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GEOGRAPHICAL DISTRIBUTION
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refers to its occurrence in Libya, Egypt, and Syria about the end of the third and the beginning of the second century before the Christian era. The next authentic account, and the first as regards Europe, refers to the great epidemic known as the plague of Justinian, which, in A.D. 542, starting from Egypt, spread to Europe and all over the Roman Empire, and which, lasting for fifty or sixty years, wrought the most frightful devastation wherever it reached, depopulating the towns and turning the country into a desert. From that time until 1841, when plague appeared for the last time in Constantinople, it recurred again and again in different parts of Europe, though latterly only in the south-eastern parts of the continent and in areas becoming gradually more circumscribed. In 1878-79 a small epidemic, which speedily died out, broke out in the Russian province of Astrakhan. With the latter exception and the limited epidemics at Oporto in 1899 and at Glasgow in 1901, and a few isolated and mostly imported cases at the large seaports, Europe has long enjoyed exemption from this worst of epidemic diseases. The plague, as a widespread epidemic, visited England for the last time in 1664-79, when, in 1664-65, upwards of 70,000 of the 460,000 inhabitants of the London of that day perished. In recent years and from time to time cases of plague have occurred in the Port of London in seamen from Eastern countries, and plague-infected rats are by no means uncommon in the docks of the metropolis, but with the exception of a limited epizootic in rats and rabbits and several fatal cases in man in 1910 in Suffolk there is no record of plague in England, apart from the cases occasionally seen in the seaports, since the seventeenth century.

Egypt, in former times a favourite haunt of the disease, until 1899 had been exempt since 1844, although several epidemics have since the latter date occurred in its neighbourhood in Tripoli (Benghasi) in 1856, in 1859, and in 1874; and on the Red Sea coast of Arabia (Assir) from 1853 to the present time. It is now known to be endemic in Uganda and in the hinterland of German East Africa.