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Despite the historical significance of the disease, the mechanisms underlying the spread of plague in Europe are poorly understood. While it is commonly assumed that rats and their fleas spread plague during the Second Pandemic, there is little historical and archaeological support for such a claim. Here, we show that human ectoparasites, like body lice and human fleas, might be more likely than rats to have caused the rapidly developing epidemics in pre-Industrial Europe. Such an alternative transmission route explains many of the notable epidemiological differences between historical and modern plague epidemics.<\/jats:p>","DOI":"10.1073\/pnas.1715640115","type":"journal-article","created":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T11:39:24Z","timestamp":1516102764000},"page":"1304-1309","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":149,"title":["Human ectoparasites and the spread of plague in Europe during the Second Pandemic"],"prefix":"10.1073","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2262-0385","authenticated-orcid":false,"given":"Katharine R.","family":"Dean","sequence":"first","affiliation":[{"name":"Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, N-0316 Oslo, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Krauer","sequence":"additional","affiliation":[{"name":"Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, N-0316 Oslo, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Wall\u00f8e","sequence":"additional","affiliation":[{"name":"Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, N-0317 Oslo, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3565-4912","authenticated-orcid":false,"given":"Ole Christian","family":"Lingj\u00e6rde","sequence":"additional","affiliation":[{"name":"Department of Computer Science, University of Oslo, N-0316 Oslo, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Bramanti","sequence":"additional","affiliation":[{"name":"Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, N-0316 Oslo, Norway;"},{"name":"Department of Biomedical and Specialty Surgical Sciences, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 35-441221 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils Chr.","family":"Stenseth","sequence":"additional","affiliation":[{"name":"Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, N-0316 Oslo, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris V.","family":"Schmid","sequence":"additional","affiliation":[{"name":"Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, N-0316 Oslo, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2018,1,16]]},"reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-024-0890-4_1"},{"key":"e_1_3_3_2_2","volume-title":"Plague Manual: Epidemiology, Distribution, Surveillance and Control","author":"Dennis DT","year":"1999","unstructured":"DT Dennis, Plague Manual: Epidemiology, Distribution, Surveillance and Control (WHO, Geneva, 1999)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2101.140564"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70438-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1004.030509"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jas.2012.12.007"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0025727300072094"},{"key":"e_1_3_3_8_2","volume-title":"The Black Death Transformed: Disease and Culture in Early Renaissance Europe","author":"Cohn SK","year":"2002","unstructured":"SK Cohn The Black Death Transformed: Disease and Culture in Early Renaissance Europe (Oxford Univ Press, London, 2002)."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/1.3.563"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2307\/204499"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.2016.0618"},{"key":"e_1_3_3_12_2","first-page":"874","article-title":"Reports on the plague investigations in India. 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