The first cases of plague in this outbreak were detected in the capital Valletta,[1] among family members of Paulus Emilius Ramadus,[2] the Port Chief Sanitary Officer. It is suspected that the latter had handled refuse material from the 1592–1593 epidemic which might have been infected, causing the 1623 outbreak.[1] The disease subsequently spread to a number of other households.[2]
Containment measures
In the 1623 outbreak health authorities implemented strict measures which managed to successfully contain the spread of the disease. Sanitary Commissioners isolated people who had been infected and those who came in contact with them on Bishop's Island in Marsamxett Harbour. Houses of infected people were guarded, and restrictions were imposed on movement between Valletta and the rest of the island. Congregations were prohibited, and other containment measures included the banning of cloaks, which were believed to facilitate contact between people.[1]
Impact
The outbreak caused the deaths of either 40[1] or 45[2] people.