epidemiologists.

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Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Manchurian_plague/html

Manchurian plague

The Manchurian plague was a pneumonic plague that occurred mainly in Manchuria in 1910–1911. It killed 60,000 people, stimulating a multinational medical response and the wearing of the first personal protective equipment (PPE).The plague is thought to have originated from a tarbagan marmot infected with bacterial pneumonia. Tarbagan marmots were hunted for their fur in Manchuria. It was an airborne spread disease and was incredibly deadly, with a near 100 percent mortality rate. Its spread was magnified by marmot hunters gathering in the bitter winter months, and the eventual travel of migrant workers during the Chinese New Year . Russia and Japan both had economic interests in the region and needed to cooperate with Chinese authorities. The Cambridge -trained doctor Wu Lien-teh led Chinese efforts to end the plague, and promoted quarantine and the wearing of cloth face masks . He also convened the International Plague Conference in Mukden in April 1911, the first major event of its kind that brought together an international team of scientists concerned with disease control. The Chinese government also sought the support of foreign doctors, a number of whom died as a consequence of the disease. In Harbin, this included the Frenchman Gérald Mesny, from the Imperial Medical College in Tientsin, who disputed Wu's recommendation of masks; a few days later, he died after catching the plague when visiting patients without wearing a mask. Another was the 26-year-old Arthur F. Jackson, a United Free Church of Scotland missionary doctor , who fell ill within eight days of inspecting and quarantining hundreds of poor laborers; he died two days later in Mukden. In the end, the death toll reached some 60,000 lives. The hardest hit cities included Changchun , Harbin , and Mukden. Although the disease was largely confined to Manchuria, cases were found elsewhere in cities such as Beijing and Tianjin . The Manchurian plague is believed to have highlighted the importance of a multinational medical response, setting precedents for organizations such as the World Health Organization . Wu Lien-teh's widespread promotion of cloth plague mask -wearing by doctors, nurses, patients, contacts, and (to the degree that it was possible) the population at large was the first time such an epidemic containment measure had been attempted. The event was also influential in establishing the use of personal protective equipment to stop the spread of disease, and is credited for the origins of the modern hazmat suit . Parallels have also been made between the management and control of the Manchurian plague and other outbreaks of infectious disease such as the Ebola epidemic in West Africa (2013–2016) and COVID-19 pandemic (2019–present) .

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Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Milhouse_of_Sand_and_Fog/html

Milhouse of Sand and Fog

" Milhouse of Sand and Fog " is the third episode of the seventeenth season of the American animated television series The Simpsons . It originally aired on Fox network in the United States on September 25, 2005.During Reverend Lovejoy 's sermon, Maggie is scratching. The family takes Maggie to see Dr. Hibbert , who diagnoses Maggie with chicken pox . Inspired by Ned Flanders ' suggestion of purposely exposing his sons to chicken pox , Homer invites all the neighborhood kids over to the Simpson house for a " pox party ". He ends up catching it himself, by drinking from Maggie's milk bottle, having no childhood immunity . Milhouse's parents Luann and Kirk attend the party, and after getting drunk on Marge 's custom Margaritas, they resume their relationship. Milhouse feels neglected because his parents are not fawning over him as they did while they were separated. He schemes to break them up again, and Bart helps him with a plot borrowed from The O.C. . The boys place a bra , belonging to Marge, on Kirk's bed. Luann finds the bra, assumes Marge is having an affair with Kirk, and informs Homer. When Homer confronts Marge, she angrily denies the allegation and kicks him out of the house. Prodded by Lisa , Bart confesses to Marge that he left the bra in Kirk's bed, but Marge refuses to reconcile with Homer as he still does not trust her. In order to bring Homer and Marge back together, Lisa inadvertently influences Bart and Milhouse to plan to throw a dummy that looks like Bart off a cliff into the river below, while Homer and Marge, after receiving false messages from each other to meet, watch. However, after breaking his glasses, Milhouse accidentally pushes the real Bart off the cliff. Homer leaps into the rapids to rescue him, but they end up clinging on to a rock near a waterfall. There Bart confesses to Homer what he did, causing Homer to strangle him. Marge tells them to trust her, and let go of the rock. They let go and she catches them, swinging from a rope attached to a tree. Once safely on the river bank, Marge and Homer reconcile. They see Milhouse, thinking Bart died, jump off the cliff, leaving his fate unresolved. Marge wonders if Milhouse can swim, to which Bart asks "What do you think?" Writer Patric M. Verrone based the episode on his own experiences at the time since he was raising three children and dealing with chickenpox.

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Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/GISAID/html

GISAID

GISAID ( / ˈ ɡ ɪ s eɪ d / ), the Global Initiative on Sharing All Influenza Data , previously the Global Initiative on Sharing Avian Influenza Data , is a global science initiative established in 2008 to provide access to genomic data of influenza viruses. The database was expanded to include the coronavirus responsible for the COVID-19 pandemic , as well as other pathogens. The database has been described as "the world's largest repository of COVID-19 sequences". GISAID facilitates genomic epidemiology and real-time surveillance to monitor the emergence of new COVID-19 viral strains across the planet. Since its establishment as an alternative to sharing avian influenza data via conventional public-domain archives, GISAID has facilitated the exchange of outbreak genome data during the H1N1 pandemic in 2009, the H7N9 epidemic in 2013, the COVID-19 pandemic and the 2022–2023 mpox outbreak . Since 1952, influenza strains had been collected by National Influenza Centers (NICs) and distributed through the WHO's Global Influenza Surveillance and Response System (GISRS). Countries provided samples to the WHO but the data was then shared with them for free with pharmaceutical companies who could patent vaccines produced from the samples. Beginning in January 2006, Italian researcher Ilaria Capua refused to upload her data to a closed database and called for genomic data on H5N1 avian influenza to be in the public domain. At a conference of the OIE/FAO Network of Expertise on Animal Influenza , Capua persuaded participants to agree to each sequence and release data on 20 strains of influenza. Some scientists had concerns about sharing their data in case others published scientific papers using the data before them, but Capua dismissed this telling Science "What is more important? Another paper for Ilaria Capua's team or addressing a major health threat? Let's get our priorities straight." Peter Bogner , a German in his 40s based in the USA and who previously had no experience in public health, read an article about Capua's call and helped to found and fund GISAID. Bogner met Nancy Cox , who was then leading the US Centers for Disease Control 's influenza division at a conference, and Cox went on to chair GISAID's Scientific Advisory Council. The acronym GISAID was coined in a correspondence letter published in the journal Nature in August 2006, putting forward an initial aspiration of creating a consortium for a new Global Initiative on Sharing Avian Influenza Data (later, "All" would replace "Avian"), whereby its members would release data in publicly available databases up to six months after analysis and validation. Initially the organisation collaborated with the Australian non-profit organization Cambia and the Creative Commons project Science Commons . Although no essential ground rules for sharing were established, the correspondence letter was signed by over 70 leading scientists, including seven Nobel laureates , because access to the most current genetic data for the highly pathogenic H5N1 zoonotic virus was often restricted, in part due to the hesitancy of World Health Organization member states to share their virus genomes and put ownership rights at risk. Towards the end of 2006, Indonesia announced it would not share samples of avian flu with the WHO which led to a global health crisis due to an ongoing epidemic. By October 2006, Indonesia had agreed to share their data with GISAID, which their health minister considered to have a "fair and transparent" mechanism for sharing data. It was one of the first countries to do so. In February 2007, GISAID and the Swiss Institute of Bioinformatics (SIB) announced a cooperation agreement, with the SIB building and administering the EpiFlu database on behalf of GISAID. Ultimately, GISAID was launched in May 2008 in Geneva on the occasion of the 61st World Health Assembly, as a registration-based database rather than a consortium. In 2009 SIB disconnected the database from the GISAID portal over a contract dispute, resulting in litigation. In April 2010 the Federal Republic of Germany announced during the 7th International Ministerial Conference on Avian and Pandemic Influenza in Hanoi , Vietnam , that GISAID had entered into a cooperation agreement with the German government, making Germany the long-term host of the GISAID platform. Under the agreement, Germany's Federal Ministry of Food, Agriculture and Consumer Protection was to ensure the sustainability of the initiative by providing technical hosting facilities, and the Federal Institute for Animal Health , the Friedrich Loeffler Institute , was to ensure the plausibility and curation of scientific data in GISAID. By 2021, the ministry was no longer involved with either database hosting nor curation. In 2013 GISAID dissolved a nonprofit organisation based in Washington DC and the organisation began to be operated by a German association called Freunde von GISAID (Friends of GISAID). Some of the earliest SARS-CoV-2 genetic sequences were released by the Chinese Center for Disease Control and Prevention and shared through GISAID in mid January 2020. Since 2020, millions of SARS-CoV-2 genome sequences have been uploaded to the GISAID database. In 2022, GISAID added Mpox virus and Respiratory syncytial virus (RSV) to the list of pathogens supported by its database. Indonesia's Ministry of Health announced in November 2023 the establishment of GISAID Academy in Bali , to focus on bioinformatics education, advance pathogen genomic surveillance, and increased regional response capacity. The GISAID model of incentivizing and recognizing those who deposit data has been recommended as a model for future initiatives; Because of this work, the entity has been described as "a critical shield for humankind". GISAID maintains what has been described as "the world's largest repository of COVID-19 sequences", and "by far the world's largest database of SARS-CoV-2 sequences". By mid-April 2021, GISAID's SARS-CoV-2 database reached over 1,200,000 submissions, a testament to the hard work of researchers in over 170 different countries. Only three months later, the number of uploaded SARS-CoV-2 sequences had doubled again, to over 2.4 million. By late 2021, the database contained over 5 million genome sequences; as of December 2021, over 6 million sequences had been submitted; by April 2022, there were 10 million sequences accumulated; and in January 2023 the number had reached 14.4 million. In January 2020, the SARS-CoV-2 genetic sequence data was shared through GISAID. Throughout the first year of the COVID-19 pandemic, most of the SARS-CoV-2 whole-genome sequences that were generated and shared globally were submitted through GISAID. When the SARS-CoV-2 Omicron variant was detected in South Africa, by quickly uploading the sequence to GISAID, the National Institute for Communicable Diseases there was able to learn that Botswana and Hong Kong had also reported cases possessing the same gene sequence. In March 2023, GISAID temporarily suspended database access for some scientists, removing raw data relevant to investigations of the origins of SARS-CoV-2 . GISAID stated that they do not delete records from their database, but data may become temporarily invisible during updates or corrections. Availability of the data was restored, with an additional restriction that any analysis based thereon would not be shared with the public. Since 1952, influenza strains had been collected by National Influenza Centers (NICs) and distributed through the WHO's Global Influenza Surveillance and Response System (GISRS). Countries provided samples to the WHO but the data was then shared with them for free with pharmaceutical companies who could patent vaccines produced from the samples. Beginning in January 2006, Italian researcher Ilaria Capua refused to upload her data to a closed database and called for genomic data on H5N1 avian influenza to be in the public domain. At a conference of the OIE/FAO Network of Expertise on Animal Influenza , Capua persuaded participants to agree to each sequence and release data on 20 strains of influenza. Some scientists had concerns about sharing their data in case others published scientific papers using the data before them, but Capua dismissed this telling Science "What is more important? Another paper for Ilaria Capua's team or addressing a major health threat? Let's get our priorities straight." Peter Bogner , a German in his 40s based in the USA and who previously had no experience in public health, read an article about Capua's call and helped to found and fund GISAID. Bogner met Nancy Cox , who was then leading the US Centers for Disease Control 's influenza division at a conference, and Cox went on to chair GISAID's Scientific Advisory Council. The acronym GISAID was coined in a correspondence letter published in the journal Nature in August 2006, putting forward an initial aspiration of creating a consortium for a new Global Initiative on Sharing Avian Influenza Data (later, "All" would replace "Avian"), whereby its members would release data in publicly available databases up to six months after analysis and validation. Initially the organisation collaborated with the Australian non-profit organization Cambia and the Creative Commons project Science Commons . Although no essential ground rules for sharing were established, the correspondence letter was signed by over 70 leading scientists, including seven Nobel laureates , because access to the most current genetic data for the highly pathogenic H5N1 zoonotic virus was often restricted, in part due to the hesitancy of World Health Organization member states to share their virus genomes and put ownership rights at risk. Towards the end of 2006, Indonesia announced it would not share samples of avian flu with the WHO which led to a global health crisis due to an ongoing epidemic. By October 2006, Indonesia had agreed to share their data with GISAID, which their health minister considered to have a "fair and transparent" mechanism for sharing data. It was one of the first countries to do so. In February 2007, GISAID and the Swiss Institute of Bioinformatics (SIB) announced a cooperation agreement, with the SIB building and administering the EpiFlu database on behalf of GISAID. Ultimately, GISAID was launched in May 2008 in Geneva on the occasion of the 61st World Health Assembly, as a registration-based database rather than a consortium. In 2009 SIB disconnected the database from the GISAID portal over a contract dispute, resulting in litigation. In April 2010 the Federal Republic of Germany announced during the 7th International Ministerial Conference on Avian and Pandemic Influenza in Hanoi , Vietnam , that GISAID had entered into a cooperation agreement with the German government, making Germany the long-term host of the GISAID platform. Under the agreement, Germany's Federal Ministry of Food, Agriculture and Consumer Protection was to ensure the sustainability of the initiative by providing technical hosting facilities, and the Federal Institute for Animal Health , the Friedrich Loeffler Institute , was to ensure the plausibility and curation of scientific data in GISAID. By 2021, the ministry was no longer involved with either database hosting nor curation. In 2013 GISAID dissolved a nonprofit organisation based in Washington DC and the organisation began to be operated by a German association called Freunde von GISAID (Friends of GISAID). Some of the earliest SARS-CoV-2 genetic sequences were released by the Chinese Center for Disease Control and Prevention and shared through GISAID in mid January 2020. Since 2020, millions of SARS-CoV-2 genome sequences have been uploaded to the GISAID database. In 2022, GISAID added Mpox virus and Respiratory syncytial virus (RSV) to the list of pathogens supported by its database. Indonesia's Ministry of Health announced in November 2023 the establishment of GISAID Academy in Bali , to focus on bioinformatics education, advance pathogen genomic surveillance, and increased regional response capacity. The GISAID model of incentivizing and recognizing those who deposit data has been recommended as a model for future initiatives; Because of this work, the entity has been described as "a critical shield for humankind". GISAID maintains what has been described as "the world's largest repository of COVID-19 sequences", and "by far the world's largest database of SARS-CoV-2 sequences". By mid-April 2021, GISAID's SARS-CoV-2 database reached over 1,200,000 submissions, a testament to the hard work of researchers in over 170 different countries. Only three months later, the number of uploaded SARS-CoV-2 sequences had doubled again, to over 2.4 million. By late 2021, the database contained over 5 million genome sequences; as of December 2021, over 6 million sequences had been submitted; by April 2022, there were 10 million sequences accumulated; and in January 2023 the number had reached 14.4 million. In January 2020, the SARS-CoV-2 genetic sequence data was shared through GISAID. Throughout the first year of the COVID-19 pandemic, most of the SARS-CoV-2 whole-genome sequences that were generated and shared globally were submitted through GISAID. When the SARS-CoV-2 Omicron variant was detected in South Africa, by quickly uploading the sequence to GISAID, the National Institute for Communicable Diseases there was able to learn that Botswana and Hong Kong had also reported cases possessing the same gene sequence. In March 2023, GISAID temporarily suspended database access for some scientists, removing raw data relevant to investigations of the origins of SARS-CoV-2 . GISAID stated that they do not delete records from their database, but data may become temporarily invisible during updates or corrections. Availability of the data was restored, with an additional restriction that any analysis based thereon would not be shared with the public. The board of Friends of GISAID consists of Peter Bogner and two German lawyers who are not involved in the day-to-day operations of the organisation. Scientific advice to the organization is provided by its Scientific Advisory Council, including directors of leading public health laboratories , such as WHO Collaborating Centres for Influenza. In 2023, GISAID's lack of transparency was criticized by some GISAID funders, including the European Commission and the Rockefeller Foundation , with long-term funding being denied from International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) . In June 2023, it was reported in Vanity Fair that Bogner had said that "GISAID will soon launch an independent compliance board 'responsible for addressing a wide range of governance matters'". The Telegraph similarly reported that GISAID's in-house counsel was developing new governance processes intended to be transparent and allow for the resolution of scientific disputes without the involvement of Bogner. The creation of the GISAID database was motivated in part by concerns raised by researchers from developing countries , with Scientific American noting in 2009 that that "a previous data-sharing system run by WHO forced them to give up intellectual property rights to their virus samples when they sent them to WHO. The virus samples would then be used by private pharmaceutical companies to make vaccines that are awarded patents and sold at a profit at prices many poor nations cannot afford". In a 2022 piece in The Lancet , it was further noted that scientists in North America and Europe sought unrestricted access, with "scientists from Africa requiring sufficient protections for those who generate and share data as per the GISAID terms and conditions". Unlike public-domain databases such as GenBank and EMBL , users of GISAID must have their identity confirmed and agree to a Database Access Agreement that governs the way GISAID data can be used. These Terms of Use are "weighted in favour of the data provider and gives them enduring control over the genetic data they upload". They prevent users from sharing any data with other users who have not agreed to them, and require that users of the data must credit the data generators in published work, and also make a reasonable attempt to collaborate with data generators and involve them in research and analysis that uses their data. A difficulty that GISAID's Data Access Agreement attempts to address is that many researchers fear sharing of influenza sequence data could facilitate its misappropriation through intellectual property claims by the vaccine industry and others, hindering access to vaccines and other items in developing countries, either through high costs or by preventing technology transfer . While most public interest experts agree with GISAID that influenza sequence data should be made public, and this is the subject of agreement by many researchers, some provide the information only after filing patent claims while others have said that access to it should be only on the condition that no patents or other intellectual property claims are filed, as was controversial with the Human Genome Project . GISAID's Data Access Agreement addresses this directly to promote sharing data. GISAID's procedures additionally suggest that those who access the EpiFlu database consult the countries of origin of genetic sequences and the researchers who discovered the sequences. As a result, the GISAID license has been important in rapid pandemic preparedness. However, these restrictions evidence common criticisms to an open data model . GISAID describes itself as "open access", which is naturally replicated by the media and in journal publications. This description indeed aligns with the original announcement of the consortium, which also mentioned depositing the data to the databases participating in the INSDC . As of March 2023, this is not the case, as "GISAID does not offer a mechanism to release data to any other database". A few academic papers have compared GISAID's licensing model to unrestricted, open databases , highlighting the differences while other researchers have signed an open letter calling for the use of any of the INSDC's unrestricted databases. In 2017, GISAID's editorial board stated that " re3data.org and DataCite , the world's leading provider of digital object identifiers (DOI) for research data, affirmed the designation of access to GISAID's database and data as Open Access". However, after several researchers had their accounts suspended in March 2023 as reported by the journal Science and other news outlets, its open access status was revoked by the Registry of Research Data Repositories (re3data) , which now classifies it as a "restricted access repository". In 2020 the World Health Organization chief scientist Soumya Swaminathan called the initiative "a game changer", while the co-director of the European Bioinformatics Institute (EBI) Rolf Apweiler has argued that because it does not allow sequences to be reshared publicly, it hampers efforts to understand the coronavirus and the rapid rise of new variants. GISAID's restrictions on access have led to conflict with "labs and institutions whose priorities are academic rather than driven by the immediate priorities of public health protection". In January 2021, GISAID's restricted access led a group of scientists to write an open letter asking for SARS-CoV-2 sequences to be deposited in open databases, which was replicated in the journals Nature and Science . Furthermore, the article from Science points out that the lack of transparency in access to the database also prevents many scientists from even criticising the platform. A paper from 2017 describing the success of GISAID mentions that revoking researchers' credentials was rare, but it did happen. The same publication described a "perceived merit in GISAID's formula for balancing the need for control and openness". In April 2023, Science and The Economist reported these issues continue as well as the lack of transparency of its governance. An investigation by The Telegraph into claims made by Science noted the incentives of various potential competitors in the field, for whom GISAID is an obstacle to consolidation of control over the field, and also noted that GISAID's position inevitably places it at the center of disputes between groups of scientists, which will tend to result in the losing side blaming GISAID for that outcome.

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/List_of_deprecated_terms_for_diseases/html

List of deprecated terms for diseases

The following is a list of deprecated terms for diseases .

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Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Raj_Panjabi/html

Raj Panjabi

Raj Panjabi (born February 3, 1981 ) is an American physician , social entrepreneur , professor and former White House official. Panjabi served in the Biden Administration from February 2021 - August 2023, most recently as White House senior director for global health security and biodefense on the United States National Security Council . Previously, Panjabi served as the 3rd U.S. Global Malaria Coordinator to lead the U.S. President's Malaria Initiative . Dr. Panjabi was named as one of the TIME 100 Most Influential People in the World in 2016, one of TIME's 50 Most Influential People in Health Care in 2018, received the 2017 TED Prize, and was listed as one of the World's 50 Greatest Leaders by Fortune in 2015 and in 2017. Panjabi is the co-founder and former CEO of Last Mile Health and has served as Assistant Professor of Medicine at Harvard Medical School (part-time) and Brigham and Women's Hospital , visiting faculty at Harvard's Kennedy School of Government, and Advisor to former Liberian President Ellen Johnson Sirleaf , Co-Chair (with former New Zealand Prime Minister Helen Clark ) of the Independent Panel for Pandemic Preparedness and Response. Panjabi's grandparents were refugees from Sindh Province following the British Partition of India and Pakistan in 1947, resettling in Mumbai and Indore in India. A generation later, Panjabi's parents migrated to West Africa, where Panjabi was born and raised in Monrovia , Liberia . After civil war broke out in Liberia in 1989 , Panjabi, at age nine, and his family fled on a rescue cargo plane to Sierra Leone and eventually sought refuge in the United States, resettling initially with a host family in High Point, North Carolina . Panjabi graduated with bachelor and medical degrees from the University of North Carolina School at Chapel Hill and received a Masters of Public Health in epidemiology from the Johns Hopkins Bloomberg School of Public Health . He was a Clinical Fellow at Harvard Medical School, and trained in internal medicine and primary care at the Massachusetts General Hospital .As White House Senior Director for global health security and biodefense and Special Assistant to the President of the United States, Panjabi played a pivotal role in the largest vaccination campaign in history against COVID-19, and White House responses to public health crises, including Mpox, Influenza, Ebola, and Marburg. Panjabi oversaw implementation of the U.S. Global COVID-19 Response and Recovery Framework, and co-organized the 2022 Presidential Global COVID-19 Summit. He played a lead role executing the 2022 National Biodefense and American Pandemic Preparedness Plans, coordinating over $12 billion in annual investment in biodefense, including in disease surveillance, diagnostics, therapeutics, vaccines and health systems. These investments are being driven by 16 federal agencies, including the Departments of Health and Human Services, Defense, Homeland Security, State, and the U.S. Agency for International Development. Panjabi also helped oversee implementation of the President's 2022 Executive Order on Advancing Biotechnology and Biomanufacturing Innovation, which directed federal agencies to drive research and development, streamline regulation, grow manufacturing, and expand markets for biotechnology products, including by leveraging artificial intelligence and synthetic biology. Internationally, Dr. Panjabi oversaw White House implementation of the 2022 U.S. Global Health Security and International Pandemic Prevention, Preparedness and Response Act, which authorized $5 billion, expanding U.S. health investments in over 50 countries across Europe, Latin America, the Middle East, Africa, and Asia. He co-developed the President's COVID-19 and health security initiatives with the G7, G20, European Union, ASEAN, Quad (India, Australia, Japan, U.S.), CARICOM, and African Union, including efforts to organize Presidential Summits, launch the Pandemic Fund at the World Bank, negotiate the Pandemic Accord at the World Health Organization, and uphold the United Nations' Biological Weapons Convention. Panjabi was appointed by President Biden as the head of the U.S. President's Malaria Initiative. Panjabi was the first Asian American and first person born in Africa, where malaria remains endemic, to serve in the role. The U.S. President's Malaria Initiative, led by the U.S. Agency for International Development and co-implemented with the U.S. Centers for Disease Control and Prevention . Panjabi oversaw efforts to help launch the world's first malaria vaccine, create a new strategy to help save 4 million more lives and prevent 1 billion more malaria cases, and approximately $800 million of annual investment in diagnostics, treatments, disease surveillance and health systems to protect 700 million people across 30 countries in Africa and Asia. Panjabi served as technical advisor to former President Ellen Johnson Sirleaf in her role as Co-Chair of the WHO Independent Panel for Pandemic Preparedness and Response. The Independent Panel was charged with publishing a landmark independent, impartial and comprehensive review of the global COVID-19 response and recommendations to prevent the next pandemic. In 2021, it published its main report, "COVID-19: Make it the Last Pandemic." Panjabi is the co-founder and former CEO of Last Mile Health, an enterprise leveraging digital technology to train thousands of healthcare providers serving millions of people. He co-founded this organisation in 2007 with a small team of Liberian civil war survivors and American health workers and $6,000 (~$ 8,817 in 2023 ) he had received as a wedding gift. In 2017, Panjabi and Last Mile Health received the $1 million (~$ 1.22 million in 2023 ) TED Prize to launch a global training platform called the Community Health Academy. In collaboration with several partners and governments, the Academy has launched online and mobile courses for frontline health leaders and providers working to strengthen community-based primary health care. Last Mile Health's health systems leadership and clinical courses have enrolled tens of thousands of current and future healthcare leaders, community health workers, nurses, midwives and frontline clinical providers, and other learners from nearly 200 countries, including the United States, India, Nigeria, Brazil, Canada, Indonesia, United Kingdom, Philippines and Pakistan. As CEO of Last Mile Health, Panjabi led key efforts in response to 2013-16 Ebola epidemic in West Africa and the COVID-19 pandemic. Panjabi and the Last Mile Health team played a significant role in the 2013-16 West Africa Ebola epidemic, helping train over a thousand frontline and community health workers, mobilize hundreds of tons of personal protective equipment and support the Government of Liberia to organize and lead its National Ebola Operations Center. Panjabi delivered testimony at the US Senate Foreign Relations Subcommittee on Africa and Global Health Policy session, "A Progress Report of the West Africa Ebola Epidemic", arguing investments in rural community health workers can help make health systems responsive to Ebola and future epidemics . Panjabi served as health advisor to the Africa Union Africa Against Ebola Trust. He and Last Mile Health received Clinton Global Citizen Award, along with a coalition, for leadership in response to the 2013-16 West Africa Ebola epidemic. In response to COVID-19, Panjabi and Last Mile Health has supported the Africa Centers for Disease Control and Prevention as well as national governments, including Liberia, Malawi, Uganda, and Ethiopia to train frontline health workers to respond to COVID-19. He has served as co-chair of the COVID Response Fund at Echoing Green, a venture philanthropy investing in social entrepreneurs addressing the most pressing social challenges facing marginalized communities across America. Panjabi trained and worked as a clinical provider in community health systems in rural Alaska, North Carolina and Massachusetts. He has cared for outpatients on Medicaid and Medicare in federally qualified health centers pioneering value-based care and inpatients at Massachusetts General and Brigham and Women's Hospitals. Panjabi worked as a physician at the Massachusetts General Hospital and Chelsea Community Health Center in Chelsea, Massachusetts, the COVID-19 epicenter in Massachusetts, where he cared for patients with COVID and urgent care needs. Panjabi has authored or co-authored numerous publications, including on malaria, tuberculosis, HIV/AIDS, Ebola and COVID-19. He has chaired the Community Health Worker Exemplars in Global Health study with Gates Ventures (Private Office of Bill Gates) and the Gates Foundation, investigating lessons learned from exemplar community health systems in Brazil, Bangladesh, Ethiopia and Liberia. His and Last Mile Health's work on community and rural health care delivery has been published in The Lancet , the Journal of the American Medical Association , PLoS Medicine , the Bulletin of the World Health Organization , and the Journal of Global Health . Panjabi was a co-author of the report Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations . The report found that extending the reach of the primary health care system by investing in community health worker programs can deliver a high economic return—up to 10:1—and calls on government leaders, international financiers, donors, and the global health community broadly to take specific actions to support the financing and scale up of community health worker programs across sub-Saharan Africa . Panjabi has lectured at Harvard Medical School, Harvard Kennedy School of Government, and Harvard Business School. He has delivered hundreds of speeches and presentations, including award-winning TED Talks. In 2017, Panjabi delivered a TED Talk entitled, "No One Should Die Because They Live Too Far From a Doctor." Panjabi's TED Talk has been viewed over one million times and was selected as a Top 10 TED Talk of 2017, alongside TED Talks from Pope Francis and Elon Musk. He gave additional TED talks in 2018 and 2019 on the power of investing in community and frontline health workers. Panjabi spoke on a panel hosted by The Elders in celebration of Nelson Mandela's 100th birthday in South Africa, with Former Irish President, Mary Robinson, and Former Liberian President, Ellen Johnson Sirleaf. Panjabi spoke at the TIME 100 Health Summit on Closing the Healthcare Gap. Panjabi highlighted the role of investing in rural community health workers at the TIME-Fortune Global Forum hosted by Pope Francis in 2016. Panjabi delivered the commencement addresses at the graduations of Johns Hopkins Bloomberg School of Public Health in 2023, University of North Carolina Gillings School of Global Public Health in 2023, and Harvard Medical School in 2015, titled "The Power of Selfless Acts". He has delivered medical grand rounds at Harvard-teaching hospitals including Boston Children's Hospital, Massachusetts General Hospital, and Brigham & Women's Hospital, and gave a keynote address at the Institute for Healthcare Improvement's 2019 National Forum. Panjabi has served on numerous boards, councils and commissions across the public, private and social sectors. These organizations include venture backed health technology companies, Merck for Mothers, Johnson & Johnson Global Public Health, the Global Fund for AIDS Tuberculosis and Malaria (as part of the U.S. constituency), the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Bipartisan Commission on Biodefense (Ex-Officio Member), the Skoll Foundation, Echoing Green, Doctors for America, Last Mile Health, Ellen Johnson Sirleaf Presidential Foundation, Healthcare Without Harm and Practice GreenHealth, and the World Health Organization's Independent Panel for Pandemic Preparedness and Response, (as advisor to former Heads of State, Ellen Johnson Sirleaf of Liberia and Helen Clark of New Zealand). Panjabi was a Gavi Champion, member of the International Advisory Group for Frontlines First at the Global Financing Facility of the World Bank Group, advisor to the Community Health Roadmap, and a member of the Community Health Worker Hub at the World Health Organization [WHO], where he served on the External Review Group for the WHO's guidelines on health policy and system support to optimize community health worker programs. Panjabi has served as advisor to the World Health Organization's Ambassador for Health Workforce. Panjabi was named one of the World's 50 Greatest Leaders by Fortune in 2015 and 2017, listed as one of the 100 Most Influential People in the World by TIME in 2016 with a tribute from President Bill Clinton , one of TIME's 50 Most Influential People in Health Care in 2018, and received the 2017 TED Prize . He was recognized by Bill Gates in his "Heroes in the Field" series. Panjabi is a recognized social entrepreneur, receiving an Echoing Green Fellowship in 2011, a Draper Richards Kaplan Foundation Fellowship in 2013, the Skoll Award for Social Entrepreneurship and Schwab Social Entrepreneur of the Year from the World Economic Forum in 2017. In 2015, Panjabi accepted the Clinton Global Citizen Award on behalf of Last Mile Health and numerous organizations for "their leadership and collective response to the Ebola outbreak in West Africa and their continued effort to improve the health and well-being of the affected communities." In 2017, President Ellen Johnson Sirleaf and the Government of Liberia recognized Panjabi with one of Liberia's highest civilian honors: Distinction of Knight Commander in the Most Venerable Order of the Pioneers of the Republic of Liberia . In 2023, he received the Dean's Medal, the highest recognition Johns Hopkins University confers on public health leaders and the university's Distinguished Public Service Award. As White House Senior Director for global health security and biodefense and Special Assistant to the President of the United States, Panjabi played a pivotal role in the largest vaccination campaign in history against COVID-19, and White House responses to public health crises, including Mpox, Influenza, Ebola, and Marburg. Panjabi oversaw implementation of the U.S. Global COVID-19 Response and Recovery Framework, and co-organized the 2022 Presidential Global COVID-19 Summit. He played a lead role executing the 2022 National Biodefense and American Pandemic Preparedness Plans, coordinating over $12 billion in annual investment in biodefense, including in disease surveillance, diagnostics, therapeutics, vaccines and health systems. These investments are being driven by 16 federal agencies, including the Departments of Health and Human Services, Defense, Homeland Security, State, and the U.S. Agency for International Development. Panjabi also helped oversee implementation of the President's 2022 Executive Order on Advancing Biotechnology and Biomanufacturing Innovation, which directed federal agencies to drive research and development, streamline regulation, grow manufacturing, and expand markets for biotechnology products, including by leveraging artificial intelligence and synthetic biology. Internationally, Dr. Panjabi oversaw White House implementation of the 2022 U.S. Global Health Security and International Pandemic Prevention, Preparedness and Response Act, which authorized $5 billion, expanding U.S. health investments in over 50 countries across Europe, Latin America, the Middle East, Africa, and Asia. He co-developed the President's COVID-19 and health security initiatives with the G7, G20, European Union, ASEAN, Quad (India, Australia, Japan, U.S.), CARICOM, and African Union, including efforts to organize Presidential Summits, launch the Pandemic Fund at the World Bank, negotiate the Pandemic Accord at the World Health Organization, and uphold the United Nations' Biological Weapons Convention. Panjabi was appointed by President Biden as the head of the U.S. President's Malaria Initiative. Panjabi was the first Asian American and first person born in Africa, where malaria remains endemic, to serve in the role. The U.S. President's Malaria Initiative, led by the U.S. Agency for International Development and co-implemented with the U.S. Centers for Disease Control and Prevention . Panjabi oversaw efforts to help launch the world's first malaria vaccine, create a new strategy to help save 4 million more lives and prevent 1 billion more malaria cases, and approximately $800 million of annual investment in diagnostics, treatments, disease surveillance and health systems to protect 700 million people across 30 countries in Africa and Asia. As White House Senior Director for global health security and biodefense and Special Assistant to the President of the United States, Panjabi played a pivotal role in the largest vaccination campaign in history against COVID-19, and White House responses to public health crises, including Mpox, Influenza, Ebola, and Marburg. Panjabi oversaw implementation of the U.S. Global COVID-19 Response and Recovery Framework, and co-organized the 2022 Presidential Global COVID-19 Summit. He played a lead role executing the 2022 National Biodefense and American Pandemic Preparedness Plans, coordinating over $12 billion in annual investment in biodefense, including in disease surveillance, diagnostics, therapeutics, vaccines and health systems. These investments are being driven by 16 federal agencies, including the Departments of Health and Human Services, Defense, Homeland Security, State, and the U.S. Agency for International Development. Panjabi also helped oversee implementation of the President's 2022 Executive Order on Advancing Biotechnology and Biomanufacturing Innovation, which directed federal agencies to drive research and development, streamline regulation, grow manufacturing, and expand markets for biotechnology products, including by leveraging artificial intelligence and synthetic biology. Internationally, Dr. Panjabi oversaw White House implementation of the 2022 U.S. Global Health Security and International Pandemic Prevention, Preparedness and Response Act, which authorized $5 billion, expanding U.S. health investments in over 50 countries across Europe, Latin America, the Middle East, Africa, and Asia. He co-developed the President's COVID-19 and health security initiatives with the G7, G20, European Union, ASEAN, Quad (India, Australia, Japan, U.S.), CARICOM, and African Union, including efforts to organize Presidential Summits, launch the Pandemic Fund at the World Bank, negotiate the Pandemic Accord at the World Health Organization, and uphold the United Nations' Biological Weapons Convention. Panjabi was appointed by President Biden as the head of the U.S. President's Malaria Initiative. Panjabi was the first Asian American and first person born in Africa, where malaria remains endemic, to serve in the role. The U.S. President's Malaria Initiative, led by the U.S. Agency for International Development and co-implemented with the U.S. Centers for Disease Control and Prevention . Panjabi oversaw efforts to help launch the world's first malaria vaccine, create a new strategy to help save 4 million more lives and prevent 1 billion more malaria cases, and approximately $800 million of annual investment in diagnostics, treatments, disease surveillance and health systems to protect 700 million people across 30 countries in Africa and Asia. Panjabi served as technical advisor to former President Ellen Johnson Sirleaf in her role as Co-Chair of the WHO Independent Panel for Pandemic Preparedness and Response. The Independent Panel was charged with publishing a landmark independent, impartial and comprehensive review of the global COVID-19 response and recommendations to prevent the next pandemic. In 2021, it published its main report, "COVID-19: Make it the Last Pandemic." Panjabi is the co-founder and former CEO of Last Mile Health, an enterprise leveraging digital technology to train thousands of healthcare providers serving millions of people. He co-founded this organisation in 2007 with a small team of Liberian civil war survivors and American health workers and $6,000 (~$ 8,817 in 2023 ) he had received as a wedding gift. In 2017, Panjabi and Last Mile Health received the $1 million (~$ 1.22 million in 2023 ) TED Prize to launch a global training platform called the Community Health Academy. In collaboration with several partners and governments, the Academy has launched online and mobile courses for frontline health leaders and providers working to strengthen community-based primary health care. Last Mile Health's health systems leadership and clinical courses have enrolled tens of thousands of current and future healthcare leaders, community health workers, nurses, midwives and frontline clinical providers, and other learners from nearly 200 countries, including the United States, India, Nigeria, Brazil, Canada, Indonesia, United Kingdom, Philippines and Pakistan. As CEO of Last Mile Health, Panjabi led key efforts in response to 2013-16 Ebola epidemic in West Africa and the COVID-19 pandemic. Panjabi and the Last Mile Health team played a significant role in the 2013-16 West Africa Ebola epidemic, helping train over a thousand frontline and community health workers, mobilize hundreds of tons of personal protective equipment and support the Government of Liberia to organize and lead its National Ebola Operations Center. Panjabi delivered testimony at the US Senate Foreign Relations Subcommittee on Africa and Global Health Policy session, "A Progress Report of the West Africa Ebola Epidemic", arguing investments in rural community health workers can help make health systems responsive to Ebola and future epidemics . Panjabi served as health advisor to the Africa Union Africa Against Ebola Trust. He and Last Mile Health received Clinton Global Citizen Award, along with a coalition, for leadership in response to the 2013-16 West Africa Ebola epidemic. In response to COVID-19, Panjabi and Last Mile Health has supported the Africa Centers for Disease Control and Prevention as well as national governments, including Liberia, Malawi, Uganda, and Ethiopia to train frontline health workers to respond to COVID-19. He has served as co-chair of the COVID Response Fund at Echoing Green, a venture philanthropy investing in social entrepreneurs addressing the most pressing social challenges facing marginalized communities across America.Panjabi trained and worked as a clinical provider in community health systems in rural Alaska, North Carolina and Massachusetts. He has cared for outpatients on Medicaid and Medicare in federally qualified health centers pioneering value-based care and inpatients at Massachusetts General and Brigham and Women's Hospitals. Panjabi worked as a physician at the Massachusetts General Hospital and Chelsea Community Health Center in Chelsea, Massachusetts, the COVID-19 epicenter in Massachusetts, where he cared for patients with COVID and urgent care needs.Panjabi has authored or co-authored numerous publications, including on malaria, tuberculosis, HIV/AIDS, Ebola and COVID-19. He has chaired the Community Health Worker Exemplars in Global Health study with Gates Ventures (Private Office of Bill Gates) and the Gates Foundation, investigating lessons learned from exemplar community health systems in Brazil, Bangladesh, Ethiopia and Liberia. His and Last Mile Health's work on community and rural health care delivery has been published in The Lancet , the Journal of the American Medical Association , PLoS Medicine , the Bulletin of the World Health Organization , and the Journal of Global Health . Panjabi was a co-author of the report Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations . The report found that extending the reach of the primary health care system by investing in community health worker programs can deliver a high economic return—up to 10:1—and calls on government leaders, international financiers, donors, and the global health community broadly to take specific actions to support the financing and scale up of community health worker programs across sub-Saharan Africa . Panjabi has lectured at Harvard Medical School, Harvard Kennedy School of Government, and Harvard Business School. He has delivered hundreds of speeches and presentations, including award-winning TED Talks. In 2017, Panjabi delivered a TED Talk entitled, "No One Should Die Because They Live Too Far From a Doctor." Panjabi's TED Talk has been viewed over one million times and was selected as a Top 10 TED Talk of 2017, alongside TED Talks from Pope Francis and Elon Musk. He gave additional TED talks in 2018 and 2019 on the power of investing in community and frontline health workers. Panjabi spoke on a panel hosted by The Elders in celebration of Nelson Mandela's 100th birthday in South Africa, with Former Irish President, Mary Robinson, and Former Liberian President, Ellen Johnson Sirleaf. Panjabi spoke at the TIME 100 Health Summit on Closing the Healthcare Gap. Panjabi highlighted the role of investing in rural community health workers at the TIME-Fortune Global Forum hosted by Pope Francis in 2016. Panjabi delivered the commencement addresses at the graduations of Johns Hopkins Bloomberg School of Public Health in 2023, University of North Carolina Gillings School of Global Public Health in 2023, and Harvard Medical School in 2015, titled "The Power of Selfless Acts". He has delivered medical grand rounds at Harvard-teaching hospitals including Boston Children's Hospital, Massachusetts General Hospital, and Brigham & Women's Hospital, and gave a keynote address at the Institute for Healthcare Improvement's 2019 National Forum. Panjabi has served on numerous boards, councils and commissions across the public, private and social sectors. These organizations include venture backed health technology companies, Merck for Mothers, Johnson & Johnson Global Public Health, the Global Fund for AIDS Tuberculosis and Malaria (as part of the U.S. constituency), the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Bipartisan Commission on Biodefense (Ex-Officio Member), the Skoll Foundation, Echoing Green, Doctors for America, Last Mile Health, Ellen Johnson Sirleaf Presidential Foundation, Healthcare Without Harm and Practice GreenHealth, and the World Health Organization's Independent Panel for Pandemic Preparedness and Response, (as advisor to former Heads of State, Ellen Johnson Sirleaf of Liberia and Helen Clark of New Zealand). Panjabi was a Gavi Champion, member of the International Advisory Group for Frontlines First at the Global Financing Facility of the World Bank Group, advisor to the Community Health Roadmap, and a member of the Community Health Worker Hub at the World Health Organization [WHO], where he served on the External Review Group for the WHO's guidelines on health policy and system support to optimize community health worker programs. Panjabi has served as advisor to the World Health Organization's Ambassador for Health Workforce.Panjabi was named one of the World's 50 Greatest Leaders by Fortune in 2015 and 2017, listed as one of the 100 Most Influential People in the World by TIME in 2016 with a tribute from President Bill Clinton , one of TIME's 50 Most Influential People in Health Care in 2018, and received the 2017 TED Prize . He was recognized by Bill Gates in his "Heroes in the Field" series. Panjabi is a recognized social entrepreneur, receiving an Echoing Green Fellowship in 2011, a Draper Richards Kaplan Foundation Fellowship in 2013, the Skoll Award for Social Entrepreneurship and Schwab Social Entrepreneur of the Year from the World Economic Forum in 2017. In 2015, Panjabi accepted the Clinton Global Citizen Award on behalf of Last Mile Health and numerous organizations for "their leadership and collective response to the Ebola outbreak in West Africa and their continued effort to improve the health and well-being of the affected communities." In 2017, President Ellen Johnson Sirleaf and the Government of Liberia recognized Panjabi with one of Liberia's highest civilian honors: Distinction of Knight Commander in the Most Venerable Order of the Pioneers of the Republic of Liberia . In 2023, he received the Dean's Medal, the highest recognition Johns Hopkins University confers on public health leaders and the university's Distinguished Public Service Award.

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GMHC

The GMHC (formerly Gay Men's Health Crisis ) is a New York City –based non-profit , volunteer-supported and community-based AIDS service organization whose mission statement is to "end the AIDS epidemic and uplift the lives of all affected." Founded in 1982, it is often billed as the "world's oldest AIDS service organization, " as well as the "nation's oldest HIV/AIDS service organization." The organization was founded in January 1982 after reports began surfacing in San Francisco and New York City that a rare form of cancer called Kaposi's sarcoma was affecting young gay men. After the Centers for Disease Control declared the new disease an epidemic , Gay Men's Health Crisis was created when 80 men gathered in New York writer Larry Kramer 's apartment to discuss the issue of " gay cancer " and to raise money for research. GMHC took its name from the fact that the earliest men who fell victim to AIDS in the early 1980s were gay . The first meeting was held in Church of St. Joseph in Greenwich Village . The founders were Nathan Fain, Larry Kramer, Lawrence D. Mass , Paul Popham , Paul Rapoport and Edmund White . They organized the formal, tax-exempt entity, which was incorporated on June 30, 1982. At the time it was the largest volunteer AIDS organization in the world. Paul Popham was chosen as the president . Rodger McFarlane began a crisis counseling hotline that originated on his own home telephone, which ultimately became one of the organization's most effective tools for sharing information about AIDS. He was named as the director of GMHC in 1982, helping create a more formal structure for the nascent organization, which had no funding or offices when he took on the role. GMHC operated out of a couple of rooms for offices in a rooming house at 318 West 22nd Street in Chelsea owned by Mel Cheren of West End Records . Paul Popham's dedication to combating the AIDS crisis and his collaboration with stakeholders worldwide emphasized his commitment to public health. Upon receiving outreach from Gordon Price , a co-founder of AIDS Vancouver , Popham traveled to Vancouver , on the west coast of Canada , offering his invaluable expertise. This pivotal partnership culminated in the inception of the inaugural AIDS Information Forum on March 12, 1983. Notably, Popham's knowledge shared during this forum was immortalized on film, signifying a momentous stride in the nascent endeavors to tackle the epidemic. Larry Kramer wrote that by the time of McFarlane's death, "the GMHC is essentially what he started: crisis counseling, legal aid, volunteers, the buddy system, social workers" as part of an organization that serves more than 15,000 people affected by HIV and AIDS. In an interview with The New York Times after McFarlane's death in May 2009, Kramer described how "single-handedly Rodger took this struggling ragtag group of really frightened and mostly young men, found us an office and set up all the programs." Kramer resigned in 1983 due to his many disagreements with the other founders. From that time on his public comments and posture toward GMHC were negative, if not hostile. Kramer's play The Normal Heart is a roman à clef of his involvement with the organization. On April 30, 1983, the GMHC sponsored the first major fund-raising event for AIDS – a benefit performance of the Ringling Bros. and Barnum & Bailey Circus . By 1984, the Centers for Disease Control had requested GMHC's assistance in planning public conferences on AIDS. That same year, the human immunodeficiency virus was discovered by the French Drs Françoise Barré-Sinoussi and Luc Montagnier . Within two years, GMHC was assisting heterosexual men and women (see Dennis Levy ), hemophiliacs , intravenous drug users, and children. From 1987 until his death from AIDS in 1989, Doctor Barry Gingell served as a medical director for the Gay Men's Health Crisis. Gay Men's Health Crisis received extensive coverage in Randy Shilts 's 1987 book And the Band Played On . The book described the progress of the pandemic , blaming the government, especially the Reagan administration and Secretary of Health Margaret Heckler , for failing to respond. It praised GMHC for its work. Shilts was a gay man who later died of AIDS. GMHC, along with several other organizations, boycotted the 1990 International AIDS Conference in San Francisco, California in protest of the federal travel ban on people with HIV entering the United States. Though representatives from GMHC did not attend the official event, they did participate in a smaller conference, for people who had boycotted, which took place simultaneously in San Francisco. The Fox Broadcasting Company donated the proceeds from the airing of the 1992 Freddie Mercury Tribute Concert in London's Wembley Stadium to GMHC. GMHC debuted an HIV prevention subway campaign featuring gay and straight couples in 1994. GMHC admitted that the posters were "more explicit" than what they had produced in the past and featured animated condoms, lubricant and messages aimed towards sexually active youth, with the slogan "Young! Hot! Safe!" Staff at GMHC later said that the organization received bomb threats specifically citing the campaign. GMHC employee James A. Fielding sued the organization alleging discrimination in 1994. Fielding sought $1.7 million in compensatory and punitive damages, claiming that he was not given a fair chance to apply for a role within GMHC, as leadership was afraid that, due to his HIV-positive status, he would have to call in sick. A 1995 New York Times report detailing the FBI keeping a record of activist group ACT UP also claimed that the FBI kept a small file dedicated to GMHC. Broadway star Bernadette Peters made her Carnegie Hall debut with a fundraiser for the organization. GMHC began offering HIV testing and prevention counseling at its offices in 1997, at the David Geffen Center for HIV Prevention and Health Education after a $2.5 million gift from the David Geffen Foundation. In 1997 the organization moved into headquarters at the nine-story Tisch Building at 119 West 24 Street in the Chelsea neighborhood. The building underwent a $12.5 million renovation. It is named for Preston Robert Tisch and Joan Tisch . The couple donated $3.5 million for the project and Joan is on the GMHC board of directors. Weill-Cornell Medical Center opened the Chelsea Center for Special Studies, in GMHC's building in 1997, in what was then described as the "first large-scale collaboration between a major New York City hospital and an AIDS social service agency." The center offered medical services to people with HIV, many of them referred from GMHC. Donna Summer headlined a fundraiser at Carnegie Hall that raised $400,000 for GMHC in 1998. GMHC supported SB4422-B, a New York state bill to track new HIV infections in New York state, breaking from a consensus against such reporting among AIDS groups in the state. In its initial statement, GMHC supported following the "same practice used for infectious diseases like syphilis and tuberculosis." In its statement, the organization did not initially say that it discouraged New York state from collecting names, though in a later clarification, it said that it supported a code-based system rather than using the names of people living with HIV. In the 1990s a fundraising event on the Atlantic Ocean beach at Fire Island Pines, New York evolved into a major circuit party and developed a reputation for being connected with unsafe sex and recreational drug use . Activist Spencer Cox wrote a letter to the New York Times defending the party, which he called a "drug-free event." He continued, "Perhaps if he had attended the party, he might have a better sense of how this annual celebration contributes to the fight against AIDS ... As a person with AIDS, I am comforted to know that the money raised will be used to finance needed services, and hope that G.M.H.C. will not sacrifice those programs by discontinuing the Morning Party." GMHC pulled the plug after the 1998 fundraiser after one man died on Fire Island of an overdose of the drug gamma hydroxy butyrate (GHB) the evening before the party and 21 revelers were arrested for drug possession . In the year 2000, Ana Oliveira, a lesbian and an acupuncturist, became the first woman to become the organization's executive director. She had been an employee there since 1996 and founded the organization's women's program. The decision to appoint Oliveira to the position was unanimous. In April 2000, GMHC released Men Like Us: The GMHC Complete Guide to Gay Men's Sexual, Physical and Emotional Well-Being , written by the organization's former communications director, Daniel Wolfe. The book included basic information about sex, sexual pleasure, as well as nutrition, exercise, communication with partners, and more. The book was one of 61 nonfiction books nominated for a Stonewall Book Award from the American Library Association . The award eventually went to Gaylaw: Challenging the Apartheid of the Closet . The Museum of the City of New York debuted an exhibit, "Gay Men's Health Crisis: 20 Years Fighting for People with HIV/AIDS," a collaboration between the museum and GMHC in April 2001. Curators of the exhibit, Jane Rossett and Jean Carlomusto alleged that the institution eliminated explicit sexual content, including depictions of sexual intimacy between gay men, from the exhibit, altering the meaning of the exhibit and the materials presented within. The materials included items documenting public health information campaigns about AIDS. Lawrence D. Mass , one of GMHC's founders, told the New York Times that the decision was "disturbing" and said the museum was practicing "real censorship and distortion of history. " In an opinion published in the New York Times, the museum's director Robert Macdonald said the museum and GMHC "decided that sexually explicit images would not be included in the exhibition" in order to present the story to the "widest possible audience." He added, "To characterize that decision as censorship demonstrates a misguided view of the purpose of the exhibition and the professional responsibilities of museums." To commemorate the 20th anniversary of AIDS in America, the AIDS Quilt hung in the GMHC lobby during World AIDS Day in 2001. In the early 2000s, GMHC began a support group for people, especially gay men, who use crystal meth . In 2004, GMHC reported that 80% of new clients in its drug program reported using crystal meth, though it had been fewer than half in 2001. As part of an effort to raise awareness about a documented rise in crystal meth use, GMHC also began a poster campaign warning about the links between crystal meth and unsafe sex practices. The posters ran on gay cruising sites such as Manhunt. GMHC and other community groups also pushed back against efforts from federal prosecutors to distribute posters with the names and faces of known crystal meth dealers in gay neighborhoods, including Chelsea. In a January 2004 letter to the editor, Ana Oliveira expressed a desire to use a harm-reduction approach to crystal meth use. Oliveira announced that she would leave GMHC, and her post as executive director, in December 2005. Dr. Marjoire Hill was named as the interim executive director in February 2006. Due to decreased funding, GMHC ended its "buddy program" in 2005. Prior to the 2008 presidential election , GMHC released a report outlining the stances of John McCain, Sarah Palin, Barack Obama, and Joe Biden on issues related to HIV/AIDS. After Barack Obama's election, GMHC released a policy brief detailing a set of federal priorities related to HIV, including the development of a national HIV/AIDS strategy, the repeal of the HIV travel ban, as well as a repeal of the federal ban on syringe exchange . GMHC has received multiple grants from the Carnegie Corporation , an organization that has supported more than 550 New York City arts and social service institutions since its inception in 2002, and which was made possible through a donation by New York City mayor Michael Bloomberg (along with 406 other arts and social service institutions). Gay Men's Health Crisis (GMHC) moved to a new and expanded home consisting of 110,000 square feet (10,000 m 2 ) of redesigned and renovated space at 446 West 33rd Street in Manhattan . At the time of the announcement, co-founder Larry Kramer expressed disappointment with the move. GMHC expanded its wide range of services for over 100,000 New Yorkers affected by HIV/AIDS. These services include health and nutrition education, legal, housing and mental health support, vocational training and case management. With a new state-of-the-art kitchen and larger dining room, free hot meals will be served to more clients. The Keith Haring Food Pantry Program will increase its capacity to provide grocery bags and nutrition counseling to more people in need. During GMHC's move into their new building they were met with discrimination from prospective landlords. Many did not understand what GMHC was and how they offered services to the community and those sick with HIV/AIDS. Even when GMHC found a place to live there were several restrictions placed upon by the landlord. A major one was that GMHC couldn't perform any sort of medical procedures on the premises. This forced the GMHC clinic to not move along with the rest of GMHC. The new location enabled GMHC to expand its services to meet the growing and complex needs of people affected by HIV/AIDS. In this 39th year of the epidemic, HIV continues to rise at alarming rates – locally and nationally – particularly among women, African Americans , Latinos and men who have sex with men . In 2010, GMHC expanded its "I Love My Boo" anti-stigma campaign into New York City subways . The ads featured Black and Latino same-sex couples embracing, holding hands and kissing and promoted HIV testing among gay men of color. The campaign, which had previously run in gay bars, received positive praise from journalist Kai Wright , who called it one of the "smartest, most compelling public health campaigns." In May 2010, GMHC celebrated the 25th anniversary of its annual fundraiser, AIDS Walk New York . GMHC had hoped to raise $5.3 million for the occasion and ended up raising $5.7 million. GMHC joined an open letter from several nonprofit organizations urging the FDA to approve Truvada for use as pre-exposure prophylaxis in 2011. GMHC partnered with GLAAD to denounce the New York City Department of Health and Mental Hygiene 's ad campaign "Never Just HIV," which used graphic images to warn people that an HIV diagnosis could lead to other comorbidities . Francisco Roque, then the director of community health, said the ad campaign "paints this picture of gay men as these sort of disease-ridden vessels." GLAAD President Jarrett Barrios called the ad "sensationalized" and added that it "misses the mark in fairly and accurately representing what it's like to live with HIV/AIDS." The New York Public Library put together an exhibition, "Celebrating 100 Years," in 2011 that was put together to "show the depth and breadth" of the library's collection. The exhibition included condoms distributed by GMHC in the 1990s. While appearing on the fifth season The Celebrity Apprentice , comedian Lisa Lampanelli raised $130,000 for GMHC. In September 2013, GMHC announced that the organization and its CEO, Dr. Marjorie Hill, had "mutually decided" that they would part ways and that she would leave her role. Subsequent reporting about Hill's departure alleged that the organization's board of directors fired Hill, apparently because Hill "angered clients and staff." After news of her departure, a group of AIDS activists and professionals in the AIDS community wrote an open letter in support of Hill, noting that her service to GMHC is "unprecedented" and that she was at the time the longest-serving CEO with a tenure of seven years. In the weeks following Hill's resignation, GMHC faced scrutiny for what some activists deemed as a lack of leadership in facing the AIDS crisis in New York City. ACT UP member Peter Staley wrote in HuffPost, " I can't tell you how many gay men I know who feel that GMHC is no longer on the community's radar," while a feature in the New York Times also spoke to several leaders who questioned the organization's direction. GMHC joined a coalition of national LGBTQ+-serving organizations and issued an open letter seeking justice for Trayvon Martin in July 2013. During the 2013 New York City mayoral election , GMHC held a forum for candidates to speak about issues related to HIV/AIDS in the city. Both Bill DeBlasio and Anthony Weiner attended the forum, which took place only three days after the Anthony Weiner sexting scandal made breaking news. Participants included New York City comptroller John C. Liu , former comptroller William C. Thompson Jr. , speaker for the New York City Council Christine Quinn , New York City Council member Sal F. Albanese and former Bronx Borough President Adolfo Carrión, Jr. A 2013 DNAInfo report alleged that donations made to the annual AIDS Walk New York fundraiser were spent on administrative costs, including rent, rather than direct services. GMHC issued a statement calling the report "grossly inaccurate" and later released a statement which said that "in a time of leadership transition we are vulnerable to the attacks of "anonymous sources." GMHC said that due to stigma from landlords, it had few options for relocating in 2011, meaning a "near doubling in rent." GMHC joined a coalition of AIDS organizations in signing an open letter to the Centers for Disease Control and Prevention urging that it stop using stigmatizing language, including "unprotected anal sex" in its materials. The letter stated that "unprotected" most often meant anal sex without a condom, but that the meaning of "unprotected" had changed alongside the approval of Truvada as pre-exposure prophylaxis . The organization announced Kelsey Louie as the new CEO in April 2014. After the approval of Truvada as pre-exposure prophylaxis in 2012, some AIDS service organizations spoke out against the drug, including Michael Weinstein of AIDS Healthcare Foundation , who called the pill a "party drug." However, GMHC embraced Truvada and in October 2014 released a statement saying that GMHC would advocate for the "widespread adoption" of PrEP. In 2016, GMHC launched an ad campaign to spread awareness around PrEP. The ads ran at 10 bus shelters in Brooklyn, Queens, the Bronx and uptown Manhattan. GMHC helped to produce the return of the drag festival Wigstock in 2018. The HIV prevention and testing programs expanded in the new GMHC Center for HIV Prevention at 224 West 29th Street in NYC which will include a new youth leadership-development program. In 2019, GMHC's Testing Center moved to 307 West 38th Street where the offices are located as of 2018. [ when? ] In order to keep up with the COVID-19 global pandemic GMHC has begun offering HIV testing at home to make sure people are sticking to social distance guidelines. They have also closed their usual testing site and created an offsite location for continuing testing. The test results can take anywhere from 2–20 minutes for people to get an answer. While GMHC cannot give out HIV medications such as PrEP or PEP they can help people find options at a lower cost once they have a prescription. In 2015 Larry Kramer was reunited with GMHC almost thirty years after he was removed from the organization. Even after years of criticism from Kramer about many of the choices made by GMHC, Kelsey Louie, a member of GMHC reached out to Kramer. After several meetings between Kelsey and Kramer a peace offering seemed to have been reached. Kramer was invited to GMHC's gala as a special guest and presented with their first ever lifetime achievement award. Kramer held no ill will towards the organization and was happy to be invited back. Since his first appearance, Kramer continued to attend GMHC events and had even been invited to speak at GMHC staff meetings before his death in May 2020. To commemorate the 40th anniversary of AIDS in the United States, GMHC launched a video series featuring prominent members of the HIV/AIDS community, including GMHC co-founder Larry Mass , activist Mark S. King , and former speakers of the New York City council Corey Johnson . Those featured in the videos were invited to "share their thoughts on what will it take to end the epidemic in our lifetimes." GMHC helped stage a response to the 2022-2023 mpox outbreak in New York City. The organization created a dedication section of the website with information about the virus and handed out information about the virus at their annual Latex Ball fundraiser. The organization was founded in January 1982 after reports began surfacing in San Francisco and New York City that a rare form of cancer called Kaposi's sarcoma was affecting young gay men. After the Centers for Disease Control declared the new disease an epidemic , Gay Men's Health Crisis was created when 80 men gathered in New York writer Larry Kramer 's apartment to discuss the issue of " gay cancer " and to raise money for research. GMHC took its name from the fact that the earliest men who fell victim to AIDS in the early 1980s were gay . The first meeting was held in Church of St. Joseph in Greenwich Village . The founders were Nathan Fain, Larry Kramer, Lawrence D. Mass , Paul Popham , Paul Rapoport and Edmund White . They organized the formal, tax-exempt entity, which was incorporated on June 30, 1982. At the time it was the largest volunteer AIDS organization in the world. Paul Popham was chosen as the president . Rodger McFarlane began a crisis counseling hotline that originated on his own home telephone, which ultimately became one of the organization's most effective tools for sharing information about AIDS. He was named as the director of GMHC in 1982, helping create a more formal structure for the nascent organization, which had no funding or offices when he took on the role. GMHC operated out of a couple of rooms for offices in a rooming house at 318 West 22nd Street in Chelsea owned by Mel Cheren of West End Records . Paul Popham's dedication to combating the AIDS crisis and his collaboration with stakeholders worldwide emphasized his commitment to public health. Upon receiving outreach from Gordon Price , a co-founder of AIDS Vancouver , Popham traveled to Vancouver , on the west coast of Canada , offering his invaluable expertise. This pivotal partnership culminated in the inception of the inaugural AIDS Information Forum on March 12, 1983. Notably, Popham's knowledge shared during this forum was immortalized on film, signifying a momentous stride in the nascent endeavors to tackle the epidemic. Larry Kramer wrote that by the time of McFarlane's death, "the GMHC is essentially what he started: crisis counseling, legal aid, volunteers, the buddy system, social workers" as part of an organization that serves more than 15,000 people affected by HIV and AIDS. In an interview with The New York Times after McFarlane's death in May 2009, Kramer described how "single-handedly Rodger took this struggling ragtag group of really frightened and mostly young men, found us an office and set up all the programs." Kramer resigned in 1983 due to his many disagreements with the other founders. From that time on his public comments and posture toward GMHC were negative, if not hostile. Kramer's play The Normal Heart is a roman à clef of his involvement with the organization. On April 30, 1983, the GMHC sponsored the first major fund-raising event for AIDS – a benefit performance of the Ringling Bros. and Barnum & Bailey Circus . By 1984, the Centers for Disease Control had requested GMHC's assistance in planning public conferences on AIDS. That same year, the human immunodeficiency virus was discovered by the French Drs Françoise Barré-Sinoussi and Luc Montagnier . Within two years, GMHC was assisting heterosexual men and women (see Dennis Levy ), hemophiliacs , intravenous drug users, and children. From 1987 until his death from AIDS in 1989, Doctor Barry Gingell served as a medical director for the Gay Men's Health Crisis. Gay Men's Health Crisis received extensive coverage in Randy Shilts 's 1987 book And the Band Played On . The book described the progress of the pandemic , blaming the government, especially the Reagan administration and Secretary of Health Margaret Heckler , for failing to respond. It praised GMHC for its work. Shilts was a gay man who later died of AIDS. GMHC, along with several other organizations, boycotted the 1990 International AIDS Conference in San Francisco, California in protest of the federal travel ban on people with HIV entering the United States. Though representatives from GMHC did not attend the official event, they did participate in a smaller conference, for people who had boycotted, which took place simultaneously in San Francisco. The Fox Broadcasting Company donated the proceeds from the airing of the 1992 Freddie Mercury Tribute Concert in London's Wembley Stadium to GMHC. GMHC debuted an HIV prevention subway campaign featuring gay and straight couples in 1994. GMHC admitted that the posters were "more explicit" than what they had produced in the past and featured animated condoms, lubricant and messages aimed towards sexually active youth, with the slogan "Young! Hot! Safe!" Staff at GMHC later said that the organization received bomb threats specifically citing the campaign. GMHC employee James A. Fielding sued the organization alleging discrimination in 1994. Fielding sought $1.7 million in compensatory and punitive damages, claiming that he was not given a fair chance to apply for a role within GMHC, as leadership was afraid that, due to his HIV-positive status, he would have to call in sick. A 1995 New York Times report detailing the FBI keeping a record of activist group ACT UP also claimed that the FBI kept a small file dedicated to GMHC. Broadway star Bernadette Peters made her Carnegie Hall debut with a fundraiser for the organization. GMHC began offering HIV testing and prevention counseling at its offices in 1997, at the David Geffen Center for HIV Prevention and Health Education after a $2.5 million gift from the David Geffen Foundation. In 1997 the organization moved into headquarters at the nine-story Tisch Building at 119 West 24 Street in the Chelsea neighborhood. The building underwent a $12.5 million renovation. It is named for Preston Robert Tisch and Joan Tisch . The couple donated $3.5 million for the project and Joan is on the GMHC board of directors. Weill-Cornell Medical Center opened the Chelsea Center for Special Studies, in GMHC's building in 1997, in what was then described as the "first large-scale collaboration between a major New York City hospital and an AIDS social service agency." The center offered medical services to people with HIV, many of them referred from GMHC. Donna Summer headlined a fundraiser at Carnegie Hall that raised $400,000 for GMHC in 1998. GMHC supported SB4422-B, a New York state bill to track new HIV infections in New York state, breaking from a consensus against such reporting among AIDS groups in the state. In its initial statement, GMHC supported following the "same practice used for infectious diseases like syphilis and tuberculosis." In its statement, the organization did not initially say that it discouraged New York state from collecting names, though in a later clarification, it said that it supported a code-based system rather than using the names of people living with HIV. In the 1990s a fundraising event on the Atlantic Ocean beach at Fire Island Pines, New York evolved into a major circuit party and developed a reputation for being connected with unsafe sex and recreational drug use . Activist Spencer Cox wrote a letter to the New York Times defending the party, which he called a "drug-free event." He continued, "Perhaps if he had attended the party, he might have a better sense of how this annual celebration contributes to the fight against AIDS ... As a person with AIDS, I am comforted to know that the money raised will be used to finance needed services, and hope that G.M.H.C. will not sacrifice those programs by discontinuing the Morning Party." GMHC pulled the plug after the 1998 fundraiser after one man died on Fire Island of an overdose of the drug gamma hydroxy butyrate (GHB) the evening before the party and 21 revelers were arrested for drug possession . In the year 2000, Ana Oliveira, a lesbian and an acupuncturist, became the first woman to become the organization's executive director. She had been an employee there since 1996 and founded the organization's women's program. The decision to appoint Oliveira to the position was unanimous. In April 2000, GMHC released Men Like Us: The GMHC Complete Guide to Gay Men's Sexual, Physical and Emotional Well-Being , written by the organization's former communications director, Daniel Wolfe. The book included basic information about sex, sexual pleasure, as well as nutrition, exercise, communication with partners, and more. The book was one of 61 nonfiction books nominated for a Stonewall Book Award from the American Library Association . The award eventually went to Gaylaw: Challenging the Apartheid of the Closet . The Museum of the City of New York debuted an exhibit, "Gay Men's Health Crisis: 20 Years Fighting for People with HIV/AIDS," a collaboration between the museum and GMHC in April 2001. Curators of the exhibit, Jane Rossett and Jean Carlomusto alleged that the institution eliminated explicit sexual content, including depictions of sexual intimacy between gay men, from the exhibit, altering the meaning of the exhibit and the materials presented within. The materials included items documenting public health information campaigns about AIDS. Lawrence D. Mass , one of GMHC's founders, told the New York Times that the decision was "disturbing" and said the museum was practicing "real censorship and distortion of history. " In an opinion published in the New York Times, the museum's director Robert Macdonald said the museum and GMHC "decided that sexually explicit images would not be included in the exhibition" in order to present the story to the "widest possible audience." He added, "To characterize that decision as censorship demonstrates a misguided view of the purpose of the exhibition and the professional responsibilities of museums." To commemorate the 20th anniversary of AIDS in America, the AIDS Quilt hung in the GMHC lobby during World AIDS Day in 2001. In the early 2000s, GMHC began a support group for people, especially gay men, who use crystal meth . In 2004, GMHC reported that 80% of new clients in its drug program reported using crystal meth, though it had been fewer than half in 2001. As part of an effort to raise awareness about a documented rise in crystal meth use, GMHC also began a poster campaign warning about the links between crystal meth and unsafe sex practices. The posters ran on gay cruising sites such as Manhunt. GMHC and other community groups also pushed back against efforts from federal prosecutors to distribute posters with the names and faces of known crystal meth dealers in gay neighborhoods, including Chelsea. In a January 2004 letter to the editor, Ana Oliveira expressed a desire to use a harm-reduction approach to crystal meth use. Oliveira announced that she would leave GMHC, and her post as executive director, in December 2005. Dr. Marjoire Hill was named as the interim executive director in February 2006. Due to decreased funding, GMHC ended its "buddy program" in 2005. Prior to the 2008 presidential election , GMHC released a report outlining the stances of John McCain, Sarah Palin, Barack Obama, and Joe Biden on issues related to HIV/AIDS. After Barack Obama's election, GMHC released a policy brief detailing a set of federal priorities related to HIV, including the development of a national HIV/AIDS strategy, the repeal of the HIV travel ban, as well as a repeal of the federal ban on syringe exchange . GMHC has received multiple grants from the Carnegie Corporation , an organization that has supported more than 550 New York City arts and social service institutions since its inception in 2002, and which was made possible through a donation by New York City mayor Michael Bloomberg (along with 406 other arts and social service institutions).Gay Men's Health Crisis (GMHC) moved to a new and expanded home consisting of 110,000 square feet (10,000 m 2 ) of redesigned and renovated space at 446 West 33rd Street in Manhattan . At the time of the announcement, co-founder Larry Kramer expressed disappointment with the move. GMHC expanded its wide range of services for over 100,000 New Yorkers affected by HIV/AIDS. These services include health and nutrition education, legal, housing and mental health support, vocational training and case management. With a new state-of-the-art kitchen and larger dining room, free hot meals will be served to more clients. The Keith Haring Food Pantry Program will increase its capacity to provide grocery bags and nutrition counseling to more people in need. During GMHC's move into their new building they were met with discrimination from prospective landlords. Many did not understand what GMHC was and how they offered services to the community and those sick with HIV/AIDS. Even when GMHC found a place to live there were several restrictions placed upon by the landlord. A major one was that GMHC couldn't perform any sort of medical procedures on the premises. This forced the GMHC clinic to not move along with the rest of GMHC. The new location enabled GMHC to expand its services to meet the growing and complex needs of people affected by HIV/AIDS. In this 39th year of the epidemic, HIV continues to rise at alarming rates – locally and nationally – particularly among women, African Americans , Latinos and men who have sex with men . In 2010, GMHC expanded its "I Love My Boo" anti-stigma campaign into New York City subways . The ads featured Black and Latino same-sex couples embracing, holding hands and kissing and promoted HIV testing among gay men of color. The campaign, which had previously run in gay bars, received positive praise from journalist Kai Wright , who called it one of the "smartest, most compelling public health campaigns." In May 2010, GMHC celebrated the 25th anniversary of its annual fundraiser, AIDS Walk New York . GMHC had hoped to raise $5.3 million for the occasion and ended up raising $5.7 million. GMHC joined an open letter from several nonprofit organizations urging the FDA to approve Truvada for use as pre-exposure prophylaxis in 2011. GMHC partnered with GLAAD to denounce the New York City Department of Health and Mental Hygiene 's ad campaign "Never Just HIV," which used graphic images to warn people that an HIV diagnosis could lead to other comorbidities . Francisco Roque, then the director of community health, said the ad campaign "paints this picture of gay men as these sort of disease-ridden vessels." GLAAD President Jarrett Barrios called the ad "sensationalized" and added that it "misses the mark in fairly and accurately representing what it's like to live with HIV/AIDS." The New York Public Library put together an exhibition, "Celebrating 100 Years," in 2011 that was put together to "show the depth and breadth" of the library's collection. The exhibition included condoms distributed by GMHC in the 1990s. While appearing on the fifth season The Celebrity Apprentice , comedian Lisa Lampanelli raised $130,000 for GMHC. In September 2013, GMHC announced that the organization and its CEO, Dr. Marjorie Hill, had "mutually decided" that they would part ways and that she would leave her role. Subsequent reporting about Hill's departure alleged that the organization's board of directors fired Hill, apparently because Hill "angered clients and staff." After news of her departure, a group of AIDS activists and professionals in the AIDS community wrote an open letter in support of Hill, noting that her service to GMHC is "unprecedented" and that she was at the time the longest-serving CEO with a tenure of seven years. In the weeks following Hill's resignation, GMHC faced scrutiny for what some activists deemed as a lack of leadership in facing the AIDS crisis in New York City. ACT UP member Peter Staley wrote in HuffPost, " I can't tell you how many gay men I know who feel that GMHC is no longer on the community's radar," while a feature in the New York Times also spoke to several leaders who questioned the organization's direction. GMHC joined a coalition of national LGBTQ+-serving organizations and issued an open letter seeking justice for Trayvon Martin in July 2013. During the 2013 New York City mayoral election , GMHC held a forum for candidates to speak about issues related to HIV/AIDS in the city. Both Bill DeBlasio and Anthony Weiner attended the forum, which took place only three days after the Anthony Weiner sexting scandal made breaking news. Participants included New York City comptroller John C. Liu , former comptroller William C. Thompson Jr. , speaker for the New York City Council Christine Quinn , New York City Council member Sal F. Albanese and former Bronx Borough President Adolfo Carrión, Jr. A 2013 DNAInfo report alleged that donations made to the annual AIDS Walk New York fundraiser were spent on administrative costs, including rent, rather than direct services. GMHC issued a statement calling the report "grossly inaccurate" and later released a statement which said that "in a time of leadership transition we are vulnerable to the attacks of "anonymous sources." GMHC said that due to stigma from landlords, it had few options for relocating in 2011, meaning a "near doubling in rent." GMHC joined a coalition of AIDS organizations in signing an open letter to the Centers for Disease Control and Prevention urging that it stop using stigmatizing language, including "unprotected anal sex" in its materials. The letter stated that "unprotected" most often meant anal sex without a condom, but that the meaning of "unprotected" had changed alongside the approval of Truvada as pre-exposure prophylaxis . The organization announced Kelsey Louie as the new CEO in April 2014. After the approval of Truvada as pre-exposure prophylaxis in 2012, some AIDS service organizations spoke out against the drug, including Michael Weinstein of AIDS Healthcare Foundation , who called the pill a "party drug." However, GMHC embraced Truvada and in October 2014 released a statement saying that GMHC would advocate for the "widespread adoption" of PrEP. In 2016, GMHC launched an ad campaign to spread awareness around PrEP. The ads ran at 10 bus shelters in Brooklyn, Queens, the Bronx and uptown Manhattan. GMHC helped to produce the return of the drag festival Wigstock in 2018. The HIV prevention and testing programs expanded in the new GMHC Center for HIV Prevention at 224 West 29th Street in NYC which will include a new youth leadership-development program. In 2019, GMHC's Testing Center moved to 307 West 38th Street where the offices are located as of 2018. [ when? ] In order to keep up with the COVID-19 global pandemic GMHC has begun offering HIV testing at home to make sure people are sticking to social distance guidelines. They have also closed their usual testing site and created an offsite location for continuing testing. The test results can take anywhere from 2–20 minutes for people to get an answer. While GMHC cannot give out HIV medications such as PrEP or PEP they can help people find options at a lower cost once they have a prescription. In 2015 Larry Kramer was reunited with GMHC almost thirty years after he was removed from the organization. Even after years of criticism from Kramer about many of the choices made by GMHC, Kelsey Louie, a member of GMHC reached out to Kramer. After several meetings between Kelsey and Kramer a peace offering seemed to have been reached. Kramer was invited to GMHC's gala as a special guest and presented with their first ever lifetime achievement award. Kramer held no ill will towards the organization and was happy to be invited back. Since his first appearance, Kramer continued to attend GMHC events and had even been invited to speak at GMHC staff meetings before his death in May 2020.To commemorate the 40th anniversary of AIDS in the United States, GMHC launched a video series featuring prominent members of the HIV/AIDS community, including GMHC co-founder Larry Mass , activist Mark S. King , and former speakers of the New York City council Corey Johnson . Those featured in the videos were invited to "share their thoughts on what will it take to end the epidemic in our lifetimes." GMHC helped stage a response to the 2022-2023 mpox outbreak in New York City. The organization created a dedication section of the website with information about the virus and handed out information about the virus at their annual Latex Ball fundraiser.

Wiki

Mpox

https://api.wikimedia.org/core/v1/wikipedia/en/page/Marc_Siegel/html

Marc Siegel

Marc K. Siegel is an American physician, clinical professor of medicine at NYU Langone Medical Center , author, and contributor to The Hill , The Wall Street Journal , Slate , Fox News , and member of the board of contributors at USA Today . He is the medical director of NYU's Doctor Radio on Sirius XM . Siegel received his medical degree in 1985 from the State University of New York at Buffalo . He completed his residency in internal medicine in 1988 at the New York University Medical Center . He is board certified in internal medicine. In his books, columns, and interviews, Siegel suggested differentiated responses to infectious disease outbreaks, such as the swine flu , SARS , and avian influenza outbreaks. As a result, he has at times praised and at times criticized public health officials and the press for what he considered fearmongering about, or excessive focus on, certain outbreaks, arguing that resources should be directed toward other health threats. He has written three books promoting this view: False Alarm: the Truth About the Epidemic of Fear (2005), Bird Flu: Everything You Need to Know About the Next Pandemic (2006), and Swine Flu: The New Pandemic (2009). Siegel promoted his book False Alarm in a September 2005 appearance on The Daily Show with Jon Stewart . In 2001, Siegel recommended that individuals focus their health efforts based on the most likely ailments, rather than those that generate the most media. At the time, bovine spongiform encephalopathy ("mad cow disease") was generating headlines, but the average American woman faced a 1-in-3 lifetime chance of heart disease, a much higher risk. Siegel suggested focusing on everyday interventions that can produce large health impacts, rather than media-driven fears. During the 2009 outbreak of Swine flu, Siegel was a proponent of administering Tamiflu to children at summer camps "where there have been large, confirmed outbreaks" in order to stop the spread; Siegel said that he respectfully disagreed with the CDC's guidance to limit the use of Tamiflu in camps when lives could be saved with more aggressive treatments. During the COVID-19 pandemic in the United States , Siegel frequently appeared in media where he at times questioned the changing CDC guidelines and at times supported them. In January 2020, he "urge[d] people not to travel to China"; the following month he reported from the quarantine center where infected people from the Diamond Princess were in isolation, stating that "the virus appears to be more contagious than the flu and therefore very difficult to contain" and described PPE in use. In a March 2020 appearance on Fox News's Hannity , Siegel stated that, based on the declining case count in China at the time, COVID-19 "should be compared to the flu." A study by Kathleen Hall Jamieson and Dolores Albarracín , published in the peer-reviewed Harvard Kennedy School Misinformation Review in April 2020, identified Siegel's statement as part of a broader set of COVID-19 misinformation "circulating in conservative media." In July 2021, Siegel interviewed Dr. Fauci on SiriusXM's Doctor Radio, during which Dr. Fauci noted that masking may be required into 2022 to protect the vulnerable. In a 2022 interview with Siegel, Dr. Fauci discussed future boosters. In July 2021, Siegel urged TV viewers to get vaccinated, noting in a TV appearance that "the vaccine works extremely well even against the delta variant, preventing infection in 90 percent of cases." In August 2021, Siegel advocated for wider availability of booster shots as a means to provide enhanced protection to broader groups. Siegel's 2020 book, COVID: The Politics of Fear and the Power of Science , juxtaposes the meaningful scientific advancements in medicine of the last decades with the role of the media and politics in stoking extreme "doom and gloom" fears. The book examines technology that, prior to the pandemic, led to the healthiest and safest period in human history, and compares that to the decision-making process early in the pandemic. The Wall Street Journal reviewed it, stating "Dr. Siegel's chief argument is hard to dismiss: that fear, encouraged by a news media obsessed with doom and misery, has impelled public-health experts ... to impose draconian policies and ordinary Americans either to exaggerate or ignore moderately serious problems like Covid-19." Siegel at times praised parts of each of President Donald Trump 's and President Joe Biden's handling of the coronavirus pandemic. During the 2022–2023 mpox outbreak , Siegel praised the U.S. CDC for making changes to public health guidance that increased the likelihood of controlling the virus. He also praised improvements in real-time data collection that allowed refinements to public health messaging, an improvement over prior diseases. He urged faster distribution of vaccines and treatments to the hardest-hit areas. Siegel also compared the sanitation and rodent control of New York City and Los Angeles during the COVID pandemic, noting that New York was improving from its early-COVID proliferation of garbage, but Los Angeles was not. He predicted that these differences would lead to a difference in public health outcomes. Following the on-field cardiac arrest of Damar Hamlin and his subsequent recovery, Siegel compared the power of positive stories to unite the country with the divisiveness of DC politics, in particular the fight over the election of House Speaker Kevin McCarthy. Siegel criticized President Barack Obama over portions of his Patient Protection and Affordable Care Act (ACA) health care reform legislation because Siegel believed the legislation would result in narrower networks, increased deductibles, and reduced access to care. In 2017, Siegel wrote an op-ed in The New York Times that criticized the ACA and its essential health benefits provision (which he described as "an overstuffed prix fixe meal filled with benefits like maternity and mental health coverage") and praised the Republican legislation to repeal the ACA . During the repeal debate, Siegel supported Republican legislation that would limit "the menu of essential benefits" and instead create subsidized "high-risk pools" for uninsured patients with pre-existing conditions, although he also opposed "drastic cuts to Medicaid" supported Medicare expansion based on the success shown in Indiana and Ohio, and urged increased interstate competition for insurers. In 2018, Siegel published an opinion piece in support of the Affordable Care Act's requirement that restaurants make calorie information available to diners , noting studies that suggest calorie labeling can reduce intake by 30-40 calories daily, which adds up to a weight change of 3 to 5 pounds per year. During the Trump administration, Siegel interviewed then-President Trump about topics including his health, during which Trump described a cognitive evaluation as requiring him to remember " person, woman, man, camera, TV. " The phrase later became a meme. The interview was praised by the Columbia Journalism Review as prompting a "six-minute meander through Trump's thicket of self-diagnosis, during which the president mentioned China, Russia, Ukraine, judicial appointments, the Twenty-fifth Amendment, and, most notably, his ability to recite a string of five words while under observation by medical experts." Siegel advocates for public release of presidential candidate health records. Siegel reviewed the medical records of Senator John McCain during his 2000 presidential campaign, among others. In September 2016, Siegel urged then-candidates Hillary Clinton and Donald Trump to release their health records, noting Trump's weight and diet created risks regarding his ability to serve. In Fox News appearances during the 2016 U.S. presidential campaign , he urged the release of health records of candidate Hillary Clinton , in order to evaluate her physical fitness for office. In a USA Today opinion piece published April 2015, Siegel compared the public release of Senator John McCain's health records during his presidential campaign to Secretary Clinton's refusal to release hers. A further piece also published in April, this time in the Washington Times, repeated similar comparisons to past candidates' disclosures. Siegel has repeatedly ridden with President George W. Bush in his Warrior 100k annual three-day mountain bike ride, where they discussed the role of endurance exercise in healing physical wounds and behavioral challenges. In 2018, Barbara Bush entered hospice after ceasing aggressive treatment for lung and heart disease. Siegel said her choice showed "fortitude [and] courage." Similarly, when President Carter entered hospice care in 2023, Siegel discussed the legacy left by Carter as well as the opportunity to educate the public regarding palliative care . The mind-body problem refers to the challenge of reconciling neuro-physiology and consciousness in the human mind and brain. In The Inner Pulse: Unlocking the Secret Code of Sickness and Health (2011), Siegel describes medical miracles and posits a perceptible but ineffable and immeasurable "essential life force" "where the physical and the spiritual combine," advising readers to engage in practices to strengthen and focus it for use in overcoming disease and healing. It was reviewed in Publishers Weekly as "an intriguing approach to the mind/body conundrum." Siegel has hosted the SiriusXM radio show Doctor Radio Reports twice a week since March 2020, focusing on the impact of the COVID-19 pandemic and the efficacy of public health efforts to neutralize it. He is the medical director of Doctor Radio. In his books, columns, and interviews, Siegel suggested differentiated responses to infectious disease outbreaks, such as the swine flu , SARS , and avian influenza outbreaks. As a result, he has at times praised and at times criticized public health officials and the press for what he considered fearmongering about, or excessive focus on, certain outbreaks, arguing that resources should be directed toward other health threats. He has written three books promoting this view: False Alarm: the Truth About the Epidemic of Fear (2005), Bird Flu: Everything You Need to Know About the Next Pandemic (2006), and Swine Flu: The New Pandemic (2009). Siegel promoted his book False Alarm in a September 2005 appearance on The Daily Show with Jon Stewart . In 2001, Siegel recommended that individuals focus their health efforts based on the most likely ailments, rather than those that generate the most media. At the time, bovine spongiform encephalopathy ("mad cow disease") was generating headlines, but the average American woman faced a 1-in-3 lifetime chance of heart disease, a much higher risk. Siegel suggested focusing on everyday interventions that can produce large health impacts, rather than media-driven fears. During the 2009 outbreak of Swine flu, Siegel was a proponent of administering Tamiflu to children at summer camps "where there have been large, confirmed outbreaks" in order to stop the spread; Siegel said that he respectfully disagreed with the CDC's guidance to limit the use of Tamiflu in camps when lives could be saved with more aggressive treatments. During the COVID-19 pandemic in the United States , Siegel frequently appeared in media where he at times questioned the changing CDC guidelines and at times supported them. In January 2020, he "urge[d] people not to travel to China"; the following month he reported from the quarantine center where infected people from the Diamond Princess were in isolation, stating that "the virus appears to be more contagious than the flu and therefore very difficult to contain" and described PPE in use. In a March 2020 appearance on Fox News's Hannity , Siegel stated that, based on the declining case count in China at the time, COVID-19 "should be compared to the flu." A study by Kathleen Hall Jamieson and Dolores Albarracín , published in the peer-reviewed Harvard Kennedy School Misinformation Review in April 2020, identified Siegel's statement as part of a broader set of COVID-19 misinformation "circulating in conservative media." In July 2021, Siegel interviewed Dr. Fauci on SiriusXM's Doctor Radio, during which Dr. Fauci noted that masking may be required into 2022 to protect the vulnerable. In a 2022 interview with Siegel, Dr. Fauci discussed future boosters. In July 2021, Siegel urged TV viewers to get vaccinated, noting in a TV appearance that "the vaccine works extremely well even against the delta variant, preventing infection in 90 percent of cases." In August 2021, Siegel advocated for wider availability of booster shots as a means to provide enhanced protection to broader groups. Siegel's 2020 book, COVID: The Politics of Fear and the Power of Science , juxtaposes the meaningful scientific advancements in medicine of the last decades with the role of the media and politics in stoking extreme "doom and gloom" fears. The book examines technology that, prior to the pandemic, led to the healthiest and safest period in human history, and compares that to the decision-making process early in the pandemic. The Wall Street Journal reviewed it, stating "Dr. Siegel's chief argument is hard to dismiss: that fear, encouraged by a news media obsessed with doom and misery, has impelled public-health experts ... to impose draconian policies and ordinary Americans either to exaggerate or ignore moderately serious problems like Covid-19." Siegel at times praised parts of each of President Donald Trump 's and President Joe Biden's handling of the coronavirus pandemic. During the 2022–2023 mpox outbreak , Siegel praised the U.S. CDC for making changes to public health guidance that increased the likelihood of controlling the virus. He also praised improvements in real-time data collection that allowed refinements to public health messaging, an improvement over prior diseases. He urged faster distribution of vaccines and treatments to the hardest-hit areas. Siegel also compared the sanitation and rodent control of New York City and Los Angeles during the COVID pandemic, noting that New York was improving from its early-COVID proliferation of garbage, but Los Angeles was not. He predicted that these differences would lead to a difference in public health outcomes. Following the on-field cardiac arrest of Damar Hamlin and his subsequent recovery, Siegel compared the power of positive stories to unite the country with the divisiveness of DC politics, in particular the fight over the election of House Speaker Kevin McCarthy. In his books, columns, and interviews, Siegel suggested differentiated responses to infectious disease outbreaks, such as the swine flu , SARS , and avian influenza outbreaks. As a result, he has at times praised and at times criticized public health officials and the press for what he considered fearmongering about, or excessive focus on, certain outbreaks, arguing that resources should be directed toward other health threats. He has written three books promoting this view: False Alarm: the Truth About the Epidemic of Fear (2005), Bird Flu: Everything You Need to Know About the Next Pandemic (2006), and Swine Flu: The New Pandemic (2009). Siegel promoted his book False Alarm in a September 2005 appearance on The Daily Show with Jon Stewart . In 2001, Siegel recommended that individuals focus their health efforts based on the most likely ailments, rather than those that generate the most media. At the time, bovine spongiform encephalopathy ("mad cow disease") was generating headlines, but the average American woman faced a 1-in-3 lifetime chance of heart disease, a much higher risk. Siegel suggested focusing on everyday interventions that can produce large health impacts, rather than media-driven fears. During the 2009 outbreak of Swine flu, Siegel was a proponent of administering Tamiflu to children at summer camps "where there have been large, confirmed outbreaks" in order to stop the spread; Siegel said that he respectfully disagreed with the CDC's guidance to limit the use of Tamiflu in camps when lives could be saved with more aggressive treatments. During the COVID-19 pandemic in the United States , Siegel frequently appeared in media where he at times questioned the changing CDC guidelines and at times supported them. In January 2020, he "urge[d] people not to travel to China"; the following month he reported from the quarantine center where infected people from the Diamond Princess were in isolation, stating that "the virus appears to be more contagious than the flu and therefore very difficult to contain" and described PPE in use. In a March 2020 appearance on Fox News's Hannity , Siegel stated that, based on the declining case count in China at the time, COVID-19 "should be compared to the flu." A study by Kathleen Hall Jamieson and Dolores Albarracín , published in the peer-reviewed Harvard Kennedy School Misinformation Review in April 2020, identified Siegel's statement as part of a broader set of COVID-19 misinformation "circulating in conservative media." In July 2021, Siegel interviewed Dr. Fauci on SiriusXM's Doctor Radio, during which Dr. Fauci noted that masking may be required into 2022 to protect the vulnerable. In a 2022 interview with Siegel, Dr. Fauci discussed future boosters. In July 2021, Siegel urged TV viewers to get vaccinated, noting in a TV appearance that "the vaccine works extremely well even against the delta variant, preventing infection in 90 percent of cases." In August 2021, Siegel advocated for wider availability of booster shots as a means to provide enhanced protection to broader groups. Siegel's 2020 book, COVID: The Politics of Fear and the Power of Science , juxtaposes the meaningful scientific advancements in medicine of the last decades with the role of the media and politics in stoking extreme "doom and gloom" fears. The book examines technology that, prior to the pandemic, led to the healthiest and safest period in human history, and compares that to the decision-making process early in the pandemic. The Wall Street Journal reviewed it, stating "Dr. Siegel's chief argument is hard to dismiss: that fear, encouraged by a news media obsessed with doom and misery, has impelled public-health experts ... to impose draconian policies and ordinary Americans either to exaggerate or ignore moderately serious problems like Covid-19." Siegel at times praised parts of each of President Donald Trump 's and President Joe Biden's handling of the coronavirus pandemic. During the 2022–2023 mpox outbreak , Siegel praised the U.S. CDC for making changes to public health guidance that increased the likelihood of controlling the virus. He also praised improvements in real-time data collection that allowed refinements to public health messaging, an improvement over prior diseases. He urged faster distribution of vaccines and treatments to the hardest-hit areas. Siegel also compared the sanitation and rodent control of New York City and Los Angeles during the COVID pandemic, noting that New York was improving from its early-COVID proliferation of garbage, but Los Angeles was not. He predicted that these differences would lead to a difference in public health outcomes. Following the on-field cardiac arrest of Damar Hamlin and his subsequent recovery, Siegel compared the power of positive stories to unite the country with the divisiveness of DC politics, in particular the fight over the election of House Speaker Kevin McCarthy. Siegel criticized President Barack Obama over portions of his Patient Protection and Affordable Care Act (ACA) health care reform legislation because Siegel believed the legislation would result in narrower networks, increased deductibles, and reduced access to care. In 2017, Siegel wrote an op-ed in The New York Times that criticized the ACA and its essential health benefits provision (which he described as "an overstuffed prix fixe meal filled with benefits like maternity and mental health coverage") and praised the Republican legislation to repeal the ACA . During the repeal debate, Siegel supported Republican legislation that would limit "the menu of essential benefits" and instead create subsidized "high-risk pools" for uninsured patients with pre-existing conditions, although he also opposed "drastic cuts to Medicaid" supported Medicare expansion based on the success shown in Indiana and Ohio, and urged increased interstate competition for insurers. In 2018, Siegel published an opinion piece in support of the Affordable Care Act's requirement that restaurants make calorie information available to diners , noting studies that suggest calorie labeling can reduce intake by 30-40 calories daily, which adds up to a weight change of 3 to 5 pounds per year. During the Trump administration, Siegel interviewed then-President Trump about topics including his health, during which Trump described a cognitive evaluation as requiring him to remember " person, woman, man, camera, TV. " The phrase later became a meme. The interview was praised by the Columbia Journalism Review as prompting a "six-minute meander through Trump's thicket of self-diagnosis, during which the president mentioned China, Russia, Ukraine, judicial appointments, the Twenty-fifth Amendment, and, most notably, his ability to recite a string of five words while under observation by medical experts." Siegel advocates for public release of presidential candidate health records. Siegel reviewed the medical records of Senator John McCain during his 2000 presidential campaign, among others. In September 2016, Siegel urged then-candidates Hillary Clinton and Donald Trump to release their health records, noting Trump's weight and diet created risks regarding his ability to serve. In Fox News appearances during the 2016 U.S. presidential campaign , he urged the release of health records of candidate Hillary Clinton , in order to evaluate her physical fitness for office. In a USA Today opinion piece published April 2015, Siegel compared the public release of Senator John McCain's health records during his presidential campaign to Secretary Clinton's refusal to release hers. A further piece also published in April, this time in the Washington Times, repeated similar comparisons to past candidates' disclosures. Siegel has repeatedly ridden with President George W. Bush in his Warrior 100k annual three-day mountain bike ride, where they discussed the role of endurance exercise in healing physical wounds and behavioral challenges. In 2018, Barbara Bush entered hospice after ceasing aggressive treatment for lung and heart disease. Siegel said her choice showed "fortitude [and] courage." Similarly, when President Carter entered hospice care in 2023, Siegel discussed the legacy left by Carter as well as the opportunity to educate the public regarding palliative care . The mind-body problem refers to the challenge of reconciling neuro-physiology and consciousness in the human mind and brain. In The Inner Pulse: Unlocking the Secret Code of Sickness and Health (2011), Siegel describes medical miracles and posits a perceptible but ineffable and immeasurable "essential life force" "where the physical and the spiritual combine," advising readers to engage in practices to strengthen and focus it for use in overcoming disease and healing. It was reviewed in Publishers Weekly as "an intriguing approach to the mind/body conundrum." Siegel has hosted the SiriusXM radio show Doctor Radio Reports twice a week since March 2020, focusing on the impact of the COVID-19 pandemic and the efficacy of public health efforts to neutralize it. He is the medical director of Doctor Radio. Siegel was born on June 15, 1956, in New York. He is married to Ludmilla Luda Siegel, who is a physician and neurologist. They have three children. Siegel is Jewish and cites the Oath of Maimonides as a medical ethics influence. He attended East Meadow High School . Following high school, he went to Brown University in Providence, Rhode Island, from 1974 to 1978. He received his Doctor of Medicine degree in 1985 from the State University of New York at Buffalo . He completed his residency in internal medicine in 1988 at New York University Medical Center . [ unreliable source ]

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https://api.wikimedia.org/core/v1/wikipedia/en/page/Marion_Koopmans/html

Marion Koopmans

Maria Petronella Gerarda Koopmans (born 21 September 1956) is a Dutch virologist who is Head of the Erasmus MC Department of Viroscience. Her research considers emerging infectious diseases , noroviruses and veterinary medicine . In 2018 she was awarded the Netherlands Organisation for Scientific Research (NWO) Stevin Prize. She serves on the scientific advisory group of the World Health Organization .Koopmans studied veterinary medicine at Utrecht University . She graduated from her Master's degree 1976, and remained there for her doctoral research . She earned two graduate degrees in veterinary medicine, and was officially registered as a veterinary microbiologist in 1977. She became increasingly interested in virology, and moved to the United States to specialise in viruses that can be transmitted between animals and humans. From 1991 to 1994 Koopmans completed a fellowship at the Centers for Disease Control and Prevention , where she studied enteric viruses . Koopmans joined the National Institute for Public Health and the Environment (RIVM), where she was appointed Chief of Virology. She was involved with restructuring the department, and translating their research out of the laboratory and into practical applications for the control of infectious diseases. In 2006 she was appointed as Professor of Public Health at the Erasmus MC hospital in Rotterdam , which allowed her to strengthen the evidence-base of infectious disease research. Her laboratory makes use of basic scientific studies and epidemiology to understand the pathogenesis of infectious diseases, to establish their transmission routes and to translate this research base into diagnostic tools. In 2003, when Influenza A virus subtype H7N7 spread around the Netherlands , Koopmans experienced her first infectious diseases outbreak. She was involved with the development of a coordinated public response, working with veterinarians and physicians to quickly develop public health policy. Her experiences in leading the response to the avian influenza outbreak prepared her for subsequent epidemics, including Middle East respiratory syndrome (MERS) and Zika virus . She was on the team that found, in 2013, that dromedary camels were an intermediate host for the virus that causes MERS. She has since worked with Elmoubasher Farag to test camels for antibodies against MERS. During the Ebola outbreak in West Africa , Koopmans was responsible for the deployment of mobile laboratories in Sierra Leone and Liberia . Her Erasmus MC team trained volunteers to run testing and treatment programmes. Koopmans is a member of the scientific advisory group (SAG) of the World Health Organization 's R&D Blueprint project. The project looks to understand what has gone wrong with epidemic and pandemic responses, and looks to build global disease preparedness. As part of this effort, Koopmans analysed the public health response to the Zika virus. She identified three significant bottlenecks to an efficient response; including delays in regulatory approvals, challenges in the logistics of laboratory support and the absence of a structured timeline for funding. Koopmans also leads the World Health Organization centre for Emerging Viral Diseases. She is the scientific coordinator of COMPARE, a Horizon 2020 project that looks to develop next generation sequencing techniques for outbreak identification and mapping. COMPARE look to contain and mitigate foodborne illnesses . In 2018 Koopmans was honoured by the Netherlands Organisation for Scientific Research (NWO) for her work on the transfer of viruses from animals to humans. In 2019 she was awarded a $9 million NWO grant to establish a consortium, the Versatile Emerging infectious disease Observatory (VEO), that will study how changes in environment and travel will impact the risk of infectious diseases. The diseases considered by VEO include vector-borne and zoonotic diseases, as well as hidden pathogens. Koopmans wrote an article for Nature in which she called for a transformation in epidemic preparedness and response. In the article, she quoted the World Health Organization's leader on health emergencies, "We are entering a very new phase of high-impact epidemics… This is a new normal." In 2019 Koopmans was elected member of the Royal Netherlands Academy of Arts and Sciences . From the start of 2020, Koopmans worked to understand SARS-CoV-2 and the spread of coronavirus disease . In the Netherlands, Koopmans made an effort to test healthcare workers, and identified that there were large numbers of asymptomatic carriers amongst the Dutch population. With her team at the Erasmus MC, Koopmans looked to understand the efficacy of antibody tests. Alongside leading the scientific response, Koopmans was also involved with scientific communication about the virus, making use of social media and media interviews to share up-to-date research with the public. Koopmans said that as humans occupied more of planet earth, the number of dangerous diseases transmitted from animals to humans would increase. She was appointed to the coronavirus disease advisory panel of the European Commission . The panel served to develop public health recommendations to the member states during the pandemic. On 2 December 2020, Koopmans was appointed to the 13 member team of the World Health Organization's investigation into the origins of COVID-19 . Marion Koopmans is a member of the Royal Netherlands Academy of Arts and Sciences (KNAW) and the Royal Holland Society of Sciences (KHMW). The Royal Netherlands Academy of Sciences is the forum, voice and conscience of science in the Netherlands. It is traditionally a society of excellent Dutch scientists. Members are elected on the basis of high-quality scientific achievements. Membership is for life. The Royal Holland Society of Sciences is a scientific society founded in 1752 in Haarlem.The 2020 Machiavelli Prize has been awarded to Marion Koopmans and Diederik Gommers, president of the Dutch Society for Intensive Care. The prize is awarded annually for outstanding achievement in the field of public communication. Koopmans and Gommers received the 2020 award for their relentless efforts to make the science on coronavirus accessible to a wide audience. Deliberately seeking dialogue with doubters about the science and opponents of the policy, during the corona pandemic, helped increase understanding, especially among young people. Both Koopmans and Gommers have made it their vocation - in addition to their daily work in fighting the coronavirus, which is so urgent - to explain the coronavirus to a broad public.Three science museums - NEMO Science Museum, Rijksmuseum Boerhaave and Teylers Museum - have created an award that rewards excellent science communication: the Iris Medal. The aim is to encourage original and effective forms of science communication. The €10,000 prize is awarded annually at the Evening of Science & Society. The prize money is made available by the KHMW. The prize was awarded to Robbert Dijkgraaf in 2019, Lowlands Science in 2020, Marion Koopmans in 2021 and University of the Netherlands in 2022.The Pandemic & Disaster Preparedness Center (PDPC) was established in 2021. Marion Koopmans is initiator of this centre that aims to learn from the corona pandemic and better prepare society in the Netherlands (and beyond) for possible new pandemics but also disasters. Koopmans is scientific director of this centre.

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https://api.wikimedia.org/core/v1/wikipedia/en/page/2023_in_England/html

2023 in England

← → Events of the year 2023 in England .

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https://api.wikimedia.org/core/v1/wikipedia/en/page/Tanja_Stadler/html

Tanja Stadler

Tanja Stadler is a mathematician and professor of computational evolution at the Swiss Federal Institute of Technology ( ETH Zurich ). She's the current president of the Swiss Scientific Advisory Panel COVID-19 and Vize-Chair of the Department of Biosystems Science and Engineering at ETH Zürich .Tanja Stadler studied applied mathematics and statistics at the Technical University of Munich , University of Cardiff , and the University of Canterbury . She continued at the Technical University of Munich to obtain a PhD in 2008 on the topic 'Evolving Trees – Models for Speciation and Extinction in Phylogenetics' (with Prof. Anusch Taraz and Prof. Mike Steel). After a postdoctoral period with Prof. Sebastian Bonhoeffer in the Department of Environmental Systems Sciences at ETH Zürich, she was promoted to Junior Group Leader at ETH Zürich in 2011. In 2014, she became an assistant professor at the Department of Biosystems Science and Engineering of ETH Zürich , where she was promoted to associate professor in 2017 and to full professor in 2021. Tanja's research addresses core questions in the life sciences through an evolutionary perspective, in particular in macroevolution , epidemiology , developmental biology and immunology . Her research questions include fundamental aspects such as how speciation processes led to the current biodiversity , as well as questions directly relevant to human societies, such as the spread of pathogens like COVID-19 or Ebola . Tanja assesses these questions by developing and applying statistical phylodynamic tools to estimate evolutionary and population dynamics from genomic sequencing data while in parallel leading consortia to produce such data. Her unique approach is an innovative mix of mathematics , computer science and biology . Tanja made major theoretical contributions to the field of phylodynamics by developing statistical frameworks to use birth-death processes in the context of phylogenetic trees. In particular, she laid the foundations to account for sampling through time in birth-death models – enabling coherent analysis of genetic sequencing data collected through time during epidemics as well as coherent analysis of fossil (collected sequentially through time) and present-day species data. Tanja used this framework for example to quantify HCV spread, the spread of Ebola during the 2014 outbreak, assess Zika spread, to show that influenza waves in a city are majorly driven by travel patterns, and to provide real-time information during the COVID-19 pandemic . In macroevolution, Tanja explored in particular the impact of dinosaur extinction on mammal diversification. Most recently, she is introducing statistical tree thinking into developmental biology . Her group founded "Taming the BEAST", in 2016. BEAST 2 is a widely used Bayesian phylogenetic software platform allowing to infer evolutionary and population dynamics from genomic sequencing data to which Tanja's team contributed many package. "Taming the BEAST" is both an international workshop series and an online resource, to teach the usage of BEAST 2. In the field of epidemiology , Tanja is currently spear-heading the use of wastewater information to understand pathogen spread. She is principal investigator of a project between ETH Zürich and Eawag . Her team is estimating the reproductive number for SARS-CoV-2 and influenza from wastewater and contributes to understanding variant dynamics. During the COVID-19 pandemic , Tanja was president of the Swiss National COVID-19 Science task force advising the authorities and decision makers of Switzerland from August 2021 until the termination of the task force in March 2022. She started the presidency after having been a member and later chaired the data & modelling group of the task force. She was responsible for the weekly communication of the pandemic situation to the Swiss Federal Government and the corresponding authorities. In addition, she presented scientific insights in briefings with the complete Federal Government and with members of the executive branches of the Federal and Cantonal Governments, as well as with different divisions of the Swiss Parliament . Tanja actively contributed core scientific insights to the Task Force. Her daily calculations of the reproductive number became a key part of the epidemic monitoring. The reproductive numbers were employed in the national "Ordinance of 19 June 2020 on Measures during the Special Situation to combat the COVID-19 Epidemic". Further, the reproductive number dashboard was highlighted when the South Africa Health department informed the world about the new variant Omicron. Tanja also lead the most extensive Swiss-based SARS-CoV-2 sequencing effort providing results on the emergence and spread of new variants. Through this effort, the first beta, gamma, and delta variants in Switzerland were detected. The platform cov-spectrum is developed by Tanja's team and became essential in SARS-CoV-2 variant tracking. It is widely used to facilitate SARS-CoV-2 lineage designation and used in policy such as the FDA advisory committee meeting discussing possible SARS-CoV-2 strains for a vaccine update. During the mpox outbreak , the team launched mpox-spectrum within days to track the newly spreading virus. In addition to advising the government and informing policy makers, she became actively involved in informing the public about the situation of the pandemic. Tanja communicated the scientific insights often on national news and national TV shows in Switzerland, as well as through Federal press conferences. Tanja's research addresses core questions in the life sciences through an evolutionary perspective, in particular in macroevolution , epidemiology , developmental biology and immunology . Her research questions include fundamental aspects such as how speciation processes led to the current biodiversity , as well as questions directly relevant to human societies, such as the spread of pathogens like COVID-19 or Ebola . Tanja assesses these questions by developing and applying statistical phylodynamic tools to estimate evolutionary and population dynamics from genomic sequencing data while in parallel leading consortia to produce such data. Her unique approach is an innovative mix of mathematics , computer science and biology . Tanja made major theoretical contributions to the field of phylodynamics by developing statistical frameworks to use birth-death processes in the context of phylogenetic trees. In particular, she laid the foundations to account for sampling through time in birth-death models – enabling coherent analysis of genetic sequencing data collected through time during epidemics as well as coherent analysis of fossil (collected sequentially through time) and present-day species data. Tanja used this framework for example to quantify HCV spread, the spread of Ebola during the 2014 outbreak, assess Zika spread, to show that influenza waves in a city are majorly driven by travel patterns, and to provide real-time information during the COVID-19 pandemic . In macroevolution, Tanja explored in particular the impact of dinosaur extinction on mammal diversification. Most recently, she is introducing statistical tree thinking into developmental biology . Her group founded "Taming the BEAST", in 2016. BEAST 2 is a widely used Bayesian phylogenetic software platform allowing to infer evolutionary and population dynamics from genomic sequencing data to which Tanja's team contributed many package. "Taming the BEAST" is both an international workshop series and an online resource, to teach the usage of BEAST 2. In the field of epidemiology , Tanja is currently spear-heading the use of wastewater information to understand pathogen spread. She is principal investigator of a project between ETH Zürich and Eawag . Her team is estimating the reproductive number for SARS-CoV-2 and influenza from wastewater and contributes to understanding variant dynamics. During the COVID-19 pandemic , Tanja was president of the Swiss National COVID-19 Science task force advising the authorities and decision makers of Switzerland from August 2021 until the termination of the task force in March 2022. She started the presidency after having been a member and later chaired the data & modelling group of the task force. She was responsible for the weekly communication of the pandemic situation to the Swiss Federal Government and the corresponding authorities. In addition, she presented scientific insights in briefings with the complete Federal Government and with members of the executive branches of the Federal and Cantonal Governments, as well as with different divisions of the Swiss Parliament . Tanja actively contributed core scientific insights to the Task Force. Her daily calculations of the reproductive number became a key part of the epidemic monitoring. The reproductive numbers were employed in the national "Ordinance of 19 June 2020 on Measures during the Special Situation to combat the COVID-19 Epidemic". Further, the reproductive number dashboard was highlighted when the South Africa Health department informed the world about the new variant Omicron. Tanja also lead the most extensive Swiss-based SARS-CoV-2 sequencing effort providing results on the emergence and spread of new variants. Through this effort, the first beta, gamma, and delta variants in Switzerland were detected. The platform cov-spectrum is developed by Tanja's team and became essential in SARS-CoV-2 variant tracking. It is widely used to facilitate SARS-CoV-2 lineage designation and used in policy such as the FDA advisory committee meeting discussing possible SARS-CoV-2 strains for a vaccine update. During the mpox outbreak , the team launched mpox-spectrum within days to track the newly spreading virus. In addition to advising the government and informing policy makers, she became actively involved in informing the public about the situation of the pandemic. Tanja communicated the scientific insights often on national news and national TV shows in Switzerland, as well as through Federal press conferences. Stadler lives with her partner and their two daughters in Basel.

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https://api.wikimedia.org/core/v1/wikipedia/en/page/2023_in_Thailand/html

2023 in Thailand

← → Following is a list of events and scheduled events in the year 2023 in Thailand . The year 2023 is reckoned as the year 2566 in Buddhist Era , the Thai calendar. Thai politics in 2023 has been marked by the 2023 General election in July, which saw the progressive Move Forward party , along with 7 other parties it formed a coalition with, win the election against pro-junta parties. However its leader, Pita Limjaroenrat , failed to secure enough votes from Parliament and was later suspended. Pheu Thai currently seeks to nominate its candidate as Prime-minister.

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https://api.wikimedia.org/core/v1/wikipedia/en/page/Outbreak_of_monkeypox_at_Rotterdam_Zoo/html

Outbreak of monkeypox at Rotterdam Zoo

In 1964 there was an outbreak of monkeypox at Rotterdam Zoo , where two Central / South American giant anteaters were first identified with the disease. Until then, monkeypox was thought to occur only in primates . Housed in one large enclosure, the monkeypox virus subsequently spread to several orangutans , chimpanzees , gorillas , guenons , squirrel monkeys , macaques , marmosets and gibbons . Unlike previous monkeypox outbreaks in laboratory monkeys, the outbreak in Rotterdam Zoo occurred in animals that were not for laboratory use, showed varying clinical presentations, and was particularly severe for orangutans. There were no reports of cases of transmission to humans . In total, 11 of the 23 affected animals died, including six orangutans, the anteaters, three squirrel monkeys, the only one Asian gibbon and an American common marmoset. Several were complicated by fatal secondary bacterial infections .Between 1958 and 1968, mainly for the purpose of producing and testing the polio vaccine , a small number of non-human primates from Africa and a larger number from Asia were being imported to Europe and the US. During transit, there were often other wild animals with several opportunities to spread infection. On 9 December 1964, without being quarantined , two Central/South American giant anteaters arrived at Rotterdam Zoo , and on 21 December developed a blistering rash. The lesions appeared on the tongue, nose, legs and soles of feet. A diagnosis of monkeypox was confirmed at the National Institute for Public Health and the Environment laboratory in Utrecht . Until 1964, monkeypox was thought to occur only in primates . The anteaters had been bought from dealers, and the virus was suspected to have been contracted from previous contact with infected monkeys elsewhere, possibly from close contact with a shipment of Malaysian cynomolgus monkeys . [lower-alpha 1]Ten days after the onset of sickness in the anteaters, two Asian orangutans that were housed in a glass cage nearby, developed small blisters. Whether transmission was by air or contaminated objects is not clear. The disease spread to several other orangutans , who became unwell with yellow nasal discharge and lesions on their face, body and legs. Also affected, and all housed in one large enclosure, were chimpanzees , gorillas , guenons , squirrel monkeys , macaques , marmosets and gibbons . Affected animals typically had a generalised illness, some with skin lesions, and several died during early symptoms, before the spots appeared. Unlike previous monkeypox outbreaks in laboratory monkeys, the outbreak at Rotterdam Zoo occurred in animals that were not for laboratory use, showed varying clinical presentations, and was particularly severe for orangutans. All 10 orangutans became ill and six died, five of whom died before the onset of the rash. Of those orangutans that survived, recovery was prolonged. They found it difficult to eat, and the ones that died were noted to have suffered problems in breathing. The affected chimpanzees had blisters on their lips and face, but were otherwise well. One of the two infected African gorillas became seriously sick, but both survived. Four of the infected guenons suffered mild illness with skin lesions. Most infected marmosets had mild symptoms. The Vervet monkey had subclinical infection ; the Asian monkeys ( cynomolgus monkey and rhesus macaque ) were noted to have a generalised rash; and the baboons also experienced a generalised rash and severe illness. The only Asian gibbon presented with lesions on its face, limbs and body, and died 18-days after suffering severe illness. Two of the three affected squirrel monkeys had no rash. The owl-faced monkey became ill with sores on their lips but recovered. Some of the marmosets had reddening and swellings around their eyes and nose with blisters on the face and tummy. One American common marmoset had a similar swelling, but with severe illness. In total, 11 of the 23 affected animals died, including in addition to the orangutans and anteaters, all three squirrel monkeys , the Asian gibbon and the severely ill American common marmoset. Several were complicated by fatal bacterial infections. No cases of transmission to humans were reported. Primates that had exposure but did not contract the disease included Ateles paniscus , red-faced spider monkey , black-headed spider monkey , siamang , Colombian white-faced capuchin , mona monkey , and L'Hoest's monkey . According to Isao Arita and Donald Henderson in 1976, how relevant that a strain of whitepox viruses, which resembled variola, were isolated from two cynomolgus monkeys at the National Institute for Public Health and the Environment three-months prior to the arrival of the anteaters was not clear. On 9 December 1964 and 4 May 1965, poxviruses resembling monkeypox were isolated from kidneys of cynomolgus monkeys at the same laboratory. A personal correspondence from Rijk Gispen 's colleague, Jacoba G. Kapsenberg , in the early 1980s, revealed that the so-called cases of "silent monkeypox" were probably a result of contamination from monkeypox virus isolated from the Zoo cases. Six years after the outbreak, Gispen detected high levels of monkeypox neutralizing antibody in two of the surviving orangutans, and concluded that it lasts long after infection. The antiviral methisazone was used unsuccessfully. Of more importance was the use of antibiotics to treat secondary bacterial infections. The outbreak was reported by J.C. Peters. The incident is an example of how an outbreak may occur in animals following an accidental infection of one susceptible other animal. No further outbreaks in captive monkeys occurred after 1968, as conditions for monkeys in transit improved, and Europe and the US increasingly bred their own monkeys.

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Oklahoma Frontier Drug Store Museum

Oklahoma Frontier Drug Store Museum was established in 1992 and located in Guthrie, Oklahoma . The museum has an occupancy in the Gaffney Building constructed in 1890 and integral to the Guthrie Historic District . The museum has nineteenth century and early twentieth century apothecary artifacts related to alchemy , elixirs , esoteric pharmacies, herbal tonics , tinctures , and traditional medicines for confronting the struggles with the diseases and epidemics of the 19th century .The Oklahoma Frontier Drug Store Museum established the Apothecary Garden in the Spring of 2006. The physic garden offers specimens of botanical and medicinal plants used for herbal medicine and homeopathy as necessitated by the Oklahoma settlers and pioneers residing in the American frontier .

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https://api.wikimedia.org/core/v1/wikipedia/en/page/Bania,_Central_African_Republic/html

Bania, Central African Republic

Bania is a village located in Mambéré-Kadéï Prefecture, Central African Republic.Pierre Savorgnan de Brazza established a post in Bania in January 1892. In 1895, sleeping sickness outbreak occurred in Bania and wiped out 30% of the residents. Örebro Mission founded a stations in Bania in 1923. Anti-balaka militias from Carnot and Bouar attacked Bania in February 2014 and killed two Muslim leaders, resulting in the Muslim residents fleeing to the bush. Moreover, 80% of the residents fled Bania and only returned three months later with the arrival of international forces. In early 2015, Anti-balaka demolished a mosque in Bania to prevent the Muslims from returning to the village. Fifty 3R rebels captured Bania on 31 December 2021 and torched several houses. The locals sought refuge in the bush due to the presence of the 3R. Gold and diamond mining and logging are the main economic activities in the village. Bania has two schools. The village has one health center.

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Lumber Yard Bar

Nathan Adams Michale Farrar Lumber Yard Bar is a gay bar in White Center , in the U.S. state of Washington . Nathan Adams and Michale Farrar opened the bar in 2018. The business relocated in 2021, the result of arson.The lumberjack -themed, queer -friendly Lumber Yard Bar operates along 16th Avenue Southwest in White Center . The interior has sanded wood and a skylight with planted succulents. In 2018, Christopher Frizzelle of The Stranger wrote: "Logs are omnipresent: logs wrapped around the cords of Edison bulbs, logs chained to walls, log benches, log stools, log pictures, etc. The menu includes 'wood pellets' (olives in cheese breading served with marinara) and a mashed potato bar." The LGBT -owned bar opened in January 2018. It claims to be, and has been described as, White Center's first gay bar. Owned by Nathan Adams and Michale Farrar, Lumber Yard has hosted drag shows , show tune sing-alongs , and viewing parties for television shows such as RuPaul's Drag Race All Stars . As of 2023, Lumber Yard hosted lesbian karaoke as well as 'tacos and trivia ' weekly, and has a monthly event dedicated to kink . A fire in July 2021, later classified as arson , forced the business to close and relocate. The owners called the incident a hate crime . A GoFundMe fundraising campaign led by White Center Pride was successful in raising $100,000 for Lumber Yard. In 2022, the bar hosted an Mpox vaccine clinic in collaboration with local public health officials. In January 2024, Lumber Yard was one of several bars raided by the Joint Enforcement Team (JET), a coalition of Seattle Police, Fire, and the Washington State Liquor and Cannabis Board (WSLCB), among other groups. The raid prompted a backlash and a policy review. Esquire included Lumber Yard in a 2022 list of the 32 best gay bars in the United States and said, "Comfortable and fun for leather daddies, trans women , bears and cubs, and lipstick lesbians alike, Lumberyard is a throwback to an earlier era, but in the best possible way. The original was burned down in an anti-gay hate-crime a few years back, but the revival has just opened across the street and is bigger and better, with a new performance space." Christopher Frizzelle included Lumber Yard in The Stranger ' s 2018 and 2023 overviews of Seattle's best LGBT establishments. In a 2023 overview of the metropolitan area's queer establishments, Seattle Gay News said Adams and Farrar "[offer] an experience that calls back to the pair's love for hosting".

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2003 Midwest monkeypox outbreak

Beginning in May 2003, by July a total of 71 cases of human monkeypox were found in six Midwestern states including Wisconsin (39 cases), Indiana (16), Illinois (12), Kansas (1), Missouri (2), and Ohio (1). The cause of the outbreak was traced to three species of African rodents ( Gambian pouched rat , dormice , rope squirrels ) imported from Ghana on April 9, 2003, into the United States by an exotic animal importer in Texas. These were shipped from Texas to an Illinois distributor, who housed them with prairie dogs , which then became infected. The outbreak marked the first time monkeypox infection appeared in the United States, and the first time in the Western Hemisphere . No deaths were reported, and no human-to-human transmission was found. All cases involved direct contact with infected prairie dogs. Electron microscopy and testing by polymerase chain reaction and immunohistochemistry were used to confirm the causative agent was human monkeypox. In May, 2003, a three-year-old Wisconsin resident was bitten by a prairie dog purchased from a local pet store. The child was hospitalized after developing fever of unknown origin ( 103 °F (39 °C) ), swollen eyes, and a red vesicular skin rash. The child's parents also developed a rash, but no other symptoms. Physicians immediately associated the symptoms with the animal bite and reported the case to the Milwaukee Health Department. Testing of both the child and the prairie dog confirmed the monkeypox virus as the causative agent. [ citation needed ] Between May 15, 2003, when the three-year-old index patient was first diagnosed through June 20, the date of the last patient with a laboratory-confirmed case of monkeypox, a total of 71 people ranging in age from 1 to 51 were infected. On April 9, 2003, a Texas importer received a shipment of 762 African rodents from Accra, Ghana , which included rope squirrels (Funiscuirus sp.), tree squirrels (Heliosciurus sp.), Gambian pouched rats (Cricetomys sp.), African brush-tailed porcupine (Atherurus sp.), dormice (Graphiurus sp.), and striped mice (Hybomys sp.). Of these 762 rodents, 584 (77%) were shipped to distributors in six US states: Texas (9), New Jersey (1), Iowa (1), Japan (1), Illinois (2), Minnesota (1) and Wisconsin (1). The remaining 178 (23%) rodents could not be traced due to lack of documentation. CDC laboratory testing of animals from this shipment confirmed monkeypox by PCR and virus isolation in one Gambian rat, three dormice, and two rope squirrels. Illinois distributor number one received Gambian rats and dormice and housed the rodents with 200 prairie dogs. This distributor shipped prairie dogs to pet stores in Wisconsin, Illinois, Indiana, Missouri, Kansas, South Carolina, and Michigan. No human cases of monkeypox were reported in Japan, Michigan, and South Carolina. Laboratory-confirmed cases occurred only in Kansas (1), Missouri (2), Indiana (16), Illinois (12), and Wisconsin (22). Of the 200 prairie dogs housed with the Gambian rats and dormice, 94 tested positive for monkeypox virus, including prairie dogs in pet stores in Wisconsin (44 cases), Indiana (24), Illinois (19), Ohio (4), Kansas (1), Missouri (1), and one case in the eastern seaboard state of New Jersey . The Gambian rats and dormice housed with the prairie dogs at Illinois distributor number one tested positive for monkeypox virus. [ citation needed ] The most recent incidence of monkeypox prior to the Midwest outbreak occurred in the Democratic Republic of the Congo in 1996–1997, with a reported 88 cases. No deaths occurred in the Midwest outbreak. This was attributed to the prompt medical care received and the standard of living in the United States, which includes soap, running water, washing machines, sterile dressing materials, and hospital use of universal precautions , including isolation, gown, mask, gloves, and handwashing. No human-to-human transmission was found during this outbreak. All cases were found to be the direct result of contact with infected prairie dogs. Human-to-human transmission has been reported in Central and West Africa. [ citation needed ]The onset of the illness among affected persons in the United States began in early May 2003. People typically experienced fever, headaches, muscle aches, chills, and nonproductive coughs, followed 1–10 days later by a generalized papular rash which developed first on the trunk, then limbs and head. The papules evolved through phases of vesiculation , pustulation , umbilication , and crusting. All persons reported direct or close contact with recently acquired prairie dogs. As no direct antiviral treatment for monkeypox was known, only supportive care and prevention of secondary infection was recommended. Universal precautions in the care of those with the disease had been shown to prevent human-to-human transmission and inoculation with the smallpox vaccine has shown to be effective in abating the progression of the disease in those with active infection, and in the prevention of the disease in the general population. [ citation needed ] In the Midwest outbreak, the CDC issued guidance on the use of smallpox vaccine , Cidofovir , and Vaccinia immune globulin . Thirty residents in six states received the smallpox vaccination. This included 28 adults and two children. Vaccine was given before exposure to seven persons (three veterinarians, two laboratory workers, and two health-care workers) and after exposure to 23 persons (10 health-care workers, seven household contacts, three laboratory workers, one public health veterinarian, one public health epidemiologist, and one work contact). Three (10%) reported rash within 2 weeks of vaccination. One adult who was vaccinated as a child did not have a major vaccine reaction or "take" 7 days after vaccination and required revaccination. [ citation needed ] No adverse reactions to the smallpox vaccine were reported to the Vaccine Adverse Event Reporting System . [ citation needed ]In the Midwest outbreak, the CDC issued guidance on the use of smallpox vaccine , Cidofovir , and Vaccinia immune globulin . Thirty residents in six states received the smallpox vaccination. This included 28 adults and two children. Vaccine was given before exposure to seven persons (three veterinarians, two laboratory workers, and two health-care workers) and after exposure to 23 persons (10 health-care workers, seven household contacts, three laboratory workers, one public health veterinarian, one public health epidemiologist, and one work contact). Three (10%) reported rash within 2 weeks of vaccination. One adult who was vaccinated as a child did not have a major vaccine reaction or "take" 7 days after vaccination and required revaccination. [ citation needed ] No adverse reactions to the smallpox vaccine were reported to the Vaccine Adverse Event Reporting System . [ citation needed ]To prevent monkeypox virus from entering into the United States again, the Centers for Disease Control banned the importation of implicated African rodents. The U.S. Food and Drug Administration issued orders banning the interstate shipment of prairie dogs and all African rodents. [ citation needed ] These were lifted in 2008.

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2023 in Colombia

← → Events in the year 2023 in Colombia .10 June – Having survived in the rainforest for 40 days, the remaining 4 passengers of the Cessna 206 aircraft, all children, were found and rescued by the Colombian military and rescuers and local volunteers.10 June – Having survived in the rainforest for 40 days, the remaining 4 passengers of the Cessna 206 aircraft, all children, were found and rescued by the Colombian military and rescuers and local volunteers.

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https://api.wikimedia.org/core/v1/wikipedia/en/page/Kathy_Ensor/html

Kathy Ensor

Katherine Bennett Ensor is an American statistician specializing in numerous methods in computational and statistical analysis of time series data, stochastic process modeling, and estimation to forecast issues in public health , community informatics , computational finance , and environmental statistics . Ensor is the Noah G. Harding Professor of Statistics and Director of the Center for Computational Finance and Economic Systems at Rice University . From 2016–2022, she was Director of the Kinder Institute Urban Data Platform, a data resource initiative for the Greater Houston area that includes the Texas Flood and COVID-19 registries. She is an Executive Team Member for Houston Wastewater Epidemiology, a SARS-CoV-2 wastewater monitoring initiative between Rice University, the Houston Health Department, Houston Public Works, and the City of Houston. In August 2022, Houston Wastewater Epidemiology was named a National Wastewater Surveillance System (NWSS) Center of Excellence by the U.S. Centers for Disease Control and Prevention . Ensor's statistical and computational methods for the development of modeling frameworks pinpoint, track and forecast issues across a wide variety of fields. Since the start of her academic career, a focus of her research has sought a deeper understanding of problems in energy, quantitative finance and risk management. In 2002, she collaborated with university and industry partners to establish the Center for Computational Finance and Economic Systems (CoFES). She has since continued to serve as the center's director and has developed numerous programs in graduate and undergraduate research and education. Ensor is widely known for her expertise in community analytics, which has grown through her career-long commitment to environmental and health-based research. Through collaborations with cross-disciplinary groups of educators, scientists, engineers, and city and public health professionals, she has quantitatively assessed air quality and human exposure to environmental contaminants. The work has also included the discovery of a correlation between ozone and heart attacks , and of geographic patterns in severe asthma attacks in schoolchildren. In May 2020, Ensor and collaborators at Rice University, the Houston Health Department, Houston Public Works, and the City of Houston, began conducting ongoing testing of the city's wastewater treatment system for the presence of SARS-CoV-2, the virus that causes COVID-19 . The wastewater monitoring system has also been adapted to provide public health information on seasonal influenza , the respiratory syncytial virus (RSV), mpox and other human pathogens . As Director of the Kinder Institute Urban Data Platform from 2016–2022, Ensor investigated historical Houston flood event trends and Hurricane Harvey and on the health and housing impacts of the COVID-19 pandemic and COVID-19 vaccines . Additional studies have investigated mitigating risk and the affects climate change. Ensor advises on statistics and data science as a member of the Board of Directors for the Accreditation Board for Engineering and Technology (ABET) – Computer Science Accreditation Board (CSAB). She serves on the Board of Scientific Counselors for the National Institute of Environmental Health Sciences (NIEHS) and the Board of Trustees for the National Science Foundation (NSF) Institute for Pure and Applied Mathematics (IPAM). She was the 117th President of the American Statistical Association 's (ASA) Board of Directors (2021–2022) and Vice President of ASA's Board of Directors from 2016–2018. She was a member of the National Academies of Sciences, Engineering and Medicine (NASEM) Committee on Applied and Theoretical Statistics (CATS) from 2015–2021. Ensor earned bachelor's and master's degrees in mathematics from Arkansas State University in 1981 and 1982. She completed her Ph.D. in statistics in 1986 from Texas A&M University ; her dissertation, supervised by H. Joseph Newton, was Some Results in Autoregressive Modeling . She has been on the Rice faculty since 1987.

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https://api.wikimedia.org/core/v1/wikipedia/en/page/Dipanjan_Pan/html

Dipanjan Pan

University of Illinois at Urbana-Champaign University of Maryland Baltimore School of Medicine University of Maryland Baltimore County Dipanjan Pan is an Indian American academic who is the Dorothy Foehr Huck & J. Lloyd Huck Chair Professor in Nanomedicine at Pennsylvania State University . Dipanjan Pan was born in India . He obtained his doctoral degree from the Indian Institute of Technology and subsequently joined Washington University in St. Louis . There, he collaborated with Karen L. Wooley on investigating the utilization of self-assembled polymeric nanoparticles for targeted drug delivery applications. Pan started his career in 2005 as an intellectual property analyst in chemistry at General Electric 's John F. Welch Technology Centre . In 2007, he joined the Washington University School of Medicine in Saint Louis as a research instructor. In 2010, he became an assistant professor in medicine and served until 2013, contributing to the field of cardiovascular research. In 2013, Pan joined the University of Illinois Urbana-Champaign as an assistant professor. In 2014, Pan co-founded InnSight Technology, a preclinical company, along with Leanne Labriola. Two years later, in 2016, he co-founded KaloCyte, a company that has developed an artificial blood called Erythromer , with Allan Doctor and Philip Spinella. He has served as a professor of radiology in the school of medicine , and professor of chemical and biochemical and environmental engineering at the University of Maryland, Baltimore County . Pan is the current head of the Pan Laboratory for Materials in Medicine. His research focuses on the development and application of nanoscale materials and techniques for the diagnosis and treatment of various diseases, particularly cancer and cardiovascular disorders. In 2014, Pan and his team reported a novel method for inhibiting cancer cell growth using nanotechnology, as detailed in a paper presented at the American Chemical Society conference. The preliminary research demonstrated success in impeding breast cancer and melanoma cell growth in laboratory settings by delivering a synthetic compound mimicking venom from bees, snakes , and scorpions . In 2015, Pan, Leanne Labriola, and other team members developed a portable sensor named OcuCheck that assesses ocular injuries through the quantification of vitamin C concentration in a patient's tears at the University of Illinois. In 2018, Pan and other researchers at the University of Illinois created a gel utilizing gold nanoparticles which has the capability to rapidly detect ocular trauma. In 2020, Pan and his team initiated the development of rapid tests for detecting COVID-19 . Within six months, they created their first test, followed by four more by the end of 2021. Three tests, including the Antisense test, have been licensed for commercialization and registered with the Food and Drug Administration . Later, he founded a company called VitruVian Bio to further develop the test for commercial applications. In 2023, Dipanjan Pan and his research team developed the first rapid test for monkeypox , as reported in the journal Advanced Functional Materials . It uses a selective molecular sensor that can detect the virus within minutes. The method employs nanomaterial heterostructures, consisting of zero-dimensional spherical gold nanoparticles and two-dimensional hafnium disulfide nanoplatelets, as building blocks to create a platform technology capable of detecting trace amounts of genetic material in biological samples. Nanomedicine: A Soft Matter Perspective Personalized Medicine with a Nanochemistry Twist: Nanomedicine

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LGBT culture in Portland, Oregon

LGBT culture in Portland, Oregon is an important part of Pacific Northwest culture .Portland's annual pride parade is primarily organized by Pride Northwest . Peacock in the Park is another annual event, running from 1987 to 2005, and, again, from 2014 to the present. The La Femme Magnifique International Pageant is an annual drag pageant. Oaks Park Roller Skating Rink has hosted Gay Skate monthly for 30 years, as of 2021. Queer Horror is an ongoing bi-monthly film festival that is shown at the Hollywood Theatre . The Portland Queer Film Festival, formerly known as the Portland Lesbian & Gay Film Festival, has been running for more than twenty years and takes place at Cinema 21 . The Portland Queer Documentary Film Festival screens LGBTQ documentaries. In 2011, Hands Across Hawthorne was organized in response to an attack on two men who were holding hands on the Hawthorne Bridge , with over 4,000 attendees. Drag-a-thon was held in 2023.Currently operating LGBT drinking establishments and nightclubs include: CC Slaughters , Crush Bar , Eagle Portland , Santé Bar , Scandals (1979), Silverado , and Stag PDX (2015). Silverado and Stag are also strip clubs , along with Fuzzy Navels. Back 2 Earth was established in 2023. Coffin Club (formerly Lovecraft Bar) has also been described as an LGBT-friendly bar. The Sports Bra , established in 2022, is an LGBTQ-owned bar focused on women's sports . Rebel Rebel is in Old Town Chinatown. 2022 also saw the openings of the LGBTQ video bar Sissy Bar, and Doc Marie's , a lesbian bar. Misfits Bar and Lounge has been described as a "laidback queer hangout". The drag venue Darcelle XV Showplace was established by Darcelle XV in 1967 and continues to host shows regularly. Other notable drag performers from Portland include Bolivia Carmichaels , Flawless Shade , and Poison Waters . Gay bathhouses operating in Portland include Hawks PDX (2012–present) and Steam Portland (since 2003). Monthly Blow Pony dances were established in Portland by Airick Redwolf in 2007. Inferno monthly dance parties hosted by Hot Flash Productions owner/operators DJ Wildfire (Jenn Davis) and Armida Hanlon that first began in Portland in 2004 and are now held regularly in Portland and Seattle. Portland also hosts Bearracuda dance events regularly. The queer-owned vegan restaurant Mis Tacones was established as a pop-up restaurant in 2016 and relocated to a brick and mortar space in 2022. The queer-owned and operated Taqueria Los Puñales opened in 2020. Defunct establishments include Egyptian Club (1995–2010), Gail's Dirty Duck Tavern , Red Cap Garage (1987–2012), Starky's , and Three Sisters Tavern (1964–2004), which also operated as a strip club. The gay bathhouse Club Portland closed in 2007. Embers Avenue , established during the 1970s, and Escape Nightclub both closed in 2017. During the COVID-19 pandemic , Hobo's and Local Lounge closed in 2020 and 2021, respectively. In late 2021, Daniel Bund opened The Queen's Head , an English-style pub and lounge hosting drag shows and burlesque performances frequently. The bar closed in 2022. The Roxy was an LGBT-friendly diner along Southwest Harvey Milk Street . The restaurant opened in 1994 and closed in March 2022. Sullivan's Gulch Bar & Grill (formerly known as Joq's Tavern, or simply Joq's) has also been described as an LGBT establishment. Shine Distillery and Grill , which closed in 2023, was described as a gay bar. The City Nightclub, an all ages drug and alcohol free gay and lesbian nightclub, was established in 1983 by Lanny Swerdlow. According to author Linnea Due , it was the only all ages gay and lesbian club in the United States. An attempt by the Portland Police Bureau in 1996 to shut down the club sparked a demonstration which was covered on MTV News: Unfiltered . Ultimately, the club shut down in December of 1996. Located at Northwest 5th Avenue and Davis Street in Old Town Chinatown , Barbarella (sometimes Barbarella PDX) was a nightclub in a building which previously housed a "grimy" music venue called Someday Lounge, followed by the Las Vegas -inspired Fifth Avenue Lounge. The bar was part of an Austin, Texas -based chain of nightclubs. Andrew Jankowski of Willamette Week described Barbarella as "a dance club with dirt-cheap drinks, themed parties running from the '50s through the '80s and an overall vibe best described as 'a straight person's idea of a gay bar'". He compared the bar to neighboring amusement arcade Ground Kontrol , but without the video games, and said, "Barbarella's aesthetic is as delightfully kitschy and low-budget as a bar named after a campy sci-fi cult classic should be." Jankowski wrote: On paper, Barbarella should be a sensation, particularly with central eastsiders who rarely deign to cross the river into the Old Town entertainment district. Sure, the lack of specialty drinks feels like a missed opportunity, and even the bartender recommended against ordering food. But with no cover charge and wells at or below $2 each, you'd imagine the place would be packed with people headed to or from the arcade bar, the gay strip club or the scores of other party spots in the neighborhood. Daily Xtra described Barbarella as a "video/dance dive bar" with dance parties, disc jockeys, and queer events in its 2019 overview of "gay Portland". The venue had two dance floors and a loft. The interior featured lava lamps , pinball machines, and mid-century modern furniture. There was a painting of a topless woman on one wall, as well as two "tributes" to Jane Fonda , who starred in the 1968 science fiction film Barbarella . According to Jankowski, "The only 21st-century features are the video projections and gently rippling rainbow LED lights behind the pre-existing sheet-metal grates." Barbarella opened on February 14 ( Valentine's Day ), 2019, and closed during the COVID-19 pandemic. The venue had hosted Mac DeMarco . Currently operating LGBT drinking establishments and nightclubs include: CC Slaughters , Crush Bar , Eagle Portland , Santé Bar , Scandals (1979), Silverado , and Stag PDX (2015). Silverado and Stag are also strip clubs , along with Fuzzy Navels. Back 2 Earth was established in 2023. Coffin Club (formerly Lovecraft Bar) has also been described as an LGBT-friendly bar. The Sports Bra , established in 2022, is an LGBTQ-owned bar focused on women's sports . Rebel Rebel is in Old Town Chinatown. 2022 also saw the openings of the LGBTQ video bar Sissy Bar, and Doc Marie's , a lesbian bar. Misfits Bar and Lounge has been described as a "laidback queer hangout". The drag venue Darcelle XV Showplace was established by Darcelle XV in 1967 and continues to host shows regularly. Other notable drag performers from Portland include Bolivia Carmichaels , Flawless Shade , and Poison Waters . Gay bathhouses operating in Portland include Hawks PDX (2012–present) and Steam Portland (since 2003). Monthly Blow Pony dances were established in Portland by Airick Redwolf in 2007. Inferno monthly dance parties hosted by Hot Flash Productions owner/operators DJ Wildfire (Jenn Davis) and Armida Hanlon that first began in Portland in 2004 and are now held regularly in Portland and Seattle. Portland also hosts Bearracuda dance events regularly. The queer-owned vegan restaurant Mis Tacones was established as a pop-up restaurant in 2016 and relocated to a brick and mortar space in 2022. The queer-owned and operated Taqueria Los Puñales opened in 2020.Defunct establishments include Egyptian Club (1995–2010), Gail's Dirty Duck Tavern , Red Cap Garage (1987–2012), Starky's , and Three Sisters Tavern (1964–2004), which also operated as a strip club. The gay bathhouse Club Portland closed in 2007. Embers Avenue , established during the 1970s, and Escape Nightclub both closed in 2017. During the COVID-19 pandemic , Hobo's and Local Lounge closed in 2020 and 2021, respectively. In late 2021, Daniel Bund opened The Queen's Head , an English-style pub and lounge hosting drag shows and burlesque performances frequently. The bar closed in 2022. The Roxy was an LGBT-friendly diner along Southwest Harvey Milk Street . The restaurant opened in 1994 and closed in March 2022. Sullivan's Gulch Bar & Grill (formerly known as Joq's Tavern, or simply Joq's) has also been described as an LGBT establishment. Shine Distillery and Grill , which closed in 2023, was described as a gay bar. The City Nightclub, an all ages drug and alcohol free gay and lesbian nightclub, was established in 1983 by Lanny Swerdlow. According to author Linnea Due , it was the only all ages gay and lesbian club in the United States. An attempt by the Portland Police Bureau in 1996 to shut down the club sparked a demonstration which was covered on MTV News: Unfiltered . Ultimately, the club shut down in December of 1996. Located at Northwest 5th Avenue and Davis Street in Old Town Chinatown , Barbarella (sometimes Barbarella PDX) was a nightclub in a building which previously housed a "grimy" music venue called Someday Lounge, followed by the Las Vegas -inspired Fifth Avenue Lounge. The bar was part of an Austin, Texas -based chain of nightclubs. Andrew Jankowski of Willamette Week described Barbarella as "a dance club with dirt-cheap drinks, themed parties running from the '50s through the '80s and an overall vibe best described as 'a straight person's idea of a gay bar'". He compared the bar to neighboring amusement arcade Ground Kontrol , but without the video games, and said, "Barbarella's aesthetic is as delightfully kitschy and low-budget as a bar named after a campy sci-fi cult classic should be." Jankowski wrote: On paper, Barbarella should be a sensation, particularly with central eastsiders who rarely deign to cross the river into the Old Town entertainment district. Sure, the lack of specialty drinks feels like a missed opportunity, and even the bartender recommended against ordering food. But with no cover charge and wells at or below $2 each, you'd imagine the place would be packed with people headed to or from the arcade bar, the gay strip club or the scores of other party spots in the neighborhood. Daily Xtra described Barbarella as a "video/dance dive bar" with dance parties, disc jockeys, and queer events in its 2019 overview of "gay Portland". The venue had two dance floors and a loft. The interior featured lava lamps , pinball machines, and mid-century modern furniture. There was a painting of a topless woman on one wall, as well as two "tributes" to Jane Fonda , who starred in the 1968 science fiction film Barbarella . According to Jankowski, "The only 21st-century features are the video projections and gently rippling rainbow LED lights behind the pre-existing sheet-metal grates." Barbarella opened on February 14 ( Valentine's Day ), 2019, and closed during the COVID-19 pandemic. The venue had hosted Mac DeMarco . Located at Northwest 5th Avenue and Davis Street in Old Town Chinatown , Barbarella (sometimes Barbarella PDX) was a nightclub in a building which previously housed a "grimy" music venue called Someday Lounge, followed by the Las Vegas -inspired Fifth Avenue Lounge. The bar was part of an Austin, Texas -based chain of nightclubs. Andrew Jankowski of Willamette Week described Barbarella as "a dance club with dirt-cheap drinks, themed parties running from the '50s through the '80s and an overall vibe best described as 'a straight person's idea of a gay bar'". He compared the bar to neighboring amusement arcade Ground Kontrol , but without the video games, and said, "Barbarella's aesthetic is as delightfully kitschy and low-budget as a bar named after a campy sci-fi cult classic should be." Jankowski wrote: On paper, Barbarella should be a sensation, particularly with central eastsiders who rarely deign to cross the river into the Old Town entertainment district. Sure, the lack of specialty drinks feels like a missed opportunity, and even the bartender recommended against ordering food. But with no cover charge and wells at or below $2 each, you'd imagine the place would be packed with people headed to or from the arcade bar, the gay strip club or the scores of other party spots in the neighborhood. Daily Xtra described Barbarella as a "video/dance dive bar" with dance parties, disc jockeys, and queer events in its 2019 overview of "gay Portland". The venue had two dance floors and a loft. The interior featured lava lamps , pinball machines, and mid-century modern furniture. There was a painting of a topless woman on one wall, as well as two "tributes" to Jane Fonda , who starred in the 1968 science fiction film Barbarella . According to Jankowski, "The only 21st-century features are the video projections and gently rippling rainbow LED lights behind the pre-existing sheet-metal grates." Barbarella opened on February 14 ( Valentine's Day ), 2019, and closed during the COVID-19 pandemic. The venue had hosted Mac DeMarco . LGBT rights organization Basic Rights Oregon is based in Portland. Local LGBT-oriented organizations include Cascade AIDS Project , Q Center , and Bradley Angle which offers LGBTQ domestic violence services. Others include:LGBT publications have included Cascade Voice , Just Out , PQ Monthly , and The Eagle .

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Mpox

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Basankusu

Basankusu is a town in Équateur Province , Democratic Republic of the Congo . It is the main town and administrative centre of the Basankusu Territory . In 2004, it had an estimated population of 23,764. It has a gravel airstrip , covered and open markets, a hospital, and three cellphone networks, the first of which was installed in 2006. The town is also known as a centre for bonobo conservation efforts. Despite such developments, most inhabitants live at a subsistence level: hunting, fishing, keeping chickens and keeping a vegetable plot. In 2010, the workers at the local palm plantation would earn an average monthly salary of $40 (US dollars), most others would have much less. The location of the town on the Lulonga River , a tributary of the Congo, at the confluence of the Lopori and Maringa Rivers has contributed to its success as a centre for trade in the region. Set deep in tropical rainforest, the rivers serve as the highways for transport of people as well as goods. Historically, Basankusu holds some stories of exploitation during the times of the Abir Congo Company but was also the gateway to much of Equateur Province for those individuals involved in the reforms which came from the Casement Report and the Berlin conference of 1884-5. The name Basankusu is said to have been misunderstood by its European explorers and colonisers, who lacked knowledge of the local language. The Mongo group that founded Basankusu were the Okutsu; their descendants were called the Basaa Okutsu , meaning the "children of the Okutsu". This name was contracted slightly into the name Basaa'kutsu . Another account of the etymology of Basankusu is that it comes from basa ba nkoso , meaning "quarrelling parrots", or possibly Baasa bankoso , "small parrots". Basankusu was the first trading post of the Abir Congo Company (ABIR) along the Congo River from Kinshasa (then known as Leopoldville), the capital of the Congo. Later known as the Compagnie du Congo Belge, the Abir Congo Company harvested natural rubber in the 19th and early 20th century. It was granted a large concession with the rights to tax the inhabitants, taken in the form of rubber. The collection system revolved around a series of trading posts along the two main rivers in the concession – the Lopori and the Maringa . Each post was commanded by a European agent and manned with armed sentries to enforce taxation and punish any rebels. ABIR would sell a kilogram of rubber in Europe for up to 10 francs (fr), which cost them only 1.35 fr to collect and transport. However, this came at a cost to the human rights of those who could not pay the tax, with imprisonment, flogging , and other corporal punishments recorded. The Casement Report comprises a multitude of individual statements gathered by the British Consul , Roger Casement , including several detailing the grim tales of killings, mutilation, kidnapping, and cruel beatings of the native population by soldiers of the Congo administration of King Leopold . The British Parliament demanded a second meeting of the 14 signatory powers of the 1885 Berlin Conference , at which time the Belgian Parliament forced a reluctant Leopold to set up an independent commission of enquiry. This led to the arrest and punishment of several officials who had been responsible for murders during a rubber-collection expedition in 1903. The reforms that followed the Casement Report, including those that concerned ABIR at Basankusu, set the foundation for the colonial Belgian state of Congo . The name Basankusu is said to have been misunderstood by its European explorers and colonisers, who lacked knowledge of the local language. The Mongo group that founded Basankusu were the Okutsu; their descendants were called the Basaa Okutsu , meaning the "children of the Okutsu". This name was contracted slightly into the name Basaa'kutsu . Another account of the etymology of Basankusu is that it comes from basa ba nkoso , meaning "quarrelling parrots", or possibly Baasa bankoso , "small parrots". Basankusu was the first trading post of the Abir Congo Company (ABIR) along the Congo River from Kinshasa (then known as Leopoldville), the capital of the Congo. Later known as the Compagnie du Congo Belge, the Abir Congo Company harvested natural rubber in the 19th and early 20th century. It was granted a large concession with the rights to tax the inhabitants, taken in the form of rubber. The collection system revolved around a series of trading posts along the two main rivers in the concession – the Lopori and the Maringa . Each post was commanded by a European agent and manned with armed sentries to enforce taxation and punish any rebels. ABIR would sell a kilogram of rubber in Europe for up to 10 francs (fr), which cost them only 1.35 fr to collect and transport. However, this came at a cost to the human rights of those who could not pay the tax, with imprisonment, flogging , and other corporal punishments recorded. The Casement Report comprises a multitude of individual statements gathered by the British Consul , Roger Casement , including several detailing the grim tales of killings, mutilation, kidnapping, and cruel beatings of the native population by soldiers of the Congo administration of King Leopold . The British Parliament demanded a second meeting of the 14 signatory powers of the 1885 Berlin Conference , at which time the Belgian Parliament forced a reluctant Leopold to set up an independent commission of enquiry. This led to the arrest and punishment of several officials who had been responsible for murders during a rubber-collection expedition in 1903. The reforms that followed the Casement Report, including those that concerned ABIR at Basankusu, set the foundation for the colonial Belgian state of Congo . The original Roman Catholic cathedral of Saints Peter and Paul, built by Jan de Koning, a brother in the Mill Hill Missionaries society, during World War II, Demolition in 2012; it was rebuilt to a very similar design. The new building used computer design technology, and used reinforced concrete in place of kiln-fired brick. It remains the tallest building in Basankusu. The Mill Hill Missionaries , and later with some support from the Congregatio Immaculati Cordis Mariae missionaries, supported the establishment of the Diocese of Basankusu , which has its episcopal seat at the cathedral. On Sunday, October 21, 2018, ten bishops and a hundred priests concelebrated Mass at which Bishop Joseph Mokobe, Bishop of Basankusu, presided, for the inauguration of the newly rebuilt cathedral. Basankusu is situated on the Lulonga River , a tributary of the Congo, at the confluence of the Lopori and Maringa Rivers. This location allows for transporting and receiving local goods to and from the cities of Mbandaka and Kinshasa. Because Basankusu is the last port of substance before the wilderness of the Lopori Basin, conservation efforts for the bonobo , use the town as a base. Being slightly more than 1° north of the Equator , Basankusu has a tropical rainforest climate . There is no real dry season, with monthly rainfall in the town ranging between averages of 69 mm and 213 mm, with most months at the higher end of that range. Average high temperatures over a year are between 30 °C and 33 °C, although throughout the day a high of 37 °C is not uncommon. Evening lows average around 20 °C. Being close to a major river and enduring frequent, heavy tropical rainfall, Basankusu is prone to the damaging effects of water. In July, 2010, the town was affected by flooding, with 1,400 people made homeless. Roads, which are all non-metalled, and bridges were also affected. Such frequent harsh weather conditions have an effect on the quality of life for local people. Waterborne diseases can become more prevalent, and the transport of goods, such as food, medicine, and trade goods, becomes more difficult.Basankusu is a centre for palm oil production and treatment. One company, Compagnie de Commerce et des Plantations (CCP), produces palm oil from plantations of African oil palms at nearby villages Lisafa and Ndeke. The factory at Lisafa is responsible for the treatment of the palm oil and production of soap. The plantation areas are as follows: 3,488 hectares (ha) of oil palms , and 372 ha given over to coffee. It is a major local employer, with almost 4,000 workers on its payroll. Although CCP is one of the successful businesses in the area, it is in dispute with village chiefs regarding land acquisition. In 2010, a worker would earn an average monthly salary of $40 (US dollars), depending on output. Basankusu's distance from the capital Kinshasa and the recent upheaval due to the First and Second Congo Wars have made trade with the outside world difficult. However, the distribution of local products, such as maize , cassava , rice , palm oil, peanuts , and rubber , is starting to increase as more river-boats make the journey from the capital. The frustration of local producers was brought to the attention of the press by Mlle Jeanne-Marie Abanda, Director of Caritas Basankusu , when she explained their difficulties in December 2009: We have had a bumper harvest this year and have managed to send 30% of our maize that was stored at the Port of Basankusu. Transporting agricultural goods from the outlying villages is one of our problems, distributing it to the major centres of population throughout the country is the other. The same information is reported by the Congolese Control Office (Office Congolais de Controle). Jef Dupain, an African Wildlife Foundation (AWF) primatologist , who has spent more than a decade on the frontlines in the Congo working with bonobos, has also stated the devastating impact a lack of transport for trade has on conservation: "You can't just tell the local people not to eat bushmeat . You're not taken seriously." Because of this, an AWF-funded cargo barge , the Ferbo I , now travels up and down the Congo and Maringa Rivers in the Congo to collect agricultural products from local farmers. The isolated situation of the town makes communication with the wider world challenging. During the military conflict of 1998 – 2003, Basankusu was in rebel ( Movement for the Liberation of Congo , MLC) hands and cut off from trade and relief from the rest of the world. The roads within Basankusu are non-metalled and prone to erosion from the frequent, torrential downpours. Roads to other towns and villages are also non-metalled; their condition has continued to decline since the country's independence from Belgium in 1960. The metal Bailey bridges , which span ravines and streams along the roads, are also in very poor condition and in danger of collapse in some cases. Motor vehicles are rare and are usually only owned by businesses, hospitals, Christian missions, and government organisations. The rivers provide the most obvious means of transporting goods and people. A 700-kilometre boat journey from Basankusu to the capital, Kinshasa, can take several weeks. Major barge operators are Transports Fluvial et Commerce de l'Equateur (TFCE) and Office National des Transports (ONATRA). Passengers often travel in cramped conditions, in some cases travelling atop the logs being pushed along the river by the barges. They are victim to high prices for food and other essentials along the way. The frequent breakdown of these river boats puts passengers in a precarious position regarding daily sustenance; a delay of several days can oblige passengers to sell all their belongings so that they can buy a meal. The poor communication within the country, generally, means that passengers cannot be helped by friends or family. There is an airport, consisting of a 1,480-metre gravelled airstrip and a small building where passengers can wait. One 28-seater passenger plane to and from Kinshasa lands at Basankusu Airport each week, and an occasional 16-seat capacity plane associated with the palm oil plantation. Several cargo planes also land here. The cost of a flight, however, is beyond the means of most private individuals; passengers tend to be people working for NGOs or businesses in Kinshasa. There is no postal service in Basankusu. To send letters, the custom is to give them to someone who is travelling or the pilot of a plane, who will send them from Kinshasa or Europe. Until recently, there was no telephone system in Basankusu. The installation of two mobile phone masts , in 2006, each with its own generator and watchman, has made a large difference in the lives of many people. The phone networks, one of which is the South African company Vodacom , enable people to keep in touch with family and friends who have migrated to Kinshasa or further afield. The signal stops as you leave Basankusu.Cassava (yuca), which originated in South America and the Caribbean, is the staple food in Basankusu. The roots are made into cassava bread, known as kwanga , and other cassava-based dishes . The leaves are also used as a green vegetable and are compared to spinach for taste and texture. Moambe mwambi or mwambe ( Lingala : mwǎmba ), is the name given to the sauce of palm oil or peanuts. Moambe chicken is also considered a national dish. The chicken meat is coated in the rich moambe sauce and is usually accompanied by rice, cooked cassava leaves ( mpondu ), and chili pepper ( pili-pili ). The people of Basankusu usually keep vegetable gardens away from the town itself. They are cut into the forest and fit the slash and burn model of farming. These plots of land are often only partially cleared, with house-sized termite hills and the trunks of felled trees left to supply firewood for the year's cooking. Cassava is the main crop. It can be grown for the table as well as for the market-place. Peanuts , maize , papaya , pineapples , avocados , oil palms, and other fruits and vegetables are also grown. Maize, although sold steaming hot as a fast food in the market, is primarily produced for alcohol production. Heads of corn are cut up and boiled into a mash, which is then fermented and distilled using improvised stills made from cut oil drums . Because of the woody core of the cobs of corn, the alcohol produced contains high levels of methanol , which is toxic. It is known as lotoko or bompulo . Palm wine , on the other hand, is made from the sap of a wild palm tree, is fermented by natural yeasts , and gives an alcohol content of between five and seven percent. The marketplace is a place for buying and selling locally grown foods and also foodstuffs from further afield, which have come up the river from centres of import, such as Kinshasa. Bananas , palm nuts , onions , cassava, and cassava leaves are sold — as well as some seasonal extras such as the savoury African plum (safu) and caterpillars ( mbinzo ) (similar to the Mopane worms of Zimbabwe). Bread, produced in cottage bakeries, is available, as is locally grown and imported rice, although neither of these products is comparable to cassava in popularity. Meat often comes from hunting. Conservation groups are concerned that, with the rise in the human population, many animal species are in danger of extinction because of the trade in bushmeat . Chimpanzee , bonobo , wild boar , monkey , antelope , and other wild animals are often sold in the market or at impromptu stalls around the town. In 1998, Jeff Dupain and others catalogued the types of bushmeat available in the two main Basankusu markets; they interviewed the stallholders to find out where the animals were hunted. Many people keep livestock around the family home. Chickens, pigs, and, less frequently, sheep and goats provide fresh food and a source of income. The rivers provide a great variety of fish, and locals often spend several days at a time fishing from improvised fishing villages along the river.The dominant people of Basankusu are the Mongo; therefore, the Bantu language Lomongo , which carries with it many Mongo beliefs and customs through its proverbs and sayings, is spoken as a first language by most people. The lingua franca , Lingala (also a Bantu language), is spoken to cross the tribal divide – as it is in a great deal of the Democratic Republic of Congo. Because of the country's Belgian colonial heritage , French is spoken in all lessons in secondary schools and in government offices.Bricks for houses are of several types. Termite hills are used to produce cement -free, cost-free, durable mud bricks in Basankusu, although fired and non-fired clay bricks are also used. Palm-thatched roofs and hard-earth floors are found in the majority of houses, but variations in construction include concrete floors and corrugated metal or fired-clay tiled roofs. Houses tend to have an outside sitting area, because of the warm climate, and overhanging roofs to create a sheltered area from the heavy tropical rain. The kitchen is usually a separate wattle and daub structure, behind the main house. The toilet, in a town without water mains , is normally a simple cubicle concealing a pit or "long drop" dry toilet . Basankusu is fortunate for having a good underground water supply and many houses have on-site water hand pumps . Habitat for Humanity has an established housing project here. Basankusu has grown rapidly since the recent national troubles of the two Congo Wars. Reasons for this may be the large increase in the population nationally, as well as migration from outlying villages. Migration is partly due to hardship caused by the lack of river transport and the poor access to everyday goods that has resulted.The Basenji is a breed of hunting dog that is often seen in Basankusu. They are small, elegant-looking, short-haired dogs with erect ears, a tightly curled tail, and a graceful neck. They are also known as "bush dogs" or "Congo dogs". They produce unusual howls, yodels , and other undulated vocalisations, in contrast to the characteristic bark of modern dog breeds. The sounds are sometimes called a barroo and are due to the unusually shaped larynx of the dogs. This trait also gives the Basenji the nickname "barkless dog". Over centuries, its structure and type have been fixed by adaptation to its habitat, as well as use – primarily net hunting in extremely dense old-growth forest vegetation. Although these hunting dogs are often mixed with European breeds in Basankusu, pure Basenjis can be found in villages further upriver. In 2010, Basankusu served as a base for an expedition to collect breeding stock for the American market. Since the independence of the 1960s , there has been an increasing deterioration in the quality of life for people of Basankusu and the Democratic Republic of Congo generally. This decline has been especially bad because of the violent conflicts that have ravaged the country. The results have been catastrophic nationally: 80% of the people survive on less than one dollar per day. 75% of the population live in a precarious situation regarding food. 54% of the population do not have access to healthcare. One child in five dies before the age of five years. These numbers are not unusual for the Congo. Having been in an area of fighting during the military conflicts that took place from 1998 onwards, the population is still recovering from the resulting long-term effects. Basankusu was captured by the Movement for the Liberation of Congo (MLC) on 29 November 1999, in a takeover that happened very quickly with no civilian casualties. However, food was taken from people's vegetable gardens during this time, although reports about treatment by the armed forces were generally positive. The health system in the Congo has eroded, not only as a result of war, but also after years of government neglect. Prevalent illnesses include meningitis , dysentery , cholera , trypanosomiasis ( sleeping sickness ), and mpox . Basankusu was the first place for an occurrence of monkeypox in humans to be recorded. There have been outbreaks of whooping cough , some cases with fatal results. In June 2010 an unidentified illness killed fourteen people in the nearby village of Songo. In 2015, Francis Hannaway, a British national, opened a therapeutic feeding centre in Basankusu, together with a team of 12 local volunteers. As of April 2020, the centre has treated over 4,000 malnourished children. Basankusu is an important staging post for conservation projects, for example, those relating to the bonobo. The town falls within the western limits of what has become known as the Maringa-Lopori-Wamba Landscape , a proposed conservation area in the basin of the Maringa and Lopori rivers that includes the Luo Scientific Reserve around the village of Wamba . The landscape consists of dense forest to the east of Basankusu and north of the village of Baringa . Project stakeholders include the Max Planck Institute , African Wildlife Foundation , Source de Lomako (SoLo), Pygmy Chimpanzee Protection Fund, Bonobo Conservation Initiative , and Milwaukee Zoological Society. Over 400 species of birds can be found in the conservation area. In certain places, the density of Congo peafowl ( Afropavo congensis ) – a species endemic to the centre and northeast of the Congolese forests, with feathers of deep blue with a metallic green and violet tinge – is probably the highest in the country. At least eleven species of diurnal primates have been observed in the Maringa-Lopori-Wamba Landscape. The Dryas monkey ( Cercopithecus dryas ) is endemic to the basins of the Maringa and the Lopori, and only two examples of the species are known. The bonobo ( Pan paniscus ), Thollon's red colobus ( Procolobus tholloni ), the golden-bellied mangabey ( Cercocebus chrysogaster ), and the black mangabey ( Lophocebus aterrimus ) are found here. Allen's swamp monkey ( Allenopithecus nigroviridis ) is endemic to the flooded or floodplain forests of the Central Basin, and the Angolan colobus ( Colobus angolensis ) is known only in the Central Basin, the northeast of the Congo, and the Africa Great Lakes region. Other large mammals include the elephant ( Loxodonta africana ), the buffalo ( Syncerus caffer ), the bongo ( Tragelaphus euryceros ) – which is an antelope characterised by a striking reddish-brown coat, white-yellow stripes, and long, slightly spiralled horns – the African golden cat ( Profelis aurata ), and the leopard ( Panthera pardus ).

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Plague

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Plague

Plague or The Plague may refer to:

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Plague

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Black Death

The Black Death was a bubonic plague pandemic occurring in Europe from 1346 to 1353. One of the most fatal pandemics in human history, as many as 50 million people perished, perhaps 50% of Europe's 14th century population. Bubonic plague is caused by the bacterium Yersinia pestis and spread by fleas . One of the most significant events in European history, the Black Death had far-reaching population, economic, and cultural impacts. It was the beginning of the second plague pandemic . The plague created religious, social and economic upheavals, with profound effects on the course of European history. The origin of the Black Death is disputed. Genetic analysis points to the evolution of Yersinia pestis in the Tian Shan mountains on the border between Kyrgyzstan and China 2,600 years ago. The immediate territorial origins of the Black Death and its outbreak remain unclear, with some evidence pointing towards Central Asia , China , the Middle East , and Europe . The pandemic was reportedly first introduced to Europe during the siege of the Genoese trading port of Kaffa in Crimea by the Golden Horde army of Jani Beg in 1347. From Crimea, it was most likely carried by fleas living on the black rats that travelled on Genoese ships, spreading through the Mediterranean Basin and reaching North Africa , Western Asia , and the rest of Europe via Constantinople , Sicily , and the Italian Peninsula . There is evidence that once it came ashore, the Black Death mainly spread from person-to-person as pneumonic plague , thus explaining the quick inland spread of the epidemic, which was faster than would be expected if the primary vector was rat fleas causing bubonic plague. In 2022, it was discovered that there was a sudden surge of deaths in what is today Kyrgyzstan from the Black Death in the late 1330s; when combined with genetic evidence, this implies that the initial spread may not have been due to Mongol conquests in the 14th century, as previously speculated. The Black Death was the second great natural disaster to strike Europe during the Late Middle Ages (the first one being the Great Famine of 1315–1317 ) and is estimated to have killed 30% to 60% of the European population, as well as approximately 33% of the population of the Middle East. There were further outbreaks throughout the Late Middle Ages and, also due to other contributing factors (the Crisis of the Late Middle Ages ), the European population did not regain its 14th century level until the 16th century. [lower-alpha 1] Outbreaks of the plague recurred around the world until the early 19th century.European writers contemporary with the plague described the disease in Latin as pestis or pestilentia , ' pestilence ' ; epidemia , ' epidemic ' ; mortalitas , ' mortality ' . In English prior to the 18th century, the event was called the "pestilence" or "great pestilence", "the plague" or the "great death". Subsequent to the pandemic "the furste moreyn " (first murrain ) or "first pestilence" was applied, to distinguish the mid-14th century phenomenon from other infectious diseases and epidemics of plague. The 1347 pandemic plague was not referred to specifically as "black" in the time of occurrence in any European language, though the expression "black death" had occasionally been applied to fatal disease beforehand. "Black death" was not used to describe the plague pandemic in English until the 1750s; the term is first attested in 1755, where it translated Danish : den sorte død , lit. ' the black death ' . This expression as a proper name for the pandemic had been popularized by Swedish and Danish chroniclers in the 15th and early 16th centuries, and in the 16th and 17th centuries was transferred to other languages as a calque : Icelandic : svarti dauði , German : der schwarze Tod , and French : la mort noire . Previously, most European languages had named the pandemic a variant or calque of the Latin : magna mortalitas , lit. ' Great Death ' . The phrase 'black death' – describing Death as black – is very old. Homer used it in the Odyssey to describe the monstrous Scylla , with her mouths "full of black Death" ( Ancient Greek : πλεῖοι μέλανος Θανάτοιο , romanized : pleîoi mélanos Thanátoio ). Seneca the Younger may have been the first to describe an epidemic as 'black death', ( Latin : mors atra ) but only in reference to the acute lethality and dark prognosis of disease. The 12th–13th century French physician Gilles de Corbeil had already used atra mors to refer to a "pestilential fever" ( febris pestilentialis ) in his work On the Signs and Symptoms of Diseases ( De signis et symptomatibus aegritudium ). The phrase mors nigra , ' black death ' , was used in 1350 by Simon de Covino (or Couvin), a Belgian astronomer, in his poem "On the Judgement of the Sun at a Feast of Saturn" ( De judicio Solis in convivio Saturni ), which attributes the plague to an astrological conjunction of Jupiter and Saturn. His use of the phrase is not connected unambiguously with the plague pandemic of 1347 and appears to refer to the fatal outcome of disease. The historian Cardinal Francis Aidan Gasquet wrote about the Great Pestilence in 1893 and suggested that it had been "some form of the ordinary Eastern or bubonic plague". [lower-alpha 2] In 1908, Gasquet said use of the name atra mors for the 14th-century epidemic first appeared in a 1631 book on Danish history by J. I. Pontanus : "Commonly and from its effects, they called it the black death" ( Vulgo & ab effectu atram mortem vocitabant ). Research from 2017 suggests plague first infected humans in Europe and Asia in the Late Neolithic - Early Bronze Age . Research in 2018 found evidence of Yersinia pestis in an ancient Swedish tomb, which may have been associated with the " Neolithic decline " around 3000 BCE, in which European populations fell significantly. This Y. pestis may have been different from more modern types, with bubonic plague transmissible by fleas first known from Bronze Age remains near Samara . The symptoms of bubonic plague are first attested in a fragment of Rufus of Ephesus preserved by Oribasius ; these ancient medical authorities suggest bubonic plague had appeared in the Roman Empire before the reign of Trajan , six centuries before arriving at Pelusium in the reign of Justinian I . In 2013, researchers confirmed earlier speculation that the cause of the Plague of Justinian (541–549 CE, with recurrences until 750) was Y . pestis . This is known as the first plague pandemic . In 610, the Chinese physician Chao Yuanfang described a "malignant bubo" "coming in abruptly with high fever together with the appearance of a bundle of nodes beneath the tissue." The Chinese physician Sun Simo who died in 652 also mentioned a "malignant bubo" and plague that was common in Lingnan ( Guangzhou ). Ole Jørgen Benedictow believes that this indicates it was an offshoot of the first plague pandemic which made its way eastward to Chinese territory by around 600. A report by the Medical Faculty of Paris stated that a conjunction of planets had caused "a great pestilence in the air" ( miasma theory ). Muslim religious scholars taught that the pandemic was a "martyrdom and mercy" from God, assuring the believer's place in paradise. For non-believers, it was a punishment. Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks. Due to climate change in Asia , rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. The plague disease, caused by the bacterium Yersinia pestis , is enzootic (commonly present) in populations of fleas carried by ground rodents , including marmots , in various areas, including Central Asia , Kurdistan , Western Asia , North India , Uganda and the western United States. Y. pestis was discovered by Alexandre Yersin , a pupil of Louis Pasteur , during an epidemic of bubonic plague in Hong Kong in 1894; Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission. The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas, drives them to aggressive feeding behaviour, and causes them to try and clear the blockage via regurgitation , resulting in thousands of plague bacteria flushing into the feeding site and infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts , keeping the disease endemic , and a second that lacks resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic . Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al. [lower-alpha 3] They assessed the presence of DNA / RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages". In 2011 these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist". Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis . Later genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor of later plague epidemics—including the third plague pandemic —and the descendant of the strain responsible for the Plague of Justinian . In addition, plague genomes from prehistory have been recovered. DNA taken from 25 skeletons from 14th century London showed that plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013 . Further DNA evidence also proves the role of Y. pestis and traces the source to the Tian Shan mountains in Kyrgyzstan . Researchers are hampered by a lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, where estimates of overall population at the start of the plague vary by over 100%, as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377. Estimates of plague victims are usually extrapolated from figures for the clergy. Mathematical modelling is used to match the spreading patterns and the means of transmission . In 2018 researchers suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of the plague's death toll, as the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, contradicting historical death data. Lars Walløe argued that these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread". Similarly, Monica Green has argued that greater attention is needed to the range of (especially non- commensal ) animals that might be involved in the transmission of plague. Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London, and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats; he argues that transmission must have been person to person. This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic . Academic debate continues, but no single alternative explanation for the plague's spread has achieved widespread acceptance. Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus , smallpox and respiratory infections . In addition to the bubonic infection, others point to additional septicemic and pneumonic forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms. In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis. Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp , no other epidemic pathogen has been discovered to bolster the alternative explanations. The importance of hygiene was not recognized until the 19th century and the germ theory of disease . Until then streets were usually unhygienic, with live animals and human parasites facilitating the spread of transmissible disease . By the early 14th century, so much filth had collected inside urban Europe that French and Italian cities were naming streets after human waste. In medieval Paris, several street names were inspired by merde, the French word for "shit". There were rue Merdeux, rue Merdelet, rue Merdusson, rue des Merdons and rue Merdiere—as well as a rue du Pipi. Pigs, cattle, chickens, geese, goats and horses roamed the streets of medieval London and Paris. Medieval homeowners were supposed to police their housefronts, including removing animal dung, but most urbanites were careless. William E. Cosner, a resident of the London suburb of Farringdon Without, received a complaint alleging that "men could not pass [by his house] for the stink [of] . . . horse dung and horse piss." One irate Londoner complained that the runoff from the local slaughterhouse had made his garden "stinking and putrid", while another charged that the blood from slain animals flooded nearby streets and lanes, "making a foul corruption and abominable sight to all dwelling near." In much of medieval Europe, sanitation legislation consisted of an ordinance requiring homeowners to shout, "Look out below!" three times before dumping a full chamber pot into the street. Early Christians considered bathing a temptation. With this danger in mind, St. Benedict declared, "To those who are well, and especially to the young, bathing shall seldom be permitted." St. Agnes took the injunction to heart and died without ever bathing. According to a team of medical geneticists led by Mark Achtman , Yersinia pestis "evolved in or near China" over 2,600 years ago. Later research by a team led by Galina Eroshenko placed its origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. However more recent research notes that the previous sampling contained East Asian bias and that sampling since then has discovered strains of Y. pestis in the Caucasus region previously thought to be restricted to China. There is also no physical or specific textual evidence of the Black Death in 14th century China. As a result, China's place in the sequence of the plague's spread is still debated to this day. According to Charles Creighton, records of epidemics in 14th century China suggest nothing more than typhus and major Chinese outbreaks of epidemic disease post-date the European epidemic by several years. The earliest Chinese descriptions of the bubonic plague do not appear until the 1640s. Nestorian gravesites dating from 1338 to 1339 near Issyk-Kul have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic ; this is supported by recent direct findings of Y. pestis DNA in teeth samples from graves in the area with inscriptions referring to "pestilence" as the cause of death. Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347. The evidence does not suggest, at least at present, that these mortality crises were caused by plague. Although some scholars, including McNeill and Cao, see the 1333 outbreak as a prelude to the outbreaks in Europe from the late 1340s to the early 1350s, scholars of the Yuan and Ming periods remain skeptical about such an interpretation. Nonetheless, the remarkably high mortality rates during the Datong mortality should discourage us from rejecting the possibility of localized/regional outbreaks of plague in different parts of China, albeit differing in scale from, and unrelated to, the pandemic mortality of the Black Death. What we lack is any indication of a plague pandemic that engulfed vast territories of the Yuan Empire and later moved into western Eurasia through Central Asia. According to John Norris, evidence from Issyk-Kul indicates a small sporadic outbreak characteristic of transmission from rodents to humans with no wide-scale impact. According to Achtman, the dating of the plague suggests that it was not carried along the Silk Road , and its widespread appearance in that region probably postdates the European outbreak. Additionally, the Silk Road had already been heavily disrupted before the spread of the Black Death; Western and Middle Eastern traders found it difficult to trade on the Silk Road by 1325 and impossible by 1340, making its role in the spread of plague less likely. There are no records of the symptoms of the Black Death from Mongol sources or writings from travelers east of the Black Sea prior to the Crimean outbreak in 1346. Others still favor an origin in China. The theory of Chinese origin implicates the Silk Road, the disease possibly spreading alongside Mongol armies and traders, or possibly arriving via ship—however, this theory is still contested. It is speculated that rats aboard Zheng He 's ships in the 15th century may have carried the plague to Southeast Asia , India and Africa. Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions. Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa , the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea . Demographic historians estimate that China's population fell by at least 15 per cent, and perhaps as much as a third, between 1340 and 1370. This population loss coincided with the Black Death that ravaged Europe and much of the Islamic world in 1347–52. However, there is a conspicuous lack of evidence for pandemic disease on the scale of the Black Death in China at this time. War and famine – and the diseases that typically accompanied them – probably were the main causes of mortality in the final decades of Mongol rule. Monica H. Green suggests that other parts of Eurasia outside the west do not contain the same evidence of the Black Plague, because there were actually four strains of Yersinia pestis that became predominant in different parts of the world. Mongol records of illness such as food poisoning may have been referring to the Black Plague. Another theory is that the plague originated near Europe and cycled through the Mediterranean, Northern Europe and Russia before making its way to China. Other historians, such as John Norris and Ole Benedictaw, believe the plague likely originated in Europe or the Middle East, and never reached China. Norris specifically argues for an origin in Kurdistan rather than Central Asia. The seventh year after it began, it came to England and first began in the towns and ports joining on the seacoasts, in Dorsetshire , where, as in other counties, it made the country quite void of inhabitants so that there were almost none left alive. ... But at length it came to Gloucester , yea even to Oxford and to London, and finally it spread over all England and so wasted the people that scarce the tenth person of any sort was left alive. Geoffrey the Baker , Chronicon Angliae Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city in 1345–1346, the Mongol Golden Horde army of Jani Beg —whose mainly Tatar troops were suffering from the disease— catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, though it is also likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants. As the disease took hold, Genoese traders fled across the Black Sea to Constantinople , where the disease first arrived in Europe in summer 1347. The epidemic there killed the 13-year-old son of the Byzantine emperor , John VI Kantakouzenos , who wrote a description of the disease modelled on Thucydides 's account of the 5th century BCE Plague of Athens , noting the spread of the Black Death by ship between maritime cities. Nicephorus Gregoras , while writing to Demetrios Kydones , described the rising death toll, the futility of medicine, and the panic of the citizens. The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347; the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point into northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles . From Italy , the disease spread northwest across Europe, striking France , Spain , Portugal, and England by June 1348, then spreading east and north through Germany , Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy , then spread to Bjørgvin (modern Bergen ). Finally, it spread to northwestern Russia in 1351. Plague was less common in parts of Europe with less-established trade relations, including the majority of the Basque Country , isolated parts of Belgium and the Netherlands , and isolated Alpine villages throughout the continent. According to some epidemiologists, periods of unfavorable weather decimated plague-infected rodent populations, forcing their fleas onto alternative hosts, inducing plague outbreaks which often peaked in the hot summers of the Mediterranean and during the cool autumn months of the southern Baltic region . [lower-alpha 4] Among many other culprits of plague contagiousness, pre-existing malnutrition weakened the immune response, contributing to an immense decline in European population. The disease struck various regions in the Middle East and North Africa during the pandemic , leading to serious depopulation and permanent change in both economic and social structures. By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople via a single merchant ship carrying slaves. By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate , cultural center of the Islamic world , and the largest city in the Mediterranean Basin ; the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died. The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex . The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites ; plague recurred in Cairo more than fifty times over the following one and a half centuries. During 1347, the disease travelled eastward to Gaza by April; by July it had reached Damascus , and in October plague had broken out in Aleppo . That year, in the territory of modern Lebanon , Syria , Israel and Palestine , the cities of Ascalon , Acre , Jerusalem , Sidon and Homs were all infected. In 1348–1349, the disease reached Antioch . The city's residents fled to the north, but most of them ended up dying during the journey. Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa. [ page needed ] The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco; this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus . Mecca became infected in 1348 by pilgrims performing the Hajj . In 1351 or 1352, the Rasulid sultan of the Yemen , al-Mujahid Ali , was released from Mamluk captivity in Egypt and carried plague with him on his return home. During 1349, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. Symptoms of the plague include fever of 38–41 °C (100–106 °F) , headaches, painful aching joints , nausea and vomiting, and a general feeling of malaise . Left untreated, 80% of victims die within eight days. Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos ) in the groin, neck and armpits, which oozed pus and bled when opened. Boccaccio 's description: In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg ... From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves. [lower-alpha 5] This was followed by acute fever and vomiting of blood . Most people died two to seven days after initial infection. Freckle-like spots and rashes, which may have been caused by flea-bites , were identified as another potential sign of plague. Lodewijk Heyligen , whose master Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague , that infected the lungs and led to respiratory problems. Symptoms include fever, cough and blood-tinged sputum . As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90–95%. Septicemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches ( purpura due to disseminated intravascular coagulation ). In cases of pneumonic and particularly septicemic plague, the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes. There are no exact figures for the death toll; the rate varied widely by locality. Urban centers with higher populations suffered longer periods of abnormal mortality. Some estimate that it may have killed between 75,000,000 and 200,000,000 people in Eurasia. [ better source needed ] A study published in 2022 of pollen samples across Europe from 1250 to 1450 was used to estimate changes in agricultural output before and after the Black Death. The authors found great variability in different regions, with evidence for high mortality in areas of Scandinavia, France, western Germany, Greece and central Italy, but uninterrupted agricultural growth in central and eastern Europe, Iberia and Ireland. The authors concluded that "the pandemic was immensely destructive in some areas, but in others it had a far lighter touch ... [the study methodology] invalidates histories of the Black Death that assume Y. pestis was uniformly prevalent, or nearly so, across Europe and that the pandemic had a devastating demographic impact everywhere." The Black Death killed, by various estimations, from 25 to 60% of Europe's population. Robert S. Gottfried writes that as early as 1351, "agents for Pope Clement VI calculated the number of dead in Christian Europe at 23,840,000. With a preplague population of about 75 million, Clement's figure accounts for mortality of 31%-a rate about midway between the 50% mortality estimated for East Anglia, Tuscany, and parts of Scandinavia, and the less-than-15% morbidity for Bohemia and Galicia. And it is unerringly close to Froissart's claim that "a third of the world died," a measurement probably drawn from St. John's figure of mortality from plague in the Book of Revelation , a favorite medieval source of information." Ole J. Benedictow proposes 60% mortality rate for Europe as a whole based on available data, with up to 80% based on poor nutritional conditions in the 14th century. [lower-alpha 6] According to medieval historian Philip Daileader , it is likely that over four years, 45–50% of the European population died of plague. [lower-alpha 7] The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of Y. pestis plague, which occurred in India and killed as much as 3% of the population of certain cities. The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons. The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical and anthropological implications of the Black Death. In 1348, the disease spread so rapidly that nearly a third of the European population perished before any physicians or government authorities had time to reflect upon its origins. In crowded cities, it was not uncommon for as much as 50% of the population to die. Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished, and a similar percentage of Londoners may have died from the disease as well, leaving a death toll of approximately 62,000 between 1346 and 1353. [lower-alpha 8] Florence's tax records suggest that 80% of the city's population died within four months in 1348. Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion . Plague did not appear in Flanders until the turn of the 15th century, and the impact was less severe on the populations of Hainaut , Finland , northern Germany and areas of Poland. Monks, nuns and priests were especially hard-hit since they cared for people ill with the plague. In 1382 the physician to the Avignon Papacy , Raimundo Chalmel de Vinario ( Latin : Magister Raimundus , lit. ' Master Raymond ' ), observed the decreasing mortality rate of successive outbreaks of plague in 1347–1348, 1362, 1371 and 1382 in his treatise On Epidemics ( De epidemica ). In the first outbreak, two thirds of the population contracted the illness and most patients died; in the next, half the population became ill but only some died; by the third, a tenth were affected and many survived; while by the fourth occurrence, only one in twenty people were sickened and most of them survived. By the 1380s in Europe, the plague predominantly affected children. Chalmel de Vinario recognised that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia , whom he disliked), and said that all true cases of plague were caused by astrological factors and were incurable; he was never able to effect a cure. The populations of some Italian cities, notably Florence , did not regain their pre-14th century size until the 19th century. The most widely accepted estimate for the Middle East, including Iraq, Iran and Syria, during this time, is for a death toll of about a third of the population. The Black Death killed about 40% of Egypt's population. In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died within eight months. By the 18th century, the population of Cairo was halved from its numbers in 1347. Italian chronicler Agnolo di Tura recorded his experience from Siena , where plague arrived in May 1348: Father abandoned child, wife husband, one brother another; for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices ... great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night ... And as soon as those ditches were filled more were dug ... And I, Agnolo di Tura ... buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world. It has been suggested that the Black Plague, like other outbreaks through history, disproportionately affected the poorest people and those already in worse physical condition than the wealthier citizens. But along with population decline from the pandemic, wages soared in response to a subsequent labor shortage. Many laborers, artisans and craftsmen—those living from money-wages alone—suffered a reduction in real incomes owing to rampant inflation. Landowners were also pushed to substitute monetary rents for labor services in an effort to keep tenants. The trade disruptions in the Mongol Empire caused by the Black Death was one of the reasons for its collapse. A study performed by Thomas Van Hoof of the Utrecht University suggests that the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation . This may have led to the Little Ice Age . Renewed religious fervor and fanaticism increased in the wake of the Black Death. Some Europeans targeted "various groups such as Jews , friars , foreigners, beggars, pilgrims ", lepers and Romani , blaming them for the crisis. Lepers , and others with skin diseases such as acne or psoriasis , were killed throughout Europe. Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrological forces, earthquakes and the poisoning of wells by Jews as possible reasons for outbreaks. Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness . There were many attacks against Jewish communities. In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered. In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed. During this period many Jews relocated to Poland , where they received a welcome from King Casimir the Great . One theory that has been advanced is that the Black Death's devastation of Florence , between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy that ultimately led to the Renaissance . Italy was particularly badly hit by the pandemic, and the resulting familiarity with death may have caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife . [lower-alpha 9] It has also been argued that the Black Death prompted a new wave of piety, manifested in the sponsorship of religious works of art. This does not fully explain why the Renaissance occurred in Italy in the 14th century; the Renaissance's emergence was most likely the result of the complex interaction of the above factors, in combination with an influx of Greek scholars after the fall of the Byzantine Empire . As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labor, workers travelled in search of the most favorable position economically. [ better source needed ] Prior to the emergence of the Black Death, the continent was considered a feudalistic society, composed of fiefs and city-states frequently managed by the Catholic Church. The pandemic completely restructured both religion and political forces; survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably contributed to the destabilization of feudalism . The word " quarantine " has its roots in this period, though the practice of isolating people to prevent the spread of disease is older. In the city-state of Ragusa (modern Dubrovnik , Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty". A report by the Medical Faculty of Paris stated that a conjunction of planets had caused "a great pestilence in the air" ( miasma theory ). Muslim religious scholars taught that the pandemic was a "martyrdom and mercy" from God, assuring the believer's place in paradise. For non-believers, it was a punishment. Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks. Due to climate change in Asia , rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. The plague disease, caused by the bacterium Yersinia pestis , is enzootic (commonly present) in populations of fleas carried by ground rodents , including marmots , in various areas, including Central Asia , Kurdistan , Western Asia , North India , Uganda and the western United States. Y. pestis was discovered by Alexandre Yersin , a pupil of Louis Pasteur , during an epidemic of bubonic plague in Hong Kong in 1894; Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission. The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas, drives them to aggressive feeding behaviour, and causes them to try and clear the blockage via regurgitation , resulting in thousands of plague bacteria flushing into the feeding site and infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts , keeping the disease endemic , and a second that lacks resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic . Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al. [lower-alpha 3] They assessed the presence of DNA / RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages". In 2011 these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist". Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis . Later genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor of later plague epidemics—including the third plague pandemic —and the descendant of the strain responsible for the Plague of Justinian . In addition, plague genomes from prehistory have been recovered. DNA taken from 25 skeletons from 14th century London showed that plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013 . Further DNA evidence also proves the role of Y. pestis and traces the source to the Tian Shan mountains in Kyrgyzstan . Researchers are hampered by a lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, where estimates of overall population at the start of the plague vary by over 100%, as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377. Estimates of plague victims are usually extrapolated from figures for the clergy. Mathematical modelling is used to match the spreading patterns and the means of transmission . In 2018 researchers suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of the plague's death toll, as the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, contradicting historical death data. Lars Walløe argued that these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread". Similarly, Monica Green has argued that greater attention is needed to the range of (especially non- commensal ) animals that might be involved in the transmission of plague. Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London, and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats; he argues that transmission must have been person to person. This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic . Academic debate continues, but no single alternative explanation for the plague's spread has achieved widespread acceptance. Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus , smallpox and respiratory infections . In addition to the bubonic infection, others point to additional septicemic and pneumonic forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms. In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis. Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp , no other epidemic pathogen has been discovered to bolster the alternative explanations. A report by the Medical Faculty of Paris stated that a conjunction of planets had caused "a great pestilence in the air" ( miasma theory ). Muslim religious scholars taught that the pandemic was a "martyrdom and mercy" from God, assuring the believer's place in paradise. For non-believers, it was a punishment. Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks. Due to climate change in Asia , rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. The plague disease, caused by the bacterium Yersinia pestis , is enzootic (commonly present) in populations of fleas carried by ground rodents , including marmots , in various areas, including Central Asia , Kurdistan , Western Asia , North India , Uganda and the western United States. Y. pestis was discovered by Alexandre Yersin , a pupil of Louis Pasteur , during an epidemic of bubonic plague in Hong Kong in 1894; Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission. The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas, drives them to aggressive feeding behaviour, and causes them to try and clear the blockage via regurgitation , resulting in thousands of plague bacteria flushing into the feeding site and infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts , keeping the disease endemic , and a second that lacks resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic . Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al. [lower-alpha 3] They assessed the presence of DNA / RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages". In 2011 these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist". Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis . Later genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor of later plague epidemics—including the third plague pandemic —and the descendant of the strain responsible for the Plague of Justinian . In addition, plague genomes from prehistory have been recovered. DNA taken from 25 skeletons from 14th century London showed that plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013 . Further DNA evidence also proves the role of Y. pestis and traces the source to the Tian Shan mountains in Kyrgyzstan . Researchers are hampered by a lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, where estimates of overall population at the start of the plague vary by over 100%, as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377. Estimates of plague victims are usually extrapolated from figures for the clergy. Mathematical modelling is used to match the spreading patterns and the means of transmission . In 2018 researchers suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of the plague's death toll, as the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, contradicting historical death data. Lars Walløe argued that these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread". Similarly, Monica Green has argued that greater attention is needed to the range of (especially non- commensal ) animals that might be involved in the transmission of plague. Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London, and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats; he argues that transmission must have been person to person. This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic . Academic debate continues, but no single alternative explanation for the plague's spread has achieved widespread acceptance. Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus , smallpox and respiratory infections . In addition to the bubonic infection, others point to additional septicemic and pneumonic forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms. In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis. Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp , no other epidemic pathogen has been discovered to bolster the alternative explanations. The importance of hygiene was not recognized until the 19th century and the germ theory of disease . Until then streets were usually unhygienic, with live animals and human parasites facilitating the spread of transmissible disease . By the early 14th century, so much filth had collected inside urban Europe that French and Italian cities were naming streets after human waste. In medieval Paris, several street names were inspired by merde, the French word for "shit". There were rue Merdeux, rue Merdelet, rue Merdusson, rue des Merdons and rue Merdiere—as well as a rue du Pipi. Pigs, cattle, chickens, geese, goats and horses roamed the streets of medieval London and Paris. Medieval homeowners were supposed to police their housefronts, including removing animal dung, but most urbanites were careless. William E. Cosner, a resident of the London suburb of Farringdon Without, received a complaint alleging that "men could not pass [by his house] for the stink [of] . . . horse dung and horse piss." One irate Londoner complained that the runoff from the local slaughterhouse had made his garden "stinking and putrid", while another charged that the blood from slain animals flooded nearby streets and lanes, "making a foul corruption and abominable sight to all dwelling near." In much of medieval Europe, sanitation legislation consisted of an ordinance requiring homeowners to shout, "Look out below!" three times before dumping a full chamber pot into the street. Early Christians considered bathing a temptation. With this danger in mind, St. Benedict declared, "To those who are well, and especially to the young, bathing shall seldom be permitted." St. Agnes took the injunction to heart and died without ever bathing. According to a team of medical geneticists led by Mark Achtman , Yersinia pestis "evolved in or near China" over 2,600 years ago. Later research by a team led by Galina Eroshenko placed its origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. However more recent research notes that the previous sampling contained East Asian bias and that sampling since then has discovered strains of Y. pestis in the Caucasus region previously thought to be restricted to China. There is also no physical or specific textual evidence of the Black Death in 14th century China. As a result, China's place in the sequence of the plague's spread is still debated to this day. According to Charles Creighton, records of epidemics in 14th century China suggest nothing more than typhus and major Chinese outbreaks of epidemic disease post-date the European epidemic by several years. The earliest Chinese descriptions of the bubonic plague do not appear until the 1640s. Nestorian gravesites dating from 1338 to 1339 near Issyk-Kul have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic ; this is supported by recent direct findings of Y. pestis DNA in teeth samples from graves in the area with inscriptions referring to "pestilence" as the cause of death. Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347. The evidence does not suggest, at least at present, that these mortality crises were caused by plague. Although some scholars, including McNeill and Cao, see the 1333 outbreak as a prelude to the outbreaks in Europe from the late 1340s to the early 1350s, scholars of the Yuan and Ming periods remain skeptical about such an interpretation. Nonetheless, the remarkably high mortality rates during the Datong mortality should discourage us from rejecting the possibility of localized/regional outbreaks of plague in different parts of China, albeit differing in scale from, and unrelated to, the pandemic mortality of the Black Death. What we lack is any indication of a plague pandemic that engulfed vast territories of the Yuan Empire and later moved into western Eurasia through Central Asia. According to John Norris, evidence from Issyk-Kul indicates a small sporadic outbreak characteristic of transmission from rodents to humans with no wide-scale impact. According to Achtman, the dating of the plague suggests that it was not carried along the Silk Road , and its widespread appearance in that region probably postdates the European outbreak. Additionally, the Silk Road had already been heavily disrupted before the spread of the Black Death; Western and Middle Eastern traders found it difficult to trade on the Silk Road by 1325 and impossible by 1340, making its role in the spread of plague less likely. There are no records of the symptoms of the Black Death from Mongol sources or writings from travelers east of the Black Sea prior to the Crimean outbreak in 1346. Others still favor an origin in China. The theory of Chinese origin implicates the Silk Road, the disease possibly spreading alongside Mongol armies and traders, or possibly arriving via ship—however, this theory is still contested. It is speculated that rats aboard Zheng He 's ships in the 15th century may have carried the plague to Southeast Asia , India and Africa. Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions. Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa , the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea . Demographic historians estimate that China's population fell by at least 15 per cent, and perhaps as much as a third, between 1340 and 1370. This population loss coincided with the Black Death that ravaged Europe and much of the Islamic world in 1347–52. However, there is a conspicuous lack of evidence for pandemic disease on the scale of the Black Death in China at this time. War and famine – and the diseases that typically accompanied them – probably were the main causes of mortality in the final decades of Mongol rule. Monica H. Green suggests that other parts of Eurasia outside the west do not contain the same evidence of the Black Plague, because there were actually four strains of Yersinia pestis that became predominant in different parts of the world. Mongol records of illness such as food poisoning may have been referring to the Black Plague. Another theory is that the plague originated near Europe and cycled through the Mediterranean, Northern Europe and Russia before making its way to China. Other historians, such as John Norris and Ole Benedictaw, believe the plague likely originated in Europe or the Middle East, and never reached China. Norris specifically argues for an origin in Kurdistan rather than Central Asia. The seventh year after it began, it came to England and first began in the towns and ports joining on the seacoasts, in Dorsetshire , where, as in other counties, it made the country quite void of inhabitants so that there were almost none left alive. ... But at length it came to Gloucester , yea even to Oxford and to London, and finally it spread over all England and so wasted the people that scarce the tenth person of any sort was left alive. Geoffrey the Baker , Chronicon Angliae Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city in 1345–1346, the Mongol Golden Horde army of Jani Beg —whose mainly Tatar troops were suffering from the disease— catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, though it is also likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants. As the disease took hold, Genoese traders fled across the Black Sea to Constantinople , where the disease first arrived in Europe in summer 1347. The epidemic there killed the 13-year-old son of the Byzantine emperor , John VI Kantakouzenos , who wrote a description of the disease modelled on Thucydides 's account of the 5th century BCE Plague of Athens , noting the spread of the Black Death by ship between maritime cities. Nicephorus Gregoras , while writing to Demetrios Kydones , described the rising death toll, the futility of medicine, and the panic of the citizens. The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347; the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point into northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles . From Italy , the disease spread northwest across Europe, striking France , Spain , Portugal, and England by June 1348, then spreading east and north through Germany , Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy , then spread to Bjørgvin (modern Bergen ). Finally, it spread to northwestern Russia in 1351. Plague was less common in parts of Europe with less-established trade relations, including the majority of the Basque Country , isolated parts of Belgium and the Netherlands , and isolated Alpine villages throughout the continent. According to some epidemiologists, periods of unfavorable weather decimated plague-infected rodent populations, forcing their fleas onto alternative hosts, inducing plague outbreaks which often peaked in the hot summers of the Mediterranean and during the cool autumn months of the southern Baltic region . [lower-alpha 4] Among many other culprits of plague contagiousness, pre-existing malnutrition weakened the immune response, contributing to an immense decline in European population. The disease struck various regions in the Middle East and North Africa during the pandemic , leading to serious depopulation and permanent change in both economic and social structures. By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople via a single merchant ship carrying slaves. By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate , cultural center of the Islamic world , and the largest city in the Mediterranean Basin ; the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died. The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex . The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites ; plague recurred in Cairo more than fifty times over the following one and a half centuries. During 1347, the disease travelled eastward to Gaza by April; by July it had reached Damascus , and in October plague had broken out in Aleppo . That year, in the territory of modern Lebanon , Syria , Israel and Palestine , the cities of Ascalon , Acre , Jerusalem , Sidon and Homs were all infected. In 1348–1349, the disease reached Antioch . The city's residents fled to the north, but most of them ended up dying during the journey. Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa. [ page needed ] The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco; this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus . Mecca became infected in 1348 by pilgrims performing the Hajj . In 1351 or 1352, the Rasulid sultan of the Yemen , al-Mujahid Ali , was released from Mamluk captivity in Egypt and carried plague with him on his return home. During 1349, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. The importance of hygiene was not recognized until the 19th century and the germ theory of disease . Until then streets were usually unhygienic, with live animals and human parasites facilitating the spread of transmissible disease . By the early 14th century, so much filth had collected inside urban Europe that French and Italian cities were naming streets after human waste. In medieval Paris, several street names were inspired by merde, the French word for "shit". There were rue Merdeux, rue Merdelet, rue Merdusson, rue des Merdons and rue Merdiere—as well as a rue du Pipi. Pigs, cattle, chickens, geese, goats and horses roamed the streets of medieval London and Paris. Medieval homeowners were supposed to police their housefronts, including removing animal dung, but most urbanites were careless. William E. Cosner, a resident of the London suburb of Farringdon Without, received a complaint alleging that "men could not pass [by his house] for the stink [of] . . . horse dung and horse piss." One irate Londoner complained that the runoff from the local slaughterhouse had made his garden "stinking and putrid", while another charged that the blood from slain animals flooded nearby streets and lanes, "making a foul corruption and abominable sight to all dwelling near." In much of medieval Europe, sanitation legislation consisted of an ordinance requiring homeowners to shout, "Look out below!" three times before dumping a full chamber pot into the street. Early Christians considered bathing a temptation. With this danger in mind, St. Benedict declared, "To those who are well, and especially to the young, bathing shall seldom be permitted." St. Agnes took the injunction to heart and died without ever bathing. According to a team of medical geneticists led by Mark Achtman , Yersinia pestis "evolved in or near China" over 2,600 years ago. Later research by a team led by Galina Eroshenko placed its origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. However more recent research notes that the previous sampling contained East Asian bias and that sampling since then has discovered strains of Y. pestis in the Caucasus region previously thought to be restricted to China. There is also no physical or specific textual evidence of the Black Death in 14th century China. As a result, China's place in the sequence of the plague's spread is still debated to this day. According to Charles Creighton, records of epidemics in 14th century China suggest nothing more than typhus and major Chinese outbreaks of epidemic disease post-date the European epidemic by several years. The earliest Chinese descriptions of the bubonic plague do not appear until the 1640s. Nestorian gravesites dating from 1338 to 1339 near Issyk-Kul have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic ; this is supported by recent direct findings of Y. pestis DNA in teeth samples from graves in the area with inscriptions referring to "pestilence" as the cause of death. Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347. The evidence does not suggest, at least at present, that these mortality crises were caused by plague. Although some scholars, including McNeill and Cao, see the 1333 outbreak as a prelude to the outbreaks in Europe from the late 1340s to the early 1350s, scholars of the Yuan and Ming periods remain skeptical about such an interpretation. Nonetheless, the remarkably high mortality rates during the Datong mortality should discourage us from rejecting the possibility of localized/regional outbreaks of plague in different parts of China, albeit differing in scale from, and unrelated to, the pandemic mortality of the Black Death. What we lack is any indication of a plague pandemic that engulfed vast territories of the Yuan Empire and later moved into western Eurasia through Central Asia. According to John Norris, evidence from Issyk-Kul indicates a small sporadic outbreak characteristic of transmission from rodents to humans with no wide-scale impact. According to Achtman, the dating of the plague suggests that it was not carried along the Silk Road , and its widespread appearance in that region probably postdates the European outbreak. Additionally, the Silk Road had already been heavily disrupted before the spread of the Black Death; Western and Middle Eastern traders found it difficult to trade on the Silk Road by 1325 and impossible by 1340, making its role in the spread of plague less likely. There are no records of the symptoms of the Black Death from Mongol sources or writings from travelers east of the Black Sea prior to the Crimean outbreak in 1346. Others still favor an origin in China. The theory of Chinese origin implicates the Silk Road, the disease possibly spreading alongside Mongol armies and traders, or possibly arriving via ship—however, this theory is still contested. It is speculated that rats aboard Zheng He 's ships in the 15th century may have carried the plague to Southeast Asia , India and Africa. Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions. Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa , the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea . Demographic historians estimate that China's population fell by at least 15 per cent, and perhaps as much as a third, between 1340 and 1370. This population loss coincided with the Black Death that ravaged Europe and much of the Islamic world in 1347–52. However, there is a conspicuous lack of evidence for pandemic disease on the scale of the Black Death in China at this time. War and famine – and the diseases that typically accompanied them – probably were the main causes of mortality in the final decades of Mongol rule. Monica H. Green suggests that other parts of Eurasia outside the west do not contain the same evidence of the Black Plague, because there were actually four strains of Yersinia pestis that became predominant in different parts of the world. Mongol records of illness such as food poisoning may have been referring to the Black Plague. Another theory is that the plague originated near Europe and cycled through the Mediterranean, Northern Europe and Russia before making its way to China. Other historians, such as John Norris and Ole Benedictaw, believe the plague likely originated in Europe or the Middle East, and never reached China. Norris specifically argues for an origin in Kurdistan rather than Central Asia. The seventh year after it began, it came to England and first began in the towns and ports joining on the seacoasts, in Dorsetshire , where, as in other counties, it made the country quite void of inhabitants so that there were almost none left alive. ... But at length it came to Gloucester , yea even to Oxford and to London, and finally it spread over all England and so wasted the people that scarce the tenth person of any sort was left alive. Geoffrey the Baker , Chronicon Angliae Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city in 1345–1346, the Mongol Golden Horde army of Jani Beg —whose mainly Tatar troops were suffering from the disease— catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, though it is also likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants. As the disease took hold, Genoese traders fled across the Black Sea to Constantinople , where the disease first arrived in Europe in summer 1347. The epidemic there killed the 13-year-old son of the Byzantine emperor , John VI Kantakouzenos , who wrote a description of the disease modelled on Thucydides 's account of the 5th century BCE Plague of Athens , noting the spread of the Black Death by ship between maritime cities. Nicephorus Gregoras , while writing to Demetrios Kydones , described the rising death toll, the futility of medicine, and the panic of the citizens. The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347; the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point into northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles . From Italy , the disease spread northwest across Europe, striking France , Spain , Portugal, and England by June 1348, then spreading east and north through Germany , Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy , then spread to Bjørgvin (modern Bergen ). Finally, it spread to northwestern Russia in 1351. Plague was less common in parts of Europe with less-established trade relations, including the majority of the Basque Country , isolated parts of Belgium and the Netherlands , and isolated Alpine villages throughout the continent. According to some epidemiologists, periods of unfavorable weather decimated plague-infected rodent populations, forcing their fleas onto alternative hosts, inducing plague outbreaks which often peaked in the hot summers of the Mediterranean and during the cool autumn months of the southern Baltic region . [lower-alpha 4] Among many other culprits of plague contagiousness, pre-existing malnutrition weakened the immune response, contributing to an immense decline in European population. The disease struck various regions in the Middle East and North Africa during the pandemic , leading to serious depopulation and permanent change in both economic and social structures. By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople via a single merchant ship carrying slaves. By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate , cultural center of the Islamic world , and the largest city in the Mediterranean Basin ; the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died. The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex . The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites ; plague recurred in Cairo more than fifty times over the following one and a half centuries. During 1347, the disease travelled eastward to Gaza by April; by July it had reached Damascus , and in October plague had broken out in Aleppo . That year, in the territory of modern Lebanon , Syria , Israel and Palestine , the cities of Ascalon , Acre , Jerusalem , Sidon and Homs were all infected. In 1348–1349, the disease reached Antioch . The city's residents fled to the north, but most of them ended up dying during the journey. Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa. [ page needed ] The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco; this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus . Mecca became infected in 1348 by pilgrims performing the Hajj . In 1351 or 1352, the Rasulid sultan of the Yemen , al-Mujahid Ali , was released from Mamluk captivity in Egypt and carried plague with him on his return home. During 1349, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. Symptoms of the plague include fever of 38–41 °C (100–106 °F) , headaches, painful aching joints , nausea and vomiting, and a general feeling of malaise . Left untreated, 80% of victims die within eight days. Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos ) in the groin, neck and armpits, which oozed pus and bled when opened. Boccaccio 's description: In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg ... From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves. [lower-alpha 5] This was followed by acute fever and vomiting of blood . Most people died two to seven days after initial infection. Freckle-like spots and rashes, which may have been caused by flea-bites , were identified as another potential sign of plague. Lodewijk Heyligen , whose master Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague , that infected the lungs and led to respiratory problems. Symptoms include fever, cough and blood-tinged sputum . As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90–95%. Septicemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches ( purpura due to disseminated intravascular coagulation ). In cases of pneumonic and particularly septicemic plague, the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes. Symptoms of the plague include fever of 38–41 °C (100–106 °F) , headaches, painful aching joints , nausea and vomiting, and a general feeling of malaise . Left untreated, 80% of victims die within eight days. Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos ) in the groin, neck and armpits, which oozed pus and bled when opened. Boccaccio 's description: In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg ... From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves. [lower-alpha 5] This was followed by acute fever and vomiting of blood . Most people died two to seven days after initial infection. Freckle-like spots and rashes, which may have been caused by flea-bites , were identified as another potential sign of plague.Lodewijk Heyligen , whose master Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague , that infected the lungs and led to respiratory problems. Symptoms include fever, cough and blood-tinged sputum . As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90–95%. Septicemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches ( purpura due to disseminated intravascular coagulation ). In cases of pneumonic and particularly septicemic plague, the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes. There are no exact figures for the death toll; the rate varied widely by locality. Urban centers with higher populations suffered longer periods of abnormal mortality. Some estimate that it may have killed between 75,000,000 and 200,000,000 people in Eurasia. [ better source needed ] A study published in 2022 of pollen samples across Europe from 1250 to 1450 was used to estimate changes in agricultural output before and after the Black Death. The authors found great variability in different regions, with evidence for high mortality in areas of Scandinavia, France, western Germany, Greece and central Italy, but uninterrupted agricultural growth in central and eastern Europe, Iberia and Ireland. The authors concluded that "the pandemic was immensely destructive in some areas, but in others it had a far lighter touch ... [the study methodology] invalidates histories of the Black Death that assume Y. pestis was uniformly prevalent, or nearly so, across Europe and that the pandemic had a devastating demographic impact everywhere." The Black Death killed, by various estimations, from 25 to 60% of Europe's population. Robert S. Gottfried writes that as early as 1351, "agents for Pope Clement VI calculated the number of dead in Christian Europe at 23,840,000. With a preplague population of about 75 million, Clement's figure accounts for mortality of 31%-a rate about midway between the 50% mortality estimated for East Anglia, Tuscany, and parts of Scandinavia, and the less-than-15% morbidity for Bohemia and Galicia. And it is unerringly close to Froissart's claim that "a third of the world died," a measurement probably drawn from St. John's figure of mortality from plague in the Book of Revelation , a favorite medieval source of information." Ole J. Benedictow proposes 60% mortality rate for Europe as a whole based on available data, with up to 80% based on poor nutritional conditions in the 14th century. [lower-alpha 6] According to medieval historian Philip Daileader , it is likely that over four years, 45–50% of the European population died of plague. [lower-alpha 7] The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of Y. pestis plague, which occurred in India and killed as much as 3% of the population of certain cities. The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons. The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical and anthropological implications of the Black Death. In 1348, the disease spread so rapidly that nearly a third of the European population perished before any physicians or government authorities had time to reflect upon its origins. In crowded cities, it was not uncommon for as much as 50% of the population to die. Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished, and a similar percentage of Londoners may have died from the disease as well, leaving a death toll of approximately 62,000 between 1346 and 1353. [lower-alpha 8] Florence's tax records suggest that 80% of the city's population died within four months in 1348. Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion . Plague did not appear in Flanders until the turn of the 15th century, and the impact was less severe on the populations of Hainaut , Finland , northern Germany and areas of Poland. Monks, nuns and priests were especially hard-hit since they cared for people ill with the plague. In 1382 the physician to the Avignon Papacy , Raimundo Chalmel de Vinario ( Latin : Magister Raimundus , lit. ' Master Raymond ' ), observed the decreasing mortality rate of successive outbreaks of plague in 1347–1348, 1362, 1371 and 1382 in his treatise On Epidemics ( De epidemica ). In the first outbreak, two thirds of the population contracted the illness and most patients died; in the next, half the population became ill but only some died; by the third, a tenth were affected and many survived; while by the fourth occurrence, only one in twenty people were sickened and most of them survived. By the 1380s in Europe, the plague predominantly affected children. Chalmel de Vinario recognised that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia , whom he disliked), and said that all true cases of plague were caused by astrological factors and were incurable; he was never able to effect a cure. The populations of some Italian cities, notably Florence , did not regain their pre-14th century size until the 19th century. The most widely accepted estimate for the Middle East, including Iraq, Iran and Syria, during this time, is for a death toll of about a third of the population. The Black Death killed about 40% of Egypt's population. In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died within eight months. By the 18th century, the population of Cairo was halved from its numbers in 1347. Italian chronicler Agnolo di Tura recorded his experience from Siena , where plague arrived in May 1348: Father abandoned child, wife husband, one brother another; for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices ... great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night ... And as soon as those ditches were filled more were dug ... And I, Agnolo di Tura ... buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world. It has been suggested that the Black Plague, like other outbreaks through history, disproportionately affected the poorest people and those already in worse physical condition than the wealthier citizens. But along with population decline from the pandemic, wages soared in response to a subsequent labor shortage. Many laborers, artisans and craftsmen—those living from money-wages alone—suffered a reduction in real incomes owing to rampant inflation. Landowners were also pushed to substitute monetary rents for labor services in an effort to keep tenants. The trade disruptions in the Mongol Empire caused by the Black Death was one of the reasons for its collapse. A study performed by Thomas Van Hoof of the Utrecht University suggests that the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation . This may have led to the Little Ice Age . Renewed religious fervor and fanaticism increased in the wake of the Black Death. Some Europeans targeted "various groups such as Jews , friars , foreigners, beggars, pilgrims ", lepers and Romani , blaming them for the crisis. Lepers , and others with skin diseases such as acne or psoriasis , were killed throughout Europe. Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrological forces, earthquakes and the poisoning of wells by Jews as possible reasons for outbreaks. Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness . There were many attacks against Jewish communities. In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered. In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed. During this period many Jews relocated to Poland , where they received a welcome from King Casimir the Great . One theory that has been advanced is that the Black Death's devastation of Florence , between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy that ultimately led to the Renaissance . Italy was particularly badly hit by the pandemic, and the resulting familiarity with death may have caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife . [lower-alpha 9] It has also been argued that the Black Death prompted a new wave of piety, manifested in the sponsorship of religious works of art. This does not fully explain why the Renaissance occurred in Italy in the 14th century; the Renaissance's emergence was most likely the result of the complex interaction of the above factors, in combination with an influx of Greek scholars after the fall of the Byzantine Empire . As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labor, workers travelled in search of the most favorable position economically. [ better source needed ] Prior to the emergence of the Black Death, the continent was considered a feudalistic society, composed of fiefs and city-states frequently managed by the Catholic Church. The pandemic completely restructured both religion and political forces; survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably contributed to the destabilization of feudalism . The word " quarantine " has its roots in this period, though the practice of isolating people to prevent the spread of disease is older. In the city-state of Ragusa (modern Dubrovnik , Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty". There are no exact figures for the death toll; the rate varied widely by locality. Urban centers with higher populations suffered longer periods of abnormal mortality. Some estimate that it may have killed between 75,000,000 and 200,000,000 people in Eurasia. [ better source needed ] A study published in 2022 of pollen samples across Europe from 1250 to 1450 was used to estimate changes in agricultural output before and after the Black Death. The authors found great variability in different regions, with evidence for high mortality in areas of Scandinavia, France, western Germany, Greece and central Italy, but uninterrupted agricultural growth in central and eastern Europe, Iberia and Ireland. The authors concluded that "the pandemic was immensely destructive in some areas, but in others it had a far lighter touch ... [the study methodology] invalidates histories of the Black Death that assume Y. pestis was uniformly prevalent, or nearly so, across Europe and that the pandemic had a devastating demographic impact everywhere." The Black Death killed, by various estimations, from 25 to 60% of Europe's population. Robert S. Gottfried writes that as early as 1351, "agents for Pope Clement VI calculated the number of dead in Christian Europe at 23,840,000. With a preplague population of about 75 million, Clement's figure accounts for mortality of 31%-a rate about midway between the 50% mortality estimated for East Anglia, Tuscany, and parts of Scandinavia, and the less-than-15% morbidity for Bohemia and Galicia. And it is unerringly close to Froissart's claim that "a third of the world died," a measurement probably drawn from St. John's figure of mortality from plague in the Book of Revelation , a favorite medieval source of information." Ole J. Benedictow proposes 60% mortality rate for Europe as a whole based on available data, with up to 80% based on poor nutritional conditions in the 14th century. [lower-alpha 6] According to medieval historian Philip Daileader , it is likely that over four years, 45–50% of the European population died of plague. [lower-alpha 7] The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of Y. pestis plague, which occurred in India and killed as much as 3% of the population of certain cities. The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons. The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical and anthropological implications of the Black Death. In 1348, the disease spread so rapidly that nearly a third of the European population perished before any physicians or government authorities had time to reflect upon its origins. In crowded cities, it was not uncommon for as much as 50% of the population to die. Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished, and a similar percentage of Londoners may have died from the disease as well, leaving a death toll of approximately 62,000 between 1346 and 1353. [lower-alpha 8] Florence's tax records suggest that 80% of the city's population died within four months in 1348. Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion . Plague did not appear in Flanders until the turn of the 15th century, and the impact was less severe on the populations of Hainaut , Finland , northern Germany and areas of Poland. Monks, nuns and priests were especially hard-hit since they cared for people ill with the plague. In 1382 the physician to the Avignon Papacy , Raimundo Chalmel de Vinario ( Latin : Magister Raimundus , lit. ' Master Raymond ' ), observed the decreasing mortality rate of successive outbreaks of plague in 1347–1348, 1362, 1371 and 1382 in his treatise On Epidemics ( De epidemica ). In the first outbreak, two thirds of the population contracted the illness and most patients died; in the next, half the population became ill but only some died; by the third, a tenth were affected and many survived; while by the fourth occurrence, only one in twenty people were sickened and most of them survived. By the 1380s in Europe, the plague predominantly affected children. Chalmel de Vinario recognised that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia , whom he disliked), and said that all true cases of plague were caused by astrological factors and were incurable; he was never able to effect a cure. The populations of some Italian cities, notably Florence , did not regain their pre-14th century size until the 19th century. The most widely accepted estimate for the Middle East, including Iraq, Iran and Syria, during this time, is for a death toll of about a third of the population. The Black Death killed about 40% of Egypt's population. In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died within eight months. By the 18th century, the population of Cairo was halved from its numbers in 1347. Italian chronicler Agnolo di Tura recorded his experience from Siena , where plague arrived in May 1348: Father abandoned child, wife husband, one brother another; for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices ... great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night ... And as soon as those ditches were filled more were dug ... And I, Agnolo di Tura ... buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world. It has been suggested that the Black Plague, like other outbreaks through history, disproportionately affected the poorest people and those already in worse physical condition than the wealthier citizens. But along with population decline from the pandemic, wages soared in response to a subsequent labor shortage. Many laborers, artisans and craftsmen—those living from money-wages alone—suffered a reduction in real incomes owing to rampant inflation. Landowners were also pushed to substitute monetary rents for labor services in an effort to keep tenants. The trade disruptions in the Mongol Empire caused by the Black Death was one of the reasons for its collapse. A study performed by Thomas Van Hoof of the Utrecht University suggests that the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation . This may have led to the Little Ice Age . Renewed religious fervor and fanaticism increased in the wake of the Black Death. Some Europeans targeted "various groups such as Jews , friars , foreigners, beggars, pilgrims ", lepers and Romani , blaming them for the crisis. Lepers , and others with skin diseases such as acne or psoriasis , were killed throughout Europe. Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrological forces, earthquakes and the poisoning of wells by Jews as possible reasons for outbreaks. Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness . There were many attacks against Jewish communities. In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered. In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed. During this period many Jews relocated to Poland , where they received a welcome from King Casimir the Great . One theory that has been advanced is that the Black Death's devastation of Florence , between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy that ultimately led to the Renaissance . Italy was particularly badly hit by the pandemic, and the resulting familiarity with death may have caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife . [lower-alpha 9] It has also been argued that the Black Death prompted a new wave of piety, manifested in the sponsorship of religious works of art. This does not fully explain why the Renaissance occurred in Italy in the 14th century; the Renaissance's emergence was most likely the result of the complex interaction of the above factors, in combination with an influx of Greek scholars after the fall of the Byzantine Empire . As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labor, workers travelled in search of the most favorable position economically. [ better source needed ] Prior to the emergence of the Black Death, the continent was considered a feudalistic society, composed of fiefs and city-states frequently managed by the Catholic Church. The pandemic completely restructured both religion and political forces; survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably contributed to the destabilization of feudalism . The word " quarantine " has its roots in this period, though the practice of isolating people to prevent the spread of disease is older. In the city-state of Ragusa (modern Dubrovnik , Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty". The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671 (although some researchers have cautions about the uncritical use of Biraben's data). The second pandemic was particularly widespread in the following years: 1360–1363; 1374; 1400; 1438–1439; 1456–1457; 1464–1466; 1481–1485; 1500–1503; 1518–1531; 1544–1548; 1563–1566; 1573–1588; 1596–1599; 1602–1611; 1623–1640; 1644–1654; and 1664–1667. Subsequent outbreaks, though severe, marked the plague's retreat from most of Europe (18th century) and northern Africa (19th century). Historian George Sussman argued that the plague had not occurred in East Africa until the 1900s. However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa. According to historian Geoffrey Parker , "France alone lost almost a million people to the plague in the epidemic of 1628–31." In the first half of the 17th century, a plague killed some 1.7 million people in Italy. More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain . The Black Death ravaged much of the Islamic world . Plague could be found in the Islamic world almost every year between 1500 and 1850. Sometimes the outbreaks affected small areas, while other outbreaks affected multiple regions. Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691 and 1740–42. Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s. Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in Constantinople , and an additional thirty-one between 1751 and 1800. Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population had died. The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone. The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin , for whom the pathogen was named. Twelve plague outbreaks in Australia between 1900 and 1925 resulted in over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus Yersinia pestis . The first North American plague epidemic was the San Francisco plague of 1900–1904 , followed by another outbreak in 1907–1908. Modern treatment methods include insecticides , the use of antibiotics , and a plague vaccine . It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995. Another outbreak in Madagascar was reported in November 2014. In October 2017, the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands. An estimate of the case fatality rate for the modern plague , after the introduction of antibiotics , is 11%, although it may be higher in underdeveloped regions. The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671 (although some researchers have cautions about the uncritical use of Biraben's data). The second pandemic was particularly widespread in the following years: 1360–1363; 1374; 1400; 1438–1439; 1456–1457; 1464–1466; 1481–1485; 1500–1503; 1518–1531; 1544–1548; 1563–1566; 1573–1588; 1596–1599; 1602–1611; 1623–1640; 1644–1654; and 1664–1667. Subsequent outbreaks, though severe, marked the plague's retreat from most of Europe (18th century) and northern Africa (19th century). Historian George Sussman argued that the plague had not occurred in East Africa until the 1900s. However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa. According to historian Geoffrey Parker , "France alone lost almost a million people to the plague in the epidemic of 1628–31." In the first half of the 17th century, a plague killed some 1.7 million people in Italy. More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain . The Black Death ravaged much of the Islamic world . Plague could be found in the Islamic world almost every year between 1500 and 1850. Sometimes the outbreaks affected small areas, while other outbreaks affected multiple regions. Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691 and 1740–42. Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s. Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in Constantinople , and an additional thirty-one between 1751 and 1800. Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population had died. The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone. The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin , for whom the pathogen was named. Twelve plague outbreaks in Australia between 1900 and 1925 resulted in over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus Yersinia pestis . The first North American plague epidemic was the San Francisco plague of 1900–1904 , followed by another outbreak in 1907–1908. Modern treatment methods include insecticides , the use of antibiotics , and a plague vaccine . It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995. Another outbreak in Madagascar was reported in November 2014. In October 2017, the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands. An estimate of the case fatality rate for the modern plague , after the introduction of antibiotics , is 11%, although it may be higher in underdeveloped regions.

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Plague

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Bubonic plague

Bubonic plague is one of three types of plague caused by the bacterium Yersinia pestis . One to seven days after exposure to the bacteria, flu-like symptoms develop. These symptoms include fever , headaches , and vomiting , as well as swollen and painful lymph nodes occurring in the area closest to where the bacteria entered the skin. Acral necrosis , the dark discoloration of skin, is another symptom. Occasionally, swollen lymph nodes, known as " buboes ", may break open. The three types of plague are the result of the route of infection: bubonic plague, septicemic plague , and pneumonic plague . Bubonic plague is mainly spread by infected fleas from small animals . It may also result from exposure to the body fluids from a dead plague-infected animal. Mammals such as rabbits , hares , and some cat species are susceptible to bubonic plague, and typically die upon contraction. In the bubonic form of plague, the bacteria enter through the skin through a flea bite and travel via the lymphatic vessels to a lymph node , causing it to swell. Diagnosis is made by finding the bacteria in the blood, sputum , or fluid from lymph nodes. Prevention is through public health measures such as not handling dead animals in areas where plague is common. While vaccines against the plague have been developed, the World Health Organization recommends that only high-risk groups, such as certain laboratory personnel and health care workers, get inoculated. Several antibiotics are effective for treatment, including streptomycin , gentamicin , and doxycycline . Without treatment, plague results in the death of 30% to 90% of those infected. Death, if it occurs, is typically within 10 days. With treatment, the risk of death is around 10%. Globally between 2010 and 2015 there were 3,248 documented cases, which resulted in 584 deaths. The countries with the greatest number of cases are the Democratic Republic of the Congo , Madagascar , and Peru . The plague is considered the likely cause of the Black Death that swept through Asia, Europe, and Africa in the 14th century and killed an estimated 50 million people, including about 25% to 60% of the European population. Because the plague killed so many of the working population, wages rose due to the demand for labor. Some historians see this as a turning point in European economic development . The disease is also considered to have been responsible for the Plague of Justinian , originating in the Eastern Roman Empire in the 6th century CE, as well as the third epidemic , affecting China , Mongolia , and India , originating in the Yunnan Province in 1855. The term bubonic is derived from the Greek word Î²Î¿Ï Î²ÏŽÎ½ , meaning "groin." The bubonic plague is an infection of the lymphatic system , usually resulting from the bite of an infected flea, Xenopsylla cheopis (the Oriental rat flea ). Several flea species carried the bubonic plague, such as Pulex irritans (the human flea ), Xenopsylla cheopis , and Ceratophyllus fasciatus . Xenopsylla cheopis was the most effective flea species for transmission. The flea is parasitic on house and field rats and seeks out other prey when its rodent host dies. Rats were an amplifying factor to bubonic plague due to their common association with humans as well as the nature of their blood. The rat's blood allows the rat to withstand a major concentration of the plague. The bacteria form aggregates in the gut of infected fleas, and this results in the flea regurgitating ingested blood, which is now infected, into the bite site of a rodent or human host. Once established, the bacteria rapidly spread to the lymph nodes of the host and multiply. The fleas that transmit the disease only directly infect humans when the rat population in the area is wiped out from a mass infection. Furthermore, in areas with a large population of rats, the animals can harbor low levels of the plague infection without causing human outbreaks. With no new rat inputs being added to the population from other areas, the infection only spread to humans in very rare cases of overcrowding. After being transmitted via the bite of an infected flea, the Y. pestis bacteria become localized in an inflamed lymph node , where they begin to colonize and reproduce. Infected lymph nodes develop hemorrhages, which result in the death of tissue. Y. pestis bacilli can resist phagocytosis and even reproduce inside phagocytes and kill them. As the disease progresses, the lymph nodes can hemorrhage and become swollen and necrotic . Bubonic plague can progress to lethal septicemic plague in some cases. The plague is also known to spread to the lungs and become the disease known as the pneumonic plague . Symptoms appear 2–7 days after getting bitten and they include: The best-known symptom of bubonic plague is one or more infected, enlarged, and painful lymph nodes, known as buboes . Buboes associated with the bubonic plague are commonly found in the armpits, upper femoral area, groin, and neck region. These buboes will grow and become more painful over time, often to the point of bursting. Symptoms include heavy breathing, continuous vomiting of blood ( hematemesis ), aching limbs, coughing, and extreme pain caused by the decay or decomposition of the skin while the person is still alive. Additional symptoms include extreme fatigue, gastrointestinal problems, spleen inflammation, lenticulae (black dots scattered throughout the body), delirium, coma , organ failure, and death. Organ failure is a result of the bacteria infecting organs through the bloodstream. Other forms of the disease include septicemic plague and pneumonic plague , in which the bacterium reproduces in the person's blood and lungs respectively. Laboratory testing is required in order to diagnose and confirm plague. Ideally, confirmation is through the identification of Y. pestis culture from a patient sample. Confirmation of infection can be done by examining serum taken during the early and late stages of infection . To quickly screen for the Y. pestis antigen in patients, rapid dipstick tests have been developed for field use. Samples taken for testing include: Bubonic plague outbreaks are controlled by pest control and modern sanitation techniques. This disease uses fleas commonly found on rats as a vector to jump from animals to humans. The mortality rate is highest in the summer and early fall. The successful control of rat populations in dense urban areas is essential to outbreak prevention. One example is the use of a machine called the Sulfurozador , used to deliver sulphur dioxide to eradicate the pest that spread the bubonic plague in Buenos Aires, Argentina during the early 18th century. Targeted chemoprophylaxis , sanitation , and vector control also played a role in controlling the 2003 Oran outbreak of the bubonic plague. Another means of prevention in large European cities was a city-wide quarantine to not only limit interaction with people who were infected, but also to limit the interaction with the infected rats. Several classes of antibiotic are effective in treating bubonic plague. These include aminoglycosides such as streptomycin and gentamicin , tetracyclines (especially doxycycline ), and the fluoroquinolone ciprofloxacin . Mortality associated with treated cases of bubonic plague is about 1–15%, compared to a mortality of 40–60% in untreated cases. People potentially infected with the plague need immediate treatment and should be given antibiotics within 24 hours of the first symptoms to prevent death. Other treatments include oxygen, intravenous fluids, and respiratory support. People who have had contact with anyone infected by pneumonic plague are given prophylactic antibiotics. Using the broad-based antibiotic streptomycin has proven to be dramatically successful against the bubonic plague within 12 hours of infection. Globally between 2010 and 2015, there were 3,248 documented cases, which resulted in 584 deaths. The countries with the greatest number of cases are the Democratic Republic of the Congo , Madagascar , and Peru . For over a decade since 2001, Zambia, India, Malawi, Algeria, China, Peru, and the Democratic Republic of the Congo had the most plague cases, with over 1,100 cases in the Democratic Republic of the Congo alone. From 1,000 to 2,000 cases are conservatively reported per year to the WHO . From 2012 to 2017, reflecting political unrest and poor hygienic conditions, Madagascar began to host regular epidemics. Between 1900 and 2015, the United States had 1,036 human plague cases, with an average of 9 cases per year. In 2015, 16 people in the western United States developed plague, including 2 cases in Yosemite National Park . These US cases usually occur in rural northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon, and far western Nevada. In November 2017, the Madagascar Ministry of Health reported an outbreak to the WHO (World Health Organization) with more cases and deaths than any recent outbreak in the country. Unusually, most of the cases were pneumonic rather than bubonic. In June 2018, a child was confirmed to be the first person in Idaho to be infected by bubonic plague in nearly 30 years. A couple died in May 2019, in Mongolia, while hunting marmots . Another two people in the province of Inner Mongolia, China, were treated in November 2019 for the disease. In July 2020, in Bayannur , Inner Mongolia of China, a human case of bubonic plague was reported. Officials responded by activating a city-wide plague-prevention system for the remainder of the year. Also in July 2020, in Mongolia, a teenager died from bubonic plague after consuming infected marmot meat. Yersinia pestis has been discovered in archaeological finds from the Late Bronze Age (~3800 BP ). The bacteria is identified by ancient DNA in human teeth from Asia and Europe dating from 2,800 to 5,000 years ago. Some authors have suggested that the plague was responsible for the Neolithic decline . The first recorded epidemic affected the Sasanian Empire and their arch-rivals, the Eastern Roman Empire (Byzantine Empire) and was named the Plague of Justinian (541–549 AD) after emperor Justinian I , who was infected but survived through extensive treatment. The pandemic resulted in the deaths of an estimated 25 million (6th century outbreak) to 50 million people (two centuries of recurrence). The historian Procopius wrote, in Volume II of History of the Wars , of his personal encounter with the plague and the effect it had on the rising empire. In the spring of 542, the plague arrived in Constantinople, working its way from port city to port city and spreading around the Mediterranean Sea , later migrating inland eastward into Asia Minor and west into Greece and Italy. The Plague of Justinian is said to have been "completed" in the middle of the 8th century. Because the infectious disease spread inland by the transferring of merchandise through Justinian's efforts in acquiring luxurious goods of the time and exporting supplies, his capital became the leading exporter of the bubonic plague. Procopius, in his work Secret History , declared that Justinian was a demon of an emperor who either created the plague himself or was being punished for his sinfulness. Medieval society's increasing population was put to deadly halt when, in the Late Middle Ages , Europe experienced the deadliest disease outbreak in history. They called it the Great Dying or The Great Pestilence, later coined The Black Death. Lasting in potency for roughly 6 years, 1346–1352, the Black Death claimed one-third of the European human population. Having mortality rates as high as 70%-80%. Some historians believe that society subsequently became more violent as the mass mortality rate cheapened life and thus increased warfare, crime, popular revolt, waves of flagellants , and persecution. The Black Death originated in Central Asia and spread from Italy and then throughout other European countries. Arab historians Ibn Al-Wardni and Almaqrizi believed the Black Death originated in Mongolia. Chinese records also show a huge outbreak in Mongolia in the early 1330s. In 2022, researchers presented evidence that the plague originated near Lake Issyk-Kul in Kyrgyzstan . The Mongols had cut the trade route (the Silk Road ) between China and Europe, which halted the spread of the Black Death from eastern Russia to Western Europe. The European epidemic may have begun with the siege of Caffa , an attack that Mongols launched on the Italian merchants' last trading station in the region, Caffa , in the Crimea . In late 1346, plague broke out among the besiegers and from them penetrated the town. The Mongol forces catapulted plague-infested corpses into Caffa as a form of attack, one of the first known instances of biological warfare . When spring arrived, the Italian merchants fled on their ships, unknowingly carrying the Black Death. Carried by the fleas on rats, the plague initially spread to humans near the Black Sea and then outwards to the rest of Europe as a result of people fleeing from one area to another. Rats migrated with humans, traveling among grain bags, clothing, ships, wagons, and grain husks. Continued research indicates that black rats , those that primarily transmitted the disease, prefer grain as a primary meal. Due to this, the major bulk grain fleets that transported major city's food shipments from Africa and Alexandria to heavily populated areas, and were then unloaded by hand, played a role in increasing the transmission effectiveness of the plague. The plague resurfaced for a third time in the mid-19th century; this is also known as "the modern pandemic". Like the two previous outbreaks, this one also originated in Eastern Asia , most likely in Yunnan , a province of China, where there are several natural plague foci . The initial outbreaks occurred in the second half of the 18th century. The disease remained localized in Southwest China for several years before spreading. In the city of Canton , beginning in January 1894, the disease had killed 80,000 people by June. Daily water traffic with the nearby city of Hong Kong rapidly spread the plague there, killing over 2,400 within two months during the 1894 Hong Kong plague . The third pandemic spread the disease to port cities throughout the world in the second half of the 19th century and the early 20th century via shipping routes. The plague infected people in Chinatown in San Francisco from 1900 to 1904, and in the nearby locales of Oakland and the East Bay again from 1907 to 1909. During the former outbreak, in 1902, authorities made permanent the Chinese Exclusion Act , a law originally signed into existence by President Chester A. Arthur in 1882. The Act was supposed to last for 10 years, but was renewed in 1892 with the Geary Act , then followed by the 1902 decision. The last major outbreak in the United States occurred in Los Angeles in 1924, though the disease is still present in wild rodents and can be passed to humans that come in contact with them. According to the World Health Organization , the pandemic was considered active until 1959, when worldwide casualties dropped to 200 per year. In 1994, a plague outbreak in five Indian states caused an estimated 700 infections (including 52 deaths) and triggered a large migration of Indians within India as they tried to avoid the disease. [ citation needed ] It was during the 1894 Hong Kong plague outbreak that Alexandre Yersin isolated the bacterium responsible ( Yersinia pestis ), a few days after Japanese bacteriologist Kitasato Shibasaburō had isolated it. However, the latter's description was imprecise and also expressed doubts of its relation to the disease, and thus the bacterium is today only named after Yersin. The first recorded epidemic affected the Sasanian Empire and their arch-rivals, the Eastern Roman Empire (Byzantine Empire) and was named the Plague of Justinian (541–549 AD) after emperor Justinian I , who was infected but survived through extensive treatment. The pandemic resulted in the deaths of an estimated 25 million (6th century outbreak) to 50 million people (two centuries of recurrence). The historian Procopius wrote, in Volume II of History of the Wars , of his personal encounter with the plague and the effect it had on the rising empire. In the spring of 542, the plague arrived in Constantinople, working its way from port city to port city and spreading around the Mediterranean Sea , later migrating inland eastward into Asia Minor and west into Greece and Italy. The Plague of Justinian is said to have been "completed" in the middle of the 8th century. Because the infectious disease spread inland by the transferring of merchandise through Justinian's efforts in acquiring luxurious goods of the time and exporting supplies, his capital became the leading exporter of the bubonic plague. Procopius, in his work Secret History , declared that Justinian was a demon of an emperor who either created the plague himself or was being punished for his sinfulness. Medieval society's increasing population was put to deadly halt when, in the Late Middle Ages , Europe experienced the deadliest disease outbreak in history. They called it the Great Dying or The Great Pestilence, later coined The Black Death. Lasting in potency for roughly 6 years, 1346–1352, the Black Death claimed one-third of the European human population. Having mortality rates as high as 70%-80%. Some historians believe that society subsequently became more violent as the mass mortality rate cheapened life and thus increased warfare, crime, popular revolt, waves of flagellants , and persecution. The Black Death originated in Central Asia and spread from Italy and then throughout other European countries. Arab historians Ibn Al-Wardni and Almaqrizi believed the Black Death originated in Mongolia. Chinese records also show a huge outbreak in Mongolia in the early 1330s. In 2022, researchers presented evidence that the plague originated near Lake Issyk-Kul in Kyrgyzstan . The Mongols had cut the trade route (the Silk Road ) between China and Europe, which halted the spread of the Black Death from eastern Russia to Western Europe. The European epidemic may have begun with the siege of Caffa , an attack that Mongols launched on the Italian merchants' last trading station in the region, Caffa , in the Crimea . In late 1346, plague broke out among the besiegers and from them penetrated the town. The Mongol forces catapulted plague-infested corpses into Caffa as a form of attack, one of the first known instances of biological warfare . When spring arrived, the Italian merchants fled on their ships, unknowingly carrying the Black Death. Carried by the fleas on rats, the plague initially spread to humans near the Black Sea and then outwards to the rest of Europe as a result of people fleeing from one area to another. Rats migrated with humans, traveling among grain bags, clothing, ships, wagons, and grain husks. Continued research indicates that black rats , those that primarily transmitted the disease, prefer grain as a primary meal. Due to this, the major bulk grain fleets that transported major city's food shipments from Africa and Alexandria to heavily populated areas, and were then unloaded by hand, played a role in increasing the transmission effectiveness of the plague. The plague resurfaced for a third time in the mid-19th century; this is also known as "the modern pandemic". Like the two previous outbreaks, this one also originated in Eastern Asia , most likely in Yunnan , a province of China, where there are several natural plague foci . The initial outbreaks occurred in the second half of the 18th century. The disease remained localized in Southwest China for several years before spreading. In the city of Canton , beginning in January 1894, the disease had killed 80,000 people by June. Daily water traffic with the nearby city of Hong Kong rapidly spread the plague there, killing over 2,400 within two months during the 1894 Hong Kong plague . The third pandemic spread the disease to port cities throughout the world in the second half of the 19th century and the early 20th century via shipping routes. The plague infected people in Chinatown in San Francisco from 1900 to 1904, and in the nearby locales of Oakland and the East Bay again from 1907 to 1909. During the former outbreak, in 1902, authorities made permanent the Chinese Exclusion Act , a law originally signed into existence by President Chester A. Arthur in 1882. The Act was supposed to last for 10 years, but was renewed in 1892 with the Geary Act , then followed by the 1902 decision. The last major outbreak in the United States occurred in Los Angeles in 1924, though the disease is still present in wild rodents and can be passed to humans that come in contact with them. According to the World Health Organization , the pandemic was considered active until 1959, when worldwide casualties dropped to 200 per year. In 1994, a plague outbreak in five Indian states caused an estimated 700 infections (including 52 deaths) and triggered a large migration of Indians within India as they tried to avoid the disease. [ citation needed ] It was during the 1894 Hong Kong plague outbreak that Alexandre Yersin isolated the bacterium responsible ( Yersinia pestis ), a few days after Japanese bacteriologist Kitasato Shibasaburō had isolated it. However, the latter's description was imprecise and also expressed doubts of its relation to the disease, and thus the bacterium is today only named after Yersin. The scale of death and social upheaval associated with plague outbreaks has made the topic prominent in many historical and fictional accounts since the disease was first recognized. The Black Death in particular is described and referenced in numerous contemporary sources , some of which, including works by Chaucer , Boccaccio , and Petrarch , are considered part of the Western canon . The Decameron , by Boccaccio, is notable for its use of a frame story involving individuals who have fled Florence for a secluded villa to escape the Black Death. First-person, sometimes sensationalized or fictionalized, accounts of living through plague years have also been popular across centuries and cultures. For example, Samuel Pepys 's diary makes several references to his first-hand experiences of the Great Plague of London in 1665–66. Later works, such as Albert Camus 's novel The Plague or Ingmar Bergman 's film The Seventh Seal have used bubonic plague in settings, such as quarantined cities in either medieval or modern times, as a backdrop to explore a variety of concepts. Common themes include the breakdown of society, institutions, and individuals during the plague, the cultural and psychological existential confrontation with mortality, and the allegorical use of the plague about contemporary moral or spiritual questions. [ citation needed ] Some of the earliest instances of biological warfare were said to have been products of the plague, as armies of the 14th century were recorded catapulting diseased corpses over the walls of towns and villages to spread the pestilence. This was done by Jani Beg when he attacked the city of Kaffa in 1343. Later, plague was used during the Second Sino-Japanese War as a bacteriological weapon by the Imperial Japanese Army . These weapons were provided by Shirō Ishii 's units and used in experiments on humans before being used in the field. For example, in 1940, the Imperial Japanese Army Air Service bombed Ningbo with fleas carrying the bubonic plague. During the Khabarovsk War Crime Trials , the accused, such as Major General Kiyoshi Kawashima, testified that, in 1941, 40 members of Unit 731 air-dropped plague -contaminated fleas on Changde . These operations caused epidemic plague outbreaks. Substantial research has been done regarding the origin of the plague and how it traveled through the continent. Mitochondrial DNA of modern rats in Western Europe indicated that these rats came from two different areas, one being Africa and the other unclear. The research regarding this pandemic has greatly increased with technology. Through archaeo-molecular investigation, researchers have discovered the DNA of plague bacillus in the dental core of those that fell ill to the plague. Analysis of teeth of the deceased allows researchers to further understand both the demographics and mortuary patterns of the disease. For example, in 2013 in England, archeologists uncovered a burial mound to reveal 17 bodies, mainly children, who had died of the Bubonic plague. They analyzed these burial remains using radiocarbon dating to determine they were from the 1530s, and dental core analysis revealed the presence of Yersinia pestis. Other evidence for rats that are currently still being researched consists of gnaw marks on bones, predator pellets and rat remains that were preserved in situ . This research allows individuals to trace early rat remains to track the path traveled and in turn connect the impact of the Bubonic Plague to specific breeds of rats. Burial sites, known as plague pits, offer archaeologists an opportunity to study the remains of people who died from the plague. Another research study indicates that these separate pandemics were all interconnected. A current computer model indicates that the disease did not go away in between these pandemics. It rather lurked within the rat population for years without causing human epidemics. Some of the earliest instances of biological warfare were said to have been products of the plague, as armies of the 14th century were recorded catapulting diseased corpses over the walls of towns and villages to spread the pestilence. This was done by Jani Beg when he attacked the city of Kaffa in 1343. Later, plague was used during the Second Sino-Japanese War as a bacteriological weapon by the Imperial Japanese Army . These weapons were provided by Shirō Ishii 's units and used in experiments on humans before being used in the field. For example, in 1940, the Imperial Japanese Army Air Service bombed Ningbo with fleas carrying the bubonic plague. During the Khabarovsk War Crime Trials , the accused, such as Major General Kiyoshi Kawashima, testified that, in 1941, 40 members of Unit 731 air-dropped plague -contaminated fleas on Changde . These operations caused epidemic plague outbreaks. Substantial research has been done regarding the origin of the plague and how it traveled through the continent. Mitochondrial DNA of modern rats in Western Europe indicated that these rats came from two different areas, one being Africa and the other unclear. The research regarding this pandemic has greatly increased with technology. Through archaeo-molecular investigation, researchers have discovered the DNA of plague bacillus in the dental core of those that fell ill to the plague. Analysis of teeth of the deceased allows researchers to further understand both the demographics and mortuary patterns of the disease. For example, in 2013 in England, archeologists uncovered a burial mound to reveal 17 bodies, mainly children, who had died of the Bubonic plague. They analyzed these burial remains using radiocarbon dating to determine they were from the 1530s, and dental core analysis revealed the presence of Yersinia pestis. Other evidence for rats that are currently still being researched consists of gnaw marks on bones, predator pellets and rat remains that were preserved in situ . This research allows individuals to trace early rat remains to track the path traveled and in turn connect the impact of the Bubonic Plague to specific breeds of rats. Burial sites, known as plague pits, offer archaeologists an opportunity to study the remains of people who died from the plague. Another research study indicates that these separate pandemics were all interconnected. A current computer model indicates that the disease did not go away in between these pandemics. It rather lurked within the rat population for years without causing human epidemics.

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Plague

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Plague (disease)

Plague is an infectious disease caused by the bacterium Yersinia pestis . Symptoms include fever , weakness and headache . Usually this begins one to seven days after exposure. There are three forms of plague, each affecting a different part of the body and causing associated symptoms. Pneumonic plague infects the lungs, causing shortness of breath, coughing and chest pain; bubonic plague affects the lymph nodes , making them swell; and septicemic plague infects the blood and can cause tissues to turn black and die . The bubonic and septicemic forms are generally spread by flea bites or handling an infected animal, whereas pneumonic plague is generally spread between people through the air via infectious droplets. Diagnosis is typically by finding the bacterium in fluid from a lymph node, blood or sputum . Those at high risk may be vaccinated . Those exposed to a case of pneumonic plague may be treated with preventive medication. If infected, treatment is with antibiotics and supportive care . Typically antibiotics include a combination of gentamicin and a fluoroquinolone . The risk of death with treatment is about 10% while without it is about 70%. Globally, about 600 cases are reported a year. In 2017, the countries with the most cases include the Democratic Republic of the Congo , Madagascar and Peru . In the United States, infections occasionally occur in rural areas, where the bacteria are believed to circulate among rodents . It has historically occurred in large outbreaks , with the best known being the Black Death in the 14th century, which resulted in more than 50 million deaths in Europe. There are several different clinical manifestations of plague. The most common form is bubonic plague, followed by septicemic and pneumonic plague. Other clinical manifestations include plague meningitis, plague pharyngitis, and ocular plague. General symptoms of plague include fever, chills, headaches, and nausea. Many people experience swelling in their lymph nodes if they have bubonic plague. For those with pneumonic plague, symptoms may (or may not) include a cough, pain in the chest, and haemoptysis. When a flea bites a human and contaminates the wound with regurgitated blood, the plague-causing bacteria are passed into the tissue. Y. pestis can reproduce inside cells, so even if phagocytosed , they can still survive. Once in the body, the bacteria can enter the lymphatic system , which drains interstitial fluid . Plague bacteria secrete several toxins , one of which is known to cause beta-adrenergic blockade . Y. pestis spreads through the lymphatic vessels of the infected human until it reaches a lymph node , where it causes acute lymphadenitis . The swollen lymph nodes form the characteristic buboes associated with the disease, and autopsies of these buboes have revealed them to be mostly hemorrhagic or necrotic . If the lymph node is overwhelmed, the infection can pass into the bloodstream, causing secondary septicemic plague and if the lungs are seeded, it can cause secondary pneumonic plague . Lymphatics ultimately drain into the bloodstream, so the plague bacteria may enter the blood and travel to almost any part of the body. In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), causing tiny clots throughout the body and possibly ischemic necrosis (tissue death due to lack of circulation/perfusion to that tissue) from the clots. DIC results in depletion of the body's clotting resources so that it can no longer control bleeding. Consequently, there is bleeding into the skin and other organs, which can cause red and/or black patchy rash and hemoptysis/hematemesis (coughing up/ vomiting of blood). There are bumps on the skin that look somewhat like insect bites; these are usually red, and sometimes white in the centre. Untreated, the septicemic plague is usually fatal. Early treatment with antibiotics reduces the mortality rate to between 4 and 15 per cent. The pneumonic form of plague arises from infection of the lungs . It causes coughing and thereby produces airborne droplets that contain bacterial cells and are likely to infect anyone inhaling them. The incubation period for pneumonic plague is short, usually two to four days, but sometimes just a few hours. The initial signs are indistinguishable from several other respiratory illnesses; they include headache, weakness, and spitting or vomiting of blood. The course of the disease is rapid; unless diagnosed and treated soon enough, typically within a few hours, death may follow in one to six days; in untreated cases, mortality is nearly 100%. When a flea bites a human and contaminates the wound with regurgitated blood, the plague-causing bacteria are passed into the tissue. Y. pestis can reproduce inside cells, so even if phagocytosed , they can still survive. Once in the body, the bacteria can enter the lymphatic system , which drains interstitial fluid . Plague bacteria secrete several toxins , one of which is known to cause beta-adrenergic blockade . Y. pestis spreads through the lymphatic vessels of the infected human until it reaches a lymph node , where it causes acute lymphadenitis . The swollen lymph nodes form the characteristic buboes associated with the disease, and autopsies of these buboes have revealed them to be mostly hemorrhagic or necrotic . If the lymph node is overwhelmed, the infection can pass into the bloodstream, causing secondary septicemic plague and if the lungs are seeded, it can cause secondary pneumonic plague . Lymphatics ultimately drain into the bloodstream, so the plague bacteria may enter the blood and travel to almost any part of the body. In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), causing tiny clots throughout the body and possibly ischemic necrosis (tissue death due to lack of circulation/perfusion to that tissue) from the clots. DIC results in depletion of the body's clotting resources so that it can no longer control bleeding. Consequently, there is bleeding into the skin and other organs, which can cause red and/or black patchy rash and hemoptysis/hematemesis (coughing up/ vomiting of blood). There are bumps on the skin that look somewhat like insect bites; these are usually red, and sometimes white in the centre. Untreated, the septicemic plague is usually fatal. Early treatment with antibiotics reduces the mortality rate to between 4 and 15 per cent. The pneumonic form of plague arises from infection of the lungs . It causes coughing and thereby produces airborne droplets that contain bacterial cells and are likely to infect anyone inhaling them. The incubation period for pneumonic plague is short, usually two to four days, but sometimes just a few hours. The initial signs are indistinguishable from several other respiratory illnesses; they include headache, weakness, and spitting or vomiting of blood. The course of the disease is rapid; unless diagnosed and treated soon enough, typically within a few hours, death may follow in one to six days; in untreated cases, mortality is nearly 100%. Transmission of Y. pestis to an uninfected individual is possible by any of the following means: droplet contact – coughing or sneezing on another person Direct physical contact;– touching an infected person, including sexual contact indirect contact – usually by touching soil contamination or a contaminated surface airborne transmission – if the microorganism can remain in the air for long periods fecal-oral transmission – usually from contaminated food or water sources vector borne transmission – carried by insects or other animals. Yersinia pestis circulates in animal reservoirs, particularly in rodents, in the natural foci of infection found on all continents except Australia. The natural foci of plague are situated in a broad belt in the tropical and sub-tropical latitudes and the warmer parts of the temperate latitudes around the globe, between the parallels 55° N and 40° S. Contrary to popular belief, rats did not directly start the spread of the bubonic plague. It is mainly a disease in the fleas ( Xenopsylla cheopis ) that infested the rats, making the rats themselves the first victims of the plague. Rodent-borne infection in a human occurs when a person is bitten by a flea that has been infected by biting a rodent that itself has been infected by the bite of a flea carrying the disease. The bacteria multiply inside the flea, sticking together to form a plug that blocks its stomach and causes it to starve. The flea then bites a host and continues to feed, even though it cannot quell its hunger, and consequently, the flea vomits blood tainted with the bacteria back into the bite wound. The bubonic plague bacterium then infects a new person and the flea eventually dies from starvation. Serious outbreaks of plague are usually started by other disease outbreaks in rodents or a rise in the rodent population. A 21st-century study of a 1665 outbreak of plague in the village of Eyam in England's Derbyshire Dales – which isolated itself during the outbreak, facilitating modern study – found that three-quarters of cases are likely to have been due to human-to-human transmission, especially within families, a much bigger proportion than previously thought. Symptoms of plague are usually non-specific and to definitively diagnose plague, laboratory testing is required. Y. pestis can be identified through both a microscope and by culturing a sample and this is used as a reference standard to confirm that a person has a case of plague. The sample can be obtained from the blood, mucus ( sputum ), or aspirate extracted from inflamed lymph nodes ( buboes ). If a person is administered antibiotics before a sample is taken or if there is a delay in transporting the person's sample to a laboratory and/or a poorly stored sample, there is a possibility for false negative results. Polymerase chain reaction (PCR) may also be used to diagnose plague, by detecting the presence of bacterial genes such as the pla gene (plasmogen activator) and caf1 gene, (F1 capsule antigen). PCR testing requires a very small sample and is effective for both alive and dead bacteria. For this reason, if a person receives antibiotics before a sample is collected for laboratory testing, they may have a false negative culture and a positive PCR result. Blood tests to detect antibodies against Y. pestis can also be used to diagnose plague, however, this requires taking blood samples at different periods to detect differences between the acute and convalescent phases of F1 antibody titres. In 2020, a study about rapid diagnostic tests that detect the F1 capsule antigen (F1RDT) by sampling sputum or bubo aspirate was released. Results show rapid diagnostic F1RDT test can be used for people who have suspected pneumonic and bubonic plague but cannot be used in asymptomatic people. F1RDT may be useful in providing a fast result for prompt treatment and fast public health response as studies suggest that F1RDT is highly sensitive for both pneumonic and bubonic plague. However, when using the rapid test, both positive and negative results need to be confirmed to establish or reject the diagnosis of a confirmed case of plague and the test result needs to be interpreted within the epidemiological context as study findings indicate that although 40 out of 40 people who had the plague in a population of 1000 were correctly diagnosed, 317 people were diagnosed falsely as positive. Bacteriologist Waldemar Haffkine developed the first plague vaccine in 1897. He conducted a massive inoculation program in British India , and it is estimated that 26 million doses of Haffkine's anti-plague vaccine were sent out from Bombay between 1897 and 1925, reducing the plague mortality by 50–85%. Since human plague is rare in most parts of the world as of 2023, routine vaccination is not needed other than for those at particularly high risk of exposure, nor for people living in areas with enzootic plague, meaning it occurs at regular, predictable rates in populations and specific areas, such as the western United States. It is not even indicated for most travellers to countries with known recent reported cases, particularly if their travel is limited to urban areas with modern hotels. The United States CDC thus only recommends vaccination for (1) all laboratory and field personnel who are working with Y. pestis organisms resistant to antimicrobials: (2) people engaged in aerosol experiments with Y. pestis ; and (3) people engaged in field operations in areas with enzootic plague where preventing exposure is not possible (such as some disaster areas). A systematic review by the Cochrane Collaboration found no studies of sufficient quality to make any statement on the efficacy of the vaccine. Diagnosing plague early leads to a decrease in transmission or spread of the disease. Pre-exposure prophylaxis for first responders and health care providers who will care for patients with pneumonic plague is not considered necessary as long as standard and droplet precautions can be maintained. In cases of surgical mask shortages, patient overcrowding, poor ventilation in hospital wards, or other crises, pre-exposure prophylaxis might be warranted if sufficient supplies of antimicrobials are available. Postexposure prophylaxis should be considered for people who had close (<6 feet), sustained contact with a patient with pneumonic plague and were not wearing adequate personal protective equipment. Antimicrobial postexposure prophylaxis also can be considered for laboratory workers accidentally exposed to infectious materials and people who had close (<6 feet) or direct contact with infected animals, such as veterinary staff, pet owners, and hunters. Specific recommendations on pre- and post-exposure prophylaxis are available in the clinical guidelines on treatment and prophylaxis of plague published in 2021. Bacteriologist Waldemar Haffkine developed the first plague vaccine in 1897. He conducted a massive inoculation program in British India , and it is estimated that 26 million doses of Haffkine's anti-plague vaccine were sent out from Bombay between 1897 and 1925, reducing the plague mortality by 50–85%. Since human plague is rare in most parts of the world as of 2023, routine vaccination is not needed other than for those at particularly high risk of exposure, nor for people living in areas with enzootic plague, meaning it occurs at regular, predictable rates in populations and specific areas, such as the western United States. It is not even indicated for most travellers to countries with known recent reported cases, particularly if their travel is limited to urban areas with modern hotels. The United States CDC thus only recommends vaccination for (1) all laboratory and field personnel who are working with Y. pestis organisms resistant to antimicrobials: (2) people engaged in aerosol experiments with Y. pestis ; and (3) people engaged in field operations in areas with enzootic plague where preventing exposure is not possible (such as some disaster areas). A systematic review by the Cochrane Collaboration found no studies of sufficient quality to make any statement on the efficacy of the vaccine. Diagnosing plague early leads to a decrease in transmission or spread of the disease. Pre-exposure prophylaxis for first responders and health care providers who will care for patients with pneumonic plague is not considered necessary as long as standard and droplet precautions can be maintained. In cases of surgical mask shortages, patient overcrowding, poor ventilation in hospital wards, or other crises, pre-exposure prophylaxis might be warranted if sufficient supplies of antimicrobials are available. Postexposure prophylaxis should be considered for people who had close (<6 feet), sustained contact with a patient with pneumonic plague and were not wearing adequate personal protective equipment. Antimicrobial postexposure prophylaxis also can be considered for laboratory workers accidentally exposed to infectious materials and people who had close (<6 feet) or direct contact with infected animals, such as veterinary staff, pet owners, and hunters. Specific recommendations on pre- and post-exposure prophylaxis are available in the clinical guidelines on treatment and prophylaxis of plague published in 2021. If diagnosed in time, the various forms of plague are usually highly responsive to antibiotic therapy. The antibiotics often used are streptomycin , chloramphenicol and tetracycline . Amongst the newer generation of antibiotics, gentamicin and doxycycline have proven effective in monotherapeutic treatment of plague. Guidelines on treatment and prophylaxis of plague were published by the Centers for Disease Control and Prevention in 2021. The plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995. Further outbreaks in Madagascar were reported in November 2014 and October 2017. Globally about 600 cases are reported a year. In 2017, the countries with the most cases include the Democratic Republic of the Congo , Madagascar and Peru . It has historically occurred in large outbreaks , with the best known being the Black Death in the 14th century which resulted in more than 50 million dead. In recent years, cases have been distributed between small seasonal outbreaks which occur primarily in Madagascar, and sporadic outbreaks or isolated cases in endemic areas. In 2022 the possible origin of all modern strands of Yersinia pestis DNA was found in human remains in three graves located in Kyrgyzstan , dated to 1338 and 1339. The siege of Caffa in Crimea in 1346, is known to have been the first plague outbreak with following strands, later to spread over Europe. Sequencing DNA compared to other ancient and modern strands paints a family tree of the bacteria. Bacteria today affecting marmots in Kyrgyzstan, are closest to the strand found in the graves, suggesting this is also the location where plague transferred from animals to humans. The plague has a long history as a biological weapon . Historical accounts from ancient China and medieval Europe details the use of infected animal carcasses, such as cows or horses, and human carcasses, by the Xiongnu / Huns , Mongols , Turks and other groups, to contaminate enemy water supplies. Han dynasty general Huo Qubing is recorded to have died of such contamination while engaging in warfare against the Xiongnu. Plague victims were also reported to have been tossed by catapult into cities under siege. In 1347, the Genoese possession of Caffa , a great trade emporium on the Crimean peninsula , came under siege by an army of Mongol warriors of the Golden Horde under the command of Jani Beg . After a protracted siege during which the Mongol army was reportedly withering from the disease, they decided to use the infected corpses as a biological weapon. The corpses were catapulted over the city walls, infecting the inhabitants. This event might have led to the transfer of the Black Death via their ships into the south of Europe , possibly explaining its rapid spread. During World War II , the Japanese Army developed weaponized plague, based on the breeding and release of large numbers of fleas. During the Japanese occupation of Manchuria , Unit 731 deliberately infected Chinese , Korean and Manchurian civilians and prisoners of war with the plague bacterium. These subjects, termed "maruta" or "logs", were then studied by dissection , others by vivisection while still conscious. Members of the unit such as Shiro Ishii were exonerated from the Tokyo tribunal by Douglas MacArthur but 12 of them were prosecuted in the Khabarovsk War Crime Trials in 1949 during which some admitted having spread bubonic plague within a 36-kilometre (22 mi) radius around the city of Changde . Ishii innovated bombs containing live mice and fleas, with very small explosive loads, to deliver the weaponized microbes, overcoming the problem of the explosive killing the infected animal and insect by the use of a ceramic, rather than metal, casing for the warhead. While no records survive of the actual usage of the ceramic shells, prototypes exist and are believed to have been used in experiments during WWII. After World War II, both the United States and the Soviet Union developed means of weaponising pneumonic plague. Experiments included various delivery methods, vacuum drying, sizing the bacterium, developing strains resistant to antibiotics, combining the bacterium with other diseases (such as diphtheria ), and genetic engineering. Scientists who worked in USSR bio-weapons programs have stated that the Soviet effort was formidable and that large stocks of weaponised plague bacteria were produced. Information on many of the Soviet and US projects is largely unavailable. Aerosolized pneumonic plague remains the most significant threat. The plague can be easily treated with antibiotics. Some countries, such as the United States, have large supplies on hand if such an attack should occur, making the threat less severe.

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Plague

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Plagues of Egypt

The Plagues of Egypt ( Hebrew : מכות מצרים ), in the account of the Book of Exodus , are ten disasters inflicted on biblical Egypt by the God of Israel (Yahweh) in order to convince the Pharaoh to emancipate the enslaved Israelites , each of them confronting Pharaoh and one of his Egyptian gods ; they serve as "signs and marvels" given by God to answer Pharaoh's taunt that he does not know Yahweh: "The Egyptians shall know that I am the L ORD ". : 117 The Ten Plagues are recited during the Passover Seder . The consensus of modern scholars is that the Pentateuch does not give an accurate account of the origins of the Israelites, who appear instead to have formed as an entity in the central highlands of Canaan in the late second millennium BCE (around the time of the Late Bronze Age collapse ) from the indigenous Canaanite culture. : 81 : 6–7This is what the L ORD says: By this you will know that I am the L ORD : With the staff that is in my hands I will strike the water of the Nile, and it will be changed into blood. The fish in the Nile will die, and the river will stink and the Egyptians will not be able to drink its water. The Bible says that Aaron turned the Nile to blood by striking it with his staff. Pharaoh's magicians used their secret arts to also strike the Nile, creating a second layer of blood. In addition to the Nile, all water that was held in reserve, such as jars, was also transformed into blood. The Egyptians were forced to dig alongside the bank of the Nile, which still had pure water. One week passed before the plague dissipated. This is what the great L ORD says: Let my people go, so that they may worship me. If you refuse to let them go, I will plague your whole country with frogs. The Nile will teem with frogs. They will come up into your palace and your bedroom and onto your bed, into the houses of your officials and on your people, and into your ovens and kneading troughs. The frogs will go up on you and your people and all your officials. The Bible says that God ordered frogs to emerge from the Nile, which then jumped around virtually everywhere in Egypt. The magicians attempted to produce frogs from their secret arts, conjuring up a second wave of frogs. Even the private quarters of Pharaoh was infested with frogs. Three days passed before all the frogs died. The Egyptians had to do much work to rid themselves of the corpses, and the land stank of frog for long afterwards. When the decision came for Pharaoh about the slaves, the Lord hardened his heart and Pharaoh decided that the slaves would not be freed. "And the L ORD said [...] Stretch out thy rod, and smite the dust of the land, that it may become lice throughout all the land of Egypt." […] When Aaron stretched out his hand with the rod and struck the dust of the ground, lice came upon men and animals. All the dust throughout the land of Egypt became lice. The fourth plague of Egypt was of creatures capable of harming people and livestock. The Bible tells us that the plagues only came against the Egyptians and did not affect the Israelites. Pharaoh asked Moses to remove this plague and promised to grant the Israelites their freedom. However, after the plague was gone, Pharaoh hardened his heart and he refused to keep his promise. Various sources use either "wild animals" or "flies". This is what the L ORD , the God of the Hebrews, says: Let my people go, so that they may worship me. If you refuse to let them go and continue to hold them back, the hand of the L ORD will bring a terrible plague on your livestock in the field—on your horses and donkeys and camels and on your cattle and sheep and goats. Then the L ORD said to Moses and Aaron, "Take handfuls of soot from a furnace and have Moses toss it into the air in the presence of Pharaoh. It will become fine dust over the whole land of Egypt, and festering boils will break out on men and animals throughout the land." This is what the L ORD , the God of the Hebrews, says: Let my people go, so that they may worship me, or this time I will send the full force of my plagues against you and against your officials and your people, so you may know that there is no one like me in all the earth. For by now I could have stretched out my hand and struck you and your people with a plague that would have wiped you off the earth. But I have raised you up for this very purpose, that I might show you my power and that my name might be proclaimed in all the earth. You still set yourself against my people and will not let them go. Therefore, at this time tomorrow I will send the worst hailstorm that has ever fallen on Egypt, from the day it was founded till now. Give an order now to bring your livestock and everything you have in the field to a place of shelter, because the hail will fall on every man and animal that has not been brought in and is still out in the field, and they will die. […] The L ORD sent thunder and hail, and lightning flashed down to the ground. So the L ORD rained hail on the land of Egypt; hail fell and lightning flashed back and forth. It was the worst storm in all the land of Egypt since it had become a nation. This is what the L ORD , the God of the Hebrews, says: 'How long will you refuse to humble yourself before me? Let my people go, so that they may worship me. If you refuse to let them go, I will bring locusts into your country tomorrow. They will cover the face of the ground so that it cannot be seen. They will devour what little you have left after the hail, including every tree that is growing in your fields. They will fill your houses and those of all your officials and all the Egyptians—something neither your fathers nor your forefathers have ever seen from the day they settled in this land till now. Then the L ORD said to Moses, "Stretch out your hand toward the sky so that darkness will spread over Egypt—darkness that can be felt." So Moses stretched out his hand toward the sky, and total darkness covered all Egypt for three days. No one could see anyone else or leave his place for three days. This is what the L ORD says: "About midnight I will go throughout Egypt. Every firstborn son in Egypt will die, from the firstborn son of Pharaoh, who sits on the throne, to the firstborn of the slave girl, who is at her hand mill, and all the firstborn of the cattle as well. There will be loud wailing throughout Egypt—worse than there has ever been or ever will be again." Before this final plague, God commands Moses to tell the Israelites to mark a lamb 's blood above their doors in order that the Angel of Death will pass over them (i.e., that they will not be touched by the death of the firstborn). Pharaoh orders the Israelites to leave, taking whatever they want, and asks Moses to bless him in the name of the Lord. The passage goes on to state that the passover sacrifice recalls the time when the L ORD "passed over the houses of the Israelites in Egypt". This is what the L ORD says: By this you will know that I am the L ORD : With the staff that is in my hands I will strike the water of the Nile, and it will be changed into blood. The fish in the Nile will die, and the river will stink and the Egyptians will not be able to drink its water. The Bible says that Aaron turned the Nile to blood by striking it with his staff. Pharaoh's magicians used their secret arts to also strike the Nile, creating a second layer of blood. In addition to the Nile, all water that was held in reserve, such as jars, was also transformed into blood. The Egyptians were forced to dig alongside the bank of the Nile, which still had pure water. One week passed before the plague dissipated. This is what the great L ORD says: Let my people go, so that they may worship me. If you refuse to let them go, I will plague your whole country with frogs. The Nile will teem with frogs. They will come up into your palace and your bedroom and onto your bed, into the houses of your officials and on your people, and into your ovens and kneading troughs. The frogs will go up on you and your people and all your officials. The Bible says that God ordered frogs to emerge from the Nile, which then jumped around virtually everywhere in Egypt. The magicians attempted to produce frogs from their secret arts, conjuring up a second wave of frogs. Even the private quarters of Pharaoh was infested with frogs. Three days passed before all the frogs died. The Egyptians had to do much work to rid themselves of the corpses, and the land stank of frog for long afterwards. When the decision came for Pharaoh about the slaves, the Lord hardened his heart and Pharaoh decided that the slaves would not be freed."And the L ORD said [...] Stretch out thy rod, and smite the dust of the land, that it may become lice throughout all the land of Egypt." […] When Aaron stretched out his hand with the rod and struck the dust of the ground, lice came upon men and animals. All the dust throughout the land of Egypt became lice.The fourth plague of Egypt was of creatures capable of harming people and livestock. The Bible tells us that the plagues only came against the Egyptians and did not affect the Israelites. Pharaoh asked Moses to remove this plague and promised to grant the Israelites their freedom. However, after the plague was gone, Pharaoh hardened his heart and he refused to keep his promise. Various sources use either "wild animals" or "flies". This is what the L ORD , the God of the Hebrews, says: Let my people go, so that they may worship me. If you refuse to let them go and continue to hold them back, the hand of the L ORD will bring a terrible plague on your livestock in the field—on your horses and donkeys and camels and on your cattle and sheep and goats.Then the L ORD said to Moses and Aaron, "Take handfuls of soot from a furnace and have Moses toss it into the air in the presence of Pharaoh. It will become fine dust over the whole land of Egypt, and festering boils will break out on men and animals throughout the land."This is what the L ORD , the God of the Hebrews, says: Let my people go, so that they may worship me, or this time I will send the full force of my plagues against you and against your officials and your people, so you may know that there is no one like me in all the earth. For by now I could have stretched out my hand and struck you and your people with a plague that would have wiped you off the earth. But I have raised you up for this very purpose, that I might show you my power and that my name might be proclaimed in all the earth. You still set yourself against my people and will not let them go. Therefore, at this time tomorrow I will send the worst hailstorm that has ever fallen on Egypt, from the day it was founded till now. Give an order now to bring your livestock and everything you have in the field to a place of shelter, because the hail will fall on every man and animal that has not been brought in and is still out in the field, and they will die. […] The L ORD sent thunder and hail, and lightning flashed down to the ground. So the L ORD rained hail on the land of Egypt; hail fell and lightning flashed back and forth. It was the worst storm in all the land of Egypt since it had become a nation.This is what the L ORD , the God of the Hebrews, says: 'How long will you refuse to humble yourself before me? Let my people go, so that they may worship me. If you refuse to let them go, I will bring locusts into your country tomorrow. They will cover the face of the ground so that it cannot be seen. They will devour what little you have left after the hail, including every tree that is growing in your fields. They will fill your houses and those of all your officials and all the Egyptians—something neither your fathers nor your forefathers have ever seen from the day they settled in this land till now.Then the L ORD said to Moses, "Stretch out your hand toward the sky so that darkness will spread over Egypt—darkness that can be felt." So Moses stretched out his hand toward the sky, and total darkness covered all Egypt for three days. No one could see anyone else or leave his place for three days.This is what the L ORD says: "About midnight I will go throughout Egypt. Every firstborn son in Egypt will die, from the firstborn son of Pharaoh, who sits on the throne, to the firstborn of the slave girl, who is at her hand mill, and all the firstborn of the cattle as well. There will be loud wailing throughout Egypt—worse than there has ever been or ever will be again." Before this final plague, God commands Moses to tell the Israelites to mark a lamb 's blood above their doors in order that the Angel of Death will pass over them (i.e., that they will not be touched by the death of the firstborn). Pharaoh orders the Israelites to leave, taking whatever they want, and asks Moses to bless him in the name of the Lord. The passage goes on to state that the passover sacrifice recalls the time when the L ORD "passed over the houses of the Israelites in Egypt". Scholars are in broad agreement that the publication of the Torah took place in the mid-Persian period (the 5th century BCE). The Book of Deuteronomy , composed in stages between the 7th and 6th centuries, mentions the "diseases of Egypt" (Deuteronomy 7:15 and 28:60) but refers to something that afflicted the Israelites, not the Egyptians, and never specifies the plagues. The traditional number of ten plagues is not actually mentioned in Exodus, and other sources differ; Psalms 78 and 105 seem to list only seven or eight plagues and order them differently. It appears that originally there were only seven, to which were added the third, sixth, and ninth, bringing the count to ten. : 83–84 In this final version, the first nine plagues form three triads, each of which God introduces by informing Moses of the main lesson it will teach. : 117 In the first triad, the Egyptians begin to experience the power of God; : 118 in the second, God demonstrates that he is directing events; : 119 and in the third, the incomparability of Yahweh is displayed. : 117 Overall, the plagues are "signs and marvels" given by the God of Israel to answer Pharaoh's taunt that he does not know Yahweh: "The Egyptians shall know that I am the L ORD ". : 117Scholars broadly agree that the Exodus is not a historical account, that the Israelites originated in Canaan and from the Canaanites and that, while a small group of proto-Israelites may have originated from Egypt, it did not happen in the massive way the Bible describes. : 81 : 6–7 The Ipuwer Papyrus , written no earlier than the late Twelfth Dynasty of Egypt (c. 1991–1803 BCE), has been put forward in popular literature as confirmation of the biblical account, most notably because of its statement that "the river is blood" and its frequent references to servants running away; however, these arguments ignore the many points on which Ipuwer contradicts Exodus, such as Asiatics arriving in Egypt rather than leaving and the fact that the "river is blood" phrase probably refers to the red sediment colouring the Nile during disastrous floods, or is simply a poetic image of turmoil. Attempts to find natural explanations for the plagues (e.g., a volcanic eruption to explain the "darkness" plague) have been dismissed by biblical scholars on the grounds that their pattern, timing, rapid succession, and above all, control by Moses mark them as supernatural . : 90 : 117–118In visual art, the plagues have generally been reserved for works in series, especially engravings. Still, relatively few depictions in art emerged compared to other religious themes until the 19th century, when the plagues became more common subjects, with John Martin and Joseph Turner producing notable canvases. This trend probably reflected a Romantic attraction to landscape and nature painting, for which the plagues were suited, a Gothic attraction to morbid stories, and a rise in Orientalism , wherein exotic Egyptian themes found currency. Given the importance of noble patronage throughout Western art history, the plagues may have found consistent disfavor because the stories emphasize the limits of a monarch's power, and images of lice, locusts, darkness, and boils were ill-suited for decoration in palaces and churches. [ citation needed ] Perhaps the most successful artistic representation of the plagues is Handel's oratorio Israel in Egypt , which, like his perennial favorite, " Messiah ", takes a libretto entirely from scripture. The work was especially popular in the 19th century because of its numerous choruses, generally one for each plague, and its playful musical depiction of the plagues. For example, the plague of frogs is performed as a light aria for alto, depicting frogs jumping in the violins, and the plague of flies and lice is a light chorus with fast scurrying runs in the violins. In visual art, the plagues have generally been reserved for works in series, especially engravings. Still, relatively few depictions in art emerged compared to other religious themes until the 19th century, when the plagues became more common subjects, with John Martin and Joseph Turner producing notable canvases. This trend probably reflected a Romantic attraction to landscape and nature painting, for which the plagues were suited, a Gothic attraction to morbid stories, and a rise in Orientalism , wherein exotic Egyptian themes found currency. Given the importance of noble patronage throughout Western art history, the plagues may have found consistent disfavor because the stories emphasize the limits of a monarch's power, and images of lice, locusts, darkness, and boils were ill-suited for decoration in palaces and churches. [ citation needed ]Perhaps the most successful artistic representation of the plagues is Handel's oratorio Israel in Egypt , which, like his perennial favorite, " Messiah ", takes a libretto entirely from scripture. The work was especially popular in the 19th century because of its numerous choruses, generally one for each plague, and its playful musical depiction of the plagues. For example, the plague of frogs is performed as a light aria for alto, depicting frogs jumping in the violins, and the plague of flies and lice is a light chorus with fast scurrying runs in the violins.

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Plague

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Plague doctor

A plague doctor was a physician who treated victims of bubonic plague during epidemics mainly in the 16th and 17th centuries. These physicians were hired by cities to treat infected patients regardless of income, especially the poor, who could not afford to pay. Plague doctors had a mixed reputation, with some citizens seeing their presence as a warning to leave the area or that death was near. Some plague doctors were said to charge patients and their families additional fees for special treatments or false cures. In many cases, these doctors were not experienced and trained physicians or surgeons , instead being volunteers, second-rate doctors, or young doctors just starting a career. In one case, a plague doctor was a fruit salesman before his employment as a physician. Plague doctors rarely cured patients, instead serving to record death tolls and the number of infected people for demographic purposes. In France and the Netherlands, plague doctors often lacked medical training and were referred to as " empirics ". Plague doctors were known as municipal or "community plague doctors", whereas "general practitioners" were separate doctors and both might be in the same European city or town at the same time. An early reference to plague doctors wearing masks is in 1373 when Johannes Jacobi recommends the use of masks, but offers no physical description of the masks themselves. According to Michel Tibayrenc's Encyclopedia of Infectious Diseases , the first mention of the iconic plague doctor is found during the 1619 plague outbreak in Paris, in a biography of royal physician Charles de Lorme , serving King Louis XIII of France at the time. After De Lorme, German engraver Gerhart Altzenbach published a famous illustration in 1656, which publisher Paulus Fürst's iconic Doctor Schnabel von Rom (1656) is based upon. In this satirical work, Fürst describes how the doctor does nothing but terrify people and take money from the dead and dying. The city of Orvieto hired Matteo fu Angelo as a plague doctor in 1348 for four times at a normal doctor's rate of 50 florins per year. Pope Clement VI hired several extra plague doctors during the Black Death plague to tend to the sick people of Avignon . Of eighteen doctors in Venice , only one was left by 1348: five had died of the plague, and twelve were missing and may have fled. Plague doctors practiced bloodletting and other remedies such as putting frogs or leeches on the buboes to "rebalance the humors ." A plague doctor's principal task, besides treating people with the plague, was to compile public records of plague deaths. In certain European cities like Florence and Perugia , plague doctors were requested to do autopsies to help determine the cause of death and how the plague affected the people. Plague doctors also sometimes took patients' last will and testament during times of plague epidemics, and gave advice to their patients about their conduct before death. This advice varied depending on the patient, and after the Middle Ages , the nature of the relationship between doctor and patient was governed by an increasingly complex ethical code. Some plague doctors wore a special costume consisting of an ankle-length overcoat and a bird-like beak mask. As an attempt to purify the air they breathed (it was believed that good smells would 'cancel out' the diseases , and people would often walk around with a flower under their nose), the wearer would fill the mask with herbs and spices (commonly lavender ). The plague doctors would also wear gloves, boots, a wide-brimmed hat, a linen hood, and an outer over-clothing garment. However, the costume was not worn by all medieval and early modern physicians studying and treating plague patients. The exact origins of the Plague costumes are unclear but have been dated back to Italy and France. Plague doctors wore a mask of some form since at least 1373. Most depictions come from satirical writings and political cartoons. The beaked plague doctor inspired costumes in Italian theatre as a symbol of general horror and death, though some historians insist that the plague doctor was originally fictional and inspired the real plague doctors later. Depictions of the beaked plague doctor rose in response to superstition and fear about the unknown source of the plague. Often, these plague doctors were the last thing a patient would see before death; therefore, the doctors were seen as a foreboding of death. It appears that the only contemporary sources which claim witness to this infamous costume are based in Italy during the 17th century. Later sources based in other areas do claim that this costume was in use in their country (most specifically during the Black Death); however, it is possible that these sources were influenced by theatre and other works of fiction. The typical mask had glass openings for the eyes and a curved leather beak, shaped like a bird's beak, with straps that held the beak in front of the doctor's nose. The mask had two small nose holes and was a type of respirator which contained aromatic items. The first known observation of the herbal-stuffed beak was during the 1656–1658 epidemic in Rome. The beak could hold dried flowers (like roses and carnations ), herbs (like lavender and peppermint ), camphor , or a vinegar sponge, as well as juniper berry , ambergris , cloves , labdanum , myrrh , and storax . The herbs right up against the nose inside the beak allowed for the doctor to have both of their hands free in order to examine the patient or corpse. The purpose of the mask was to keep away bad smells such as decaying bodies and the smell taken with the most caution was known as miasma , a noxious form of "bad air". This was thought to be the principal cause of the disease. Doctors believed the herbs would counter the "evil" smells of the plague and prevent them from becoming infected. The wide-brimmed leather hat indicated their profession, they used wooden canes in order to point out areas needing attention and to examine patients without touching them. The canes were also used to keep people away and to remove clothing from plague victims without having to touch them. The doctor's long robe was made from linen because it was said germs did not stick to linen as easily as other materials. The robe was also sometimes made from goat skin, which was said to be stronger against the plague than linen because of its small pores and polished texture. It was heard of for the robe to be sealed with oil or wax for an extra layer of protection so the "bad air" could not seep through the holes of the linen material. Though contemporary theories about the plague's nature were incorrect, it is likely that the costume actually did afford the wearer some protection. The garments covered the body, shielding against splattered blood, lymph and cough droplets, and the waxed robe prevented fleas (the true carriers of the plague) from touching the body or clinging to the linen. The costume of the plague doctor is one of the earliest examples of a hazmat suit . This well known costume now is used as common costume in festivals mainly in Europe and within the art of theatre. A plague doctor's contract was an agreement between a town's administrators and a doctor to treat bubonic plague patients. These contracts are present in European city archives. Their contractual responsibility was to treat plague patients, and no other type of patient, to prevent spreading the disease to the uninfected. A plague doctor had to serve a long quarantine after seeing a plague patient. The doctor was regarded as a "contact" who by agreement had to live in isolation to be quarantined. The bargaining which always preceded the final contract often consisted of serious negotiations. For example, the town administrators of Turin in 1630 were considering the terms of an agreement requested by one Dr. Maletto to become their plague doctor. After much negotiating, they instructed their broker representatives to make a fair and prompt deal as soon as possible with Dr. Maletto. They were told to get the best possible deal for their city, but to be careful not to lose the opportunity of hiring this plague doctor, as it would be difficult to find someone else to perform these dangerous duties at such a low rate. As an example of the tough negotiating that went on between plague doctors and infected European towns, there is in Pavia an original agreement between one Giovanni de Ventura and the city in their archives that shows a sixteen clause contract that was further amended after it was originally written. Clause one originally showed 30 florins per month for pay but was later modified to be net of living expenses. Clause two was originally that the pay was to be given two months in advance but later modified to monthly. Clause five provided originally a severance pay of two months but later modified that to one month's pay. Clause six stated that "the said master Giovanni shall not be bound nor held under obligation except only in attending the plague patients", which was later amplified with "...the doctor must treat all patients and visit infected places as it shall be found to be necessary." Clause seven had to do with full citizenship and the original text was modified with "according to how he shall behave himself." Bernardino di Francesco Rinaldi obtained a clause in his contract when he was hired as plague doctor by the city of Volterra in 1527 that said essentially that the city had the obligation to provide Bernardino with all and everything necessary for his life support (i.e. food, water), and for these living expenses to be paid through the city expenditures. In 1527, in the city of Prato , a plague doctor named Stefano Mezzettino was seen attending to other patients without a custodian. The rule in the plague doctor contract was that a custodian must always be with the plague doctor when he visits other patients. This created much danger for the public. He was fined for his illegal act and breaking the rule of the plague doctor contract. The bargaining which always preceded the final contract often consisted of serious negotiations. For example, the town administrators of Turin in 1630 were considering the terms of an agreement requested by one Dr. Maletto to become their plague doctor. After much negotiating, they instructed their broker representatives to make a fair and prompt deal as soon as possible with Dr. Maletto. They were told to get the best possible deal for their city, but to be careful not to lose the opportunity of hiring this plague doctor, as it would be difficult to find someone else to perform these dangerous duties at such a low rate. As an example of the tough negotiating that went on between plague doctors and infected European towns, there is in Pavia an original agreement between one Giovanni de Ventura and the city in their archives that shows a sixteen clause contract that was further amended after it was originally written. Clause one originally showed 30 florins per month for pay but was later modified to be net of living expenses. Clause two was originally that the pay was to be given two months in advance but later modified to monthly. Clause five provided originally a severance pay of two months but later modified that to one month's pay. Clause six stated that "the said master Giovanni shall not be bound nor held under obligation except only in attending the plague patients", which was later amplified with "...the doctor must treat all patients and visit infected places as it shall be found to be necessary." Clause seven had to do with full citizenship and the original text was modified with "according to how he shall behave himself." Bernardino di Francesco Rinaldi obtained a clause in his contract when he was hired as plague doctor by the city of Volterra in 1527 that said essentially that the city had the obligation to provide Bernardino with all and everything necessary for his life support (i.e. food, water), and for these living expenses to be paid through the city expenditures. In 1527, in the city of Prato , a plague doctor named Stefano Mezzettino was seen attending to other patients without a custodian. The rule in the plague doctor contract was that a custodian must always be with the plague doctor when he visits other patients. This created much danger for the public. He was fined for his illegal act and breaking the rule of the plague doctor contract.

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Plague

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Plague of Justinian

The plague of Justinian or Justinianic plague (AD 541–549) was an epidemic that afflicted the entire Mediterranean Basin, Europe, and the Near East, severely affecting the Sasanian Empire and the Byzantine Empire , especially Constantinople . The plague is named for the Byzantine Emperor Justinian I (r. 527–565), who according to his court historian Procopius contracted the disease and recovered in 542, at the height of the epidemic which killed about a fifth of the population in the imperial capital. The contagion arrived in Roman Egypt in 541, spread around the Mediterranean Sea until 544, and persisted in Northern Europe and the Arabian Peninsula until 549. By 543, the plague had spread to every corner of the empire. As the first episode of the first plague pandemic , it had profound economic, social, and political effects across Europe and the Near East and cultural and religious impact on Eastern Roman society. In 2013, researchers confirmed earlier speculation that the cause of the plague of Justinian was Yersinia pestis , the same bacterium responsible for the Black Death (1346–1353). Ancient and modern Yersinia pestis strains are closely related to the ancestor of the Justinian plague strain that has been found in the Tian Shan , a system of mountain ranges on the borders of Kyrgyzstan , Kazakhstan , and China , suggesting that the Justinian plague originated in or near that region. However, there would appear to be no mention of bubonic plague in China until the year 610. The Byzantine historian Procopius first reported the epidemic in 541 from the port of Pelusium , near Suez in Egypt. Two other first hand reports of the plague's ravages were by the Syriac church historian John of Ephesus and Evagrius Scholasticus , who was a child in Antioch at the time and later became a church historian. Evagrius was afflicted with the buboes associated with the disease but survived. During the disease's four returns in his lifetime, he lost his wife, a daughter and her child, other children, most of his servants and people from his country estate. According to contemporary sources, the outbreak in Constantinople was thought to have been carried to the city by infected rats on grain ships arriving from Egypt. To feed its citizens, the city and outlying communities imported large amounts of grain, mostly from Egypt. The rat population in Egypt thrived on feeding from the large granaries maintained by the government, and the fleas thrived as well. [ citation needed ] Procopius, in a passage closely modelled on Thucydides , recorded that at its peak the plague was killing 10,000 people in Constantinople daily, but the accuracy of the figure is in question, and the true number will probably never be known. He noted that because there was no room to bury the dead, bodies were left stacked in the open. Funeral rites were often left unattended to, and the entire city smelled like the dead. Given such circumstances, it is highly probable that a sudden increase in mortality rates may not have been as accurately recorded, hence why the overall death toll is based on an estimate. In his Secret History , he records the devastation in the countryside and reports the ruthless response by the hard-pressed Justinian: When pestilence swept through the whole known world and notably the Roman Empire, wiping out most of the farming community and of necessity leaving a trail of desolation in its wake, Justinian showed no mercy towards the ruined freeholders. Even then, he did not refrain from demanding the annual tax, not only the amount at which he assessed each individual, but also the amount for which his deceased neighbors were liable. As a result of the plague in the countryside, farmers could not take care of crops and the price of grain rose in Constantinople. Justinian had expended huge amounts of money for wars against the Vandals in the region of Carthage and the Ostrogoths ' kingdom in Italy . He had invested heavily in the construction of great churches, such as Hagia Sophia . As the empire tried to fund the projects, the plague caused tax revenues to decline through the massive number of deaths and the disruption of agriculture and trade. Justinian swiftly enacted new legislation to deal more efficiently with the glut of inheritance suits being brought as a result of victims dying intestate . The plague's long-term effects on European and Christian history were enormous. As the disease spread to port cities around the Mediterranean, the struggling Goths were reinvigorated and their conflict with Constantinople entered a new phase. The plague weakened the Byzantine Empire at a critical point, when Justinian's armies had nearly retaken all of Italy and the western Mediterranean coast; the evolving conquest would have reunited the core of the Western Roman Empire with the Eastern Roman Empire. Although the conquest occurred in 554, the reunification did not last long. In 568, the Lombards invaded Northern Italy , defeated the small Byzantine army that had been left behind and established the Kingdom of the Lombards . Gaul is known to have suffered severely from the plague, and plague victims at an early Anglo-Saxon burial site at Edix Hill near Cambridge show that it also reached Britain. The Plague of Justinian is the first and the best known outbreak of the first plague pandemic, which continued to recur until the middle of the 8th century. Some historians believe the first plague pandemic was one of the deadliest pandemics in history , resulting in the deaths of an estimated 15–100 million people during two centuries of recurrence, a death toll equivalent to 25–60% of Europe's population at the time of the first outbreak. Research published in 2019 argued that the 200-year-long pandemic's death toll and social effects have been exaggerated, comparing it to the modern third plague pandemic (1855–1960s). Furthermore, historians seek to play down the effects of the late-antique bubonic plague, arguing that our eyewitness accounts of the disease are hysterical in tone and misleading in effect. The Plague of Justinian is the first and the best known outbreak of the first plague pandemic, which continued to recur until the middle of the 8th century. Some historians believe the first plague pandemic was one of the deadliest pandemics in history , resulting in the deaths of an estimated 15–100 million people during two centuries of recurrence, a death toll equivalent to 25–60% of Europe's population at the time of the first outbreak. Research published in 2019 argued that the 200-year-long pandemic's death toll and social effects have been exaggerated, comparing it to the modern third plague pandemic (1855–1960s). Furthermore, historians seek to play down the effects of the late-antique bubonic plague, arguing that our eyewitness accounts of the disease are hysterical in tone and misleading in effect. The plague of Justinian is generally regarded as the first historically recorded epidemic of Yersinia pestis . This conclusion is based on historical descriptions of the clinical manifestations of the disease and the detection of Y. pestis DNA from human remains at ancient grave sites dated to that period. Genetic studies of modern and ancient Yersinia pestis DNA suggest that the origin of the Justinian plague was in Central Asia . The most basal or root level existing strains of the Yersinia pestis as a whole species are found in Qinghai , China . Other scholars contest that, rather than Central Asia, the specific strain that composed the Justinian plague began in sub-Saharan Africa, and that the plague was spread to the Mediterranean by merchants from the Kingdom of Aksum in East Africa. This point of origin aligns more with the general south–north spread of the disease from Egypt into the rest of the Mediterranean world. It also explains why Sassanid Persia saw a later development of the outbreak despite stronger trade links with Central Asia. After samples of DNA from Yersinia pestis were isolated from skeletons of Justinian plague victims in Germany, it was found that modern strains currently found in the Tian Shan mountain range system are most basal known in comparison with the Justinian plague strain. Additionally, a skeleton found in Tian Shan dating to around 180 AD and identified as an "early Hun" was found to contain DNA from Yersinia pestis closely related to the Tian Shan strain basal ancestor of the Justinian plague strain German samples. This finding suggests that the expansion of nomadic peoples who moved across the Eurasian steppe , such as the Xiongnu and the later Huns , had a role in spreading plague to West Eurasia from an origin in Central Asia. Earlier samples of Yersinia pestis DNA have been found in skeletons dating from 3000 to 800 BC, across West and East Eurasia. The strain of Yersinia pestis responsible for the Black Death , the devastating pandemic of bubonic plague , does not appear to be a direct descendant of the Justinian plague strain. However, the spread of Justinian plague may have caused the evolutionary radiation that gave rise to the currently extant 0ANT.1 clade of strains. The number of deaths is uncertain. Some modern scholars believe that the plague killed up to 5,000 people per day in Constantinople at the peak of the pandemic. According to one view, the initial plague ultimately killed perhaps 40% of the city's inhabitants and caused the deaths of up to a quarter of the human population of the Eastern Mediterranean . Frequent subsequent waves of the plague continued to strike throughout the 6th, 7th and 8th centuries, with the disease becoming more localized and less virulent. [ citation needed ] A revisionist view expressed by scholars such as Lee Mordechai and Merle Eisenberg argues that the mortality of the Justinian Plague was far lower than previously believed. They say that the plague might have caused high mortality in specific places, but it did not cause widespread demographic decline or decimate Mediterranean populations. According to them, any direct mid-to-long term effects of plague were minor. However, their position has been the subject of a concerted critique by Peter Sarris. Sarris challenged both their core methodology and their handling of the sources. Sarris also provides up-to-date discussion of the genetic evidence, including the suggestion that the plague may have entered Western Eurasia via more than one route, and perhaps struck England before Constantinople. The plague of Justinian is generally regarded as the first historically recorded epidemic of Yersinia pestis . This conclusion is based on historical descriptions of the clinical manifestations of the disease and the detection of Y. pestis DNA from human remains at ancient grave sites dated to that period. Genetic studies of modern and ancient Yersinia pestis DNA suggest that the origin of the Justinian plague was in Central Asia . The most basal or root level existing strains of the Yersinia pestis as a whole species are found in Qinghai , China . Other scholars contest that, rather than Central Asia, the specific strain that composed the Justinian plague began in sub-Saharan Africa, and that the plague was spread to the Mediterranean by merchants from the Kingdom of Aksum in East Africa. This point of origin aligns more with the general south–north spread of the disease from Egypt into the rest of the Mediterranean world. It also explains why Sassanid Persia saw a later development of the outbreak despite stronger trade links with Central Asia. After samples of DNA from Yersinia pestis were isolated from skeletons of Justinian plague victims in Germany, it was found that modern strains currently found in the Tian Shan mountain range system are most basal known in comparison with the Justinian plague strain. Additionally, a skeleton found in Tian Shan dating to around 180 AD and identified as an "early Hun" was found to contain DNA from Yersinia pestis closely related to the Tian Shan strain basal ancestor of the Justinian plague strain German samples. This finding suggests that the expansion of nomadic peoples who moved across the Eurasian steppe , such as the Xiongnu and the later Huns , had a role in spreading plague to West Eurasia from an origin in Central Asia. Earlier samples of Yersinia pestis DNA have been found in skeletons dating from 3000 to 800 BC, across West and East Eurasia. The strain of Yersinia pestis responsible for the Black Death , the devastating pandemic of bubonic plague , does not appear to be a direct descendant of the Justinian plague strain. However, the spread of Justinian plague may have caused the evolutionary radiation that gave rise to the currently extant 0ANT.1 clade of strains. The number of deaths is uncertain. Some modern scholars believe that the plague killed up to 5,000 people per day in Constantinople at the peak of the pandemic. According to one view, the initial plague ultimately killed perhaps 40% of the city's inhabitants and caused the deaths of up to a quarter of the human population of the Eastern Mediterranean . Frequent subsequent waves of the plague continued to strike throughout the 6th, 7th and 8th centuries, with the disease becoming more localized and less virulent. [ citation needed ] A revisionist view expressed by scholars such as Lee Mordechai and Merle Eisenberg argues that the mortality of the Justinian Plague was far lower than previously believed. They say that the plague might have caused high mortality in specific places, but it did not cause widespread demographic decline or decimate Mediterranean populations. According to them, any direct mid-to-long term effects of plague were minor. However, their position has been the subject of a concerted critique by Peter Sarris. Sarris challenged both their core methodology and their handling of the sources. Sarris also provides up-to-date discussion of the genetic evidence, including the suggestion that the plague may have entered Western Eurasia via more than one route, and perhaps struck England before Constantinople.

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Plague

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Plague Inc.

Ndemic Creations Miniclip (Android) WW : 26 May 2012 WW : 4 October 2012 WW : 13 May 2015 Plague Inc. is a real-time strategy simulation video game , developed and published by UK -based independent video game studio Ndemic Creations. The game was inspired by the 2011 film Contagion and the 2008 Adobe Flash game Pandemic 2 . The player creates and evolves a pathogen to annihilate the human population with a deadly pandemic . The game uses an epidemic model with a complex and realistic set of variables to simulate the spread and severity of the plague. It was released on 26 May 2012 for iOS , 4 October 2012 for Android and 13 May 2015 for Windows Phone . The Steam ( Microsoft Windows , macOS , and Linux ) and console version is entitled Plague Inc: Evolved and includes adjustments and additions to the gameplay. According to Ndemic Creations, Plague Inc. has been downloaded over 160 million times as of May 2021 [ update ] . The game was positively received by critics, and it was a runner-up in the IGN Game of the Year 2012 awards for 'Overall Best Strategy Game'. Plague Inc. continues to have an active community and is regularly updated. In 2017, the developer released a physical board game based on Plague Inc. titled Plague Inc.: The Board Game . In December 2018, the studio released Rebel Inc . , a follow-up game with a political theme. The game has seen large surges of new users in several countries after significant virus outbreaks, such as the 2014–16 Ebola outbreak and the COVID-19 pandemic . Plague Inc. is a strategy-simulation game in which the player indirectly controls a plague, which has infected patient zero. The player can choose between game modes and pathogens and complete the objective set by the game mode by evolving the plague and adapting to various environments. The goals include but are not limited to, infecting and killing the world's population with a pathogen, enslaving the world's population with the 'Neurax Worm', converting the world's population into zombies with the 'Necroa Virus', establishing the Planet of the Apes with the 'Simian Flu', or corrupting humanity with the 'Shadow Plague'. However, there is a time pressure to complete the game before humans (the opponent) develop a cure for the plague. The developer has said it is 'a bit like the film Contagion except you are on the other side'. The film Contagion was a partial inspiration for the game, according to the developer. The developer has said the game was partially inspired by Pandemic 2 , a browser-based Flash game released in 2008 by Dark Realm Studios. The remake Plague Inc: Evolved for Steam and consoles has similar gameplay to the original Plague Inc but includes several features not present in the mobile version, such as multiplayer. The remake Plague Inc: Evolved for Steam and consoles has similar gameplay to the original Plague Inc but includes several features not present in the mobile version, such as multiplayer. The player can use many different types of pathogens, each with its own advantages and disadvantages which influence evolution decisions. Initially, the player may only select bacteria . There are four modes of gameplay for each plague type. They are Casual, Normal, Brutal, and Mega Brutal; with Mega Brutal being accessed by clicking the yellow biohazard button under the Brutal icon. Subsequent pathogens are unlocked by winning the game with the previous one on Normal or Brutal Mode. These include virus , fungus , parasite , prion , nano-virus , and bio-weapon . There are also fictional special plague types, including the mind-controlling Neurax Worm, the zombie plague Necroa Virus, the "Simian Flu" from Rise of the Planet of the Apes , the vampire themed Shadow Plague, and the customizable Disease X from the 1.18.6 "The Cure" In addition to these disease types, there are scenarios. Plague Inc gives you the Fake News, Ultimate Boardgames, Science Denial, Mad Cow Disease, and The Black Death scenarios for free. However, all other scenarios cost $0.99 each. You can also buy a scenario pack, giving you all the scenarios for $2.99.Development most likely started in 2011 with the creator, James Vaughan, working on the game in his evenings and afternoons. The game was released on 26 May 2012. In July 2014, Ndemic Creations partnered with 20th Century Fox on an update themed as a tie-in to the film Dawn of the Planet of the Apes . Players cultivate the film's "Simian Flu" virus, which kills humans while making apes more intelligent. Players spread the virus to eradicate humans while helping apes survive and advance. In 2017, the developer released a physical board game based on Plague Inc. titled Plague Inc.: The Board Game . [lower-alpha 1] $355,000 was raised for the board game on Kickstarter . According to developer James Vaughan, "[he] really wanted the challenge of making a physical game to go alongside the video game - especially as board games are getting increasingly popular now". On 6 December 2018, Ndemic Creations released Rebel Inc. , a follow-up game with a political theme based around the "complexities and consequences of foreign intervention and counter insurgency." In it, players must stabilize a post-war country while stopping insurgents from taking power. Though the game was originally only available on iOS, a port for Android devices was released on 11 February the following year. On 28 February 2019, the studio announced that they would add an in-game scenario about vaccine hesitancy to the game, after a Change.org petition to do so gained over 10,000 signatures. On 24 March 2020, the studio announced that they would add a "cure mode" about stopping the plague outbreak due to the ongoing COVID-19 pandemic. Plague Inc received "generally favorable" reviews according to review aggregator Metacritic , with an aggregated score of 80/100. Wired.com cited Plague Inc. as a notable independent developer success story as it "bucked the system by staying near the top of the charts in numerous countries for the entirety of its existence, pulling in millions in revenue while competing with the big players". It was #1 paid app for both iPhone and iPad in the U.S. for two weeks after launch. IGN said that "Killing billions has never been so fun". TouchArcade said that " Plague Inc. will snag your attention in all the right ways and keep it there". In December 2012, Plague Inc. was one of five games nominated for Best Strategy Game in IGN's Game of the Year 2012, both for mobile and for all platforms. It also won the 'Players Choice' award for best Mobile Strategy Game of 2012. Overall, Plague Inc. was the 15th most downloaded paid iPhone game of 2012 in the U.S. (and 18th on iPad). It was also the 76th highest-grossing game of 2012. In March 2013, the game went on to win multiple categories of the Pocket Gamer Awards , including Overall Game of the Year. It was the 5th most downloaded paid iPhone game in the US in 2013. According to Ndemic Creations, Plague Inc. has been downloaded over 160 million times, as of May 2021. It has remained at the top of the charts worldwide for five years. Overall, it was the 15th most downloaded paid iPhone game of 2012 in the United States and the 5th most downloaded paid iPhone game of 2013 in the U.S. In 2014, it was the #3 best selling iPhone game in the U.S. and the #1 best selling iPhone app in China. In 2015, it was the 7th best selling iPhone game in the U.S. In 2016, it was the 4th best selling iPhone game there. As of April 2019, Plague Inc. The Board Game has sold over 35 thousand copies. In the wake of the COVID-19 pandemic in January 2020, Plague, Inc. became the top-selling app in the Chinese market, and saw increased sales and number of concurrent players on other platforms. The interest was believed to be from Chinese video gamers trying to find a way to deal with fears raised by the outbreak. Ndemic reminded players that while Plague Inc. was developed based on scientific understanding of the spread of infectious diseases, the game was not on par with any scientific model, and added links to the World Health Organization 's website on their own website in response to people inquiring about the coronavirus. By February 2020, as the pandemic spread globally, Plague, Inc. had resurged to be the top paid app on the iOS app store, beating out Minecraft . In response to newfound interest in the game, Ndemic added a mode, developed in conjunction with WHO, about fighting off a pandemic from spreading, based on some of the scientific techniques and lessons learned from the coronavirus spread. On 27 February 2020, the Chinese government forced the game to be removed from the App Store in China, with the Cyberspace Administration of China citing "illegal content" in the game, though they have not provided any further explanation to Ndemic. Plague, Inc. had been updated with a "Fake News" content update, which they had yet to authorize to release to China, which has been believed to be the reason behind the ban given China's stance on media that is derogatory of their state media. Dark Realm Studios initially complained on Twitter to IGN reviewer Justin Davis about the Plague Inc. release, saying that the game was "just an attempt to cash in on Pandemic 2.5 " due to similarities in gameplay between the titles. The reviewer responded with an article defending Plague Inc. and saying "there's no denying that it bears a close resemblance to Pandemic , but there is also no denying that it improves on that basic disease-spreading premise" Plague Inc. developer James Vaughan rejected the cash-in accusation. In 2013, Dark Realm Studios said they did not consider Plague Inc. to be a clone and they "regard the situation as a learning opportunity". In March 2013, James Vaughan, the developer of Plague Inc. , was invited to talk at the Centers for Disease Control and Prevention (CDC) about Plague Inc. He spoke about how he had modeled the spread of infectious disease inside the game as well as how games like Plague Inc. can be used to inform and educate the public. Following the talk, the CDC said that it was interested in Plague Inc. as "it uses a non-traditional route to raise public awareness on epidemiology, disease transmission, and diseases/pandemic information. The game creates a compelling world that engages the public on serious public health topics". The game itself got updated with more realistic situations following the CDC meeting as Vaughan got scientific tips regarding pathogens and transmission. The game became the number one selling app in China early during the epidemic phase of the COVID-19 pandemic in Wuhan, China ; the company received so many inquiries that via its Twitter account it referred its users to the CDC website for information. Plague Inc received "generally favorable" reviews according to review aggregator Metacritic , with an aggregated score of 80/100. Wired.com cited Plague Inc. as a notable independent developer success story as it "bucked the system by staying near the top of the charts in numerous countries for the entirety of its existence, pulling in millions in revenue while competing with the big players". It was #1 paid app for both iPhone and iPad in the U.S. for two weeks after launch. IGN said that "Killing billions has never been so fun". TouchArcade said that " Plague Inc. will snag your attention in all the right ways and keep it there". In December 2012, Plague Inc. was one of five games nominated for Best Strategy Game in IGN's Game of the Year 2012, both for mobile and for all platforms. It also won the 'Players Choice' award for best Mobile Strategy Game of 2012. Overall, Plague Inc. was the 15th most downloaded paid iPhone game of 2012 in the U.S. (and 18th on iPad). It was also the 76th highest-grossing game of 2012. In March 2013, the game went on to win multiple categories of the Pocket Gamer Awards , including Overall Game of the Year. It was the 5th most downloaded paid iPhone game in the US in 2013. According to Ndemic Creations, Plague Inc. has been downloaded over 160 million times, as of May 2021. It has remained at the top of the charts worldwide for five years. Overall, it was the 15th most downloaded paid iPhone game of 2012 in the United States and the 5th most downloaded paid iPhone game of 2013 in the U.S. In 2014, it was the #3 best selling iPhone game in the U.S. and the #1 best selling iPhone app in China. In 2015, it was the 7th best selling iPhone game in the U.S. In 2016, it was the 4th best selling iPhone game there. As of April 2019, Plague Inc. The Board Game has sold over 35 thousand copies. In the wake of the COVID-19 pandemic in January 2020, Plague, Inc. became the top-selling app in the Chinese market, and saw increased sales and number of concurrent players on other platforms. The interest was believed to be from Chinese video gamers trying to find a way to deal with fears raised by the outbreak. Ndemic reminded players that while Plague Inc. was developed based on scientific understanding of the spread of infectious diseases, the game was not on par with any scientific model, and added links to the World Health Organization 's website on their own website in response to people inquiring about the coronavirus. By February 2020, as the pandemic spread globally, Plague, Inc. had resurged to be the top paid app on the iOS app store, beating out Minecraft . In response to newfound interest in the game, Ndemic added a mode, developed in conjunction with WHO, about fighting off a pandemic from spreading, based on some of the scientific techniques and lessons learned from the coronavirus spread. On 27 February 2020, the Chinese government forced the game to be removed from the App Store in China, with the Cyberspace Administration of China citing "illegal content" in the game, though they have not provided any further explanation to Ndemic. Plague, Inc. had been updated with a "Fake News" content update, which they had yet to authorize to release to China, which has been believed to be the reason behind the ban given China's stance on media that is derogatory of their state media. Dark Realm Studios initially complained on Twitter to IGN reviewer Justin Davis about the Plague Inc. release, saying that the game was "just an attempt to cash in on Pandemic 2.5 " due to similarities in gameplay between the titles. The reviewer responded with an article defending Plague Inc. and saying "there's no denying that it bears a close resemblance to Pandemic , but there is also no denying that it improves on that basic disease-spreading premise" Plague Inc. developer James Vaughan rejected the cash-in accusation. In 2013, Dark Realm Studios said they did not consider Plague Inc. to be a clone and they "regard the situation as a learning opportunity". In March 2013, James Vaughan, the developer of Plague Inc. , was invited to talk at the Centers for Disease Control and Prevention (CDC) about Plague Inc. He spoke about how he had modeled the spread of infectious disease inside the game as well as how games like Plague Inc. can be used to inform and educate the public. Following the talk, the CDC said that it was interested in Plague Inc. as "it uses a non-traditional route to raise public awareness on epidemiology, disease transmission, and diseases/pandemic information. The game creates a compelling world that engages the public on serious public health topics". The game itself got updated with more realistic situations following the CDC meeting as Vaughan got scientific tips regarding pathogens and transmission. The game became the number one selling app in China early during the epidemic phase of the COVID-19 pandemic in Wuhan, China ; the company received so many inquiries that via its Twitter account it referred its users to the CDC website for information. On 11 November 2020, Ndemic Creations added a new game mode to the game, named "Plague Inc. The Cure" in which players play against the disease, attempting to cure it. Originally released on the mobile version only, the game mode was later brought to Evolved on PC via a downloadable content update on 28 January 2021. Ndemic released the DLC for free saying that '' Plague Inc: The Cure will be free for all Plague Inc. players until COVID-19 is under control. '' with the game as of the 28th of October 2022 no longer being free costing a base price of 3,29€ or $4.99

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Plague

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Pneumonic plague

Pneumonic plague is a severe lung infection caused by the bacterium Yersinia pestis . Symptoms include fever , headache, shortness of breath , chest pain , and coughing. They typically start about three to seven days after exposure. It is one of three forms of plague , the other two being septicemic plague and bubonic plague . The pneumonic form may occur following an initial bubonic or septicemic plague infection. It may also result from breathing in airborne droplets from another person or animal infected with pneumonic plague. The difference between the forms of plague is the location of infection; in pneumonic plague the infection is in the lungs, in bubonic plague the lymph nodes , and in septicemic plague within the blood. Diagnosis is by testing the blood, sputum, or fluid from a lymph node. While vaccines are being developed, in most countries they are not yet commercially available. Prevention is by avoiding contact with infected rodents, people, or cats. It is recommended that those infected be isolated from others. Treatment of pneumonic plague is with antibiotics . Plague is present among rodents in Africa, the Americas, and Asia. Pneumonic plague is more serious and less common than bubonic plague. The total reported number of cases of all types of plague in 2013 was 783. Left untreated, pneumonic plague is always fatal. Some hypothesize that the pneumonic version of the plague was mainly responsible for the Black Death that resulted in approximately 75 - 200 million deaths in the 1300s. The most apparent symptom of pneumonic plague is coughing, often with hemoptysis (coughing up blood). With pneumonic plague, the first signs of illness are fever, headache, weakness and rapidly developing pneumonia with shortness of breath, chest pain, cough and sometimes bloody or watery sputum . The pneumonia progresses for two to four days and may cause respiratory failure and shock . Patients will die without early treatment, some within 36 hours. [ citation needed ] Initial pneumonic plague symptoms can often include the following: [ citation needed ] Rapidly developing pneumonia with: [ citation needed ]Pneumonic plague can be caused in two ways: primary, which results from the inhalation of aerosolized plague bacteria , or secondary, when septicemic plague spreads into lung tissue from the bloodstream. Pneumonic plague is not exclusively vector-borne like bubonic plague; instead, it can be spread from person to person. There have been cases of pneumonic plague resulting from the dissection or handling of contaminated animal tissue. This is one of the types of plague formerly known as the Black Death . Pneumonic plague is a very aggressive infection requiring early treatment, which must be given within 24 hours of first symptoms to reduce the risk of death. Streptomycin , gentamicin , tetracyclines and chloramphenicol are all able to kill the causative bacterium. [ citation needed ] Antibiotic treatment for seven days will protect people who have had direct, close contact with infected patients. Wearing a close-fitting surgical mask also protects against infection. The mortality rate from untreated pneumonic plague approaches 100%. Since 2002, the World Health Organization (WHO) has reported seven plague outbreaks, though some may go unreported because they often happen in remote areas. Between 1998 and 2009, nearly 24,000 cases have been reported, including about 2,000 deaths, in Africa, Asia, the Americas, and Eastern Europe. Ninety-eight percent of the world's cases occur in Africa. Two outbreaks occurred in the Democratic Republic of the Congo in 2005 and 2006. The outbreak in 2005 was only detected by looking back at blood samples. The total death toll was 111. In September 1994, India experienced an outbreak of plague that killed 50 and caused travel to New Delhi by air to be suspended until the outbreak was brought under control. The outbreak was feared to be much worse because the plague superficially resembles other common diseases such as influenza and bronchitis; over 200 people that had been quarantined were released when they did not test positive for the plague. All but two of the deaths occurred around the city of Surat . [ citation needed ] A major outbreak of the pneumonic plague occurred in Manchuria from 1910 to 1911, in what became known as the Manchurian plague , killing around 60,000 people. The Qing court dispatched Wu Lien-teh , a doctor educated at Cambridge University , to oversee disease control and treatment efforts. He made the novel observation that the disease was transmitted by air , and developed prototypical respirators to help prevent its spread. A second, less deadly outbreak occurred in 1920–21, killing approximately 9,300 people. The People's Republic of China has eradicated pneumonic plague from most parts of the country, but still reports occasional cases in remote western areas, where the disease is carried by rats and the marmots that live across the Himalayan plateau . Outbreaks can be caused when a person eats an infected marmot or comes into contact with fleas carried by rats. A 2006 WHO report from an international meeting on plague cited a Chinese government disease expert as saying that most cases of the plague in China's northwest occur when hunters are contaminated while skinning infected animals. The expert said at the time that, due to the region's remoteness, the disease killed more than half the infected people. The report also said that since the 1990s, there was a rise in plague cases in humans—from fewer than 10 in the 1980s to nearly 100 cases in 1996 and 254 in 2000. In September 2008, two people in East Tibet died of pneumonic plague. An outbreak of the disease in China began in August 2009 in Ziketan Town located in Qinghai Province . The town was sealed off and several people died as a result of the disease. According to spokesperson Vivian Tan of the WHO office in Beijing , "In cases like this [in August 2009], we encourage the authorities to identify cases, to investigate any suspicious symptoms among close contacts, and to treat confirmed cases as soon as possible. So far, they have done exactly that. There have been sporadic cases reported around the country in the last few years so the authorities do have the experience to deal with this." In September 2010, five cases of pneumonic plague were reported in Tibet. In July 2014, Chinese media reported one case found in Gansu. On 12 November 2019, It was announced that two people from the Chinese province of Inner Mongolia were diagnosed with pneumonic plague. They received treatment in Chaoyang District, Beijing , and authorities implemented preventative control measures. Later in November, a third case of plague was confirmed. A 55-year-old man was diagnosed with bubonic plague after eating wild rabbit in Inner Mongolia. The region's health commission says it has no evidence to suggest that this case is linked to the previous two. By the end of November, a fourth case was confirmed. Chinese health authorities reported a fresh case of bubonic plague in the country's northern Inner Mongolia region, bringing the total number of reported plague cases originating from Inner Mongolia to four. In August 2010, Peru's health minister Oscar Ugarte announced that an outbreak of plague had killed a 14-year-old boy and had infected at least 31 people in a northern coastal province. The boy died of bubonic plague on 26 July 2010. Ugarte stated that authorities were screening sugar and fish meal exports from Ascope Province , located about 325 miles (520 km) northwest of Lima , not far from the popular Chicama beach . Most of the infections in Peru were bubonic plague, with four cases of pneumonic plague. The first recorded plague outbreak in Peru was in 1903. Prior to the above case, the last known outbreak was in 1994, killing 35 people. In November 2013, an outbreak of plague occurred in the African island nation of Madagascar . As of 16 December, at least 89 people were infected, with 39 deaths with at least two cases involving pneumonic plague. However, as many as 90% of cases were later reported to have involved pneumonic plague. From 23 August to 30 September 2017, a total of 73 suspected, probable, and confirmed cases of pneumonic plague, including 17 deaths, were reported in Madagascar. The diagnosis was confirmed by the Institut Pasteur de Madagascar by a polymerase chain reaction test, while field health workers used a Rapid Diagnostic Test. The WHO and Institut Pasteur de Madagascar were both involved in administering antibiotic compounds and attempting to stop the spread of the disease. By mid-October, there were an estimated 684 confirmed cases of plague with 474 pneumonic, 156 bubonic and one septicemic. The remainder were not classified. At least 74 deaths have been ascribed to pneumonic plague. The outbreak officially ended on 26 November 2017 with 2,348 cases and 202 deaths officially reported. In the fall of 1924, an outbreak occurred in Los Angeles that killed 30 people. On 2 November 2007, wildlife biologist Eric York died of pneumonic plague in Grand Canyon National Park . York was exposed to the bacteria while conducting a necropsy on a cougar carcass. In 2014, the Colorado Department of Public Health and Environment confirmed that a Colorado man had been diagnosed with pneumonic plague, the first confirmed human case in Colorado in more than 10 years, and one of only 60 cases since 1957. The man was found to have the disease after the family dog died unexpectedly and a necropsy revealed that the disease was the cause. Three additional pneumonic plague cases were confirmed in Colorado before the outbreak ended. Two outbreaks occurred in the Democratic Republic of the Congo in 2005 and 2006. The outbreak in 2005 was only detected by looking back at blood samples. The total death toll was 111.In September 1994, India experienced an outbreak of plague that killed 50 and caused travel to New Delhi by air to be suspended until the outbreak was brought under control. The outbreak was feared to be much worse because the plague superficially resembles other common diseases such as influenza and bronchitis; over 200 people that had been quarantined were released when they did not test positive for the plague. All but two of the deaths occurred around the city of Surat . [ citation needed ]A major outbreak of the pneumonic plague occurred in Manchuria from 1910 to 1911, in what became known as the Manchurian plague , killing around 60,000 people. The Qing court dispatched Wu Lien-teh , a doctor educated at Cambridge University , to oversee disease control and treatment efforts. He made the novel observation that the disease was transmitted by air , and developed prototypical respirators to help prevent its spread. A second, less deadly outbreak occurred in 1920–21, killing approximately 9,300 people. The People's Republic of China has eradicated pneumonic plague from most parts of the country, but still reports occasional cases in remote western areas, where the disease is carried by rats and the marmots that live across the Himalayan plateau . Outbreaks can be caused when a person eats an infected marmot or comes into contact with fleas carried by rats. A 2006 WHO report from an international meeting on plague cited a Chinese government disease expert as saying that most cases of the plague in China's northwest occur when hunters are contaminated while skinning infected animals. The expert said at the time that, due to the region's remoteness, the disease killed more than half the infected people. The report also said that since the 1990s, there was a rise in plague cases in humans—from fewer than 10 in the 1980s to nearly 100 cases in 1996 and 254 in 2000. In September 2008, two people in East Tibet died of pneumonic plague. An outbreak of the disease in China began in August 2009 in Ziketan Town located in Qinghai Province . The town was sealed off and several people died as a result of the disease. According to spokesperson Vivian Tan of the WHO office in Beijing , "In cases like this [in August 2009], we encourage the authorities to identify cases, to investigate any suspicious symptoms among close contacts, and to treat confirmed cases as soon as possible. So far, they have done exactly that. There have been sporadic cases reported around the country in the last few years so the authorities do have the experience to deal with this." In September 2010, five cases of pneumonic plague were reported in Tibet. In July 2014, Chinese media reported one case found in Gansu. On 12 November 2019, It was announced that two people from the Chinese province of Inner Mongolia were diagnosed with pneumonic plague. They received treatment in Chaoyang District, Beijing , and authorities implemented preventative control measures. Later in November, a third case of plague was confirmed. A 55-year-old man was diagnosed with bubonic plague after eating wild rabbit in Inner Mongolia. The region's health commission says it has no evidence to suggest that this case is linked to the previous two. By the end of November, a fourth case was confirmed. Chinese health authorities reported a fresh case of bubonic plague in the country's northern Inner Mongolia region, bringing the total number of reported plague cases originating from Inner Mongolia to four. In August 2010, Peru's health minister Oscar Ugarte announced that an outbreak of plague had killed a 14-year-old boy and had infected at least 31 people in a northern coastal province. The boy died of bubonic plague on 26 July 2010. Ugarte stated that authorities were screening sugar and fish meal exports from Ascope Province , located about 325 miles (520 km) northwest of Lima , not far from the popular Chicama beach . Most of the infections in Peru were bubonic plague, with four cases of pneumonic plague. The first recorded plague outbreak in Peru was in 1903. Prior to the above case, the last known outbreak was in 1994, killing 35 people. In November 2013, an outbreak of plague occurred in the African island nation of Madagascar . As of 16 December, at least 89 people were infected, with 39 deaths with at least two cases involving pneumonic plague. However, as many as 90% of cases were later reported to have involved pneumonic plague. From 23 August to 30 September 2017, a total of 73 suspected, probable, and confirmed cases of pneumonic plague, including 17 deaths, were reported in Madagascar. The diagnosis was confirmed by the Institut Pasteur de Madagascar by a polymerase chain reaction test, while field health workers used a Rapid Diagnostic Test. The WHO and Institut Pasteur de Madagascar were both involved in administering antibiotic compounds and attempting to stop the spread of the disease. By mid-October, there were an estimated 684 confirmed cases of plague with 474 pneumonic, 156 bubonic and one septicemic. The remainder were not classified. At least 74 deaths have been ascribed to pneumonic plague. The outbreak officially ended on 26 November 2017 with 2,348 cases and 202 deaths officially reported. In the fall of 1924, an outbreak occurred in Los Angeles that killed 30 people. On 2 November 2007, wildlife biologist Eric York died of pneumonic plague in Grand Canyon National Park . York was exposed to the bacteria while conducting a necropsy on a cougar carcass. In 2014, the Colorado Department of Public Health and Environment confirmed that a Colorado man had been diagnosed with pneumonic plague, the first confirmed human case in Colorado in more than 10 years, and one of only 60 cases since 1957. The man was found to have the disease after the family dog died unexpectedly and a necropsy revealed that the disease was the cause. Three additional pneumonic plague cases were confirmed in Colorado before the outbreak ended.

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Antonine Plague

The Antonine Plague of AD 165 to 180, also known as the Plague of Galen (after Galen , the Greek physician who described it), was a prolonged and destructive epidemic , which impacted the Roman Empire . It was possibly contracted and spread by soldiers who were returning from campaign in the Near East . Scholars generally believe the plague was smallpox , although measles has also been suggested, and recent genetic evidence strongly suggests that the most severe form smallpox only arose in Europe much later. In AD 169 the plague may have claimed the life of the Roman emperor Lucius Verus , who was co-regnant with Marcus Aurelius . These two emperors had risen to the throne by virtue of being adopted by the previous emperor, Antoninus Pius , and as a result, their family name, Antoninus, has become associated with the pandemic. Ancient sources agree that the plague is likely to have appeared during the Roman siege of the Mesopotamian city of Seleucia in the winter of 165–166, during the Parthian campaign of Lucius Verus . Ammianus Marcellinus reported that the plague spread to Gaul and to the legions along the Rhine . Eutropius stated that a large proportion of the empire's population died from this outbreak. According to the contemporary Roman historian Cassius Dio , the disease broke out again 9 years later in 189 AD and caused up to 2,000 deaths a day in the city of Rome , 25% of those who were affected. The total death count has been estimated at 5–10 million, roughly 10% of the population of the empire. The disease was particularly deadly in the cities and in the Roman army . The Antonine plague occurred during the last years of what is called the Pax Romana , the high point in the influence, territorial control, and population of the Roman Empire. Historians differ in their opinions of the impact of the plague on the empire in the increasingly troubled eras after its appearance. Historians have noted similar plagues in the Han Empire of China during the mid-to-late 2nd century AD that caused devastating effects there, at a time when ancient Chinese historians claimed diplomatic contacts were made with what they perceived to be the Roman Empire . Based on archaeological records, Roman commercial activity in the Indian Ocean extending to the Indian subcontinent and Southeast Asia from ports of Roman Egypt seems to have suffered a major setback after the plague.Epidemics were common in the ancient world, but the Antonine plague was the first known pandemic of the Roman Empire. The Antonine plague spread throughout the Roman Empire, and perhaps other areas, including China, and infected many millions of people. The pandemic erupted during the last years of what is often considered the "golden age" of Rome during the reign of co-emperor Marcus Aurelius . The Roman Empire at that time had a population estimated at 75 million people, about one-fourth of all human beings then living. Historians generally agree that the population of the Roman Empire peaked at about the time that the Antonine Plague appeared and, thereafter, population declined. The economic prosperity of the Roman Empire notwithstanding, the conditions were propitious for a pandemic. The population was unhealthy. About 20 percent of the population—a large percentage by ancient standards—lived in one of hundreds of cities; Rome, with a population estimated at one million, being the largest. The cities were a "demographic sink" even in the best of times. The death rate exceeded the birth rate and a constant in-migration of new residents was necessary to maintain the urban population. As perhaps more than one-half of children died before reaching adulthood, the average life expectancy at birth was only in the mid-twenties. Dense urban populations and poor sanitation contributed to the dangers of disease. The connectivity by land and sea between the vast territories of the Roman Empire made the transfer of infectious diseases from one region to another easier and more rapid than it was in smaller, more geographically confined societies. Epidemics of infectious diseases in the empire were common, with nine recorded between 43 BC and 148 AD. The rich were not immune to the unhealthy conditions. Only two of emperor Marcus Aurelius' fourteen children are known to have reached adulthood. A good indicator of nutrition and the disease burden is the average height of the population. The conclusion of the study of thousands of skeletons is that the average Roman was shorter in stature than the people of pre-Roman societies of Italy and the post-Roman societies of the Middle Ages. The view of historian Kyle Harper is that "not for the last time in history, a precocious leap forward in social development brought biological reverses". Despite increasing development, average height did not increase in Europe between 1000 and 1800, while it increased in the 5th and 6th centuries during late antiquity. The traditional Roman view attributed the cause of the Antonine plague to the violation by the Roman army of a temple in the city of Seleucia during the Parthian campaign of Lucius Verus , then the soldiers carried it back to the Roman Empire from the Parthian Empire in early 166. However, the first documented case of the plague was in Smyrna (in Roman Anatolia ) in 165 where the orator Aelius Aristides almost died from the disease. From the east the plague spread westward reaching Rome in 166 and nearly every corner of the empire by 172. The co-emperor Lucius Verus died from the plague in 169 and it ravaged the Roman army. The plague endured until about 180 and another epidemic, possibly related, is reported by Dio Cassius to have struck the city of Rome in 189. Two thousand people in the city often died on a single day. Whether this new epidemic, or recurrence of the Antonine plague, impacted the empire outside the city of Rome is unknown. In 166, during the epidemic, the Greek physician and writer Galen traveled from Rome to his home in Asia Minor and returned to Rome in 168, when he was summoned by the two Augusti , the co-emperors Marcus Aurelius and Lucius Verus . He was present at the outbreak among troops stationed at Aquileia in the winter of 168/69. Galen briefly recorded observations and a description of the epidemic in the treatise Methodus Medendi ("Method of Treatment"), and he scattered other references to it among his voluminous writings. He described the plague as "great" and of long duration, and mentioned fever , diarrhea , and pharyngitis as well as a skin eruption, sometimes dry and sometimes pustular , that appeared on the 9th day of the illness. The information that was provided by Galen does not unambiguously identify the nature of the disease, but scholars have generally preferred to diagnose it as smallpox . The historian William H. McNeill asserts that the Antonine Plague and the later Plague of Cyprian (251–c. 270) were outbreaks of two different diseases, one of smallpox and one of measles but not necessarily in that order. The severe devastation to the European population from the two plagues may indicate that people had no previous exposure to either disease, which brought immunity to survivors. Other historians believe that both outbreaks involved smallpox. The latter view is bolstered by molecular estimates that place the evolution of measles sometime after 1000 AD. However, Galen's description of the Antonine Plague is not completely consistent with smallpox. Historians differ in their assessment of the impact of the Antonine Plague on Rome. To some, the plague was the beginning of the decline of the Roman Empire. To others, it was a minor event, documented by Galen and other writers but only slightly more deadly than other epidemics which frequently ravaged parts of the empire. Estimates of the fatalities from the pandemic range from 2 to 33% of the Roman Empire's population with deaths between 1.5 and 25 million people. Most estimates coalesce around a fatality rate of about 10% (7.5 million people) of the total population of the empire with death rates of up to 15% in the cities and the army. If the pandemic was indeed smallpox, the number who died would have probably been about 25% of those infected as the survival rate from smallpox is often around 75%, or 3 out of 4 people infected. The traditional view was expressed by Barthold Georg Niebuhr (1776–1831) who concluded that "as the reign of Marcus Aurelius forms a turning point in so many things, and above all in literature and art, I have no doubt that this crisis was brought about by that plague ... The ancient world never recovered from the blow inflicted on it by the plague which visited it in the reign of Marcus Aurelius." More recently, scholar Kyle Harper said something similar: the pandemic "in any account of Rome's destiny ... merit[s] a place squarely in the forefront." To the contrary, a team of six historians questioned the "extreme" position of Harper and others on this plague as "ignoring scholarship that suggests it had a less than catastrophic outcome," but the historians affirmed that "we do not doubt that disease and climate had some of the impact Harper describes." Some historians have hypothesized that the epidemic resulted in a surge in the popularity of the cult of Asclepius , the god of medicine; the epigraphic record, however, shows no evidence of such increase in the cult's popularity. The ancient chroniclers portray the plague as a disaster for the Roman army with the army "reduced almost to extinction." This came in 166 at the beginning at the Marcomannic Wars in which Germanic tribes were invading Roman territory south of the middle Danube River in what is now the Czech Republic and Slovakia , and south to Italy. The impact of the plague forced Marcus Aurelius to recruit and train additional soldiers from among "gladiators, slaves, and bandits." After a delay of two years, in 169 the emperor launched an attack against the Germanic tribes. By 171, the Roman army had driven the invaders out of Roman territory. The war would continue sporadically until 180 when Marcus Aurelius died, possibly of the plague. The plague may also have impacted the Germanic tribes. The ancient chroniclers portray the plague as a disaster for the Roman army with the army "reduced almost to extinction." This came in 166 at the beginning at the Marcomannic Wars in which Germanic tribes were invading Roman territory south of the middle Danube River in what is now the Czech Republic and Slovakia , and south to Italy. The impact of the plague forced Marcus Aurelius to recruit and train additional soldiers from among "gladiators, slaves, and bandits." After a delay of two years, in 169 the emperor launched an attack against the Germanic tribes. By 171, the Roman army had driven the invaders out of Roman territory. The war would continue sporadically until 180 when Marcus Aurelius died, possibly of the plague. The plague may also have impacted the Germanic tribes. Although Ge Hong was the first writer of traditional Chinese medicine who accurately described the symptoms of smallpox, the historian Rafe de Crespigny mused that the plagues afflicting the Eastern Han Empire during the reigns of Emperor Huan of Han (r. 146–168) and Emperor Ling of Han (r. 168–189) – with outbreaks in 151, 161, 171, 173, 179, 182, and 185 – were perhaps connected to the Antonine plague on the western end of Eurasia . De Crespigny suggests that the plagues led to the rise of the cult faith healing millenarian movement led by Zhang Jue (d. 184), who instigated the disastrous Yellow Turban Rebellion (184–205). He also stated that "it may be only chance" that the outbreak of the Antonine plague in 166 coincides with the Roman embassy of " Daqin " (the Roman Empire) landing in Jiaozhi (northern Vietnam) and visiting the Han court of Emperor Huan, claiming to represent "Andun" ( 安敦 ; a transliteration of Marcus Aurelius Antoninus or his predecessor Antoninus Pius ). Raoul McLaughlin wrote that the Roman subjects visiting the Han Chinese court in 166 could have ushered in a new era of Roman Far East trade, but it was a "harbinger of something much more ominous" instead. McLaughlin surmised that the origins of the plague lay in Central Asia, from some unknown and isolated population group, which then spread to the Chinese and the Roman worlds. The plague caused "irreparable" damage to the Roman maritime trade in the Indian Ocean as proven by the archaeological record spanning from Egypt to India as well as significantly decreased Roman commercial activity in Southeast Asia . However, as evidenced by the 6th-century Christian Topography by Cosmas Indicopleustes , Roman maritime trade into the Indian Ocean, particularly in the silk and spice trades , certainly did not cease but continued until the loss of Egypt to the Muslim Rashidun Caliphate .

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The Plague Dogs

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Plague

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Great Plague of London

The Great Plague of London , lasting from 1665 to 1666, was the last major epidemic of the bubonic plague to occur in England . It happened within the centuries-long Second Pandemic , a period of intermittent bubonic plague epidemics that originated in Central Asia in 1331 (the first year of the Black Death ), and included related diseases such as pneumonic plague and septicemic plague , which lasted until 1750. The Great Plague killed an estimated 100,000 people—almost a quarter of London's population—in 18 months. The plague was caused by the Yersinia pestis bacterium , which is usually transmitted to a human by the bite of a flea or louse. The 1665–66 epidemic was on a much smaller scale than the earlier Black Death pandemic . It became known afterwards as the "great" plague mainly because it was the last widespread outbreak of bubonic plague in England during the 400-year Second Pandemic. The plague was endemic in 17th-century London, as it was in other European cities at the time. The disease periodically erupted into massive epidemics. There were 30,000 deaths due to the plague in 1603, 35,000 in 1625, 10,000 in 1636, and smaller numbers in other years. In late 1664, a bright comet was seen in the sky, and the people of London became fearful, wondering what evil event it portended. London at that time was a city of about 448 acres surrounded by a city wall that had originally been built to keep out raiding bands, and, in the south, by the River Thames . There were gates in the wall at Ludgate , Newgate , Aldersgate , Cripplegate , Moorgate , Bishopsgate and Aldgate , and the Thames was crossable at London Bridge . In the poorer parts of the city, filled with overcrowded tenements and garrets, hygiene was impossible to maintain. There was no sanitation, and open drains flowed along the centre of winding streets. The cobbles were slippery with animal droppings, rubbish and the slops thrown out of the houses; they were muddy and buzzing with flies in summer, and awash with sewage in winter. The City Corporation employed "rakers" to remove the worst of the filth, and it was transported to mounds outside the walls, where it accumulated and continued to decompose. The stench was overwhelming, and people walked around with handkerchiefs or nosegays pressed against their nostrils. Some of the city's necessities, such as coal, arrived by barge , but most came by road. Carts, carriages, horses and pedestrians were crowded together, and the gateways in the wall formed bottlenecks through which it was difficult to progress. The nineteen-arch London Bridge was even more congested. Those who were better-off used hackney carriages and sedan chairs to get to their destinations without getting filthy. The poor walked, and might be drenched by water tossed up by wheeled vehicles, slops thrown into the street, or water pouring off overhanging roofs. Another hazard was the choking black smoke belching forth from soap factories, breweries , iron smelters and about 15,000 households that were burning coal to heat their homes. Outside the city walls, shanty towns with wooden shacks and no sanitation had sprung up, providing homes for the craftsmen and tradespeople who had flocked to the already overcrowded city. The government had tried to limit the development of these "suburbs", but had failed: Over a quarter of a million people lived in them. When Royalists had fled the country during the Commonwealth , they had left many fine town houses vacant, and some immigrants to London had crowded into them, converting them into tenements that housed different families in every room. These properties were soon vandalised and became rat-infested. The City of London proper was administered by the Lord Mayor, the Aldermen and the common councillors, but some parts of the greater metropolitan area were not legally part of the city. Some of these areas, both inside the City walls and outside its boundaries, had long been organised into districts of various sizes, called " liberties ", that had historically been granted rights to self-government. (Many had originally been associated with the religious institutions that were abolished in the Dissolution of the Monasteries , whereupon their historic rights and property had been transferred to secular owners.) By 1665, the walled City was surrounded by a ring of liberties which had come under its authority, and these had come to be referred to collectively as 'the City and Liberties'. However, this area was surrounded by additional suburbs with other independent administrations. For example, Westminster was an independent town with its own liberties, joined to London by urban development, and the Tower of London was an independent liberty. Areas that were not part of any of these various independent administrations came under the authority of the county of Middlesex if they were north of the river, and under the authority of Surrey if they were south of the river. At that time, bubonic plague was a much feared disease, but its cause was not understood. Many mistakenly blamed emanations from the earth, "pestilential effluvia", unusual weather, sickness in livestock, abnormal behaviour of animals or an increase in the numbers of moles, frogs, mice or flies. It was not until 1894 that its causal agent, the bacterium Yersinia pestis , was identified by Alexandre Yersin , and its transmission by rat fleas became known. Although the Great Plague in London was long assumed to be bubonic plague, caused by Yersinia pestis , this was only confirmed (by DNA analysis) in 2016. It is now believed that human body lice also played a key role in causing infections, perhaps more so than rats. In order to judge the severity of an epidemic, it is first necessary to know how big the population was in which it occurred. There was no official census of the population to provide this figure, and the best contemporary count comes from the work of John Graunt (1620–1674), who was one of the earliest Fellows of the Royal Society and one of the first demographers , bringing a scientific approach to the collection of statistics. In 1662, he estimated that 384,000 people lived in the City of London, the Liberties, Westminster and the out-parishes, based on figures in the Bills of Mortality published each week in the capital. These different districts with different administrations constituted the officially recognized extent of London as a whole. In 1665, he revised his estimate to "not above 460,000". Other contemporaries put the figure higher (the French Ambassador, for example, suggested 600,000), but with no mathematical basis to support their estimates. The next largest city in the kingdom was Norwich , with a population of 30,000. There was no duty to report a death to anyone in authority. Instead, each parish appointed two or more " searchers of the dead ", whose duty was to inspect a corpse and determine the cause of death. A searcher was entitled to charge a small fee from relatives for each death they reported, and so habitually the parish would appoint someone to the post who would otherwise be destitute and would be receiving support from the parish poor rate. Typically, this meant searchers would be old women who were illiterate, might know little about identifying diseases and who would be open to dishonesty. Searchers would typically learn about a death either from the local sexton who had been asked to dig a grave or from the tolling of a church bell. Anyone who did not report a death to their local church, such as Quakers , Anabaptists , other non-Anglican Christians or Jews , frequently did not get included in the official records. Searchers during times of plague were required to live apart from the community, avoid other people and carry a white stick to warn of their occupation when outdoors, and stay indoors except when performing their duties, to avoid spreading the diseases. Searchers reported to the Parish Clerk, who made a return each week to the Company of Parish Clerks in Brode Lane. Figures were then passed to the Lord Mayor and then to the Minister of State once plague became a matter of national concern. The reported figures were used to compile the Bills of Mortality, which listed total deaths in each parish and whether by the plague. The system of Searchers to report the cause of death continued until 1836. Graunt recorded the incompetence of the Searchers at identifying true causes of death, remarking on the frequent recording of 'consumption' rather than other diseases which were recognized then by physicians. He suggested a cup of ale and a doubling of their fee to two groats rather than one was sufficient for Searchers to change the cause of death to one more convenient for the householders. No one wished to be known as having had a death by plague in their household, and Parish Clerks, too, connived in covering up cases of plague in their official returns. Analysis of the Bills of Mortality during the months plague took hold shows a rise in deaths other than by plague well above the average death rate, a tell-tale sign of misrepresentation of the true cause of death. As plague spread, a system of quarantine was introduced, whereby any house where someone had died from plague would be locked up and no one allowed to enter or leave for 40 days. This frequently led to the deaths of the other inhabitants, by neglect if not from the plague, and provided ample incentive not to report the disease. The official returns record 68,596 cases of plague, but a reasonable estimate suggests this figure is 30,000 short of the true total. A plague house was marked with a red cross on the door with the words "Lord have mercy upon us", and a watchman stood guard outside. Reports of plague around Europe began to reach England in the 1660s, causing the Privy Council to consider what steps might be taken to prevent it crossing to England. Quarantining (isolation) of ships had been used during previous outbreaks and was again introduced for ships coming to London in November 1663, following outbreaks in Amsterdam and Hamburg . Two naval ships were assigned to intercept any vessels entering the Thames estuary. Ships from infected ports were required to moor at Hole Haven on Canvey Island for a trentine – period of 30 days – before being allowed to travel up-river. Ships from ports free of plague or completing their isolation period were given a certificate of health and allowed to travel on. A second inspection line was established between the forts on opposite banks of the Thames at Tilbury and Gravesend with instructions to pass only ships with a certificate. The isolation period was increased to forty days – a quarantine – in May 1664 as the continental plague worsened, and the areas subject to quarantine changed with the news of the spread of plague to include all of Holland , Zeeland and Friesland (all regions of the Dutch Republic ); restrictions on Hamburg were removed in November. Quarantine measures against ships coming from the Dutch Republic were put in place in 29 other ports from May, starting with Great Yarmouth . The Dutch ambassador objected at the constraint of trade with his country, but England responded that it had been one of the last countries introducing such restrictions. Regulations were enforced quite strictly, so that people or houses where voyagers had come ashore without serving their quarantine were also subjected to 40 days of quarantine. Plague was one of the hazards of life in Britain from its dramatic appearance in 1348 with the Black Death. The Bills of Mortality began to be published regularly in 1603, in which year 33,347 deaths were recorded from plague. Between then and 1665, only four years had no recorded cases. In 1563, a thousand people were reportedly dying in London each week. In 1593, there were 15,003 deaths, 1625 saw 41,313 dead, between 1640 and 1646 came 11,000 deaths, culminating in 3,597 for 1647. The 1625 outbreak was recorded at the time as the 'Great Plague', until deaths from the plague of 1665 surpassed it. These official figures are likely to under-report actual numbers. Plague was sufficiently uncommon that medical practitioners might have had no personal experience of seeing the disease; medical training varied from those who had attended the college of physicians, to apothecaries who also acted as doctors, to charlatans. Other diseases abounded, such as an outbreak of smallpox the year before, and these uncertainties all added to difficulties identifying the true start of the epidemic. Contemporary accounts suggest cases of plague occurred through the winter of 1664–65, some of which were fatal but a number of which did not display the virulence of the later epidemic. The winter was cold, the ground frozen from December to March, river traffic on the Thames twice blocked by ice, and it may be that the cold weather held back its spread. This outbreak of bubonic plague in England is thought to have spread from the Netherlands, where the disease had been occurring intermittently since 1599. It is unclear exactly where the disease first struck but the initial contagion may have arrived with Dutch trading ships carrying bales of cotton from Amsterdam , which was ravaged by the disease in 1663–64, with a mortality given of 50,000. The first areas to be struck are believed to be the dock areas just outside London, and the parish of St Giles . In both of these localities, poor workers were crowded into ill-kept structures. Two suspicious deaths were recorded in St Giles parish in 1664 and another in February 1665. These did not appear as plague deaths on the Bills of Mortality, so no control measures were taken by the authorities, but the total number of people dying in London during the first four months of 1665 showed a marked increase. By the end of April, only four plague deaths had been recorded, two in the parish of St. Giles, but total deaths per week had risen from around 290 to 398. There had been three official cases in April, a level of plague which in earlier years had not induced any official response, but the Privy Council now acted to introduce household quarantine. Justices of the Peace in Middlesex were instructed to investigate any suspected cases and to shut up the house if it was confirmed. Shortly after, a similar order was issued by the King's Bench to the City and Liberties. A riot broke out in St. Giles when the first house was sealed up; the crowd broke down the door and released the inhabitants. Rioters caught were punished severely. Instructions were given to build pest-houses, which were essentially isolation hospitals built away from other people where the sick could be cared for (or stay until they died). This official activity suggests that despite the few recorded cases, the government was already aware that this was a serious outbreak of plague. With the arrival of warmer weather, the disease began to take a firmer hold. In the week 2–9 May, there were three recorded deaths in the parish of St Giles, four in neighbouring St Clement Danes and one each in St Andrew Holborn and St Mary Woolchurch Haw . Only the last was actually inside the city walls. A Privy Council committee was formed to investigate methods to best prevent the spread of plague, and measures were introduced to close some of the ale houses in affected areas and limit the number of lodgers allowed in a household. In the city, the Lord Mayor issued a proclamation that all householders must diligently clean the streets outside their property, which was a householder's responsibility, not a state one (the city employed scavengers and rakers to remove the worst of the mess). Matters just became worse, and Aldermen were instructed to find and punish those failing their duty. As cases in St. Giles began to rise, an attempt was made to quarantine the area and constables were instructed to inspect everyone wishing to travel and contain inside vagrants or suspect persons. People began to be alarmed. Samuel Pepys , who had an important position at the Admiralty , stayed in London and provided a contemporary account of the plague through his diary. On 30 April he wrote: "Great fears of the sickness here in the City it being said that two or three houses are already shut up. God preserve us all!" Another source of information on the time is A Journal of the Plague Year , which was written by Daniel Defoe and published in 1722. He had been only five when the plague struck but made use of his family's recollections (his uncle was a saddler in East London and his father a butcher in Cripplegate ), interviews with survivors and sight of such official records as were available. The onset of the disease was recalled two years later by Puritan minister Thomas Vincent : It was in the month of May that the Plague was first taken notice of; our Bill of Mortality did let us know but of three which died of the disease in the whole year before; but in the beginning of May the bill tells us of nine...fear quickly begins to creep upon peoples hearts; great thoughts and discourse there is in Town about the Plague, and they cast in their minds whether they should go if the Plague should increase. Yet when the next weeks Bill signifieth to them the disease from nine to three their minds are something appeased; discourse of that subject cools; fears are hushed, and hopes take place, that the black cloud did but threaten, and give a few drops; but the wind would drive it away. But when in the next Bill the number of the dead by the Plague is mounted from three to fourteen, and in the next to seventeen, and in the next to forty-three, and the disease begins so much to increase, and disperse. Now secure sinners begin to be startled, and those who would have slept at quiet still in their nests, are unwillingly awakened. By July 1665, plague was rampant in the City of London. The rich ran away, including King Charles II of England , his family and his court, who left the city for Salisbury , moving on to Oxford in September when some cases of plague occurred in Salisbury. The aldermen and most of the other city authorities opted to stay at their posts. The Lord Mayor of London , Sir John Lawrence , also decided to stay in the city. Businesses were closed when merchants and professionals fled. Defoe wrote "Nothing was to be seen but wagons and carts, with goods, women, servants, children, coaches filled with people of the better sort, and horsemen attending them, and all hurrying away". As the plague raged throughout the summer, only a small number of clergymen , physicians and apothecaries remained to cope with an increasingly large number of victims. Ellen Cotes, author of London's Dreadful Visitation , expressed the hope that "Neither the Physicians of our Souls or Bodies may hereafter in such great numbers forsake us". The poorer people were also alarmed by the contagion and some left the city, but it was not easy for them to abandon their accommodation and livelihoods for an uncertain future elsewhere. Before exiting through the city gates, they were required to possess a certificate of good health signed by the Lord Mayor and these became increasingly difficult to obtain. As time went by and the numbers of plague victims rose, people living in the villages outside London began to resent this exodus and were no longer prepared to accept townsfolk from London, with or without a certificate. The refugees were turned back, were not allowed to pass through towns and had to travel across country, and were forced to live rough on what they could steal or scavenge from the fields. Many died in wretched circumstances of starvation and dehydration in the hot summer that was to follow. In the last week of July, the London Bill of Mortality showed 3,014 deaths, of which 2,020 had died from the plague. The number of deaths as a result of plague may have been underestimated, as deaths in other years in the same period were much lower, at around 300. As the number of victims affected mounted up, burial grounds became overfull, and pits were dug to accommodate the dead. Drivers of dead-carts travelled the streets calling "Bring out your dead" and carted away piles of bodies. The authorities became concerned that the number of deaths might cause public alarm and ordered that body removal and interment should take place only at night. As time went on, there were too many victims, and too few drivers, to remove the bodies which began to be stacked up against the walls of houses. Daytime collection was resumed and the plague pits became mounds of decomposing corpses. In the parish of Aldgate, a great hole was dug near the churchyard, fifty feet long and twenty feet wide. Digging was continued by labourers at one end while the dead-carts tipped in corpses at the other. When there was no room for further extension it was dug deeper until ground water was reached at twenty feet. When finally covered with earth it housed 1,114 corpses. Plague doctors traversed the streets diagnosing victims, many of them without formal medical training. Several public health efforts were attempted. Physicians were hired by city officials and burial details were carefully organized, but panic spread through the city and, out of the fear of contagion, bodies were hastily buried in overcrowded pits. The means of transmission of the disease were not known but thinking they might be linked to the animals, the City Corporation ordered a cull of dogs and cats. This decision may have affected the length of the epidemic since those animals could have helped keep in check the rat population carrying the fleas which transmitted the disease. Thinking bad air was involved in transmission, the authorities ordered giant bonfires to be burned in the streets and house fires to be kept burning night and day, in the hope that the air would be cleansed. Tobacco was thought to be a prophylactic and it was later said that no London tobacconist had died from the plague during the epidemic. Trade and business had dried up, and the streets were empty of people except for the dead-carts and the dying victims, as witnessed and recorded by Samuel Pepys in his diary: "Lord! How empty the streets are and how melancholy, so many poor sick people in the streets full of sores… in Westminster, there is never a physician and but one apothecary left, all being dead." That people did not starve was down to the foresight of Sir John Lawrence and the Corporation of London who arranged for a commission of one farthing to be paid above the normal price for every quarter of corn landed in the Port of London. Another food source was the villages around London which, denied of their usual sales in the capital, left vegetables in specified market areas, negotiated their sale by shouting, and collected their payment after the money had been left submerged in a bucket of vinegar to "disinfect" the coins. Records state that plague deaths in London and the suburbs crept up over the summer from 2,000 people per week to over 7,000 per week in September. These figures are likely to be a considerable underestimate. Many of the sextons and parish clerks who kept the records themselves died. Quakers refused to co-operate and many of the poor were just dumped into mass graves unrecorded. It is not clear how many people caught the disease and made a recovery because only deaths were recorded and many records were destroyed in the Great Fire of London the following year. In the few districts where intact records remain, plague deaths varied between 30% and over 50% of the total population. Vincent wrote: it was very dismal to behold the red crosses, and read in great letters "LORD, HAVE MERCY UPON US" on the doors, and watchmen standing before them with halberds...people passing by them so gingerly, and with such fearful looks as if they had been lined with enemies in ambush to destroy them...a man at the corner of Artillery-wall, that as I judge, through the dizziness of his head with the disease, which seized upon him there, had dasht his face against the wall; and when I came by, he lay hanging with his bloody face over the rails, and bleeding upon the ground...I went and spoke to him; he could make no answer, but rattled in the throat, and as I was informed, within half an hour died in the place. It would be endless to speak of what we have seen and heard, of some in their frenzy, rising out of their beds, and leaping about their rooms; others crying and roaring at their windows; some coming forth almost naked, and running into the streets...scarcely a day passed over my head for, I think, a month or more together, but I should hear of the death of some one or more that I knew. The first day that they were smitten, the next day some hopes of recovery, and the third day, that they were dead. The outbreak was concentrated in London, but it affected other areas as well. Perhaps the best known example occurred in the village of Eyam in Derbyshire . The plague allegedly arrived with a merchant carrying a parcel of cloth sent from London. The villagers imposed a quarantine on themselves to stop the further spread of the disease. This prevented the disease from moving into surrounding areas, but around 33% of the village's inhabitants died over a period of fourteen months. Other places hit hard included Derby and Norwich . In Bristol strenuous efforts by the City Council seems to have limited the death rate to c.0.6 per cent during an outbreak lasting from April to September 1666. Plague was sufficiently uncommon that medical practitioners might have had no personal experience of seeing the disease; medical training varied from those who had attended the college of physicians, to apothecaries who also acted as doctors, to charlatans. Other diseases abounded, such as an outbreak of smallpox the year before, and these uncertainties all added to difficulties identifying the true start of the epidemic. Contemporary accounts suggest cases of plague occurred through the winter of 1664–65, some of which were fatal but a number of which did not display the virulence of the later epidemic. The winter was cold, the ground frozen from December to March, river traffic on the Thames twice blocked by ice, and it may be that the cold weather held back its spread. This outbreak of bubonic plague in England is thought to have spread from the Netherlands, where the disease had been occurring intermittently since 1599. It is unclear exactly where the disease first struck but the initial contagion may have arrived with Dutch trading ships carrying bales of cotton from Amsterdam , which was ravaged by the disease in 1663–64, with a mortality given of 50,000. The first areas to be struck are believed to be the dock areas just outside London, and the parish of St Giles . In both of these localities, poor workers were crowded into ill-kept structures. Two suspicious deaths were recorded in St Giles parish in 1664 and another in February 1665. These did not appear as plague deaths on the Bills of Mortality, so no control measures were taken by the authorities, but the total number of people dying in London during the first four months of 1665 showed a marked increase. By the end of April, only four plague deaths had been recorded, two in the parish of St. Giles, but total deaths per week had risen from around 290 to 398. There had been three official cases in April, a level of plague which in earlier years had not induced any official response, but the Privy Council now acted to introduce household quarantine. Justices of the Peace in Middlesex were instructed to investigate any suspected cases and to shut up the house if it was confirmed. Shortly after, a similar order was issued by the King's Bench to the City and Liberties. A riot broke out in St. Giles when the first house was sealed up; the crowd broke down the door and released the inhabitants. Rioters caught were punished severely. Instructions were given to build pest-houses, which were essentially isolation hospitals built away from other people where the sick could be cared for (or stay until they died). This official activity suggests that despite the few recorded cases, the government was already aware that this was a serious outbreak of plague. With the arrival of warmer weather, the disease began to take a firmer hold. In the week 2–9 May, there were three recorded deaths in the parish of St Giles, four in neighbouring St Clement Danes and one each in St Andrew Holborn and St Mary Woolchurch Haw . Only the last was actually inside the city walls. A Privy Council committee was formed to investigate methods to best prevent the spread of plague, and measures were introduced to close some of the ale houses in affected areas and limit the number of lodgers allowed in a household. In the city, the Lord Mayor issued a proclamation that all householders must diligently clean the streets outside their property, which was a householder's responsibility, not a state one (the city employed scavengers and rakers to remove the worst of the mess). Matters just became worse, and Aldermen were instructed to find and punish those failing their duty. As cases in St. Giles began to rise, an attempt was made to quarantine the area and constables were instructed to inspect everyone wishing to travel and contain inside vagrants or suspect persons. People began to be alarmed. Samuel Pepys , who had an important position at the Admiralty , stayed in London and provided a contemporary account of the plague through his diary. On 30 April he wrote: "Great fears of the sickness here in the City it being said that two or three houses are already shut up. God preserve us all!" Another source of information on the time is A Journal of the Plague Year , which was written by Daniel Defoe and published in 1722. He had been only five when the plague struck but made use of his family's recollections (his uncle was a saddler in East London and his father a butcher in Cripplegate ), interviews with survivors and sight of such official records as were available. The onset of the disease was recalled two years later by Puritan minister Thomas Vincent : It was in the month of May that the Plague was first taken notice of; our Bill of Mortality did let us know but of three which died of the disease in the whole year before; but in the beginning of May the bill tells us of nine...fear quickly begins to creep upon peoples hearts; great thoughts and discourse there is in Town about the Plague, and they cast in their minds whether they should go if the Plague should increase. Yet when the next weeks Bill signifieth to them the disease from nine to three their minds are something appeased; discourse of that subject cools; fears are hushed, and hopes take place, that the black cloud did but threaten, and give a few drops; but the wind would drive it away. But when in the next Bill the number of the dead by the Plague is mounted from three to fourteen, and in the next to seventeen, and in the next to forty-three, and the disease begins so much to increase, and disperse. Now secure sinners begin to be startled, and those who would have slept at quiet still in their nests, are unwillingly awakened. By July 1665, plague was rampant in the City of London. The rich ran away, including King Charles II of England , his family and his court, who left the city for Salisbury , moving on to Oxford in September when some cases of plague occurred in Salisbury. The aldermen and most of the other city authorities opted to stay at their posts. The Lord Mayor of London , Sir John Lawrence , also decided to stay in the city. Businesses were closed when merchants and professionals fled. Defoe wrote "Nothing was to be seen but wagons and carts, with goods, women, servants, children, coaches filled with people of the better sort, and horsemen attending them, and all hurrying away". As the plague raged throughout the summer, only a small number of clergymen , physicians and apothecaries remained to cope with an increasingly large number of victims. Ellen Cotes, author of London's Dreadful Visitation , expressed the hope that "Neither the Physicians of our Souls or Bodies may hereafter in such great numbers forsake us". The poorer people were also alarmed by the contagion and some left the city, but it was not easy for them to abandon their accommodation and livelihoods for an uncertain future elsewhere. Before exiting through the city gates, they were required to possess a certificate of good health signed by the Lord Mayor and these became increasingly difficult to obtain. As time went by and the numbers of plague victims rose, people living in the villages outside London began to resent this exodus and were no longer prepared to accept townsfolk from London, with or without a certificate. The refugees were turned back, were not allowed to pass through towns and had to travel across country, and were forced to live rough on what they could steal or scavenge from the fields. Many died in wretched circumstances of starvation and dehydration in the hot summer that was to follow. In the last week of July, the London Bill of Mortality showed 3,014 deaths, of which 2,020 had died from the plague. The number of deaths as a result of plague may have been underestimated, as deaths in other years in the same period were much lower, at around 300. As the number of victims affected mounted up, burial grounds became overfull, and pits were dug to accommodate the dead. Drivers of dead-carts travelled the streets calling "Bring out your dead" and carted away piles of bodies. The authorities became concerned that the number of deaths might cause public alarm and ordered that body removal and interment should take place only at night. As time went on, there were too many victims, and too few drivers, to remove the bodies which began to be stacked up against the walls of houses. Daytime collection was resumed and the plague pits became mounds of decomposing corpses. In the parish of Aldgate, a great hole was dug near the churchyard, fifty feet long and twenty feet wide. Digging was continued by labourers at one end while the dead-carts tipped in corpses at the other. When there was no room for further extension it was dug deeper until ground water was reached at twenty feet. When finally covered with earth it housed 1,114 corpses. Plague doctors traversed the streets diagnosing victims, many of them without formal medical training. Several public health efforts were attempted. Physicians were hired by city officials and burial details were carefully organized, but panic spread through the city and, out of the fear of contagion, bodies were hastily buried in overcrowded pits. The means of transmission of the disease were not known but thinking they might be linked to the animals, the City Corporation ordered a cull of dogs and cats. This decision may have affected the length of the epidemic since those animals could have helped keep in check the rat population carrying the fleas which transmitted the disease. Thinking bad air was involved in transmission, the authorities ordered giant bonfires to be burned in the streets and house fires to be kept burning night and day, in the hope that the air would be cleansed. Tobacco was thought to be a prophylactic and it was later said that no London tobacconist had died from the plague during the epidemic. Trade and business had dried up, and the streets were empty of people except for the dead-carts and the dying victims, as witnessed and recorded by Samuel Pepys in his diary: "Lord! How empty the streets are and how melancholy, so many poor sick people in the streets full of sores… in Westminster, there is never a physician and but one apothecary left, all being dead." That people did not starve was down to the foresight of Sir John Lawrence and the Corporation of London who arranged for a commission of one farthing to be paid above the normal price for every quarter of corn landed in the Port of London. Another food source was the villages around London which, denied of their usual sales in the capital, left vegetables in specified market areas, negotiated their sale by shouting, and collected their payment after the money had been left submerged in a bucket of vinegar to "disinfect" the coins. Records state that plague deaths in London and the suburbs crept up over the summer from 2,000 people per week to over 7,000 per week in September. These figures are likely to be a considerable underestimate. Many of the sextons and parish clerks who kept the records themselves died. Quakers refused to co-operate and many of the poor were just dumped into mass graves unrecorded. It is not clear how many people caught the disease and made a recovery because only deaths were recorded and many records were destroyed in the Great Fire of London the following year. In the few districts where intact records remain, plague deaths varied between 30% and over 50% of the total population. Vincent wrote: it was very dismal to behold the red crosses, and read in great letters "LORD, HAVE MERCY UPON US" on the doors, and watchmen standing before them with halberds...people passing by them so gingerly, and with such fearful looks as if they had been lined with enemies in ambush to destroy them...a man at the corner of Artillery-wall, that as I judge, through the dizziness of his head with the disease, which seized upon him there, had dasht his face against the wall; and when I came by, he lay hanging with his bloody face over the rails, and bleeding upon the ground...I went and spoke to him; he could make no answer, but rattled in the throat, and as I was informed, within half an hour died in the place. It would be endless to speak of what we have seen and heard, of some in their frenzy, rising out of their beds, and leaping about their rooms; others crying and roaring at their windows; some coming forth almost naked, and running into the streets...scarcely a day passed over my head for, I think, a month or more together, but I should hear of the death of some one or more that I knew. The first day that they were smitten, the next day some hopes of recovery, and the third day, that they were dead. The outbreak was concentrated in London, but it affected other areas as well. Perhaps the best known example occurred in the village of Eyam in Derbyshire . The plague allegedly arrived with a merchant carrying a parcel of cloth sent from London. The villagers imposed a quarantine on themselves to stop the further spread of the disease. This prevented the disease from moving into surrounding areas, but around 33% of the village's inhabitants died over a period of fourteen months. Other places hit hard included Derby and Norwich . In Bristol strenuous efforts by the City Council seems to have limited the death rate to c.0.6 per cent during an outbreak lasting from April to September 1666. By late autumn, the death toll in London and the suburbs began to slow until, in February 1666, it was considered safe enough for the King and his entourage to come back to the city. With the return of the monarch, others began to return: The gentry returned in their carriages accompanied by carts piled high with their belongings. The judges moved back from Windsor to sit in Westminster Hall ; Parliament , which had been prorogued in April 1665, did not reconvene until September 1666. Trade recommenced and businesses and workshops opened up. London was the goal of a new wave of people who flocked to the city in expectation of making their fortunes. Writing at the end of March 1666, Lord Clarendon , the Lord Chancellor , stated "... the streets were as full, the Exchange as much crowded, the people in all places as numerous as they had ever been seen ...". Plague cases continued to occur sporadically at a modest rate until mid-1666. That September, the Great Fire of London destroyed much of the City of London, and some people believed that the fire put an end to the epidemic. It is now thought that the plague had largely subsided before the fire took place. Most of the later cases of plague were found in the suburbs, and it was the City of London that was destroyed by the fire. According to the Bills of Mortality, there were in total 68,596 deaths in London from the plague in 1665. Lord Clarendon estimated that the true number of mortalities was probably twice that figure. 1666 saw further deaths in other cities but on a lesser scale. Dr Thomas Gumble , chaplain to the Duke of Albemarle , both of whom had stayed in London for the whole of the epidemic, estimated that the total death count for the country from plague during 1665 and 1666 was about 200,000. Among the more notable death victims were Samuel Fisher , John Godwin , John Lewger and George Starkey . The Great Plague of 1665/1666 was the last major outbreak of bubonic plague in Great Britain. The last recorded death from plague came in 1679, and it was removed as a specific category in the Bills of Mortality after 1703. It spread to other towns in East Anglia and the southeast of England but fewer than ten per cent of parishes outside London had a higher than average death rate during those years. Urban areas were more affected than rural ones; Norwich, Ipswich, Colchester, Southampton and Winchester were badly affected, while the west of England and areas of the English Midlands escaped altogether. The population of England in 1650 was approximately 5.25 million, which declined to about 4.9 million by 1680, recovering to just over 5 million by 1700. Other diseases, such as smallpox, took a high toll on the population without the contribution by plague. The higher death rate in cities, both generally and specifically from the plague, was made up by continuous immigration, from small towns to larger ones and from the countryside to the towns. There were no contemporary censuses of London's population, but available records suggest that the population returned to its previous level within a couple of years. Burials in 1667 had returned to 1663 levels, Hearth Tax returns had recovered, and John Graunt contemporarily analysed baptism records and concluded they represented a recovered population. Part of this could be accounted for by the return of wealthy households, merchants and manufacturing industries, all of which needed to replace losses among their staff and took steps to bring in necessary people. Colchester had suffered more severe depopulation, but manufacturing records for cloth suggested that production had recovered or even increased by 1669, and the total population had nearly returned to pre-plague levels by 1674. Other towns did less well: Ipswich was affected less than Colchester, but in 1674, its population had dropped by 18%, more than could be accounted for by the plague deaths alone. [ dubious – discuss ] As a proportion of the population who died, the London death toll was less severe than in some other towns. The total of deaths in London was greater than in any previous outbreak for 100 years, though as a proportion of the population, the epidemics in 1563, 1603 and 1625 were comparable or greater. Perhaps around 2.5% of the English population died. The plague in London largely affected the poor, as the rich were able to leave the city by either retiring to their country estates or residing with kin in other parts of the country. The subsequent Great Fire of London ruined many city merchants and property owners. As a result of these events, London was largely rebuilt and Parliament enacted the Rebuilding of London Act 1666 . The street plan of the capital remained relatively unchanged, but some improvements were made: streets were widened, pavements were created, open sewers abolished, wooden buildings and overhanging gables forbidden, and the design and construction of buildings controlled. The use of brick or stone was mandatory and many gracious buildings were constructed. Not only was the capital rejuvenated, but it became a healthier environment in which to live. Londoners had a greater sense of community after they had overcome the great adversities of 1665 and 1666. Rebuilding took over ten years and was supervised by Robert Hooke as Surveyor of London. The architect Sir Christopher Wren was involved in the rebuilding of St Paul's Cathedral and more than fifty London churches . King Charles II did much to foster the rebuilding work. He was a patron of the arts and sciences and founded the Royal Observatory and supported the Royal Society , a scientific group whose early members included Robert Hooke, Robert Boyle and Sir Isaac Newton . In fact, out of the fire and pestilence flowed a renaissance in the arts and sciences in England. Plague pits have been archaeologically excavated during underground construction work. Between 2011 and 2015, 3,500 burials from the ' New Churchyard ' or 'Bethlam burial ground' were discovered during the construction of the Crossrail railway at Liverpool Street. Yersinia pestis DNA was found in the teeth of individuals found buried in pits at the site, confirming they had died of bubonic plague.

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White plague

White plague may refer to:

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Septicemic plague

Septicemic plague is one of the three forms of plague , and is caused by Yersinia pestis , a gram-negative species of bacterium . Septicemic plague is a systemic disease involving infection of the blood and is most commonly spread by bites from infected fleas. Septicemic plague can cause disseminated intravascular coagulation and is always fatal when untreated. The other varieties of the plague are bubonic plague and pneumonic plague . The usual symptoms are: Abdominal pain Bleeding under the skin due to blood clotting problems Bleeding from mouth, nose or rectum Gastrointestinal symptoms, including nausea, vomiting, which can be with blood , and diarrhea Fever Chills Low blood pressure Organ failure Shock Death of tissue ( gangrene ) in extremities, mostly fingers, nose, and toes Difficulty breathing Death These symptoms are common to many human illnesses and are not considered, in and of themselves, to signify infection with any form of plague. [ citation needed ] It is important to note that septicemic plague may be asymptomatic and may cause death absent of any symptoms. [ citation needed ]Human Yersinia infections most commonly result from the bite of an infected flea or occasionally an infected mammal, but like most bacterial systemic diseases , the disease may be transmitted through an opening in the skin or by inhaling infectious droplets of moisture from sneezes or coughs. In both cases septicemic plague need not be the result, and in particular, not the initial result, but it occasionally happens that bubonic plague for example leads to infection of the blood, and septicemic plague results. If the bacteria happen to enter the bloodstream rather than the lymph or lungs, they multiply in the blood, causing bacteremia and severe sepsis . In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), where tiny blood clots form throughout the body, commonly resulting in localised ischemic necrosis , tissue death from lack of circulation and perfusion . [ citation needed ] DIC results in depletion of the body's clotting resources, so that it can no longer control bleeding. Consequently, the unclotted blood bleeds into the skin and other organs, leading to a red or black patchy rash and to hematemesis (vomiting blood) or hemoptysis (coughing up blood). The rash may cause bumps on the skin that look somewhat like insect bites, usually red, sometimes white in the centre. [ citation needed ] Septicemic plague is caused by horizontal and direct transmission. Horizontal transmission is the transmitting of a disease from one individual to another regardless of blood relation. Direct transmission occurs from close physical contact with individuals, through common air usage, or from direct bite from a flea or an infected rodent. Most common rodents may carry the bacteria and so may Leporidae such as rabbits. The bacteria are cosmopolitan, mainly in rodents on all continents except Australia and Antarctica. The greatest frequency of human plague infections occurs in Africa. The bacteria most commonly appear in rural areas and wherever there is poor sanitation, overcrowding, and high rodent populations in urban areas. Outdoor activities such as hiking, camping, or hunting where plague-infected animals may be found, increase the risk of contracting septicemic plague, and so do certain occupations such as veterinary or other animal-related work. Human Yersinia infections most commonly result from the bite of an infected flea or occasionally an infected mammal, but like most bacterial systemic diseases , the disease may be transmitted through an opening in the skin or by inhaling infectious droplets of moisture from sneezes or coughs. In both cases septicemic plague need not be the result, and in particular, not the initial result, but it occasionally happens that bubonic plague for example leads to infection of the blood, and septicemic plague results. If the bacteria happen to enter the bloodstream rather than the lymph or lungs, they multiply in the blood, causing bacteremia and severe sepsis . In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), where tiny blood clots form throughout the body, commonly resulting in localised ischemic necrosis , tissue death from lack of circulation and perfusion . [ citation needed ] DIC results in depletion of the body's clotting resources, so that it can no longer control bleeding. Consequently, the unclotted blood bleeds into the skin and other organs, leading to a red or black patchy rash and to hematemesis (vomiting blood) or hemoptysis (coughing up blood). The rash may cause bumps on the skin that look somewhat like insect bites, usually red, sometimes white in the centre. [ citation needed ] Septicemic plague is caused by horizontal and direct transmission. Horizontal transmission is the transmitting of a disease from one individual to another regardless of blood relation. Direct transmission occurs from close physical contact with individuals, through common air usage, or from direct bite from a flea or an infected rodent. Most common rodents may carry the bacteria and so may Leporidae such as rabbits. The bacteria are cosmopolitan, mainly in rodents on all continents except Australia and Antarctica. The greatest frequency of human plague infections occurs in Africa. The bacteria most commonly appear in rural areas and wherever there is poor sanitation, overcrowding, and high rodent populations in urban areas. Outdoor activities such as hiking, camping, or hunting where plague-infected animals may be found, increase the risk of contracting septicemic plague, and so do certain occupations such as veterinary or other animal-related work. A doctor or veterinarian will perform a physical exam which includes asking about the medical history and possible sources of exposure. The following possible test could include: Blood samples (detecting antibodies) Culture samples of body fluids (check for the bacteria Yersinia pestis ) Kidney and liver testing Checking lymphatic system for signs of infection Examining body fluids for abnormal signs Checking for swelling Checking for signs of dehydration Checking for fever Checking for lung infection The following steps and precautions should be used to avoid infection of the septicemic plague: Caregivers of infected patients should wear masks, gloves, goggles and gowns Take antibiotics if close contact with the infected patient has occurred Use insecticides throughout the house Avoid contact with dead rodents or sick cats Set traps if mice or rats are present around the house Do not allow family pets to roam in areas where plague is common Flea control and treatment for animals (especially rodents)Starting antibiotics early is the first step in treating septicemic plague in humans. One of the following antibiotics may be used: [ citation needed ] Lymph nodes may require draining and the patient will need close monitoring. In animals, antibiotics such as tetracycline or doxycycline can be used. Intravenous drip may be used to assist in dehydration scenarios. Flea treatment can also be used. In some cases, euthanasia may be the best option for treatment and to prevent further spreading. Untreated septicemic plague is almost always fatal. Early treatment with antibiotics reduces the mortality rate to between 4 and 15 per cent. Death is almost inevitable if treatment is delayed more than about 24 hours, and some people may even die on the same day they present with the disease. [ citation needed ]In 2015, Taylor Gaes, a 16-year-old in Larimer County in northern Colorado, contracted septicemic plague and subsequently died after being bitten by a flea that had bitten a rodent on his family's rural property. Only three people in Colorado had contracted the bacteria in the previous thirty years. The septicemic plague was the least common of the three plague varieties that occurred during the Black Death from 1348 to 1350 (the other two being bubonic plague and pneumonic plague ). Like the others, septicemic plague spread from East Asia through trade routes on the Black Sea and down to the Mediterranean Sea . [ citation needed ] Major port cities and trade centres such as Venice and Florence were hit the hardest. The massive loss of the working population in Europe following the Black Death, resulting in the increased economic bargaining power of the serf labour force, was a major precipitating factor for the Peasants' Revolt of 1381. [ citation needed ]Septicemic plague is a zoonosis , a disease that generally is acquired by humans from animals, such as rodents and carnivores. Goats, sheep and camels also may carry the bacteria. Cats rarely develop clinical signs but can be infected. Areas west of the Great Plains of North America are one region where plague-infected animals commonly occur. Plague-infested animals are found in many other countries as well, especially in developing countries where health controls are not effective. [ citation needed ] Animals that commonly carry plague bacteria are large rodents and Leporidae , but carnivores sometimes also become infected by their prey. Prey animals are not immune to the disease, and outbreaks of various strains of plague, such as sylvatic plague , have on occasion devastated populations of black-tailed prairie dogs and black-footed ferrets . Plague has been active in black-tailed prairie dog populations since the 1960s. In the United States outbreaks only occur in the western States and they are devastating, with mortality rates near 100% because the animals have no immunity to the plague. Survivors are the ones that happened not to become infected and colonies that recover from a plague outbreak remain at risk. Because black-footed ferrets prey on black-tailed prairie dogs, wild ferret populations also fall victim to sylvatic plague. An outbreak can kill nearly 100% of ferrets in a population, and surviving ferrets commonly face starvation because prairie dogs are their main prey. Spray-and-vaccinate campaigns have aimed at preventing the spread of the plague among these animals. Similar septicemic problems occur in many countries across the world, especially in developing countries where spending on health systems is very low and health controls are not effective. [ citation needed ]

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Plague

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Plague of Cyprian

The Plague of Cyprian was a pandemic that afflicted the Roman Empire from about AD 249 to 262, or 251/2 to 270. The plague is thought to have caused widespread manpower shortages for food production and the Roman army , severely weakening the empire during the Crisis of the Third Century . Its modern name commemorates St. Cyprian , bishop of Carthage , an early Christian writer who witnessed and described the plague. The agent of the plague is highly speculative because of sparse sourcing, but suspects have included smallpox , measles , and viral haemorrhagic fever ( filoviruses ) like the Ebola virus . There are no accounts comprehensive enough to estimate the total number of deaths of the plague in the Roman Empire. At the height of the outbreak, 5,000 people a day were said to be dying in Rome . One historian has calculated that the population of Alexandria dropped from 500,000 to 190,000 during the plague. Some of the decline in the city's population was probably due to people fleeing. Pope Dionysus the Great wrote about the plague's effects in Alexandria soon after the Decian persecution of 250 or Valerian persecutions of 257, as reported by Eusebius: Now, alas! all is lamentation, everyone is mourning, and the city resounds with weeping because of the numbers that have died and are dying every day. As Scripture says of the firstborn of the Egyptians, so now there has been a great cry: there is not a house in which there is not one dead - how I wish it had been only one! (...) The most brilliant festival of all was kept by the fulfilled martyrs, who were feasted in heaven. After that came war and famine, which struck at Christian and heathen alike. We alone had to bear the injustices they did to us, but we profited by what they did to each other and suffered at each other's hands; so yet again we found joy in the peace which Christ has given to us alone. But when both we and they had been allowed a tiny breathing-space, out of the blue came this disease, a thing more terrifying to them than any terror, more frightful than any disaster whatever... Cyprian's biographer, Pontius of Carthage , wrote of the plague at Carthage : Afterwards there broke out a dreadful plague, and excessive destruction of a hateful disease invaded every house in succession of the trembling populace, carrying off day by day with abrupt attack numberless people, every one from his own house. All were shuddering, fleeing, shunning the contagion, impiously exposing their own friends, as if with the exclusion of the person who was sure to die of the plague, one could exclude death itself also. There lay about the meanwhile, over the whole city, no longer bodies, but the carcasses of many, and, by the contemplation of a lot which in their turn would be theirs, demanded the pity of the passers-by for themselves. No one regarded anything besides his cruel gains. No one trembled at the remembrance of a similar event. No one did to another what he himself wished to experience. In Carthage, the Decian persecution , unleashed at the onset of the plague, perhaps inadvertently led to the criminalization of Christians' refusal to take an oath. Fifty years later, a North African convert to Christianity , Arnobius , defended his new religion from pagan allegations: [...] that a plague was brought upon the earth after the Christian religion came into the world, and after it revealed the mysteries of hidden truth? But pestilences, say my opponents, and droughts, wars, famines, locusts, mice, and hailstones, and other hurtful things, by which the property of men is assailed, the gods bring upon us, incensed as they are by your wrong-doings and by your transgressions. Cyprian drew moralizing analogies in his sermons to the Christian community and drew a word picture of the plague's symptoms in his essay De mortalitate ("On the Plague"): This trial, that now the bowels, relaxed into a constant flux, discharge the bodily strength; that a fire originated in the marrow ferments into wounds of the fauces ; that the intestines are shaken with a continual vomiting; that the eyes are on fire with the injected blood; that in some cases the feet or some parts of the limbs are taken off by the contagion of diseased putrefaction; that from the weakness arising by the maiming and loss of the body, either the gait is enfeebled, or the hearing is obstructed, or the sight darkened;—is profitable as a proof of faith. What a grandeur of spirit it is to struggle with all the powers of an unshaken mind against so many onsets of devastation and death! what sublimity, to stand erect amid the desolation of the human race, and not to lie prostrate with those who have no hope in God ; but rather to rejoice, and to embrace the benefit of the occasion; that in thus bravely showing forth our faith, and by suffering endured, going forward to Christ by the narrow way that Christ trod, we may receive the reward of His life and faith according to His own judgment! Accounts of the plague date it about AD 251 to 262. There was a later incident in 270 that involved the death of Claudius II Gothicus , but it is unknown if this was the same plague or a different outbreak. According to the Historia Augusta , "in the consulship of Antiochianus and Orfitus the favour of heaven furthered Claudius' success. For a great multitude, the survivors of the barbarian tribes, who had gathered in Haemimontum were so stricken with famine and pestilence that Claudius now scorned to conquer them further ... during this same period the Scythians [ Goths ] attempted to plunder in Crete and Cyprus as well, but everywhere their armies were likewise stricken with pestilence and so were defeated". Contemporary sources indicate that the plague originated in Aethiopia , but treating Aethiopia as the source of contagious diseases goes at least as far back as Thucydides ' account of the Plague of Athens . That the plague reached Alexandria at least one year before it reached Rome, however, is a mark in favour of an East African origin. The severe devastation to the European population from the two plagues may indicate that the population had no previous exposure or immunity to the plague's cause. The historian William Hardy McNeill asserts that both the earlier Antonine Plague (166–180) and the Plague of Cyprian (251–270) were the first transfers from animal hosts to humanity of two different diseases, one of smallpox and one of measles, but not necessarily in that order. Dionysios Stathakopoulos asserts that both outbreaks were of smallpox. According to the historian Kyle Harper, the symptoms attributed by ancient sources to the Plague of Cyprian better match a viral disease causing a hemorrhagic fever , such as Ebola , rather than smallpox. (Conversely, Harper believes that the Antonine Plague was caused by smallpox.) According to Harper, the plague nearly saw the end of the Roman Empire, and in the period between AD 248 and 268, "the history of Rome is a confusing tangle of violent failures. The structural integrity of the imperial machine burst apart. The frontier system crumbled. The collapse of legitimacy invited one usurper after another to try for the throne. The empire fragmented and only the dramatic success of later emperors in putting the pieces back together prevented this moment from being the final act of Roman imperial history." Both the threat of imminent death from the plague and the unwavering conviction among many of the Christian clergy in the face of it won many converts to that religion.

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Plague

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New York University

New York University ( NYU ) is a private research university in New York City , United States . Chartered in 1831 by the New York State Legislature , NYU was founded in 1832 by a group of New Yorkers led by Albert Gallatin as a non-denominational all-male institution near City Hall based on a curriculum focused on a secular education . The university moved in 1833 and has maintained its main campus in Greenwich Village surrounding Washington Square Park . Since then, the university has added an engineering school in Brooklyn's MetroTech Center and graduate schools throughout Manhattan . NYU has become the largest private university in the United States by enrollment, with a total of 51,848 enrolled students, including 26,733 undergraduate students and 25,115 graduate students in 2019. It is one of the most applied-to schools in the country and admissions are considered selective. NYU's main campus in New York City is organized into ten undergraduate schools, including the College of Arts & Science , Gallatin School , Steinhardt School , Stern School of Business , Tandon School of Engineering , and Tisch School of the Arts . NYU's 15 graduate schools include the Grossman School of Medicine , School of Law , Wagner Graduate School of Public Service , School of Professional Studies , Silver School of Social Work , and Rory Meyers School of Nursing . The university's internal academic centers include the Courant Institute of Mathematical Sciences , Center for Data Science , Center for Neural Science , Clive Davis Institute , Institute for the Study of the Ancient World , Institute of Fine Arts , and the NYU Langone Health System . NYU is a global university system with degree-granting portal campuses at NYU Abu Dhabi in United Arab Emirates and NYU Shanghai in China , and academic learning centers in Accra , Berlin , Buenos Aires , Florence , London , Los Angeles , Madrid , Paris , Prague , Sydney , Tel Aviv , and Washington, D.C. Past and present faculty and alumni include 39 Nobel Laureates, 8 Turing Award winners, 5 Fields Medalists, 31 MacArthur Fellows , 26 Pulitzer Prize winners, 3 heads of state , 5 U.S. governors , 12 U.S. senators , 58 members of the U.S. House of Representatives .Albert Gallatin , Secretary of the Treasury under Thomas Jefferson and James Madison , declared his intention to establish "in this immense and fast-growing city ... a system of rational and practical education fitting and graciously opened to all." A three-day-long "literary and scientific convention" held in City Hall in 1830 and attended by over 100 delegates debated the terms of a plan for a new university. These New Yorkers believed the city needed a university designed for young men who would be admitted based upon merit rather than birthright or social class. On April 18, 1831, the institution that would become NYU was established with the support of a group of prominent New York City residents from the city's merchants , bankers , and traders . Albert Gallatin was elected as its first president. On April 21, 1831, the new institution received its charter and was incorporated as the University of the City of New York by the New York State Legislature ; older documents often refer to it by that name. The university has been popularly known as New York University since its inception and was officially renamed New York University in 1896. In 1832, NYU held its first classes in rented rooms of four-story Clinton Hall, situated near City Hall. In 1835, the School of Law , NYU's first professional school, was established. Although the impetus to found a new school was partly a reaction by evangelical Presbyterians to what they perceived as the Episcopalianism of Columbia College , NYU was created non-denominational , unlike many American colleges at the time. The American Chemical Society was founded in 1876 at NYU. Soon after its founding, it became one of the nation's largest universities, with an enrollment of 9,300 in 1917. The university purchased a campus at University Heights in the Bronx because of overcrowding on the old campus. NYU also had a desire to follow New York City's development further uptown. NYU's move to the Bronx occurred in 1894, spearheaded by the efforts of Chancellor Henry Mitchell MacCracken . The University Heights campus was far more spacious than its predecessor was. As a result, most of the university's operations, along with the undergraduate College of Arts and Science and School of Engineering, were housed there. NYU's administrative operations were moved to the new campus, but the graduate schools of the university remained at Washington Square. In 1914, Washington Square College was founded as the downtown undergraduate college of NYU. [ citation needed ] In 1935, NYU opened the "Nassau College-Hofstra Memorial of New York University at Hempstead, Long Island." This extension would later become a fully independent Hofstra University . In 1950, NYU was elected to the Association of American Universities , a nonprofit organization of leading public and private research universities. Financial crisis gripped the New York City government in the late 1960s and early 1970s, and the troubles spread to the city's institutions, including NYU. Feeling the pressures of imminent bankruptcy, NYU President James McNaughton Hester negotiated the sale of the University Heights campus to the City University of New York , which occurred in 1973. In 1973, the New York University School of Engineering and Science merged into Polytechnic Institute of Brooklyn , which eventually merged back into NYU in 2014, forming the present Tandon School of Engineering . After the sale of the Bronx campus, University College merged with Washington Square College. In the 1980s, under the leadership of President John Brademas , NYU launched a billion-dollar campaign that was led by Naomi B. Levine and was spent almost entirely on updating facilities. The campaign was set to complete in 15 years, but ended up being completed in 10. In 1991, L. Jay Oliva was inaugurated the 14th president of the university. Following his inauguration, he moved to form the League of World Universities , an international organization consisting of rectors and presidents from urban universities across six continents. The league and its 47 representatives gather every two years to discuss global issues in education . In 2003, President John Sexton launched a $2.5 billion campaign for funds to be spent especially on faculty and financial aid resources. Under Sexton's leadership, NYU also began its transformation into a global university, including the opening of a campus in Abu Dhabi in 2010. Mortgage loans issued to some administrators and faculty by the university were criticized following published reports of August 2013, detailing terms of the loans, including that the school had issued some which approached zero percent interest rates, and some that were partially forgiven. Uniquely, among universities, the school had also issued multi-million-dollar loans for luxury vacation homes. President Sexton would step down at the end of his term in 2016, in the wake of a vote of no confidence in March 2013, closely followed by controversy over having received a vacation home loan from NYU. In August 2018, the New York University Grossman School of Medicine announced it would be offering full-tuition scholarships to all current and future students in its MD program regardless of need or merit, making it the only top-10 medical school in the United States to do so. In Spring 2022, President Andrew D. Hamilton announced that the 2023 academic year would be his last, and that he would be returning to research. He will be succeeded by Linda G. Mills , the university's first female president. From 2007 to 2018, NYU experienced a 114% increase in applications to its university system, increasing from around 35,000 applicants to more than 100,000 in 2020. This has also caused the acceptance rate to drop significantly, with a record-low acceptance rate of 8% in 2023 and 2024. In parallel to NYU's expansion in the early 1900s, the university similarly expanded vigorously in the early 2000s, becoming the largest private university in the United States with a combined undergraduate/graduate enrollment of over 59,000 students as of 2018 [ update ] . The university logo, the upheld torch , is derived from the Statue of Liberty , signifying NYU's service to New York City. The torch is depicted on both the NYU seal and the more abstract NYU logo, designed in 1965 by renowned graphic designer Tom Geismar of the branding and design firm Chermayeff & Geismar . There are at least two versions of the possible origin of the university color, violet . Some believe that it may have been chosen because violets are said to have grown abundantly in Washington Square and around the buttresses of the Old University Building. Others argue that the color may have been adopted because the violet was the flower associated with Athens , the center of learning in ancient Greece . Washington Square and Greenwich Village have been hubs of cultural life in New York City since the early 19th century. Much of this culture has intersected with NYU at various points in its history. Artists of the Hudson River School , the United States' first prominent school of painters, settled around Washington Square. Samuel F.B. Morse , a noted artist who also pioneered the telegraph and created the Morse Code, served as the first chair of Painting and Sculpture. He and Daniel Huntington were early tenants of the Old University Building in the mid-19th century. (The university rented out studio space and residential apartments within the "academic" building.) As a result, they had notable interaction with the cultural and academic life of the university. In the 1870s, sculptors Augustus Saint-Gaudens and Daniel Chester French lived and worked near the Square. By the 1920s, Washington Square Park was nationally recognized as a focal point for artistic and moral rebellion. As such, the Washington Square campus became more diverse and bustled with urban energy, contributing to academic change at NYU. Famed residents of this time include Eugene O'Neill , John Sloan , and Maurice Prendergast . In the 1930s, the abstract expressionists Jackson Pollock and Willem de Kooning , and the realists Edward Hopper and Thomas Hart Benton had studios around Washington Square. In the 1960s the area became one of the centers of the beat and folk generation, when Allen Ginsberg and Bob Dylan settled there. This led to tension with the university, which at the time was in the midst of an aggressive facilities expansion phase. In 1975, the university opened The Grey Art Gallery at 100 Washington Square East, housing the NYU art collection and featuring museum quality exhibitions. NYU has successfully completed a seven-year, $2.5 billion campaign, surpassing expectations by raising more than $3 billion over the seven-year period. Started in 2001, this campaign was the university's largest in its history, in which they planned to "raise $1 million per day for scholarships and financial aid, faculty building, new academic initiatives, and enhancing NYU's physical facilities." The campaign included a $50 million gift from the Tisch family (after which one building and the art school are named) and a $60 million gift from six trustees called "The Partners Fund", aimed at hiring new faculty. On October 15, 2007, the university announced that the Silver family donated $50 million to the School of Social Work , which will be renamed as a result. This is the largest donation ever to a school of social work in the United States. The 2007–2008 academic year was the most successful fundraising year to date for NYU, with the school raising $698 million in only the first 11 months of the year, representing a 70% increase in donations from the prior year. The university also recently announced plans for NYU's Call to Action, a new initiative to ask alumni and donors to support financial aid for students at NYU. The university has announced a 25-year strategic development plan, scheduled to coincide with its bicentennial in 2031. Included in the "NYU 200" plans are increasing resident and academic space, hiring additional faculty, and involving the New York City community in a transparent planning process. Additionally, NYU hopes to make their buildings more environmentally friendly, which will be facilitated by an evaluation of all campus spaces. As a part of this plan, NYU purchased 118 million kilowatt-hours of wind power during the 2006–2007 academic year – the largest purchase of wind power by any university in the country and any institution in New York City. For 2007, the university expanded its purchase of wind power to 132 million kilowatt-hours. As a result, the EPA ranked NYU as one of the greenest colleges in the country in its annual College & University Green Power Challenge. NYU consistently ranks as one of the top fundraising institutions in the country, raising $506.4 million in 2015 and $648 million in 2016. NYU is also the 19th wealthiest university in America with $5.3 billion in cash and investments in fiscal year 2014. From 2007 to 2018, NYU experienced a 114% increase in applications to its university system, increasing from around 35,000 applicants to more than 100,000 in 2020. This has also caused the acceptance rate to drop significantly, with a record-low acceptance rate of 8% in 2023 and 2024. In parallel to NYU's expansion in the early 1900s, the university similarly expanded vigorously in the early 2000s, becoming the largest private university in the United States with a combined undergraduate/graduate enrollment of over 59,000 students as of 2018 [ update ] .The university logo, the upheld torch , is derived from the Statue of Liberty , signifying NYU's service to New York City. The torch is depicted on both the NYU seal and the more abstract NYU logo, designed in 1965 by renowned graphic designer Tom Geismar of the branding and design firm Chermayeff & Geismar . There are at least two versions of the possible origin of the university color, violet . Some believe that it may have been chosen because violets are said to have grown abundantly in Washington Square and around the buttresses of the Old University Building. Others argue that the color may have been adopted because the violet was the flower associated with Athens , the center of learning in ancient Greece .Washington Square and Greenwich Village have been hubs of cultural life in New York City since the early 19th century. Much of this culture has intersected with NYU at various points in its history. Artists of the Hudson River School , the United States' first prominent school of painters, settled around Washington Square. Samuel F.B. Morse , a noted artist who also pioneered the telegraph and created the Morse Code, served as the first chair of Painting and Sculpture. He and Daniel Huntington were early tenants of the Old University Building in the mid-19th century. (The university rented out studio space and residential apartments within the "academic" building.) As a result, they had notable interaction with the cultural and academic life of the university. In the 1870s, sculptors Augustus Saint-Gaudens and Daniel Chester French lived and worked near the Square. By the 1920s, Washington Square Park was nationally recognized as a focal point for artistic and moral rebellion. As such, the Washington Square campus became more diverse and bustled with urban energy, contributing to academic change at NYU. Famed residents of this time include Eugene O'Neill , John Sloan , and Maurice Prendergast . In the 1930s, the abstract expressionists Jackson Pollock and Willem de Kooning , and the realists Edward Hopper and Thomas Hart Benton had studios around Washington Square. In the 1960s the area became one of the centers of the beat and folk generation, when Allen Ginsberg and Bob Dylan settled there. This led to tension with the university, which at the time was in the midst of an aggressive facilities expansion phase. In 1975, the university opened The Grey Art Gallery at 100 Washington Square East, housing the NYU art collection and featuring museum quality exhibitions. NYU has successfully completed a seven-year, $2.5 billion campaign, surpassing expectations by raising more than $3 billion over the seven-year period. Started in 2001, this campaign was the university's largest in its history, in which they planned to "raise $1 million per day for scholarships and financial aid, faculty building, new academic initiatives, and enhancing NYU's physical facilities." The campaign included a $50 million gift from the Tisch family (after which one building and the art school are named) and a $60 million gift from six trustees called "The Partners Fund", aimed at hiring new faculty. On October 15, 2007, the university announced that the Silver family donated $50 million to the School of Social Work , which will be renamed as a result. This is the largest donation ever to a school of social work in the United States. The 2007–2008 academic year was the most successful fundraising year to date for NYU, with the school raising $698 million in only the first 11 months of the year, representing a 70% increase in donations from the prior year. The university also recently announced plans for NYU's Call to Action, a new initiative to ask alumni and donors to support financial aid for students at NYU. The university has announced a 25-year strategic development plan, scheduled to coincide with its bicentennial in 2031. Included in the "NYU 200" plans are increasing resident and academic space, hiring additional faculty, and involving the New York City community in a transparent planning process. Additionally, NYU hopes to make their buildings more environmentally friendly, which will be facilitated by an evaluation of all campus spaces. As a part of this plan, NYU purchased 118 million kilowatt-hours of wind power during the 2006–2007 academic year – the largest purchase of wind power by any university in the country and any institution in New York City. For 2007, the university expanded its purchase of wind power to 132 million kilowatt-hours. As a result, the EPA ranked NYU as one of the greenest colleges in the country in its annual College & University Green Power Challenge. NYU consistently ranks as one of the top fundraising institutions in the country, raising $506.4 million in 2015 and $648 million in 2016. NYU is also the 19th wealthiest university in America with $5.3 billion in cash and investments in fiscal year 2014. NYU's New York City campus includes more than 171 buildings spread between Manhattan and Brooklyn . Most of the school's buildings in Manhattan are located across a roughly 230-acre (93 ha) area bounded by Houston Street to the south, Broadway to the east, 14th Street to the north, and Sixth Avenue (Avenue of the Americas) to the west. The core of NYU consists of buildings that surround Washington Square Park. In addition to its New York campus, NYU has 49 additional buildings overseas located throughout two 'portal' campuses and 12 Global Academic Centers. Since the late 1970s, the central part of NYU has been its Washington Square campus in the heart of Greenwich Village. The Washington Square Arch is an unofficial symbol of NYU. Until 2007, NYU had held its commencement ceremonies in Washington Square Park, but because of renovations to Washington Square moved the 2008 ceremonies to the original Yankee Stadium and all subsequent ones to the current Yankee Stadium . The Silver Center for Arts and Science , home to the College of Arts & Science and the Graduate School of Arts & Science , is one of the main academic buildings on the Washington Square campus. It is located on Washington Square East, between Washington Place and Waverly Place , and many individual departments of the two schools it houses are located in its vicinity. Meanwhile, Vanderbilt Hall, the main building for the School of Law , is located near the southwest corner of Washington Square between Macdougal Street and Sullivan Street on Washington Square South . The Kimmel Center for University Life is also on Washington Square South, and is the primary hub for student life at the university, providing event and meeting space for student organizations and other gatherings. Located closer to the eastern edge of the campus along Broadway are the main buildings for the Tisch School of the Arts and the Gallatin School of Individualized Study , as well as the main office for Liberal Studies and NYU's Bookstore and Student Health Center. Other nearby university buildings and complexes of note include 5 Washington Place, which houses NYU's distinguished Department of Philosophy , 7 East 12th Street, which serves as the main building for the School of Professional Studies , the Brown Building , which was the location of the infamous Triangle Shirtwaist Factory Fire before its acquisition by NYU, as well as Washington Square Village and University Village , two housing complexes for faculty members and graduate students. Undergraduate residence halls in the immediate surroundings of Washington Square include Goddard Hall, Lipton Hall, and Weinstein Hall, while those that are slightly farther but still nearby include Brittany Hall and Rubin Hall. In the 1990s, NYU became a "two square" university by building a second community around Union Square , in close proximity to Washington Square. NYU's Union Square community primarily consists of the priority residence halls of Carlyle Court, Palladium Residence Hall, Alumni Hall, Coral Tower, Thirteenth Street Hall, University Hall, Third North Residence Hall, and Founders Hall. On its Washington Square campus, NYU operates theaters and performance facilities that are often used by the Tisch School of the Arts as well as the university's music conservatory , which is within the Steinhardt School of Culture, Education, and Human Development . External productions are also occasionally held in NYU's facilities. The largest performance accommodations at NYU are the Skirball Center for Performing Arts (850 seats) at 566 LaGuardia Place, just south of Washington Square South, and the Eisner-Lubin Auditorium (560 seats) in the Kimmel Center. Notably, the Skirball Center has hosted important speeches on foreign policy by John Kerry [ citation needed ] and Al Gore . The Skirball Center is the largest performing arts facility south of 42nd Street . NYU also has international houses meant to foster the study of particular cultures and languages on its Washington Square campus, including the Deutsches Haus, La Maison Française , Casa Italiana Zerilli Marimò , the Glucksman Ireland House to foster Irish studies , the King Juan Carlos I of Spain Center, the Hagop Kevorkian Center, an Africa House, and a China House. Most of these international houses are located on Washington Mews , a private street north of Washington Square Park. The closest New York City Subway stations servicing the Washington Square campus are Eighth Street–New York University and West Fourth Street–Washington Square . In addition, NYU runs its own shuttle service, University Transportation Services, linking the Washington Square campus to other university locations and major transit hubs. The nearest major highway is the West Side Highway ( NY 9A ) to the west. The campus is located less than 1 mile (1.6 km) from the Holland Tunnel , and 4 miles (6.4 km) from the Brooklyn Bridge . The Jeffrey S. Gould Plaza, located between Washington Square East and Mercer Street on West 4th Street, is surrounded by the buildings for some departments of the College of Arts and Science as well as the main buildings for the Stern School of Business and the Courant Institute of Mathematical Sciences . Other NYU buildings near the plaza include the Bonomi Family Admissions Center, the Jeffrey S. Gould Welcome Center, the Alumni Relations building, Goddard Hall, Frederick Loewe Theatre, and the main building for the Steinhardt School of Culture, Education, and Human Development, as well as unrelated religious institutions such as Judson Memorial Church , the Islamic Center at NYU, and Hebrew Union College - Jewish Institute of Religion . Because of its high student traffic during the academic year, Gould Plaza has become a popular meeting spot for NYU students and a performance area for street musicians and buskers . The Elmer Holmes Bobst Library, built between 1967 and 1972, is the largest library at NYU and one of the largest academic libraries in the United States. Designed by Philip Johnson and Richard Foster , the 12-story, 425,000-square-foot (39,500 m 2 ) structure sits on the southern edge of Washington Square Park (at 70 Washington Square South) and is the flagship of an eight-library, 4.5 million-volume system. Bobst Library offers one Multidisciplinary Reference Center, a Research Commons, 28 miles (45 km) of open-stacks shelving, and approximately 2,000 seats for student study. The library is visited by more than 6,800 users each day, and circulates more than one million books annually. Bobst's Avery Fisher Center for Music and Media is one of the world's largest academic media centers, where students and researchers use more than 95,000 audio and video recordings per year. Bobst Library is also home to many special collections. The Fales Collection houses collections of English and American fiction in the United States, the unique Downtown Collection, documenting the New York literary avant-garde arts scene from the 1970s to the present, and the Food and Cookery Collection, which documents American food history with a focus on New York City. Bobst Library also houses the Tamiment Library, which holds collections in labor history, socialism, anarchism, communism, and American radicalism for scholarly research. Tamiment includes the Robert F. Wagner Labor Archives, the Archives of Irish America, the Center for the Cold War and the U.S., and the Frederic Ewen Academic Freedom Center. Bobst Library made headlines in the early 2000s when Steven Stanzak , who is also known as "Bobst Boy", gained a following for living in Bobst Library after he was unable to pay for board at the university and began to write about his life on a self published blog. The story was reported by Washington Square News before becoming an overnight national sensation, which helped Stanzak receive financial assistance from NYU until graduation. NYU's Brooklyn campus is located at MetroTech Center , an urban academic-industrial research park . It sits on top of the Jay Street–MetroTech station , is only a few blocks from the Brooklyn Bridge, and is connected to NYU's Manhattan campus via the NYU Shuttle Bus System. It houses the Tandon School of Engineering, the Center for Urban Science and Progress and also several of Tisch School of the Arts and Steinhardt School of Culture, Education, and Human Development's degree programs. MetroTech Commons, the 3.5-acre (14,000 m 2 ) privately owned public space at the heart of the MetroTech complex, functions as a quad for students at the Brooklyn campus in much the same way that Washington Square Park does for students at the main campus, hosting events including concerts, health fairs, chess tournaments and holiday celebrations. Bounded by Lawrence and Duffield Streets, the square is frequently adorned by modern art exhibits. Two pieces called Alligator and Visionary are part of the Commons' permanent public art collection by the well-known sculptor Tom Otterness . The Brooklyn campus is home to NYU's Game Center Open Library, which is the largest collection of games held by any university in the world, as well as the NYU MakerSpace and Design Lab, which allows all NYU students who undergo training sessions to access advanced 3D printing , prototyping , CNC machining , and stress testing devices. In 2014, NYU Langone Medical Center acquired a 125,000 square feet (11,600 m 2 ) healthcare facility in Brooklyn. Quickly following this announcement, NYU announced in 2017 that it would invest over $500 million in the coming years to renovate and expand its Brooklyn campus, including 370 Jay Street , which opened in December 2017. The NYU Langone Health medical center is situated near the East River waterfront at 550 First Avenue between East 30th and 34th Streets. The campus hosts the NYU Grossman School of Medicine , Tisch Hospital, Kimmel Pavilion, Hassenfeld Children's Hospital, and the Rusk Institute of Rehabilitation Medicine . Other NYU and NYU-affiliated medical centers across the city include the NYU Langone Orthopedic Hospital, the NYU Langone Hospital – Brooklyn , and the Bellevue Hospital . In Mineola, Long Island, the NYU Langone Hospital – Long Island campus is home to NYU's second medical school, the NYU Long Island School of Medicine. NYU's Silver School of Social Work (formerly Ehrenkranz School of Social Work) manages branch campus programs in Westchester County at Sarah Lawrence College and in Rockland County at St. Thomas Aquinas College . In Sterling Forest , near Tuxedo , NYU has a research facility that contains various institutes, in particular the Nelson Institute of Environmental Medicine. The Midtown Center at 11 West 42nd Street is home to the NYU Schack Institute of Real Estate. The Woolworth Building in the financial district is home to some of NYU's professional studies and education programs. NYU has two units located on the Upper East Side . The Institute for the Study of the Ancient World , a discrete entity within NYU, independent of any other school or department of the university, is located on East 84th Street, while the Institute of Fine Arts , a graduate school of art history and fine arts, is located at the James B. Duke House at 1 East 78th Street. Additionally, the nearby Stephen Chan House at 14 East 78th Street houses the Conservation Center of the Institute of Fine Arts, which boasts the oldest graduate degree-granting conservation program in the world. NYU has a host of foreign facilities used for study away programs, referred to as Global Academic Centers. As of 2012 [ update ] , NYU operates 12 academic sites in Africa, Asia and the Middle East, Australia, Europe, North America, and South America, including undergraduate academic-year and summer study away programs in Accra , Berlin , Buenos Aires , Florence , London , Los Angeles , Madrid , Paris , Prague , Sydney , Tel Aviv , and Washington, D.C. One of the most noteworthy sites is the 57-acre (230,000 m 2 ) campus of NYU Florence, located at Villa LaPietra in Italy. The estate was bequeathed by the late Sir Harold Acton to NYU in 1994, and at the time it was the largest donation to a university in history. In spring 2014, NYU Paris moved to a new campus, formerly occupied by the École Spéciale des Travaux Publics (ESTP Paris), in the student area of the Quartier Latin , where NYU Law also set up an EU Regulatory Policy Clinic in partnership with HEC Paris taught by Alberto Alemanno and Vincent Chauvet . In addition to the Global Academic Centers, NYU also maintains 10 Global Research Initiative Institutes, 9 of them are located in the academic centers at Berlin, Florence, London, Madrid, Paris, Prague, Shanghai, Tel Aviv, and Washington DC, with the other being located in Athens. Meant to provide faculty and graduate students with NYU infrastructural support while conducting international research projects, those who are interested can apply for fellowships at all sites during the academic-year and a limited number of sites during the summer. Spearheaded by John Sexton , president of the university during 2002—2015; in Fall 2010, New York University Abu Dhabi (NYUAD) opened as the university's first overseas "Portal Campus" with an inaugural class of 150 students. The campus faced controversy even before it opened. In 2009, the university responded to a series of interviews in The New York Times that showed a pattern of labor abuses at its fledgling Abu Dhabi location (which would open for classes the next year), creating a statement of labor values for Abu Dhabi campus workers. A 2014 follow-up article found that while some conditions had improved, contractors for the university were still frequently subjecting their workers to third-world labor conditions. The article documented that these conditions included confiscation of worker passports, forced overtime, recruitment fees and cockroach-filled dorms where workers had to sleep under beds. According to the article, workers who attempted to protest the NYU contractors' conditions were promptly arrested. Reports also claimed that those arrested by police were later abused at the police station. Many workers who were not local were then deported to their home countries. The university quickly responded to the reports with an apology to the workers. Though the campus construction costs were entirely funded by the Abu Dhabi government, as will be the operational costs and any future expansions, in 2015, NYU additionally compensated thousands of migrant workers on its Abu Dhabi complex. Unlike NYU's other study abroad centers, NYUAD functions as a separate liberal arts college within a university, offering complete degree programs to students admitted directly to NYUAD. NYUAD recruits students from all over the world and describes itself as the "World's Honor College". The main campus for NYUAD is on Saadiyat Island and opened in 2014. Until then, the school operated from a campus located in downtown Abu Dhabi. In 2011, NYU announced plans to open another portal campus, NYU Shanghai, for the fall semester of 2013. It was set to have about 3,000 undergraduate students, the majority of whom would be Chinese . It was approved by the Ministry of Education of the People's Republic of China in January 2011. NYU's local partner would be East China Normal University (ECNU). ECNU's president Yu Lizhong would be the chancellor and play a major role in government relations while Jeffrey S. Lehman , former president of Cornell amongst other positions, would serve as vice chancellor and have "free rein in academic affairs". Since late summer of 2014, NYU Shanghai has been based in Pudong, Shanghai , at 1555 Century Ave. The main campus is contained in a single building, the Academic Center, a new 15-story building with two underground floors. On May 30, 2019, the groundbreaking ceremony was held for the new campus building in the Qiantan International Business Zone . The Qiantan campus building will also be located in Pudong, and is being designed and built by architectural firm Kohn Pedersen Fox (KPF) . The design features four buildings arranged in a pinwheel shape reminiscent of NYU Shanghai's logo, that are connected as one building above the fifth floor. The university hopes to move up to 4,000 undergraduate and graduate students into the new campus by 2022. Tisch School of the Arts, Asia was NYU's first branch campus abroad. The result of a partnership between Tisch School of the Arts and the Singapore Government, it offered Master of Fine Arts degrees in animation and digital arts, dramatic writing, film and international media producing. The campus opened in fall 2007 with the intention to enroll approximately 250 students. Anticipated enrollment figures were not achieved, financial irregularities were alleged, and President Pari Sara Shirazi was dismissed from her post by NYU in November 2011. She subsequently announced her intention to commence legal proceedings against NYU alleging wrongful termination and defamation. In a letter to the Tisch Asia community dated November 8, 2012, Dean Mary Schmidt Campbell announced that the campus would close after 2014 with recruitment and admission of new students suspended with immediate effect. In 2016, three former students of the now defunct Tisch Asia sued NYU. Before moving to its current location at the former campus of ESTP Paris, NYU Paris was located in a small building in the historic neighborhood of Passy . NYU houses approximately 12,000 undergraduate and graduate residents, and had the seventh-largest university housing system in the U.S. as of 2007 [ update ] , and one of the largest among private schools. NYU's undergraduate housing system consists of more than 20 residence halls and is governed by the Inter-Residence Hall Council (IRHC), an umbrella student council organization. Uniquely, many of NYU's residence halls are converted apartment complexes or old hotels. In general, NYU residence halls receive favorable ratings, and some are opulent. Many rooms are spacious and contain amenities considered rare for individual college residence hall rooms, such as kitchens, lavatories, living rooms and common areas. The university operates its own transit system to transport its students by bus to its campus. A few of the residence halls are considered to be among the nicest in the nation, being furnished with granite counter-tops, stainless-steel appliances, in-hall gyms, wood flooring, marble bathroom fixtures, large floor lounges, floor to ceiling windows and extensive views of lower and midtown Manhattan. Undergraduate students are guaranteed housing during their enrollment at NYU and are split into two categories, FYRE (First-Year Residential Experience) and TRUE (The Residential Upperclassmen Experience). Most FYRE halls are located near the Washington Square area. While nearly all TRUE halls are located near the Union Square area, two former residence halls were located in the Financial District and one is still in use in Chinatown . Two residence halls are located in and around the MetroTech Commons, intended to serve NYU's Brooklyn Campus. In 2007, the National Association of College and University Residence Halls (NACURH) named NYU the National School of the Year for IRHC and NRHH 's strong efforts over the past year. In addition, NYU was named the National Program of the Year for UltraViolet Live, the annual inter-hall competition that raises funds for Relay For Life . NYU has made the greening of its campus a large priority. For example, NYU has been the largest university purchaser of wind energy in the U.S. since 2009. With this switch to renewable power, NYU is achieving benefits equivalent to removing 12,000 cars from the road or planting 72,000 trees. In May 2008, the NYU Sustainability Task Force awarded $150,000 in grants to 23 projects that would focus research and efforts toward energy, food, landscape, outreach, procurement, transportation and waste. These projects include a student-led bike-sharing program modeled after Paris' Velib program with 30 bikes free to students, staff, and faculty. NYU received a grade of "B" on the College Sustainability Report Card 2010 from the Sustainable Endowments Institute. NYU purchased 118 million kilowatt-hours of wind power during the 2006–2007 academic year – the largest purchase of wind power by any university in the country and any institution in New York City. For 2007, the university expanded its purchase of wind power to 132 million kilowatt-hours. The EPA ranked NYU as one of the greenest colleges in the country in its annual College & University Green Power Challenge. In 2007, NYU created a strategic plan for a six billion-dollar, 25-year, 6,000,000-square-foot (560,000 m 2 ) expansion scheduled to conclude by the university's bicentennial in 2031. Details of the plan include 2,000,000 sq ft (190,000 m 2 ) of additional on-campus housing and 3,500,000 sq ft (330,000 m 2 ) of modern academic spaces spread between NYU's New York City campuses. The expansion started in earnest in 2017 with the groundbreaking of 181 Mercer Street , a new multi-purpose building that will act as the flagship athletic facility for NYU, while also accompanying a 350-bed Residence Hall, 58 general purpose classrooms and a 350-seat theater. The roughly 800,000-square-foot (74,000 m 2 ) , $1.1 billion building is directly adjacent to the south eastern corner of the Washington Square campus and represents a significant focus on the university owned super blocks. Work on the plans second project, 370 Jay Street, a 500,000-square-foot (46,000 m 2 ) addition to the Brooklyn campus is scheduled to conclude in 2019. The building will house 'the digital arts and sciences' such as the Tandon School of Engineering departments of Computer Science, Electrical and Computer Engineering; the Tisch School of the Arts Clive Davis Institute for Recorded Music and Game Center and various other NYU initiatives such as the Center for Urban Science and Progress (CUSP) and NYU Wireless (5G research). To date, NYU has confirmed specific construction details for its NYU 2031 plan to the tune of 1,300,000 sq ft (120,000 m 2 ) at a cost of $1.6 billion with roughly 12 years to go until the university's bicentennial. In order to meet the plans outlined goals on time, the university would have to significantly increase spending, fundraising and construction over the next decade.Since the late 1970s, the central part of NYU has been its Washington Square campus in the heart of Greenwich Village. The Washington Square Arch is an unofficial symbol of NYU. Until 2007, NYU had held its commencement ceremonies in Washington Square Park, but because of renovations to Washington Square moved the 2008 ceremonies to the original Yankee Stadium and all subsequent ones to the current Yankee Stadium . The Silver Center for Arts and Science , home to the College of Arts & Science and the Graduate School of Arts & Science , is one of the main academic buildings on the Washington Square campus. It is located on Washington Square East, between Washington Place and Waverly Place , and many individual departments of the two schools it houses are located in its vicinity. Meanwhile, Vanderbilt Hall, the main building for the School of Law , is located near the southwest corner of Washington Square between Macdougal Street and Sullivan Street on Washington Square South . The Kimmel Center for University Life is also on Washington Square South, and is the primary hub for student life at the university, providing event and meeting space for student organizations and other gatherings. Located closer to the eastern edge of the campus along Broadway are the main buildings for the Tisch School of the Arts and the Gallatin School of Individualized Study , as well as the main office for Liberal Studies and NYU's Bookstore and Student Health Center. Other nearby university buildings and complexes of note include 5 Washington Place, which houses NYU's distinguished Department of Philosophy , 7 East 12th Street, which serves as the main building for the School of Professional Studies , the Brown Building , which was the location of the infamous Triangle Shirtwaist Factory Fire before its acquisition by NYU, as well as Washington Square Village and University Village , two housing complexes for faculty members and graduate students. Undergraduate residence halls in the immediate surroundings of Washington Square include Goddard Hall, Lipton Hall, and Weinstein Hall, while those that are slightly farther but still nearby include Brittany Hall and Rubin Hall. In the 1990s, NYU became a "two square" university by building a second community around Union Square , in close proximity to Washington Square. NYU's Union Square community primarily consists of the priority residence halls of Carlyle Court, Palladium Residence Hall, Alumni Hall, Coral Tower, Thirteenth Street Hall, University Hall, Third North Residence Hall, and Founders Hall. On its Washington Square campus, NYU operates theaters and performance facilities that are often used by the Tisch School of the Arts as well as the university's music conservatory , which is within the Steinhardt School of Culture, Education, and Human Development . External productions are also occasionally held in NYU's facilities. The largest performance accommodations at NYU are the Skirball Center for Performing Arts (850 seats) at 566 LaGuardia Place, just south of Washington Square South, and the Eisner-Lubin Auditorium (560 seats) in the Kimmel Center. Notably, the Skirball Center has hosted important speeches on foreign policy by John Kerry [ citation needed ] and Al Gore . The Skirball Center is the largest performing arts facility south of 42nd Street . NYU also has international houses meant to foster the study of particular cultures and languages on its Washington Square campus, including the Deutsches Haus, La Maison Française , Casa Italiana Zerilli Marimò , the Glucksman Ireland House to foster Irish studies , the King Juan Carlos I of Spain Center, the Hagop Kevorkian Center, an Africa House, and a China House. Most of these international houses are located on Washington Mews , a private street north of Washington Square Park. The closest New York City Subway stations servicing the Washington Square campus are Eighth Street–New York University and West Fourth Street–Washington Square . In addition, NYU runs its own shuttle service, University Transportation Services, linking the Washington Square campus to other university locations and major transit hubs. The nearest major highway is the West Side Highway ( NY 9A ) to the west. The campus is located less than 1 mile (1.6 km) from the Holland Tunnel , and 4 miles (6.4 km) from the Brooklyn Bridge . The Jeffrey S. Gould Plaza, located between Washington Square East and Mercer Street on West 4th Street, is surrounded by the buildings for some departments of the College of Arts and Science as well as the main buildings for the Stern School of Business and the Courant Institute of Mathematical Sciences . Other NYU buildings near the plaza include the Bonomi Family Admissions Center, the Jeffrey S. Gould Welcome Center, the Alumni Relations building, Goddard Hall, Frederick Loewe Theatre, and the main building for the Steinhardt School of Culture, Education, and Human Development, as well as unrelated religious institutions such as Judson Memorial Church , the Islamic Center at NYU, and Hebrew Union College - Jewish Institute of Religion . Because of its high student traffic during the academic year, Gould Plaza has become a popular meeting spot for NYU students and a performance area for street musicians and buskers . The Elmer Holmes Bobst Library, built between 1967 and 1972, is the largest library at NYU and one of the largest academic libraries in the United States. Designed by Philip Johnson and Richard Foster , the 12-story, 425,000-square-foot (39,500 m 2 ) structure sits on the southern edge of Washington Square Park (at 70 Washington Square South) and is the flagship of an eight-library, 4.5 million-volume system. Bobst Library offers one Multidisciplinary Reference Center, a Research Commons, 28 miles (45 km) of open-stacks shelving, and approximately 2,000 seats for student study. The library is visited by more than 6,800 users each day, and circulates more than one million books annually. Bobst's Avery Fisher Center for Music and Media is one of the world's largest academic media centers, where students and researchers use more than 95,000 audio and video recordings per year. Bobst Library is also home to many special collections. The Fales Collection houses collections of English and American fiction in the United States, the unique Downtown Collection, documenting the New York literary avant-garde arts scene from the 1970s to the present, and the Food and Cookery Collection, which documents American food history with a focus on New York City. Bobst Library also houses the Tamiment Library, which holds collections in labor history, socialism, anarchism, communism, and American radicalism for scholarly research. Tamiment includes the Robert F. Wagner Labor Archives, the Archives of Irish America, the Center for the Cold War and the U.S., and the Frederic Ewen Academic Freedom Center. Bobst Library made headlines in the early 2000s when Steven Stanzak , who is also known as "Bobst Boy", gained a following for living in Bobst Library after he was unable to pay for board at the university and began to write about his life on a self published blog. The story was reported by Washington Square News before becoming an overnight national sensation, which helped Stanzak receive financial assistance from NYU until graduation. The Jeffrey S. Gould Plaza, located between Washington Square East and Mercer Street on West 4th Street, is surrounded by the buildings for some departments of the College of Arts and Science as well as the main buildings for the Stern School of Business and the Courant Institute of Mathematical Sciences . Other NYU buildings near the plaza include the Bonomi Family Admissions Center, the Jeffrey S. Gould Welcome Center, the Alumni Relations building, Goddard Hall, Frederick Loewe Theatre, and the main building for the Steinhardt School of Culture, Education, and Human Development, as well as unrelated religious institutions such as Judson Memorial Church , the Islamic Center at NYU, and Hebrew Union College - Jewish Institute of Religion . Because of its high student traffic during the academic year, Gould Plaza has become a popular meeting spot for NYU students and a performance area for street musicians and buskers .The Elmer Holmes Bobst Library, built between 1967 and 1972, is the largest library at NYU and one of the largest academic libraries in the United States. Designed by Philip Johnson and Richard Foster , the 12-story, 425,000-square-foot (39,500 m 2 ) structure sits on the southern edge of Washington Square Park (at 70 Washington Square South) and is the flagship of an eight-library, 4.5 million-volume system. Bobst Library offers one Multidisciplinary Reference Center, a Research Commons, 28 miles (45 km) of open-stacks shelving, and approximately 2,000 seats for student study. The library is visited by more than 6,800 users each day, and circulates more than one million books annually. Bobst's Avery Fisher Center for Music and Media is one of the world's largest academic media centers, where students and researchers use more than 95,000 audio and video recordings per year. Bobst Library is also home to many special collections. The Fales Collection houses collections of English and American fiction in the United States, the unique Downtown Collection, documenting the New York literary avant-garde arts scene from the 1970s to the present, and the Food and Cookery Collection, which documents American food history with a focus on New York City. Bobst Library also houses the Tamiment Library, which holds collections in labor history, socialism, anarchism, communism, and American radicalism for scholarly research. Tamiment includes the Robert F. Wagner Labor Archives, the Archives of Irish America, the Center for the Cold War and the U.S., and the Frederic Ewen Academic Freedom Center. Bobst Library made headlines in the early 2000s when Steven Stanzak , who is also known as "Bobst Boy", gained a following for living in Bobst Library after he was unable to pay for board at the university and began to write about his life on a self published blog. The story was reported by Washington Square News before becoming an overnight national sensation, which helped Stanzak receive financial assistance from NYU until graduation. NYU's Brooklyn campus is located at MetroTech Center , an urban academic-industrial research park . It sits on top of the Jay Street–MetroTech station , is only a few blocks from the Brooklyn Bridge, and is connected to NYU's Manhattan campus via the NYU Shuttle Bus System. It houses the Tandon School of Engineering, the Center for Urban Science and Progress and also several of Tisch School of the Arts and Steinhardt School of Culture, Education, and Human Development's degree programs. MetroTech Commons, the 3.5-acre (14,000 m 2 ) privately owned public space at the heart of the MetroTech complex, functions as a quad for students at the Brooklyn campus in much the same way that Washington Square Park does for students at the main campus, hosting events including concerts, health fairs, chess tournaments and holiday celebrations. Bounded by Lawrence and Duffield Streets, the square is frequently adorned by modern art exhibits. Two pieces called Alligator and Visionary are part of the Commons' permanent public art collection by the well-known sculptor Tom Otterness . The Brooklyn campus is home to NYU's Game Center Open Library, which is the largest collection of games held by any university in the world, as well as the NYU MakerSpace and Design Lab, which allows all NYU students who undergo training sessions to access advanced 3D printing , prototyping , CNC machining , and stress testing devices. In 2014, NYU Langone Medical Center acquired a 125,000 square feet (11,600 m 2 ) healthcare facility in Brooklyn. Quickly following this announcement, NYU announced in 2017 that it would invest over $500 million in the coming years to renovate and expand its Brooklyn campus, including 370 Jay Street , which opened in December 2017. The NYU Langone Health medical center is situated near the East River waterfront at 550 First Avenue between East 30th and 34th Streets. The campus hosts the NYU Grossman School of Medicine , Tisch Hospital, Kimmel Pavilion, Hassenfeld Children's Hospital, and the Rusk Institute of Rehabilitation Medicine . Other NYU and NYU-affiliated medical centers across the city include the NYU Langone Orthopedic Hospital, the NYU Langone Hospital – Brooklyn , and the Bellevue Hospital . In Mineola, Long Island, the NYU Langone Hospital – Long Island campus is home to NYU's second medical school, the NYU Long Island School of Medicine. NYU's Silver School of Social Work (formerly Ehrenkranz School of Social Work) manages branch campus programs in Westchester County at Sarah Lawrence College and in Rockland County at St. Thomas Aquinas College . In Sterling Forest , near Tuxedo , NYU has a research facility that contains various institutes, in particular the Nelson Institute of Environmental Medicine. The Midtown Center at 11 West 42nd Street is home to the NYU Schack Institute of Real Estate. The Woolworth Building in the financial district is home to some of NYU's professional studies and education programs. NYU has two units located on the Upper East Side . The Institute for the Study of the Ancient World , a discrete entity within NYU, independent of any other school or department of the university, is located on East 84th Street, while the Institute of Fine Arts , a graduate school of art history and fine arts, is located at the James B. Duke House at 1 East 78th Street. Additionally, the nearby Stephen Chan House at 14 East 78th Street houses the Conservation Center of the Institute of Fine Arts, which boasts the oldest graduate degree-granting conservation program in the world. NYU has a host of foreign facilities used for study away programs, referred to as Global Academic Centers. As of 2012 [ update ] , NYU operates 12 academic sites in Africa, Asia and the Middle East, Australia, Europe, North America, and South America, including undergraduate academic-year and summer study away programs in Accra , Berlin , Buenos Aires , Florence , London , Los Angeles , Madrid , Paris , Prague , Sydney , Tel Aviv , and Washington, D.C. One of the most noteworthy sites is the 57-acre (230,000 m 2 ) campus of NYU Florence, located at Villa LaPietra in Italy. The estate was bequeathed by the late Sir Harold Acton to NYU in 1994, and at the time it was the largest donation to a university in history. In spring 2014, NYU Paris moved to a new campus, formerly occupied by the École Spéciale des Travaux Publics (ESTP Paris), in the student area of the Quartier Latin , where NYU Law also set up an EU Regulatory Policy Clinic in partnership with HEC Paris taught by Alberto Alemanno and Vincent Chauvet . In addition to the Global Academic Centers, NYU also maintains 10 Global Research Initiative Institutes, 9 of them are located in the academic centers at Berlin, Florence, London, Madrid, Paris, Prague, Shanghai, Tel Aviv, and Washington DC, with the other being located in Athens. Meant to provide faculty and graduate students with NYU infrastructural support while conducting international research projects, those who are interested can apply for fellowships at all sites during the academic-year and a limited number of sites during the summer. Spearheaded by John Sexton , president of the university during 2002—2015; in Fall 2010, New York University Abu Dhabi (NYUAD) opened as the university's first overseas "Portal Campus" with an inaugural class of 150 students. The campus faced controversy even before it opened. In 2009, the university responded to a series of interviews in The New York Times that showed a pattern of labor abuses at its fledgling Abu Dhabi location (which would open for classes the next year), creating a statement of labor values for Abu Dhabi campus workers. A 2014 follow-up article found that while some conditions had improved, contractors for the university were still frequently subjecting their workers to third-world labor conditions. The article documented that these conditions included confiscation of worker passports, forced overtime, recruitment fees and cockroach-filled dorms where workers had to sleep under beds. According to the article, workers who attempted to protest the NYU contractors' conditions were promptly arrested. Reports also claimed that those arrested by police were later abused at the police station. Many workers who were not local were then deported to their home countries. The university quickly responded to the reports with an apology to the workers. Though the campus construction costs were entirely funded by the Abu Dhabi government, as will be the operational costs and any future expansions, in 2015, NYU additionally compensated thousands of migrant workers on its Abu Dhabi complex. Unlike NYU's other study abroad centers, NYUAD functions as a separate liberal arts college within a university, offering complete degree programs to students admitted directly to NYUAD. NYUAD recruits students from all over the world and describes itself as the "World's Honor College". The main campus for NYUAD is on Saadiyat Island and opened in 2014. Until then, the school operated from a campus located in downtown Abu Dhabi. In 2011, NYU announced plans to open another portal campus, NYU Shanghai, for the fall semester of 2013. It was set to have about 3,000 undergraduate students, the majority of whom would be Chinese . It was approved by the Ministry of Education of the People's Republic of China in January 2011. NYU's local partner would be East China Normal University (ECNU). ECNU's president Yu Lizhong would be the chancellor and play a major role in government relations while Jeffrey S. Lehman , former president of Cornell amongst other positions, would serve as vice chancellor and have "free rein in academic affairs". Since late summer of 2014, NYU Shanghai has been based in Pudong, Shanghai , at 1555 Century Ave. The main campus is contained in a single building, the Academic Center, a new 15-story building with two underground floors. On May 30, 2019, the groundbreaking ceremony was held for the new campus building in the Qiantan International Business Zone . The Qiantan campus building will also be located in Pudong, and is being designed and built by architectural firm Kohn Pedersen Fox (KPF) . The design features four buildings arranged in a pinwheel shape reminiscent of NYU Shanghai's logo, that are connected as one building above the fifth floor. The university hopes to move up to 4,000 undergraduate and graduate students into the new campus by 2022. Tisch School of the Arts, Asia was NYU's first branch campus abroad. The result of a partnership between Tisch School of the Arts and the Singapore Government, it offered Master of Fine Arts degrees in animation and digital arts, dramatic writing, film and international media producing. The campus opened in fall 2007 with the intention to enroll approximately 250 students. Anticipated enrollment figures were not achieved, financial irregularities were alleged, and President Pari Sara Shirazi was dismissed from her post by NYU in November 2011. She subsequently announced her intention to commence legal proceedings against NYU alleging wrongful termination and defamation. In a letter to the Tisch Asia community dated November 8, 2012, Dean Mary Schmidt Campbell announced that the campus would close after 2014 with recruitment and admission of new students suspended with immediate effect. In 2016, three former students of the now defunct Tisch Asia sued NYU. Before moving to its current location at the former campus of ESTP Paris, NYU Paris was located in a small building in the historic neighborhood of Passy . Spearheaded by John Sexton , president of the university during 2002—2015; in Fall 2010, New York University Abu Dhabi (NYUAD) opened as the university's first overseas "Portal Campus" with an inaugural class of 150 students. The campus faced controversy even before it opened. In 2009, the university responded to a series of interviews in The New York Times that showed a pattern of labor abuses at its fledgling Abu Dhabi location (which would open for classes the next year), creating a statement of labor values for Abu Dhabi campus workers. A 2014 follow-up article found that while some conditions had improved, contractors for the university were still frequently subjecting their workers to third-world labor conditions. The article documented that these conditions included confiscation of worker passports, forced overtime, recruitment fees and cockroach-filled dorms where workers had to sleep under beds. According to the article, workers who attempted to protest the NYU contractors' conditions were promptly arrested. Reports also claimed that those arrested by police were later abused at the police station. Many workers who were not local were then deported to their home countries. The university quickly responded to the reports with an apology to the workers. Though the campus construction costs were entirely funded by the Abu Dhabi government, as will be the operational costs and any future expansions, in 2015, NYU additionally compensated thousands of migrant workers on its Abu Dhabi complex. Unlike NYU's other study abroad centers, NYUAD functions as a separate liberal arts college within a university, offering complete degree programs to students admitted directly to NYUAD. NYUAD recruits students from all over the world and describes itself as the "World's Honor College". The main campus for NYUAD is on Saadiyat Island and opened in 2014. Until then, the school operated from a campus located in downtown Abu Dhabi. In 2011, NYU announced plans to open another portal campus, NYU Shanghai, for the fall semester of 2013. It was set to have about 3,000 undergraduate students, the majority of whom would be Chinese . It was approved by the Ministry of Education of the People's Republic of China in January 2011. NYU's local partner would be East China Normal University (ECNU). ECNU's president Yu Lizhong would be the chancellor and play a major role in government relations while Jeffrey S. Lehman , former president of Cornell amongst other positions, would serve as vice chancellor and have "free rein in academic affairs". Since late summer of 2014, NYU Shanghai has been based in Pudong, Shanghai , at 1555 Century Ave. The main campus is contained in a single building, the Academic Center, a new 15-story building with two underground floors. On May 30, 2019, the groundbreaking ceremony was held for the new campus building in the Qiantan International Business Zone . The Qiantan campus building will also be located in Pudong, and is being designed and built by architectural firm Kohn Pedersen Fox (KPF) . The design features four buildings arranged in a pinwheel shape reminiscent of NYU Shanghai's logo, that are connected as one building above the fifth floor. The university hopes to move up to 4,000 undergraduate and graduate students into the new campus by 2022. Tisch School of the Arts, Asia was NYU's first branch campus abroad. The result of a partnership between Tisch School of the Arts and the Singapore Government, it offered Master of Fine Arts degrees in animation and digital arts, dramatic writing, film and international media producing. The campus opened in fall 2007 with the intention to enroll approximately 250 students. Anticipated enrollment figures were not achieved, financial irregularities were alleged, and President Pari Sara Shirazi was dismissed from her post by NYU in November 2011. She subsequently announced her intention to commence legal proceedings against NYU alleging wrongful termination and defamation. In a letter to the Tisch Asia community dated November 8, 2012, Dean Mary Schmidt Campbell announced that the campus would close after 2014 with recruitment and admission of new students suspended with immediate effect. In 2016, three former students of the now defunct Tisch Asia sued NYU. Before moving to its current location at the former campus of ESTP Paris, NYU Paris was located in a small building in the historic neighborhood of Passy . NYU houses approximately 12,000 undergraduate and graduate residents, and had the seventh-largest university housing system in the U.S. as of 2007 [ update ] , and one of the largest among private schools. NYU's undergraduate housing system consists of more than 20 residence halls and is governed by the Inter-Residence Hall Council (IRHC), an umbrella student council organization. Uniquely, many of NYU's residence halls are converted apartment complexes or old hotels. In general, NYU residence halls receive favorable ratings, and some are opulent. Many rooms are spacious and contain amenities considered rare for individual college residence hall rooms, such as kitchens, lavatories, living rooms and common areas. The university operates its own transit system to transport its students by bus to its campus. A few of the residence halls are considered to be among the nicest in the nation, being furnished with granite counter-tops, stainless-steel appliances, in-hall gyms, wood flooring, marble bathroom fixtures, large floor lounges, floor to ceiling windows and extensive views of lower and midtown Manhattan. Undergraduate students are guaranteed housing during their enrollment at NYU and are split into two categories, FYRE (First-Year Residential Experience) and TRUE (The Residential Upperclassmen Experience). Most FYRE halls are located near the Washington Square area. While nearly all TRUE halls are located near the Union Square area, two former residence halls were located in the Financial District and one is still in use in Chinatown . Two residence halls are located in and around the MetroTech Commons, intended to serve NYU's Brooklyn Campus. In 2007, the National Association of College and University Residence Halls (NACURH) named NYU the National School of the Year for IRHC and NRHH 's strong efforts over the past year. In addition, NYU was named the National Program of the Year for UltraViolet Live, the annual inter-hall competition that raises funds for Relay For Life . NYU has made the greening of its campus a large priority. For example, NYU has been the largest university purchaser of wind energy in the U.S. since 2009. With this switch to renewable power, NYU is achieving benefits equivalent to removing 12,000 cars from the road or planting 72,000 trees. In May 2008, the NYU Sustainability Task Force awarded $150,000 in grants to 23 projects that would focus research and efforts toward energy, food, landscape, outreach, procurement, transportation and waste. These projects include a student-led bike-sharing program modeled after Paris' Velib program with 30 bikes free to students, staff, and faculty. NYU received a grade of "B" on the College Sustainability Report Card 2010 from the Sustainable Endowments Institute. NYU purchased 118 million kilowatt-hours of wind power during the 2006–2007 academic year – the largest purchase of wind power by any university in the country and any institution in New York City. For 2007, the university expanded its purchase of wind power to 132 million kilowatt-hours. The EPA ranked NYU as one of the greenest colleges in the country in its annual College & University Green Power Challenge. In 2007, NYU created a strategic plan for a six billion-dollar, 25-year, 6,000,000-square-foot (560,000 m 2 ) expansion scheduled to conclude by the university's bicentennial in 2031. Details of the plan include 2,000,000 sq ft (190,000 m 2 ) of additional on-campus housing and 3,500,000 sq ft (330,000 m 2 ) of modern academic spaces spread between NYU's New York City campuses. The expansion started in earnest in 2017 with the groundbreaking of 181 Mercer Street , a new multi-purpose building that will act as the flagship athletic facility for NYU, while also accompanying a 350-bed Residence Hall, 58 general purpose classrooms and a 350-seat theater. The roughly 800,000-square-foot (74,000 m 2 ) , $1.1 billion building is directly adjacent to the south eastern corner of the Washington Square campus and represents a significant focus on the university owned super blocks. Work on the plans second project, 370 Jay Street, a 500,000-square-foot (46,000 m 2 ) addition to the Brooklyn campus is scheduled to conclude in 2019. The building will house 'the digital arts and sciences' such as the Tandon School of Engineering departments of Computer Science, Electrical and Computer Engineering; the Tisch School of the Arts Clive Davis Institute for Recorded Music and Game Center and various other NYU initiatives such as the Center for Urban Science and Progress (CUSP) and NYU Wireless (5G research). To date, NYU has confirmed specific construction details for its NYU 2031 plan to the tune of 1,300,000 sq ft (120,000 m 2 ) at a cost of $1.6 billion with roughly 12 years to go until the university's bicentennial. In order to meet the plans outlined goals on time, the university would have to significantly increase spending, fundraising and construction over the next decade.Admission to NYU is highly selective. For the undergraduate first-year class of 2028, 8% were admitted from an applicant pool of more than 118,000. Three of NYU's undergraduate colleges offered admission to fewer than 5% of applicants. In 2021, NYU became the first private university in the US to top 100,000 applications. Of those admitted, about 6,500 made up the total enrollment for the class, representing 102 countries, all 50 US states, and the District of Columbia . Most freshmen have a typical unweighted GPA of 3.7/A (90–95%) and are in the top 10% of their high school graduating class. The median SAT score was 1540 out of 1600 (within the 99th percentile). The student-to-faculty ratio at the New York campus is 9:1, and less than that at the Abu Dhabi and Shanghai campuses. The average scholarship amount awarded to freshmen is over $35,000, and 20% of freshmen received Pell Grants. As of 2016 [ update ] , NYU's graduate schools have acceptance rates of 1.8% to the School of Medicine, 23% to the School of Business, 28% to the School of Engineering, 29% to the Graduate School of Arts and Science, and 34% to the School of Law. Average MCAT score of students at the School of Medicine is 522, average GMAT score of graduate students at the School of Business is 723, and the median LSAT score of students at the School of Law is 170. NYU is a private, global, non-sectarian and not-for-profit institution of higher education organized into 10 undergraduate schools and 15 graduate/professional schools, with a roughly even split of students between the divisions. Arts and Science is currently NYU's largest academic division. It has three subdivisions: the College of Arts and Science, the Graduate School of Arts and Science, and the Liberal Studies program. The College of Arts and Science and Liberal Studies program are undergraduate divisions, and the former has existed since the founding of NYU. According to NYU, it has created a "global network university" with its primary campus, two "portal" campuses, and 12 academic sites. The portal campuses at NYU Shanghai and NYU Abu Dhabi function as full-fledged colleges, allowing students to study all four years of their undergraduate studies and receive a degree, never having set foot on NYU's traditional campus in New York. The academic sites at Accra, Berlin, Buenos Aires, Florence, London, Los Angeles, Madrid, Paris, Prague, Sydney, Tel Aviv, and Washington, D.C. function as study away sites, allowing students to spend up to a year away from their home campus. NYU, citing a report by the Institute of International Education , asserts that it has sent more students abroad and brought more international students in than any other university for five continuous years. The President of New York University , is selected by the board of trustees and serves as the primary executive officer of the university for an unspecified term length. On July 1st, 2023, Linda G. Mills became the 17th and current President of NYU. NYU is classified among "R1: Doctoral Universities – Very high research activity" and research expenditures totaled $917.7 million in 2017. The university was the founding institution of the American Chemical Society. The NYU Grossman School of Medicine received $305 million in external research funding from the National Institutes of Health in 2014. [ citation needed ] NYU was granted 90 patents in 2014, the 19th most of any institution in the world. NYU owns the fastest supercomputer in New York City. As of 2016 [ update ] , NYU hardware researchers and their collaborators enjoy the largest outside funding level for hardware security of any institution in the United States , including grants from the National Science Foundation (NSF), the Office of Naval Research , the Defense Advanced Research Projects Agency (DARPA), the United States Army Research Laboratory , the Air Force Research Laboratory , the Semiconductor Research Corporation , and companies including Twitter , Boeing , Microsoft , and Google . In 2019, four NYU Arts & Science departments ranked in Top 10 of Shanghai Academic Ranking of World Universities by academic subjects ( economics , politics , psychology , and sociology ). Nationally, NYU is ranked 17th in the Center for World University Rankings , 9th by QS World University Rankings , 17th in the Academic Ranking of World Universities , 27th by Business Insider , and 25th by U.S. News & World Report . Globally, NYU is ranked 23 in the Center for World University Rankings , 25th in the Academic Ranking of World Universities , 26th in the Times Higher Education World University Rankings , and 35th in the QS World University Rankings . Additionally, NYU is ranked 26th in the Times Higher Education World University Rankings Reputation Rankings. U.S. News & World Report ranks NYU's graduate schools 6th for law, 10th for public policy, 9th for mathematics (1st for applied mathematics), 8th for Occupational therapy under Steinhardt School of Culture, Education, and Human Development, 10th for business, 11th for economics, 12th for political science, 4th for medical school research, 10th for education, 19th for nursing doctorate, 38th for physical therapy, 30th for computer science, 36th for psychology, and 38th for engineering. Globally, NYU's social sciences are ranked 8th by the Academic Ranking of World Universities , 15th by the Times Higher Education World University Rankings , and 16th by the QS World University Rankings . NYU is globally ranked 11th for psychology by the QS World University Ranking . The Social Psychology Network ranks NYU 5th for industrial/organizational psychology, 14th for clinical psychology, and U.S. News & World Report ranks NYU 9th for social psychology and 9th for behavioral neuroscience. U.S. News & World Report ranks the New York University School of Law 1st for tax law, 1st for international law, 1st for business and corporate law (tie), and 1st in criminal law. The publication also ranks The Robert F. Wagner Graduate School of Public Service 10th in public policy. The NYU Department of Philosophy is globally ranked 1st by The Philosophical Gourmet Report and the QS World University Rankings . The annual Global Employability Survey in The New York Times ranks NYU 11th nationally and 29th globally for employability. NYU ranks 19th in the world based on the number of patents generated. Globally, NYU is ranked 7th by the Times Higher Education World University Rankings for producing alumni who are millionaires, 5th among universities with the highest number of alumni worth $30 million or more, and 4th by Wealth-X for producing ultra high net-worth and billionaire alumni. Admission to NYU is highly selective. For the undergraduate first-year class of 2028, 8% were admitted from an applicant pool of more than 118,000. Three of NYU's undergraduate colleges offered admission to fewer than 5% of applicants. In 2021, NYU became the first private university in the US to top 100,000 applications. Of those admitted, about 6,500 made up the total enrollment for the class, representing 102 countries, all 50 US states, and the District of Columbia . Most freshmen have a typical unweighted GPA of 3.7/A (90–95%) and are in the top 10% of their high school graduating class. The median SAT score was 1540 out of 1600 (within the 99th percentile). The student-to-faculty ratio at the New York campus is 9:1, and less than that at the Abu Dhabi and Shanghai campuses. The average scholarship amount awarded to freshmen is over $35,000, and 20% of freshmen received Pell Grants. As of 2016 [ update ] , NYU's graduate schools have acceptance rates of 1.8% to the School of Medicine, 23% to the School of Business, 28% to the School of Engineering, 29% to the Graduate School of Arts and Science, and 34% to the School of Law. Average MCAT score of students at the School of Medicine is 522, average GMAT score of graduate students at the School of Business is 723, and the median LSAT score of students at the School of Law is 170. NYU is a private, global, non-sectarian and not-for-profit institution of higher education organized into 10 undergraduate schools and 15 graduate/professional schools, with a roughly even split of students between the divisions. Arts and Science is currently NYU's largest academic division. It has three subdivisions: the College of Arts and Science, the Graduate School of Arts and Science, and the Liberal Studies program. The College of Arts and Science and Liberal Studies program are undergraduate divisions, and the former has existed since the founding of NYU. According to NYU, it has created a "global network university" with its primary campus, two "portal" campuses, and 12 academic sites. The portal campuses at NYU Shanghai and NYU Abu Dhabi function as full-fledged colleges, allowing students to study all four years of their undergraduate studies and receive a degree, never having set foot on NYU's traditional campus in New York. The academic sites at Accra, Berlin, Buenos Aires, Florence, London, Los Angeles, Madrid, Paris, Prague, Sydney, Tel Aviv, and Washington, D.C. function as study away sites, allowing students to spend up to a year away from their home campus. NYU, citing a report by the Institute of International Education , asserts that it has sent more students abroad and brought more international students in than any other university for five continuous years. The President of New York University , is selected by the board of trustees and serves as the primary executive officer of the university for an unspecified term length. On July 1st, 2023, Linda G. Mills became the 17th and current President of NYU. NYU is classified among "R1: Doctoral Universities – Very high research activity" and research expenditures totaled $917.7 million in 2017. The university was the founding institution of the American Chemical Society. The NYU Grossman School of Medicine received $305 million in external research funding from the National Institutes of Health in 2014. [ citation needed ] NYU was granted 90 patents in 2014, the 19th most of any institution in the world. NYU owns the fastest supercomputer in New York City. As of 2016 [ update ] , NYU hardware researchers and their collaborators enjoy the largest outside funding level for hardware security of any institution in the United States , including grants from the National Science Foundation (NSF), the Office of Naval Research , the Defense Advanced Research Projects Agency (DARPA), the United States Army Research Laboratory , the Air Force Research Laboratory , the Semiconductor Research Corporation , and companies including Twitter , Boeing , Microsoft , and Google . In 2019, four NYU Arts & Science departments ranked in Top 10 of Shanghai Academic Ranking of World Universities by academic subjects ( economics , politics , psychology , and sociology ). Nationally, NYU is ranked 17th in the Center for World University Rankings , 9th by QS World University Rankings , 17th in the Academic Ranking of World Universities , 27th by Business Insider , and 25th by U.S. News & World Report . Globally, NYU is ranked 23 in the Center for World University Rankings , 25th in the Academic Ranking of World Universities , 26th in the Times Higher Education World University Rankings , and 35th in the QS World University Rankings . Additionally, NYU is ranked 26th in the Times Higher Education World University Rankings Reputation Rankings. U.S. News & World Report ranks NYU's graduate schools 6th for law, 10th for public policy, 9th for mathematics (1st for applied mathematics), 8th for Occupational therapy under Steinhardt School of Culture, Education, and Human Development, 10th for business, 11th for economics, 12th for political science, 4th for medical school research, 10th for education, 19th for nursing doctorate, 38th for physical therapy, 30th for computer science, 36th for psychology, and 38th for engineering. Globally, NYU's social sciences are ranked 8th by the Academic Ranking of World Universities , 15th by the Times Higher Education World University Rankings , and 16th by the QS World University Rankings . NYU is globally ranked 11th for psychology by the QS World University Ranking . The Social Psychology Network ranks NYU 5th for industrial/organizational psychology, 14th for clinical psychology, and U.S. News & World Report ranks NYU 9th for social psychology and 9th for behavioral neuroscience. U.S. News & World Report ranks the New York University School of Law 1st for tax law, 1st for international law, 1st for business and corporate law (tie), and 1st in criminal law. The publication also ranks The Robert F. Wagner Graduate School of Public Service 10th in public policy. The NYU Department of Philosophy is globally ranked 1st by The Philosophical Gourmet Report and the QS World University Rankings . The annual Global Employability Survey in The New York Times ranks NYU 11th nationally and 29th globally for employability. NYU ranks 19th in the world based on the number of patents generated. Globally, NYU is ranked 7th by the Times Higher Education World University Rankings for producing alumni who are millionaires, 5th among universities with the highest number of alumni worth $30 million or more, and 4th by Wealth-X for producing ultra high net-worth and billionaire alumni. The Student Government Assembly (SGA) is the governing student body at NYU. The SGA has been involved in controversial debates on campus, including a campus-wide ban on the sale of Coca-Cola products in 2005, and the Graduate Student Organizing Committee unionization in 2001 and subsequent strike in 2005. The Coke ban was lifted by the University Senate on February 5, 2009. SGA consists of 75 voting members from subsidiary student government organs including the Student Senators Council (SSC) and the Presidents Council, which are elected from their respective individual undergraduate and graduate colleges. In 2018, the structure of the university's student government was called into question by students through school newspapers and social media pages calling for "sweeping changes to its byzantine structure." Advocates claimed the structure of SGA failed to represent all students, wasted university funds and operated in an undemocratic manner. Opponents claimed that advocates were merely motivated by legislation supporting the BDS movement that was likely to pass. NYU has over 450 student clubs and organizations on campus. In addition to the sports teams, fraternities, sororities, and study clubs, there are many organizations on campus that focus on entertainment, arts, and culture. These organizations include various student media clubs: for instance, the daily student newspaper the Washington Square News , the NYU Local daily blog, The Plague comedy magazine, " Washington Square Local web-based satire news source, and the literary journals Washington Square Review and The Minetta Review , as well as student-run event producers such as the NYU Program Board and the Inter-Residence Hall Council. It also operates radio station WNYU-FM 89.1 with a diverse college radio format, transmitting to the entire New York metropolitan area from the original campus, and via booster station WNYU-FM1 which fills in the signal in lower Manhattan from atop one of the Silver Towers, next to the football field at the Washington Square campus. Students publish a campus comedy magazine, The Plague . Like many college humor magazines , this often pokes fun at popular culture as well as campus life and the idiosyncrasies of New York University. The Plague was founded in 1978 by Howard Ostrowsky along with Amy Burns, John Rawlins, Joe Pinto and Dan Fiorella, and is currently published once per semester. It is not NYU's first humor magazine, as The Medley was a humor magazine published by the Eucleian Society from 1913 to 1950. Since winning the national championship in the 2003–2004 season, the NYU Cross Examination Debate Association (CEDA) debate team is considered one of the perennial collegiate policy debate teams in the country. For the 2020–21 season, they placed 5th in the nation at CEDA Open Nationals and 2nd in the nation at JV Nationals, along with students named the 1st and 4th place speakers at Novice Nationals. In 2021, they ranked 10th in the nation, finishing ahead of Harvard and Cornell. This marked 14 years of Top 20 National finishes dating back to the 2007 season. The New York University Mock Trial team is consistently ranked as one of the best collegiate mock trial teams in the country. NYU has qualified for the National Championship Tournament for 10 consecutive seasons and placed in the top 10 during each of those years. In the 2009–2010 season, NYU won the 26th National Championship Tournament in Memphis over rival Harvard . The following season, they qualified for the final round once more only to be the runners-up to UCLA . In the American Mock Trial Association's 2015–2016 power rankings, NYU ranks third, behind Harvard and Yale . NYU has traditions which have persisted across campuses. Since the beginning of the 20th century initiation ceremonies have welcomed incoming NYU freshmen. At the Bronx University Heights Campus, seniors used to grab unsuspecting freshmen, take them to a horse-watering trough, and then dunk them head-first into what was known colloquially as "the Fountain of Knowledge". This underground initiation took place until the 1970s. Today freshmen take part in university-sponsored activities during what is called "Welcome Week". In addition, throughout the year the university traditionally holds Apple Fest (an apple-themed country fest that began at the University Heights campus), the Violet Ball (a dance in the atrium of Bobst Library), Strawberry Fest (featuring New York City's longest Strawberry Shortcake ), and the semi-annual midnight breakfast where Student Affairs administrators serve free breakfast to students before finals . NYU is home to a number of student-run a cappella groups, several of which compete regularly at the International Championship of Collegiate A Cappella (ICCA). Most notable of these groups is The NYU N'Harmonics, who won the ICCA title in 2019. In 2020, The A Cappella Archive ranked The NYU N'Harmonics at #6 among all ICCA-competing groups. Some of the first fraternities in the country were formed at NYU. Greek life first formed on the NYU campus in 1837 when Psi Upsilon chartered its Delta Chapter. The first fraternities at NYU were social ones. With their athletic, professional, intellectual, and service activities, later groups sought to attract students who also formed other groups. Since then, Greek letter organizations have proliferated to include 25 social fraternities and sororities. As of 2014 [ update ] , approximately 13% of NYU undergraduate students are members of fraternities or sororities. Four governing boards oversee Greek life at the university. The Interfraternity Council (IFC) has jurisdiction over all twelve recognized fraternities on campus. Eight sororities are under the jurisdiction of the Panhellenic Council (PhC), which features seven national sororities (ΔΦΕ, ΑΕΦ, ΑΣΤ, ΠΒΦ, ΚΚΓ, ΖΤΑ, ΔΓ) and two local sororities (ΑΦΖ and ΘΦΒ). Five multicultural organizations maintain membership in the Multicultural Greek Council (MGC), including two fraternities and three sororities. All three of the aforementioned boards are managed under the auspices of the Inter-Greek Council. Greek organizations have historical significance at NYU. Delta Phi Epsilon , Zeta Psi , Alpha Epsilon Pi , Tau Delta Phi , Alpha Kappa Psi and Delta Sigma Pi were founded at NYU. Zeta Psi was chartered in 1847, Delta Sigma Pi in 1907, Alpha Epsilon Pi in 1913 Delta Phi Epsilon was founded in 1917. The NYU Gamma chapter of Delta Phi , founded in 1841, is the longest continuously active fraternity chapter in the world, having never gone inactive since its establishment. Delta Phi is also the oldest continuously active fraternity in the United States, being the only organization in the original Union Triad to remain active since its institute. The NYU Gamma chapter of Zeta Beta Tau is the oldest active ΖΒΤ chapter in the country. During the University Heights era, an apparent rift evolved with some organizations distancing themselves from students from the downtown schools. The exclusive Philomathean Society operated from 1832 to 1888 (formally giving way in 1907 and reconstituted into the Andiron Club ). Included among the Andiron's regulations was "Rule No.11: Have no relations save the most casual and informal kind with the downtown schools." The Eucleian Society , rival to the Philomathean Society, was founded in 1832. The Knights of the Lamp was a social organization founded in 1914 at the School of Commerce. This organization met every full moon and had a glowworm as its mascot. The Red Dragon Society , founded in 1898, is thought to be the most selective society at NYU. In addition, NYU's first yearbook was formed by fraternities and "secret societies" at the university. There have been several attempts to restart old societies by both former and incoming undergraduate classes. NYU does not have an ROTC program on campus. However, NYU students may participate in the U.S. Army ROTC program through NYC Army ROTC (Yankee Battalion), headquartered at Fordham University . Students may also participate in the U.S. Air Force ROTC program through AFROTC Detachment 560 headquartered at Manhattan College. The Student Government Assembly (SGA) is the governing student body at NYU. The SGA has been involved in controversial debates on campus, including a campus-wide ban on the sale of Coca-Cola products in 2005, and the Graduate Student Organizing Committee unionization in 2001 and subsequent strike in 2005. The Coke ban was lifted by the University Senate on February 5, 2009. SGA consists of 75 voting members from subsidiary student government organs including the Student Senators Council (SSC) and the Presidents Council, which are elected from their respective individual undergraduate and graduate colleges. In 2018, the structure of the university's student government was called into question by students through school newspapers and social media pages calling for "sweeping changes to its byzantine structure." Advocates claimed the structure of SGA failed to represent all students, wasted university funds and operated in an undemocratic manner. Opponents claimed that advocates were merely motivated by legislation supporting the BDS movement that was likely to pass. NYU has over 450 student clubs and organizations on campus. In addition to the sports teams, fraternities, sororities, and study clubs, there are many organizations on campus that focus on entertainment, arts, and culture. These organizations include various student media clubs: for instance, the daily student newspaper the Washington Square News , the NYU Local daily blog, The Plague comedy magazine, " Washington Square Local web-based satire news source, and the literary journals Washington Square Review and The Minetta Review , as well as student-run event producers such as the NYU Program Board and the Inter-Residence Hall Council. It also operates radio station WNYU-FM 89.1 with a diverse college radio format, transmitting to the entire New York metropolitan area from the original campus, and via booster station WNYU-FM1 which fills in the signal in lower Manhattan from atop one of the Silver Towers, next to the football field at the Washington Square campus. Students publish a campus comedy magazine, The Plague . Like many college humor magazines , this often pokes fun at popular culture as well as campus life and the idiosyncrasies of New York University. The Plague was founded in 1978 by Howard Ostrowsky along with Amy Burns, John Rawlins, Joe Pinto and Dan Fiorella, and is currently published once per semester. It is not NYU's first humor magazine, as The Medley was a humor magazine published by the Eucleian Society from 1913 to 1950. Since winning the national championship in the 2003–2004 season, the NYU Cross Examination Debate Association (CEDA) debate team is considered one of the perennial collegiate policy debate teams in the country. For the 2020–21 season, they placed 5th in the nation at CEDA Open Nationals and 2nd in the nation at JV Nationals, along with students named the 1st and 4th place speakers at Novice Nationals. In 2021, they ranked 10th in the nation, finishing ahead of Harvard and Cornell. This marked 14 years of Top 20 National finishes dating back to the 2007 season. The New York University Mock Trial team is consistently ranked as one of the best collegiate mock trial teams in the country. NYU has qualified for the National Championship Tournament for 10 consecutive seasons and placed in the top 10 during each of those years. In the 2009–2010 season, NYU won the 26th National Championship Tournament in Memphis over rival Harvard . The following season, they qualified for the final round once more only to be the runners-up to UCLA . In the American Mock Trial Association's 2015–2016 power rankings, NYU ranks third, behind Harvard and Yale . NYU has traditions which have persisted across campuses. Since the beginning of the 20th century initiation ceremonies have welcomed incoming NYU freshmen. At the Bronx University Heights Campus, seniors used to grab unsuspecting freshmen, take them to a horse-watering trough, and then dunk them head-first into what was known colloquially as "the Fountain of Knowledge". This underground initiation took place until the 1970s. Today freshmen take part in university-sponsored activities during what is called "Welcome Week". In addition, throughout the year the university traditionally holds Apple Fest (an apple-themed country fest that began at the University Heights campus), the Violet Ball (a dance in the atrium of Bobst Library), Strawberry Fest (featuring New York City's longest Strawberry Shortcake ), and the semi-annual midnight breakfast where Student Affairs administrators serve free breakfast to students before finals . NYU is home to a number of student-run a cappella groups, several of which compete regularly at the International Championship of Collegiate A Cappella (ICCA). Most notable of these groups is The NYU N'Harmonics, who won the ICCA title in 2019. In 2020, The A Cappella Archive ranked The NYU N'Harmonics at #6 among all ICCA-competing groups. These organizations include various student media clubs: for instance, the daily student newspaper the Washington Square News , the NYU Local daily blog, The Plague comedy magazine, " Washington Square Local web-based satire news source, and the literary journals Washington Square Review and The Minetta Review , as well as student-run event producers such as the NYU Program Board and the Inter-Residence Hall Council. It also operates radio station WNYU-FM 89.1 with a diverse college radio format, transmitting to the entire New York metropolitan area from the original campus, and via booster station WNYU-FM1 which fills in the signal in lower Manhattan from atop one of the Silver Towers, next to the football field at the Washington Square campus. Students publish a campus comedy magazine, The Plague . Like many college humor magazines , this often pokes fun at popular culture as well as campus life and the idiosyncrasies of New York University. The Plague was founded in 1978 by Howard Ostrowsky along with Amy Burns, John Rawlins, Joe Pinto and Dan Fiorella, and is currently published once per semester. It is not NYU's first humor magazine, as The Medley was a humor magazine published by the Eucleian Society from 1913 to 1950. Since winning the national championship in the 2003–2004 season, the NYU Cross Examination Debate Association (CEDA) debate team is considered one of the perennial collegiate policy debate teams in the country. For the 2020–21 season, they placed 5th in the nation at CEDA Open Nationals and 2nd in the nation at JV Nationals, along with students named the 1st and 4th place speakers at Novice Nationals. In 2021, they ranked 10th in the nation, finishing ahead of Harvard and Cornell. This marked 14 years of Top 20 National finishes dating back to the 2007 season. The New York University Mock Trial team is consistently ranked as one of the best collegiate mock trial teams in the country. NYU has qualified for the National Championship Tournament for 10 consecutive seasons and placed in the top 10 during each of those years. In the 2009–2010 season, NYU won the 26th National Championship Tournament in Memphis over rival Harvard . The following season, they qualified for the final round once more only to be the runners-up to UCLA . In the American Mock Trial Association's 2015–2016 power rankings, NYU ranks third, behind Harvard and Yale . NYU has traditions which have persisted across campuses. Since the beginning of the 20th century initiation ceremonies have welcomed incoming NYU freshmen. At the Bronx University Heights Campus, seniors used to grab unsuspecting freshmen, take them to a horse-watering trough, and then dunk them head-first into what was known colloquially as "the Fountain of Knowledge". This underground initiation took place until the 1970s. Today freshmen take part in university-sponsored activities during what is called "Welcome Week". In addition, throughout the year the university traditionally holds Apple Fest (an apple-themed country fest that began at the University Heights campus), the Violet Ball (a dance in the atrium of Bobst Library), Strawberry Fest (featuring New York City's longest Strawberry Shortcake ), and the semi-annual midnight breakfast where Student Affairs administrators serve free breakfast to students before finals . NYU is home to a number of student-run a cappella groups, several of which compete regularly at the International Championship of Collegiate A Cappella (ICCA). Most notable of these groups is The NYU N'Harmonics, who won the ICCA title in 2019. In 2020, The A Cappella Archive ranked The NYU N'Harmonics at #6 among all ICCA-competing groups. Some of the first fraternities in the country were formed at NYU. Greek life first formed on the NYU campus in 1837 when Psi Upsilon chartered its Delta Chapter. The first fraternities at NYU were social ones. With their athletic, professional, intellectual, and service activities, later groups sought to attract students who also formed other groups. Since then, Greek letter organizations have proliferated to include 25 social fraternities and sororities. As of 2014 [ update ] , approximately 13% of NYU undergraduate students are members of fraternities or sororities. Four governing boards oversee Greek life at the university. The Interfraternity Council (IFC) has jurisdiction over all twelve recognized fraternities on campus. Eight sororities are under the jurisdiction of the Panhellenic Council (PhC), which features seven national sororities (ΔΦΕ, ΑΕΦ, ΑΣΤ, ΠΒΦ, ΚΚΓ, ΖΤΑ, ΔΓ) and two local sororities (ΑΦΖ and ΘΦΒ). Five multicultural organizations maintain membership in the Multicultural Greek Council (MGC), including two fraternities and three sororities. All three of the aforementioned boards are managed under the auspices of the Inter-Greek Council. Greek organizations have historical significance at NYU. Delta Phi Epsilon , Zeta Psi , Alpha Epsilon Pi , Tau Delta Phi , Alpha Kappa Psi and Delta Sigma Pi were founded at NYU. Zeta Psi was chartered in 1847, Delta Sigma Pi in 1907, Alpha Epsilon Pi in 1913 Delta Phi Epsilon was founded in 1917. The NYU Gamma chapter of Delta Phi , founded in 1841, is the longest continuously active fraternity chapter in the world, having never gone inactive since its establishment. Delta Phi is also the oldest continuously active fraternity in the United States, being the only organization in the original Union Triad to remain active since its institute. The NYU Gamma chapter of Zeta Beta Tau is the oldest active ΖΒΤ chapter in the country. During the University Heights era, an apparent rift evolved with some organizations distancing themselves from students from the downtown schools. The exclusive Philomathean Society operated from 1832 to 1888 (formally giving way in 1907 and reconstituted into the Andiron Club ). Included among the Andiron's regulations was "Rule No.11: Have no relations save the most casual and informal kind with the downtown schools." The Eucleian Society , rival to the Philomathean Society, was founded in 1832. The Knights of the Lamp was a social organization founded in 1914 at the School of Commerce. This organization met every full moon and had a glowworm as its mascot. The Red Dragon Society , founded in 1898, is thought to be the most selective society at NYU. In addition, NYU's first yearbook was formed by fraternities and "secret societies" at the university. There have been several attempts to restart old societies by both former and incoming undergraduate classes.NYU does not have an ROTC program on campus. However, NYU students may participate in the U.S. Army ROTC program through NYC Army ROTC (Yankee Battalion), headquartered at Fordham University . Students may also participate in the U.S. Air Force ROTC program through AFROTC Detachment 560 headquartered at Manhattan College. NYU's sports teams are referred to as the NYU Violets , the colors being the trademarked hue "NYU Violet" and white. Since 1981, the school mascot has been a bobcat, whose origin can be traced back to the abbreviation then being used by the Bobst Library computerized catalog—short: Bobcat. NYU's sports teams include baseball, men's and women's varsity basketball, cross country, fencing, golf, soccer, softball, swimming and diving, tennis, track and field, volleyball, and wrestling. Most of NYU's sports teams participate in the NCAA's Division III and the University Athletic Association , while fencing and ice hockey participate in Division I . While NYU has had All-American football players, the school has not had a varsity football team since 1952. NYU students also compete in club and intramural sports, including badminton , baseball , basketball , crew , cycling , equestrianism , ice hockey , lacrosse , martial arts , rugby , softball , squash , tennis , triathlon , and ultimate . The Palladium Athletic Facility serves as the home base of NYU's Varsity and Club intercollegiate athletic teams, while NYU's 404 and Brooklyn athletic facilities offer additional space for the NYU fitness community. Many of NYU's varsity teams play their games at various facilities and fields throughout Manhattan because of the scarcity of space for playing fields near campus. NYU is currently in the process of building a new billion dollar flagship athletic facility known as 181 Mercer Street . When complete, the new home of NYU Athletics will host a six-lane swimming pool, four full basketball courts, a complete in-door running track and other sports related offerings.As of 2020 [ update ] , multiple heads of state , royalty, one U.S. Supreme Court justice , five U.S. governors , 17 billionaires , 38 Nobel Laureates, [ citation needed ] 8 Turing Award winners, 5 Fields Medalists, 31 MacArthur Fellows , 167 Guggenheim Fellows , three astronauts , seven Abel Prize winners, seven Lasker Award winners, a Crafoord Prize winner, 26 Pulitzer Prize winners, 37 Academy Award winners, 30 Emmy Award winners, 25 Tony Award winners, 12 Grammy Award winners, multiple Forbes 30 under 30 and Time 100 notables, and numerous members of the National Academies of Sciences , American Academy of Arts and Sciences , United States Congress , and U.S. diplomats have been affiliated with faculty or alumni . Multiple Rhodes Scholars , Marshall Scholars , Schwarzman Scholars and a Mitchell Scholar are affiliated with the university, with NYU Abu Dhabi producing more Rhodes Scholars per student than any university in the world. NYU has more than 500,000 living alumni as of 2015 [ update ] . As of October 2020 [ update ] , 38 Nobel Prize winners are affiliated with NYU. The university is also associated with a great number of important inventions and discoveries, such as cardiac defibrillator and artificial cardiac pacemaker ( Barouh Berkovits ), closed-chest cardiac defibrillator ( William B. Kouwenhoven ), laser ( Gordon Gould ), atom bomb ( Frederick Reines ), polio vaccine ( Albert Sabin ), RFID ( Mario Cardullo ), telephone handset ( Robert G. Brown ), wireless microphone ( Hung-Chang Lin ), first digital image scanner ( Russell A. Kirsch ), television ( Benjamin Adler ), light beer ( Joseph Owades ), non-stick cookware ( John Gilbert ), black hole thermodynamics ( Jacob Bekenstein ), polymer science ( Herman Francis Mark ), microwave ( Ernst Weber ), X-ray crystallography ( Paul Peter Ewald ), barcode ( Jerome Swartz ), structure of the DNA ( Francis Crick ), tau lepton ( Martin Lewis Perl ), processes for creating food coloring , decaffeination and sugar substitute ( Torunn Atteraas Garin ), processes for the mass production of penicillin ( Jasper H. Kane ), X-ray generator and rotational radiation therapy ( John G. Trump ), nuclear reactor and hydrogen bomb ( John Archibald Wheeler ), and contact lenses ( Norman Gaylord ), among many others. Alumnus Fred Waller who invented Cinerama and the Waller Gunnery Trainer , also obtained the first patent for a water ski . The first patents for touch screen cash machine (Richard J. Orford), and zoom lens (Leonard Bergstein), were also obtained by NYU alumni. Some of the most prolific inventors in American history are NYU alumni, for example Jerome H. Lemelson whose 605 patents involved the cordless telephone , fax machine , videocassette recorder and camcorder , among others; Samuel Ruben whose inventions include electric battery ; James Wood who invented cable-lift elevator , fabricated the steel cables for the Brooklyn Bridge and contributed to the development of lockmaking , submarine , electric generator , electric motor , transformer and the design of the refrigerator ; and Albert Macovski whose innovations include the single-tube color camera and real-time phased array imaging for ultrasound . NYU is the birthplace of the tractor beam and 5G . Before and during World War II , NYU's Tandon School of Engineering worked on problems whose solution led to the development of radar , and later broke ground in electromagnetic theory, electronics in general, and solved re-entry problems of the crewed space capsules , as well as helped develop and design the NASDAQ Automated Quote System and trading floors. Developer of the early telephone systems in the United States Bancroft Gherardi Jr. , developer of the submarine communications facilities Jack M. Sipress , inventor of Italy 's first computer Mario Tchou , designer of the Panama Canal locks Henry C. Goldmark , designer of the Pentagon Hugh John Casey , designer of the Apollo Lunar Module Thomas J. Kelly , as well as the designer of virtually every major bridge in New York City from the George Washington to the Verrazzano , Leopold Just , are also NYU alumni. Many of the world's most renowned companies, such as IBM ( Charles Ranlett Flint ), Twitter (Jack Dorsey), Bloomberg L.P. ( Charles Zegar ), Jacobs Engineering Group ( Joseph J. Jacobs ), Hudson Group ( Robert B. Cohen ), MTV ( Tom Freston ), Barnes & Noble ( Leonard Riggio ), Northrop Grumman ( William T. Schwendler ), Automatic Data Processing ( Henry Taub ), Duracell (Samuel Ruben), Bugle Boy ( William C. W. Mow ), Virgin Mobile USA ( Dan Schulman ), among many others, were founded or co-founded by NYU alumni. Many of the world's most famous companies were either owned or led by NYU alumni. These include, Lockheed Martin ( Robert J. Stevens ), Xerox ( Ursula Burns ), Yahoo! ( Alfred Amoroso ), TPV Technology ( Jason Hsuan ), 20th Century Fox ( Marvin Davis ), BAE Systems Inc ( Mark Ronald ), AECOM ( John Dionisio ), Pfizer ( John Elmer McKeen ), Ingersoll Rand ( Herbert L. Henkel ), General Motors ( Alfred P. Sloan ), and Sears ( Arthur C. Martinez ). Others include The New York Times ( Spencer Trask ), Stanley Black & Decker ( John Trani ), American International Group ( Harvey Golub ), American Express ( Edward P. Gilligan ), Qwest ( Joseph Nacchio ), Chase Bank ( Walter V. Shipley ), CBS ( Laurence Alan Tisch ), Bristol-Myers Squibb Company ( Charles A. Heimbold, Jr. ), Citigroup ( Robert I. Lipp ), Morgan Stanley ( Robert A. Kindler ), Marvel Entertainment ( John Turitzin ), ConocoPhillips ( John Carrig ), Deloitte ( Barry Salzberg ), Sony Pictures Entertainment ( Peter Guber ), GQ ( Steven Florio ), Viacom ( Thomas E. Dooley ), Liberty Media ( John C. Malone ), Verizon ( Lawrence Babbio Jr. ) and Chemtura ( Vincent A. Calarco ). A pioneer of Silicon Valley , Eugene Kleiner , and the World Trade Center site owner, Larry Silverstein , are also alumni. Hun Manet , Prime Minister of Cambodia ; Master of Arts in economics,2002

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Plague

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Plague doctor costume

The clothing worn by plague doctors was intended to protect them from airborne diseases during outbreaks of bubonic plague in Europe. It is often seen as a symbol of death and disease. However, the costume was mostly worn by late Renaissance and early modern physicians studying and treating plague patients. The costume consists of a leather hat, mask with glass eyes and a beak, stick to remove clothes of a plague victim, gloves, waxed linen robe, and boots. The typical mask had glass openings for the eyes and a curved beak shaped like a bird's beak with straps that held the beak in front of the doctor's nose. The mask had two small nose holes and was a type of respirator which contained aromatic items. The beak could hold dried flowers (commonly roses and carnations ), herbs (commonly lavender and peppermint ), camphor , or a vinegar sponge, as well as juniper berry , ambergris , cloves , labdanum , myrrh , and storax . The purpose of the mask was to keep away bad smells, such as the smell of decaying bodies. The smell taken with the most caution was known as miasma , a noxious form of "bad air". This was thought to be the principal cause of the disease. Doctors believed the herbs would counter the "evil" smells of the plague and prevent them from becoming infected. Though these particular theories about the plague's nature were incorrect, it is likely that the costume actually did afford the wearer some protection. The garments covered the body, shielding against splattered blood, lymph, and cough droplets, and the waxed robe prevented fleas (the true carriers of the plague) from touching the body or clinging to the linen. The wide-brimmed leather hat indicated their profession. Doctors used wooden canes in order to point out areas needing attention and to examine patients without touching them. The canes were also used to keep people away and to remove clothing from plague victims without having to touch them. The exact origins of the costume are unclear, as most depictions come from satirical writings and political cartoons. An early reference to plague doctors wearing masks is in 1373 when Johannes Jacobi recommends their use but he offers no physical description of them. The beaked plague doctor inspired costumes in Italian theatre as a symbol of general horror and death, though some historians insist that the plague doctor was originally fictional and inspired the real plague doctors later. Depictions of the beaked plague doctor rose in response to superstition and fear about the unknown source of the plague. Often, these plague doctors were the last thing a patient would see before death; therefore, the doctors were seen as a foreboding of death. The garments were first mentioned by a physician to King Louis XIII of France , Charles de Lorme , who wrote in a 1619 plague outbreak in Paris that he developed an outfit made of Moroccan goat leather , including boots, breeches, a long coat, hat, and gloves modeled after a soldier's canvas gown which went from the neck to the ankle. The garment was impregnated with similar fragrant items as the mask. De Lorme wrote that the mask had a "nose half a foot long, shaped like a beak, filled with perfume with only two holes, one on each side near the nostrils, but that can suffice to breathe and to carry along with the air one breathes the impression of the drugs enclosed further along in the beak." However, recent research has revealed that strong caveats must be applied with regard to De Lorme's assertions. The Genevan physician, Jean-Jacques Manget , in his 1721 work Treatise on the Plague written just after the Great Plague of Marseille , describes the costume worn by plague doctors at Nijmegen in 1636–1637. The costume forms the frontispiece of Manget's 1721 work. Their robes, leggings, hats, and gloves were also made of Morocco leather. This costume was also worn by plague doctors during the Naples Plague of 1656 , which killed 145,000 people in Rome and 300,000 in Naples . The costume is also associated with a commedia dell'arte character called Il Medico della Peste (lit.: The Plague Doctor ), who wears a distinctive plague doctor's mask . The Venetian mask was normally white, consisting of a hollow beak and round eye-holes covered with clear glass, and is one of the distinctive masks worn during the Carnival of Venice . During the COVID-19 pandemic beginning in 2020, the plague doctor costume grew in popularity due to its relevance to the pandemic, with news reports of plague doctor-costumed individuals in public places and photos of people wearing plague doctor costumes appearing in social media.

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Plague

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Dancing plague of 1518

The dancing plague of 1518 , or dance epidemic of 1518 ( French : Épidémie dansante de 1518 ), was a case of dancing mania that occurred in Strasbourg , Alsace (modern-day France ), in the Holy Roman Empire from July 1518 to September 1518. Somewhere between 50 and 400 people took to dancing for weeks. There are many theories behind the phenomenon, the most popular being stress-induced mass hysteria, suggested by John Waller. Other theories include ergot and religious explanations. There is controversy concerning the number of deaths. The outbreak began in July 1518 when a woman called Frau Troffea began to dance fervently and uncontrollably in a street in Strasbourg. Troffea kept up the constant dancing for a week. Soon, three dozen others joined in. By August, the "dancing plague" had claimed 400 victims. Dancers were beginning to collapse. It is said some even died from a stroke or heart attack. No one knew what caused this reaction, which meant no one understood how to remedy it. By early September, the outbreak began to subside, when the dancers were sent to a mountain shrine to pray for absolution. Historical documents, including "physician notes, cathedral sermons, local and regional chronicles, and even notes issued by the Strasbourg city council" are clear that the victims danced; it is not known why. Historical sources agree that there was an outbreak of dancing after a single woman started dancing, and the dancing did not seem to die down. It lasted for such a long time that it even attracted the attention of the authorities; until the council gave up authority to the physicians, who prescribed the afflicted to "dance themselves free of it." There are claims that guild halls were refurbished to accommodate the dancing, as well as musicians and strong people to help keep those dealing with the dancing mania to stay upright. This backfired, and the council was forced to ban public dancing as people danced in fear it was a punishment from Saint Vitus ; and to be "free of sin" many joined in on the dancing epidemic. The council went as far as to ban music, as well. Those who danced were then ordered to go to the shrine of Saint Vitus, wore red shoes that were sprinkled with holy water and had painted crosses on the tops and soles. They also had to hold small crosses in their hands; and incense and Latin incantations were part of this "ritual." Apparently "forgiven by Vitus," word was spread of a successful ritual and the Dancing Plague had ended. Events similar to this are said to have occurred throughout the medieval age including 11th century in Kölbigk, Saxony, where it was believed to be the result of divine judgment . In 15th century Apulia, Italy, a woman was bitten by a tarantula, the venom making her dance convulsively. The only way to cure the bite was to "shimmy" and to have the right sort of music available, which was an accepted remedy by scholars like Athanasius Kircher . Contemporaneous explanations included demonic possession and overheated blood. The outbreak began in July 1518 when a woman called Frau Troffea began to dance fervently and uncontrollably in a street in Strasbourg. Troffea kept up the constant dancing for a week. Soon, three dozen others joined in. By August, the "dancing plague" had claimed 400 victims. Dancers were beginning to collapse. It is said some even died from a stroke or heart attack. No one knew what caused this reaction, which meant no one understood how to remedy it. By early September, the outbreak began to subside, when the dancers were sent to a mountain shrine to pray for absolution. Historical documents, including "physician notes, cathedral sermons, local and regional chronicles, and even notes issued by the Strasbourg city council" are clear that the victims danced; it is not known why. Historical sources agree that there was an outbreak of dancing after a single woman started dancing, and the dancing did not seem to die down. It lasted for such a long time that it even attracted the attention of the authorities; until the council gave up authority to the physicians, who prescribed the afflicted to "dance themselves free of it." There are claims that guild halls were refurbished to accommodate the dancing, as well as musicians and strong people to help keep those dealing with the dancing mania to stay upright. This backfired, and the council was forced to ban public dancing as people danced in fear it was a punishment from Saint Vitus ; and to be "free of sin" many joined in on the dancing epidemic. The council went as far as to ban music, as well. Those who danced were then ordered to go to the shrine of Saint Vitus, wore red shoes that were sprinkled with holy water and had painted crosses on the tops and soles. They also had to hold small crosses in their hands; and incense and Latin incantations were part of this "ritual." Apparently "forgiven by Vitus," word was spread of a successful ritual and the Dancing Plague had ended. Events similar to this are said to have occurred throughout the medieval age including 11th century in Kölbigk, Saxony, where it was believed to be the result of divine judgment . In 15th century Apulia, Italy, a woman was bitten by a tarantula, the venom making her dance convulsively. The only way to cure the bite was to "shimmy" and to have the right sort of music available, which was an accepted remedy by scholars like Athanasius Kircher . Contemporaneous explanations included demonic possession and overheated blood. Controversy exists over whether people ultimately danced to their deaths. Some sources claim that for a period the plague killed around fifteen people per day, but the sources of the city of Strasbourg at the time of the events did not mention the number of deaths, or even if there were fatalities. There do not appear to be any sources related to the events that make note of any fatalities. Ned Pennant-Rea also claims that the final death toll is not known, but if the claims of fifteen people dying per day were true then the toll could be "into the hundreds." The main source for the claim is John Waller, who has written several journal articles on the subject and the book A Time to Dance, a Time to Die: The Extraordinary Story of the Dancing Plague of 1518 . The sources cited by Waller that mention deaths were all from later accounts of the events. There is also uncertainty around the identity of the initial dancer (either an unnamed woman or "Frau Troffea") and the number of dancers involved (somewhere between 50 and 400). Of the six chronicle accounts, four support Lady Troffea as the first dancer. Some believe the dancing could have been brought on by food poisoning caused by the toxic and psychoactive chemical products of ergot fungi ( ergotism ), which grows commonly on grains (such as rye) used for baking bread. Ergotamine is the main psychoactive product of ergot fungi; it is structurally related to the drug lysergic acid diethylamide (LSD-25) and is the substance from which LSD-25 was originally synthesized. The same fungus has also been implicated in other major historical anomalies, including the Salem witch trials . In The Lancet , John Waller argues that "this theory does not seem tenable, since it is unlikely that those poisoned by ergot could have danced for days at a time. Nor would so many people have reacted to its psychotropic chemicals in the same way. The ergotism theory also fails to explain why almost every outbreak occurred somewhere along the Rhine and Moselle rivers, areas linked by water but with quite different climates and crops". This could have been an example of fully developed cases of psychogenic movement disorder happening in mass hysteria or mass psychogenic illness , which involves many individuals suddenly exhibiting the same bizarre behavior. The behavior spreads rapidly and broadly in an epidemic pattern. This kind of comportment could have been caused by elevated levels of psychological stress , caused by the ruthless years (even by the rough standards of the early modern period) the people of Alsace were suffering. Waller speculates that the dancing was "stress-induced psychosis " on a mass level, since the region where the people danced was riddled with starvation and disease, and the inhabitants tended to be superstitious. Seven other cases of dancing plague were reported in the same region during the medieval era . This psychogenic illness could have created a chorea (from the Greek khoreia meaning "to dance"), a situation comprising random and intricate unintentional movements that flit from body part to body part. Diverse choreas ( St. Vitus' dance, St. John's dance , and tarantism ) were labeled in the Middle Ages referring to the independent epidemics of "dancing mania" that happened in central Europe, particularly at the time of the plague. Some believe the dancing could have been brought on by food poisoning caused by the toxic and psychoactive chemical products of ergot fungi ( ergotism ), which grows commonly on grains (such as rye) used for baking bread. Ergotamine is the main psychoactive product of ergot fungi; it is structurally related to the drug lysergic acid diethylamide (LSD-25) and is the substance from which LSD-25 was originally synthesized. The same fungus has also been implicated in other major historical anomalies, including the Salem witch trials . In The Lancet , John Waller argues that "this theory does not seem tenable, since it is unlikely that those poisoned by ergot could have danced for days at a time. Nor would so many people have reacted to its psychotropic chemicals in the same way. The ergotism theory also fails to explain why almost every outbreak occurred somewhere along the Rhine and Moselle rivers, areas linked by water but with quite different climates and crops". This could have been an example of fully developed cases of psychogenic movement disorder happening in mass hysteria or mass psychogenic illness , which involves many individuals suddenly exhibiting the same bizarre behavior. The behavior spreads rapidly and broadly in an epidemic pattern. This kind of comportment could have been caused by elevated levels of psychological stress , caused by the ruthless years (even by the rough standards of the early modern period) the people of Alsace were suffering. Waller speculates that the dancing was "stress-induced psychosis " on a mass level, since the region where the people danced was riddled with starvation and disease, and the inhabitants tended to be superstitious. Seven other cases of dancing plague were reported in the same region during the medieval era . This psychogenic illness could have created a chorea (from the Greek khoreia meaning "to dance"), a situation comprising random and intricate unintentional movements that flit from body part to body part. Diverse choreas ( St. Vitus' dance, St. John's dance , and tarantism ) were labeled in the Middle Ages referring to the independent epidemics of "dancing mania" that happened in central Europe, particularly at the time of the plague. The event inspired Jonathan Glazer 's 2020 short film Strasbourg 1518 . It was also the inspiration behind the 2022 choral song "Choreomania" by Florence and the Machine . It was the third track on the album Dance Fever , which took its title from the song. The book series A Collection of Utter Speculation released a title The Dancing Plague: A Collection of Utter Speculation in 2022. It is a fictional account of the events that happened in Strasbourg. The 2023 novel The Dance Tree by Kiran Millwood Hargrave is a fictionalized version of the summer of 1518 in Strasbourg. The event is featured as part of the first season of Watcher Entertainment's Puppet History in the episode "The Dancing Plague".

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Plague

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List of epidemics and pandemics

This is a list of the largest known epidemics and pandemics caused by an infectious disease . Widespread non-communicable diseases such as cardiovascular disease and cancer are not included. An epidemic is the rapid spread of disease to a large number of people in a given population within a short period of time; in meningococcal infections , an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic. Due to the long time spans, the first plague pandemic (6th century – 8th century) and the second plague pandemic (14th century – early 19th century) are shown by individual outbreaks, such as the Plague of Justinian (first pandemic) and the Black Death (second pandemic). Infectious diseases with high prevalence are listed separately (sometimes in addition to their epidemics), such as malaria , which may have killed 50–60 billion people throughout history, or about half of all humans that have ever lived. Ongoing epidemics and pandemics are in boldface . For a given epidemic or pandemic, the average of its estimated death toll range is used for ranking. If the death toll averages of two or more epidemics or pandemics are equal, then the smaller the range, the higher the rank. For the historical records of major changes in the world population, see world population . Not included in the above table are many waves of deadly diseases brought by Europeans to the Americas and Caribbean. Western Hemisphere populations were ravaged mostly by smallpox , but also typhus , measles , influenza , bubonic plague , cholera , malaria , tuberculosis , mumps , yellow fever , and pertussis . The lack of written records in many places and the destruction of many native societies by disease, war, and colonization make estimates uncertain. Deaths probably numbered in the tens or perhaps over a hundred million, with perhaps 90% of the population dead in the worst-hit areas. Lack of scientific knowledge about microorganisms and lack of surviving medical records for many areas makes attribution of specific numbers to specific diseases uncertain. There have been various major infectious diseases with high prevalence worldwide, but they are currently not listed in the above table as epidemics/pandemics due to the lack of definite data, such as time span and death toll.Ongoing epidemics and pandemics are in boldface . For a given epidemic or pandemic, the average of its estimated death toll range is used for ranking. If the death toll averages of two or more epidemics or pandemics are equal, then the smaller the range, the higher the rank. For the historical records of major changes in the world population, see world population . Not included in the above table are many waves of deadly diseases brought by Europeans to the Americas and Caribbean. Western Hemisphere populations were ravaged mostly by smallpox , but also typhus , measles , influenza , bubonic plague , cholera , malaria , tuberculosis , mumps , yellow fever , and pertussis . The lack of written records in many places and the destruction of many native societies by disease, war, and colonization make estimates uncertain. Deaths probably numbered in the tens or perhaps over a hundred million, with perhaps 90% of the population dead in the worst-hit areas. Lack of scientific knowledge about microorganisms and lack of surviving medical records for many areas makes attribution of specific numbers to specific diseases uncertain.There have been various major infectious diseases with high prevalence worldwide, but they are currently not listed in the above table as epidemics/pandemics due to the lack of definite data, such as time span and death toll.Events in boldface are ongoing.

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Plague

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A Plague Tale: Requiem

A Plague Tale: Requiem is an action-adventure stealth video game developed by Asobo Studio and published by Focus Entertainment . The game is the sequel to A Plague Tale: Innocence (2019), and follows siblings Amicia and Hugo de Rune who must look for a cure to Hugo's blood disease in Southern France while fleeing from soldiers of the Inquisition and hordes of rats that are spreading the black plague . It was released for Nintendo Switch ( cloud version ), PlayStation 5 , Windows , and Xbox Series X/S on 18 October 2022. It received generally positive reviews from critics. At The Game Awards 2022 , it received five nominations including Game of the Year .Requiem is an action-adventure game played from a third-person perspective . In the game, the player assumes control of Amicia and must face off against both hostile humans and hordes of rats that are spreading the black plague . Gameplay is largely similar to the first game, though the combat system is significantly expanded. Amicia is equipped with weapons such as a knife to stab enemies, a sling that can be used to throw rocks, and a crossbow which allows her to defeat armoured opponents. Crossbow bolts, throwing pots, and rocks can be combined with alchemical mixtures. In addition to Ignifer and Extinguis, which allows the player to light and extinguish flame, respectively, the game introduces tar , which increases the radius of the light source, and can be used to ignite enemies. Locations are also larger in Requiem , giving the player additional options to progress. Stealth is expanded in Requiem . Unlike Innocence , Amicia would not die after being hit once by enemies. She can also return to stealth after she was discovered by enemies, and counter their attacks if she gets too close to them. Amicia's brother Hugo, who has a connection to the plague, can use an ability named "Echo" which reveals the locations of enemies through walls. Hugo can also control the hordes of rats to overwhelm enemies. Similar to the first game, the rats, which are light-averse, play a huge role in the game. Amicia and Hugo must stay in the light, or they will be devoured by the rats. Amicia can use the rats to her advantage, manipulating them to solve puzzles , or even lure them to kill enemies. The game also features a progression system in which the player will be awarded additional skills and abilities. Stealth players will unlock skills that allows them to sneak around more efficiently, while those who prefer a more lethal approach will unlock additional combat skills. The player's gear and equipment can also be upgraded at workbenches. In 1349, six months following the events of the first game , siblings Amicia (Charlotte McBurney) and Hugo de Rune (Logan Hannan), along with their mother Beatrice (Lucy Briggs-Owen) and her apprentice Lucas ( Kit Connor ), seek refuge among an organization of alchemists called the Order. A hostile group of survivalist beekeepers attack the siblings, causing the Prima Macula to reawaken in Hugo. The group hides in a fortified town in Provence where Beatrice enlists the aid of Order representative Vaudin (Antony Byrne) to treat Hugo; the treatments only exacerbate his condition, resulting in the town being swarmed by rats and left in ruins. Vaudin is killed while the others escape on a boat bound for the Order's headquarters in Marseille . Unwilling to see Hugo locked up as the Order's test subject, Amicia takes Hugo and leaves Beatrice and Lucas to seek an island of which Hugo has recurring dreams, hoping it will lead to a cure for the Macula. Along the way, they are pursued by Provence soldiers, as well as mercenaries led by the disgraced knight Arnaud (Harry Myers). Arnaud offers to arrange transport to the island from Hugo's dreams, La Cuna. They sail to the island on the ship of Arnaud's smuggler friend Sophia ( Anna Demetriou ). Arriving at La Cuna, the group discovers that the residents, led by Count Victor ( Alistair Petrie ) and Countess Emilie (Ellie Heydon), worship a pagan deity called the Child of Embers. Arnaud tries to coerce Hugo into summoning rats to attack Victor — whom he blames for the death of his son — but Amicia intervenes, and Arnaud is arrested. Amicia deduces that the Count and Countess are unknowingly worshipping a previous Macula carrier as the Child. With Sophia, they delve into an ancient Order temple, following the history of the carrier, Basilius, and his protector, Aelia. Entering a chapel where Aelia was imprisoned after rebelling against the Order, the group encounters a cult of slavers who offer human sacrifices to the Child; Hugo summons rats to kill the slavers. The group discovers that there is no cure and there never was; Basilius was imprisoned underground by the Order to contain the Macula, and Aelia died before she could reach him. Without Aelia, Basilius gave in to the Macula and unleashed the Justinian Plague . Amicia realizes the Macula showed Hugo the dream to lure him into its clutches, and they flee the prison as it collapses under a horde of rats. Amicia and Hugo return to Victor's castle and reunite with Beatrice and Lucas. Amicia reasons that, if they are there to support Hugo, the Macula will remain dormant. However, Victor reveals Emilie believes Hugo is the Child — a myth Victor invented for Emilie, who is infertile — so they must kill Hugo's old family and adopt him. After Emilie kills Beatrice in a ritual sacrifice, Hugo summons a horde of rats which devours Emilie and destroys much of the island. Amicia's group rescues Arnaud before escaping on Sophia's ship, with Victor in pursuit. Victor wounds Amicia and captures Hugo while the rest are forced overboard. On shore, Arnaud sacrifices himself to allow Amicia to kill Victor, but they are too late to prevent Hugo, who believes Amicia to be dead, from giving himself over to the Macula. A cloud blots out the sun, allowing the rats to spread unchecked and destroy Marseille. Amicia and Lucas enter the ruined city and sink into a phantasmic reality created by the Macula. Here, Hugo's voice tells Amicia that, having now fully merged with the Macula, the only way to stop the rats is to kill him. Hugo is killed by Lucas if Amicia refuses to do so. One year later, Amicia has a home in the mountains, and Lucas is continuing his alchemy studies elsewhere. Amicia prepares to journey with Sophia to find the next Macula carrier and protector so that she can help guide them. Before she leaves, she pays her respects to Hugo's grave. In a post-credits scene set in the modern era, a child is on a ventilator, with signs of the Macula on its skin.Requiem was developed by French video game development company Asobo Studio . Similar to the first game, the game is set in Medieval France during the mid-14th century . To ensure the authenticity of the locations, the team collaborated with Roxane Chila, a doctor in Medieval History, and browsed both Wikipedia and other specialized websites for additional information. They also drew inspirations from the personal experiences of some of their team members. The team decided early on that the game would have a different colour palette when compared with its predecessor. As a result, the setting of the game was moved from the gloomy, war-torn Aquitaine to Provence , which is more colorful and vibrant. According to lead writer Sébastien Renard, this created a "sharper contrast between the harsh reality of the medieval setting, in which terrible events are happening, and beautiful, sometimes uncharted environments". To create additional opportunities for puzzle-solving, the game introduces several new locations including harbours and marketplaces, in Requiem . The voice actors speak British English, whereas in the previous game, they spoke English with a French accent. A Plague Tale: Requiem was announced by Asobo Studio and publisher Focus Entertainment during Microsoft's E3 2021 press conference. The game competed for the Tribeca Games Award and was included as an official selection. The game was released on 18 October 2022 for PlayStation 5 , Windows , and Xbox Series X/S . The release of a new generation of consoles allowed the game to render more than 300,000 rats at once. A cloud-only version was also to be released for Nintendo Switch on the same day. The original soundtrack of A Plague Tale: Requiem, is composed by Olivier Deriviere , recorded at Estonian Public Broadcasting Studio and released under Black Screen Records. The soundtrack is an orchestral arrangement, including performers like Eric-Maria Couturier and the Estonian Philharmonic Chamber Choir . It was published on multiple platforms on the same day as the game's release. Alongside cello as a principal instrument, a diverse array of medieval musical instruments, such as medieval guitar, bagpipes , lute , flute , nyckelharpa , and viola de gamba were used. A 43-minute concert was performed on 24 November 2022 and broadcast on the official YouTube channel of the publisher of the game, Focus Entertainment . According to Olivier Deriviere's official channel on Spotify and shazammed tracks, following the main theme, which shares its name with the game, specific tracks like "No Turning Back" and "Brother" have resonated with more audiences. The lyrics of "Ô ma belle lune" ( English: O my beautiful moon ) are written by Olivier Deriviere and are featured in both the first and last tracks of the A Plague Tale: Requiem Original Soundtrack . The composer created a walkthrough on YouTube in which he explained the in-game music in detail. A Plague Tale: Requiem received "generally favorable" reviews from critics, according to review aggregator website Metacritic . In the United Kingdom, the game was the fifth best-selling retail game in its week of release. On 4 November 2022, Focus Entertainment announced that the game had reached over 1 million players. On 21 November 2023, it was announced that the game had reached 3 million players. In the United Kingdom, the game was the fifth best-selling retail game in its week of release. On 4 November 2022, Focus Entertainment announced that the game had reached over 1 million players. On 21 November 2023, it was announced that the game had reached 3 million players.

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Plague

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Plague of Athens

The Plague of Athens ( Ancient Greek : Λοιμὸς τῶν Ἀθηνῶν , Loimos tôn Athênôn ) was an epidemic that devastated the city-state of Athens in ancient Greece during the second year (430 BC) of the Peloponnesian War when an Athenian victory still seemed within reach. The plague killed an estimated 75,000 to 100,000 people, around 25% of the population, and is believed to have entered Athens through Piraeus , the city's port and sole source of food and supplies. Much of the eastern Mediterranean also saw an outbreak of the disease, albeit with less impact. The war, along with the plague, had serious effects on Athens' society. This resulted in a lack of adherence to laws and religious belief; in response, laws became stricter, resulting in the punishment of non-citizens claiming to be Athenian. Among the victims of the plague was Pericles , the leader of Athens. The plague returned twice more, in 429 BC and in the winter of 427/426 BC. Some 30 pathogens have been suggested as having caused the plague. Sparta and its allies, except for Corinth , were almost exclusively land-based powers, able to summon large land armies that were very nearly unbeatable. In the face of a combined campaign on land from Sparta and its allies beginning in 431 BC, the Athenians, under the direction of Pericles , pursued a policy of retreat within the city walls of Athens, relying on Athenian maritime supremacy for supply while the superior Athenian navy harassed Spartan troop movements. Unfortunately, the strategy also resulted in massive migration from the Attic countryside into an already highly populated city, generating overpopulation and resource shortage. Due to the close quarters and poor hygiene exhibited at that time, Athens became a breeding ground for disease, and many citizens died. In the history of epidemics in wartime, the 'Plague' of Athens is remarkable for the limitation of the affliction to one side as well as for its influence on the outcome of the war. [ citation needed ] The Athenians thought that the Spartans could have poisoned their water supply to kill them to win the Peloponnesian War. The Spartans somehow were unaffected by the plague, which may have been a reason for the Athenians' suspicion. It has been noted that the Plague of Athens was the worst sickness of Classical Greece. In his History of the Peloponnesian War , the historian Thucydides , who was present and contracted the disease himself and survived, describes the epidemic. He writes of a disease coming from Ethiopia and passing through Egypt and Libya into the Greek world and spreading throughout the wider Mediterranean; a plague so severe and deadly that no one could recall anywhere its like, and physicians ignorant of its nature not only were helpless but themselves died the fastest, having had the most contact with the sick. In overcrowded Athens, the disease killed an estimated 25% of the population. The sight of the burning funeral pyres of Athens caused the Spartans to withdraw their troops, being unwilling to risk contact with the diseased enemy. Many of Athens' infantry and expert seamen died. According to Thucydides , not until 415 BC had Athens recovered sufficiently to mount a major offensive, the disastrous Sicilian Expedition . [ citation needed ] The first corroboration of the plague was not revealed until 1994-95 when excavation revealed the first mass grave . Upon this discovery, Thucydides' accounts of the event as well as analysis of the remains had been used to try and identify the cause of the epidemic. [ citation needed ]Thucydides claims that the plague spread from Ethiopia to Athens. The plague first emerged in the port of Piraeus from ships with plague infected passengers. From there it spread to Athens via the Long Walls where refugees would camp out. The small space and poor hygiene of the people living in the Long Walls led to a significant spread of the plague. The plague affected certain groups over others, however, there is a lack of details of how the plague spread among inbreeds and certain working members. Physicians and health care workers were at a higher risk to catch the plague due to the exposure of other diseases. Higher-ranking members of society were at a lower risk of catching the plague due to better living standards and better hygiene. Lack of food was not an issue for Athens, for they had plenty of grain storage. Athens lacked vitamin C due to their mainly grain diet. The lack of vitamin C caused a lower immunity. The lower immunity left Athenians more susceptible to diseases. The Plague of Athens was most likely caused by a reservoir disease or respiratory disease , though neither has been confirmed. If the plague was caused by a reservoir disease, it would be very similar to arboviral diseases or typhus as later mentioned. If it was a respiratory disease, it would most likely be similar to smallpox . Most Athenian doctors and physicians believed in Humorism . The belief is centered around the idea that a person contains four humors-yellow bile, black bile, phlegm, and blood-that must be equally balanced to have a healthy body. Practices to balance the humors include blood-letting, purging, urine sampling, and using the opposite humor to treat the imbalanced humor.Accounts of the Athenian plague graphically describe the social consequences of an epidemic. Thucydides' account details the complete disappearance of social morals during the time of the plague: ...the catastrophe was so overwhelming that men, not knowing what would happen next to them, became indifferent to every rule of religion or law." The perceived impact of the Athenian plague on collective social and religious behavior echoes accounts of the medieval pandemic best known as the Black Death , although scholars have disputed its objective veracity in both instances, citing a historical link between epidemic disease and unsubstantiated moral panic that bordered on hysteria . Thucydides states that people ceased fearing the law since they felt they were already living under a death sentence. Likewise, people started spending money indiscriminately. Many felt they would not live long enough to enjoy the fruits of wise investment, while some of the poor unexpectedly became wealthy by inheriting the property of their relatives. It is also recorded that people refused to behave honorably because most did not expect to live long enough to enjoy a good reputation for it. Another reason for the lack of honorable behavior was the sheer contagiousness of the illness. Those who tended to the ill were most vulnerable to catching the disease. This meant that many people died alone because no one was willing to risk caring for them. The dead were heaped on top of each other, left to rot, or shoved into mass graves. Sometimes those carrying the dead would come across an already burning funeral pyre, dump a new body on it, and walk away. Others appropriated prepared pyres to have enough fuel to cremate their own dead. Survivors of the plague developed an immunity and so became the main caretakers of those who later fell ill. A mass grave and nearly 1,000 tombs, dated between 430 and 426 BC, have been found just outside Athens' ancient Kerameikos cemetery. The mass grave was bordered by a low wall that seemed to have protected the cemetery from a wetland. Excavated during 1994–95, the shaft-shaped grave may have contained a total of 240 individuals, at least ten of them children. Skeletons in the graves were randomly placed with no layers of soil between them. [ citation needed ] Excavator Efi Baziotopoulou-Valavani, of the Third Ephoreia (Directorate) of Antiquities, reported that "[t]he mass grave did not have a monumental character. The offerings we found consisted of common, even cheap, burial vessels; black-finished ones, some small red-figured, as well as white lekythoi (oil flasks) of the second half of the 5th century BC. The bodies were placed in the pit within a day or two. These [factors] point to a mass burial in a state of panic, quite possibly due to a plague." During this time refugees from the Peloponnesian war had immigrated within the Long Walls of Athens, inflating the populations of both the polis of Athens and the port of Piraeus. The population had tripled in this time increasing the chance of infection and worsening hygiene. The plague also caused religious uncertainty and doubt. Since the disease struck without regard to a person's piety toward the gods, people felt abandoned by the gods and there seemed to be no benefit to worshiping them. The temples themselves were sites of great misery, as refugees from the Athenian countryside had been forced to find accommodation in the temples. Soon the sacred buildings were filled with the dead and dying. The Athenians pointed to the plague as evidence that the gods favored Sparta, and this was supported by an oracle that Apollo himself (the god of disease and medicine) would fight for Sparta if they fought with all their might. An earlier oracle had warned that "A Dorian [Spartan] war will come, and bring a pestilence with it". Thucydides was skeptical of these conclusions and believed that people were simply being superstitious. He relied upon the prevailing medical theory of the day, Hippocratic theory , and strove to gather evidence through direct observation. He observed that carrion -eating birds and animals disappeared, though he left it an open question whether they died after eating the corpses or refused to eat them and were driven away: All the birds and beasts that prey upon human bodies, either abstained from touching them (though there were many lying unburied), or died after tasting them. In proof of this, it was noticed that birds of this kind disappeared; they were not about the bodies, or indeed to be seen at all. The plague was an unforeseen event that resulted in one of the largest recorded loss of life in ancient Greece as well as a breakdown of Athenian society. The epidemic caused the death of an estimated 25% of Athens, which at the time ranged from 250,000 to 300,000. The balance of power between citizens had changed due to many of the rich dying and their fortunes being inherited by remaining relatives of the lower class. According to Thucydides, those who had become ill and survived were the most sympathetic to others suffering: believing that they could no longer succumb to any illness, many survivors offered to assist with the remaining sick. The plague also contributed to Athens' overall loss of power and ability to expand. Many of the remaining Athenians were found to be metics who had forged their documentation or had bribed officials to hide their original status. A number of these people were reduced to slaves once they were caught. This resulted in the passing of the Citizenship Law of Pericles. This law stated that only those born to two Athenian parents could be considered an Athenian citizen, reducing both their number of potential soldiers and amount of political power, but also a decline in treatment and rights for metics in Athens. The plague dealt massive damage to Athens two years into the Peloponnesian War, from which it never recovered. Their political strength had weakened, and morale among their armies and citizens had fallen significantly. Athens would then go on to be defeated by Sparta and fall from being a major power in Ancient Greece. [ citation needed ]Thucydides states that people ceased fearing the law since they felt they were already living under a death sentence. Likewise, people started spending money indiscriminately. Many felt they would not live long enough to enjoy the fruits of wise investment, while some of the poor unexpectedly became wealthy by inheriting the property of their relatives. It is also recorded that people refused to behave honorably because most did not expect to live long enough to enjoy a good reputation for it. Another reason for the lack of honorable behavior was the sheer contagiousness of the illness. Those who tended to the ill were most vulnerable to catching the disease. This meant that many people died alone because no one was willing to risk caring for them. The dead were heaped on top of each other, left to rot, or shoved into mass graves. Sometimes those carrying the dead would come across an already burning funeral pyre, dump a new body on it, and walk away. Others appropriated prepared pyres to have enough fuel to cremate their own dead. Survivors of the plague developed an immunity and so became the main caretakers of those who later fell ill. A mass grave and nearly 1,000 tombs, dated between 430 and 426 BC, have been found just outside Athens' ancient Kerameikos cemetery. The mass grave was bordered by a low wall that seemed to have protected the cemetery from a wetland. Excavated during 1994–95, the shaft-shaped grave may have contained a total of 240 individuals, at least ten of them children. Skeletons in the graves were randomly placed with no layers of soil between them. [ citation needed ] Excavator Efi Baziotopoulou-Valavani, of the Third Ephoreia (Directorate) of Antiquities, reported that "[t]he mass grave did not have a monumental character. The offerings we found consisted of common, even cheap, burial vessels; black-finished ones, some small red-figured, as well as white lekythoi (oil flasks) of the second half of the 5th century BC. The bodies were placed in the pit within a day or two. These [factors] point to a mass burial in a state of panic, quite possibly due to a plague." During this time refugees from the Peloponnesian war had immigrated within the Long Walls of Athens, inflating the populations of both the polis of Athens and the port of Piraeus. The population had tripled in this time increasing the chance of infection and worsening hygiene. The plague also caused religious uncertainty and doubt. Since the disease struck without regard to a person's piety toward the gods, people felt abandoned by the gods and there seemed to be no benefit to worshiping them. The temples themselves were sites of great misery, as refugees from the Athenian countryside had been forced to find accommodation in the temples. Soon the sacred buildings were filled with the dead and dying. The Athenians pointed to the plague as evidence that the gods favored Sparta, and this was supported by an oracle that Apollo himself (the god of disease and medicine) would fight for Sparta if they fought with all their might. An earlier oracle had warned that "A Dorian [Spartan] war will come, and bring a pestilence with it". Thucydides was skeptical of these conclusions and believed that people were simply being superstitious. He relied upon the prevailing medical theory of the day, Hippocratic theory , and strove to gather evidence through direct observation. He observed that carrion -eating birds and animals disappeared, though he left it an open question whether they died after eating the corpses or refused to eat them and were driven away: All the birds and beasts that prey upon human bodies, either abstained from touching them (though there were many lying unburied), or died after tasting them. In proof of this, it was noticed that birds of this kind disappeared; they were not about the bodies, or indeed to be seen at all. The plague was an unforeseen event that resulted in one of the largest recorded loss of life in ancient Greece as well as a breakdown of Athenian society. The epidemic caused the death of an estimated 25% of Athens, which at the time ranged from 250,000 to 300,000. The balance of power between citizens had changed due to many of the rich dying and their fortunes being inherited by remaining relatives of the lower class. According to Thucydides, those who had become ill and survived were the most sympathetic to others suffering: believing that they could no longer succumb to any illness, many survivors offered to assist with the remaining sick. The plague also contributed to Athens' overall loss of power and ability to expand. Many of the remaining Athenians were found to be metics who had forged their documentation or had bribed officials to hide their original status. A number of these people were reduced to slaves once they were caught. This resulted in the passing of the Citizenship Law of Pericles. This law stated that only those born to two Athenian parents could be considered an Athenian citizen, reducing both their number of potential soldiers and amount of political power, but also a decline in treatment and rights for metics in Athens. The plague dealt massive damage to Athens two years into the Peloponnesian War, from which it never recovered. Their political strength had weakened, and morale among their armies and citizens had fallen significantly. Athens would then go on to be defeated by Sparta and fall from being a major power in Ancient Greece. [ citation needed ]According to Thucydides, the illness began by showing symptoms in the head as it worked its way through the rest of the body. He also described in detail the symptoms that victims of the plague experienced. Fever Redness and inflammation in the eyes Sore throats leading to bleeding and bad breath Sneezing Loss of voice Coughing Vomiting Pustules and ulcers on the body Extreme thirst Insomnia Diarrhea Convulsions GangreneHistorians have long tried to identify the disease behind the Plague of Athens. The disease has traditionally been considered an outbreak of the bubonic plague in its many forms, but a reconsideration of the reported symptoms and epidemiology have led scholars to advance alternative explanations. These include typhus , smallpox , measles , and toxic shock syndrome . Based upon striking descriptive similarities with recent outbreaks in Africa, as well as the fact that the Athenian plague itself came from Africa (as Thucydides recorded), Ebola or a related viral hemorrhagic fever has been considered. Given the possibility that profiles of a known disease may have changed over time, or that the plague was caused by a disease that no longer exists, the exact nature of the Athenian plague may never be known. In addition, crowding caused by the influx of refugees into the city led to inadequate food and water supplies and a probable proportionate increase in insects, lice, rats, and waste. These conditions would have encouraged more than one epidemic disease during the outbreak. [ citation needed ] In January 1999, the University of Maryland devoted their fifth annual medical conference, dedicated to notorious case histories, to the Plague of Athens. They concluded that the disease that killed the Greeks was typhus . "Epidemic typhus fever is the best explanation," said Dr. David Durack, consulting professor of medicine at Duke University . "It hits hardest in times of war and privation, it has about 20 percent mortality, it kills the victim after about seven days, and it sometimes causes a striking complication: gangrene of the tips of the fingers and toes. The Plague of Athens had all these features." In typhus cases, progressive dehydration, debilitation, and cardiovascular collapse ultimately cause the patient's death. [ citation needed ] This medical opinion is supported by the opinion of A. W. Gomme , who wrote a comprehensive annotated edition of Thucydides and who also believed typhus was the cause of the epidemic. This opinion is expressed in his monumental work An Historical Commentary on Thucydides , completed after Gomme's death by A. Andrewes and K. J. Dover. Angelos Vlachos ( Άγγελος Βλάχος ), a member of the Academy of Athens and a diplomat, in his Remarks on Thucydides ( Παρατηρήσεις στο Î˜Î¿Ï ÎºÏ Î´Î¯Î´Î· , I: 177–178) acknowledges and supports Gomme's opinion: "Today, according to Gomme, it is generally acceptable that it was typhus" (" Σήμερα, όπως γράφει ο Gomme, έχει γίνει από ÏŒÎ»Î¿Ï Ï‚ παραδεκτό ότι ήταν τύφος "). The theory has also found recent support in a study of the plague by Greek epidemiologists. Symptoms generally associated with typhoid resemble Thucydides' description. They include: Some characteristics of typhoid are at clear variance from Thucydides' description. Scavenger animals do not die from infection with typhoid, The onset of fever in typhoid is typically slow and subtle, and typhoid generally kills later in the disease course. As typhoid is most commonly transmitted through poor hygiene habits and public sanitation conditions in crowded urban areas, it is an unlikely cause of a plague emerging in the less urbanized Africa, as reported by Thucydides. [ citation needed ] A 2005 DNA study of dental pulp from teeth recovered from an ancient Greek burial pit, led by orthodontist Dr. Manolis Papagrigorakis of the University of Athens, found DNA sequences similar to those of Salmonella enterica ( S. enterica ), the organism that causes typhoid fever . A second group of researchers, including American evolutionary molecular biologist Dr. Beth Shapiro of the University of California, Santa Cruz , disputed the Papagrigorakis team's findings, citing what they claim are serious methodological flaws. In a letter to the International Journal of Infectious Diseases , Shapiro et al. stated that "while this DNA analysis confirms that the Athens sequence is possibly Salmonella , it demonstrates clearly that it is not typhoid." The technique used by the Papagrigorakis team ( PCR ) has shown itself to be prone to contamination-induced false-positive results, and the source burial site is known to have been heavily trafficked in antiquity by hogs, carriers of another Salmonella serovar that may have been confused with the one that causes typhoid fever. Nonetheless, the Papagrigorakis team asserts that the basis of this refutation is flimsy, and that the methodology used by the Shapiro team has historically produced conflicting results. Thucydides' narrative pointedly refers to increased risk among caregivers, more typical of the person-to-person contact spread of viral hemorrhagic fever (e.g., Ebola virus disease or Marburg virus ) than typhus or typhoid. Unusual in the history of plagues during military operations, besieging Spartan troops are described as not having been afflicted by the illness raging near them within the city. Thucydides' description further invites comparison with VHF in the character and sequence of symptoms developed and of the usual fatal outcome on about the eighth day. Some scientists have interpreted Thucydides' expression " lygx kenē " ( λύγξ κενή ) as the unusual symptom of hiccups, which is now recognized as a common finding in Ebola virus disease. Outbreaks of VHF in Africa in 2012 and 2014 reinforced observations of the increased hazard to caregivers and the necessity of barrier precautions for preventing disease spread related to grief rituals and funerary rites. The 2015 West African Ebola outbreak noted the persistence of effects on genitalia and eyes in some survivors, both described by Thucydides. With an up to 21-day clinical incubation period, and up to 565-day infectious potential recently demonstrated in a semen-transmitted infection, movement of Ebola via Nile commerce into the busy port of Piraeus is plausible. Ancient Greek intimacy with African sources is reflected in accurate renditions of monkeys in the art of frescoes and pottery, most notably guenons ( Cercopithecus ), the type of primates responsible for transmitting Marburg virus into Germany and Yugoslavia when that disease was first characterized in 1967. Circumstantially tantalizing is the requirement for the large quantity of ivory used in the Athenian sculptor Phidias' two monumental ivory and gold statues of Athena and of Zeus (one of the Seven Wonders ), which were fabricated in the same decade. Never again in antiquity was ivory used on such a large scale. [ citation needed ] A second ancient narrative suggestive of hemorrhagic fever etiology is that of Titus Lucretius Carus . Writing in the 1st century BC, Lucretius characterized the Athenian plague as having bloody discharges from bodily orifices ( Book 6.1146–47: "sudabant etiam fauces intrinsecus atrae / sanguine" – the throat sweated within, black with blood). That descriptor may have been derived from direct observation because Lucretius cited scientific predecessors in Greek Sicily- Empedocles and Acron . While none of the original works of Acron , a physician, are extant, it is reported that he died c. 430 BC after traveling from Sicily to Athens to assist against the plague. [ citation needed ] Unfortunately, DNA sequence-based identification is limited by the inability of some important pathogens to leave a "footprint" retrievable from archaeological remains after several millennia. The lack of a durable signature by RNA viruses means some etiologies, notably the hemorrhagic fever viruses, are not testable hypotheses using currently available scientific techniques. [ citation needed ]In January 1999, the University of Maryland devoted their fifth annual medical conference, dedicated to notorious case histories, to the Plague of Athens. They concluded that the disease that killed the Greeks was typhus . "Epidemic typhus fever is the best explanation," said Dr. David Durack, consulting professor of medicine at Duke University . "It hits hardest in times of war and privation, it has about 20 percent mortality, it kills the victim after about seven days, and it sometimes causes a striking complication: gangrene of the tips of the fingers and toes. The Plague of Athens had all these features." In typhus cases, progressive dehydration, debilitation, and cardiovascular collapse ultimately cause the patient's death. [ citation needed ] This medical opinion is supported by the opinion of A. W. Gomme , who wrote a comprehensive annotated edition of Thucydides and who also believed typhus was the cause of the epidemic. This opinion is expressed in his monumental work An Historical Commentary on Thucydides , completed after Gomme's death by A. Andrewes and K. J. Dover. Angelos Vlachos ( Άγγελος Βλάχος ), a member of the Academy of Athens and a diplomat, in his Remarks on Thucydides ( Παρατηρήσεις στο Î˜Î¿Ï ÎºÏ Î´Î¯Î´Î· , I: 177–178) acknowledges and supports Gomme's opinion: "Today, according to Gomme, it is generally acceptable that it was typhus" (" Σήμερα, όπως γράφει ο Gomme, έχει γίνει από ÏŒÎ»Î¿Ï Ï‚ παραδεκτό ότι ήταν τύφος "). The theory has also found recent support in a study of the plague by Greek epidemiologists. Symptoms generally associated with typhoid resemble Thucydides' description. They include: Some characteristics of typhoid are at clear variance from Thucydides' description. Scavenger animals do not die from infection with typhoid, The onset of fever in typhoid is typically slow and subtle, and typhoid generally kills later in the disease course. As typhoid is most commonly transmitted through poor hygiene habits and public sanitation conditions in crowded urban areas, it is an unlikely cause of a plague emerging in the less urbanized Africa, as reported by Thucydides. [ citation needed ] A 2005 DNA study of dental pulp from teeth recovered from an ancient Greek burial pit, led by orthodontist Dr. Manolis Papagrigorakis of the University of Athens, found DNA sequences similar to those of Salmonella enterica ( S. enterica ), the organism that causes typhoid fever . A second group of researchers, including American evolutionary molecular biologist Dr. Beth Shapiro of the University of California, Santa Cruz , disputed the Papagrigorakis team's findings, citing what they claim are serious methodological flaws. In a letter to the International Journal of Infectious Diseases , Shapiro et al. stated that "while this DNA analysis confirms that the Athens sequence is possibly Salmonella , it demonstrates clearly that it is not typhoid." The technique used by the Papagrigorakis team ( PCR ) has shown itself to be prone to contamination-induced false-positive results, and the source burial site is known to have been heavily trafficked in antiquity by hogs, carriers of another Salmonella serovar that may have been confused with the one that causes typhoid fever. Nonetheless, the Papagrigorakis team asserts that the basis of this refutation is flimsy, and that the methodology used by the Shapiro team has historically produced conflicting results. Symptoms generally associated with typhoid resemble Thucydides' description. They include: Some characteristics of typhoid are at clear variance from Thucydides' description. Scavenger animals do not die from infection with typhoid, The onset of fever in typhoid is typically slow and subtle, and typhoid generally kills later in the disease course. As typhoid is most commonly transmitted through poor hygiene habits and public sanitation conditions in crowded urban areas, it is an unlikely cause of a plague emerging in the less urbanized Africa, as reported by Thucydides. [ citation needed ]A 2005 DNA study of dental pulp from teeth recovered from an ancient Greek burial pit, led by orthodontist Dr. Manolis Papagrigorakis of the University of Athens, found DNA sequences similar to those of Salmonella enterica ( S. enterica ), the organism that causes typhoid fever . A second group of researchers, including American evolutionary molecular biologist Dr. Beth Shapiro of the University of California, Santa Cruz , disputed the Papagrigorakis team's findings, citing what they claim are serious methodological flaws. In a letter to the International Journal of Infectious Diseases , Shapiro et al. stated that "while this DNA analysis confirms that the Athens sequence is possibly Salmonella , it demonstrates clearly that it is not typhoid." The technique used by the Papagrigorakis team ( PCR ) has shown itself to be prone to contamination-induced false-positive results, and the source burial site is known to have been heavily trafficked in antiquity by hogs, carriers of another Salmonella serovar that may have been confused with the one that causes typhoid fever. Nonetheless, the Papagrigorakis team asserts that the basis of this refutation is flimsy, and that the methodology used by the Shapiro team has historically produced conflicting results. Thucydides' narrative pointedly refers to increased risk among caregivers, more typical of the person-to-person contact spread of viral hemorrhagic fever (e.g., Ebola virus disease or Marburg virus ) than typhus or typhoid. Unusual in the history of plagues during military operations, besieging Spartan troops are described as not having been afflicted by the illness raging near them within the city. Thucydides' description further invites comparison with VHF in the character and sequence of symptoms developed and of the usual fatal outcome on about the eighth day. Some scientists have interpreted Thucydides' expression " lygx kenē " ( λύγξ κενή ) as the unusual symptom of hiccups, which is now recognized as a common finding in Ebola virus disease. Outbreaks of VHF in Africa in 2012 and 2014 reinforced observations of the increased hazard to caregivers and the necessity of barrier precautions for preventing disease spread related to grief rituals and funerary rites. The 2015 West African Ebola outbreak noted the persistence of effects on genitalia and eyes in some survivors, both described by Thucydides. With an up to 21-day clinical incubation period, and up to 565-day infectious potential recently demonstrated in a semen-transmitted infection, movement of Ebola via Nile commerce into the busy port of Piraeus is plausible. Ancient Greek intimacy with African sources is reflected in accurate renditions of monkeys in the art of frescoes and pottery, most notably guenons ( Cercopithecus ), the type of primates responsible for transmitting Marburg virus into Germany and Yugoslavia when that disease was first characterized in 1967. Circumstantially tantalizing is the requirement for the large quantity of ivory used in the Athenian sculptor Phidias' two monumental ivory and gold statues of Athena and of Zeus (one of the Seven Wonders ), which were fabricated in the same decade. Never again in antiquity was ivory used on such a large scale. [ citation needed ] A second ancient narrative suggestive of hemorrhagic fever etiology is that of Titus Lucretius Carus . Writing in the 1st century BC, Lucretius characterized the Athenian plague as having bloody discharges from bodily orifices ( Book 6.1146–47: "sudabant etiam fauces intrinsecus atrae / sanguine" – the throat sweated within, black with blood). That descriptor may have been derived from direct observation because Lucretius cited scientific predecessors in Greek Sicily- Empedocles and Acron . While none of the original works of Acron , a physician, are extant, it is reported that he died c. 430 BC after traveling from Sicily to Athens to assist against the plague. [ citation needed ] Unfortunately, DNA sequence-based identification is limited by the inability of some important pathogens to leave a "footprint" retrievable from archaeological remains after several millennia. The lack of a durable signature by RNA viruses means some etiologies, notably the hemorrhagic fever viruses, are not testable hypotheses using currently available scientific techniques. [ citation needed ]

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Plague

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Plague (painting)

Plague is an 1898 painting in tempera by the Swiss symbolist artist Arnold Böcklin , held in the Kunstmuseum Basel . It exemplifies the artist's obsession with nightmares of war, pestilence and death. The painting shows Death riding on a bat-like winged creature, who travels through the street of a medieval European town. Plague is rendered mostly using shades of pale green, a colour often associated with decomposition . The other predominant tones are black and dull browns; for example, in the clothes worn by the figures shown in the mid and background as they dive for safety before Death's path. The red cloth of the woman shown in the mid-foreground is the only vivid colour seen; she lies across the corpse of a woman who was cut down also.

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Plague

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A Plague Tale: Innocence

David Dedeine Kevin Choteau Brice Davin Jamal Rguigui A Plague Tale: Innocence is an action-adventure stealth game developed by Asobo Studio and published by Focus Home Interactive . The game was released for PlayStation 4 , Windows , and Xbox One in May 2019. It was made available on the cloud-based service Amazon Luna in November 2020. The PlayStation 5 and Xbox Series X/S versions of the game were released in July 2021, alongside a cloud version for the Nintendo Switch . Set in mid-14th century Aquitaine , France, during the Hundred Years' War , the game focuses on the plight of Amicia de Rune and her ill brother Hugo as they flee from soldiers of the French Inquisition and from hordes of rats that are spreading the black plague . The player controls Amicia, using a combination of stealth and limited tools to hide from, distract, or knock out soldiers, evade rat hordes, and solve puzzles, incorporating elements of survival horror games. A Plague Tale: Innocence received generally positive reviews from critics and sold over one million units by July 2020. A sequel, A Plague Tale: Requiem , was released in 2022.In A Plague Tale: Innocence , the player assumes control of Amicia de Rune from a third-person perspective . For the majority of the game, the player needs to utilize stealth to avoid hostile encounters, as enemies will kill Amicia instantly if they catch her. Amicia is equipped with a sling that can throw rocks to break chains, create distractions, or stun guards long enough for the rats to ambush them; she can also kill enemies with a headshot if their head is unprotected. The game consists of a series of survival puzzles, which mostly consist of the player having to use specific methods to scare away or distract the hordes of hungry rats in order to gain access to new areas or direct them towards enemies. The primary method of warding rats off is fire, as they will seldom enter within the radius of burning torches and braziers. Amicia can craft special ammunition and supplies, which include fire-starting sulfur stones that ignite braziers, stink bombs that attract rats, or fire suppressants to extinguish torches carried by enemies. Amicia's younger brother, Hugo, can be directed towards specific tasks when Amicia is busy, and can also access certain areas that she cannot. However, this is risky, as Hugo will start to panic if left alone and can attract unwanted attention. Later in the game, the player can assume control of Hugo, who cannot craft items but can control rats and sneak through small spaces.In 1348, Amicia de Rune is a 15-year-old French girl of noble descent who lives in Aquitaine during the Hundred Years' War between England and France . Her 5-year-old brother, Hugo, has been ill since birth; their mother, Beatrice, an alchemist, has sheltered him in their estate while trying to devise a cure. While hunting with her father Robert in the forest, Amicia encounters an unusual substance on the ground, and her dog Lion is gruesomely consumed by an unseen entity. French Inquisition troops, led by Lord Nicholas, arrive at the de Rune estate in search of Hugo, executing Robert and slaughtering the family servants. Beatrice helps her children escape and instructs Amicia to take Hugo to a doctor named Laurentius. The children flee to a nearby village, where they learn that hordes of rats have been spreading the black plague (known as the Bite). The two are wanted by the Inquisition and have to evade the villagers; Amicia and Hugo eventually reach Laurentius's farm and find him severely ill with the plague. Laurentius implores Amicia to finish her mother's work seconds before the farm is overrun by rats; the siblings flee with Laurentius's apprentice, Lucas, to seek the Chateau d'Ombrage, which once belonged to the de Rune family. As they cross a battlefield patrolled by English soldiers, Lucas explains that Hugo's blood carries a supernatural evil called the Prima Macula , which has lain dormant within certain noble bloodlines since the Plague of Justinian . Beatrice and Laurentius had been trying to find an elixir that would mitigate Hugo's symptoms, while Vitalis Benevent, the Grand Inquisitor of France, seeks to harness Hugo's power so that the Inquisition can rule France. Hugo and Amicia are briefly captured by the English, but escape with the help of sibling thieves Mélie and Arthur; Arthur is captured as the others escape to Chateau d'Ombrage. Lucas needs a forbidden book called the Sanguinis Itinera to complete an elixir that may help Hugo. Amicia infiltrates the university to retrieve the book while Mélie rescues her brother. Amicia recovers the book and meets a young blacksmith named Rodric, who helps her escape. Back at the Chateau, Arthur reveals that Beatrice is still alive but imprisoned. Amicia insists they not tell Hugo, but he overhears the conversation. His anger appears to worsen his symptoms, so Amicia and Lucas return to the de Rune estate, looking for Beatrice's research. In a hidden laboratory, they complete the elixir and administer it to Hugo to alleviate his symptoms. Angry at his sister for not telling him the truth, Hugo runs away and joins the Inquisition to find Beatrice. Vitalis injects himself with Hugo's blood so that he can possess the power of the Macula, but due to Lucas' elixir, he is unable to fully attain Hugo's powers. Hugo escapes and finds Beatrice. Before their recapture, she reveals that the Macula gives him the power to control the rats. Vitalis threatens Beatrice's life to force Hugo's powers to fully awaken. Chateau d'Ombrage is then attacked by a swarm of rats guided by Hugo, still angry at Amicia. Nicholas, who is accompanying him, kills Arthur and orders Hugo to kill Amicia, but she convinces her brother to reject the Inquisition, and they work together to battle Nicholas until the rats consume him. The children decide to confront Vitalis. As they fight their way to the Bastion, Rodric sacrifices himself to protect Hugo and Amicia. Vitalis awaits their arrival, having bred thousands of white rats that only he can control. Hugo ultimately overpowers Vitalis and Amicia kills him. Three days later, both the rats and the plague have disappeared and life begins to return to normal; many remain wary of Hugo and his power, including Mélie, who parts ways with the group. Amicia, Hugo, Lucas, and an ailing Beatrice leave in search of a new home.The game's development was led by Asobo Studio . It is their first original title since the team created the racing game Fuel (2009), and the company wanted to create a narrative-driven experience inspired by The Last of Us and Brothers: A Tale of Two Sons . The main theme of A Plague Tale: Innocence is family and how the characters' relationships are challenged during adverse circumstances. Another important theme is innocence. Hugo, in particular, will observe the player character's behaviors and slowly transform from an innocent boy to a ruthless individual. Child actors Charlotte McBurney and Logan Hannan provided their voice for Amicia and Hugo respectively. The two also participated in the writing process by suggesting changes to dialogue and alternative takes. The voice actors speak English with a French accent, but in the sequel, they dropped the French accent and switched to a more native British English. Up to 5,000 rats can appear on-screen simultaneously. To ensure the game can handle rendering so many enemies without sacrificing performance, the team introduced four layers of details when rendering the rats, in which rats furthest away from the player character exist as a "background, non-animated mesh", whereas the rats closest to the player are animated in detail. Publisher Focus Home Interactive announced the game in January 2017 as The Plague . A first look game trailer appeared at E3 2017 . The game was released worldwide for PlayStation 4 , Windows , and Xbox One on 14 May 2019. The game was released for Amazon Luna on 24 November 2020. The Nintendo Switch , PlayStation 5 and Xbox Series X/S versions of the game was released on 6 July 2021. The Nintendo Switch version was playable via cloud . Downloadable content The "Coats of Arms" DLC is available for all the three platforms, and came bundled with the pre-order version of the game. It adds three alternate skins for Amicia and Hugo's outfits and coats of arms. The additional content is cosmetic in nature. A Plague Tale: Innocence received "generally favorable" reviews from critics, according to review aggregator website Metacritic. In the United Kingdom, the game was the ninth-best-selling retail game in its week of release. In July 2020, Focus Home Interactive announced that it had sold over one million units. In the United Kingdom, the game was the ninth-best-selling retail game in its week of release. In July 2020, Focus Home Interactive announced that it had sold over one million units. A sequel, titled A Plague Tale: Requiem , was released on 18 October 2022 for Nintendo Switch , PlayStation 5 , Windows , and Xbox Series X/S . The Nintendo Switch version is a cloud -based game. A television series adaptation to be produced by Mediawan in association with Asobo and Focus Home was announced in March 2022.

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Plague

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Plague pit

A plague pit is the informal term used to refer to mass graves in which victims of the Black Death were buried. The term is most often used to describe pits located in Great Britain , but can be applied to any place where bubonic plague victims were buried. [ citation needed ]The plague which swept across China , Middle East , and Europe in the 14th century is estimated to have killed between one-third and two-thirds of Europe's population . Disposal of the bodies of those who died presented huge problems for the authorities, and eventually the normal patterns of burial and funerary observance broke down. [ citation needed ]Plague pits were used especially often during major plague outbreaks, such as the London epidemic of 1665 . Graveyards rapidly filled and parishes became strained; for example the number of deaths in the parish of St Bride's Church , Fleet Street, in 1665 was almost six times normal.

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Second plague pandemic

The second plague pandemic was a major series of epidemics of plague that started with the Black Death , which reached medieval Europe in 1346 and killed up to half of the population of Eurasia in the next four years. It followed the first plague pandemic that began in the 6th century with the Plague of Justinian , but had ended in the 8th century. Although the plague died out in most places, it became endemic and recurred regularly. A series of major epidemics occurred in the late 17th century, and the disease recurred in some places until the late 18th century or the early 19th century. After this, a new strain of the bacterium gave rise to the third plague pandemic , which started in Asia around the mid-19th century. Plague is caused by the bacterium Yersinia pestis , which exists in parasitic fleas of several species in the wild and of rats in human society. In an outbreak, it may kill all of its immediate hosts and thus die out, but it can remain active in other hosts that it does not kill, thereby causing a new outbreak years or decades later.There have been three major outbreaks of plague. The Plague of Justinian in the 6th and 7th centuries is the first known attack on record, and marks the first firmly recorded pattern of plague . From historical descriptions, as much as 40% of the population of Constantinople died from the plague. Modern estimates suggest that half of Europe's population died as a result of this first plague pandemic before it disappeared in the 700s. After 750, plague did not appear again in Europe until the Black Death of the 14th century. The second pandemic's origins are disputed; it originated either in Central Asia or Crimea, and appeared in Crimea by 1347. It may have reduced the world population from an estimated 450 million to 350–375 million by the year 1400. Evidence for Yersinia pestis was found in the teeth of early plague victims in the Tian Shan mountains , now northern Kyrgyzstan , indicating a likely origin of that iteration of the plague. The plague returned at intervals with varying virulence and mortality until the early 19th century. In England, for example, the plague returned between 1360 and 1363, killing 20% of Londoners, and then again in 1369, killing 10–15%. In the 16th century, the plague hit San Cristóbal de La Laguna in the Canary Islands between 1582 and 1583. In the 17th century, there were a series of European "great plague" outbreaks: the Great Plague of Seville between 1647 and 1652, the Great Plague of London between 1665 and 1666, and the Great Plague of Vienna in 1679. The great plague of northern China arose in Shanxi in 1633 and arrived at Beijing in 1641, contributing to the downfall of the Ming Dynasty in 1644. [ citation needed ] In the 18th century, there was the Great Plague of Marseille , which took place between 1720 and 1722; the Great Plague of 1738 , which occurred in Eastern Europe between 1738 and 1740; and the Russian plague of 1770–1772 , which took place in Central Russia and particularly affected Moscow. However, the plague in its virulent form seemed to gradually disappear from Europe, though lingering in Egypt and the Middle East. [ citation needed ] By the early 19th century, the threat of plague had diminished, though it was quickly replaced by the spread of another deadly infectious disease in the first cholera pandemic , beginning in 1817, the first of several cholera pandemics to sweep through Asia and Europe during the 19th and 20th centuries. The third plague pandemic hit China in the 1890s and devastated India. While it was largely contained in the East, it became endemic in the western United States, where sporadic outbreaks of plague continue to occur. Arab historians Ibn Al-Wardi and Almaqrizi believed the Black Death originated in Mongolia , and Chinese records show a huge outbreak in Mongolia in the early 1330s. In recent years, more research has emerged that shows the Black Death most likely originated on the northwestern shores of the Caspian Sea , and may not even have reached India and China, as research on the Delhi Sultanate and the Yuan Dynasty showed no evidence of any serious epidemic in 14th-century India and no specific evidence of plague in 14th-century China. There were large epidemics in China in 1331 and between 1351 and 1354 in the provinces of Hebei , Shanxi , and others, which are considered to have killed between 50% and 90% of the local populations, with numbers running into the tens of millions. However, there is no proof currently that these were caused by plague, though there are indications for the second set of epidemics. Europe was initially protected by a hiatus in the Silk Road . [ citation needed ] Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in Crimea in 1347. During a protracted siege of the city , between 1345 and 1346, the Mongol Golden Horde army of Jani Beg , whose mainly Tatar troops were suffering from the disease, catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, though it is more likely that infected rats travelling across the siege lines spread the epidemic to the inhabitants. As the disease took hold, Genoese traders fled across the Black Sea to Constantinople , where the disease first arrived in Europe in summer 1347. The epidemic there killed the 13-year-old son of the Byzantine emperor , John VI Kantakouzenos , who wrote a description of the disease modelled on Thucydides ' account of the 5th-century BCE Plague of Athens , but noting the spread of the Black Death by ship between maritime cities. Nicephorus Gregoras also described in writing to Demetrios Kydones the rising death toll, the futility of medicine against it, and the panic of the citizens. It arrived at Genoa and Venice in January 1348, while simultaneously spreading through Asia Minor and into Egypt. The bubonic form was described graphically in Florence in The Decameron and Guy de Chauliac also described the pneumonic form at Avignon . It rapidly spread to France and Spain and, by 1349, was in England. In 1350, it was afflicting Eastern Europe and had reached the centre of Russia by 1351. [ citation needed ] The 14th-century eruption of the Black Death had a drastic effect on Europe's population, irrevocably changing its social structures, and resulted in the widespread persecution of minorities such as Jews , foreigners, beggars, and lepers . The uncertainty of daily survival has been seen as creating a general mood of morbidity , influencing people to "live for the moment", as illustrated by Giovanni Boccaccio in The Decameron (1353). Petrarch , noting the unparalleled and unbelievable extremity of the disease's effects, wrote that "happy posterity, who will not experience such abysmal woe ... will look upon our testimony as a fable". The second pandemic spread throughout Eurasia and the Mediterranean Basin . The plague repeatedly returned to haunt Europe and the Mediterranean Basin throughout the 16th to 17th centuries. The plague ravaged much of the Islamic world . Plague was present in at least one location in the Islamic world virtually every year between 1500 and 1850. According to Jean-Noel Biraben, plague was present somewhere in Europe in every year between 1346 and 1671. According to Ellen Schiferl, between 1400 and 1600, there was a plague epidemic recorded in at least one part of Europe for every year except 1445. In the Byzantine Empire , the 1347 Black Death outbreak in Constantinople lasted a year, but plague recurred ten times before 1400. Plague was repeatedly reintroduced to the city because of its strategic location between the Mediterranean Sea and the Black Sea , and between Europe and Asia, as well as its position as the imperial capital. Constantinople retained its imperial status at the centre of the Ottoman Empire after the Fall of Constantinople to Mehmed the Conqueror in 1453. Approximately 1–2% of the city's population died annually of plague. Especially severe episodes were recorded by the Ottoman historians Mustafa Âlî and Hora Saadettin between 1491 and 1503, with 1491 through 1493 being the most afflicted years. Plague returned in 1511 until 1514 and, after 1520, was endemic in the city until 1529. Plague was endemic in Constantinople again between 1533 and 1549, 1552 and 1567, and for most of the remaining 16th-century. In the 17th century, plague epidemics within Constantinople were noted in the following years: 1603, 1611 to 1613, 1647 to 1649, 1653 to 1656, 1659 to 1688, 1671 to 1680, 1685 to 1695, and 1697 to 1701. [ citation needed ] In the 18th century, there were 64 years in which plague broke out in the capital, and a further 30 plague years which occurred in the first half of the 19th century. Of these later 94 plague epidemics in Constantinople between 1700 and 1850, six of them—occurring in 1705, 1726, 1751, 1778, 1812, and 1836—are estimated to have killed more than 5% of the population, whereas 83 of the epidemics killed 1% or fewer. [ clarification needed ] Plague repeatedly struck the cities of North Africa. Between 1620 and 1621, Algiers lost 30,000–50,000 people to it, with outbreaks returning in 1654 to 1657, 1665, 1691, and 1740 to 1742. Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, 37 large-scale and smaller epidemics were recorded in Constantinople, with a further 31 occurring between 1751 and 1800. The Great Plague of 1738 affected Ottoman territory in the Balkans , lasting until 1740. [ citation needed ] Baghdad suffered severely from visitations of the plague, with outbreaks reducing the population to one-third of its size by 1781. One of the last epidemics to strike the Balkans during the second plague pandemic was Caragea's plague , between 1813 and 1814. Swiss explorer Johann Ludwig Burckhardt witnessed the plague epidemics that ravaged Hejaz and Egypt between 1812 and 1816. He wrote: "In five or six days after my arrival [in Yanbu ] the mortality increased; forty or fifty persons died in a day, which, in a population of five or six thousand, was a terrible mortality." Although regular outbreaks of disease were common for decades prior to 1618, the Thirty Years' War (1618–48) greatly accelerated their spread. Based on local records, military action accounted for less than 3% of civilian deaths; the major causes were starvation (12%) and bubonic plague (64%). The modern consensus is that the population of the Holy Roman Empire declined from 18–20 million in 1600 to 11–13 million in 1650, and did not regain pre-war levels until 1750. The Great Plague of Vienna struck Vienna, the dynastic seat of the Holy Roman Empire, in 1679, killing an estimated 76,000 people. Emperor Leopold I fled the city upon the outbreak, but vowed to erect a Marian column in thanksgiving if the plague would end. Vienna's Plague Column , located on the Graben , was commissioned in 1683 and inaugurated in 1694. [ citation needed ] By 1357, the plague had returned to Venice, and from 1361 to 1363, the rest of Italy experienced the first recurrence of the pandemic. Pisa , Pistoia and Florence in Tuscany were especially badly affected; there pesta secunda , ' second pestilence ' killed a fifth of the population. In the pesta tertia , ' third pestilence ' of 1369 to 1371, 10–15% died. Survivors were aware that the Black Death of 1347–51 was not a unique event and that life was now "far more frightening and precarious than before". The Italian peninsula was struck with an outbreak of plague in 68% of the years between 1348 and 1600. There were 22 outbreaks of plague in Venice between 1361 and 1528. Petrarch , writing to Giovanni Boccaccio in September 1363, lamented that while the Black Death's arrival in Italy in 1348 had been mourned as an unprecedented disaster, "Now we realize that it is only the beginning of our mourning, for since then this evil force, unequalled and unheard of in human annals through the centuries, has never ceased, striking everywhere on all sides, on the left and right, like a skilled warrior." In the Jubilee Year of 1400, announced by Pope Boniface IX , one of the most severe occurrences of plague was exacerbated by the many pilgrims making their way to and from Rome; in the city itself 600–800 died daily. As recorded by the undertakers' records in Florence, at least 10,406 people died; the total death toll was estimated at twice that figure by 15th-century chronicler Giovanni Morelli. Half of the population of Pistoia and its hinterland were killed that year. Another outbreak occurred in Padua in 1405 and claimed 18,000 lives. In the plague epidemic of 1449–52, 30,000 Milanese died in 1451 alone. A particularly deadly plague struck Italy between 1478 and 1482. The territories of the Republic of Venice saw 300,000 dead in the epidemic's eight-year course. Luca Landucci wrote in 1478 that the citizens of Florence "were in a sorry plight. They lived in dread, and no one had any heart to work. The poor creatures could not procure silk or wool ... so that all classes suffered." In addition to plague, Florence was suffering both from excommunication leading to war with the Papal States and from the political strife following the Pazzi conspiracy . In 1479, the plague broke out in Rome; Bartolomeo Platina , the head of the Vatican Library was killed, and Pope Sixtus IV fled the city and was absent for more than a year. Federico da Montefeltro , Duke of Urbino , also died. Following the Sack of Rome in 1527 by Charles V, Holy Roman Emperor , plague broke out in both Rome and Florence. The plague emerged in Rome and killed 30,000 Florentines—a quarter of the city's inhabitants. The Description of the Plague at Florence in the Year 1527 , by Lorenzo di Filippo Strozzi , records this plague in detail; it was copied out by Niccolò Machiavelli with annotations by Strozzi. He wrote: Our pitiful Florence now looks like nothing but a town which has been stormed by infidels and then forsaken. One part of the inhabitants ... have retired to distant country houses, one part is dead, and yet another part is dying. Thus the present is torment, the future menace, so we contend with death and only live in fear and trembling. The clean, fine streets which formerly teemed with rich and noble citizens are now stinking and dirty; crowds of beggars drag themselves through them with anxious groans and only with difficulty and dread can one pass them. Shops and inns are closed, at the factories work has ceased, the law courts are empty, the laws are trampled on. Now one hears of some theft, now of some murder. The squares, the market places on which citizens used frequently to assemble, have now been converted into graves and into the resort of the wicked rabble. ... If by chance relations meet, a brother, a sister, a husband, a wife, they carefully avoid each other. What further words are needed? Fathers and mothers avoid their own children and forsake them. ... A few provision stores are still open, where bread is distributed, but where in the crush plague boils are also spread. Instead of conversation ... one hears now only pitiful, mournful tidings – such a one is dead, such a one is sick, such a one has fled, such a one is interned in his house, such a one is in hospital, such a one has nurses, another is without aid, such like news which by imagination alone would suffice to make Aesculapius sick. Further plague epidemics accompanied the Siege of Florence in 1529; there, religious buildings became hospitals and 600 temporary structures were built to house the infected outside the city walls. After 1530, political strife calmed and warfare in Italy became less frequent. Subsequently, plague outbreaks became more rare, affecting only individual cities or regions, but were particularly severe. In the 43 years between 1533 and 1575, there were 18 epidemics of plague. The especially damaging Italian plague of 1575–78 travelled both north and southwards through the peninsula from either end; the death toll was particularly high. By official reckoning, Milan lost 17,329 to plague in 1576, while Brescia recorded 17,396 killed in a town that did not exceed 46,000 total inhabitants. Venice, meanwhile, saw between a quarter and a third of its population die of plague in the epidemic of 1576–77 with 50,000 deaths. In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy, or about 14% of the population. The Great Plague of Milan (1629–31) was possibly the most disastrous of the century: the city of Milan lost half its population of about 100,000, while Venice was as afflicted as in its severe 1553–56 outbreak. The Italian Plague of 1656–57 was the last major catastrophic plague in Italy, with the Naples Plague the most severe. In 1656, the plague killed about half of Naples 's 300,000 inhabitants. Messina saw the last epidemic in Italy, in 1742–44. The final recorded incidence of plague in Italy was in 1815–16, when plague broke out in Noja, a town near Bari . Over 60% of Norway's population died from 1348 to 1350. The last plague outbreak ravaged Oslo in 1654. In Russia, the disease hit somewhere once every five or six years from 1350 to 1490. In 1654, the Russian plague killed about 700,000 inhabitants. In 1709–13, a plague epidemic followed the Great Northern War (1700–1721), between Sweden and the Tsardom of Russia and its allies, killing about 100,000 in Sweden and 300,000 in Prussia . The plague killed two-thirds of the inhabitants of Helsinki , and claimed a third of Stockholm 's population. This was the last plague in Scandinavia, but the Russian plague of 1770–1772 killed up to 100,000 people in Moscow . The 1560s European wave of the plague first hit Lithuania and Russian Pskov in 1564-1565 but didn't progress further east until 1566, when it ravaged in Muscovian lands already suffering from the Livonian War and the Oprichnina . It made a pause until hitting even harder in two waves in 1569-1570 and 1571-1572, which, combined with concurrent famine, may have killed between a third and a quarter of Russian population. The Great Plague of 1738 was a pandemic of plague lasting 1738–40 and affecting areas in the modern nations of Romania , Hungary , Ukraine , Serbia , Croatia , and Austria . The Russian plague epidemic of 1770-1772 killed as many as 100,000 people in Moscow alone, with thousands more dying in the surrounding countryside. In 1466, perhaps 40,000 people died of plague in Paris. During the 16th and 17th centuries, plague visited Paris nearly once every three years on average. According to historian Geoffrey Parker , " France alone lost almost a million people to plague in the epidemic of 1628–31." Western Europe's last major epidemic occurred in 1720 in Marseilles . Plague epidemics ravaged London in the 1563 London plague , in 1593, 1603, 1625, 1636, and 1665, reducing its population by 10 to 30% during those years. The 1665–66 Great Plague of London was the final major epidemic of the pandemic, with the last death of plague in the walled City of London recorded fourteen years later in 1679. [ citation needed ] Over 10% of Amsterdam 's population died in 1623–25, and again in 1635–36, 1655, and 1664. More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain . The plague of 1649 probably reduced the population of Seville by half. Malta suffered from a number of plague outbreaks during the second pandemic between the mid-14th and early 19th centuries. The most severe outbreak was the epidemic of 1675–1676 , which killed around 11,300 people, followed by the epidemic of 1813–1814 and that of 1592–1593 , which killed around 4,500 and 3,000 people respectively. The 1582 Tenerife plague epidemic (also 1582 San Cristóbal de La Laguna plague epidemic) was an outbreak of bubonic plague that occurred between 1582 and 1583 on the island of Tenerife , Spain. It is currently believed to have caused between 5,000 and 9,000 deaths on an island with fewer than 20,000 inhabitants at that time (approximately 25-45% of the island's population). In the Byzantine Empire , the 1347 Black Death outbreak in Constantinople lasted a year, but plague recurred ten times before 1400. Plague was repeatedly reintroduced to the city because of its strategic location between the Mediterranean Sea and the Black Sea , and between Europe and Asia, as well as its position as the imperial capital. Constantinople retained its imperial status at the centre of the Ottoman Empire after the Fall of Constantinople to Mehmed the Conqueror in 1453. Approximately 1–2% of the city's population died annually of plague. Especially severe episodes were recorded by the Ottoman historians Mustafa Âlî and Hora Saadettin between 1491 and 1503, with 1491 through 1493 being the most afflicted years. Plague returned in 1511 until 1514 and, after 1520, was endemic in the city until 1529. Plague was endemic in Constantinople again between 1533 and 1549, 1552 and 1567, and for most of the remaining 16th-century. In the 17th century, plague epidemics within Constantinople were noted in the following years: 1603, 1611 to 1613, 1647 to 1649, 1653 to 1656, 1659 to 1688, 1671 to 1680, 1685 to 1695, and 1697 to 1701. [ citation needed ] In the 18th century, there were 64 years in which plague broke out in the capital, and a further 30 plague years which occurred in the first half of the 19th century. Of these later 94 plague epidemics in Constantinople between 1700 and 1850, six of them—occurring in 1705, 1726, 1751, 1778, 1812, and 1836—are estimated to have killed more than 5% of the population, whereas 83 of the epidemics killed 1% or fewer. [ clarification needed ] Plague repeatedly struck the cities of North Africa. Between 1620 and 1621, Algiers lost 30,000–50,000 people to it, with outbreaks returning in 1654 to 1657, 1665, 1691, and 1740 to 1742. Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, 37 large-scale and smaller epidemics were recorded in Constantinople, with a further 31 occurring between 1751 and 1800. The Great Plague of 1738 affected Ottoman territory in the Balkans , lasting until 1740. [ citation needed ] Baghdad suffered severely from visitations of the plague, with outbreaks reducing the population to one-third of its size by 1781. One of the last epidemics to strike the Balkans during the second plague pandemic was Caragea's plague , between 1813 and 1814. Swiss explorer Johann Ludwig Burckhardt witnessed the plague epidemics that ravaged Hejaz and Egypt between 1812 and 1816. He wrote: "In five or six days after my arrival [in Yanbu ] the mortality increased; forty or fifty persons died in a day, which, in a population of five or six thousand, was a terrible mortality." Although regular outbreaks of disease were common for decades prior to 1618, the Thirty Years' War (1618–48) greatly accelerated their spread. Based on local records, military action accounted for less than 3% of civilian deaths; the major causes were starvation (12%) and bubonic plague (64%). The modern consensus is that the population of the Holy Roman Empire declined from 18–20 million in 1600 to 11–13 million in 1650, and did not regain pre-war levels until 1750. The Great Plague of Vienna struck Vienna, the dynastic seat of the Holy Roman Empire, in 1679, killing an estimated 76,000 people. Emperor Leopold I fled the city upon the outbreak, but vowed to erect a Marian column in thanksgiving if the plague would end. Vienna's Plague Column , located on the Graben , was commissioned in 1683 and inaugurated in 1694. [ citation needed ]By 1357, the plague had returned to Venice, and from 1361 to 1363, the rest of Italy experienced the first recurrence of the pandemic. Pisa , Pistoia and Florence in Tuscany were especially badly affected; there pesta secunda , ' second pestilence ' killed a fifth of the population. In the pesta tertia , ' third pestilence ' of 1369 to 1371, 10–15% died. Survivors were aware that the Black Death of 1347–51 was not a unique event and that life was now "far more frightening and precarious than before". The Italian peninsula was struck with an outbreak of plague in 68% of the years between 1348 and 1600. There were 22 outbreaks of plague in Venice between 1361 and 1528. Petrarch , writing to Giovanni Boccaccio in September 1363, lamented that while the Black Death's arrival in Italy in 1348 had been mourned as an unprecedented disaster, "Now we realize that it is only the beginning of our mourning, for since then this evil force, unequalled and unheard of in human annals through the centuries, has never ceased, striking everywhere on all sides, on the left and right, like a skilled warrior." In the Jubilee Year of 1400, announced by Pope Boniface IX , one of the most severe occurrences of plague was exacerbated by the many pilgrims making their way to and from Rome; in the city itself 600–800 died daily. As recorded by the undertakers' records in Florence, at least 10,406 people died; the total death toll was estimated at twice that figure by 15th-century chronicler Giovanni Morelli. Half of the population of Pistoia and its hinterland were killed that year. Another outbreak occurred in Padua in 1405 and claimed 18,000 lives. In the plague epidemic of 1449–52, 30,000 Milanese died in 1451 alone. A particularly deadly plague struck Italy between 1478 and 1482. The territories of the Republic of Venice saw 300,000 dead in the epidemic's eight-year course. Luca Landucci wrote in 1478 that the citizens of Florence "were in a sorry plight. They lived in dread, and no one had any heart to work. The poor creatures could not procure silk or wool ... so that all classes suffered." In addition to plague, Florence was suffering both from excommunication leading to war with the Papal States and from the political strife following the Pazzi conspiracy . In 1479, the plague broke out in Rome; Bartolomeo Platina , the head of the Vatican Library was killed, and Pope Sixtus IV fled the city and was absent for more than a year. Federico da Montefeltro , Duke of Urbino , also died. Following the Sack of Rome in 1527 by Charles V, Holy Roman Emperor , plague broke out in both Rome and Florence. The plague emerged in Rome and killed 30,000 Florentines—a quarter of the city's inhabitants. The Description of the Plague at Florence in the Year 1527 , by Lorenzo di Filippo Strozzi , records this plague in detail; it was copied out by Niccolò Machiavelli with annotations by Strozzi. He wrote: Our pitiful Florence now looks like nothing but a town which has been stormed by infidels and then forsaken. One part of the inhabitants ... have retired to distant country houses, one part is dead, and yet another part is dying. Thus the present is torment, the future menace, so we contend with death and only live in fear and trembling. The clean, fine streets which formerly teemed with rich and noble citizens are now stinking and dirty; crowds of beggars drag themselves through them with anxious groans and only with difficulty and dread can one pass them. Shops and inns are closed, at the factories work has ceased, the law courts are empty, the laws are trampled on. Now one hears of some theft, now of some murder. The squares, the market places on which citizens used frequently to assemble, have now been converted into graves and into the resort of the wicked rabble. ... If by chance relations meet, a brother, a sister, a husband, a wife, they carefully avoid each other. What further words are needed? Fathers and mothers avoid their own children and forsake them. ... A few provision stores are still open, where bread is distributed, but where in the crush plague boils are also spread. Instead of conversation ... one hears now only pitiful, mournful tidings – such a one is dead, such a one is sick, such a one has fled, such a one is interned in his house, such a one is in hospital, such a one has nurses, another is without aid, such like news which by imagination alone would suffice to make Aesculapius sick. Further plague epidemics accompanied the Siege of Florence in 1529; there, religious buildings became hospitals and 600 temporary structures were built to house the infected outside the city walls. After 1530, political strife calmed and warfare in Italy became less frequent. Subsequently, plague outbreaks became more rare, affecting only individual cities or regions, but were particularly severe. In the 43 years between 1533 and 1575, there were 18 epidemics of plague. The especially damaging Italian plague of 1575–78 travelled both north and southwards through the peninsula from either end; the death toll was particularly high. By official reckoning, Milan lost 17,329 to plague in 1576, while Brescia recorded 17,396 killed in a town that did not exceed 46,000 total inhabitants. Venice, meanwhile, saw between a quarter and a third of its population die of plague in the epidemic of 1576–77 with 50,000 deaths. In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy, or about 14% of the population. The Great Plague of Milan (1629–31) was possibly the most disastrous of the century: the city of Milan lost half its population of about 100,000, while Venice was as afflicted as in its severe 1553–56 outbreak. The Italian Plague of 1656–57 was the last major catastrophic plague in Italy, with the Naples Plague the most severe. In 1656, the plague killed about half of Naples 's 300,000 inhabitants. Messina saw the last epidemic in Italy, in 1742–44. The final recorded incidence of plague in Italy was in 1815–16, when plague broke out in Noja, a town near Bari . Over 60% of Norway's population died from 1348 to 1350. The last plague outbreak ravaged Oslo in 1654. In Russia, the disease hit somewhere once every five or six years from 1350 to 1490. In 1654, the Russian plague killed about 700,000 inhabitants. In 1709–13, a plague epidemic followed the Great Northern War (1700–1721), between Sweden and the Tsardom of Russia and its allies, killing about 100,000 in Sweden and 300,000 in Prussia . The plague killed two-thirds of the inhabitants of Helsinki , and claimed a third of Stockholm 's population. This was the last plague in Scandinavia, but the Russian plague of 1770–1772 killed up to 100,000 people in Moscow . The 1560s European wave of the plague first hit Lithuania and Russian Pskov in 1564-1565 but didn't progress further east until 1566, when it ravaged in Muscovian lands already suffering from the Livonian War and the Oprichnina . It made a pause until hitting even harder in two waves in 1569-1570 and 1571-1572, which, combined with concurrent famine, may have killed between a third and a quarter of Russian population. The Great Plague of 1738 was a pandemic of plague lasting 1738–40 and affecting areas in the modern nations of Romania , Hungary , Ukraine , Serbia , Croatia , and Austria . The Russian plague epidemic of 1770-1772 killed as many as 100,000 people in Moscow alone, with thousands more dying in the surrounding countryside. In 1466, perhaps 40,000 people died of plague in Paris. During the 16th and 17th centuries, plague visited Paris nearly once every three years on average. According to historian Geoffrey Parker , " France alone lost almost a million people to plague in the epidemic of 1628–31." Western Europe's last major epidemic occurred in 1720 in Marseilles . Plague epidemics ravaged London in the 1563 London plague , in 1593, 1603, 1625, 1636, and 1665, reducing its population by 10 to 30% during those years. The 1665–66 Great Plague of London was the final major epidemic of the pandemic, with the last death of plague in the walled City of London recorded fourteen years later in 1679. [ citation needed ]Over 10% of Amsterdam 's population died in 1623–25, and again in 1635–36, 1655, and 1664. More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain . The plague of 1649 probably reduced the population of Seville by half. Malta suffered from a number of plague outbreaks during the second pandemic between the mid-14th and early 19th centuries. The most severe outbreak was the epidemic of 1675–1676 , which killed around 11,300 people, followed by the epidemic of 1813–1814 and that of 1592–1593 , which killed around 4,500 and 3,000 people respectively. The 1582 Tenerife plague epidemic (also 1582 San Cristóbal de La Laguna plague epidemic) was an outbreak of bubonic plague that occurred between 1582 and 1583 on the island of Tenerife , Spain. It is currently believed to have caused between 5,000 and 9,000 deaths on an island with fewer than 20,000 inhabitants at that time (approximately 25-45% of the island's population). The 18th- and 19th-century outbreaks, though severe, marked the retreat of the pandemic from most of Europe (18th century), northern Africa, and the Near East (19th century). The pandemic died out progressively across Europe. One documented case was in 17th-century London, where the first proper demographer , John Graunt , failed by just five years to see the last recorded death from plague, which happened in 1679, 14 years after the Great Plague of London . The reasons it died out totally are not well understood. It is tempting to think that the Great Fire of London the next year destroyed the hiding places of the rats in the roofs. There was not a single recorded plague death "within the walls" after 1666. However, by this time, the city had spread well beyond the walls, which contained most of the fire, and most plague cases happened beyond the limits of the fire. Likely more significant was the fact that all buildings after the fire were constructed of brick rather than wood and other flammable materials. [ citation needed ] This pattern was broadly followed after major epidemics in northern Italy (1631), southern and eastern Spain (1652), southern Italy and Genoa (1657), and Paris (1668). Appleby considers six possible explanations: People developed immunity. Improvements in nutrition made people more resistant. Improvements in housing, urban sanitation and personal cleanliness reduced the number of rats and rat fleas. The dominant rat species changed. (The brown rat did not arrive in London until 1727.) Quarantine methods improved in the 17th century. Some rats developed immunity, so fleas never left them in droves to humans; non-resistant rats were eliminated and this broke the cycle. Synder suggests that the replacement of the Black rat ( Rattus rattus ), which thrived among people and was frequently kept as a pet, by the more aggressive and prolific Norway or brown rat ( Rattus norvegicus ) was a major factor. The Brown rat, which arrived as an invasive species from the East, is skittish and avoids human contact, and its aggressive and asocial behaviour made it less attractive to humans. As the Brown rat violently drove out the Black rat in country after country, becoming the dominant species in that ecological niche, rat-to-human contact declined, as did the opportunities for plague to pass from rat fleas to humans. One of the major demarcations for hot spots in the third plague pandemic was the places where the Black rat had yet to be replaced, such as Bombay (now Mumbai) in India. [ citation needed ] It has been suggested that evolutionary processes may have favoured less virulent strains of the pathogen Yersinia pestis . In all probability, almost all of these factors had some effect in bringing about the end of the pandemic, though the main cause may never be conclusively determined. The disappearance happened rather later in the Nordic and eastern European countries, but there was a similar halt after major epidemics. [ citation needed ]

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Plague

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A Feast in Time of Plague

A Feast in Time of Plague ( Russian : «Пир во время чумы» , romanized : Pir vo vremya chumy ) is an 1830 play by Alexander Pushkin . The plot concerns a banquet in which the central figure taunts death with a toast "And so, O Plague, we hail thy reign!". The story is based on 4th scene of Act 1 of John Wilson 's play The City of Plague (1816). The play was written in 1830 and published in 1832 as one of four Little Tragedies (Malenkie tragedii, Russian : Маленькие трагедии ) together with The Stone Guest (Kamenny gost', Russian : Каменный гость ); Mozart and Salieri (Motsart i Salyeri, Russian : Моцарт и Сальери ) and The Miserly Knight (Skupoy rytsar, Russian : Скупой рыцарь ). All four of these plays were set as one act operas by Russian composers; Dargomyzhsky, Rimsky-Korsakov, Rachmaninov, and for the Feast , César Cui .

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Plague

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Third plague pandemic

The third plague pandemic was a major bubonic plague pandemic that began in Yunnan , China, in 1855. This episode of bubonic plague spread to all inhabited continents, and ultimately led to more than 12 million deaths in India and China (and perhaps over 15 million worldwide ), and at least 10 million Indians were killed in British Raj India alone, making it one of the deadliest pandemics in history. According to the World Health Organization , the pandemic was considered active until 1960 when worldwide casualties dropped to 200 per year. Plague deaths have continued at a lower level for every year since. The name refers to the third of at least three known major plague pandemics. The first began with the Plague of Justinian , which ravaged the Byzantine Empire and surrounding areas in 541 and 542; the pandemic persisted in successive waves until the middle of the 8th century. The second began with the Black Death , which killed at least one third of Europe 's population in a series of expanding waves of infection from 1346 to 1353; this pandemic recurred regularly until the 19th century. Casualty patterns indicate that waves of this late-19th-century/early-20th-century pandemic may have come from two different sources. The first was primarily bubonic and was carried around the world through ocean-going trade, through transporting infected persons, rats , and cargoes harboring fleas . The second, more virulent strain, was primarily pneumonic in character with a strong person-to-person contagion. This strain was largely confined to Asia. [ citation needed ]The bubonic plague was endemic in populations of infected ground rodents in Central Asia and was a known cause of death among the migrant and established human populations in that region for centuries. An influx of new people because of political conflicts and global trade led to the spread of the disease throughout the world from Asia to the rest of Europe, to reach Africa and the Americas . [ citation needed ] A natural reservoir or nidus for plague is in western Yunnan and is still an ongoing health risk. The third pandemic of plague originated in the area after a rapid influx of Han Chinese to exploit the demand for minerals, primarily copper , in the second half of the 19th century. By 1850, the population had exploded to over 7 million people. Increasing transportation throughout the region brought people in contact with plague-infected fleas , the primary vector between the yellow-breasted rat ( Rattus flavipectus ) and humans. People brought the fleas and rats back into growing urban areas, where small outbreaks sometimes reached epidemic proportions. The plague spread further and began to appear in the Pearl River delta, including Canton and Hong Kong . Although William McNeil and others believe the plague to have been brought from the interior to the coastal regions by troops returning from battles against the Muslim rebels, Benedict suggested evidence to favor the growing and lucrative opium trade, which began after about 1840. In the city of Canton, beginning in March 1894, the disease killed 80,000 people in a few weeks. Daily water-traffic with the nearby city of Hong Kong rapidly spread the plague. Within two months, after 100,000 deaths, the death rates dropped below epidemic rates, but the disease continued to be endemic in Hong Kong until 1929. The network of global shipping ensured the widespread distribution of the disease over the next few decades. Recorded outbreaks included the following: Each of the areas, as well as Great Britain , France , and other areas of Europe, continued to experience plague outbreaks and casualties until the 1960s, although extremely few of these occurred after 1950. The last significant outbreak of plague associated with the pandemic occurred in Peru and Argentina in 1945. [ citation needed ] The 1894 Hong Kong plague was a major outbreak of the third global pandemic from the late 19th century to the early 20th century. The first case, discovered in May 1894, was a hospital clerk who had just returned from Canton . The hardest hit was the mountainous area in Sheung Wan , the most densely-populated area in Hong Kong, characterised by Chinese-style buildings. From May to October 1894, the plague killed more than 6,000 people, leading to the exodus of one third of the population. In the 30 years starting in 1926 [ dubious – discuss ] , the plague occurred in Hong Kong almost every year and killed more than 20,000 people. Through maritime traffic, the epidemic spread to the rest of the country after 1894 and eventually spread to British Raj India where about ten million Indians were killed . There were several reasons for the rapid outbreak and spread of the plague. Firstly, in the early days, Sheung Wan was a Chinese settlement. Houses — in the mountains — had no drainage channels, toilets, or running water. The houses were small and the floors were not paved. Secondly, during the Ching Ming Festival in 1894, many Chinese living in Hong Kong returned to the countryside to tend to family graves, which coincided with the outbreak of the epidemic in Canton and the introduction of bacteria into Hong Kong. Thirdly, in the first four months of 1894, rainfall decreased and soil dried up, accelerating the spread of the plague. The main preventive measures were setting up plague hospitals and deploying medical staff to treat and isolate plague patients; conducting house-to-house search operations, discovering and transferring plague patients, and cleaning and disinfecting infected houses and areas; and setting up designated cemeteries and assigning a person responsible for transporting and burying the plague dead. The 1894 Hong Kong plague was a major outbreak of the third global pandemic from the late 19th century to the early 20th century. The first case, discovered in May 1894, was a hospital clerk who had just returned from Canton . The hardest hit was the mountainous area in Sheung Wan , the most densely-populated area in Hong Kong, characterised by Chinese-style buildings. From May to October 1894, the plague killed more than 6,000 people, leading to the exodus of one third of the population. In the 30 years starting in 1926 [ dubious – discuss ] , the plague occurred in Hong Kong almost every year and killed more than 20,000 people. Through maritime traffic, the epidemic spread to the rest of the country after 1894 and eventually spread to British Raj India where about ten million Indians were killed . There were several reasons for the rapid outbreak and spread of the plague. Firstly, in the early days, Sheung Wan was a Chinese settlement. Houses — in the mountains — had no drainage channels, toilets, or running water. The houses were small and the floors were not paved. Secondly, during the Ching Ming Festival in 1894, many Chinese living in Hong Kong returned to the countryside to tend to family graves, which coincided with the outbreak of the epidemic in Canton and the introduction of bacteria into Hong Kong. Thirdly, in the first four months of 1894, rainfall decreased and soil dried up, accelerating the spread of the plague. The main preventive measures were setting up plague hospitals and deploying medical staff to treat and isolate plague patients; conducting house-to-house search operations, discovering and transferring plague patients, and cleaning and disinfecting infected houses and areas; and setting up designated cemeteries and assigning a person responsible for transporting and burying the plague dead. Researchers working in Asia during the "Third Pandemic" identified plague vectors and the plague bacillus. In 1894, in Hong Kong, Swiss-born French bacteriologist Alexandre Yersin isolated the responsible bacterium ( Yersinia pestis , named for Yersin) and determined the common mode of transmission. His discoveries led in time to modern treatment methods, including insecticides , the use of antibiotics and eventually plague vaccines . In 1898, French researcher Paul-Louis Simond demonstrated the role of fleas as a vector. The disease is caused by a bacterium usually transmitted by the bite of fleas from an infected host, often a black rat . The bacteria are transferred from the blood of infected rats to flea ( Xenopsylla cheopis ). The bacillus multiplies in the stomach of the flea, blocking it. When the flea next bites a mammal, the consumed blood is regurgitated along with the bacillus into the bloodstream of the bitten animal. Any serious outbreak of plague in humans is preceded by an outbreak in the rodent population. During the outbreak, infected fleas that have lost their normal rodent hosts seek other sources of blood. The British colonial government in India pressed medical researcher Waldemar Haffkine to develop a plague vaccine. After three months of persistent work with a limited staff, a form for human trials was ready. On January 10, 1897, Haffkine tested it on himself. After the initial test was reported to the authorities, volunteers at the Byculla jail were used in a control test. All inoculated prisoners survived the epidemics, while seven inmates of the control group died. By the turn of the century, the number of inoculees in India alone reached four million. Haffkine was appointed the Director of the Plague Laboratory (now called the Haffkine Institute ) in Bombay. In the early 1900s, despite the increasing knowledge of germ theory and the rapid growth of scientific communities around the prevention of major disease, there was little the international communities could do other than create standard protocols for how to deal with an outbreak of the plague. In 1897 and 1903, two conventions were held known as International Sanitary Conferences; the first in Venice and the second in Paris, to help deal with threat of the new outbreaks of the bubonic plague. From these conventions was formed an international disease convention supervised by the Office International d'Hygiene Publique (OIHP) in Paris which would be one of the major predecessors of the League of Nations health organization. From these conventions came the standard Protocols used in dealing with the bubonic plague throughout the early 1900s. These protocols were often old fashioned and were generally summarized as the 3 "I's": Isolation, Incineration, and Inoculation. Isolation is a standard protocol of many modern disease outbreaks, but the usage of incineration was a protocol of disease control used most uniquely for dealing with the bubonic plague. Burning was used often to deal with the Plague as it was believed to the be most effective way to eliminate strains of the disease from places inhabited by the infected. But it was also a problematic technique as it led to the creation of many out-of-control fires that devastated communities, the most notable being the great fire in Honolulu which devastated the Chinatown community there. Inoculation was the usage of newly invented plague vaccines, with some in India being recorded to have an efficacy of over 50%. In many instances, the third plague pandemic either revealed or exacerbated major social conflicts and racial inequalities. Many of the ports infected during the plague were at the time in British colonies. Because of this, the British authorities often ended up enforcing western hygiene and medical practices and radical quarantine measures in countries and provinces such as India, South Africa and Hong Kong. In India harsh quarantines were initially implemented by the British governments, leading to Indian resentment of quarantine measures. In South Africa, when the plague broke out in Cape Colony , the colonial government forced a large group of Black South Africans to move out of a supposed slum into areas on the outskirts of the city, which historians have argued as a racially-motivated move by White South Africans to segregate Blacks into other parts of the city. In Hong Kong the British enforced many locally unfamiliar medical practices, such as floating plague victims out on boats onto the water and cooling plague victims with ice, which scared many Chinese residents of Hong Kong and led to their migrating back to mainland China, which was then even more badly affected by the plague. Another instance of social harm caused by the response to the plague is the "great fire of Honolulu " in 1900, in which much of Chinatown in Honolulu was burned by the Honolulu Board of Health in order to control the plague, rendering over 7,000 Chinese and Japanese residents homeless. In America when the plague reached San Francisco, the medical board of the city implemented a strict quarantine of the entire Chinatown district after discovering only one case of the plague; this has led historians to question whether this measure was motivated by racial bias among medical professionals.

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Plague

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Plague vaccine

none Plague vaccine is a vaccine used against Yersinia pestis to prevent the plague . Inactivated bacterial vaccines have been used since 1890 but are less effective against the pneumonic plague , so live, attenuated vaccines and recombinant protein vaccines have been developed to prevent the disease. The first plague vaccine was developed by bacteriologist Waldemar Haffkine in 1897. He tested the vaccine on himself to prove that the vaccine was safe. Later, Haffkine conducted a massive inoculation program in British India , and it is estimated that 26 million doses of Haffkine's anti-plague vaccine were sent out from Bombay between 1897 and 1925, reducing the plague mortality by 50%-85%. A plague vaccine is used for an induction of active specific immunity in an organism susceptible to plague by means of administrating an antigenic material (a vaccine ) via a variety of routes to people at risk of contracting any clinical form of plague. This method is known as plague immunization . There is strong evidence for the efficacy of administration of some plague vaccines in preventing or ameliorating the effects of a variety of clinical forms of infection by Yersinia pestis . Plague immunization also encompasses incurring a state of passive specific immunity to plague in a susceptible organism after administration of a plague serum or plague immunological in people with an immediate risk of developing the disease. A systematic review by the Cochrane Collaboration found no studies of sufficient quality to be included in the review, and were thus unable to make any statement on the efficacy of modern vaccines.

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Plague

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My Plague

3 : 40 (album version) 2 : 59 (New Abuse mix) Ross Robinson Slipknot " My Plague " is a song by American heavy metal band Slipknot . Produced by Ross Robinson and the band, it was featured on the band's second studio album Iowa (2001) and released as the second single from the album on July 8, 2002. The single version is a remix by Terry Date known as the "New Abuse mix", which was produced for the soundtrack to the film Resident Evil . The song reached number 43 on the UK Singles Chart and was nominated for the Grammy Award for Best Metal Performance in 2003." Sid [Wilson, DJ] came up with this great beat, so we tried to come up with riffs around it. The last thing we added was that chorus… We got Grammy nominations for 'My Plague' and ' Left Behind ', which was pretty weird. People were telling me it was a big deal. I was like, 'Is it?' If the people that nominated us had ever seen us, they would have run a mile." – Corey Taylor "My Plague" is one of the more melodic songs on Iowa , while still featuring many heavier elements. For Billboard , Eric Aiese described it as "catchy enough to pick up some spins at rock radio", noting that it features both "intimidating" and "melodic" vocals. British music magazine Kerrang! highlighted it as an "immensely heavy track but ... with an incredibly catchy and melodic chorus amid the sick riffs and thunderous percussion." Metal Hammer writer Luke Morton claimed the track is "one of Iowa ' s more accessible songs due to the clean vocals"; adding, "it stills carries that threatening edge like the rest of the record". Victoria Segal of the NME called the song "filthy noise", while E! Online 's review of Iowa describes it as "surprisingly melodic". Rolling Stone identified "My Plague" as an example of the "opposition" of "emotional negativity" and "perversely hook-heavy writing" on the album. In January 2002, it was announced that a reworked version of "My Plague" dubbed the "New Abuse mix" would be featured on the Resident Evil soundtrack and released as a single in February. The track was remixed by Terry Date and features "cleaner vocals and some minor arrangement shifts", according to Blabbermouth.net . Speaking about the song's "New Abuse mix", Slipknot bassist Paul Gray explained that "On the album version there were some kind of weird vocal effects on some of the parts, and we took them out and just had Corey [Taylor] sing", adding that a section of the song had to be removed in order to make it suitable for radio airplay. The single release was later delayed to July 8, with live recordings of " The Heretic Anthem " and "(sic)" from a show in Stockholm , Sweden on January 22 featured as B-sides. The music video for "My Plague" is made up of a combination of clips from Resident Evil and footage from the band's performance at London Arena on February 16, 2002, the entirety of which was later featured on the band's second video album Disasterpieces released in November. The live concert footage was directed by Matthew Amos and the film was directed by Paul Anderson , however Amos and editor Simon Hilton are credited as the video's directors. Hilton claims that he edited the video while wearing a Slipknot mask. The video was featured on the "My Plague" single, as well as on the Disasterpieces album later in the year. The "My Plague" music video was nominated for Best Video at the 2002 Kerrang! Awards alongside " Tainted Love " by Marilyn Manson , " Tribute " by Tenacious D , " In the End " by Linkin Park and " The One " by Foo Fighters . The award was won by "Tainted Love". As of October 2023, the music video for "My Plague" has over 20 million views on YouTube . "My Plague" received mixed reviews from critics. Tom Dunne of Hot Press magazine hailed the song as "stupid, staged, ridiculous and laughably over the top", which he claimed made it "essential listening". Playlouder writer William Ruff and Dotmusic writer John Mulvey both praised the song's lyric "You fucking touch me I will rip you apart/I'll reach in and take a bite out of that shit you call a heart", however this line was criticised by Tom Sinclair of Entertainment Weekly as uninventive. Louis Pattison of the NME complained that "you can spot a Slipknot single a mile off: they're the very average ones that feature big, echoing stadium-goth vocals, rather than the sound of a man screaming so loud that his gall bladder evacuates his body through the mouth", describing the track as "Not, let's be fair, primest 'Knot material". In a retrospective feature published in 2016, Luke Morton of Metal Hammer ranked "My Plague" as the fourth best track on Iowa , praising it as "a masterclass in writing emotional, pissed off metal that can still get on the radio". In January 2003, "My Plague" was nominated for the Grammy Award for Best Metal Performance at the 45th Annual Grammy Awards , alongside " Here to Stay " by Korn , "Portrait" by P.O.D. , " Get Inside " by Corey Taylor's second band Stone Sour and "Never Gonna Stop (The Red, Red Kroovy)" by Rob Zombie . The award was won by "Here to Stay". All tracks are written by Slipknot include music video "My Plague" (New Abuse mix)

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Plague

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Winds of Plague

Jonathan Cooke-Hayden Michael Montoya Justin Bock Adrienne Cowan Shane Slade Josh Johnson Josh Blackburn Raffi Brandon Pitcher Paul Salem Corey Fine Kevin Grant Chris Cooke Matt Feinman Jeff Tenney Kristen Randall Lisa Marx Nick Eash Nick Piunno Andrew Glover Brandon Galindo Tyler Riley Davey Oberlin Chris Silva Alana Potocnik Art Cruz Winds of Plague is an American deathcore band from Upland, California . Formed in 2002, the band is known for being the first of several deathcore bands to incorporate symphonic elements into their music. The band's name is derived from a section of lyrics in the Unearth song " Endless ": "Growing wings of sorrow/have brought you to the winds of plague."Winds of Plague was founded in 2002 in Upland, California . During the time of the band's inception, its name was originally Bleak December . However, they changed their name in April 2005, to Winds of Plague , being named after a lyric from the Unearth song, "Endless". They released their demo A Cold Day in Hell in late 2005 independently. Several of the songs would subsequently be re-recorded for the following album. Decimate the Weak , the band's first album for Century Media Records , was released in 2008. The album included several re-recorded tracks from A Cold Day In Hell . The Great Stone War was released on August 11, 2009. The album features two singles, "Approach the Podium" and "Chest and Horns", though no music videos were ever shot for any songs on the album. On October 14, 2009, keyboardist Kristen Randall stated that she would be leaving the band and did so days afterward. The band approached musician Lisa Marx to fill in on keyboard for their Australian/New Zealand tour. Afterwards the band found Alana Potocnik who has since been inducted as Winds of Plague's keyboardist. Against the World was released in 2011 to widespread critical acclaim. "Refined in the Fire" and "California" have been released as singles, and music videos for "Drop the Match", "California" and "Refined in the Fire" have also been released. The band also appeared on the soundtrack for the game Homefront performing a cover of the Buffalo Springfield song " For What It's Worth ". A cover of " Zombie " by The Cranberries was included in an iTunes extended play for "California", but the EP was later removed from the iTunes store for unknown reasons. Winds of Plague's fourth studio album, Resistance , was recorded in early to mid-2013 and was released on October 29, 2013. In December 2015, while playing the Affliction Metal Show at The Observatory in Santa Ana with Suicide Silence , vocalist Johnny Plague announced that after going through a brief hiatus, Winds of Plague would resume touring and working on a new album in 2016. Winds of Plague's fifth studio album, Blood of My Enemy , was recorded from 2016 to 2017 and was released on October 27, 2017.Winds of Plague was founded in 2002 in Upland, California . During the time of the band's inception, its name was originally Bleak December . However, they changed their name in April 2005, to Winds of Plague , being named after a lyric from the Unearth song, "Endless". They released their demo A Cold Day in Hell in late 2005 independently. Several of the songs would subsequently be re-recorded for the following album.Decimate the Weak , the band's first album for Century Media Records , was released in 2008. The album included several re-recorded tracks from A Cold Day In Hell .The Great Stone War was released on August 11, 2009. The album features two singles, "Approach the Podium" and "Chest and Horns", though no music videos were ever shot for any songs on the album. On October 14, 2009, keyboardist Kristen Randall stated that she would be leaving the band and did so days afterward. The band approached musician Lisa Marx to fill in on keyboard for their Australian/New Zealand tour. Afterwards the band found Alana Potocnik who has since been inducted as Winds of Plague's keyboardist.Against the World was released in 2011 to widespread critical acclaim. "Refined in the Fire" and "California" have been released as singles, and music videos for "Drop the Match", "California" and "Refined in the Fire" have also been released. The band also appeared on the soundtrack for the game Homefront performing a cover of the Buffalo Springfield song " For What It's Worth ". A cover of " Zombie " by The Cranberries was included in an iTunes extended play for "California", but the EP was later removed from the iTunes store for unknown reasons.Winds of Plague's fourth studio album, Resistance , was recorded in early to mid-2013 and was released on October 29, 2013. In December 2015, while playing the Affliction Metal Show at The Observatory in Santa Ana with Suicide Silence , vocalist Johnny Plague announced that after going through a brief hiatus, Winds of Plague would resume touring and working on a new album in 2016.Winds of Plague's fifth studio album, Blood of My Enemy , was recorded from 2016 to 2017 and was released on October 27, 2017.The band has toured with Despised Icon , Parkway Drive , Impending Doom , Danzig , Dimmu Borgir , Veil of Maya , With Dead Hands Rising, and As Blood Runs Black . They also played at the New England Metal and Hardcore Festival , toured the US on the "Blackest of the Black" tour and finished a 2010 Japan tour with Parkway Drive, 50 Lions, Despised Icon, The Warriors, and Terror . They were featured on The Atticus Metal Tour with Emmure , All Shall Perish , Abacabb, Terror , and The Ghost Inside . In the summer of 2009 was in the Summer Slaughter tour with Necrophagist , Suffocation , Darkest Hour and others. After the Summer Slaughter tour, they joined Hatebreed , Chimaira , Dying Fetus , and Toxic Holocaust on the Decimation of the Nation tour. On January 20, 2010, it was announced that Winds of Plague would be playing on the Jägermeister Stage at the 2010 Rockstar Mayhem Festival in July and August. During April 2010, Winds of Plague toured with Despised Icon , The Warriors , Parkway Drive , and 50 Lions for Parkway Drive's UK and Europe Tour. During February 2011, Winds of Plague toured in the US with After the Burial and headliners As I Lay Dying . They played several songs from their then upcoming new album. They played the entire Warped Tour 2011 on the Advent Clothing stage along with The Acacia Strain , Set Your Goals , We Came As Romans and others. They will also be headlining the 2011 "Thrash and Burn" tour with Chelsea Grin , As Blood Runs Black, and numerous others. They replaced All Shall Perish during Caliban 's "Get Infected" Tour 2012 with support of We Butter the Bread with Butter , Eyes Set To Kill and Attila which started off on February 2 in Karlsruhe, Germany. For their 2014 tour supporting Bleeding Through , with Scars of Tomorrow and Lionheart, Johnny Plague was unable to perform due to undisclosed circumstances. Rather than leave the tour, the band opted to have Mike Milford (of Scars of Tomorrow ) fill in on vocals. The band did a tour in February 2017 with DevilDriver, Death Angel, the Agonist, and Azrael. Just recently, [ when? ] the band also did a tour on the first ever Chaos & Carnage tour supporting Carnifex. Oceano, Archspire, Spite, Buried Above Ground, Shadow of Intent and Widowmaker were also on the tour.Current members Jonathan "Johnny Plague" Cooke-Hayden – unclean vocals (2002–present) ; bass (2002–2004, 2015, 2017) Michael Montoya – lead guitar (2015–present) Justin Bock – rhythm guitar (2017–present) ; bass (2015–2017, 2017) Adrienne Cowan – keyboards, clean vocals (2017–present) Shane Slade – bass (2018–present; touring member 2017–2018) Josh Johnson – drums, percussion (2022–present) Former members Corey Fine – percussion (2002–2005) ; drums (2003–2005) ; keyboards (2003–2004) Josh Blackburn – guitars, bass (2002) Raffi – drums (2002–2003) Brandon Pitcher – keyboards (2002–2003) Nick Eash – lead guitar (2002–2015) ; rhythm guitar, bass (2002–2004) ; keyboards (2003–2004) Nick Piunno – rhythm guitar (2002–2015) ; lead guitar, bass (2002–2004) ; keyboards (2003–2004) Paul Salem – bass, keyboards (2003–2004) Jeff Tenney – drums, percussion (2004–2008) Kevin Grant – bass (2004–2006) Chris Cooke – keyboards (2004–2006) Andrew Glover – bass (2006–2015) Matt Feinman – keyboards (2006–2008) Kristen Randall – keyboards, clean vocals (2008–2009) Art Cruz – drums, percussion (2008–2012, 2015–2022) Lisa Marx – keyboards (2009) Alana Potocnik – keyboards (2009–2017) Brandon Galindo – drums, percussion (2012–2015) Tyler Riley – guitars (2013–2015) Davey Oberlin – rhythm guitar (2015–2017) Chris Silva – bass (2017) TimelineReleased: February 5, 2008 Label: Century Media Formats: CD, digital download Released: August 11, 2009 Label: Century Media Formats: CD, digital download Released: April 19, 2011 Label: Century Media Formats: CD, digital download Released: October 29, 2013 Label: Century Media Formats: CD, digital download (2008) "The Impaler" (from the album Decimate the Weak ) (2011) "Drop the Match" (from the album Against the World ) (2011) "California" (from the album Against the World ) (2013) "Open the Gates of Hell" (from the album Resistance ) (2013) "Say Hello to the Undertaker" (from the album Resistance ) (2017) "Never Alone" (from the album Blood of My Enemy )Released: February 5, 2008 Label: Century Media Formats: CD, digital download Released: August 11, 2009 Label: Century Media Formats: CD, digital download Released: April 19, 2011 Label: Century Media Formats: CD, digital download Released: October 29, 2013 Label: Century Media Formats: CD, digital download (2008) "The Impaler" (from the album Decimate the Weak ) (2011) "Drop the Match" (from the album Against the World ) (2011) "California" (from the album Against the World ) (2013) "Open the Gates of Hell" (from the album Resistance ) (2013) "Say Hello to the Undertaker" (from the album Resistance ) (2017) "Never Alone" (from the album Blood of My Enemy )

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Plague

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The Plague (novel)

The Plague ( French : La Peste ) is a 1947 absurdist novel by Albert Camus . It tells the story from the point of view of a narrator in the midst of a plague sweeping the French Algerian city of Oran . The narrator remains unknown until the beginning of the last chapter. The novel presents a snapshot into life in Oran as seen through the author's distinctive absurdist point of view. Camus used as source material the cholera epidemic that killed a large proportion of Oran's population in 1849, but set the novel in the 1940s. Oran and its surroundings were struck by disease several times before Camus published his novel. According to an academic study, Oran was decimated by the bubonic plague in 1556 and 1678, but all later outbreaks (in 1921: 185 cases; 1931: 76 cases; and 1944: 95 cases) were very far from the scale of the epidemic described in the novel. The Plague is considered an existentialist classic despite Camus' objection to the label. The novel stresses the powerlessness of the individual characters to affect their own destinies. The narrative tone is similar to Kafka 's, especially in The Trial , whose individual sentences potentially have multiple meanings; the material often pointedly resonating as stark allegory of phenomenal consciousness and the human condition .The Narrator : the narrator presents himself at the outset of the book as witness to the events and privy to documents, but does not identify himself until the ending of the novel. The Prefect : The Prefect believes at first that the talk of plague is a false alarm, but on the advice of his medical association, he authorizes limited measures to combat it. When they do not work, he attempts to avoid responsibility, saying he will ask the government for orders. He later takes responsibility for tightening up the regulations relating to the plague and issues the order to close the town. Dr. Castel : Dr. Castel is one of Rieux's medical colleagues and is much older than Rieux. He realizes after the first few cases that the disease is bubonic plague and is aware of the seriousness of the situation. He works hard to make an antiplague serum, but as the epidemic continues, he shows increasing signs of wear and tear. M. Othon : M. Othon is a magistrate in Oran. He is tall and thin, and Tarrou describes him as follows: "Two small eyes, round, and hard, a thin nose, a horizontal mouth give the air of a well-brought-up owl." Othon treats his wife and children unkindly, but after his son Philippe dies of the plague, his character softens. After he finishes his time at the isolation camp, where he was sent because his son is infected, he wants to return there because it would make him feel closer to his lost son. However, before Othon can do this, he contracts the plague and dies. Philippe Othon : Philippe Othon is M. Othon's young son. When he contracts the plague, he is the first to receive Dr. Castel's antiplague serum. The serum is ineffective, and Philippe Othon dies after a long and painful struggle. Mme. Rieux : Mme. Rieux is Dr. Rieux's mother, who comes to stay with him when his sick wife goes to the sanatorium. She is a serene woman who, after taking care of the housework, sits quietly in a chair. She says that at her age, there is nothing much left to fear. Dr. Richard : Dr. Richard is chairman of the Oran Medical Association. He is slow to recommend any action to combat the plague for fear of public alarm. He does not want even to admit that the disease is the plague, referring instead to "a fever that had inguinal complications". M. Michel : M. Michel is the concierge of the building in which Rieux lives. An old man, he is the first victim of the plague. Raoul : Raoul is the man who agrees, for a fee of ten thousand francs, to arrange for Rambert to escape. He introduces Rambert to Gonzales. Gonzales : Gonzales is the smuggler who makes the arrangements for Rambert's escape and bonds with him over football. Asthma Patient : the asthma patient receives regular visits from Dr. Rieux. He is a seventy-five-year-old Spaniard with a rugged face, who comments on events in Oran that he hears about on the radio and in the newspapers. He sits in his bed all day and measures the passing of time by putting chickpeas from one jug into another. Louis : Louis is one of the sentries who take part in the plan for Rambert to escape. Marcel : Marcel, Louis's brother, is also a sentry who is part of the escape plan for Rambert. Garcia : Garcia is a man who knows the group of smugglers in Oran. He introduces Rambert to Raoul.The book begins with an epigraph quoting Daniel Defoe , author of A Journal of the Plague Year : In the town of Oran, thousands of rats, initially unnoticed by the populace, begin to die in the streets. Hysteria develops soon afterward, causing the local newspapers to report the incident. Authorities responding to public pressure order the collection and cremation of the rats, unaware that the collection itself was the catalyst for the spread of the bubonic plague . The main character, Dr. Bernard Rieux, lives comfortably in an apartment building when strangely the building's concierge, M. Michel, a confidante, dies from a fever. Dr. Rieux consults his colleague, Dr. Castel, about the illness until they come to the conclusion that a plague is sweeping the town. They both approach fellow doctors and town authorities about their theory but are eventually dismissed on the basis of one death. However, as more deaths quickly ensue, it becomes apparent that there is an epidemic. Meanwhile, Rieux's wife has been sent to a sanatorium in another city, to be treated for an unrelated chronic illness. Authorities, including the Prefect, are slow to accept that the situation is serious and quibble over the appropriate action to take. Official notices enacting control measures are posted, but the language used is optimistic and downplays the seriousness of the situation. A "special ward" is opened at the hospital, but its 80 beds are filled within three days. As the death toll begins to rise, more desperate measures are taken. Homes are quarantined; corpses and burials are strictly supervised. A supply of plague serum finally arrives, but there is enough to treat only existing cases, and the country's emergency reserves are depleted. When the daily number of deaths jumps to 30, the town is sealed, and an outbreak of plague is officially declared. The town is sealed off. The town gates are shut, rail travel is prohibited, and all mail service is suspended. The use of telephone lines is restricted only to "urgent" calls, leaving short telegrams as the only means of communicating with friends or family outside the town. The separation affects daily activity and depresses the spirit of the townspeople, who begin to feel isolated and introverted, and the plague begins to affect various characters. One character, Raymond Rambert, devises a plan to escape the city to join his wife in Paris after city officials refused his request to leave. He befriends some underground criminals so that they may smuggle him out of the city. Another character, Father Paneloux, uses the plague as an opportunity to advance his stature in the town by suggesting that the plague was an act of God punishing the citizens' sinful nature. His diatribe falls on the ears of many citizens of the town, who turned to religion in droves, but would not have done so under normal circumstances. Cottard, a criminal remorseful enough to attempt suicide but fearful of being arrested, becomes wealthy as a major smuggler. Meanwhile, Jean Tarrou, a vacationer; Joseph Grand, a civil engineer; and Dr. Rieux, exhaustively treat patients in their homes and in the hospital. Rambert informs Tarrou of his escape plan, but when Tarrou tells him that there are others in the city, including Dr. Rieux, who have loved ones outside the city whom they are not allowed to see, Rambert becomes sympathetic and offers to help Rieux fight the epidemic until he leaves town. In mid-August, the situation continues to worsen. People try to escape the town, but some are shot by armed sentries. Violence and looting break out on a small scale, and the authorities respond by declaring martial law and imposing a curfew. Funerals are conducted with more speed, no ceremony and little concern for the feelings of the families of the deceased. The inhabitants passively endure their increasing feelings of exile and separation. Despondent, they waste away emotionally as well as physically. In September and October, the town remains at the mercy of the plague. Rieux hears from the sanatorium that his wife's condition is worsening. He also hardens his heart regarding the plague victims so that he can continue to do his work. Cottard, on the other hand, seems to flourish during the plague because it gives him a sense of being connected to others, since everybody faces the same danger. Cottard and Tarrou attend a performance of Gluck 's opera Orfeo ed Euridice , but the actor portraying Orpheus collapses with plague symptoms during the performance. After extended negotiations with guards, Rambert finally has a chance to escape, but he decides to stay, saying that he would feel ashamed of himself if he left. Towards the end of October, Castel's new antiplague serum is tried for the first time, but it cannot save the life of Othon's young son, who suffers greatly, as Paneloux, Rieux, and Tarrou tend to his bedside in horror. Paneloux, who has joined the group of volunteers fighting the plague, gives a second sermon. He addresses the problem of an innocent child's suffering and says it is a test of a Christian's faith since it requires him either to deny everything or believe everything. He urges the congregation not to give up the struggle but to do everything possible to fight the plague. A few days after the sermon, Paneloux is taken ill. His symptoms do not conform to those of the plague, but the disease still proves fatal. Tarrou and Rambert visit one of the isolation camps, where they meet Othon. When Othon's period of quarantine ends, he chooses to stay in the camp as a volunteer because this will make him feel less separated from his dead son. Tarrou tells Rieux the story of his life. To take their mind off the epidemic, the two men go swimming together in the sea. Grand catches the plague and instructs Rieux to burn all his papers. However, Grand makes an unexpected recovery, and deaths from the plague start to decline. By late January, the plague is in full retreat, and the townspeople begin to celebrate the imminent opening of the town gates. Othon, however, does not escape death from the disease. Cottard is distressed by the ending of the epidemic from which he has profited by shady dealings. Two government employees approach him, and he flees. Despite the epidemic's ending, Tarrou contracts the plague and dies after a heroic struggle. Rieux is later informed via telegram that his wife has died at the sanatorium. In February, the town gates open and people are reunited with their loved ones from other cities. Rambert is reunited with his wife. Cottard goes mad and shoots at people from his home, and is soon arrested after a brief skirmish with the police. Grand begins working on his novel again. The narrator of the chronicle discloses his identity and states that he tried to present an objective view of the events. He reflects on the epidemic and declares he wrote the chronicle "to write simply about what can be learned in the middle of scourges, that there is more to admire in humans than there is to scorn". In the town of Oran, thousands of rats, initially unnoticed by the populace, begin to die in the streets. Hysteria develops soon afterward, causing the local newspapers to report the incident. Authorities responding to public pressure order the collection and cremation of the rats, unaware that the collection itself was the catalyst for the spread of the bubonic plague . The main character, Dr. Bernard Rieux, lives comfortably in an apartment building when strangely the building's concierge, M. Michel, a confidante, dies from a fever. Dr. Rieux consults his colleague, Dr. Castel, about the illness until they come to the conclusion that a plague is sweeping the town. They both approach fellow doctors and town authorities about their theory but are eventually dismissed on the basis of one death. However, as more deaths quickly ensue, it becomes apparent that there is an epidemic. Meanwhile, Rieux's wife has been sent to a sanatorium in another city, to be treated for an unrelated chronic illness. Authorities, including the Prefect, are slow to accept that the situation is serious and quibble over the appropriate action to take. Official notices enacting control measures are posted, but the language used is optimistic and downplays the seriousness of the situation. A "special ward" is opened at the hospital, but its 80 beds are filled within three days. As the death toll begins to rise, more desperate measures are taken. Homes are quarantined; corpses and burials are strictly supervised. A supply of plague serum finally arrives, but there is enough to treat only existing cases, and the country's emergency reserves are depleted. When the daily number of deaths jumps to 30, the town is sealed, and an outbreak of plague is officially declared.The town is sealed off. The town gates are shut, rail travel is prohibited, and all mail service is suspended. The use of telephone lines is restricted only to "urgent" calls, leaving short telegrams as the only means of communicating with friends or family outside the town. The separation affects daily activity and depresses the spirit of the townspeople, who begin to feel isolated and introverted, and the plague begins to affect various characters. One character, Raymond Rambert, devises a plan to escape the city to join his wife in Paris after city officials refused his request to leave. He befriends some underground criminals so that they may smuggle him out of the city. Another character, Father Paneloux, uses the plague as an opportunity to advance his stature in the town by suggesting that the plague was an act of God punishing the citizens' sinful nature. His diatribe falls on the ears of many citizens of the town, who turned to religion in droves, but would not have done so under normal circumstances. Cottard, a criminal remorseful enough to attempt suicide but fearful of being arrested, becomes wealthy as a major smuggler. Meanwhile, Jean Tarrou, a vacationer; Joseph Grand, a civil engineer; and Dr. Rieux, exhaustively treat patients in their homes and in the hospital. Rambert informs Tarrou of his escape plan, but when Tarrou tells him that there are others in the city, including Dr. Rieux, who have loved ones outside the city whom they are not allowed to see, Rambert becomes sympathetic and offers to help Rieux fight the epidemic until he leaves town.In mid-August, the situation continues to worsen. People try to escape the town, but some are shot by armed sentries. Violence and looting break out on a small scale, and the authorities respond by declaring martial law and imposing a curfew. Funerals are conducted with more speed, no ceremony and little concern for the feelings of the families of the deceased. The inhabitants passively endure their increasing feelings of exile and separation. Despondent, they waste away emotionally as well as physically.In September and October, the town remains at the mercy of the plague. Rieux hears from the sanatorium that his wife's condition is worsening. He also hardens his heart regarding the plague victims so that he can continue to do his work. Cottard, on the other hand, seems to flourish during the plague because it gives him a sense of being connected to others, since everybody faces the same danger. Cottard and Tarrou attend a performance of Gluck 's opera Orfeo ed Euridice , but the actor portraying Orpheus collapses with plague symptoms during the performance. After extended negotiations with guards, Rambert finally has a chance to escape, but he decides to stay, saying that he would feel ashamed of himself if he left. Towards the end of October, Castel's new antiplague serum is tried for the first time, but it cannot save the life of Othon's young son, who suffers greatly, as Paneloux, Rieux, and Tarrou tend to his bedside in horror. Paneloux, who has joined the group of volunteers fighting the plague, gives a second sermon. He addresses the problem of an innocent child's suffering and says it is a test of a Christian's faith since it requires him either to deny everything or believe everything. He urges the congregation not to give up the struggle but to do everything possible to fight the plague. A few days after the sermon, Paneloux is taken ill. His symptoms do not conform to those of the plague, but the disease still proves fatal. Tarrou and Rambert visit one of the isolation camps, where they meet Othon. When Othon's period of quarantine ends, he chooses to stay in the camp as a volunteer because this will make him feel less separated from his dead son. Tarrou tells Rieux the story of his life. To take their mind off the epidemic, the two men go swimming together in the sea. Grand catches the plague and instructs Rieux to burn all his papers. However, Grand makes an unexpected recovery, and deaths from the plague start to decline.By late January, the plague is in full retreat, and the townspeople begin to celebrate the imminent opening of the town gates. Othon, however, does not escape death from the disease. Cottard is distressed by the ending of the epidemic from which he has profited by shady dealings. Two government employees approach him, and he flees. Despite the epidemic's ending, Tarrou contracts the plague and dies after a heroic struggle. Rieux is later informed via telegram that his wife has died at the sanatorium. In February, the town gates open and people are reunited with their loved ones from other cities. Rambert is reunited with his wife. Cottard goes mad and shoots at people from his home, and is soon arrested after a brief skirmish with the police. Grand begins working on his novel again. The narrator of the chronicle discloses his identity and states that he tried to present an objective view of the events. He reflects on the epidemic and declares he wrote the chronicle "to write simply about what can be learned in the middle of scourges, that there is more to admire in humans than there is to scorn". Germaine Brée has characterised the struggle of the characters against the plague as "undramatic and stubborn", and in contrast to the ideology of "glorification of power" in the novels of André Malraux , whereas Camus' characters "are obscurely engaged in saving, not destroying, and this in the name of no ideology". Lulu Haroutunian has discussed Camus' own medical history, including a bout with tuberculosis, and how it informs the novel. Marina Warner notes its larger philosophical themes of "engagement", "paltriness and generosity", "small heroism and large cowardice", and "all kinds of profoundly humanist problems, such as love and goodness, happiness and mutual connection". Thomas L Hanna and John Loose have separately discussed themes related to Christianity in the novel, with particular respect to Father Paneloux and Dr Rieux. Louis R Rossi briefly discusses the role of Tarrou in the novel, and the sense of philosophical guilt behind his character. Elwyn Sterling has analysed the role of Cottard and his final actions at the end of the novel. Father Paneloux has been subject to several literary analyses in the context of faith faced with great suffering. Dr Rieux has been described as a classic example of an idealist doctor. He has also been an inspiration to the life and career of the French doctor Réjean Thomas, and also to the fictional character of Jeanne Dion, starring in the movie trilogy directed by Bernard Émond (beginning with The Novena ). Perri Klass has noted that at the time of the novel, sulfa drugs were available for treatment against plague, and has criticised the novel for this historical-medical omission. The novel has been read as an allegorical treatment of the French resistance to Nazi occupation during World War II. The novel became a bestseller during the worldwide COVID-19 pandemic of 2020 to the point that its British publisher Penguin Classics reported struggling to keep up with demand. The prescience of the fictional cordon sanitaire of Oran with real-life COVID-19 lockdowns worldwide brought revived popular attention. Sales in Italy tripled and it became a top-ten bestseller during its nationwide lockdown . Penguin Classics' editorial director said "it couldn't be more relevant to the current moment" and Camus' daughter Catherine said that the message of the novel had newfound relevance in that "we are not responsible for coronavirus but we can be responsible in the way we respond to it". As early as April 1941, Camus had been working on the novel, as evidenced in his diaries in which he wrote down a few ideas on "the redeeming plague". On 13 March 1942, he informed André Malraux that he was writing "a novel on the plague", adding "Said like that it might sound strange, […] but this subject seems so natural to me."

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Plague

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Plague of Amwas

The plague of Amwas ( Arabic : طاعون ع٠واس , romanized : ṭāʿūn ʿAmwās ), also spelled plague of Emmaus , was an ancient bubonic plague epidemic that afflicted Islamic Syria in 638–639, during the first plague pandemic and toward the end of the Muslim conquest of the region . It was likely a reemergence of the mid-6th-century Plague of Justinian . Named after Amwas in Palestine , the principal camp of the Muslim Arab army, the plague killed up to 25,000 soldiers and their relatives, including most of the army's high command, and caused considerable loss of life and displacement among the indigenous Christians of Syria. The appointment of Mu'awiya ibn Abi Sufyan to the governorship of Syria in the wake of the commanders' deaths paved the way for his establishment of the Umayyad Caliphate in 661, while recurrences of the disease may have contributed to the Umayyad dynasty 's downfall in 750. Depopulation in the Syrian countryside may have been a factor in the resettlement of the land by the Arabs unlike in other conquered regions where the Arabs largely secluded themselves to new garrison cities . [ citation needed ] The plague of Amwas received more attention in the Arabic sources than any other epidemic until the 14th-century Black Death . Traditional narratives about reactions to the plague of Amwas by Caliph Umar and his top commander Abu Ubayda ibn al-Jarrah informed medieval Muslim theological responses to epidemics, including the Black Death. Principles derived from the narratives were cited in debates about predestination and free will, prohibitions on fleeing or entering plague-affected lands and contagion. [ citation needed ]The plague of Amwas was likely a bubonic plague epidemic, though the sources do not elaborate on specific symptoms of the disease. It was the second recorded plague of the Islamic era, which began in the 620s, and the first to directly afflict the Muslims. It was likely a reemergence of the Plague of Justinian , which originated in Pelusium (near modern Suez ) in 541 and spread west to Alexandria and east to Palestine before reaching the Byzantine capital Constantinople in 541–542 and afflicting the rest of Europe and the Sasanian Empire , as noted by the Byzantine historian Procopius (d. c. 570 ). The Plague of Justinian recurred in at least nine to twelve cycles throughout the mid-6th century and the 7th century. The first caliph (head of the Muslim community), Abu Bakr ( r. 632–634 ), dispatched four armies from Medina , led respectively by Amr ibn al-As , Yazid ibn Abi Sufyan , Shurahbil ibn Hasana and Abu Ubayda ibn al-Jarrah to conquer Byzantine Syria (Abu Ubayda may not have been dispatched until after the accession of Abu Bakr's successor, Umar , in mid-634. ) Amwas, the Arabic name for Emmaus Nicopolis , had been a fortified Roman army camp in the first century, which grew into a small city by the early third. It was captured by the Muslims from the Byzantines following the Battle of Ajnadayn in 634 or the Battle of the Yarmuk in 636. At the onset of the plague, the site served as the principal camp of the Arab Muslim troops in Syria where spoils were divided and soldiers paid. The plague of Amwas occurred in the Islamic calendar years of 17 AH /638 AD and/or 18 AH/639 AD. According to the 8th-century historian Sayf ibn Umar , it struck in Muharram – Safar 17 AH/January–February 638, then dissipated before returning once more and inflicting numerous deaths "to the advantage of the enemy [the Byzantines]." Al-Suyuti (d. 1505) holds the plague had reemerged not long after its initial outbreak, which the historian M. W. Dols suggests "accounts for the two dates [638 and 639]". The plague struck at some point during a nine-month drought in Syria referred to by the Arabs as the 'Year of the Ashes'. Widespread famine in Syria–Palestine possibly set the stage for the plague due to weakened immune resistance and the stockpiling of food reserves in towns and villages, which could attract plague-infected rodents and bring them into contact with the human population, according to Dols. It spread across Syria and also affected Iraq and Egypt, before subsiding in Shawwal 18 AH/ October 639. According to one of the main narratives of the Islamic traditional sources, Umar, intending to prevent the illness and death of his top commander Abu Ubayda, summoned the latter to Medina; Abu Ubayda, aware of Umar's intent, refused to abandon his men. Umar subsequently embarked for Syria to assess the situation, meeting with the army leaders at a desert way-stop called Sargh (thirteen days' march north of Medina). His first consultations were with leaders from the Muhajirun and Ansar factions, collectively the earliest Muslim converts and elite of the nascent Muslim state, who argued against fleeing the plague-affected areas. Disagreeing with their recommendations, he next consulted the leaders of the later converts from the Quraysh , the tribe to which the Islamic prophet Muhammad and the caliphs belonged, who proposed that the army should withdraw from the area of the epidemic, which Umar accepted. Abu Ubayda protested the army's withdrawal on the basis of a purported prohibition by Muhammad on Muslims fleeing or entering a plague-affected land. Umar retorted that a person would naturally choose the green side of a valley rather than the barren side, but regardless of the person's decision it would be God's will. This narrative was used by medieval Muslim scholars as a precedent justifying flight from an epidemic. The summit at Sargh concluded with Umar ordering Abu Ubdaya to lead the army to healthier grounds and the caliph's return to Medina. Abu Ubayda moved to encamp the army at the old Ghassanid capital of Jabiya in the highland region of the Hauran . Due to its healthy climate, Jabiya effectively acted as a sanatorium for plague-stricken troops and the center for the distribution of war spoils. On the way there, in 639, Abu Ubayda succumbed to the plague. His successor Mu'adh ibn Jabal and two of Mu'adh's wives and son (or his entire family) died immediately after, followed by Mu'adh's successor Yazid ibn Abi Sufyan. Shurahbil also died from the plague. Among the other prominent Muslims and companions of Muhammad in the army to succumb were Suhayl ibn Amr , Suhayl's son Abu Jandal , al-Fadl ibn Abbas , al-Harith ibn Hisham , and many of al-Harith's seventy family members who had settled in Syria. Amr ibn al-As is credited for leading the surviving Muslim troops to Jabiya. In December 639, he embarked on the conquest of Egypt . The Islamic traditional accounts maintain between 20,000 and 25,000 Muslim soldiers in Syria and their family members died in the plague. By 639, 4,000 Muslim troops were left in Jabiya out of some 24,000 in 637, though the modern historian Fred Donner notes that it is unclear how many of the missing troops had died or had temporarily fled and returned to Syria eventually. The plague caused substantial loss of life among the local Christian population in Syria. It also resulted in price rises and hoarding, prompting Umar to prohibit hoarding. According to al-Tabari (d. 923), after returning to Medina from Sargh, Umar informed his advisers of his intention to visit his troops in Syria–Palestine and assess the chaos wrought by the plague. During his purported visit in 639, he gave directions on the disposition of the estates of the Muslims who died in the epidemic and settled suspicious claims by some of the troops. As a result of the deaths of his top commanders in Syria, Umar appointed Yazid's brother and deputy, Mu'awiya ibn Abi Sufyan , commander of the army there, ultimately laying the foundation for the establishment of the Syria-centered Umayyad Caliphate by Mu'awiya in 661. The historian Wilferd Madelung surmises that the plague in Syria had precluded Umar from deploying commanders more preferable to him from Medina and he thus appointed Mu'awiya in lieu of a suitable alternative. The losses among the Muslim troops in Syria caused by the Amwas plague contributed to Mu'awiya's heavy military reliance on older-established, formerly Byzantine-allied and Christian Arab tribes in Syria, particularly the Banu Kalb , who had largely stayed neutral during the fighting between the Muslims and the Byzantines. Amwas was replaced as the Arabs' headquarters in Palestine first by Lydda and/or Jerusalem , followed by Ramla , which was founded by the Umayyad caliph Sulayman ibn Abd al-Malik in the early 8th century. As late as the 1870s a well in the village of Amwas bore the name bir al-ta'un (well of the plague). Jabiya remained the Arabs' principal military camp in Syria until the reign of Sulayman. There were recurrences of the plague in Syria–Palestine about every decade between 688/89 and 744/45. "The Umaiyad [sic] dynasty was literally plagued by this disease", in the words of Dols. The deaths of the Umayyad caliphs Mu'awiya II ( r. 683–684 ), Marwan I ( r. 684–685 ), Abd al-Malik ( r. 685–705 ), Sulayman ( r. 715–717 ) and the Umayyad governors in Iraq al-Mughira ibn Shu'ba ( r. 661–671 ) and Ziyad ibn Abihi ( r. 685–673 ) may all possibly have been caused by the plague epidemics in Syria and Iraq. The caliphs routinely withdrew from the cities to their desert palaces when the plague emerged during the summer months. Notable among them was Caliph Hisham ( r. 724–743 ), who preferred his palace at Rusafa over Damascus because he viewed the latter to be unhealthy. Dols speculates that the frequent recurrences may have consistently undercut natural population growth in Syria–Palestine, the center of the Umayyad Caliphate, and weakened Umayyad power. Concurrently, Arab tribal migrations into the far eastern province of Khurasan , which was spared from the plague epidemics, led to the lopsided growth and predominance of the eastern half of the Caliphate and the rise of the Abbasid Movement there, which toppled the Umayyads in 750. In the view of Conrad, by the end of these plague cycles, the Umayyads had lost practical control of the eastern Caliphate and "it is tempting to view the interminable plagues of the last years of the dynasty as an important factor in the victory of the Abbasid revolution". Modern historians concur that the actual circumstances of the plague of Amwas are not reconstructable and largely focus on the descriptions of the event in the 8th–10th-century Islamic histories and collections of hadith (traditions and sayings of Muhammad) in the context of theological debates on predestination , the status of Muslim sinners, and contagion. The plague of Amwas received more attention in medieval Arabic literature than any other epidemic until the 14th-century Black Death . Representations of the plague by the sources were "varied and contradictory", according to the historian Justin K. Stearns . The narratives of the response to the plague by Muhammad's companions Umar, Abu Ubayda, Amr and Mu'adh informed Muslim religious and legal interpretations of plague throughout the Middle Ages, including the response to the Black Death. Medieval Muslim scholars derived three principals from the contemporary reactions to the plague of Amwas: the first was that the plague was a form of divine mercy or martyrdom for the Muslim faithful and a punishment to non-believers; the second was the prohibition on Muslims entering or fleeing plague-stricken lands; and the third was the plague was not a contagion, rather it was directly imposed by God. The tenets consistently caused theological disagreements throughout the epidemic recurrences of the Middle Ages as a result of the difficulty in accepting plague as divine mercy or punishment and observable contagion. In the assessment of Dols, native Christian and Jewish attitudes and natural human anxieties likely influenced aspects of the first principle, namely that plague represented divine punishment or warnings. Muslims in this camp related the plague to lax morals among the Muslim troops in Syria, such as the consumption of wine, which supposedly led Umar to order the lashing of drinkers. On the other hand, the interpretation of plague as mercy or martyrdom is evident in Abu Ubayda's speeches to the troops at Amwas and in the council at Sargh. A poem about the plague of Amwas recorded by the Damascene historian Ibn Asakir (d. 1175) reflects the martyrdom belief: How many brave horsemen and how many beautiful, chaste women were killed in the valley of 'Amwas They had encountered the Lord, but He was not unjust to them When they died, they were among the non-aggrieved people in Paradise. We endure the plague as the Lord knows, and we were consoled in the hour of death. On the principle of predestination, the events of Amwas were used to argue that whether a person fled or remained in a plague-affected area their death had already been decreed by God. During an episode of plague in the Iraqi garrison city of Kufa , the prominent statesman and scholar Abu Musa al-Ash'ari (d. 662) turned away visitors to his home due to someone in his household having the plague, and he justified Muslims fleeing plague on the basis of Umar's actions at Sargh. According to Dols, this also implied a recognition of contagion despite the contradiction with the purported hadith rejecting contagion as a pre-Islamic theory. According to one of the main narratives of the Islamic traditional sources, Umar, intending to prevent the illness and death of his top commander Abu Ubayda, summoned the latter to Medina; Abu Ubayda, aware of Umar's intent, refused to abandon his men. Umar subsequently embarked for Syria to assess the situation, meeting with the army leaders at a desert way-stop called Sargh (thirteen days' march north of Medina). His first consultations were with leaders from the Muhajirun and Ansar factions, collectively the earliest Muslim converts and elite of the nascent Muslim state, who argued against fleeing the plague-affected areas. Disagreeing with their recommendations, he next consulted the leaders of the later converts from the Quraysh , the tribe to which the Islamic prophet Muhammad and the caliphs belonged, who proposed that the army should withdraw from the area of the epidemic, which Umar accepted. Abu Ubayda protested the army's withdrawal on the basis of a purported prohibition by Muhammad on Muslims fleeing or entering a plague-affected land. Umar retorted that a person would naturally choose the green side of a valley rather than the barren side, but regardless of the person's decision it would be God's will. This narrative was used by medieval Muslim scholars as a precedent justifying flight from an epidemic. The summit at Sargh concluded with Umar ordering Abu Ubdaya to lead the army to healthier grounds and the caliph's return to Medina. Abu Ubayda moved to encamp the army at the old Ghassanid capital of Jabiya in the highland region of the Hauran . Due to its healthy climate, Jabiya effectively acted as a sanatorium for plague-stricken troops and the center for the distribution of war spoils. On the way there, in 639, Abu Ubayda succumbed to the plague. His successor Mu'adh ibn Jabal and two of Mu'adh's wives and son (or his entire family) died immediately after, followed by Mu'adh's successor Yazid ibn Abi Sufyan. Shurahbil also died from the plague. Among the other prominent Muslims and companions of Muhammad in the army to succumb were Suhayl ibn Amr , Suhayl's son Abu Jandal , al-Fadl ibn Abbas , al-Harith ibn Hisham , and many of al-Harith's seventy family members who had settled in Syria. Amr ibn al-As is credited for leading the surviving Muslim troops to Jabiya. In December 639, he embarked on the conquest of Egypt . The Islamic traditional accounts maintain between 20,000 and 25,000 Muslim soldiers in Syria and their family members died in the plague. By 639, 4,000 Muslim troops were left in Jabiya out of some 24,000 in 637, though the modern historian Fred Donner notes that it is unclear how many of the missing troops had died or had temporarily fled and returned to Syria eventually. The plague caused substantial loss of life among the local Christian population in Syria. It also resulted in price rises and hoarding, prompting Umar to prohibit hoarding. According to al-Tabari (d. 923), after returning to Medina from Sargh, Umar informed his advisers of his intention to visit his troops in Syria–Palestine and assess the chaos wrought by the plague. During his purported visit in 639, he gave directions on the disposition of the estates of the Muslims who died in the epidemic and settled suspicious claims by some of the troops. As a result of the deaths of his top commanders in Syria, Umar appointed Yazid's brother and deputy, Mu'awiya ibn Abi Sufyan , commander of the army there, ultimately laying the foundation for the establishment of the Syria-centered Umayyad Caliphate by Mu'awiya in 661. The historian Wilferd Madelung surmises that the plague in Syria had precluded Umar from deploying commanders more preferable to him from Medina and he thus appointed Mu'awiya in lieu of a suitable alternative. The losses among the Muslim troops in Syria caused by the Amwas plague contributed to Mu'awiya's heavy military reliance on older-established, formerly Byzantine-allied and Christian Arab tribes in Syria, particularly the Banu Kalb , who had largely stayed neutral during the fighting between the Muslims and the Byzantines. Amwas was replaced as the Arabs' headquarters in Palestine first by Lydda and/or Jerusalem , followed by Ramla , which was founded by the Umayyad caliph Sulayman ibn Abd al-Malik in the early 8th century. As late as the 1870s a well in the village of Amwas bore the name bir al-ta'un (well of the plague). Jabiya remained the Arabs' principal military camp in Syria until the reign of Sulayman. There were recurrences of the plague in Syria–Palestine about every decade between 688/89 and 744/45. "The Umaiyad [sic] dynasty was literally plagued by this disease", in the words of Dols. The deaths of the Umayyad caliphs Mu'awiya II ( r. 683–684 ), Marwan I ( r. 684–685 ), Abd al-Malik ( r. 685–705 ), Sulayman ( r. 715–717 ) and the Umayyad governors in Iraq al-Mughira ibn Shu'ba ( r. 661–671 ) and Ziyad ibn Abihi ( r. 685–673 ) may all possibly have been caused by the plague epidemics in Syria and Iraq. The caliphs routinely withdrew from the cities to their desert palaces when the plague emerged during the summer months. Notable among them was Caliph Hisham ( r. 724–743 ), who preferred his palace at Rusafa over Damascus because he viewed the latter to be unhealthy. Dols speculates that the frequent recurrences may have consistently undercut natural population growth in Syria–Palestine, the center of the Umayyad Caliphate, and weakened Umayyad power. Concurrently, Arab tribal migrations into the far eastern province of Khurasan , which was spared from the plague epidemics, led to the lopsided growth and predominance of the eastern half of the Caliphate and the rise of the Abbasid Movement there, which toppled the Umayyads in 750. In the view of Conrad, by the end of these plague cycles, the Umayyads had lost practical control of the eastern Caliphate and "it is tempting to view the interminable plagues of the last years of the dynasty as an important factor in the victory of the Abbasid revolution". There were recurrences of the plague in Syria–Palestine about every decade between 688/89 and 744/45. "The Umaiyad [sic] dynasty was literally plagued by this disease", in the words of Dols. The deaths of the Umayyad caliphs Mu'awiya II ( r. 683–684 ), Marwan I ( r. 684–685 ), Abd al-Malik ( r. 685–705 ), Sulayman ( r. 715–717 ) and the Umayyad governors in Iraq al-Mughira ibn Shu'ba ( r. 661–671 ) and Ziyad ibn Abihi ( r. 685–673 ) may all possibly have been caused by the plague epidemics in Syria and Iraq. The caliphs routinely withdrew from the cities to their desert palaces when the plague emerged during the summer months. Notable among them was Caliph Hisham ( r. 724–743 ), who preferred his palace at Rusafa over Damascus because he viewed the latter to be unhealthy. Dols speculates that the frequent recurrences may have consistently undercut natural population growth in Syria–Palestine, the center of the Umayyad Caliphate, and weakened Umayyad power. Concurrently, Arab tribal migrations into the far eastern province of Khurasan , which was spared from the plague epidemics, led to the lopsided growth and predominance of the eastern half of the Caliphate and the rise of the Abbasid Movement there, which toppled the Umayyads in 750. In the view of Conrad, by the end of these plague cycles, the Umayyads had lost practical control of the eastern Caliphate and "it is tempting to view the interminable plagues of the last years of the dynasty as an important factor in the victory of the Abbasid revolution". Modern historians concur that the actual circumstances of the plague of Amwas are not reconstructable and largely focus on the descriptions of the event in the 8th–10th-century Islamic histories and collections of hadith (traditions and sayings of Muhammad) in the context of theological debates on predestination , the status of Muslim sinners, and contagion. The plague of Amwas received more attention in medieval Arabic literature than any other epidemic until the 14th-century Black Death . Representations of the plague by the sources were "varied and contradictory", according to the historian Justin K. Stearns . The narratives of the response to the plague by Muhammad's companions Umar, Abu Ubayda, Amr and Mu'adh informed Muslim religious and legal interpretations of plague throughout the Middle Ages, including the response to the Black Death. Medieval Muslim scholars derived three principals from the contemporary reactions to the plague of Amwas: the first was that the plague was a form of divine mercy or martyrdom for the Muslim faithful and a punishment to non-believers; the second was the prohibition on Muslims entering or fleeing plague-stricken lands; and the third was the plague was not a contagion, rather it was directly imposed by God. The tenets consistently caused theological disagreements throughout the epidemic recurrences of the Middle Ages as a result of the difficulty in accepting plague as divine mercy or punishment and observable contagion. In the assessment of Dols, native Christian and Jewish attitudes and natural human anxieties likely influenced aspects of the first principle, namely that plague represented divine punishment or warnings. Muslims in this camp related the plague to lax morals among the Muslim troops in Syria, such as the consumption of wine, which supposedly led Umar to order the lashing of drinkers. On the other hand, the interpretation of plague as mercy or martyrdom is evident in Abu Ubayda's speeches to the troops at Amwas and in the council at Sargh. A poem about the plague of Amwas recorded by the Damascene historian Ibn Asakir (d. 1175) reflects the martyrdom belief: How many brave horsemen and how many beautiful, chaste women were killed in the valley of 'Amwas They had encountered the Lord, but He was not unjust to them When they died, they were among the non-aggrieved people in Paradise. We endure the plague as the Lord knows, and we were consoled in the hour of death. On the principle of predestination, the events of Amwas were used to argue that whether a person fled or remained in a plague-affected area their death had already been decreed by God. During an episode of plague in the Iraqi garrison city of Kufa , the prominent statesman and scholar Abu Musa al-Ash'ari (d. 662) turned away visitors to his home due to someone in his household having the plague, and he justified Muslims fleeing plague on the basis of Umar's actions at Sargh. According to Dols, this also implied a recognition of contagion despite the contradiction with the purported hadith rejecting contagion as a pre-Islamic theory.

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Plague

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Nights of Plague

Nights of Plague ( Turkish : Veba Geceleri ) is a 2021 novel by Orhan Pamuk . Its Pamuk's 11th and longest novel. Inspired by historical events, it is set on a fictitious island, Mingheria, in the eastern Mediterranean between Crete and Cyprus . A number of early reviewers observed that Nights of Plague 's plot resembles that of Albert Camus 's novel The Plague . Its English translation, by Ekin Oklap, was published by Knopf Doubleday in the United States and Faber and Faber in the United Kingdom . In 2016, Pamuk began writing a historical novel about a bubonic plague epidemic on a fictitious island. He was particularly interested in the way plagues are Orientalized in such books as Defoe 's A Journal of the Plague Year , Manzoni 's The Betrothed , and Camus 's The Plague . In a 2020 article, he wrote that Western observers such as Defoe saw a fatalistic tendency in the Muslim worldview—the religious concept of "Every Man's end being determined", as Defoe put it. In 1901, a ship from Istanbul arrives on the island of Mingheria, where bubonic plague has broken out. Mingheria serves as a microcosm of the declining Ottoman Empire , where diverse groups coexist but are on the brink of disintegration. The plague reflects the empire's metaphorical characterization as "the sick man of Europe". To combat it, Sultan Abdul Hamid II dispatches Bonkowski Pasha, the empire's chief inspector of public health, and a Muslim epidemiologist, Prince Consort Doctor Nuri, and his wife, the sultan's niece Princess Pakize. When Bonkowski is murdered, it falls upon Pakize and Nuri to employ methods reminiscent of Sherlock Holmes to identify the culprit. Simultaneously, Western approaches to controlling the plague are attempted. But the islanders resist quarantine measures, resulting in an increasing number of infectious bodies. Amid this chaos, gruesome discoveries like two corpses fused together are made, leaving questions about their relationship unanswered. Matt A. Hanson of World Literature Today noted that the motifs of Nights of Plague are prevalent in the latter years of Ottoman collapse , notably during Abdul Hamid's disastrous reign. Pamuk fictionalizes the formation of the fragmented political identities that sparked World War I and eventually strengthened the foundations of the Turkish republic. In The Atlantic , Judith Shulevitz wrote that Nights of Plague is plainly satire and metaphor, mordantly riffing on Ottoman, revolutionary, and nationalist leadership styles in a critique of Atatürk , Kemalism , and even President Erdoğan 's government—but not in a single sentence. In his review for The New Yorker , James Wood noted that Pamuk, though aware how plague has historically been unfairly Orientalized, seems to relish Orientalizing Mingheria, imbuing it with swirls of Ottoman magic and mythology. Toward the end of the book, its narrator mentions the "negatively inflected sense" of Edward Said 's term " Orientalism ". In his review for The Times , Peter Kemp wrote that Nights of Plague masterfully weaves a tale of intrigue and disease.

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Plague

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First plague pandemic

The first plague pandemic was the first historically recorded Old World pandemic of plague , the contagious disease caused by the bacterium Yersinia pestis . Also called the early medieval pandemic , it began with the Plague of Justinian in 541 and continued until 750 or 767; at least fifteen or eighteen major waves of plague following the Justinianic plague have been identified from historical records. The pandemic affected the Mediterranean Basin most severely and most frequently, but also infected the Near East and Northern Europe , and potentially East Asia as well. The Roman emperor Justinian I 's name is sometimes applied to the whole series of plague epidemics in late Antiquity . The pandemic is best known from its first and last outbreaks: the Justinianic Plague of 541 – 549, described by the contemporary Roman historian Procopius , and the late 8th century plague of Naples described by Neapolitan historian John the Deacon in the following century (distinct from the much later Naples Plague ). Other accounts from contemporaries of the pandemic are included in the texts of Evagrius Scholasticus , John of Ephesus , Gregory of Tours , Paul the Deacon , and Theophanes the Confessor ; most seem to have believed plague was a divine punishment for human misdeeds. While Latin and Byzantine Greek texts treated the disease as a generic pestilence ( Ancient Greek: λοιμός , romanized: loimós , Latin: plaga ), only later did Arabic writers term the condition ṭāʿūn (to some extent interchangeable with wabāʾ , 'plague'). In Syriac , both bubonic plague and the buboes themselves are called sharʿūṭā . The Chronicle of Seert makes this term synonymous with Arabic ṭāʿūn . Often, however, Syriac writers referred to an outbreak simply as a pestilence or mortality, mawtānā , equivalent to Arabic wabāʾ . In Pseudo-Zacharias Rhetor 's Historia Miscellanea , the clarifying combined form mawtānā d sharʿūṭā (plague of tumors) is found. The Chronicle of 640 of Thomas the Presbyter dates the "first plague" ( mawtānā qadmayā ) to the year AG 854 (AD 542/3). Several sources attest the plague's origins in Africa. According to Jacob of Edessa (died 708), the "great plague ( mawtānā rabbā ) began in the region of Kush ( Nubia ), south of Egypt, in the year AG 853 (AD 541–542). Evagrius Scholasticus (died 594) and the Historia Miscellanea also place its origins in Aethiopia (Nubia) on the border of Egypt. Michael the Syrian , relying on the lost chronicle of John of Ephesus (died c. 590), says that it began in Kush on the border of Egypt and in Himyar (Yemen). An inscription dated to 543 records how Abraha , the Ethiopian ruler of Himyar, repaired the Maʾrib dam after sickness and death had struck the local community. The Chronicle of Seert records that Aksum ( al-Habasha ) was hit by the pandemic. Early Arabic sources record that plague was endemic in Nubia and Abyssinia. The testimony of Procopius , who says that the plague began in Pelusium in the east of the Nile Delta and then spread to Alexandria , is consistent with an introduction from the Red Sea region, possible via ship-borne rats if the Canal of the Pharaohs was still open. The plague could have originated in commercial links with India or in growing Roman religious links with Nubia and Aksum. A link with India is rendered less likely by the fact that the plague arrived in the Roman Empire before arriving in Persia or China, which had closer links with India. According to Peter Sarris, the "geopolitical context of the early sixth century," with an Aksumite–Roman alliance against Himyar and Persia, "was arguably the crucial prerequisite for the transmission of the plague from Africa to Byzantium." According to the bishop - chronicler of Tours in the late 6th century, Gregory of Tours , there were numerous epidemics of plague in the Kingdom of the Franks after the Justinianic Plague struck Arelate ( Arles ) and the surrounding region in the late 540s. Various portents were witnessed and to expiate them the inhabitants of affected areas resorted to processions , prayers , and vigils . Gregory records an epidemic in 571 in the Auvergne and in the cities of Divio ( Dijon ), Avaricum ( Bourges ), Cabillonum ( Chalon-sur-Saône ), and Lugdunum ( Lyon ). Gregory's description of the plague as causing wounds in the armpit or groin that he described as resembling snakebite and of patients dying delirious within two or three days allow identification of the disease as bubonic plague; the "wounds" are the characteristic buboes . In 582 Gregory of Tours reports an epidemic in Narbo Martius ( Narbonne ). According to him, the majority of the townsfolk at Albi in 584 died of an outbreak of plague. Massilia ( Marseille ) was hit by plague in 588; there the king Guntram of Francia recommended a strict diet of barley bread and water. Gregory blames a ship arriving from Hispania for being the source of the contagion, and the epidemic recurred several times thereafter. In 590 Gregory records another plague epidemic at Vivarium ( Viviers ) and at Avenio ( Avignon ) at the same time as the plague broke out in Rome under Pope Pelagius II . These plagues affected the Byzantine Empire , West Asia , Syria , and Mesopotamia and the Byzantine Empire, West Asia, and Africa respectively.In 610, Chao Yuanfang mentioned an endemic plague of "malignant bubo" described as "coming on abruptly with high fever together with the appearance of a bundle of nodes beneath the tissue." Sun Simo, who died in 652, also mentioned a "malignant bubo" and plague that was common in Lingnan ( Guangdong ). Ole Benedictow posits that it was an offshoot of the first plague pandemic that reached Chinese territory around 600. The historian Lester Little suggests that just as the Black Death led to the near disappearance of serfdom in western Europe, the first pandemic resulted in the end of ancient slavery , at least in Italy and Spain. A 2019 study, however, suggests that the first plague pandemic was not a major cause of the demographic, economic, political, and social changes across Europe and the Near East from the 6th to 8th centuries AD and that upper estimates of the pandemic's mortality are unsupported by historical, archaeological, genetic, and palynological evidence.

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Plague Soundscapes

Plague Soundscapes is the second studio album by The Locust , and their first with ANTI- Records. It features a more refined sound than previous The Locust albums, with a greater emphasis on keyboards.

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Plague

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Shovel Knight: Plague of Shadows

September 17, 2015 Nintendo Switch March 3, 2017 Shovel Knight: Plague of Shadows is a downloadable content (DLC) expansion for the 2014 platform game Shovel Knight , developed and published by Yacht Club Games . The player takes control of Plague Knight, an alchemist on a journey to create the ultimate potion. Plague Knight attacks by throwing alchemical bombs, and has the ability to double jump and perform a more powerful "burst jump" that sends him forward through the air. Gameplay is similar to the original Shovel Knight but features a new story and alterations to the levels to account for Plague Knight's movement. The game was originally conceived as a minor add-on to Shovel Knight but grew in scale as development commenced. Yacht Club Games decided to retain the levels of the original game while using Plague Knight's abilities and moveset to make the stage feel fun to play again. The team faced trouble balancing the levels, and increased the difficulty of Plague Knight's movement to ensure the game remained challenging. Plague of Shadows received positive reviews on release, particularly for its story and Plague Knight's moveset, with some critics considering it to be more difficult than its predecessor. Yacht Club Games used player feedback on Plague of Shadows to help design the following Shovel Knight DLC, Specter of Torment .Like Shovel Knight , Plague of Shadows is a 2D side-scrolling platform game . Players take control of Plague Knight, an alchemist on a journey to create the ultimate potion. Plague Knight attacks enemies by throwing bombs, and can perform both a double jump and a powerful "burst jump" in which he triggers an explosion beneath himself to send him through the air. Inside levels are green coins that Plague Knight can give to his assistant, a witch named Mona, who uses them to alter the effects of his bombs or burst jump. These altered effects include bombs which create a wall of fire on the ground, take a longer time to explode, or circle around the player. Altered burst jumps include ones that cause him to fall slowly after jumping or shoot projectiles. Plague Knight features a lower amount of health than Shovel Knight but can drink potions found inside levels to increase his maximum amount. This increase lasts until the player dies. In addition to Plague Knight's bombs and burst jump, he can gain abilities called Arcana, which are obtained by selling the Relics of the original Shovel Knight when he finds them inside hidden chests. The levels of Plague of Shadows are the same as those of the original game, but feature changes to account for Plague Knight's different methods of movement, including new secret passages and areas. Running parallel to Shovel Knight , Plague Knight, a member of the Order of No Quarter, plots a scheme. He plans to steal essence from Shovel Knight and the other members of the order to use as ingredients in the ultimate potion, capable of granting any of its user's desires. He is aided by his alchemists and assistant Mona, who pursue alchemy in secret due to the local villagers fearing and rejecting it. Plague Knight gradually defeats the other members of the Order of No Quarter as well as Shovel Knight and gathers their essences into his alchemical machine. While collecting the essences, Mona and Plague Knight are revealed to harbor hidden romantic feelings for each other. Mona later leaves Plague Knight after a conversation with Black Knight, convinced that Plague Knight is only using her as a tool for his scheme. Once Plague Knight defeats all the knights, he journeys to the Tower of Fate for the Enchantress' essence. He confronts and defeats the Order of No Quarter again, but is knocked off the tower by Shovel Knight while celebrating his victory. As Plague Knight reaches the Enchantress' chamber and finishes the potion with her essence, Black Knight and Mona arrive and try to stop him. Plague Knight reveals that his intention was always to use the potion to win Mona's heart, but she confesses her love for him. Plague Knight attempts to stop the reaction, but it goes out of control, creating a dark version of himself. The real Plague Knight defeats the shadow and stabilizes the potion; Mona and Plague Knight decide to use it to destroy the Tower of Fate. The villagers learn of the tower's destruction, and hail Plague Knight and his alchemists as heroes. In a post-credits scene, Plague Knight and Mona share a dance in their laboratory.As part of the Kickstarter crowdfunding campaign for Shovel Knight back in 2013, Yacht Club Games listed several stretch goals: additional features for the game added when the funding met a certain target. Among the stretch goals was the addition of three downloadable content (DLC) expansions based around three of the boss characters from the original Shovel Knight . The developers held a vote on which bosses would receive campaigns, and Plague Knight was one of the winning characters. Plague of Shadows was the first follow-up expansion to Shovel Knight . The developers had never added content to a previous game, and first envisioned the expansion to be similar to Mega Man Powered Up , where the only changes would be the addition of a new character with different movements and slightly altered bosses . As production commenced, the team decided to create Plague of Shadows as an independent title. While the developers decided to retain most of the existing levels, they wanted to use Plague Knight's unique mobility make the old stages fun to play again. Although the original Shovel Knight character featured simple movement that was easy to understand, Yacht Club Games hoped to design a character where the player could find new ways to control how they moved. The developers desired for the playable Plague Knight to act similarly to his boss battle in the original game, and designed the burst jump and bomb attacks to fit his themes of chaos and explosions. Yacht Club Games found it troublesome to balance the game when the player could use the jumping movement to reach every part of the level, and designed Plague Knight's movement to be difficult to control to ensure the game remained challenging. The team cited the greater mobility as a way to make the player feel like they were breaking the levels of the original Shovel Knight . The soundtrack for the game was composed by Jake Kaufman, who had done the same for the original Shovel Knight . The soundtrack features a vocal arrangement by Mint Potion, a musical project founded by Kaufman, vocalist Dale "CorgiKing" North, and Jeff Ball. The team created the expansion while porting the original game to new platforms, and finished development on August 4, 2015. Plague of Shadows was released on September 17, 2015, for Windows , Linux , macOS , PlayStation 3 , PlayStation 4 , PlayStation Vita , Nintendo 3DS , Wii U , and Xbox One . A port to Nintendo Switch was launched on March 3, 2017. The expansion was released concurrently with a new Challenge Mode that features gameplay scenarios that the player can complete, including speedruns . After release, Yacht Club Games felt that Plague of Shadows was not effectively advertised as an independent game because of how similar its levels appeared compared to the original Shovel Knight . For their following DLC expansion, Shovel Knight: Specter of Torment , the developers relied upon player feedback for Plague of Shadows to design the playable protagonist and the difficulty balancing . According to the review aggregator website Metacritic , Plague of Shadows received "generally favorable reviews" for its PC and Wii U versions. Critics felt that Plague of Shadows was a worthy expansion to Shovel Knight . Nintendo World Report said that the expansion increased the appeal of the original game, while Gamer.nl called the DLC well-designed and executed. Eurogamer and Destructoid wrote that the game felt like an entirely new experience while still reusing content from Shovel Knight . Nintendo Life opined that the game was just as good as the original, and that its use of new and old content gave it a unique feel. Reviewers highlighted Plague Knight's moveset. Destructoid found Plague Knight to be an agile character, finding him to be more difficult to control than the character of Shovel Knight and featuring more complex combat. Nintendo World Report reiterated Plague Knight's new mobility and controls, adding that the game featured a strategic element with each of the different weapon alterations to choose from. Eurogamer considered Plague Knight's movement to be bizarre, but said that this strangeness made the DLC feel compelling to play. The story received a positive response. Nintendo Life said that the narrative helped make Plague Knight into a complex character, and helped justify playing through the same platforming levels again. Gamer.nl highlighted how the story ran parallel with the original game, and found it to be comedic and improved Plague Knight's characterization. Other reviewers mentioned the game's difficulty. Nintendo World Report called the expansion more frustrating than the original Shovel Knight, while Nintendo Life found the platforming to be tough because of Plague Knight's abilities. Some critics liked the health potion system. Destructoid called it their favorite mechanical addition, and Nintendo Life said that it added an aspect of risk to the gameplay.

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The Plague (1992 film)

1992 ( 1992 ) The Plague (original title: La Peste ) is a 1992 Argentine-French-British drama film written and directed by Luis Puenzo and starring William Hurt , Sandrine Bonnaire , Robert Duvall and Raul Julia . It is based on the novel La Peste by Albert Camus . It entered the competition at the 49th Venice International Film Festival . Set in the 1990s (Camus's novel was set in 1940s), 'The Plague' tells the story of Dr. Bernard Rieux. The film takes place in the city of Oran , where several cases of plague have been recorded. At first, the authorities want to hide the disease from the population, but the news ends up reaching the citizens. Oran is in quarantine and the army surrounds the entire city, preventing anyone from getting in or getting out.William Hurt as Dr. Bernard Rieux Sandrine Bonnaire as Martine Rambert Jean-Marc Barr as Jean Tarrou Robert Duvall as Joseph Grand Raul Julia as Cottard Jorge Luz as Old Man With The Cats Victoria Tennant as Alicia Rieux Atilio Veronelli as Dr. Horacio Francisco Cocuzza as Miguel Laura Palmucci as Miguel's Wife Norman Erlich as Dr. Castel Marcos Woinsky as Dr. Grunewald Duilio Marzio as Judge Orbon Pancho Ibáñez as Newscaster Horacio Fontova as Attendant Bruno Chmelik as Felipe, Judge Orbon's Son Monica Tozer as Dr. Rieux's Receptionist Lautaro Murúa as Father Paneloux Peter McFarlane as Hoese Lidia Catalano as Sara Fabiana Uria as Teresa Norman Briski as The Preacher China Zorrilla as Emma Rieux Juana Hidalgo as Mr. Castel Silvina Chediek as Newscaster Verónica Llinás as Stripteaser

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1629–1631 Italian plague

The Italian plague of 1629–1631 , also referred to as the Great Plague of Milan , was part of the second plague pandemic that began with the Black Death in 1348 and ended in the 18th century. One of two major outbreaks in Italy during the 17th century, it affected northern and central Italy and resulted in at least 280,000 deaths, with some estimating fatalities as high as one million, or about 35% of the population. The plague may have contributed to the decline of Italy's economy relative to those of other Western European countries. Thought to have originated in Northern France in 1623, the plague was carried throughout Europe as a result of troop movements associated with the Thirty Years' War and was allegedly brought to Lombardy in 1629 by soldiers involved in the War of the Mantuan Succession . The disease first spread to Venetian troops and in October 1629 reached Milan , Lombardy's major commercial centre. Although the city instituted a quarantine and limited access to external visitors and trade goods, it failed to eliminate the disease. A major outbreak in March 1630 resulted from relaxed health measures during the carnival season, followed by a second wave in the spring and summer of 1631. Overall, Milan suffered approximately 60,000 fatalities out of a total population of 130,000. East of Lombardy, the Republic of Venice was infected in 1630–31. The city of Venice was severely hit, with recorded casualties of 46,000 out of a population of 140,000. Some historians believe that the drastic loss of life, and its impact on commerce, ultimately resulted in the downfall of Venice as a major commercial and political power. The papal city of Bologna lost an estimated 15,000 citizens to the plague, with neighboring smaller cities of Modena and Parma also being heavily affected. This outbreak of plague also spread north into Tyrol , an alpine region of western Austria and northern Italy. [ citation needed ] Later outbreaks of bubonic plague in Italy occurred in the city of Florence in 1630–1633 and the areas surrounding Naples , Rome and Genoa in 1656–57. [ citation needed ] Population before the plague and death toll, selected cities: A 2019 study argues the plague of 1629–1631 led to lower growth in several cities affected by the plague and "caused long-lasting damage to the size of Italian urban populations and to urbanization rates. These findings support the hypothesis that seventeenth-century plagues played a fundamental role in triggering the process of relative decline of the Italian economies." The 1630 Milan plague is the backdrop for several chapters of Alessandro Manzoni 's 1840 novel The Betrothed ( Italian : I promessi sposi ). Although a work of fiction, Manzoni's description of the conditions and events in plague-ravaged Milan are completely historical and extensively documented from primary sources researched by the author. [ citation needed ] An expunged section of the book, describing the historical trial and execution of three alleged "plague-spreaders", was later published in a pamphlet entitled Storia della colonna infame (History of the pillar of infamy). [ citation needed ]

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Plague Column, Vienna

The Plague Column ( German : die Wiener Pestsäule ), or Trinity Column ( German : Dreifaltigkeitssäule ), is a Holy Trinity column located on the Graben , a street in the inner city of Vienna , Austria . Erected after the Great Plague epidemic in 1679, the Baroque memorial is one of the best known and most prominent sculptural artworks in the city. Christine M. Boeckl, author of Images of Plague and Pestilence , calls it "one of the most ambitious and innovative sculptural ensembles created anywhere in Europe in the post- Bernini era." In 1679, Vienna suffered one of the last great plague epidemics. Fleeing the city, the Habsburg emperor Leopold I vowed to erect a mercy column if the epidemic would end. In the same year, a provisional wooden column made by Johann Frühwirth was inaugurated, showing the Holy Trinity on a Corinthian column together with nine sculpted angels (for the Nine Choirs of Angels ). In 1683, Matthias Rauchmiller was commissioned to create a general design as well as some sculptures. Rauchmiller died in 1686, but his basic conception and three of his angel figures can still be seen on the modern monument. Several new designs followed, among others by Johann Bernhard Fischer von Erlach , who designed the sculptures at the base of the column. Finally, the project management was assigned to Paul Strudel , who based his work on the concept of theatre engineer Lodovico Burnacini . Below the Trinity figure, Burnacini envisioned a cloud pyramid with angel sculptures as well as the kneeling emperor Leopold, praying to a sculpture of faith. Among others, the sculptors Tobias Kracker and Johann Bendel contributed to the column. The column was inaugurated in 1694. In spite of the long construction period, the frequent amendments of the design and the large number of sculptors involved, the monument appears quite homogeneous. During the design period, it changed from a conservative memorial column to a High Baroque scene, narrating a story in a theatrical form. The monument thus indicates the transition to the era of High Baroque in Vienna. It highly influenced the style and was imitated in the whole Austrian region.The column has a complex iconography , the basic message of which is that the plague and the Ottomans' Second Siege of Vienna (1683) , both of them punishments for sin, were averted or defeated by the piety and intercession of the Emperor Leopold I. (The pillar thus also represents a (victory) monument to that emperor.) In the iconography, the Trinity expresses itself several times in the number three, namely vertically in three stages: the pedestal, reserved for mankind, in the upper third of which Leopold I prays to God as an intercessor; a second, higher level occupied by angels, in an intermediate zone between God and mankind; and the highest level, reserved for the Holy Trinity. In addition, there is also a tripartite division in plan, which establishes a connection between the sacral program and the three parts of the Habsburg monarchy:

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Plague

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Sylvatic plague

Sylvatic plague is an infectious bacterial disease caused by the plague bacterium ( Yersinia pestis ) that primarily affects rodents , such as prairie dogs . It is the same bacterium that causes bubonic and pneumonic plague in humans. Sylvatic, or sylvan, means 'occurring in woodland,' and refers specifically to the form of plague in rural wildlife. Urban plague refers to the form in urban wildlife. It is primarily transmitted among wildlife through flea bites and contact with infected tissue or fluids. Sylvatic plague is most commonly found in prairie dog colonies and some mustelids , like the black-footed ferret . The flea that feeds on prairie dogs and other mammals serves as the vector for transmission of sylvatic plague to the new host, primarily through flea bites, or contact with contaminated fluids or tissue, through predation or scavenging. Humans can contract plague from wildlife through flea bites and handling animal carcasses . Yersinia pestis circulates in rodent reservoirs on all continents except Australia. Sylvatic plague affects over 50 species of rodents worldwide. It is vectored by a variety of flea species. Non-rodent animals susceptible to the disease include shrews , lagomorphs , ferrets , badgers , skunks , weasels , coyotes , domestic dogs and cats , bobcats , cougars , camels , goats , sheep , pigs , deer , and primates , including humans . Birds are not known to be susceptible. Sylvatic plague is normally enzootic , meaning it occurs at regular, predictable rates in populations and specific areas. At unpredictable times, it becomes epizootic in unexpected places. It is during these epizootic outbreaks that transmission to humans is most common. Factors that predispose to epizootic cycles include dense populations of rodents, multiple species of rodents in a particular area, and multiple rodent species in diverse habitats. Prairie dog colonies reach nearly 100% mortality rates during outbreaks. Prairie dogs are a keystone species and play a vital role as the primary prey of black-footed ferrets. Developing methods to control plague is of high concern for preserving ferrets and the conservation of Western prairie and grassland ecosystems. In the absence of understanding the prairie dog/plague cycles, dusting rodent dens with pesticides to kill fleas is currently the main method of controlling sylvatic plague in the wild, with some interest in using vaccines developing. An oral live vaccine for prairie dogs was developed by the U.S. Geological Survey, National Wildlife Health Center, from a recombinant raccoon poxvirus expressing plague antigens. It was originally developed by a Fort Detrick company in 2003 which showed it protected mice against lethal plague.

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Plague

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The White Plague

The White Plague is a 1982 science fiction novel by American author Frank Herbert about an engineered disease which kills only women. It was nominated for a best science fiction novel Locus Award in 1983.On May 20, 1996, an IRA terrorist car bomb explodes, killing the wife and children of molecular biologist John Roe O'Neill. Driven halfway insane by his loss, his mind fragments into several personalities that carry out his plan for him. O'Neill plans a gendercidal revenge and creates a plague that kills only women, but for which men are the carriers. O'Neill then releases it in Ireland (for supporting the IRA), England (for their actions in Ireland and giving the IRA a cause), and Libya (for training said terrorists); he demands that the governments of the world send all citizens of those countries back to their countries, and that they quarantine those countries and let the plague run its course, so they will lose what he has lost; if they do not, he has more plagues to release. After releasing the plague, O'Neill goes to Ireland to hide, planning to offer his services as a molecular biologist in the hopes of sabotaging whatever work is done there on finding a cure. When he arrives in Ireland, he is suspected of being O'Neill (whom the investigatory agencies of the world have deduced is responsible). To travel to the lab at Killaloe , he is forced to walk with a priest, a boy who has taken a vow of silence due to the death of his mother, and Joseph Herity, the IRA bomber who detonated the explosive that killed O'Neill's wife and children; their purpose is to confirm his identity, either through Herity's indirect questioning, or the possibility that he will confess to the priest when confronted with the pain his revenge has caused for the boy. Meanwhile, law and order have broken down in England and Ireland, and the old Irish ways are coming back. Local IRA thugs appoint themselves "kings of old", and others recreate ancient Celtic religions centered on the rowan tree. The IRA has effective control of Ireland, but as the governments of the world grow certain that O'Neill is there and essentially in custody, they consider wiping out the three targeted countries to end the lingering threat.Dave Langford reviewed The White Plague for White Dwarf #41, and stated that "There's plenty of edge-of-the-seat suspense and good thumping melodrama in the race to crack the gene-structure of the plague while a few women are still left alive." The White Plague was nominated for a Locus Award for best science fiction novel in 1983, but lost to Isaac Asimov's novel Foundation's Edge .

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Evisceration Plague

Evisceration Plague is the eleventh studio album by American death metal band Cannibal Corpse . Released on February 3, 2009 by Metal Blade Records , the album was produced at Mana Recording Studios by Hate Eternal guitarist Erik Rutan . The album entered the US Billboard 200 at number 66, selling 9,600 copies its first week. Bassist Alex Webster said about the record: In Cannibal Corpse, our goal has always been to try and make each new album we record our heaviest. That goal was a bit more challenging this time since we were extremely satisfied with our last album Kill , but we knew that by working with producer Erik Rutan at Mana Recording Studios again, we would be able to start at that same level of heaviness and take it even further... Evisceration Plague has the best guitar sound we've ever recorded, and the entire band has never played with more precision and power. In another interview with Terrorizer magazine, drummer Paul Mazurkiewicz stated his thoughts on the album saying: "I think working with Erik again has definitely brought things up a little for us. I mean all the band were involved in the writing process of this album along with Rutan and so I think this one's a tad more individual than Kill ."The cover art was released December 14 and samples were made available through Amazon.com. The album was released with a bonus track in Europe and DVD as a deluxe edition. An autographed version of the album is now available for pre-order on the Metal Blade Records website. It is the fifth Cannibal Corpse album to contain a title track (following Butchered at Birth , The Bleeding , Gallery of Suicide and The Wretched Spawn ) and a video was produced for the song. They also released a comic book where each song has its own comic. A video for the song "Evisceration Plague" was released on May 9, 2009 on the YouTube account of Metal Blade Records. A video was produced for the song "Priests of Sodom". The video was released on March 25, 2010. Rob Barrett WebsterWriting, performance and production credits are adapted from the album liner notes.

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The Plague (2006 film)

Hal Masonberg Teal Minton Midnight Picture Show Armada Pictures September 5, 2006 ( 2006-09-05 ) The Plague (also known as Clive Barker's The Plague ) is a 2006 horror film directed by Hal Masonberg and written by Masonberg and Teal Minton. It was produced by Clive Barker .In 1983, one day all of the world's children under the age of nine simultaneously fall into a catatonic state. For the next ten years, every child who is born, is born in a state of catatonia . During this state, the children experience seizures twice a day which develops and maintains muscle mass . In 1993, all the children wake up in zombie-like state, unrelentingly pursuing, attacking and murdering all adults. Things are revealed to be even more dire as the children have both superhuman strength and some kind of collective intelligence - what one learns, they all learn. The children's tactics quickly become more sophisticated. First, they disable the engines in almost every car and then set up roadblocks to stop the adults from escaping. Then, they learn how to use firearms. The children also take the souls of the ones they kill as a part of deliverance. The adults must find a way to stop them before it's too late.James Van Der Beek as Tom Russel Ivana Miličević as Jean Raynor Brad Hunt as Sam Raynor Joshua Close as Kip Brittany Scobie as Claire Bradley Sawatzky as Nathan Burgandy John P. Connolly as Sheriff Cal Stewart Dee Wallace as Nora John Ted Wynne as Dr. Jenkins Arne McPherson as DavidThe Region 1 DVD was released September 5, 2006. The Plague: Writer's & Director's Cut , exists but has, to date, has remained unreleased. Bloody Disgusting rated it 3/5 stars and wrote, "But even as the premise of The Plague continues to titillate and intrigue, the film can't quite deliver on its promise, rendering it slightly entertaining and ultimately forgettable." Steve Barton of Dread Central rated it 2/5 stars and wrote, "Clive Barker may have in some way produced this mess and lent his name to it, but rest assured there's nothing Barker-esque about it. All that's here is a giant missed opportunity which — pardon the really bad, yet fitting pun — you should avoid like the plague." Scott Weinberg of DVD Talk rated it 2.5/5 stars and wrote that it does not live up the premise, instead "devolving into yet another (and very stale) zombie-type chase thriller". David Johnson of DVD Verdict wrote, " The Plague is an inscrutable movie that starts out strong, but loses forward momentum, eventually grinding to an awkward halt."

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The Plague of Doves

The Plague of Doves is a 2008 New York Times bestseller and the first entry in a loosely-connected trilogy by Ojibwe author Louise Erdrich . The Plague of Doves follows the townsfolk of the fictional Pluto, North Dakota , who are plagued by a farming family's unsolved murder from generations prior. The novel incorporates Erdrich's multiple narrator trope that is present in other works including the Love Medicine series. Its sequel is the National Book Award winning novel The Round House . Erdrich concluded the "Justice" trilogy with LaRose in 2016. The central plot of The Plague of Doves revolves around an act of racism that took place in the early 20th century. Peter G. Beidler outlines how Louise Erdrich's plot for the novel was influenced by real-life events that happened in North Dakota in the late 1890s. As Beidler explains, a white family, the Spicers, were murdered by a group of Native Americans. While the murderers were tried and sentenced to death for their crimes, the citizens of the town believed the three witnesses, also Native Americans, were guilty as well. Nine months after the trial, the citizens stormed the jailhouse where the men were being held, overpowered the guards, and proceeded to hang the three men in question. One of the men was a 19-year-old boy named Paul Holy Track, believed to be the direct influence for Erdrich's character, the thirteen-year-old Holy Track. The novel begins with a family's grisly murder resulting in a baby being the only surviving member. A lynch mob blames four innocent Ojibwe people from the nearby reservation and hangs three of them, including a boy named Holy Track. Years later, a young girl named Evelina, who struggles with her sexuality in grade school, listens to her grandfather's, Mooshum's, tales of Pluto, North Dakota's past. In 1896, a flock of doves terrorized the town and the people within it. Mooshum also explains how he was the only surviving member of the lynch mob. This trauma caused Mooshum to flee the town for years before returning to the reservation, married and ready to start a family. Upon returning, Mooshum and his brother, Shamengwa, develop an alcohol dependency. These tales leave Evelina with more questions than answers, and Mooshum is hesitant to divulge everything. Evelina is nervous to express the attraction she has for both her teacher and her classmate. Next enters Billy Peace, whose sister is having an affair with John Wildstrand. John is married to Neve Harp, the woman who rejected Mooshum's romantic advances. The affair between John Wildstrand and Billy Peace's sister results in a child out of wedlock . After the kidnapping of Neve Harp backfires, he goes to join the army. The army is Billy's introduction to religion . When Billy returns home, he starts a church. Billy marries Marn Wolde as both bond over running away from past issues. Marn becomes increasingly unhappy in her marriage and with the way Billy disciplines their children and how he interacts with her. Eventually, Marn murders her husband and flees Pluto with her children in tow. An older Evelina, now working at a diner, runs into Marn. The interaction recalls Evelina's former attractions to Marn's nephew. Evelina is also provided with information from her former crush and teacher that causes her to suffer mentally. While at the mental hospital, Evelina meets with patients but takes note of the weird actions of one in particular named Warren Wolde. Warren Wolde dies in the hospital after hearing Corwin Peace play the violin while visiting Evelina. Warren's death unravels some of the town's hidden mystery. Métis and Ojibwe history is featured heavily throughout the novel. The Métis connection comes to the forefront with the character Mooshum noting Louis Riel as a personal hero. Evelina also mentions a picture of Riel that her mother kept on display. The characters frequently refer to Riel and imagine what could have been had he succeeded in establishing a Michif nation. Additionally, throughout the novel the characters speak in both Michif and Anishinaabe . As Corrine Bancroft argues, Erdrich's novel allows readers "to face the way history still bleeds into the present and challenges us to develop a type of responsibility that is attentive to different and possibly incommensurate human experiences." Crime and punishment are two prominent themes in The Plague of Doves . Literary critic Lara Feigel notes that Erdrich offers several moments where the issues of what constitutes justice emerge as central to the plot. In addition to the main plot regarding the family's murder, there are other instances of criminal enterprises. For example, Billy Peace plans to rob John Wildstrand of $10,000. For his part, Wildstrand also suggests that the two kidnap Neve, who is his current wife. They agree upon this plan and Billy kidnaps Neve, then makes John tie himself up, and John goes the extra mile to fake tears in front of Neve. Feigel also explains how the world that Erdrich built is entangled with love and dedication. For example, Joseph and Bull's journey through the storm exemplifies this factor by showcasing their determination to stick together and withstand a cold storm. Evelina and Corwin also remain loyal friends throughout the novel. Métis and Ojibwe history is featured heavily throughout the novel. The Métis connection comes to the forefront with the character Mooshum noting Louis Riel as a personal hero. Evelina also mentions a picture of Riel that her mother kept on display. The characters frequently refer to Riel and imagine what could have been had he succeeded in establishing a Michif nation. Additionally, throughout the novel the characters speak in both Michif and Anishinaabe . As Corrine Bancroft argues, Erdrich's novel allows readers "to face the way history still bleeds into the present and challenges us to develop a type of responsibility that is attentive to different and possibly incommensurate human experiences." Crime and punishment are two prominent themes in The Plague of Doves . Literary critic Lara Feigel notes that Erdrich offers several moments where the issues of what constitutes justice emerge as central to the plot. In addition to the main plot regarding the family's murder, there are other instances of criminal enterprises. For example, Billy Peace plans to rob John Wildstrand of $10,000. For his part, Wildstrand also suggests that the two kidnap Neve, who is his current wife. They agree upon this plan and Billy kidnaps Neve, then makes John tie himself up, and John goes the extra mile to fake tears in front of Neve. Feigel also explains how the world that Erdrich built is entangled with love and dedication. For example, Joseph and Bull's journey through the storm exemplifies this factor by showcasing their determination to stick together and withstand a cold storm. Evelina and Corwin also remain loyal friends throughout the novel. At the time of its release, The Plague of Doves received many favorable reviews that often deemed it a challenging, and multilayered book. The novel was named a "Best Book of The Year" by The Washington Post , Chicago Tribune , San Francisco Chronicle , and The Christian Science Monitor . In a review from The New York Times , Bruce Barcott notes that Erdrich created "an often gorgeous, sometimes maddeningly opaque portrait of a community strangled by its own history." In another The New York Times review, Michiko Kakutani states that Erdrich "uses several characters to narrate alternating chapters, giving us a choral story that unfolds from multiple perspectives." Writing for The Los Angeles Times , Brigette Frase described how "Erdrich moves seamlessly from grief to sexual ecstasy, from comedy (Mooshum's proof of the nonexistence of hell is priceless) to tragedy, from richly layered observations of nature and human nature to magical realism. She is less storyteller than medium. One has the sense that voices and events pour into her and reemerge with crackling intensity, as keening music trembling between sorrow and joy." Additionally, the book was also selected as a finalist for the Pulitzer Prize in 2009. In the same year, the novel also won the Anisfield-Wolf Book Award , which is awarded to books that have made a vital contribution to understanding racism and human diversity.

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Plague Angel

Plague Angel is the ninth studio album by Swedish black metal band Marduk . It was recorded and mixed at Endarker Studio in September 2004 and released that November by Regain Records . Plague Angel is the first Marduk album to feature Mortuus on vocals and Magnus "Devo" Andersson, ex-guitarist for Marduk following his departure in 1994, on bass and mixing. This album marked a definitive shift in Marduk's lyrical approach. Instead of overt Satanism, much of the lyrics take a more religious-like direction. This is due to Morgan and Mortuus' fascination with the Bible , as they both admit to being Bible experts (despite Marduk's anti-religious stance, Morgan has admitted that he uses the Bible as inspiration solely for its violent content, as he finds death and violence to be most inspirational for Marduk, and that he can "write a complete song mentally by just looking at a violent painting or image"). "The Hangman of Prague" refers to Reinhard Heydrich after the invasion of Czechoslovakia .Ketoladog Ketoladog

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