In 165-166 CE, Roman soldiers returning from the siege of Seleucia on the Tigris brought a disease, likely smallpox based on symptoms described by Galen, westward through the empire. The epidemic spread along military and trade routes from Mesopotamia to Gaul and the Rhine frontier. Contemporary sources recorded mortality rates reaching 2,000 deaths per day in Rome at the epidemic peak. Scholars estimate total deaths at 5 to 10 million over a 15-year period, representing approximately 7-10 percent of the empire population. The outbreak weakened frontier garrisons and contributed to economic contraction during the later reign of Marcus Aurelius.