Published online by Cambridge University Press: 28 October 2009
As we have seen, the plague in London in the later part of the 16th century broke out sporadically and the epidemics steadily increased in intensity whilst it grumbled on in the interepidemic years (section 6.2), becoming endemic in the 17th century with outbreaks of unparalleled ferocity and mortality (Chapter 8). Meanwhile, there were many reports of widespread outbreaks scattered through the provinces throughout the 16th century (section 6.3). Parish registers were required by law to record burials from pestilence during the Elizabethan period but even though these provide a great deal of invaluable information (much of which has still to be extracted and analysed), it is difficult to discern a pattern in the underlying epidemiology of these outbreaks in the provinces. In general, these provincial outbreaks do not appear to have come from a focus in London. Were there many introductions of the disease via the Kent coast (e.g. in 1532), the south coasts (e.g. in 1544 and 1590) and the East Anglian ports (e.g. in 1585), or was the infection grumbling on through the century with low infectivity (R0 ≤ 1) but spread widely by apparently healthy carriers (because of the long incubation period), with epidemics flaring up when and where the conditions were right? Improved communications and much wider travel associated with the wool trade would have exacerbated the spread (see discussion in section 13.9).
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