MILANS FORGOTTEN EPIDEMIC OF SUMMER 1629, A FEW MONTHS BEFORE THE LAST GREAT PLAGUE: AN INVESTIGATION INTO THE POSSIBLE CAUSE.

An epidemic not attributable to plague caused thousands of deaths in Milan in the summer of 1629, a time of war and famine that immediately preceded the even more fatal Great Plague of 1630, which is estimated to have killed tens of thousands of people. The 5,993 deaths of 1629 recorded in the Liber Mortuorum of Milan (a city with an estimated population of 130,000 inhabitants at the time) were 45.7% more than the average number recorded between 1601 and 1628. Mortality peaked in July, and 49% of the deaths were attributed to acute fever without a rash or any organ involvement. These deaths involved 1,627 males and 1,334 females, and occurred at a median age 40 years (range 0-95). In this paper, we discuss the possible cause of the epidemic, which may have been an outbreak of typhoid fever.