The Center for Disease Control (CDC) is calling the outbreak an epidemic. According to Curtis Allen, spokesperson for the CDC, “When the H3N2 virus circulates, we tend to have a more severe season. It can cause more hospitalizations and kill more people ages 65 and over.” In fact, Massachusetts Governor Deval Patrick has declared a state of emergency and ABC named Boston a “city under flu crisis.”
Sounds bad, doesn’t it? But this doesn’t compare to the incalculable number of deaths related to the Athenian plague of 430 BCE and the Justinian plague of 542 CE. The British Museum estimates that between 426 and 430 BC Athens lost 1/3 of its population. And in 542 CE, the historian Procopius estimated that 10,000 people died each day in Constantinople alone–and this continued for four months. 
Today, we are lucky to have a vaccine which is 62 percent successful.  Curtis Allen explains that part of the reason the vaccine is not 100 percent successful is because the flu vaccine actually has to be developed anew each year as influenza strains are constantly changing. “One thing about influenza is that it is notoriously unpredictable. When selecting antigens to include in the vaccine, it’s like trying to predict the weather a year out,” says Allen. He goes on to explain that only three antigens can be selected for the vaccine. Projections are pretty accurate, and there was a good match this year as far which antigens were selected. However, this year we also see a fourth strain that researchers anticipated but could not include in the vaccine. About 90 percent of the cases we see this year are influenza strains that were included in the vaccine and 10 percent of the cases are from the fourth strain that was not included in the vaccine. There is ongoing research aiming to develop a way to include four strains in the influenza vaccine.
The ancients had no way of predicting these changes and developing a vaccine. Isolation and prayer were the only forms of prevention.
The plague in these early civilizations spread fastest in urban centers, military camps and trading cities. Christine A. Smith writes in “Plague in the Ancient World: A Study from Thucydides to Justinian” that ancient cities became paralyzed by the plague, and the illness in military camps and subsequent deaths could have drastically reduced the ranks and played a part in the demise of the Greek and Roman Empires.
“The plague left a severe impact on urban life. Although the urban poor were the first to suffer from the devastating effects, the pestilence soon spread to the wealthier districts. As if the threat of disease was not problematic enough, bread became scarce, and some of the sick may actually have died of starvation, rather than disease. Many houses became tombs, as whole families died from the plague without anyone from the outside world even knowing. Streets were deserted, and all trades abandoned. Inflation soared…. As the taxation base shrank dramatically, financial pressure on the cities also increased. In an effort to economize, civic governments curtailed salaries for teachers and physicians and slashed the budgets for public entertainment.” 
The catastrophic effects of the plague on the population also produced the unraveling of the social and political order. The longer the plague continued, the more despairing people became about society and the government’s ability to stem the tide of destruction.
This does not compare to a few days missed from work and how modern society copes with illness. (Although the Walking Dead TV show certainly captures the zeitgeist.)
As if this were not enough, we have another reason to be very thankful that we do not live in the time of ancient plague–the symptoms of the modern influenza are extremely mild compared to the plagues of 430 BCE and 542 CE. Today, flu sufferers might experience fever, body aches, tiredness, cough, nausea and vomiting. But if you had the flu in 430 CE, now believed to be a form of the Ebola virus, you suffered through several stages of disease. Thucydides recorded these stages in graphic detail in History of the World with a goal to “describe what it was like, and set down the symptoms, knowledge of which will enable it to be recognized, if it should ever break out again.” Stage one included symptoms such as headaches, conjunctivitis, rash and fever. One would then begin coughing up blood, vomiting and suffering from extremely painful stomach cramps. Many patients also experienced insomnia and an unquenchable thirst that drove some to throw themselves into wells. This usually led to death on the 7th or 8th day, but if you survived you would be struck down by horrible diarrhea which would often lead to death. If you managed to live through the final stages, you faced paralysis, amnesia and permanent blindness. 
The plague of 542 CE was far worse. The disease is believed to have been related to the bubonic plague, similar to the Black Death that ravaged Europe in the 14th century. The plague symptoms were preceded by hallucinations, and quickly led to fever, facial inflammation and fatigue. The illness from this point became dramatically disabling, with buboes– open cysts of pus and blood– appearing in the groin and armpits. Most individuals died from infection within two to three days, their buboes gangrenous. A survivor of the plague was often left with deformities of the thighs and tongue. 
If you currently have symptoms of the modern flu, which you can find on the flu.gov website, seek medical attention. Microscopic and replicating rapidly, viruses pack a punch, whether in 2013 or 430 BCE. And remember, despite your pounding head, aching body, stuffy nose and intestinal meanderings, be grateful for vaccines and modern treatment.
Stay tuned to the AntiquityNOW blog for upcoming articles discussing the sociological and political consequences of plagues, as well as plague and the arts. For example, Michael Wolgemut’s Dance of Death from 1493 illustrates how the plague was a scourge for centuries and one of the reasons death became a common theme in art.
1. Procopius, History of the Wars (The Persian War) II, 23, 1 quoted in Christine A. Smith, “Plague in the Ancient World: A Study from Thucydides to Justinian,” Loyola University Student Historical Journal, 1996.
2.”More states reporting high flu levels,” CNN, January 18, 2013.
4. Thucydides, History of the Peloponnesian War II, 49, quoted in Christine A. Smith, “Plague in the Ancient World: A Study from Thucydides to Justinian,” Loyola University Student Historical Journal, 1996.