Control Measures of a 400-Year-Old Plague Epidemic: An Example of Past Efficiency at Controlling Disease and Similarities with Current Epidemics

The plague caused by the bacterium Yersinia pestis, provides one of the best historical examples of pan- demic infection. It can therefore be considered the first “globalized” disease, thanks also to the crowds that favoured the rebalancing of infectious agents between Europe and the Middle East. In this paper we analyse all the official documents of the time, highlighting the most effective prevention measures implemented in the city of Ferrara during the Italian plague. Historical mortality data for the 1630 Italian plague in northern Italy are first analysed. In contrast to the high rates recorded throughout the area from Milan to Florence, the mortality rate in Fer- rara remained normal over the period. From the city’s documents it emerged that the authorities, from the 16th century onwards, had already understood that the spread of the contagion could also occur through domestic animals, although rats are never mentioned. The strength of Ferrara’s response to the “plague emer- gency” stems from an efficient and emergency-ready health control system, financed and supported by the “permanent surveillance team of the city and the Pon- tifical Legation of Ferrara - Azienda Sanitaria Pubblica” even in times of great economic difficulty for the State. Among the various measures that the city of Ferrara adopted to deal with the plague the following should be mentioned: guards at the city gates, lazarettos, safe- ty of doctors, self-isolation and treatment of every sus- picious case as if it were a real case of plague, meas- ures to support the poorer classes of the population, veterinary and hygiene standards for the city and for housing, management of Catholic religious functions and the precepts of the Legation of Ferrara, which was under papal control, closure of churches to avoid mass gatherings, and limitations of all kinds of social and economic relations within and outside the population. The broad regimen, laid down in the 16th century, con- tains extremely modern health rules which are very much in line with those recommended by the WHO and the health authorities of each individual state in the current COVID-19 pandemic, even starting with hand-washing. The fight against epidemics of the past, especially the history of the plague in the 17th centu- ry, anticipates very important and valid concepts, and represents a wake-up call for the recent epidemics of emerging pathogens.