Why? When you look back at whole populations wiped out by the Black Plague in Europe they were all caused by poor sanitation worldwide especially in the big cities of Europe. Therefore the rats and mice tended to spread the black plague through the food and water and poor sanitation. Once doctors began to understand better the poor sanitation caused by so many people living so close together many more people moved out into the country to farms where sanitation and water and food was less contaminated by feces of rats and mice and other animals and people.
For example, even in 1986 when I went to Kathmandu, Nepal there was dried feces in the dirt roads that gave especially Westerners like ourselves Giardia from the dust. Almost every westerner (white person from places like the Americas and Europe Giardia from the dust. However, that's not the problem in Kathmandu now. Instead now the air pollution is so bad that you can no longer see the Himalayan Mountains from Kathmandu. However, the roads are all paved now so the problem in 1985 likely doesn't exist anymore.
- Death Toll: While 25 million is a common baseline, many scholars now estimate that the total number of deaths in Europe alone was much higher, potentially closer to 50 million due to recent reassessments.
- Total Deaths: Some estimates suggest the plague's global, or wider, death toll, including parts of Asia and North Africa, reached 75 to 200 million.
- Impact: The pandemic led to such high mortality that it prompted massive social and economic changes across Europe, including the decline of feudalism.
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