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The earliest known visitation of the plague to Europe occurred in Athens in 430 B.C. A disastrous epidemic occurred in the Mediterranean during the time of the Roman emperor Justinian; an estimated 25% to 50% of the population is reported to have succumbed. The most widespread epidemic began in Constantinople in 1334, spread throughout Europe (returning Crusaders were a factor), and in less than 20 years is estimated to have killed three quarters of the population of Europe and Asia. The great plague of London in 1665 is recorded in many works of literature. Quarantine measures helped contain the disease, but serious epidemics continued to occur even in the 19th cent. The disease is still prevalent in parts of Asia. In Surat, India, in 1994, 5,000 cases of pneumonic plague were reported in an outbreak; an estimated 100 people died, and over 400,000 people fled the city. Because the number of cases of plague has been increasing annually, it is categorized as a re-emerging infectious disease by the World Health Organization.
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