Summary of the world’s most killer pandemics and epidemics in history

Plagues and epidemics have ravaged humanity throughout its existence sometimes with devastating consequences. They have often changed the course of history and at times, signalled the end of entire civilizations. Below is a brief history of the worst epidemics and pandemics, dating from prehistoric times.

1. Prehistoric epidemic: Circa 3000 B.C.

The discovery of a 5,000-year-old house in China filled with skeletons is evidence of a deadly epidemic.  (Image credit: Photo courtesy Chinese Archaeology)

About 5,000 years ago, an epidemic wiped out a prehistoric village in China. Bodies were found stuffed inside a house that was later burned down. Skeletons of juveniles, young adults and middle-age people were found inside the house an indication that no age group was spared. The archaeological site is now called “Hamin Mangha” and is one of the best-preserved prehistoric sites in northeastern China. Archaeological and anthropological study indicates that the epidemic happened quickly enough that there was no time for proper burials, and the site was not inhabited again. 

2. Plague of Athens: 430 B.C.

Remains of the Parthenon, one of the buildings on the acropolis of Athens. The city experienced a five year pandemic around 430 B.C.  (Image credit: Shutterstock)

Around 430 B.C., not long after a war between Athens and Sparta began, an epidemic ravaged the people of Athens and lasted for five years. Some estimates put the death toll as high as 100,000 people. The Greek historian Thucydides (460-400 B.C.) wrote that “people in good health were all of a sudden attacked by violent heats in the head, and redness and inflammation in the eyes, the inward parts, such as the throat or tongue, becoming bloody and emitting an unnatural and fetid breath” (translation by Richard Crawley from the book “The History of the Peloponnesian War,” London Dent, 1914). 

This epidemic has elicited a lot of debate among the scientific community for centuries. No one is quite sure exactly what disease it was, therefore different possibilities have been put forward including typhoid, fever and Ebola. The devastating effect must have been exacerbated by the wars and overcrowding refugee situations.

3. Antonine Plague: A.D. 165-180

The angel of death striking a door during the plague of Rome. An engraving by Levasseur after Jules-Elie Delaunay

The Antonine Plague of 165 to 180 A.D, also known as the Plague of Galen (after Galen, a Greek physician who lived in the Roman Empire and described it), was an ancient pandemic brought to the Roman Empire by troops who were returning from campaigns in the Near East. Scholars have suspected it to have been either smallpox or measles,but the true cause remains undetermined

The total deaths have been estimated at 5 million with a mortality rate of 25% and the disease killed as much as one third of the population in some areas and devastated the Roman army.

Ancient sources agree that the epidemic appeared first during the Roman siege of Seleucia in the winter of 165–166.

4. Plague of Cyprian: A.D. 250-271

The remains found where a bonfire incinerated many of the victims of an ancient epidemic in the city of Thebes in Egypt.  (Image credit: N.Cijan/Associazione Culturale per lo Studio dell’Egitto e del Sudan ONLUS)

Named after St. Cyprian, a bishop of Carthage (a city in Tunisia) who described the epidemic as signaling the end of the world, the Plague of Cyprian is estimated to have killed 5,000 people a day in Rome alone. In 2014, archaeologists in Luxor found what appears to be a mass burial site of plague victims. Their bodies were covered with a thick layer of lime (historically used as a disinfectant). Archaeologists found three kilns used to manufacture lime and the remains of plague victims burned in a giant bonfire. Experts aren’t sure what disease caused the epidemic. “The bowels, relaxed into a constant flux, discharge the bodily strength [and] a fire originated in the marrow ferments into wounds of the fauces (an area of the mouth),” Cyprian wrote in Latin in a work called “De mortalitate” (translation by Philip Schaff from the book “Fathers of the Third Century: Hippolytus, Cyprian, Caius, Novatian, Appendix,” Christian Classics Ethereal Library, 1885).

5. Plague of Justinian: A.D. 541-542

Saint Sebastian pleads with Jesus for the life of a gravedigger afflicted by plague during the Plague of Justinian. (Josse Lieferinxe, c. 1497–1499)

The Plague of Justinian (541–542 A.D, with recurrences until 750) was a pandemic that afflicted the Byzantine (Eastern Roman) Empire and especially its capital, Constantinople, as well as the Sasanian Empire and port cities around the entire Mediterranean Sea, as merchant ships harbored rats that carried fleas infected with plague. Historians believe the plague of Justinian was one of the deadliest pandemics in history with death toll estimated between 25–100 million people during two centuries of recurrence.

6. The Black Death: 1346-1353

Illustration from Liber chronicarum, 1. CCLXIIII; Skeletons are rising from the dead for the dance of death. (Image credit: Anton Koberger, 1493/Public domain)

The Black Death, also known as the Pestilence and the Plague, was the most fatal pandemic recorded in human history, resulting in the deaths of up to 75–200 million people in Eurasia and North Africa,peaking in Europe from 1347 to 1351. The bodies of victims were buried in mass graves.  Plague, the disease caused by the bacterium Yersinia pestis, was the cause; Y. pestis infection most commonly results in bubonic plague, but can cause septicaemic or pneumonic plagues.

The plague changed the course of Europe’s history. With so many dead, labor became harder to find, bringing about better pay for workers and the end of Europe’s system of serfdom. Studies suggest that surviving workers had better access to meat and higher-quality bread. The lack of cheap labor may also have contributed to technological innovation.

7. Cocoliztli epidemic: 1545-1548

This epidemic was caused by an infection in the form of viral hemorrhagic fever that killed 15 million inhabitants of Mexico and Central America. Among a population already weakened by extreme drought, the disease proved to be utterly catastrophic. “Cocoliztli” is the Aztec word for “pest.” 

A recent study that examined DNA from the skeletons of victims found that they were infected with a subspecies of Salmonella known as S. paratyphi C, which causes enteric fever, a category of fever that includes typhoid. Enteric fever can cause high fever, dehydration and gastrointestinal problems and is still a major health threat today. 

8. American Plagues: 16th century

The American Plagues are a cluster of Eurasian diseases brought to the Americas by European explorers. These illnesses, including smallpox, contributed to the collapse of the Inca and Aztec civilizations. Some estimates suggest that 90% of the indigenous population in the Western Hemisphere was killed off. 

The diseases helped a Spanish force led by Hernán Cortés conquer the Aztec capital of Tenochtitlán in 1519 and another Spanish force led by Francisco Pizarro conquer the Incas in 1532. The Spanish took over the territories of both empires. In both cases, the Aztec and Incan armies had been ravaged by disease and were unable to withstand the Spanish forces. When citizens of Britain, France, Portugal and the Netherlands began exploring, conquering and settling the Western Hemisphere, they were also helped by the fact that disease had vastly reduced the size of any indigenous groups that opposed them. 

9. Great Plague of London: 1665-1666

A model re-enactment of the 1666 Great Fire of London. The fire occured right after the city suffered through a devastating plague.  (Image credit: Shutterstock)

The Black Death’s last major outbreak in Great Britain caused a mass exodus from London, led by King Charles II. The plague started in April 1665 and spread rapidly through the hot summer months. Fleas from plague-infected rodents were one of the main causes of transmission. By the time the plague ended, about 100,000 people, including 15% of the population of London, had died. But this was not the end of that city’s suffering. On Sept. 2, 1666, the Great Fire of London started, lasting for four days and burning down a large portion of the city. 

10. Great Plague of Marseille: 1720-1723

Contemporary painting of Marseille during the Great Plague

Historical records say that the Great Plague of Marseille started when a ship called Grand-Saint-Antoine docked in Marseille, France, carrying a cargo of goods from the eastern Mediterranean. Although the ship was quarantined, plague still got into the city, likely through fleas on plague-infected rodents. 

Over a period of three years the Plague spread quickly. The death toll is estimated to be around 100,000 people. It’s estimated that up to 30% of the population of Marseille may have perished. 

11. Russian Plague: 1770-1772

The City of Moscow was ravaged by the ferocious nature of the Plague, the terrifed quarantined citizens of the City resorted to violence. Riots spread through the city and culminated in the murder of Archbishop Ambrosius, who was encouraging crowds not to gather for worship. By the time the plague ended, as many as 100,000 people may have died.

12. Philadelphia yellow fever epidemic: 1793

This occurred when Philadelphia was United States’ capital, slaves were wrongly assumed to be immune to the infection and therefore people of African origin were recruited in masses to nurse the sick.

The disease is carried and transmitted by mosquitoe bites, which experienced a population boom during the particularly hot and humid summer weather in Philadelphia that year. It wasn’t until winter arrived — and the mosquitoes died out — that the epidemic finally stopped. By then, more than 5,000 people had died.

13. Flu pandemic: 1889-1890

Wood engraving showing nurses attending to patients in Paris during the 1889-90 flu pandemic. The pandemic killed an estimated 1 million people.   (Image credit: Shutterstock)

The earliest cases were reported in Russia. The virus spread rapidly throughout St. Petersburg before it quickly made its way throughout Europe and the rest of the world. It took just five weeks for the epidemic to reach peak mortality. Within the first few months the disease killed around 1 million people around the world.

14. American polio epidemic: 1916

A polio epidemic that started in New York City caused 27,000 cases and 6,000 deaths in the United States. The disease mainly affects children and sometimes leaves survivors with permanent disabilities. 

Polio epidemics occurred sporadically in the United States until the Salk vaccine was developed in 1954. As the vaccine became widely available, cases in the United States declined. The last polio case in the United States was reported in 1979. Worldwide vaccination efforts have greatly reduced the disease, although it is not yet completely eradicated. 

15. Spanish Flu: 1918-1920

Emergency hospital during influenza epidemic, Camp Funston, Kansas.  (Image credit: Otis Historical Archives, National Museum of Health and Medicine)

The Spanish flu, also known as the 1918 flu pandemic, was an unusually deadly influenza pandemic caused by the H1N1 influenza A virus. Lasting about 15 months from spring 1918 (northern hemisphere) to early summer 1919, it infected 500 million people – about a third of the world’s population at the time. The death toll is estimated to have been anywhere from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in human history.

Despite what the name suggests Spanish flu did not originate in Spain and never was Spain the epicenter of the flu. Since Spain was a neutral country during the first world war, there wasn’t media censorship and therefore early information about the illness and rising death toll was initially reported in the country leading to the name Spanish flu.

16. Asian Flu: 1957-1958

Chickens being tested for the avian flu. An outbreak of the avian flu killed 1 million people in the late 1950s.  (Image credit: Shutterstock)

The Asian Flu pandemic had it’s roots in China, the disease claimed more than 1 million lives. The virus that caused the pandemic was a blend of avian flu viruses. 

The Centers for Disease Control and Prevention notes that the disease spread rapidly and was reported in Singapore in February 1957, Hong Kong in April 1957, and the coastal cities of the United States in the summer of 1957. The total death toll was more than 1.1 million worldwide, with 116,000 deaths occurring in the United States alone.

17. AIDS pandemic and epidemic: 1981-present day

HIV/AIDS, or Human Immunodeficiency Virus, is considered by some authors a global pandemic.However, the WHO currently uses the term ‘global epidemic’ to describe HIV. As of 2018, approximately 37.9 million people are infected with HIV globally. Currently, about 64% of the estimated 40 million living with human immunodeficiency virus (HIV) live in sub-Saharan Africa.

A reconstruction of its genetic history shows that the HIV pandemic almost certainly originated in Kinshasa, the capital of the Democratic Republic of the Congo, around 1920. AIDS was first recognized in 1981, in 1983 the HIV virus was discovered and identified as the cause of AIDS, and by 2009 AIDS caused nearly 30 million deaths

For decades, the disease had no known cure, but medication developed in the 1990s now allows people with the disease to experience a normal life span with regular treatment. Even more encouraging, two people have been cured of HIV as of early 2020. 

18. H1N1 Swine Flu pandemic: 2009-2010

The 2009 swine flu pandemic was an influenza pandemic that lasted for about 19 months, from January 2009 to August 2010, and the second of two pandemics involving H1N1 influenza virus (the first being the 1918–1919 Spanish flu pandemic which lasted about 15 months). It was first described in April 2009, the virus appeared to be a new strain of H1N1, which resulted from a previous triple reassortment of bird, swine, and human flu viruses further combined with a Eurasian pig flu virus,leading to the term “swine flu”. The outbreak was first reported in Mexico in the spring of 2009 before spreading to the rest of the world, the virus infected as many as 1.4 billion people across the globe and killed between 151,700 and 575,400 people in one year, according to the CDC.

The disease mainly affected children and young adults, and nearly 80% of the deaths were in people younger than 65. Considering that most strains of flu viruses, including those that cause seasonal flu, cause the highest percentage of deaths in people ages 65 and older, this was viewed unusual. It was the case that older people seemed to have already built up enough immunity to the group of viruses that H1N1 belongs to, so weren’t affected as much. A vaccine for the H1N1 virus that caused the swine flu is now included in the annual flu vaccine. 

19. West African Ebola epidemic: 2014-2016

Health care workers put on protective gear before entering an Ebola treatment unit in Liberia during the 2014 Ebola outbreak. (Image credit: CDC/Sally Ezra/Athalia Christie (Public Domain))

The first known cases of Ebola occurred in Sudan and the Democratic Republic of Congo in 1976, and the virus may have originated in bats. Between 2014 and 2016 the disease devastated parts of West Africa, with 28,600 reported cases and 11,325 deaths. The first case to be reported was in Guinea in December 2013, then the disease quickly spread to Liberia and Sierra Leone. The bulk of the cases and deaths occurred in those three countries. A smaller number of cases occurred in Nigeria, Mali, Senegal, the United States and Europe, the Centers for Disease Control and Prevention reported. 

There is no cure for Ebola, although efforts at finding a vaccine are ongoing.

20. Zika Virus epidemic: 2015-present day

Goldsmith, Cynthia (18 March 2005). TEM image of the Zika virus”. Centers for Disease Control and Prevention.

Zika virus is a member of the virus family Flaviviridae. It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus. Its name comes from the Ziika Forest of Uganda, where the virus was first isolated in 1947. Zika virus is related to the dengue, yellow fever, Japanese encephalitis, and West Nile viruses. Since the 1950s, it has been known to occur within a narrow equatorial belt from Africa to Asia. Zika can spread from a pregnant woman to her baby. This can result in microcephaly, severe brain malformations, and other birth defects. Zika infections in adults may result rarely in Guillain–Barré syndrome.

From 2007 to 2016, the virus spread eastward, across the Pacific Ocean to the Americas, leading to the 2015–2016 Zika virus epidemic. The outbreak began in April 2015 in Brazil, and spread to other countries in South America, Central America, North America, and the Caribbean. It was estimated that 1.5 million people were infected by Zika in Brazil, with over 3,500 cases of microcephaly reported between October 2015 and January 2016. As of August 2017 the number of new Zika virus cases in the Americas had fallen dramatically.

While there is no specific treatment for Zika fever, paracetamol (acetaminophen) and rest may help with the symptoms. As of April 2019, no vaccines have been approved for clinical use, however a number of vaccines are currently in clinical trials.

21. The Coronavirus pandemic 2020 ongoing

The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing pandemic of coronavirus disease 2019 (COVID‑19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). The outbreak was first identified in Wuhan, China, in December 2019. The World Health Organization declared the outbreak a public health emergency of international concern on 30 January, and a pandemic on 11 March. As of 26 May 2020, more than 5.49 million cases of COVID-19 have been reported in more than 188 countries and territories, resulting in more than 346,000 deaths. More than 2.23 million people have recovered from the virus. Europe and United States account for the biggest percentage of cases and deaths, in particular USA, UK, Italy, Spain and France.

The virus is primarily spread between people during close contact, most often via small droplets produced by coughing, sneezing, and talking. Common symptoms include fever, cough, fatigue, shortness of breath, and loss of sense of smell and taste.

Recommended preventive measures include washing hands regularly, covering one’s mouth when coughing, maintaining social distance, wearing a face mask in public settings, and monitoring and self isolation for people who suspect they are infected.

The pandemic has caused global social and economic disruption, including the largest global recession since the Great Depression. It has led to the postponement or cancellation of sporting events, religious, political and cultural gathering.

Antiviral medications are under investigation for COVID-19, as well as medications targeting the immune response. None has yet been shown to be clearly effective on mortality in published randomised controlled trials.

Stay safe, stay alert and defeat Covid 19.

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