Changes

The pace of knowledge on pandemics increased in Late Antiquity. One of the first recorded in this period was the Antonine Plague in 165-180 CE, likely caused by small pox brought back from the Middle East or elsewhere in the Roman empire, where the pandemic killed perhaps tens of thousands in the capital. Millions may have died globally form this devastating pandemic. One of the first large-scale killers comparable in scale to the Black Death was the Plague of Justinian, which likely started around 541 CE. A likely killer was an early form of the bacterial bubonic plague, similar to the Black Death plague in the 14th century. This was also one of the first to likely span nearly every major Old World major city. It is estimated that Constantinople lost 40% of its population with up to half of Europe's population being affected or killed by this plague. In fact, this devastation likely kept Europe in a prolonged Dark Age, where few recorded historical records were produced because of the very low population levels in the regionuntil about the 10th century. By the 8th century, only small towns existed through most of Europe and the population was still very low compared to its level seen in the Late Roman period in the 4th century. Similarly, perhaps the same or similar plagues weakened the Sasanian Empire in the 7th century, which led to that state becoming weak and eventually it collapsed during the Islamic invasion in 651. The Sasanian Sasanians were a very urban society, making them vulnerable for disease to spread rapidly through their cities. Overall, no disease would approach the scale of the Justinian Plague until the Black Death. Recent work has suggested that the plague started in Central Asia before spreading to the Byzantine Empire, the Near East, and then Europe. the The Byzantine Emperor Justinian did, in fact, contract the plague but he managed to survive it.<ref>For more on Late Antiquity pandemics, see: Bray, R.S., 2004. <i>Armies of pestilence the effects of pandemics on history</i>. Clarke, Cambridge.</ref>

A contender for the most devastating pandemic in history is the Black Death between 1346–1353. While it does seem that pandemics did greatly shape the course of history in earlier periods, such as the Justinian Plague and the typhoid that likely weakened Athens, few events shaped global history as the Black Death. The Black Death weakened many states, including those across the Middle East, China, India, and Europe. Some regions did not recover more quickly, while others were never able to recover completely until the 19th century, such as parts of Italy. For Europe, it took over 200 years for the population to approach levels of the early 14th century. Historians have argued that although the plague was devastating, it may have helped to spark the Renaissance and innovation, as new inventions were developed because of population decline. Regardless, the remnants of this plague have been found to reoccur or break out in various regions in the Old World, including in Central Asia where it likely originated, until the early 20th century.<ref>For more on the Black Death, see: Cantor, N.F., 2002. <i>In the wake of the plague: the Black death and the world it made</i>, 1st Perennial ed. ed. Perennial/HarperCollins, New York. </ref>