Researching the world’s most deadly pandemics, it was interesting to learn that two of the major ones were caused by bacteria: bubonic plague and cholera. The remaining ones have been viral. Circling the News thought it might be interesting to compare the different pandemics: how many people worldwide were infected, how many people were killed by the disease.
BUBONIC PLAGUE or BLACK DEATH (1346-1353)
The plague is caused by bacteria (Yersinia pestis) and usually spread by fleas. It was known as the Black Death during medieval times, and still exists; it can be deadly if not treated promptly with antibiotics. The rarest and deadliest form of the plague affects the lungs and can be spread from person to person.
The estimated death toll was between 75 to 200 million people in Europe, Africa and Asia. No effective vaccine is available. In the United States, plague is rare, but it has been known to occur in several western and southwestern states — primarily New Mexico, Arizona, California and Colorado.
THIS is an infectious disease caused by the bacteria vibrio cholerae, which triggers severe watery diarrhea that can lead to dehydration. The disease is usually found in food or water contaminated by feces from a person with the infection and is most common in places with poor sanitation, crowding, war and famine.
There have been seven deadly cholera pandemics and the third one (1852-1860) produced a death toll of about one million people. It originated in India and spread to Asia, Europe, North America and Africa.
The sixth cholera pandemic, in 1910, also started in India, where it killed more than 800,000 people, before spreading to the Middle East, North Africa, Eastern Europe and Russia.
Officials estimate that this bacterium still causes 28,800 to 130,000 deaths a year, worldwide. Given the lack of sanitary conditions in refugee camps and homeless camps, it can still be deadly.
RUSSIAN FLU (1889-1890)
The 1889-1890 flu pandemic, known as the “Asiatic flu” or “Russian flu,” killed about one million people worldwide. It is often cited as the first modern flu pandemic.
The czar of Russia, the king of Belgium and the emperor of Germany contracted the disease, but all survived.
“Tracing [the flu’s] path, scientists would observe that it tended to follow the major roads, rivers and, most notably, railway lines—many of which hadn’t existed during last major pandemic in the 1840s,” according to the History channel.
The flu came to the U.S. via steamships and spread across the country via people traveling by trains.
“Persons with weak lungs and those suffering from heart disease or kidney troubles are most seriously affected, and in many cases the influenza leads quickly to pneumonia,” the New York Tribune reported in 1890.
The total U.S. death toll was just under 13,000, according to the U.S. Census Office.
SPANISH INFUENZA (1918-2020)
The Spanish flu, also known as the 1918 influenza pandemic, infected about 500 million people, which then was a quarter of the world’s population. The virus strain is the H1N1, with genes of avian origin.
Deaths were estimated between 17-50 million, with about 675,000 occurring in the United States. Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality (2.5 percent) in healthy people, including those in the 20-40-year-old age group, was a unique feature of this pandemic.
There was a shortage of hospital facilities and staff, because of the number of military men being treated with wounds and from mustard gas burns incurred during World War I.
Many doctors were with the troops, which left medical students to care for the sick in the U.S. Third- and fourth-year medical school classes were closed, and the students assigned jobs as interns or nurses.
Additionally, doctors and nurses fell victim to the epidemic. In the U.S., the Red Cross created a National Committee on Influenza to mobilize all forces to fight Spanish influenza. In some areas of the U.S., the nursing shortage was so acute that the Red Cross had to ask local businesses to allow workers to have the day off if they volunteered in the hospitals at night.
Emergency hospitals were created. The public health departments distributed gauze masks to be worn in public. Stores could not hold sales and funerals were limited to 15 minutes. Some towns required a signed certificate to enter and railroads would not accept passengers without them.
Those who ignored the flu ordinances had to pay steep fines enforced by extra officers. Besides the lack of health care workers and medical supplies, there was a shortage of coffins, morticians and gravediggers.
ASIAN FLU (1956-1958)
The Asian flu (Influenza A, subtype H2N2) originated most likely from strains of avian and human influenza viruses. It was first identified in China in Guizhou province in February 1957 and reached the United States in June 1957, causing about 70,000 deaths. Estimates for total death varies, but the World Health Organization places it about two million deaths.
The 1957 outbreak was associated with variations in susceptibility and symptoms: some people had minor symptoms, such as cough and mild fever, others experienced life-threatening complications such a pneumonia.
This pandemic is considered to be the least severe of the three influenza pandemics of the 20th century.
The H2N2 virus underwent modification and produced a new subtype H3N2, which gave rise to the 1968 flu pandemic.
HONG KONG FLU (1968-1969)
The Hong Kong flu pandemic was caused by an influenza A (H3N2) virus comprised of two genes from an avian influenza A virus, but also contained the N2 neuraminidase from the 1957 H2N2 virus. It was estimated that about one to four million people died world-wide.
The first case was reported in July 1968 in Hong Kong, and 17 days later there were outbreaks in Singapore and Vietnam. About 500,000 residents of Hong Kong died, which was about 15 percent of its population at the time.
The flu first came to the United States in 1968, with about 100,000 deaths and those in the 65+ ages most affected.
The human immunodeficiency virus causes AIDS (acquired immunodeficiency syndrome) and interferes with the body’s ability to fight infections. It has killed more than 36 million people since 1981.
Thanks to better antiviral treatments, most people with HIV in the U.S. today don’t develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.
The disease is sexually transmitted but can also be spread by contact with infected blood, hypodermic needles from mother to child during pregnancy, childbirth or breast-feeding.
The primary causes of death from HIV/AIDS are opportunistic infections and cancer, both of which can happen with a failure of the immune system.
Experts believe that the virus started in West Africa and spread from chimpanzees to humans, most likely during “bush meat trading.” Either the hunters ate infected chimps or chimps’ infected blood got into the cuts or wounds of hunters. It is thought the virus spread from Africa to Haiti and then the Caribbean, arriving in the United States in the 1980s.
At the end of 2017, about 36.9 million people worldwide were living with HIV/AIDS and 940,000 people died from AIDS-related illnesses that year, according to the World Health Organization. About 658,507 people in the U.S. with an AIDS diagnosis have died since the first diagnosis.
In 2019, President Trump announced a plan to ending the HIV epidemic here, because about 14 percent of Americans don’t know they have HIV and an estimated 55 percent of young people, aged 13-24, were unaware of their infection.
On December 1, 2019, the first case of a novel coronavirus was documented in the Wuhan region of China by the World Health Organization, although there are some reports it may have occurred earlier.
A coronavirus is a type of virus that is found in animals and can be transmitted from animals to humans, then from person to person.
Mostly likely this virus was found in bats and may have been transmitted to pangolins and then humans. (Other human coronaviruses have included MERS-Middle East respiratory syndrome – most likely from dromedary camels; and SARS-Guangdong province in southern China – most likely bat to civet cats to humans.)
This virus spread incredibly rapidly because it was new, and no one had developed immunity.
Symptoms include fever, cough, shortness of breath and in severe cases, patients have pneumonia in both lungs, multi-organ failure and death.
As of April 7, 1.4 million cases have been reported around the world, with 81,978 deaths reported. The total reported cases in the United States are 395,739 with deaths reported at 12,796.
Dr. Anthony Fauci, the top American infectious disease specialist, was quoted on April 4 in Time magazine: “Unless we get this globally under control, there is a very good chance that it will assume a seasonal nature in the sense that if – and I hope it’s not only if but when – we get it down to a point where it is really at a low level, we need to be prepared.
“Since it will be unlikely to be completely eradicated from the planet, as we get into next season, we may see the beginning of a resurgence. And that’s why we’re pushing so hard to get our preparedness much better than it was but, importantly, pushing on a vaccine and doing clinical trials for therapeutic interventions so that hopefully, if in fact we do see that resurgence, we will have interventions that we did not have in the beginning of the situation that we’re in right now”
SMALLPOX AND POLIO
SMALLPOX is thought to have emerged in human populations in 10,000 BC. It is estimated that smallpox, caused by the variola virus, was responsible for 300-500 million deaths. As late as 1967, the WHO estimated that 15 million people contracted the disease and that two million died in that year.
“The Spanish inadvertently owe much of their success in conquering the Aztecs and Incas in Mexico in the 16th century, thanks to smallpox,” the BBC wrote.
There is no cure and no treatment for smallpox. There is a vaccine to prevent smallpox, but there are side effects.
Immunity or partial immunity after a smallpox vaccine may last up to 10 years, and 20 years with revaccination. If an outbreak ever occurred, people who were vaccinated as children would still likely receive a new vaccination after direct exposure to someone with the virus.
WHO certified the global eradiction of smallpox in December 1979. In 1984, smallpox virus samples were moved to two laboratories, one in Russia and one in America.
POLIO is caused by the pliovirus, which spreads from person to person and can infect a person’s spinal cord, causing paralysis. Franklin D. Roosevelt contracted polio 12 years before he became president but concealed the extent to which he had suffered.
In the late 1940s, polio outbreaks in the U.S. crippled an average of more than 35,000 people each year.
In 1952, nearly 60,000 were infected, thousands were paralyzed and 3,000 died. In 1955, the U.S. began to vaccinate and by 1979, the virus had been completely eliminated from this country.
Pulitzer Prize-winning author Richard Rhodes wrote in “A Hole in the World” that “Polio was a plague. One day you had a headache and an hour later you were paralyzed. How far the virus crept up your spine determined whether you could walk afterward or even breathe. Parents waited fearfully every summer to see if it would strike. One case turned up and then another. The count began to climb. The city closed the swimming pools and we all stayed home, cooped indoors, shunning other children. Summer seemed like winter then.”
It’s interesting to note that the current coronavirus is the first pandemic where entire populations have access to social media, which allows for better information: it also allows for more misinformation.
The easy access to Twitter, Facebook, Instagram and Nextdoor also allows people to feed on each other’s fears and causes otherwise rational people to start to panic and lash out at others.
(Editor’s note: I used several online sources to compile the information in this story, including mphonline.org, mayoclinic.org, webmd.com, history.com, cdc.gov, virus.stanford.edu, Britannica.com, worldometers.info, familydoctor.org, who.int/ith/diseases, bbc.co.uk and npr.org/secionts/health-shots).
National Archives at College Park, MD
National Archives at Fort Worth
Black plague – genetic literacy project
CirculatNow from NLM-NIH
From The French Satirical Publication Le Grelot. 12th January 1890.