Humans have dealt with epidemics and mass mortality events caused by viral, bacterial, and fungal agents long before the rise of the first cities around the 8th millennium B.C.E. From ancient texts we glean details of some significant disease incidents. Already in the second millennium B.C.E. Egyptian sources report a rapidly spreading disease around Byblos (in modern day Lebanon) that also affected regions as far east as Babylonia (modern Iraq) and was also carried northward and westward into Anatolia and Cyprus. This episode is sometimes referred to as the ‘Hittite plague’ after the ancient empire that dominated Anatolia and parts of Syria and contested control of the region. The sources which mention the Hittite plague belong to the Egyptian empire, then ruled by Pharaoh Akhenaten (ca. 1353-36 B.C.E.), famous for controversial religious forms as well as the father of the most famous Pharaoh of all, Tutenkhamun (1334-25 B.C.E.), the ambitious and star-crossed warrior king who fought the Hittites in the very region where the disease is first recorded.
After the Hittites attacked the Egyptian borderlands in Syria around the Litani River (today in Lebanon), diseased prisoners and animals taken as plunder spread contagion along the length of the march back to the Anatolian heartland of the Hittite Empire. At the wealthy trading city state of Ugarit in northern Syria, a number of merchants fell prey to the illness, struck down, the sources say, “by the hand of god”. In the Hittite capital of Hattusa, royalty was no protection: the famous and mighty king Suppiluliuma (ca. 1344-22 B.C.E.) died of the illness, as did his son.
Scholars have argued that the symptoms teased from the scant sources indicate the agent involved in this frightening event was Tularemia, caused by the bacillus Francisella tularensis and now relatively rare. Tularemia is spread by drinking infected water or by biting insect carriers that transmit the bacteria to animals and humans. Humans are most often infected when they contact diseased animals. Onset is marked by a fever which can be as high as 104º F. Depending on the form, skin ulcers, enlargement of the lymph nodes, swelling of the eyes, sore throat, and tonsillitis are symptoms. The most serious form of Tularemia is the pneumonic variety: chest pains, coughing, difficulty breathing mark this type. This serious and often fatal form can arise when other forms of the disease are left untreated; in the world before antibiotics, this was likely the fate of many who were infected. No wonder ancient people described the onset of such terrifying illnesses to the handiwork of the gods. If we are correct in identifying the agent of the disease, the feeling of the sick being burned by fire and the metaphor of being struck by lightning cast the invisible hands of angry, capricious gods alluded to in the Hittite texts, is unsurprising given the high fever and agony associated with untreated Tularemia.
Like all disease outbreaks known to us from texts and for many others that were never recorded in writing, we may be able to unlock the secret of the Hittite plague through the use of advanced scientific methods. When scholars proposed Tularemia as the likely causative agent of the epidemic, they were likely informed in part by the notion that certain other diseases were not present in the Fertile Crescent in the Bronze Age. Any notion, for instance, that the dread Bubonic plague (Yersinia pestis) was absent from the western Eurasian stage until the sixth century C.E. has been shattered by recent archaeological discoveries in Scandinavia, where researchers have discovered the presence of Yersinia pestis in the remains of a young woman buried some 5400 years ago, more than four thousand years before the Hittite Plague. Like Tularemia, Bubonic plague kills many different species of animals and humans and history bears grisly witness to its destructive potential. Was the disease that felled the great Hittite rival of Akhenaten and struck down many thousands of victims along the thriving trade routes of the Bronze Age Near East not Tularemia but the much more infamous agent, Bubonic plague? If so, the Hittite plague may well have been a proto-Black Death event in which a series of advanced, thriving societies were ravaged on a scale comparable to those we witness in the writings that record the first historical pandemic, the Plague of Justinian some 2000 years later.
Siro Igino Trevisanato. 2007. “The ‘Hittite plague’, an epidemic of tularemia and the first record of biological warfare” Medical Hypotheses 69: 1371-74.
Lizzie Wade, “Did a new form of plague destroy Europe’s Stone Age societies?” https://www.sciencemag.org/news/2018/12/did-new-form-plague-destroy-europe-s-stone-age-societies
Center for Disease Control and Prevention: Tularemia. https://www.cdc.gov/tularemia/index.html
© 2020 Michael J. Decke