In This Article Epidemic Diseases and their Effects on History

  • Introduction
  • General Overviews
  • Reference Works
  • Journals
  • Smallpox
  • Yellow Fever and Malaria
  • Cholera
  • Influenza
  • American Indians and Epidemics

International Relations Epidemic Diseases and their Effects on History
Christian W. McMillen
  • LAST REVIEWED: 19 May 2017
  • LAST MODIFIED: 24 July 2013
  • DOI: 10.1093/obo/9780199743292-0155


There is perhaps no longer-lasting historical relationship than that between humans and disease, especially epidemic disease. The relationship predates agriculture, the formation of cities, and, if current research on the emergence of diseases like tuberculosis is correct, human migration out of Africa. From the earliest times to the present, epidemics have affected human history in myriad ways: demographically, culturally, politically, financially, and biologically. Humans have never known a time in history when epidemics did not loom large. This is as true today as it ever was. This article seeks to introduce readers to this large and varied topic through a selection of key readings from around the globe and across time. The historiography is rich and remarkably comprehensive in scope. Yet there are limitations. The evidence for epidemics in the non-Western world before significant contact with Europeans, and in the New World before contact with Europeans, is scant. This is not to say that epidemic disease did not affect parts of Africa, for instance, before European colonization or that the cholera epidemics that emerged in early-19th-century India were the first instances of epidemic disease there. We just do not know. By contrast, there is a massive amount of evidence on the Black Death and its effects on medieval Europe; likewise, the so-called virgin soil epidemics that devastated native populations all over the world in the wake of European conquest are also well documented, if not always well understood. What follows is a consideration of the topics that have received the most attention from historians: plague, cholera, influenza, smallpox, among others. Likewise, certain topics—the impact of epidemic disease on indigenous peoples and the effects of colonialism, for instance—have a well-developed historiography. The same is not the case for measles; there is no well-developed historiography of this killer disease despite its powerful impact and regular occurrence. Typhus, which does not have its own entry, is nevertheless important, and one can learn about it in the discussion of war and disease in Harrison 2004 (cited under General Overviews). Tuberculosis—another critically important infectious disease—does not have its own entry. One final thing to note: the focus here is on the effects of epidemic diseases and thus this is not a general history of medicine. For that reason, subjects such as infant mortality that would very easily fit into a discussion of medicine and imperialism will not be discussed here.

General Overviews

There are quite a number of excellent introductions to the history of epidemics and their effects on history. General works, covering broad swaths of human history and geographic space, necessarily overlap slightly. However, the following each offer a unique approach. The global history McNeill 1998 is perhaps the most accessible starting point and a touchstone for all future work. Taking a more topical approach, and written after the appearance of HIV/AIDS, Hays 2009 is comprehensive and readable. Ranger and Slack 1995 presents essays on a wide variety of topics concerning the ways in which people have thought about epidemic disease. Writing on different time scales, and considering different places, Crosby 2009, Diamond 1997, and Ladurie 1981 all consider epidemics and the transfer of germs across space to be defining elements of human history. Rosenberg 1989 offers a thoughtful discussion of the various features epidemics have in common. Not discussed here are the many works on the history of medicine more generally that consider epidemic disease yet do not make it a focus.

  • Crosby, Alfred. Ecological Imperialism: The Biological Expansion of Europe, 900–1900. Cambridge, UK: Cambridge University Press, 2009.

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    Influential book originally published in 1986, but updated. Not solely about epidemic disease, yet disease is a central feature of the story of Europe’s “biological expansion” into and the creation of “neo-Europes” in North America, Australia, and New Zealand.

  • Diamond, Jared. Guns, Germs, and Steel: The Fates of Human Societies. New York: Norton, 1997.

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    Considers the peopling of the earth and eventual dominance of Europeans. Argues that geographic advantage led to the development of agriculture and the domestication of animals, which in turn led to settlement and crowd diseases—diseases those in the New World never encountered until confronted by Europeans starting in the 15th century.

  • Harrison, Mark. Disease and the Modern World: 1500 to the Present Day. Cambridge, UK: Polity, 2004.

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    Lively, brief, and wide-ranging survey. Excellent on impact of disease on the New World, changing views of disease causation, effects of industrialization, impact of war, and efforts in more recent times to rid the world of disease. Central is Harrison’s contention that efforts to control disease and the rise of the modern state go hand in hand.

  • Hays, J. N. The Burden of Disease: Epidemics and Human Response in Western History. Rev. ed. New Brunswick, NJ: Rutgers University Press, 2009.

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    Originally published 1998. From ancient times to the present, the scope of Hays’s survey is impressive. Especially clear is Hays’s sympathy for the view that there is a close connection between poverty, power, and disease and that the disparities in wealth across the globe are often at the root of epidemics. Excellent introduction to a vast array of literature and a superb bibliography. Covers diseases, such as typhus and others, not given their own entries elsewhere.

  • Ladurie, Emmanuel Le Roy. “A Concept: The Unification of the Globe by Disease.” In The Mind and the Method of the Historian. By Emmanuel Le Roy Ladurie, 28–83. Translated by Siân Reynolds and Ben Reynolds. Chicago: University of Chicago Press, 1981.

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    During the three centuries from 1300 to 1600, a “‘common market’ of microbes” developed and engulfed the globe like never before (p. 30). The Black Death and the importation of disease to the Americas were particularly devastating.

  • McNeill, William. Plagues and Peoples. New York: Anchor Books, 1998.

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    Originally published in 1976. Has had an inestimable influence by arguing, before others and in what became a very popular book, that epidemic disease should be placed at the center of history. “Events but little noticed in traditional histories assume central importance for my account,” McNeill wrote (p. 21).

  • Ranger, Terence, and Paul Slack, eds. Epidemics and Ideas: Essays on the Historical Perception of Pestilence. Cambridge, UK: Cambridge University Press, 1995.

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    Essays on the power of epidemics to shape ideas, influence policy, and affect demography as well as a consideration of how ideas about epidemics have changed over time and space. Evans’s well-regarded essay “Epidemics and Revolutions” is included, as are essays on the plague in India, and changing ideas about Christianity in the face of epidemic disease in eastern and southern Africa.

  • Rosenberg, Charles E. “What Is an Epidemic? AIDS in Historical Perspective.” Daedalus 118.2 (1989): 1–17.

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    Examines responses to epidemics across time and space. Argues that epidemics have a “dramaturgic form” (p. 2): initial revelation, response, crisis, and closure. Responses can happen on different time scales: the 1918 flu epidemic and the AIDS epidemic might have similar “dramaturgic forms” yet operate on completely different time scales. Most epidemics are united in their ability to raise questions of “volition, responsibility, and susceptibility” (p. 6).

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