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In real history, I believe it was mites and/or fleas on the rats that carried the plague.
https://www.youtube.com/watch?v=JzY9TaNUBHo
For example, the game doesn't tell you where babies come from in Dunwall, but you could probably assume they come from the same places as in real life.
Fleas was my first guess, I just didn't know if it was lore or not. Thanks for the answers, though.
https://m.youtube.com/watch?v=15rCw2uOAqQ