Was the Justinian Plague caused by the 1918 flu virus?

Abstract

The influenza pandemic of 1918 caused more deaths than any single infectious disease event in human history. The Black Death (1347–1351) had the highest kill rate on a world human population basis of any disease in historical times. Scott and Duncan [1] noted a number of important features of the Black Death not consistent with Y. pestis as the causative pathogen: an apparently person-to-person transmission of the disease, and a rate faster and to places that rats and fleas did not go, and a kill rate far higher than in modern disease caused by the bacterium. Scott and Duncan suggested a hemorrhagic virus such as Ebola as the cause of the Black Death. However, such viruses have never been known to cause a worldwide pandemic. As an alternative we suggested [2] that the 1918 pandemic influenza strain be considered. The symptom/sign in Black Death sufferers of bullae in the axila and groin is not typically seen in flu victims, but perhaps it could have been occurred in the past to a populace naive to influenza. Here we want to put forth pandemic influenza as a possible cause of ‘‘Justinian’s” Plague that ravaged the Mediterranean, near East, Western and South-Central Europe from 540 to 543 CE. As we noted [2], if lymphocyte DNA could be extracted from dental pulp one could look for evidence of anti-(pandemic) influenza in individuals who died after, but not before the Black Death or Justinian Plague. Here we add another possible way to test pandemic influenza as a cause of these plagues: In genome scans signals could be sought in time and populations — for example with those native to the Americas as ‘‘out” groups — for genes that mediate survival to influenza.