###Answer the question from the input provided. Please answer from input only.

###Input: From Italy, the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east through Germany and Scandinavia from 1348 to 1350. It was introduced in Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland. Finally it spread to northwestern Russia in 1351. The plague was somewhat less common in parts of Europe that had smaller trade relations with their neighbours, including the Kingdom of Poland, the majority of the Basque Country, isolated parts of Belgium and the Netherlands, and isolated alpine villages throughout the continent.

The plague struck various countries in the Middle East during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. As it spread to western Europe, the disease entered the region from southern Russia also. By autumn 1347, the plague reached Alexandria in Egypt, probably through the port's trade with Constantinople, and ports on the Black Sea. During 1347, the disease travelled eastward to Gaza, and north along the eastern coast to cities in Lebanon, Syria and Palestine, including Ashkelon, Acre, Jerusalem, Sidon, Damascus, Homs, and Aleppo. In 1348–49, the disease reached Antioch. The city's residents fled to the north, most of them dying during the journey, but the infection had been spread to the people of Asia Minor.[citation needed]

Gasquet (1908) claimed that the Latin name atra mors (Black Death) for the 14th-century epidemic first appeared in modern times in 1631 in a book on Danish history by J.I. Pontanus: "Vulgo & ab effectu atram mortem vocatibant. ("Commonly and from its effects, they called it the black death"). The name spread through Scandinavia and then Germany, gradually becoming attached to the mid 14th-century epidemic as a proper name. In England, it was not until 1823 that the medieval epidemic was first called the Black Death.

Medical knowledge had stagnated during the Middle Ages. The most authoritative account at the time came from the medical faculty in Paris in a report to the king of France that blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air". This report became the first and most widely circulated of a series of plague tracts that sought to give advice to sufferers. That the plague was caused by bad air became the most widely accepted theory. Today, this is known as the Miasma theory. The word 'plague' had no special significance at this time, and only the recurrence of outbreaks during the Middle Ages gave it the name that has become the medical term.

The dominant explanation for the Black Death is the plague theory, which attributes the outbreak to Yersinia pestis, also responsible for an epidemic that began in southern China in 1865, eventually spreading to India. The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin, after whom the pathogen was named Yersinia pestis. The mechanism by which Y. pestis was usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage results in starvation and aggressive feeding behaviour by the fleas, which repeatedly attempt to clear their blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts, keeping the disease endemic, and a second that lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic.



###Question: What effect did the plague have on the Middle East?

###Answer: {'answer':'serious depopulation and permanent change in both economic and social structures'}