In the 2nd year of the Peloponnesian War, 430 BCE, an outbreak of plague erupted in Athens. The illness would persist throughout scattered parts of Greece and the eastern Mediterranean until finally dying out in 426 BCE. The origin of the epidemic occurred in sub-Saharan Africa just south of Ethiopia. The disease swept north and west through Egypt and Libya across the Mediterranean Sea into Persia and Greece. The plague entered Athens through the city’s port of Piraeus.

The Greek historian Thucydides recorded the outbreak in his monumental work on the Peloponnesian war (431-404 BCE) between Athens and Sparta. According to various scholars, by its end, the epidemic killed upwards of 1/3 of the population; a population which numbered 250,000-300,000 in the 5th century BCE. By most accounts, the plague which struck Athens was the most lethal episode of illness in the period of Classical Greece history.

Thucydides Description of the Plague

Thucydides, in the History of the Peloponnesian War, paused in his narrative of the war to provide an extremely detailed description of the symptoms of those he observed to be afflicted; symptoms he shared as he too was struck by the illness. Despite his lack of medical training, Thucydides provided a vivid account of a variety of ailments which afflicted the diseases:

Violent heats in the head; redness and inflammation of the eyes; throat and tongue quickly suffused with blood; breath became unnatural and fetid; sneezing and hoarseness; violent cough’ vomiting; retching; violent convulsions; the body externally not so hot to the touch, nor yet pale; a livid color inkling to red; breaking out in pustules and ulcers. (2.49-2.50)

Thucydides further described patients whose fever was so intense that they preferred to be naked than wear any clothing which touched their skin; some even preferred to be submerged in cold water. Thucydides observed that the ill were “tormented by an unceasing thirst” which was not satiated regardless of the amount of liquids consumed. Many of the sick found it difficult to sleep, instead, displaying a constant restlessness. Many of the sufferers died within 7-9 days from the onset of symptoms.

If the ill were fortunate enough to live beyond the initial period of the infection, Thucydides observed that the patient suffered from “violent ulceration” and severe diarrhea usually resulting in their death. Those who survived the full run of the illness often suffered from disfigurement of their genitals, fingers and toes (which were sometimes lost), blindness, and memory loss (of others as well as themselves). Thucydides noticed that in some instances birds and other animals which usually fed on human flesh were repulsed by the diseased bodies or died themselves from consuming the diseased and rotting flesh.

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Which disease?

For nearly 2500 years, historians and scholars have attempted to identify exactly what disease swept Athens resulting in so many deaths. Thucydides, not trained in medicine, did not specify an exact illness only a description of the various symptoms, people’s reactions to being sick and outcomes of the course of the disease. He did note that physicians attempted numerous cures and remedies which failed. The doctors were also some of the earliest casualties due to their repeated contact with those who had fallen ill from the disease thus suggesting that whatever the disease was it was contagious. In the heat of war, it was suggested that the water drawn from local wells had been poisoned causing even men in the prime of health to become suddenly afflicted.

J.F.D. Shrewsbury - Measles

In just the last 60 years, the plague which struck Athens has been identified as one of a dozen infectious diseases. J.F.D. Shrewsbury, in “The Plague of Athens,” identified the disease as being “new” to Athens. Thucydides suggested that Greek physicians did not recognize the illness which struck the population. Thucydides reason for describing the symptoms was to allow future people to recognize the illness should it ever strike again. Shrewsbury provides a list of opinions from the 1940s CE attempting to identify the disease. Typhus, typhoid, smallpox, bubonic plague and a combination of the aforementioned were all offered as the culprit.

FOR NEARLY 2500 YEARS, HISTORIANS & SCHOLARS HAVE ATTEMPTED TO IDENTIFY EXACTLY WHAT DISEASE SWEPT ATHENS RESULTING IN SO MANY DEATHS.

Smallpox emerged as the most likely culprit followed by typhus and bubonic plague. Shrewsbury eliminated smallpox as people stricken with that illness would not be capable of physically moving from their beds much less throw themselves into cold water as Thucydides remarked some did. Nor does Thucydides describe any backaches, a symptom specific to the early onset of smallpox. Typhus was eliminated as there appeared to be no critical amount of black rats carrying the lice nor was any evidence offered that Athens or its citizens lived in dirt and squalor, lacked basic personal hygiene (bathing or clean clothes) to support lice. Deafness, rather than blindness which afflicted the sufferers of Athens, is another tell-tale symptom of typhus. Bubonic plague was dismissed just as easily due to a lack of evidence showing the presence of black rats which carried the fleas containing the Yesinia pestis microbe. Pneumonic plague was likewise discarded as the source of the illness as Thucydides failed to mention coughing or spitting of blood, symptoms commonly associated with that deadly infection. Typhoid fever, a water-borne illness, was also eliminated due to Thucydides' failure to describe polluted waterways or any patients suffering from rectal bleeding. Finally, Shrewsbury settled upon measles as the primary disease. The virulence of the disease suggested its “newness” to Athens along with Thucydides description of common measles symptoms such as blindness, diarrhea, gangrene, sneezing, fever and thirst.

See more at: https://www.ancient.eu/article/939/the-plague-at-athens-430-427-bce/