During the Great Northern War (1700–1721), many towns and areas of the Circum-Baltic and East Central Europe suffered from a severe outbreak of the plague with a peak from 1708 to 1712. This epidemic was probably part of a pandemic affecting an area from Central Asia to the Mediterranean. Most probably via Constantinople, it spread to Pinczów in southern Poland, where it was first recorded in a Swedish military hospital in 1702. The plague then followed trade, travel and army routes, reached the Baltic coast at Prussia in 1709, affected areas all around the Baltic Sea by 1711 and reached Hamburg by 1712. Therefore, the course of the war and the course of the plague mutually affected each other: while soldiers and refugees were often agents of the plague, the death toll in the military as well as the depopulation of towns and rural areas sometimes severely impacted the ability to resist enemy forces or to supply troops.