The English Sweating Sickness
I came across a review article entitled “The sweating sickness in Tudor England: a plague of the Renaissance,” which was published in the journal Hektoen International. Outbreaks with these signs and symptoms were described periodically in historical accounts throughout the 15th and 16th centuries, but has not reappeared since. Descriptions of the outbreaks can potentially shed light on the basis of the disease. The outbreaks were renowned for the speed with which they arose, as well as how quickly they disappeared. Additionally, it seemed to be an English malady exclusively.
An eyewitness description by Richard Grafton in 1569 stated:
A new kind of sickness…through the whole region, which was so sore, so painful and sharp, that the like was never heard of to anyone’s remembrance before that time.
The main signs of the disease were pronounced sweating, flushed appearance, headache and other pain, which repeated several times as the disease recurred. Death was frequently due to dehydration.
Charles Creighton, in his History of epidemics in Britain, noted that the initial outbreak of the sweating sickness coincided with Henry VII’s invasion of England to take the crown from Richard III in 1485. Much of Henry’s army was composed of French mercenaries, who potentially were carriers of the disease. Creighton postulated that populations from continental Europe including France were essentially immune to the disease, due to generations of prior exposure. The isolation of the British Isles resulted in a population that had no previous exposure to the agent, so that when Henry brought the French troops into London, they also brought an infectious agent that the population had no innate defenses against. This resulted in periodic outbreaks that ravaged the population for a period of time until a measure of immunity was built up.
Several historians have postulated on the nature of the infectious agent, but no clear consensus has emerged to match a specific pathogenic agent with the described signs and symptoms. McSweegan in 2004 noted the similarity between reports of sweating sickness, and the presentation of disease during the anthrax terrorist attacks of 2001. Analysis of buried remains could implicate the presence of anthrax spores in tissue, a technique which has previously effectively been used to map the change in virulence of the agent of Bubonic Plague. Other investigators have noted the similarities between sweating sickness and presentation of disease due to hantavirus, or any of a number of arbovirus-based diseases such as Yellow Fever.
To date, no clear front runner candidate pathogen has emerged to explain the origin of the outbreaks. The speed with which it emerged as well as how it vanished suggests that it was a novel infection to the population, that was introduced by a rapidly growing population that had little innate resistance. Remains of victims with demonstrated provenance might help to shed light on potential causes of the disease, however many agents (particularly viral agents) would likely not be in recoverable form at this point.