Cramped space makes disease easier to transmute from person to person, making the impact larger than a smaller population over a faster amount of time before people can have the chance to develop immunities. With more people and animals producing waste faster than can be properly dealt with, some animal borne diseases transfered to humans. Animals also carried parasites which compounded in moist geography and areas that were developed with irrigation.
Large production of resources and established settlements made trade more common and easier even across broad distances. Remaining nomadic groups would travel from settlement to settlement with not only goods but also carried diseases with them between populations. This pattern had many different effects, including weeding out the weak, crippling a settlement against invasions, or even completely wiping them out.
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