The English sweating sickness, 1485-1551: a viral pulmonary disease?

A recent article in this journal describes an analysis of the 1551 outbreak of the sweating sickness.1 Dr Dyer's research, based on 680 extant parish registers, represents to date the most comprehensive and detailed analysis of the demographic impact of any of the five outbreaks of the sweating sickness of 1485, 1508, 1517, 1528 and 1551. Furthermore, his article supersedes previous analyses of the demographic impact of the sweating sickness based on either parish registers2 or testamentary evidence.3 Contemporary impressions of strong age, class, and sex predispositions of the victims of the sweating sickness to young, rich males are modified to give a more dispassionate and informed picture. He also shows how the sweating sickness was predominantly a rural rather than an urban disease, with a limited overall demographic impact, and that there may have been occurrences outside the five "classic" epidemic years.4 This extensive demographic material is then used to provide a fuller epidemiological explanation for the aetiology of the sweating sickness. The underlying hypothesis is that the causative agent of the sweating sickness was spread by human-to-human contact as well as initially through a zoonosis or an environmental vector. This suggestion of humanto-human transmission stems from two aspects of the register data: first, the observable sequences of gender biases and intra-familial trends of mortalities at a parish level, and secondly from the spread of the epidemic at a national level. Dyer shows that when London was affected in the early weeks of July there was a distinct male preponderance of victims, although the total number of deaths was not strikingly high. This male preponderance was not always paralleled outside the capital, however; Dyer observes that in rural parishes mortalities due to the sweating sickness