great northern war plague outbreak great northern war plague outbreak during the great northern war (1700–1721), many towns and areas around the baltic sea and east-central europe had a severe outbreak of the plague with a peak from 1708 to 1712. this epidemic was probably part of a pandemic affecting an area from central asia to the mediterranean. most probably via constantinople, it spread to pińczów in southern poland, where it was first recorded in a swedish military hospital in 1702. the plague then followed trade, travel and army routes, reached the baltic coast at prussia in 1709, affected areas all around the baltic sea by 1711 and reached hamburg by 1712. therefore, the course of the war and the course of the plague mutually affected each other: while soldiers and refugees were often agents of the plague, the death toll in the military as well as the depopulation of towns and rural areas sometimes severely impacted the ability to resist enemy forces or to supply troops. this plague was the last to affect the area around the baltic, which had experienced several waves of the plague since the black death of the 14th century. however, for some areas, it was the most severe. people died within a few days of first showing symptoms. especially on the eastern coast from prussia to estonia, the average death toll for wide areas was up to two thirds or three quarters of the population, and many farms and villages were left completely desolated. it is, however, hard to distinguish between deaths due to a genuine plague infection and deaths due to starvation and other diseases that spread along with the plague. while buboes are recorded among the symptoms, contemporary means of diagnosis were poorly developed, and death records are often unspecific, incomplete or lost. some towns and areas were affected only for one year, while in other places the plague recurred annually throughout several subsequent years. in some areas, a disproportionally high death toll is recorded for children and women, which may be due to famine and the men being drafted. as the cause of the plague was unknown to contemporaries, with speculations reaching from religious causes over "bad air" to contaminated clothes, the only means of fighting the disease was containment, to separate the ill from the healthy. cordons sanitaire were established around infected towns like stralsund and königsberg; one was also established around the whole duchy of prussia and another one between scania and the danish isles along the sound, with saltholm as the central quarantine station. "plague houses" to quarantine infected people were established within or before the city walls. an example of the latter is the charité of berlin, which was spared from the plague. background local outbreaks of the plague are grouped into three plague pandemics, whereby the respective start and end dates and the assignment of some outbreaks to one or another pandemic are still subject to discussion. according to joseph p. byrne from belmont university, the pandemics were: the first plague pandemic from 541 to ~750, spreading from egypt to the mediterranean (starting with the plague of justinian) and northwestern europe the second plague pandemic from ~1345 to ~1840, spreading from central asia to the mediterranean and europe (starting with the black death), and probably also to china the third plague pandemic from 1866 to the 1960s, spreading from china to various places around the world, notably the us-american west coast and india. however, the late medieval black death is sometimes seen not as the start of the second, but as the end of the first pandemic – in that case, the second pandemic's start would be 1361; the end dates of the second pandemic given in literature also vary, e.g. ~1890 instead of ~1840. the plague during the great northern war falls within the second pandemic, which by the late 17th century had its final recurrence in western europe (e.g. the great plague of london 1666–68) and, in the 18th century final recurrences in the rest of europe (e.g. the plague during the great northern war in the area around the baltic sea, the great plague of marseille 1720–22 in southern europe, and the russian plague of 1770–1772 in eastern europe), being thereafter confined to less severe outbreaks in ports of the ottoman empire until the 1830s. in the late 17th century, the plague had retreated from europe, making a last appearance in northern germany in 1682 and vanishing from the continent in 1684. the subsequent wave hitting europe during the great northern war most probably had its origins in central asia, spreading to europe via anatolia and constantinople in the ottoman empire. georg sticker numbered this epidemic as the "12th period" of plague epidemics, first recorded in ahmedabad in 1683 and until 1724 affecting a territory from india over persia, asia minor, the levant and egypt to nubia and ethiopia as well as to morocco and southern france on the one hand and to east central europe up to scandinavia on the other hand. constantinople was reached in 1685 and remained a site of infection for the subsequent years. sporadically, the plague had entered poland–lithuania since 1697, yet the wave of the plague that met and followed the armies of the great northern war was first recorded in poland in 1702. along with the plague, other diseases like dysentery, smallpox and spotted fever spread during the war, and at least in some regions the population encountered those while starving. already in 1695–1697, a great famine had already struck finland (death toll between a quarter and a third of the population), estonia (death toll about a fifth of the population), livonia, and lithuania (where the famine as well as epidemics and warfare killed half of the population of the grand duchy of lithuania between 1648 and 1697). in addition, the winter of 1708-1709 was exceptionally long and severe; as a result, the winter seed froze to death in denmark and prussia, and the soil had to be plowed and tilled again in the spring. 1702–1706: southern poland by 1702, the armies of charles xii of sweden had repelled and taken up pursuit of the armies of augustus the strong, elector of saxony, king of poland and grand duke of lithuania, defeating them in july at klissow near pińczów on the nida in southern poland. in their military hospital in pińczów, the swedish army suffered its first plague infections of soldiers, recorded on the basis of reports from "trustworthy people from that very land" by danzig (gdańsk) physician johann christoph gottwald. in poland, the plague recurred in various places until 1714. during the following two years, plague broke out in ruthenia, podolia and volhynia, with lviv (lemberg, lwów) suffering around 10,000 plague deaths in 1704 and 1705 (40% of all inhabitants). from 1705 to 1706, occurrences of plague in the polish–lithuanian commonwealth were also recorded in kołomyję (kolomyja, kolomea), stanisławów (stanislaviv, stanislau), stryj (stryi), sambor (sambir), przemyśl, and jarosław. spread in poland–lithuania after 1706 after the swedish incursion, the polish–lithuanian commonwealth was in a state of civil war between the warsaw confederation, supportive of the pro-swedish king stanisław i leszczyński, and the sandomierz confederation, supportive of sweden's adversaries, i.e. the russian tsar and august the strong, who was forced to abdicate in 1706 by charles xii. in 1707, the plague reached cracow, where according to frandsen (2009) 20,000 people died within three years, according to sticker (1905) 18,000 people within two years, most in 1707, and according to burchardt et al. (2009) 12,000 people between 1706 and 1709. from cracow, the plague spread to lesser poland (the surrounding area), mazovia (including the city of warsaw) and great poland with the cities of ostrów, kalisz (kalisch) and poznań (posen). in warsaw, 30,000 people died in annually recurring plague epidemics between 1707 and 1710. poznań lost around 9,000 people, about two thirds of its 14,000 inhabitants, to the plague between 1707 and 1709. in 1708, the plague spread north to the war-torn town of toruń (thorn) in royal prussia, killing more than 4,000 people. when news of the plague in poland arrived in the kingdom of prussia, then still neutral in the war, precautions were taken to prevent it spreading across the border. from 1704, health certificates were compulsory for travellers from poland. from 1707, a broad cordon sanitaire extended around the border of the former duchy of prussia, and those crossing into the prussian exclave were quarantined. yet the border was long and wooded, and not all roads could be guarded; thus bridges were demolished, lesser roads blocked, and orders were given to hang people avoiding the guarded crossings and burn or fumigate all incoming goods. there were, however, many exemptions for people with cross-border estates or occupations, who were allowed to pass freely. spread in the area around the baltic sea 1708–1713 prussia samuel donnet: illustration of the great plague in danzig (gdańsk) 1709, contemporary woodcut with an annotation noting the death toll a few days after a prussian official in soldau forwarded the information that on 18 august 1708 the plague had reached the village of piekielko on the polish side of the border, the epidemic had crossed into the village of bialutten on the prussian side, killing most of its inhabitants within a month. the prussian authorities reacted by containing the village with a palisade; however, the survivors, led by the local reverend, had already taken refuge in the nearby woods. on 13 september 1708, a prussian official from hohenstein reported that the plague had been brought to this small border town by the son of the local hatter returning from polish service. by december, 400 people had died in hohenstein. while the plague faded out during the hard winter, food became scarce due to war contributions and conscription, and the cordon sanitaire and the respective restrictions were lifted by edict on 12 july 1709. in january 1709, the plague reached pillupönen (now nevskoye in kaliningrad oblast) in the rural prussian east, and by the end of the winter it reached danzig (gdansk). danzig, at that time a largely autonomous, protestant and german-speaking town in polish royal prussia, had become one of the greatest towns in the area around the baltic sea due to its position as a hub between polish trade (via the vistula) and international trade (via the baltic sea). while it had so far avoided participation in the war, the conflict had affected it indirectly by a reduction of its trade volume, rising taxes and food shortages. the city council adopted a dual strategy of actively downplaying the plague to the outside world, especially danzig's trading partners, thus keeping the city open and allowing international and local trade to continue with few restrictions, while at the same time the restrictions on burials were eased due to a coffin shortage and the deaths of many grave diggers, plague (pest) houses and new graveyards were designated, and a "health commission" to organize the anti-plague measures was implemented to, for example, collect weekly reports from the physicians and provide the plague victims with food. until the end of may, it seemed that the plague would not be as severe, and the health commission's reports were openly accessible. however, the plague was not contained and spread from the plague houses to the poorer suburbs and surrounding countryside, and starting in early june the death toll rose significantly. the health commission's reports were then declared secret. when the plague faded out by december 1709 never to return to danzig, the town had lost about half of its inhabitants. the next large town to the east of danzig was königsberg in the prussian kingdom, which had so far profited from the war by taking over some of the swedish and polish livonian trade. in preparation for the plague, a collegium sanitatis (health commission) was set up, including physicians from the university and leading civilian and military officials of the town. the plague arrived in august 1709, most probably carried by a danzig sailor. the provincial government was exiled to wehlau while the chancellor, von creytzen, remained in königsberg and continued to work as the chairman of the collegium sanitatis, which met daily. the city walls were manned by the military, the burghers were conscripted into