Fatal epidemics in the Eastern Mediterranean have been going on since at least the start of the Bronze Age. However, the best evidence for big outbreaks is in 18th century and 14th century BC.
After about 500 BC historians occasionally took the trouble to chronicle the fatal epidemics they experienced. However, due to a lack of historians there’s not much on earlier epidemics. Here’s what evidence I’ve found so far.
I’ll start with the earliest evidence and move forward. Bear in mind that all of these are epidemics of unknown strains of disease, poorly reported, and no diagnosis is suggested. If anybody knows of other events then please do say.
At the end I will discuss the results and suggest patterns.
?30th century BC
Manetho, in copies of the 3rd century BC ‘Aegyptica’, states the following of ‘(Se)mempses’ (1st dynasty, 30th century BC pharaoh Semerkhet):
‘In his reign many portents and…’ depending on the reading ‘… a great pestilence occurred…’ or ‘…a very great calamity (befell Egypt).’
This evidence is weak as calamities come in various forms and ‘pestilence’ may be a later reading.
20th century BC
‘The Story of Sinuhe’ – Egypt
This comes from two papyri from Egypt, Berlin Papyrus 3022 (lines 43-45), thought to be 20th cent BC date or later, and Papyrus 10499 (line 67), from the 19th century BC.
‘Then he said to me: “How will that land be without him, that excellent god, fear of whom was throughout the lands, like of (the goddess) Sekhmet/the Great One in a year of pestilence?”‘
The story concerns events which happened in the 12th dynasty, around the 20th century BC. However, there is no reference to a particular event, just the idea that epidemics may already be a concept people are familiar with in Egypt.
18th century BC
There are three very different pieces of evidence for epidemic from this period, both from Egypt and the Middle East.
‘The Appeal to Utu’ – Larsa, Southern Mesopotamia
This is from the Royal Correspondence of Larsa (II.1 1-13, III.30.), dated to about 1780 BC. The king, Sîn-iddinam, asks the god Utu why Larsa’s population, after 5 or 7 years of peace, has been struck down but people of other regions have been spared. Here are the main relevant excerpts (Elam is modern southwestern Iran, Subir is probably northern Mesopotamia, Cimack, or Kimas, is probably in the Zagros Mountains to north).
‘Distress has been caused in your city, Larsa, which you have chosen in your heart. The broad squares where days have been passed in merriment have been reduced to silence. Your commendable troops who were assembled have been annihilated (?) like reeds from a reed fence splitting apart. Your young men have been harvested like barley at the due time; they have been picked and have been plucked like ripened fruit (?). The people have been smashed like terracotta figurines; they (?) have perished all together. An evil storm took away the little ones from the laps (?) of their mothers…
The mountain land of Elam where there are no dead in great numbers (?) like ……, and Subir, a heavy cloud, which knows no reverence even towards the gods — these districts have not been ……; their time has not yet come. The Cimackian does not elect nugig or lukur priestesses for the places of the gods. His soldiers are numerous like grass; his seed is widespread. He who lives in tents, who does not know of the places of the gods: like a wild beast which mounts, he knows nothing of eca flour nor the offering of prayers. The evil namtar demon and the distressing asag demon have not carried him off (?). Who …… a divine oath is committing sacrilege, yet his troops are in good health.’
The evidence, such as it is, suggests an epidemic which the king of Larsa perceives to be localised in Southern Mesopotamia.
Avaris excavations – Tell el-Dab’a, Nile Delta, Egypt
Excavations of areas F/I and A/II of the ancient Hyksos capital by Manfred Bietak and his team recovered several communal pit graves without evidence of burial gifts in stratum G (?3 or 4), as well as subsequent partial abandonment of the site (? area A/II). These graves are dated to the 13th Dynasty Period, around 1740-1710BC.
Bietak interprets them as evidence of an fatal epidemic outbreak. According to Wikipedia there is papyrus evidence to corroborate this, but this is unreferenced and I currently have my doubts that this is any more than the ‘Story of Sinuhe’ above or one of the medical texts listed below.
Mari Royal Letters, Eastern Syria
The royal letters contain a series of tablets (26 17 & 26 259-261 & 263 to 265), written in the years before the destruction of Mari around 1760 BC, which appear to contain good evidence of fatal epidemics (the ‘hand of god’ or the ‘devouring of a god’) within the region.
The letters to King Yasmah Adad date from between about 1795 and 1775 BC. They may be describing the same epidemic. Those to Zimri-Lim date from about 1775 to 1760 BC. Both discuss epidemics upriver.
26 259 from La’um to Yasmah Adad ‘About the devouring of a god, concerning which my lord wrote me – in Tuttul there are cases of illness. Death is rare. In Dunnum below Lasqum is a corpse heap. Within two day days about 20 men of the troops died. And the [Dunnites left] the city and went to the mountain of Lasqum. Muban, Manuhatan, in the vicinity of Dunnum, are well. Dunnum itself is diseased. Mari is well, the land is well.’
26 260 from La’um to Yasmah Adad ‘The hand of [the god] has abated [ on the bank of the Euphrates] and [ ]. It did not [spread (more) infection]. (Before,) 10 men, 5 [died] a day. Now the hand [of the god]. 1 man [ ] in a day. The god has made peace. I had [extispicies] done for [the burying] of the corpse heap and will write a full report [to] my lord after (sending) [this tablet of mine].’
26 261 from Ikšud-Appašu to Yasmah Adad ‘My lord wrote me [about my trip]. My lord [knows] that I do [not] put off a trip. The journey is on schedule. And my lord wrote me strict orders about small-boats, and I was present 3 days where they fixed them up, and I had a burning fever. I am ill, I cannot go to my lord. Further, a god spread infection in Zurubban. It has not yet calmed down. And now he spreads infection in Zapad…’
26 263 to Yasmah Adad ‘The god has become reconciled with the [land, all of it. From] the 25th day of [? a month ] until the month [of Tirum] (the 12th month) the 5th day being in progress, [ ]. A sick (man) who was touched [ ] melted away. I had extispicies done for the burying of the corpse heap on the 10th day of the month of Tirum. The god has answered. All of them were viewing (the corpses). ?They (each) buried the corpse belonging to them. The exorcists and cantors cleansed the city thoroughly on the 14th of the month of Tirum…’
26 265 to Yasmah Adad ‘the hand of god has abated. The palace is well. There are numerous fatalities among the domestics, the weaver women, prisons and cultivators…
26 264 from Mašiya to Yasmah Adad ‘About the hand of god, which abated in [ ] – I [drew up] a tablet of the [dead] among the weaver women, the cultivators, the [ ] and the prisons [and sent (it)] to my lord…’
26 17 to Zimri-Lim I don’t have a copy of this text, but the gist is that there is an epidemic in the district of Saggaratum to the north, and that the king should not go beyond Terqa because of it.
According to historian Adrienne Mayor (see below) there may also be a tablet forbidding people from plague-ridden towns travelling to healthy towns. However, I haven’t seen a translation of the original source text for this quote.
These text show that there were at least two outbreaks of epidemic between 1795 and 1760 BC, affecting towns and regions on the Upper Euphrates at slightly different times.
?15th century BC
‘Short Plague prayer’ – Ḫattuša, Turkey
This prayer (CTH 376C) is formulaic and of unknown date (the tablets of Ḫattuša are all from a 13th century context), although the some of the words suggest that it’s older than the Ḫattuša prayers listed below. It appears to make reference to some kind of population loss which may be epidemic. However, it also talks about attacks on the land of Hatti by enemies, so it’s not clear exactly what it refers to. I have just quoted the introduction, which is very fragmentary.
‘[O Gods, why did you do these things?] You let [the pestilence] spread, and [the whole] la[nd is dying]. Nobody [is preparing for you bread loaves] and libations [anymore]…’
14th century BC
‘The Plague Prayers of Mursilis II’ – Ḫattuša, Turkey
These prayers by Mursilis (CTH 376A, 377, 378 & 379) record a fatal epidemic around 1300 BC in the Lands of Hatti, not just in the capital but in other towns. This was thought by Mursilis to be a return of an epidemic which had previously killed his father, King Suppiluliuma, and large numbers of the population twenty years before, and was now killing again.
The prayer seems to indicate that Suppiluliuma’s soldiers brought back this disease while fighting the Egyptians in Syria. However, references in prayer IV to plague in the time of his grandfather, Tudhaliya II, make this confusing (this is perhaps the confusion of the original prayer writer, as the period of Tudhaliya II is known to be one where Hatti was overrun). The following are relevant passages from the prayers.
CTH 378.iii ‘O Sun-goddess of Arinna, my lady! O gods, my lords! What is this [you have done?] You have allowed a plague into Hatti, so that Hatti has been badly oppressed [by the plague. People kept dying] at the time of my father, at the time of my brother, and now since I have become priest of the gods, they keep on dying [in my time] For twenty years now people have been dying [in great numbers] in Hatti. Hatti [has been very badly damaged] by the plague.
‘Hatti has been very much oppressed by the plague [if someone] produces a child [the…] of the plague [?snatches?] it from him. Should he reach adulthood, he will not attain old age. [And even if old age?] will be left for someone he [will be oppressed? by] the plague. He will not [return] to his previous condition. We he reaches old age [he will…] but he will not keep warm…
… May the gods, my lords, again have pity on Hatti. May it thrive and grow and [return to] its previous condition.’
CTH 378.ii ‘At that time too the Storm-god of Hatti, my lord, by his verdict caused my father to prevail, and he defeated the infantry and the chariotry of Egypt and beat them. But when the prisoners of war who had been captured were led back to Hatti a plague broke out among the prisoners of war and [they began] to die. When the prisoners of war were carried off to Hatti, the prisoners of war brought the plague into Hatti. From that day on people have been dying in Hatti.’
CTH 379.iv ‘All of a sudden, in the time of my grandfather Hatti was oppressed, [and it] became [devastated] by the enemy. Mankind was [reduced in number] by plague and your [servants] were reduced in number… But when my [father] became king, [you] O gods, my lords, stood behind him. He settled the [depopulated] lands… When my father went to Egyptian territory, since that day of Egypt, death has persisted in [Hatti] and from that time Hatti has been dying… Send the plague away from the land. Let it subside in the towns where people are dying, and let the plague not return to the towns in which it has subsided…’
This is clearly an extensive fatal epidemic. The evidence suggests that epidemic is recurring, no longer spreading uniformly but attacking individual towns at different times. The first wave of the epidemic is suggested to be around 1322 BC (short chronology) but could be earlier, perhaps dating to before 1344 BC.
These all date to the Amarna period, between 1343 and 1328 BC, and are from the letters sent between various Kings of the Middle East and either Akhenaten or, perhaps, Tutankhaten (Tutankhamun).
EA35 from the King of Alashiya, Cyprus
This letter comes from the King of Alashiya and refers to difficulties in supplying a copper order to Egypt due to the ‘hand of Nergal’ (death) killing men, including copper workers, as well as one of his son’s.
‘…My brother, behold, my messenger I have sent with your messenger to you to Egypt. Now I have sent 500 (talents) of copper to you; I have sent it to you as a gift – for my brother. Do not let my brother be concerned that the amount of copper is too little, for in my land the hand of Nergal, my lord, has killed all the men of my land, and so there is not a (single) copper-worker…
‘Do not be concerned, my brother, that your messenger has remained three years in my land, for the hand of Nergal is upon my land and upon my house. My wife bore a son, who is now dead, my brother.’
No doubt the death of all men is an exagerration. However, it does appear to be significant.
EA244 from Biridiya of Megiddo, Levant
This letter makes passing reference in a request to Pharaoh for archers to defend the city, he mentions:
‘…In truth, the city is destroyed by death as a result of pestilence and disease…’
EA 96 from A Chief to his father Rib Addi (?of Byblos, Levant)
The chief shows some irritation about not being able to get donkeys for a caravan because of pestilence (Simyra is Tell Kazel in Levantine southern Syria. Some people choose to read this as Sumer, but this seems unlikely).
‘May the gods be concerned for thy welfare (and) the welfare of the dynasty! Because thou sayest, “I will not permit the entrance of the men of Simyra into my city; there is a pestilence in Simyra”. Is it a “pestilence” attacking people or donkeys? What sort of “pestilence” attacks donkeys that donkeys can’t go on caravans?‘
Again, this suggests the outbreak of epidemic in one coastal town but not another. There is also a suggestion that whatever kind of epidemic it is, the writer does not expect it to infect animals as well.
EA 2110 Plea from Ewiri-shar of Ugarit (Ras Shamrah), Levant
Written to P-l-s-y about some disaster and a request for help.
‘May it be well with thee, with T-r-x-d-s and with K-l-b-y! Thou hast heard of the blows by which we have been shattered (ruined) – indeed, behold, there is nothing (left) – we are ruined! So send (help) to me. And the hand of the god is here, for the death (?pestilence) is exceeding sore…‘
In this letter it’s not clear what the cause of death is although epidemic is a possibility.
?13th century BC
Hittite Rituals Against Pestilence – Turkey
This ‘scapegoat’ ritual (KUB IX 31 ii 45-60) appears to be written by Ashalla of Hapalla (?western central Turkey), although where it was found I don’t know (quite possibly Ḫattuša).
‘If people are dying in the country and if some enemy god has caused that, I act as follows: They drive up one ram. They twine together blue wool, red wool, yellow wool, black wool and white wool, make it into a crown and crown the ram with it. They drive the ram on to the road leading to the enemy and while doing so they speak as follows: “Whatever god of the enemy land has caused this plague—see! We have now driven up this crowned ram to pacify thee, O god! Just as the herd is strong, but keeps peace with the ram, do thou, the god who has caused this plague, keep peace with the Hatti land!‘
This ritual, known as the ‘Ritual of Pulisa’ (KBo V I), is similar but uses both ewe and bull.
‘If the king has been fighting the enemy and returns from the enemy and out of the enemy country a pestilence comes and afflicts the people: they drive in a bull and a ewe, these both from the enemy country, and they decorate the bull’s ears with ear rings and red wool, green wool, black wool and white wool, and they say “Whatever has made the king red, green, black or white shall go back to the enemy country”‘
Finally, the Ritual of Dandaku (KUB II 7 iii 11-18) uses a donkey or clay subsitute.
‘They drive in a donkey -if it is a poor man they make one of clay – and they turn its face to the enemy country and say, “Thou, Yarri, hast inflicted evil on this country and its army. Let this donkey lift it and carry it into the enemy country.”‘
While these don’t refer to any particular fatal epidemic event, they suggest a familiarity with, and expectation of, epidemics and an assumption that they are caused by action of, or infection from, enemy countries. This mirrors the ‘Plague Prayers of Mursilis’, perhaps suggesting a similar or later date.
Oracle bone, Anyang, China
Quoted by William H NcNeill in ‘Plagues & Peoples’ as a translation by Joseph Cha. I can find nothing more about this or of Joseph Cha.
‘Will this year have pestilence and will it be deaths?’
If confirmed it shows a first date for written evidence of epidemics in China. However, I think that the reading of texts on oracle bones could not currently allow us to tell whether ‘pestilence’ is simply ‘illness’ and whether this is applicable to a large area or just a palace setting. This is point will be discussed further at the end.
8th century BC
The Eponym Chronicles of Assyria record terse statements of epidemics (‘mass death’s) occurring to the Assyrian army in the Levant during the end of the 9th and the 8th centuries BC, as noted by Karen Radner. The examples she quotes are:
802 BC ‘to the sea; mass death’ (presumably the Mediterranean)
765 BC ‘to Ḫatarikka; mass death’ (on Orontes River, Levant)
759 BC ‘revolt in Guzana; mass death’ (same place as the Mari outbreak)
7th century BC
Epic of Gilgamesh, Nineveh, Northern Iraq
This is lines 184-185? of tablet XI (the famous ‘Flood Tablet’) from the standard version of the famous story of Gilgamesh, found in the Library of Assurbanipal, Nineveh.
? 6th century BC (The Bible)
There are several references to possible epidemics often sited from the Biblical Canon.
Exodus, Chapters 9-12 – the ten plagues of Egypt
Numbers, Chapter 11 – eating too much quail (could happen to anyone I suppose)
I Samuel Chapters 5 & 6 – Philistines being cursed with possible groin swellings
II Samuel Chapter 24 – Pestilence among the people of Israel
2 Kings 18-19, Isaiah Chapter 37 – Destruction of Sennacherib’s Assyrian army outside Jerusalem (around 700 BC).
These references can be dated anywhere from the time of compilation in the 7th or 6th century BC back theoretically to 12th to 14th centuries BC (e.g. the events of Exodus). However, while they reveal some understanding of epidemics they have questionable historical value.
As well as what’s recorded above, there are descriptions which could be diseases related to epidemic and which some have argued are evidence of bubonic plague. These occur in various papyri from Egypt, including the Ebers Papyrus (16th century BC copy), the Hearst Papyrus (16th century BC or older) and, arguably, the London Medical Papyrus (18th century BC). There is also evidence of quarantine and prevention of infection in the Mari Royal Tablets (Early 18th century BC – tablet ARM X from King Zimrilim to Queen Šibtu).
There is also the evidence potential smallpox in various Egyptian mummified corpses, one from the 18th dynasty (1580-1350BC), and two from the 20th dynasty (1200-1100BC) including that of pharaoh Rameses V who reportedly died in 1157 BC. However, all of these are not in themselves evidence of epidemic events.
This is a rag-bag of evidence. Nearly all of it is written, which immediately excludes all those areas of the world without writing at the time. Better archaeology may find evidence of other graves like those of Avaris, but then we’re going to be limited to regions such as the Eastern Mediterranean, Middle East and China.
For the writings themselves there are ritual elements to some, such as the Hittite prayers, which make it complicated to understand their purpose. More importantly, there is ambiguity in some of the writing which makes it difficult to know whether what’s being read refers to an epidemic or something else. However, the combined evidence does suggest that fatal epidemics were known from about the beginning of the 2nd millennium BC in the Middle East and Egypt.
As for individual events this is more difficult. For a start, absence of evidence is not evidence of absence. Papyri and tablet libraries may date back to the middle of the 3rd millennium BC, but they may simply not have recorded any evidence for epidemics by chance. More than that, the libraries that have been preserved are often a result of chance events themselves, such as fire or city abandonment, and epidemics may have occurred at other times (Middle Eastern libraries exist from the 25th, 23rd, 18th, 15th, 13th and 7th centuries BC).
That said, lets try some speculation. There may be a event in Egypt around the beginning of the 2nd millennium BC. However, this is nothing more than speculation based on a story and should probably be discounted.
There may be more widespread epidemic outbreaks across the Middle East and Egypt during the 18th century BC. Notably, there appear to be outbreaks concentrated along the Euphrates River sometime between 1795 and 1775 BC. The Egyptian outbreak appears to be a bit later.
Lastly, there may well be widespread epidemic outbreaks from the Southern Levant to Anatolia in the middle to late 14th century BC. I’m not the first to suggest the last epidemic. It has been suggested as a pivotal moment in western history by Jan Assman in ‘Moses the Egyptian’. Although I haven’t read this yet, I can’t help but guess that this adds in aspects of the Biblical plagues of Egypt as part of this epidemic.
Alternatively, Siro Trevisanato argues that this apparent epidemic phase is the result of biological warfare involving deliberate infection of animals with Francisella tularensis. Personally, this seems like a misreading of the evidence of scapegoats recorded by the Hittites. Scapegoats don’t have to be infected – they are symbolic, as shown by the use of clay models where people can’t afford animals. Furthermore, the fatal strain of this disease is North American, not Western Asian. Until the paper is uploaded in full to the internet where I can see it I can say no more.
Widespread epidemic events after this time and before 500 BC are not obvious from the data I’ve seen. However, localised epidemics, such as those attacking Assyrian armies in the 9th and 8th centuries BC, were clearly familiar during the early first millennium BC.
Bietak, M. 1996 Avaris, The Capital of the Hyksos, Recent Excations at Dell el-Dab’a, British Museum Press.
See page 6, Fig. 3 and page 35 for the relevant discussion of evidence for epidemic.
Bremmer, J. 2004 Ritual, In: Religions of the Ancient World (ed. S.I.Johnston), Harvard, p33-34
Source for the background of the Hittite ritual against pestilence
Source of place locations near Mari.
Dollinger, A. 2006+ The Amarna Letters, from ‘An Introduction to the History and Culture of Pharaonic Egypt’ (website).
My main source for the Amarna Letters, the translations of which come from various sources quoted here.
Fenner, F. et al. 1988 The History of Smallpox and its Spread Around the World, Chapter 5 from Smallpox and its Eradication, WHO Geneva, p209-244.
Useful information about the possible evidence of smallpox in preserved Egyptian mummies on pages 210 and 211.
Heimpel, W. 2003 Letters to the King of Mari: A New Translation, with Historical Introduction, Notes, and Commentary, Eisenbrauns.
Source for Mari tablets.
Letter from Sîn-iddinam to the god Utu, from ‘The Electronic Text Corpus of Sumerian Literature‘ (website), Oxford University.
Lorenzi, R. 2007 Killer donkeys were first bioweapons, ABC Science website.
Journalistic discussion of the Trevisanato paper, with comments from Adrienne Mayor on the Mari letters.
Martin, S. 2015 A Short History of Disease: From the Black Death to Ebola, Oldcastle.
Mayor, A. 2003 Greek Fire, Poison Arrows, and Scorpion Bombs: Biological and Chemical Warfare in the Ancient World, Duckworth 2003, p 11.
Not read but apparently the source for the Mari reference.
McNeill, W.H. 1976 Plagues and Peoples, Penguin, p80.
Source for the oracle bone information.
Moyer, J.C. 1983 Hittite and Israelite Cultic Practices: a selected comparison, In: Scripture in Context II: More Essays on the Comparative Method (W.W. Hallo et al. eds.), Eisenbrauns, p33-35.
Source for other Hittite ritual prayers.
Nederhof, M-J. 2011 Sinuhe (pdf) transliteration and translation, St. Andrews.
Panagiotakopulu, E. 2004 Pharaonic Egypt and the origins of plague, J. Biogeography 31, 269–275.
Radner, K. 2009 The Assyrian King and his Scholars: The Syro-Anatolian and the Egyptian Schools
In: Of Gods, Trees, Kings, and scholars, Studia Orientalia 106, p230.
Details of Assyrian plagues
Robertson, W.C. 2007 Drought, Famine, Plague and Pestilence: Ancient Israel’s Understandings of and Responses to Natural Catastrophes, PhD, Drew University.
Source for the Mari contagion letter.
Serafimov, P. & Tomezzoli, G. ?2009 The Inscription from Tell el-Dab’a, Proceedings of the Seventh International Topical Conference: Origin of Europeans, Ljubljana, 89-96.
Singer, I. & Hoffner, H.A. 2002 Hittite Prayers, Brill.
Includes all the plague prayers.
Spalinger, A. 2010 Two Screen Plays: ‘Kamose’ and ‘Apophis and Seqenenre’, J. Egyptian History 3, p115-135.
Fragmentary stories relating to a crisis in Egypt during the Amarna Period, which refers the Harris Papyrus and to a book ‘Moses the Egyptian’ by Jan Assman, which I think I must have a look at.
Torri, G. A 2010 A ‘New’ Prayer from the ‘House on the Slope’. In ‘Pax Hethitica: Studies on the Hittites and Their Neighbours’ (Cohen, Y. et al. eds.), Harrasowitz, 362-371.
Source of Hittite prayer CTH376C.
Trevisanato, S.I. 2007 The ‘Hittite plague’, an epidemic of tularemia and the first record of biological warfare, Medical Hypotheses Magazine 69, p1371-1374.
Wadell, W.G. 1940 Manetho’s Aegyptica (online translation)