ABSTRACT

There have been three pandemics of plague recorded in modern times. The first, known as the Justinian plague, began in the busy port of Pelusium in Egypt in the sixth century

, ultimately spreading to Mediterranean Europe and Asia Minor. There have been estimates of 15-40% mortality for a particular plague epidemic during this period [6]. The second pandemic, originating in central Asia in the early 14th century, spread along trade routes from China, eventually encompassing the Mediterranean basin, the Middle East, and most of Europe. The first European epidemic, which began in Messina in 1347, is thought to have killed approximately 30-40% of the European population and eventually became known as the Black Death [7]. For hundreds of years, this second pandemic ravaged Europe, with epidemics continuing late into the 17th century. The current (Modern or Third) pandemic most likely began in China, reaching Hong Kong and other Asian ports in 1894. In just a few years, plague had been disseminated via rat-infested steamships to ports worldwide, leading to an estimated 26 million plague cases and 12 million deaths during the first 35 years of the pandemic [8]. It was during the early years of the Modern pandemic that

Y. pestis

was introduced to new locations in North and South America, Southern Africa, Australia, the Philippines, and Japan [8].