Pandemic

Pandemic

Overview
A pandemic is an epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

 of infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

 that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics
Influenza pandemic
An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in...

 generally exclude recurrences of seasonal flu. Throughout history there have been a number of pandemics, such as smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

.
Discussion
Ask a question about 'Pandemic'
Start a new discussion about 'Pandemic'
Answer questions from other users
Full Discussion Forum
 
Recent Discussions
Encyclopedia
A pandemic is an epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

 of infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

 that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics
Influenza pandemic
An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in...

 generally exclude recurrences of seasonal flu. Throughout history there have been a number of pandemics, such as smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

. More recent pandemics include the HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 pandemic and the H1n1 pandemic.

Definition and stages


The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 (WHO) produce a six-stage classification that describes the process by which a novel influenza virus moves from the first few infections in humans through to a pandemic. This starts with the virus mostly infecting animals, with a few cases where animals infect people, then moves through the stage where the virus begins to spread directly between people, and ends with a pandemic when infections from the new virus have spread worldwide.

A disease or condition is not a pandemic merely because it is widespread or kills many people;it must also be infectious. For instance, cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 is responsible for many deaths but is not considered a pandemic because the disease is not infectious or contagious.

In a virtual press conference in May 2009 on the influenza pandemic Dr Keiji Fukuda, Assistant Director-General ad Interim for Health Security and Environment, WHO said "An easy way to think about pandemic ... is to say: a pandemic is a global outbreak. Then you might ask yourself: “What is a global outbreak”? Global outbreak means that we see both spread of the agent ... and then we see disease activities in addition to the spread of the virus."

In planning for a possible influenza pandemic the WHO published a document on pandemic preparedness guidance in 1999, revised in 2005 and in February 2009, defining phases and appropriate actions for each phase in an aide memoir entitled WHO pandemic phase descriptions and main actions by phase. The 2009 revision, including definitions of a pandemic and the phases leading to its declaration, were finalized in February 2009. The pandemic H1N1 2009 virus, was neither on the horizon at that time nor mentioned in the document All versions of this document refer to influenza. The phases are defined by the spread of the disease; virulence
Virulence
Virulence is by MeSH definition the degree of pathogenicity within a group or species of parasites as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. The pathogenicity of an organism - its ability to cause disease - is determined by its...

 and mortality
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...

 are not mentioned in the current WHO definition, although these factors have previously been included.

HIV and AIDS



HIV spread to the United States and much of the rest of the world beginning around 1969. HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

, the virus that causes AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

, is currently a pandemic, with infection rates as high as 25% in southern and eastern Africa. In 2006 the HIV prevalence rate among pregnant women in South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...

 was 29.1%. Effective education about safer sexual practices and bloodborne infection precautions training have helped to slow down infection rates in several African countries sponsoring national education programs. Infection rates are rising again in Asia and the Americas. AIDS could kill 31 million people in India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

 and 18 million in China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

 by 2025, according to projections by U.N. population researchers. AIDS death toll in Africa
Africa
Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...

 may reach 90-100 million by 2025.

Pandemics and notable epidemics through history


There have been a number of significant pandemics recorded in human history
History
History is the discovery, collection, organization, and presentation of information about past events. History can also mean the period of time after writing was invented. Scholars who write about history are called historians...

, generally zoonoses
Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...

 which came about with domestication
Domestication
Domestication or taming is the process whereby a population of animals or plants, through a process of selection, becomes accustomed to human provision and control. In the Convention on Biological Diversity a domesticated species is defined as a 'species in which the evolutionary process has been...

 of animals, such as influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

 and tuberculosis. There have been a number of particularly significant epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

s that deserve mention above the "mere" destruction of cities:
  • Plague of Athens
    Plague of Athens
    The Plague of Athens was a devastating epidemic which hit the city-state of Athens in ancient Greece during the second year of the Peloponnesian War , when an Athenian victory still seemed within reach. It is believed to have entered Athens through Piraeus, the city's port and sole source of food...

    , 430 BC. Typhoid fever
    Typhoid fever
    Typhoid fever, also known as Typhoid, is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica, serovar Typhi...

     killed a quarter of the Athenian troops, and a quarter of the population over four years. This disease fatally weakened the dominance of Athens
    Athens
    Athens , is the capital and largest city of Greece. Athens dominates the Attica region and is one of the world's oldest cities, as its recorded history spans around 3,400 years. Classical Athens was a powerful city-state...

    , but the sheer virulence of the disease prevented its wider spread; i.e. it killed off its hosts at a rate faster than they could spread it. The exact cause of the plague was unknown for many years. In January 2006, researchers from the University of Athens analyzed teeth recovered from a mass grave
    Mass grave
    A mass grave is a grave containing multiple number of human corpses, which may or may not be identified prior to burial. There is no strict definition of the minimum number of bodies required to constitute a mass grave, although the United Nations defines a mass grave as a burial site which...

     underneath the city, and confirmed the presence of bacteria
    Bacteria
    Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

     responsible for typhoid.
  • Antonine Plague
    Antonine Plague
    The Antonine Plague, AD 165–180, also known as the Plague of Galen, who described it, was an ancient pandemic, either of smallpox or measles, brought back to the Roman Empire by troops returning from campaigns in the Near East...

    , 165–180. Possibly smallpox brought to the Italian peninsula by soldiers returning from the Near East; it killed a quarter of those infected, and up to five million in all. At the height of a second outbreak, the Plague of Cyprian
    Plague of Cyprian
    The Plague of Cyprian is the name given to a pandemic, probably of smallpox, that afflicted the Roman Empire from AD 250 onwards. It was still raging in 270, when it claimed the life of emperor Claudius II Gothicus . The plague caused widespread manpower shortages in agriculture and the Roman army....

     (251–266), which may have been the same disease, 5,000 people a day were said to be dying in Rome
    Rome
    Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...

    .
  • Plague of Justinian
    Plague of Justinian
    The Plague of Justinian was a pandemic that afflicted the Eastern Roman Empire , including its capital Constantinople, in 541–542 AD. It was one of the greatest plagues in history. The most commonly accepted cause of the pandemic is bubonic plague, which later became infamous for either causing or...

    , from 541 to 750, was the first recorded outbreak of the bubonic plague
    Bubonic plague
    Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

    . It started in Egypt
    Egypt
    Egypt , officially the Arab Republic of Egypt, Arabic: , is a country mainly in North Africa, with the Sinai Peninsula forming a land bridge in Southwest Asia. Egypt is thus a transcontinental country, and a major power in Africa, the Mediterranean Basin, the Middle East and the Muslim world...

    , and reached Constantinople
    Constantinople
    Constantinople was the capital of the Roman, Eastern Roman, Byzantine, Latin, and Ottoman Empires. Throughout most of the Middle Ages, Constantinople was Europe's largest and wealthiest city.-Names:...

     the following spring, killing (according to the Byzantine chronicler Procopius
    Procopius
    Procopius of Caesarea was a prominent Byzantine scholar from Palestine. Accompanying the general Belisarius in the wars of the Emperor Justinian I, he became the principal historian of the 6th century, writing the Wars of Justinian, the Buildings of Justinian and the celebrated Secret History...

    ) 10,000 a day at its height, and perhaps 40% of the city's inhabitants. The plague went on to eliminate a quarter to a half of the human population that it struck throughout the known world. It caused Europe's population
    Medieval demography
    This article discusses human demography in Europe during the Middle Ages, including population trends and movements. Demographic changes helped to shape and define the Middle Ages...

     to drop by around 50% between 550 and 700.
  • Black Death
    Black Death
    The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

    , started 14th century. The total number of deaths worldwide is estimated at 75 million people. Eight hundred years after the last outbreak, the plague returned to Europe
    Europe
    Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

    . Starting in Asia
    Asia
    Asia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.7% of the Earth's total surface area and with approximately 3.879 billion people, it hosts 60% of the world's current human population...

    , the disease reached Mediterranean and western Europe in 1348 (possibly from Italian merchants fleeing fighting in the Crimea
    Crimea
    Crimea , or the Autonomous Republic of Crimea , is a sub-national unit, an autonomous republic, of Ukraine. It is located on the northern coast of the Black Sea, occupying a peninsula of the same name...

    ), and killed an estimated 20 to 30 million Europeans in six years; a third of the total population, and up to a half in the worst-affected urban areas. It was the first of a cycle of European plague epidemics that continued until the 18th century. During this period, more than 100 plague epidemics swept across Europe. In England, for example, epidemics would continue in two to five-year cycles from 1361 to 1480. By the 1370s, England's population was reduced by 50%. The Great Plague of London
    Great Plague of London
    The Great Plague was a massive outbreak of disease in the Kingdom of England that killed an estimated 100,000 people, 20% of London's population. The disease is identified as bubonic plague, an infection by the bacterium Yersinia pestis, transmitted through a flea vector...

     of 1665–66 was the last major outbreak of the plague in England
    Black Death in England
    The pandemic known to history as the Black Death entered England in 1348, and killed between a third and more than half of the nation's inhabitants. The Black Death was the first and most severe manifestation of the Second Pandemic, probably caused by the Yersinia pestis bacteria. Originating in...

    . The disease killed approximately 100,000 people, 20% of London's population.
  • Third Pandemic, started in China in the middle of the 19th century, spreading plague to all inhabited continents and killing 10 million people in India alone. During this pandemic, the United States saw its first case of plague in 1900 in San Francisco. Today, isolated cases of plague are still found in the western United States.


Encounters between European explorers and populations in the rest of the world often introduced local epidemics of extraordinary virulence. Disease killed part of the native population of the Canary Islands
Canary Islands
The Canary Islands , also known as the Canaries , is a Spanish archipelago located just off the northwest coast of mainland Africa, 100 km west of the border between Morocco and the Western Sahara. The Canaries are a Spanish autonomous community and an outermost region of the European Union...

 in the 16th century (Guanches
Guanches
Guanches is the name given to the aboriginal Berber inhabitants of the Canary Islands. It is believed that they migrated to the archipelago sometime between 1000 BCE and 100 BCE or perhaps earlier...

). Half the native population of Hispaniola
Hispaniola
Hispaniola is a major island in the Caribbean, containing the two sovereign states of the Dominican Republic and Haiti. The island is located between the islands of Cuba to the west and Puerto Rico to the east, within the hurricane belt...

 in 1518 was killed by smallpox. Smallpox also ravaged Mexico
Mexico
The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...

 in the 1520s, killing 150,000 in Tenochtitlán alone, including the emperor, and Peru
Peru
Peru , officially the Republic of Peru , is a country in western South America. It is bordered on the north by Ecuador and Colombia, on the east by Brazil, on the southeast by Bolivia, on the south by Chile, and on the west by the Pacific Ocean....

 in the 1530s, aiding the European conquerors. Measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...

 killed a further two million Mexican natives in the 17th century. In 1618–1619, smallpox wiped out 90% of the Massachusetts Bay
Massachusetts Bay
The Massachusetts Bay, also called Mass Bay, is one of the largest bays of the Atlantic Ocean which forms the distinctive shape of the coastline of the U.S. state of Massachusetts. Its waters extend 65 miles into the Atlantic Ocean. Massachusetts Bay includes the Boston Harbor, Dorchester Bay,...

 Native Americans. During the 1770s, smallpox killed at least 30% of the Pacific Northwest
Pacific Northwest
The Pacific Northwest is a region in northwestern North America, bounded by the Pacific Ocean to the west and, loosely, by the Rocky Mountains on the east. Definitions of the region vary and there is no commonly agreed upon boundary, even among Pacific Northwesterners. A common concept of the...

 Native Americans. Smallpox epidemics in 1780–1782
North American smallpox epidemic
The 1775–1782 North American smallpox epidemic was a smallpox epidemic that spread across most of the continent of North America. The epidemic coincided with the years of the American Revolutionary War , which was gripping much of the continent from the colonies, western frontiers, and southern...

 and 1837–1838
1837-38 smallpox epidemic
The smallpox epidemic that ravaged the people of the Great Plains in 1837 and 1838 was believed to have begun in spring of 1837 when a deckhand became ill aboard an American Fur Company steamboat, the S.S. St. Peter. The steamboat traveling up the Missouri River to Fort Union from St. Louis, docked...

 brought devastation and drastic depopulation among the Plains Indians
Plains Indians
The Plains Indians are the Indigenous peoples who live on the plains and rolling hills of the Great Plains of North America. Their colorful equestrian culture and resistance to White domination have made the Plains Indians an archetype in literature and art for American Indians everywhere.Plains...

. Some believe that the death of up to 95% of the Native American population
Population history of American indigenous peoples
The population figures for Indigenous peoples in the Americas before the 1492 voyage of Christopher Columbus have proven difficult to establish and rely on archaeological data and written records from European settlers...

 of the New World
New World
The New World is one of the names used for the Western Hemisphere, specifically America and sometimes Oceania . The term originated in the late 15th century, when America had been recently discovered by European explorers, expanding the geographical horizon of the people of the European middle...

 was caused by Old World
Old World
The Old World consists of those parts of the world known to classical antiquity and the European Middle Ages. It is used in the context of, and contrast with, the "New World" ....

 diseases such as smallpox, measles, and influenza. Over the centuries, the Europeans had developed high degrees of immunity
Immunity (medical)
Immunity is a biological term that describes a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. Immunity involves both specific and non-specific components. The non-specific components act either as barriers or as eliminators of wide...

 to these diseases, while the indigenous peoples
Indigenous peoples
Indigenous peoples are ethnic groups that are defined as indigenous according to one of the various definitions of the term, there is no universally accepted definition but most of which carry connotations of being the "original inhabitants" of a territory....

 had no such immunity.

Smallpox devastated the native population of Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

, killing around 50% of Indigenous Australians
Indigenous Australians
Indigenous Australians are the original inhabitants of the Australian continent and nearby islands. The Aboriginal Indigenous Australians migrated from the Indian continent around 75,000 to 100,000 years ago....

 in the early years of British colonisation. It also killed many New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...

 Māori. As late as 1848–49, as many as 40,000 out of 150,000 Hawaii
Hawaii
Hawaii is the newest of the 50 U.S. states , and is the only U.S. state made up entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean, southwest of the continental United States, southeast of Japan, and northeast of...

ans are estimated to have died of measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...

, whooping cough and influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

. Introduced diseases, notably smallpox, nearly wiped out the native population of Easter Island
Easter Island
Easter Island is a Polynesian island in the southeastern Pacific Ocean, at the southeasternmost point of the Polynesian triangle. A special territory of Chile that was annexed in 1888, Easter Island is famous for its 887 extant monumental statues, called moai, created by the early Rapanui people...

. In 1875, measles killed over 40,000 Fiji
Fiji
Fiji , officially the Republic of Fiji , is an island nation in Melanesia in the South Pacific Ocean about northeast of New Zealand's North Island...

ans, approximately one-third of the population. The disease devastated the Andamanese
Andamanese
The Andamanese people are the various aboriginal inhabitants of the Andaman Islands, which is the northern district of the Andaman and Nicobar Islands union territory of India, located in the southeastern part of the Bay of Bengal. They include the Great Andamanese, Jarawa, Onge, Sentinelese, and...

 population. Ainu
Ainu people
The , also called Aynu, Aino , and in historical texts Ezo , are indigenous people or groups in Japan and Russia. Historically they spoke the Ainu language and related varieties and lived in Hokkaidō, the Kuril Islands, and much of Sakhalin...

 population decreased drastically in the 19th century, due in large part
to infectious diseases brought by Japanese settlers pouring into Hokkaido
Hokkaido
, formerly known as Ezo, Yezo, Yeso, or Yesso, is Japan's second largest island; it is also the largest and northernmost of Japan's 47 prefectural-level subdivisions. The Tsugaru Strait separates Hokkaido from Honshu, although the two islands are connected by the underwater railway Seikan Tunnel...

.

Researchers concluded that syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

 was carried from the New World to Europe after Columbus
Christopher Columbus
Christopher Columbus was an explorer, colonizer, and navigator, born in the Republic of Genoa, in northwestern Italy. Under the auspices of the Catholic Monarchs of Spain, he completed four voyages across the Atlantic Ocean that led to general European awareness of the American continents in the...

' voyages. The findings suggested Europeans could have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions of Europe. The disease was more frequently fatal than it is today. Syphilis was a major killer in Europe during the Renaissance
Renaissance
The Renaissance was a cultural movement that spanned roughly the 14th to the 17th century, beginning in Italy in the Late Middle Ages and later spreading to the rest of Europe. The term is also used more loosely to refer to the historical era, but since the changes of the Renaissance were not...

. Between 1602 and 1796, the Dutch East India Company
Dutch East India Company
The Dutch East India Company was a chartered company established in 1602, when the States-General of the Netherlands granted it a 21-year monopoly to carry out colonial activities in Asia...

 sent almost a million Europeans to work in the Asia. Ultimately, only less than one-third made their way back to Europe. The majority died of diseases. Disease killed more British soldiers in India than war. Between 1736 and 1834 only some 10% of East India Company
East India Company
The East India Company was an early English joint-stock company that was formed initially for pursuing trade with the East Indies, but that ended up trading mainly with the Indian subcontinent and China...

's officers survived to take the final voyage home.

As early as 1803, the Spanish
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...

 Crown organized a mission (the Balmis expedition
Balmis Expedition
The Balmis Expedition was a three year mission to the Americas led by Dr Francisco Javier de Balmis with the aim of giving thousands the smallpox vaccine. He set off from La Coruña on 30 November 1803...

) to transport the smallpox vaccine to the Spanish colonies
Spanish Empire
The Spanish Empire comprised territories and colonies administered directly by Spain in Europe, in America, Africa, Asia and Oceania. It originated during the Age of Exploration and was therefore one of the first global empires. At the time of Habsburgs, Spain reached the peak of its world power....

, and establish mass vaccination programs there. By 1832, the federal government of the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 established a smallpox vaccination
Smallpox vaccine
The smallpox vaccine was the first successful vaccine to be developed. The process of vaccination was discovered by Edward Jenner in 1796, who acted upon his observation that milkmaids who caught the cowpox virus did not catch smallpox...

 program for Native Americans. From the beginning of the 20th century onwards, the elimination or control of disease in tropical countries became a driving force for all colonial
Colonialism
Colonialism is the establishment, maintenance, acquisition and expansion of colonies in one territory by people from another territory. It is a process whereby the metropole claims sovereignty over the colony and the social structure, government, and economics of the colony are changed by...

 powers. The sleeping sickness epidemic in Africa was arrested due to mobile teams systematically screening millions of people at risk. In the 20th century, the world saw the biggest increase in its population
World population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be  billion by the United States Census Bureau...

 in human history due to lessening of the mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...

 in many countries due to medical advances. The world population
World population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be  billion by the United States Census Bureau...

 has grown from 1.6 billion in 1900 to an estimated 7 billion today.

Cholera

  • First cholera pandemic
    First cholera pandemic
    The first cholera pandemic, also known as the first Asiatic cholera pandemic or Asiatic cholera, lasted from 1817 to 1824. While cholera had spread across India many times previously, this outbreak went further; it reached as far as China and the Caspian Sea before receding...

     1816-1826. Previously restricted to the Indian subcontinent
    Indian subcontinent
    The Indian subcontinent, also Indian Subcontinent, Indo-Pak Subcontinent or South Asian Subcontinent is a region of the Asian continent on the Indian tectonic plate from the Hindu Kush or Hindu Koh, Himalayas and including the Kuen Lun and Karakoram ranges, forming a land mass which extends...

    , the pandemic began in Bengal
    Bengal
    Bengal is a historical and geographical region in the northeast region of the Indian Subcontinent at the apex of the Bay of Bengal. Today, it is mainly divided between the sovereign land of People's Republic of Bangladesh and the Indian state of West Bengal, although some regions of the previous...

    , then spread across India by 1820. 10,000 British troops and countless Indians died during this pandemic. It extended as far as China
    China
    Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

    , Indonesia (where more than 100,000 people succumbed on the island of Java
    Java
    Java is an island of Indonesia. With a population of 135 million , it is the world's most populous island, and one of the most densely populated regions in the world. It is home to 60% of Indonesia's population. The Indonesian capital city, Jakarta, is in west Java...

     alone) and the Caspian Sea
    Caspian Sea
    The Caspian Sea is the largest enclosed body of water on Earth by area, variously classed as the world's largest lake or a full-fledged sea. The sea has a surface area of and a volume of...

     before receding. Deaths in India
    Indian subcontinent
    The Indian subcontinent, also Indian Subcontinent, Indo-Pak Subcontinent or South Asian Subcontinent is a region of the Asian continent on the Indian tectonic plate from the Hindu Kush or Hindu Koh, Himalayas and including the Kuen Lun and Karakoram ranges, forming a land mass which extends...

     between 1817 and 1860 are estimated to have exceeded 15 million persons. Another 23 million died between 1865 and 1917. Russian
    Russian Empire
    The Russian Empire was a state that existed from 1721 until the Russian Revolution of 1917. It was the successor to the Tsardom of Russia and the predecessor of the Soviet Union...

     deaths during a similar period exceeded 2 million.
  • Second cholera pandemic
    Second cholera pandemic
    The second cholera pandemic also known as the Asiatic Cholera Pandemic was a Cholera pandemic from 1829-1849.-History:This pandemic began, like the first, with outbreaks along the Ganges River delta. From there the disease spread along trade routes to cover most of India. By 1828 the disease had...

     1829–1851. Reached Russia (see Cholera Riots
    Cholera Riots
    - Cholera Riots in Russia :The Cholera Riots were the riots of the urban population, peasants and soldiers in Russia in 1830-1831 during the cholera outbreak....

    ), Hungary (about 100,000 deaths) and Germany in 1831, London
    London
    London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

     in 1832 (more than 55,000 persons died in the United Kingdom
    United Kingdom of Great Britain and Ireland
    The United Kingdom of Great Britain and Ireland was the formal name of the United Kingdom during the period when what is now the Republic of Ireland formed a part of it....

    ), France, Canada
    Canada
    Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

     (Ontario
    Ontario
    Ontario is a province of Canada, located in east-central Canada. It is Canada's most populous province and second largest in total area. It is home to the nation's most populous city, Toronto, and the nation's capital, Ottawa....

    ), and United States
    United States
    The United States of America is a federal constitutional republic comprising fifty states and a federal district...

     (New York
    New York
    New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...

    ) in the same year, and the Pacific coast of North America by 1834. A two-year outbreak began in England
    England
    England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...

     and Wales
    Wales
    Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...

     in 1848 and claimed 52,000 lives. It is believed that over 150,000 Americans died of cholera between 1832 and 1849.
  • Third pandemic
    Third cholera pandemic
    The third cholera pandemic was an outbreak of cholera that occurred from 1852-1860, and mainly affected Russia, with over a million deaths. In 1853-1854, London's epidemic claimed over 10,000 lives with 23,000 deaths for all of Britain.-External links:*...

     1852–1860. Mainly affected Russia
    Russia
    Russia or , officially known as both Russia and the Russian Federation , is a country in northern Eurasia. It is a federal semi-presidential republic, comprising 83 federal subjects...

    , with over a million deaths. In 1852, cholera spread east to Indonesia
    Indonesia
    Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...

     and later invaded China and Japan
    Japan
    Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...

     in 1854. The Philippines were infected in 1858 and Korea
    Korea
    Korea ) is an East Asian geographic region that is currently divided into two separate sovereign states — North Korea and South Korea. Located on the Korean Peninsula, Korea is bordered by the People's Republic of China to the northwest, Russia to the northeast, and is separated from Japan to the...

     in 1859. In 1859, an outbreak in Bengal again led to the transmission of the disease to Iran
    Iran
    Iran , officially the Islamic Republic of Iran , is a country in Southern and Western Asia. The name "Iran" has been in use natively since the Sassanian era and came into use internationally in 1935, before which the country was known to the Western world as Persia...

    , Iraq
    Iraq
    Iraq ; officially the Republic of Iraq is a country in Western Asia spanning most of the northwestern end of the Zagros mountain range, the eastern part of the Syrian Desert and the northern part of the Arabian Desert....

    , Arabia and Russia.
  • Fourth pandemic
    Fourth cholera pandemic
    The fourth cholera pandemic was the fourth major pandemic of cholera that spread from 1863 to 1879. It began in the Bengal region, and Indian Muslim pilgrims visiting Mecca spread the disease through the Middle East.-External links:*...

     1863–1875. Spread mostly in Europe and Africa
    Africa
    Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...

    . At least 30,000 of the 90,000 Mecca
    Mecca
    Mecca is a city in the Hijaz and the capital of Makkah province in Saudi Arabia. The city is located inland from Jeddah in a narrow valley at a height of above sea level...

     pilgrims fell victim to the disease. Cholera claimed 90,000 lives in Russia in 1866.
  • In 1866, there was an outbreak in North America. It killed some 50,000 Americans.
  • Fifth pandemic
    Fifth cholera pandemic
    The fifth cholera pandemic was the fifth major outbreak of cholera that occurred in the years 1881-1896 starting in India. The 1892 outbreak in Hamburg, Germany was the only major European outbreak; about 8,600 people died in Hamburg. Although generally held responsible for the virulence of the...

     1881-1896. The 1883-1887 epidemic cost 250,000 lives in Europe and at least 50,000 in Americas
    Americas
    The Americas, or America , are lands in the Western hemisphere, also known as the New World. In English, the plural form the Americas is often used to refer to the landmasses of North America and South America with their associated islands and regions, while the singular form America is primarily...

    . Cholera claimed 267,890 lives in Russia
    Russian Empire
    The Russian Empire was a state that existed from 1721 until the Russian Revolution of 1917. It was the successor to the Tsardom of Russia and the predecessor of the Soviet Union...

     (1892); 120,000 in Spain; 90,000 in Japan
    Japan
    Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...

     and 60,000 in Persia
    Iran
    Iran , officially the Islamic Republic of Iran , is a country in Southern and Western Asia. The name "Iran" has been in use natively since the Sassanian era and came into use internationally in 1935, before which the country was known to the Western world as Persia...

    .
  • In 1892, cholera contaminated the water supply of Hamburg
    Hamburg
    -History:The first historic name for the city was, according to Claudius Ptolemy's reports, Treva.But the city takes its modern name, Hamburg, from the first permanent building on the site, a castle whose construction was ordered by the Emperor Charlemagne in AD 808...

    , and caused 8606 deaths.
  • Sixth pandemic
    Sixth cholera pandemic
    The sixth cholera pandemic was a major outbreak of cholera from the years 1899 to 1923. It killed more than 800,000 in India then erupted in the Middle East, northern Africa, Russia and Eastern Europe....

     1899–1923. Had little effect in Europe because of advances in public health
    Public health
    Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...

    , but Russia was badly affected again (more than 500,000 people dying of cholera during the first quarter of the 20th century). The sixth pandemic killed more than 800,000 in India. The 1902-1904 cholera epidemic claimed over 200,000 lives in the Philippines
    Philippines
    The Philippines , officially known as the Republic of the Philippines , is a country in Southeast Asia in the western Pacific Ocean. To its north across the Luzon Strait lies Taiwan. West across the South China Sea sits Vietnam...

    . 27 epidemics were recorded during pilgrimages to Mecca
    Mecca
    Mecca is a city in the Hijaz and the capital of Makkah province in Saudi Arabia. The city is located inland from Jeddah in a narrow valley at a height of above sea level...

     from the 19th century to 1930, and more than 20,000 pilgrims died of cholera during the 1907–08 hajj
    Hajj
    The Hajj is the pilgrimage to Mecca, Saudi Arabia. It is one of the largest pilgrimages in the world, and is the fifth pillar of Islam, a religious duty that must be carried out at least once in their lifetime by every able-bodied Muslim who can afford to do so...

    .
  • Seventh pandemic
    Seventh cholera pandemic
    The seventh cholera pandemic was the seventh major outbreak of cholera and occurred from the years 1961 to the 1970s and has continued to the present. The outbreak began in Indonesia, called El Tor after the strain, and reached Bangladesh in 1963, India in 1964, and the USSR in 1966. From North...

     1962-66. Began in Indonesia
    Indonesia
    Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...

    , called El Tor
    El Tor
    El Tor is the name given to a particular strain of the bacterium Vibrio cholerae, the causative agent of cholera. Also known as V. cholera biotype eltor, it has been the dominant strain in the seventh global pandemic. It is distinguished from the classic strain at a genetic level, although both are...

     after the strain, and reached Bangladesh
    Bangladesh
    Bangladesh , officially the People's Republic of Bangladesh is a sovereign state located in South Asia. It is bordered by India on all sides except for a small border with Burma to the far southeast and by the Bay of Bengal to the south...

     in 1963, India in 1964, and the USSR
    Soviet Union
    The Soviet Union , officially the Union of Soviet Socialist Republics , was a constitutionally socialist state that existed in Eurasia between 1922 and 1991....

     in 1966.

Influenza



  • The Greek physician Hippocrates
    Hippocrates
    Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...

    , the "Father of Medicine", first described influenza in 412 BCE.
  • The first influenza pandemic was recorded in 1580 and since then influenza pandemics occurred every 10 to 30 years.
  • The "Asiatic Flu", 1889–1890, was first reported in May 1889 in Bukhara
    Bukhara
    Bukhara , from the Soghdian βuxārak , is the capital of the Bukhara Province of Uzbekistan. The nation's fifth-largest city, it has a population of 263,400 . The region around Bukhara has been inhabited for at least five millennia, and the city has existed for half that time...

    , Uzbekistan. By October, it had reached Tomsk
    Tomsk
    Tomsk is a city and the administrative center of Tomsk Oblast, Russia, located on the Tom River. One of the oldest towns in Siberia, Tomsk celebrated its 400th anniversary in 2004...

     and the Caucasus
    Caucasus
    The Caucasus, also Caucas or Caucasia , is a geopolitical region at the border of Europe and Asia, and situated between the Black and the Caspian sea...

    . It rapidly spread west and hit North America
    North America
    North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...

     in December 1889, South America in February–April 1890, India in February–March 1890, and Australia in March–April 1890. It was purportedly caused by the H2N8 type of flu virus. It had a very high attack and mortality rate
    Mortality rate
    Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...

    . About 1 million people died in this pandemic."
  • The "Spanish flu
    Spanish flu
    The 1918 flu pandemic was an influenza pandemic, and the first of the two pandemics involving H1N1 influenza virus . It was an unusually severe and deadly pandemic that spread across the world. Historical and epidemiological data are inadequate to identify the geographic origin...

    ", 1918–1919. First identified early in March 1918 in US troops training at Camp Funston
    Fort Riley
    Fort Riley is a United States Army installation located in Northeast Kansas, on the Kansas River, between Junction City and Manhattan. The Fort Riley Military Reservation covers 100,656 acres in Geary and Riley counties and includes two census-designated places: Fort Riley North and Fort...

    , Kansas
    Kansas
    Kansas is a US state located in the Midwestern United States. It is named after the Kansas River which flows through it, which in turn was named after the Kansa Native American tribe, which inhabited the area. The tribe's name is often said to mean "people of the wind" or "people of the south...

    . By October 1918, it had spread to become a worldwide pandemic on all continents, and eventually infected about one-third of the world's population (or ≈500 million persons). Unusually deadly and virulent, it ended nearly as quickly as it began, vanishing completely within 18 months. In six months, some 50 million were dead; some estimates put the total of those killed worldwide at over twice that number. About 17 million died in India, 675,000 in the United States
    United States
    The United States of America is a federal constitutional republic comprising fifty states and a federal district...

     and 200,000 in the UK. The virus was recently reconstructed by scientists at the CDC
    Centers for Disease Control and Prevention
    The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

     studying remains preserved by the Alaskan permafrost
    Permafrost
    In geology, permafrost, cryotic soil or permafrost soil is soil at or below the freezing point of water for two or more years. Ice is not always present, as may be in the case of nonporous bedrock, but it frequently occurs and it may be in amounts exceeding the potential hydraulic saturation of...

    . The H1N1
    H1N1
    'Influenza A virus is a subtype of influenza A virus and was the most common cause of human influenza in 2009. Some strains of H1N1 are endemic in humans and cause a small fraction of all influenza-like illness and a small fraction of all seasonal influenza. H1N1 strains caused a few percent of...

     virus has a small, but crucial structure that is similar to the Spanish Flu.
  • The "Asian Flu
    Asian flu
    Asian Flu may refer to:* The Asian Financial Crisis of 1997, or* Asian Flu, the H2N2 virus...

    ", 1957–58. An H2N2 virus caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957. It caused about 2 million deaths globally.
  • The "Hong Kong Flu
    Hong Kong flu
    The Hong Kong flu was a category 2 flu pandemic whose outbreak in 1968 and 1969 killed an estimated one million people worldwide. It was caused by an H3N2 strain of the influenza A virus, descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes reassorted...

    ", 1968–69. An H3N2 caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968, and spread to the United States later that year. This pandemic of 1968 and 1969 killed approximately one million people worldwide. Influenza A (H3N2
    H3N2
    Influenza A virus subtype H3N2 is a subtype of viruses that cause influenza . H3N2 Viruses can infect birds and mammals. In birds, humans, and pigs, the virus has mutated into many strains...

    ) viruses still circulate today.

Typhus


Typhus
Typhus
Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters...

 is sometimes called "camp fever" because of its pattern of flaring up in times of strife. (It is also known as "gaol fever" and "ship fever", for its habits of spreading wildly in cramped quarters, such as jails and ships.) Emerging during the Crusades
Crusades
The Crusades were a series of religious wars, blessed by the Pope and the Catholic Church with the main goal of restoring Christian access to the holy places in and near Jerusalem...

, it had its first impact in Europe in 1489, in Spain. During fighting between the Christian Spaniards and the Muslims in Granada
Granada
Granada is a city and the capital of the province of Granada, in the autonomous community of Andalusia, Spain. Granada is located at the foot of the Sierra Nevada mountains, at the confluence of three rivers, the Beiro, the Darro and the Genil. It sits at an elevation of 738 metres above sea...

, the Spanish lost 3,000 to war casualties, and 20,000 to typhus. In 1528, the French lost 18,000 troops in Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

, and lost supremacy in Italy to the Spanish. In 1542, 30,000 soldiers died of typhus while fighting the Ottomans
Ottoman Empire
The Ottoman EmpireIt was usually referred to as the "Ottoman Empire", the "Turkish Empire", the "Ottoman Caliphate" or more commonly "Turkey" by its contemporaries...

 in the Balkans.

During the Thirty Years' War
Thirty Years' War
The Thirty Years' War was fought primarily in what is now Germany, and at various points involved most countries in Europe. It was one of the most destructive conflicts in European history....

 (1618–1648), about 8 million Germans were killed by bubonic plague and typhus fever. The disease also played a major role in the destruction of Napoleon's Grande Armée
La Grande Armée
The Grande Armée first entered the annals of history when, in 1805, Napoleon I renamed the army that he had assembled on the French coast of the English Channel for the proposed invasion of Britain...

in Russia in 1812. Felix Markham thinks that 450,000 soldiers crossed the Neman
Neman River
Neman or Niemen or Nemunas, is a major Eastern European river rising in Belarus and flowing through Lithuania before draining into the Curonian Lagoon and then into the Baltic Sea at Klaipėda. It is the northern border between Lithuania and Russia's Kaliningrad Oblast in its lower reaches...

 on 25 June 1812, of whom less than 40,000 recrossed in anything like a recognizable military formation. In early 1813 Napoleon raised a new army of 500,000 to replace his Russian losses. In the campaign of that year over 219,000 of Napoleon's soldiers were to die of typhus. Typhus played a major factor in the Irish Potato Famine. During the World War I
World War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...

, typhus epidemics have killed over 150,000 in Serbia
Serbia
Serbia , officially the Republic of Serbia , is a landlocked country located at the crossroads of Central and Southeast Europe, covering the southern part of the Carpathian basin and the central part of the Balkans...

. There were about 25 million infections and 3 million deaths from epidemic typhus
in Russia
Russia
Russia or , officially known as both Russia and the Russian Federation , is a country in northern Eurasia. It is a federal semi-presidential republic, comprising 83 federal subjects...

 from 1918 to 1922. Typhus also killed numerous prisoners in the Nazi concentration camps
Nazi concentration camps
Nazi Germany maintained concentration camps throughout the territories it controlled. The first Nazi concentration camps set up in Germany were greatly expanded after the Reichstag fire of 1933, and were intended to hold political prisoners and opponents of the regime...

 and Soviet prisoner of war camps during World War II. More than 3.5 million Soviet POWs
Nazi crimes against Soviet POWs
The Nazi crimes against Soviet Prisoners of War relate to the deliberately genocidal policies taken towards the captured soldiers of the Soviet Union by Nazi Germany...

 died in the Nazi custody out of 5.7 million.

Smallpox


Smallpox is a highly contagious disease caused by the Variola virus. The disease killed an estimated 400,000 Europeans per year during the closing years of the 18th century. During the 20th century, it is estimated that smallpox was responsible for 300–500 million deaths. As recently as early 1950s an estimated 50 million cases of smallpox occurred in the world each year. After successful vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

 campaigns throughout the 19th and 20th centuries, the WHO certified the eradication of smallpox in December 1979. To this day, smallpox is the only human infectious disease to have been completely eradicated.

Measles


Historically, measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...

 was prevalent throughout the world, as it is highly contagious. According to the National Immunization Program, 90% of people were infected with measles by age 15. Before the vaccine was introduced in 1963, there were an estimated 3-4 million
cases in the U.S. each year. In roughly the last 150 years, measles has been estimated to have killed about 200 million people worldwide. In 2000 alone, measles killed some 777,000 worldwide.
There were some 40 million cases of measles globally that year.

Measles is an endemic disease, meaning that it has been continually present in a community, and many people develop resistance. In populations that have not been exposed to measles, exposure to a new disease can be devastating. In 1529, a measles outbreak in Cuba
Cuba
The Republic of Cuba is an island nation in the Caribbean. The nation of Cuba consists of the main island of Cuba, the Isla de la Juventud, and several archipelagos. Havana is the largest city in Cuba and the country's capital. Santiago de Cuba is the second largest city...

 killed two-thirds of the natives who had previously survived smallpox. The disease had ravaged Mexico
Mexico
The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...

, Central America
Central America
Central America is the central geographic region of the Americas. It is the southernmost, isthmian portion of the North American continent, which connects with South America on the southeast. When considered part of the unified continental model, it is considered a subcontinent...

, and the Inca civilization.

Tuberculosis


One–third of the world's current population
World population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be  billion by the United States Census Bureau...

 has been infected with Mycobacterium tuberculosis
Mycobacterium tuberculosis
Mycobacterium tuberculosis is a pathogenic bacterial species in the genus Mycobacterium and the causative agent of most cases of tuberculosis . First discovered in 1882 by Robert Koch, M...

, and new infections occur at a rate of one per second. About 5-10% of these latent infections will eventually progress to active disease, which, if left untreated, kills more than half of its victims. Annually, 8 million people become ill with tuberculosis, and 2 million people die from the disease worldwide. In the 19th century, tuberculosis killed an estimated one-quarter of the adult population of Europe; by 1918 one in six deaths in France were still caused by TB. By the late 19th century, 70 to 90% of the urban populations of Europe and North America were infected with M. tuberculosis, and about 40% of working-class deaths in cities were from TB. During the 20th century, tuberculosis killed approximately 100 million people. TB is still one of the most important health problems in the developing world.

Leprosy


Leprosy
Leprosy
Leprosy or Hansen's disease is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Named after physician Gerhard Armauer Hansen, leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions...

, also known as Wopat’s Disease, is caused by a bacillus
Bacillus
Bacillus is a genus of Gram-positive, rod-shaped bacteria and a member of the division Firmicutes. Bacillus species can be obligate aerobes or facultative anaerobes, and test positive for the enzyme catalase. Ubiquitous in nature, Bacillus includes both free-living and pathogenic species...

, Mycobacterium leprae
Mycobacterium leprae
Mycobacterium leprae, also known as Hansen’s coccus spirilly, mostly found in warm tropical countries, is a bacterium that causes leprosy . It is an intracellular, pleomorphic, acid-fast bacterium. M. leprae is an aerobic bacillus surrounded by the characteristic waxy coating unique to mycobacteria...

. It is a chronic disease with an incubation period of up to five years. Since 1985, 15 million people worldwide have been cured of leprosy. In 2002, 763,917 new cases were detected. It is estimated that there are between one and two million people permanently disabled because of leprosy.

Historically, leprosy has affected people since at least 600 BCE, and was well-recognized in the civilizations of ancient China
History of China
Chinese civilization originated in various regional centers along both the Yellow River and the Yangtze River valleys in the Neolithic era, but the Yellow River is said to be the Cradle of Chinese Civilization. With thousands of years of continuous history, China is one of the world's oldest...

, Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...

 and India
History of India
The history of India begins with evidence of human activity of Homo sapiens as long as 75,000 years ago, or with earlier hominids including Homo erectus from about 500,000 years ago. The Indus Valley Civilization, which spread and flourished in the northwestern part of the Indian subcontinent from...

. During the High Middle Ages
High Middle Ages
The High Middle Ages was the period of European history around the 11th, 12th, and 13th centuries . The High Middle Ages were preceded by the Early Middle Ages and followed by the Late Middle Ages, which by convention end around 1500....

, Western Europe witnessed an unprecedented outbreak of leprosy. Numerous leprosaria, or leper hospitals, sprang up in the Middle Ages; Matthew Paris
Matthew Paris
Matthew Paris was a Benedictine monk, English chronicler, artist in illuminated manuscripts and cartographer, based at St Albans Abbey in Hertfordshire...

 estimated that in the early 13th century there were 19,000 across Europe.

Malaria


Malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

 is widespread in tropical
Tropics
The tropics is a region of the Earth surrounding the Equator. It is limited in latitude by the Tropic of Cancer in the northern hemisphere at approximately  N and the Tropic of Capricorn in the southern hemisphere at  S; these latitudes correspond to the axial tilt of the Earth...

 and subtropical regions, including parts of the Americas
Americas
The Americas, or America , are lands in the Western hemisphere, also known as the New World. In English, the plural form the Americas is often used to refer to the landmasses of North America and South America with their associated islands and regions, while the singular form America is primarily...

, Asia
Asia
Asia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.7% of the Earth's total surface area and with approximately 3.879 billion people, it hosts 60% of the world's current human population...

, and Africa
Africa
Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...

. Each year, there are approximately 350–500 million cases of malaria. Drug resistance
Drug resistance
Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial or an antineoplastic in curing a disease or condition. When the drug is not intended to kill or inhibit a pathogen, then the term is equivalent to dosage failure or drug tolerance. More commonly, the term is used...

 poses a growing problem in the treatment of malaria in the 21st century, since resistance is now common against all classes of antimalarial drugs, except for the artemisinins.

Malaria was once common in most of Europe and North America
North America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...

, where it is now for all purposes non-existent. Malaria may have contributed to the decline of the Roman Empire
Roman Empire
The Roman Empire was the post-Republican period of the ancient Roman civilization, characterised by an autocratic form of government and large territorial holdings in Europe and around the Mediterranean....

. The disease became known as "Roman fever
Roman Fever (disease)
Roman fever refers to a particularly deadly strain of malaria that affected Rome, Italy, throughout various epochs in history; an epidemic of Roman fever during the fifth century AD may have contributed to the fall of the Roman empire...

". Plasmodium falciparum
Plasmodium falciparum
Plasmodium falciparum is a protozoan parasite, one of the species of Plasmodium that cause malaria in humans. It is transmitted by the female Anopheles mosquito. Malaria caused by this species is the most dangerous form of malaria, with the highest rates of complications and mortality...

became a real threat to colonists and indigenous people alike when it was introduced into the Americas along with the slave trade. Malaria devastated the Jamestown
Jamestown, Virginia
Jamestown was a settlement in the Colony of Virginia. Established by the Virginia Company of London as "James Fort" on May 14, 1607 , it was the first permanent English settlement in what is now the United States, following several earlier failed attempts, including the Lost Colony of Roanoke...

 colony and regularly ravaged the South and Midwest. By 1830 it had reached the Pacific Northwest. During the American Civil War
American Civil War
The American Civil War was a civil war fought in the United States of America. In response to the election of Abraham Lincoln as President of the United States, 11 southern slave states declared their secession from the United States and formed the Confederate States of America ; the other 25...

, there were over 1.2 million cases of malaria among
soldiers of both sides. The southern U.S. continued to be afflicted with millions of cases of malaria into the 1930s.

Yellow fever


Yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....

 has been a source of several devastating epidemics. Cities as far north as New York, Philadelphia, and Boston were hit with epidemics. In 1793, one of the largest yellow fever epidemics
Yellow Fever Epidemic of 1793
The Yellow Fever Epidemic of 1793 is believed to have killed several thousand people in Philadelphia, Pennsylvania, United States.-Beginnings:...

 in U.S. history killed as many as
5,000 people in Philadelphia—roughly 10% of the population. About half of the residents had fled the city, including President George Washington. Approximately 300,000 people are believed to have died from yellow fever in Spain during the 19th century. In colonial times, West Africa became known as "the white man's grave" because of malaria and yellow fever.

Unknown causes


There are also a number of unknown diseases that were extremely serious but have now vanished, so the etiology
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

 of these diseases cannot be established. The cause of English Sweat
Sweating sickness
Sweating sickness, also known as "English sweating sickness" or "English sweate" , was a mysterious and highly virulent disease that struck England, and later continental Europe, in a series of epidemics beginning in 1485. The last outbreak occurred in 1551, after which the disease apparently...

in 16th-century England, which struck people down in an instant and was more greatly feared than even the bubonic plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

, is still unknown.

Viral hemorrhagic fevers


Some Viral Hemorrhagic Fever causing agents like Lassa fever
Lassa fever
Lassa fever is an acute viral hemorrhagic fever caused by the Lassa virus and first described in 1969 in the town of Lassa, in Borno State, Nigeria, in the Yedseram river valley at the south end of Lake Chad. Clinical cases of the disease had been known for over a decade but had not been connected...

, Rift Valley fever
Rift Valley fever
Rift Valley Fever is a viral zoonosis causing fever. It is spread by the bite of infected mosquitoes, typically the Aedes or Culex genera. The disease is caused by the RVF virus, a member of the genus Phlebovirus...

, Marburg virus
Marburg virus
Marburg virus disease is the name for the human disease caused by any of the two marburgviruses Marburg virus and Ravn virus...

, Ebola virus
Ebola
Ebola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...

 and Bolivian hemorrhagic fever
Bolivian hemorrhagic fever
Bolivian hemorrhagic fever , also known as black typhus or Ordog Fever, is a hemorrhagic fever and zoonotic infectious disease originating in Bolivia after infection by Machupo virus....

 are highly contagious and deadly diseases, with the theoretical potential to become pandemics. Their ability to spread efficiently enough to cause a pandemic is limited, however, as transmission of these viruses requires close contact with the infected vector, and the vector only has a short time before death or serious illness. Furthermore, the short time between a vector becoming infectious and the onset of symptoms allows medical professionals to quickly quarantine
Quarantine
Quarantine is compulsory isolation, typically to contain the spread of something considered dangerous, often but not always disease. The word comes from the Italian quarantena, meaning forty-day period....

 vectors, and prevent them from carrying the pathogen elsewhere. Genetic mutations could occur, which could elevate their potential for causing widespread harm; thus close observation by contagious disease specialists is merited.

Antibiotic resistance



Antibiotic-resistant microorganisms, sometimes referred to as "superbug
Antibiotic resistance
Antibiotic resistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. While a spontaneous or induced genetic mutation in bacteria may confer resistance to antimicrobial drugs, genes that confer resistance can be transferred between bacteria in a...

s", may contribute to the re-emergence of diseases which are currently well-controlled. For example, cases of tuberculosis that are resistant to traditionally effective treatments remain a cause of great concern to health professionals. Every year, nearly half a million new cases of multidrug-resistant tuberculosis (MDR-TB) are estimated to occur worldwide. China and India have the highest rate of multidrug-resistant TB. The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 (WHO) reports that approximately 50 million people worldwide are infected with MDR TB, with 79 percent of those cases resistant to three or more antibiotics. In 2005, 124 cases of MDR TB were reported in the United States. Extensively drug-resistant tuberculosis (XDR TB) was identified in Africa in 2006, and subsequently discovered to exist in 49 countries, including the United States. There are about 40,000 new cases of XDR-TB per year, the WHO estimates.

In the past 20 years, common bacteria including Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus is a facultative anaerobic Gram-positive coccal bacterium. It is frequently found as part of the normal skin flora on the skin and nasal passages. It is estimated that 20% of the human population are long-term carriers of S. aureus. S. aureus is the most common species of...

, Serratia marcescens
Serratia marcescens
Serratia marcescens is a species of Gram-negative, rod-shaped bacterium in the family Enterobacteriaceae. A human pathogen, S. marcescens is involved in nosocomial infections, particularly catheter-associated bacteremia, urinary tract infections and wound infections, and is responsible for 1.4% of...

and Enterococcus
Enterococcus
Enterococcus is a genus of lactic acid bacteria of the phylum Firmicutes. Enterococci are Gram-positive cocci that often occur in pairs or short chains, and are difficult to distinguish from streptococci on physical characteristics alone. Two species are common commensal organisms in the...

, have developed resistance to various antibiotics such as vancomycin
Vancomycin
Vancomycin INN is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. It has traditionally been reserved as a drug of "last resort", used only after treatment with other antibiotics had failed, although the emergence of...

, as well as whole classes of antibiotics, such as the aminoglycosides and cephalosporins. Antibiotic-resistant organisms have become an important cause of healthcare-associated (nosocomial) infections (HAI). In addition, infections caused by community-acquired strains of methicillin-resistant Staphylococcus aureus (MRSA) in otherwise healthy individuals have become more frequent in recent years.

Inappropriate antibiotic treatment and overuse of antibiotics have been an element in the emergence of resistant bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

. The problem is further exacerbated by self-prescribing of antibiotics by individuals without the guidelines of a qualified clinician and the non-therapeutic use of antibiotics as growth promoters in agriculture.

SARS


In 2003, there were concerns that Severe Acute Respiratory Syndrome (SARS
Severe acute respiratory syndrome
Severe Acute Respiratory Syndrome is a respiratory disease in humans which is caused by the SARS coronavirus . Between November 2002 and July 2003 an outbreak of SARS in Hong Kong nearly became a pandemic, with 8,422 cases and 916 deaths worldwide according to the WHO...

), a new and highly contagious form of atypical pneumonia
Atypical pneumonia
Atypical pneumonia aka "walking pneumonia" is a pneumonia not caused by one of the more traditional pathogens, and with a clinical presentation inconsistent with typical pneumonia. It can be caused by a variety of microorganisms...

, might become pandemic. It is caused by a coronavirus
Coronavirus
Coronaviruses are species in the genera of virus belonging to the subfamily Coronavirinae in the family Coronaviridae. Coronaviruses are enveloped viruses with a positive-sense single-stranded RNA genome and a helical symmetry. The genomic size of coronaviruses ranges from approximately 16 to 31...

 dubbed SARS-CoV. Rapid action by national and international health authorities such as the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 helped to slow transmission and eventually broke the chain of transmission. That ended the localized epidemics before they could become a pandemic. However, the disease has not been eradicated. It could re-emerge. This warrants monitoring and reporting of suspicious cases of atypical pneumonia.

Influenza


Wild aquatic birds are the natural hosts for a range of influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

 A viruses. Occasionally, viruses are transmitted from these species to other species, and may then cause outbreaks in domestic poultry or, rarely, in humans.

H5N1 (Avian Flu)


In February 2004, avian influenza virus was detected in birds in Vietnam
Vietnam
Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...

, increasing fears of the emergence of new variant strains. It is feared that if the avian influenza virus combines with a human influenza virus (in a bird or a human), the new subtype created could be both highly contagious and highly lethal in humans. Such a subtype could cause a global influenza pandemic, similar to the Spanish Flu
Spanish flu
The 1918 flu pandemic was an influenza pandemic, and the first of the two pandemics involving H1N1 influenza virus . It was an unusually severe and deadly pandemic that spread across the world. Historical and epidemiological data are inadequate to identify the geographic origin...

, or the lower mortality pandemics such as the Asian Flu
Asian flu
Asian Flu may refer to:* The Asian Financial Crisis of 1997, or* Asian Flu, the H2N2 virus...

 and the Hong Kong Flu
Hong Kong flu
The Hong Kong flu was a category 2 flu pandemic whose outbreak in 1968 and 1969 killed an estimated one million people worldwide. It was caused by an H3N2 strain of the influenza A virus, descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes reassorted...

.

From October 2004 to February 2005, some 3,700 test kits of the 1957 Asian Flu
Asian flu
Asian Flu may refer to:* The Asian Financial Crisis of 1997, or* Asian Flu, the H2N2 virus...

 virus were accidentally spread around the world from a lab in the US.

In May 2005, scientists urgently call nations to prepare for a global influenza pandemic
Influenza pandemic
An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in...

 that could strike as much as 20% of the world's population.

In October 2005, cases of the avian flu (the deadly strain H5N1
H5N1
Influenza A virus subtype H5N1, also known as "bird flu", A or simply H5N1, is a subtype of the influenza A virus which can cause illness in humans and many other animal species...

) were identified in Turkey
Turkey
Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...

. EU Health Commissioner Markos Kyprianou said: "We have received now confirmation that the virus found in Turkey is an avian flu H5N1 virus. There is a direct relationship with viruses found in Russia, Mongolia and China." Cases of bird flu were also identified shortly thereafter in Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...

, and then Greece
Greece
Greece , officially the Hellenic Republic , and historically Hellas or the Republic of Greece in English, is a country in southeastern Europe....

. Possible cases of the virus have also been found in Croatia
Croatia
Croatia , officially the Republic of Croatia , is a unitary democratic parliamentary republic in Europe at the crossroads of the Mitteleuropa, the Balkans, and the Mediterranean. Its capital and largest city is Zagreb. The country is divided into 20 counties and the city of Zagreb. Croatia covers ...

, Bulgaria
Bulgaria
Bulgaria , officially the Republic of Bulgaria , is a parliamentary democracy within a unitary constitutional republic in Southeast Europe. The country borders Romania to the north, Serbia and Macedonia to the west, Greece and Turkey to the south, as well as the Black Sea to the east...

 and the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

.

By November 2007, numerous confirmed cases of the H5N1
H5N1
Influenza A virus subtype H5N1, also known as "bird flu", A or simply H5N1, is a subtype of the influenza A virus which can cause illness in humans and many other animal species...

 strain had been identified across Europe. However, by the end of October only 59 people had died as a result of H5N1 which was atypical of previous influenza pandemics.

Avian flu cannot yet be categorized as a "pandemic", because the virus cannot yet cause sustained and efficient human-to-human transmission. Cases so far are recognized to have been transmitted from bird to human, but as of December 2006 there have been very few (if any) cases of proven human-to-human transmission. Regular influenza viruses establish infection by attaching to receptors in the throat and lungs, but the avian influenza virus can only attach to receptors located deep in the lungs of humans, requiring close, prolonged contact with infected patients, and thus limiting person-to-person transmission.

Biological warfare


In 1346, the bodies of Mongol warriors who had died of plague were thrown over the walls of the besieged Crimea
Crimea
Crimea , or the Autonomous Republic of Crimea , is a sub-national unit, an autonomous republic, of Ukraine. It is located on the northern coast of the Black Sea, occupying a peninsula of the same name...

n city of Kaffa (now Theodosia). After a protracted siege, during which the Mongol
Mongol Empire
The Mongol Empire , initially named as Greater Mongol State was a great empire during the 13th and 14th centuries...

 army under Jani Beg
Jani Beg
Jani Beg was a khan of the Golden Horde from 1342 to 1357, succeeding his father Uzbeg Khan.After putting two of his brothers to death, Jani Beg crowned himself in Saray-Jük. He is known to have actively interfered in the affairs of Russian principalities and of Lithuania...

 was suffering the disease, they catapulted the infected corpses over the city walls to infect the inhabitants. It has been speculated that this operation may have been responsible for the arrival of the Black Death
Black Death
The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

 in Europe.

The Native American
Indigenous peoples of the Americas
The indigenous peoples of the Americas are the pre-Columbian inhabitants of North and South America, their descendants and other ethnic groups who are identified with those peoples. Indigenous peoples are known in Canada as Aboriginal peoples, and in the United States as Native Americans...

 population was devastated after contact with the Old World
Old World
The Old World consists of those parts of the world known to classical antiquity and the European Middle Ages. It is used in the context of, and contrast with, the "New World" ....

 due to the introduction of many different fatal diseases. There is, however, only one documented case of germ warfare, involving British commander Jeffrey Amherst and Swiss-British officer Colonel Henry Bouquet
Henry Bouquet
Henry Bouquet was a prominent British Army officer in the French and Indian War and Pontiac's War. Bouquet is best known for his victory over Native Americans at the Battle of Bushy Run, lifting the siege of Fort Pitt during Pontiac's War.-Early life:Bouquet was born into a moderately wealthy...

, whose correspondence included a reference to the idea of giving smallpox-infected blankets to Indians as part of an incident known as Pontiac's Rebellion
Pontiac's Rebellion
Pontiac's War, Pontiac's Conspiracy, or Pontiac's Rebellion was a war that was launched in 1763 by a loose confederation of elements of Native American tribes primarily from the Great Lakes region, the Illinois Country, and Ohio Country who were dissatisfied with British postwar policies in the...

 which occurred during the Siege of Fort Pitt (1763) late in the French and Indian War
French and Indian War
The French and Indian War is the common American name for the war between Great Britain and France in North America from 1754 to 1763. In 1756, the war erupted into the world-wide conflict known as the Seven Years' War and thus came to be regarded as the North American theater of that war...

. It is uncertain whether this documented British attempt successfully infected the Indians.

During the Sino-Japanese War (1937–1945), Unit 731
Unit 731
was a covert biological and chemical warfare research and development unit of the Imperial Japanese Army that undertook lethal human experimentation during the Second Sino-Japanese War and World War II. It was responsible for some of the most notorious war crimes carried out by Japanese...

 of the Imperial Japanese Army
Imperial Japanese Army
-Foundation:During the Meiji Restoration, the military forces loyal to the Emperor were samurai drawn primarily from the loyalist feudal domains of Satsuma and Chōshū...

 conducted human experimentation on thousands, mostly Chinese. In military campaigns, the Japanese army used biological weapons on Chinese soldiers and civilians. Plague fleas, infected clothing, and infected supplies encased in bombs were dropped on various targets. The resulting cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

, anthrax
Anthrax
Anthrax is an acute disease caused by the bacterium Bacillus anthracis. Most forms of the disease are lethal, and it affects both humans and other animals...

, and plague were estimated to have killed around 400,000 Chinese civilians.

Diseases considered for or known to be used as a weapon include anthrax
Anthrax
Anthrax is an acute disease caused by the bacterium Bacillus anthracis. Most forms of the disease are lethal, and it affects both humans and other animals...

, ebola
Ebola
Ebola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...

, Marburg virus
Marburg virus
Marburg virus disease is the name for the human disease caused by any of the two marburgviruses Marburg virus and Ravn virus...

, plague, cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

, typhus
Typhus
Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters...

, Rocky Mountain spotted fever
Rocky Mountain spotted fever
Rocky Mountain spotted fever is the most lethal and most frequently reported rickettsial illness in the United States. It has been diagnosed throughout the Americas. Some synonyms for Rocky Mountain spotted fever in other countries include “tick typhus,” “Tobia fever” , “São Paulo fever” or “febre...

, tularemia
Tularemia
Tularemia is a serious infectious disease caused by the bacterium Francisella tularensis. A Gram-negative, nonmotile coccobacillus, the bacterium has several subspecies with varying degrees of virulence. The most important of those is F...

, brucellosis
Brucellosis
Brucellosis, also called Bang's disease, Crimean fever, Gibraltar fever, Malta fever, Maltese fever, Mediterranean fever, rock fever, or undulant fever, is a highly contagious zoonosis caused by ingestion of unsterilized milk or meat from infected animals or close contact with their secretions...

, Q fever
Q fever
Q fever is a disease caused by infection with Coxiella burnetii, a bacterium that affects humans and other animals. This organism is uncommon but may be found in cattle, sheep, goats and other domestic mammals, including cats and dogs...

, machupo, Coccidioides mycosis, Glanders
Glanders
Glanders is an infectious disease that occurs primarily in horses, mules, and donkeys. It can be contracted by other animals such as dogs, cats and goats...

, Melioidosis
Melioidosis
Melioidosis is an infectious disease caused by a Gram-negative bacterium, Burkholderia pseudomallei, found in soil and water. It is of public health importance in endemic areas, particularly in Thailand and northern Australia. It exists in acute and chronic forms. Symptoms may include pain in...

, Shigella
Shigella
Shigella is a genus of Gram-negative, nonspore forming, non-motile, rod-shaped bacteria closely related to Escherichia coli and Salmonella. The causative agent of human shigellosis, Shigella causes disease in primates, but not in other mammals. It is only naturally found in humans and apes. During...

, Psittacosis
Psittacosis
In medicine , psittacosis — also known as parrot disease, parrot fever, and ornithosis — is a zoonotic infectious disease caused by a bacterium called Chlamydophila psittaci and contracted from parrots, such as macaws, cockatiels and budgerigars, and pigeons, sparrows, ducks, hens, gulls and many...

, Japanese B encephalitis
Japanese Encephalitis
Japanese encephalitis —previously known as Japanese B encephalitis to distinguish it from von Economo's A encephalitis—is a disease caused by the mosquito-borne Japanese encephalitis virus. The Japanese encephalitis virus is a virus from the family Flaviviridae. Domestic pigs and wild birds are...

, Rift Valley fever
Rift Valley fever
Rift Valley Fever is a viral zoonosis causing fever. It is spread by the bite of infected mosquitoes, typically the Aedes or Culex genera. The disease is caused by the RVF virus, a member of the genus Phlebovirus...

, yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....

, and smallpox.

Spores of weaponized anthrax were accidentally released from a military facility near the Soviet closed city
Closed city
A closed city or closed town is a settlement with travel and residency restrictions in the Soviet Union and some of its successor countries. In modern Russia, such places are officially known as "closed administrative-territorial formations" ....

 of Sverdlovsk
Yekaterinburg
Yekaterinburg is a major city in the central part of Russia, the administrative center of Sverdlovsk Oblast. Situated on the eastern side of the Ural mountain range, it is the main industrial and cultural center of the Urals Federal District with a population of 1,350,136 , making it Russia's...

 in 1979. The Sverdlovsk anthrax leak
Sverdlovsk anthrax leak
The Sverdlovsk anthrax leak is an incident when spores of anthrax were accidentally released from a military facility in the city of Sverdlovsk 1450 km east of Moscow on April 2, 1979. This accident is sometimes called "biological Chernobyl"...

 is sometimes called "biological Chernobyl
Chernobyl disaster
The Chernobyl disaster was a nuclear accident that occurred on 26 April 1986 at the Chernobyl Nuclear Power Plant in Ukraine , which was under the direct jurisdiction of the central authorities in Moscow...

". China
People's Republic of China
China , officially the People's Republic of China , is the most populous country in the world, with over 1.3 billion citizens. Located in East Asia, the country covers approximately 9.6 million square kilometres...

 possibly suffered a serious accident at one of its biological weapons plants in the late 1980s. The Soviets suspected that two separate epidemics of hemorrhagic fever that swept the region in the late 1980s were caused by an accident in a lab where Chinese scientists were weaponizing viral diseases. In January 2009, an Al-Qaeda
Al-Qaeda
Al-Qaeda is a global broad-based militant Islamist terrorist organization founded by Osama bin Laden sometime between August 1988 and late 1989. It operates as a network comprising both a multinational, stateless army and a radical Sunni Muslim movement calling for global Jihad...

 training camp in Algeria
Algeria
Algeria , officially the People's Democratic Republic of Algeria , also formally referred to as the Democratic and Popular Republic of Algeria, is a country in the Maghreb region of Northwest Africa with Algiers as its capital.In terms of land area, it is the largest country in Africa and the Arab...

 was reportedly wiped out by the plague, killing approximately 40 Islamic extremists. Some experts said that the group was developing biological weapons, however, a couple of days later the Algerian Health Ministry flatly denied this rumour stating "No case of plague of any type has been recorded in any region of
Algeria since 2003".

Literature

  • The Andromeda Strain
    The Andromeda Strain
    The Andromeda Strain , by Michael Crichton, is a techno-thriller novel documenting the efforts of a team of scientists investigating a deadly extraterrestrial microorganism that rapidly and fatally clots human blood, while in other people inducing insanity...

    a 1969 science fiction
    Science fiction
    Science fiction is a genre of fiction dealing with imaginary but more or less plausible content such as future settings, futuristic science and technology, space travel, aliens, and paranormal abilities...

     novel by Michael Crichton
    Michael Crichton
    John Michael Crichton , best known as Michael Crichton, was an American best-selling author, producer, director, and screenwriter, best known for his work in the science fiction, medical fiction, and thriller genres. His books have sold over 200 million copies worldwide, and many have been adapted...

  • Company of Liars
    Company of Liars
    Company of Liars is a historical novel by Karen Maitland, set in the fourteenth century. The setting is a Britain which is being decimated by a pandemic known as the Plague....

    (2008), by Karen Maitland
    Karen Maitland
    Karen Maitland is a British author of medieval thriller fiction. Maitland has an honours degree in Human Communication and doctorate in Psycholinguistics. Her works include The White Room published in 1996 by Yorkshire Art Circus, Company of Liars, published in 2008 by Delacorte Press; The Owl...

  • The Decameron
    The Decameron
    The Decameron, also called Prince Galehaut is a 14th-century medieval allegory by Giovanni Boccaccio, told as a frame story encompassing 100 tales by ten young people....

    , a 14th century writing by Italian author Giovanni Boccaccio
    Giovanni Boccaccio
    Giovanni Boccaccio was an Italian author and poet, a friend, student, and correspondent of Petrarch, an important Renaissance humanist and the author of a number of notable works including the Decameron, On Famous Women, and his poetry in the Italian vernacular...

    , circa 1353
  • Earth Abides
    Earth Abides
    Earth Abides is a 1949 post-apocalyptic science fiction novel by American writer George R. Stewart. It tells the story of the fall of civilization from deadly disease and its rebirth. Beginning in the United States in the 1940s, it deals with Isherwood "Ish" Williams, Emma, and the community they...

    , a 1949 novel by George R. Stewart
    George R. Stewart
    George Rippey Stewart was an American toponymist, a novelist, and a professor of English at the University of California, Berkeley...

  • I Am Legend, a 1954 science fiction/horror novel by American writer Richard Matheson
    Richard Matheson
    Richard Burton Matheson is an American author and screenwriter, primarily in the fantasy, horror, and science fiction genres. He is perhaps best known as the author of What Dreams May Come, Bid Time Return, A Stir of Echoes, The Incredible Shrinking Man, and I Am Legend, all of which have been...

  • The Last Canadian
    The Last Canadian
    The Last Canadian is a 1974 science fiction novel by William C. Heine about the adventures of Eugene Arnprior after North America is devastated by a plague. The U.S. release of the novel was titled Death Wind.- Plot introduction :...

    , a 1974 novel by William C. Heine
    William C. Heine
    William C. Heine is a Canadian author most notably known for The Last Canadian, a science fiction novel filmed as The Patriot starring Steven Seagal. Heine was editor in chief of the London Free Press, London, Ontario, Canada....

  • The Last Town on Earth
    The Last Town on Earth
    The Last Town on Earth is a 2006 novel by Thomas Mullen. The novel focuses on the town of Commonwealth, Washington in 1918 during World War I and the emergence of the Spanish Flu. The town agrees to quarantine itself from the outside world, to hopefully save itself from the flu...

    , a 2006 novel by Thomas Mullen
    Thomas Mullen
    Thomas Mullen was an Irish teacher and Fianna Fáil politician.Mullen was born in Roemore, Breaffy, County Mayo, to national-school teacher parents, Thomas and Mary. He was educated in St. Jarlath's College, Tuam, and University College Galway. He too became a teacher and taught in Tullamore and...

  • Pale Horse, Pale Rider
    Pale Horse, Pale Rider
    Pale Horse, Pale Rider is a collection of three short novels by American author Katherine Anne Porter published in 1939....

    , a 1939 short novel by Katherine Anne Porter
    Katherine Anne Porter
    Katherine Anne Porter was a Pulitzer Prize-winning American journalist, essayist, short story writer, novelist, and political activist. Her 1962 novel Ship of Fools was the best-selling novel in America that year, but her short stories received much more critical acclaim...

  • The Stand
    The Stand
    The Stand is a post-apocalyptic horror/fantasy novel by American author Stephen King. It demonstrates the scenario in his earlier short story, Night Surf...

    , a 1978 novel by Stephen King
    Stephen King
    Stephen Edwin King is an American author of contemporary horror, suspense, science fiction and fantasy fiction. His books have sold more than 350 million copies and have been adapted into a number of feature films, television movies and comic books...

  • World War Z
    World War Z
    World War Z: An Oral History of the Zombie War is a 2006 post-apocalyptic horror novel by Max Brooks. It is a follow-up to his 2003 book The Zombie Survival Guide. Rather than a grand overview or narrative, World War Z is a collection of individual accounts in the form of first-person anecdote...

    , a 2006 novel by Max Brooks
    Max Brooks
    Maximillian Michael "Max" Brooks is an American author and screenwriter, with a particular interest in zombies. Brooks is also a television and voice-over actor.- Early life and education :...

  • Two Journeys
    Two Journeys
    Two Journeys is a apocalyptic and post-apocalyptic fiction adventure novel by Clemens P. Suter, which describes the aftermath of a global pandemic that has eradicated all of humankind...

    , a 2009 novel by Clemens P. Suter
  • The time-travel fiction of Connie Willis
    Connie Willis
    Constance Elaine Trimmer Willis is an American science fiction writer. She has won eleven Hugo Awards and seven Nebula Awards. Willis most recently won a Hugo Award for Blackout/All Clear...

     (such as The Doomsday Book and To Say Nothing of the Dog
    To Say Nothing of the Dog
    To Say Nothing of the Dog: How We Found the Bishop's Bird Stump at Last is a 1997 comic science fiction novel by Connie Willis. It takes place in the same universe of time-traveling historians she explored in her story Fire Watch and novel Doomsday Book.To Say Nothing of the Dog won both the Hugo...

    ) set in the mid-twenty-first century, frequently references a pandemic that occurred in the early part of the century.

Film

  • The Seventh Seal
    The Seventh Seal
    The Seventh Seal is a 1957 Swedish film written and directed by Ingmar Bergman. Set during the Black Death, it tells of the journey of a medieval knight and a game of chess he plays with the personification of Death , who has come to take his life. Bergman developed the film from his own play...

    (1957), set during the black death.
  • The Last Man on Earth (1964), an Italian horror/science fiction film based upon the Richard Matheson
    Richard Matheson
    Richard Burton Matheson is an American author and screenwriter, primarily in the fantasy, horror, and science fiction genres. He is perhaps best known as the author of What Dreams May Come, Bid Time Return, A Stir of Echoes, The Incredible Shrinking Man, and I Am Legend, all of which have been...

     novel I Am Legend
    I Am Legend (film)
    I Am Legend is a 2007 post-apocalyptic science fiction film directed by Francis Lawrence and starring Will Smith. It is the third feature film adaptation of Richard Matheson's 1954 novel of the same name, following 1964's The Last Man on Earth and 1971's The Omega Man. Smith plays virologist Robert...

    . The film was directed by Ubaldo Ragona and Sidney Salkow
    Sidney Salkow
    Sidney Salkow was an American film director , screen writer, and television director....

    , and stars Vincent Price
    Vincent Price
    Vincent Leonard Price, Jr. was an American actor, well known for his distinctive voice and serio-comic attitude in a series of horror films made in the latter part of his career.-Early life and career:Price was born in St...

    .
  • The Omega Man
    The Omega Man
    The Omega Man is a 1971 American science fiction film directed by Boris Sagal and starring Charlton Heston. It is based on the novel I Am Legend by American writer Richard Matheson...

    (1971), an English science fiction film directed by Boris Sagal
    Boris Sagal
    Boris Sagal was a Ukrainian-born American television and film director.-Early life and career:Born in Yekaterinoslav, Soviet Union, Sagal emigrated to the United States where he attended the Yale School of Drama. Sagal's many TV credits include directing episodes of The Twilight Zone, "T.H.E...

    , based on the Richard Matheson
    Richard Matheson
    Richard Burton Matheson is an American author and screenwriter, primarily in the fantasy, horror, and science fiction genres. He is perhaps best known as the author of What Dreams May Come, Bid Time Return, A Stir of Echoes, The Incredible Shrinking Man, and I Am Legend, all of which have been...

     novel I Am Legend.
  • The Horseman on the Roof
    The Horseman on the Roof
    The Horseman on the Roof is a 1995 French film directed by Jean-Paul Rappeneau, and starring Juliette Binoche and Olivier Martinez...

    (Le Hussard sur le Toit) (1995), a French film dealing with an 1832 cholera outbreak.
  • Twelve Monkeys
    Twelve Monkeys
    12 Monkeys is a 1995 science fiction film directed by Terry Gilliam, inspired by Chris Marker's 1962 short film La jetée, and starring Bruce Willis, Madeleine Stowe, Brad Pitt, and Christopher Plummer....

    (1995). In a future world devastated by disease, a convict is sent back in time to gather information about the man-made virus that wiped out most of the human population on the planet.
  • Outbreak
    Outbreak
    Outbreak is a term used in epidemiology to describe an occurrence of disease greater than would otherwise be expected at a particular time and place. It may affect a small and localized group or impact upon thousands of people across an entire continent. Two linked cases of a rare infectious...

    (1995). The film focuses on an outbreak of a fictional Ebola-like virus called Motaba in Zaire and later in a small town in the United States.
  • Smallpox 2002 (2002), a fictional BBC docudrama.
  • 28 Days Later
    28 Days Later
    28 Days Later is an acclaimed 2002 British horror film directed by Danny Boyle. The screenplay was written by Alex Garland, and the film stars Cillian Murphy, Naomie Harris, Brendan Gleeson, Megan Burns, and Christopher Eccleston...

    (2002), a fictional horror film following the outbreak of an infectious 'rage' virus that destroys all of mainland Britain.
  • End Day
    End Day
    End Day is a 2005 docu-drama produced by the BBC and aired on the National Geographic Channel, on the TV series, National Geographic Channel Presents, that depicts various doomsday scenarios. The documentary follows the fictional scientist Dr...

    (2005), a fictional BBC docudrama.
  • I Am Legend (2007), a film starring Will Smith based on the Richard Matheson
    Richard Matheson
    Richard Burton Matheson is an American author and screenwriter, primarily in the fantasy, horror, and science fiction genres. He is perhaps best known as the author of What Dreams May Come, Bid Time Return, A Stir of Echoes, The Incredible Shrinking Man, and I Am Legend, all of which have been...

     novel I Am Legend.
  • 28 Weeks Later
    28 Weeks Later
    28 Weeks Later is a 2007 British/Spanish film sequel to the 2002 post-apocalyptic horror film 28 Days Later. 28 Weeks Later was directed by Juan Carlos Fresnadillo and released in the United Kingdom and United States on 11 May 2007...

    (2007), the sequel film to 28 Days Later, involving the NATO-led, United States Army supported repatriation of the British people, following the cessation of quarantine measures, and the complete erasure of infection surrounding mainland Britain. The film ends with the evident spread of 'rage' infection to Paris, and the remainder of mainland Europe.
  • Doomsday
    Doomsday (film)
    Doomsday is a 2008 British science fiction film written and directed by Neil Marshall. The film takes place in the future. Scotland has been quarantined because of a deadly virus. When the virus is found in London, political leaders send a team led by Major Eden Sinclair to Scotland to find a...

    (2008). Scotland is quarantined following a pandemic, only for a commando team to be sent in years later after the same contagion has re-emerged in England.
  • After Armageddon (2010), fictional History Channel docudrama
    Docudrama
    In film, television programming and staged theatre, docudrama is a documentary-style genre that features dramatized re-enactments of actual historical events. As a neologism, the term is often confused with docufiction....

    .
  • Contagion
    Contagion (film)
    Contagion is a 2011 American medical thriller disaster film directed by Steven Soderbergh. The film has an ensemble cast that includes Marion Cotillard, Matt Damon, Laurence Fishburne, Jude Law, Gwyneth Paltrow, Kate Winslet, and Bryan Cranston. Contagion follows the rapid progress of a lethal...

    (2011), American thriller film centered on the threat posed by a deadly disease and an international team of doctors contracted by the CDC to deal with the outbreak.

See also


  • Epidemic
    Epidemic
    In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

  • Endemic
    Endemic (epidemiology)
    In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic in the UK, but malaria is not...

  • Syndemic
    Syndemic
    Syndemic refers to the aggregation of two or more diseases in a population in which there is some level of positive biological interaction that exacerbates the negative health effects of any or all of the diseases...

  • Pandemic Severity Index
    Pandemic Severity Index
    The Pandemic Severity Index is a proposed classification scale for reporting the severity of influenza pandemics in the United States. The PSI was accompanied by a set of guidelines intended to help communicate appropriate actions for communities to follow in potential pandemic situations...

  • Biological hazard
    Biological hazard
    Biological hazards, refer to biological substances that pose a threat to the health of living organisms, primarily that of humans. This can include medical waste or samples of a microorganism, virus or toxin that can impact human health. It can also include substances harmful to animals...

  • Bioterrorism
    Bioterrorism
    Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents are bacteria, viruses, or toxins, and may be in a naturally occurring or a human-modified form. For the use of this method in warfare, see biological warfare.-Definition:According to the...

  • Biological warfare
    Biological warfare
    Biological warfare is the use of biological toxins or infectious agents such as bacteria, viruses, and fungi with intent to kill or incapacitate humans, animals or plants as an act of war...

  • Influenza pandemic
    Influenza pandemic
    An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in...

  • Mortality from infectious diseases
  • Risks to civilization, humans and planet Earth
    Risks to civilization, humans and planet Earth
    Various existential risks could threaten humankind as a whole, have adverse consequences for the course of human civilization, or even cause the end of planet Earth.-Types of risks:...

  • Medieval demography
    Medieval demography
    This article discusses human demography in Europe during the Middle Ages, including population trends and movements. Demographic changes helped to shape and define the Middle Ages...

  • Globalization and disease
    Globalization and disease
    Globalization, the flow of information, goods, capital and people across political and geographic boundaries, has helped to spread some of the deadliest infectious diseases known to humans. The spread of diseases across wide geographic scales has increased through history...

  • Tropical disease
    Tropical disease
    Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation. Insects such as mosquitoes and...

    s
  • Centers for Disease Control and Prevention
    Centers for Disease Control and Prevention
    The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

     (CDC)
  • European Centre for Disease Prevention and Control
    European Centre for Disease Prevention and Control
    The European Centre for Disease Prevention and Control is an independent agency of the European Union aimed at strengthening Europe's defences against infectious diseases. It was established in 2005 and is located in Solna, Sweden....

     (ECDC)
  • WHO pandemic phases


Further reading


  • Steward's "The Next Global Threat: Pandemic Influenza".
  • American Lung Association. (2007, April), Multidrug Resistant Tuberculosis Fact Sheet. As retrieved from www.lungusa.org/site/pp.aspx?c=dvLUK9O0E&b=35815 November 29, 2007.