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International Journal of Health Sciences & Research (www.ijhsr.org) 165
Vol.4; Issue: 2; February 2014
International Journal of Health Sciences and Research
www.ijhsr.org ISSN: 2249-9571
Review Article
A Historical Exploration of Pandemics of Some Selected Diseases in the World
Janmejaya Samal
Former District Epidemiologist, Gadchiroli, Maharashtra, Presently MPH Scholar, Padmashree School of Public
Health (under RGUHS), Nagarbhavi Circle, Nagarbhavi, Bangalore, India.
Received: 12/12//2013 Revised: 08/01/2014 Accepted: 08/01/2014
ABSTRACT
A pandemic is an epidemic occurring on a scale which crosses international boundaries, usually affecting
a large number of people. In a simple way a pandemic is an epidemic with higher magnitude in terms of
geographical area, number of cases and days of suffering resulting in disabilities or deaths. Human
population have suffered from many pandemics throughout history be it the earlier form of smallpox or
tuberculosis or the recent incidence of HIV/AIDS or H1N1. It has created catastrophic damage in many
different forms. Public health around the globe is improving by leaps and bound but the occurrence of a
pandemic is not always unexpected. The epidemiological transition in different form may be one of the
important factors for such incidents in and around the globe. In this paper an attempt has been made to
explore historically some calendar of events of some selected pandemics around the globe.
Key Words: Pandemic, Selected Disease, World
INTRODUCTION
Pandemic is the form of epidemic
that spreads through human population
affecting large number of people, major part
of a nation, entire nation, a continent or a
part of the entire world.(1) 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 is
responsible for many deaths but is not
considered a pandemic because the disease
is not infectious or contagious. Human
population have suffered from many
pandemics throughout history be it the
earlier form of smallpox or tuberculosis or
the recent incidence of HIV/AIDS or H1N1.
It has created catastrophic damage in many
different forms. While 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. 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.(2) All versions
of this document refer to influenza. The
phases are defined by the spread of the
disease; virulence and mortality are not
mentioned in the current WHO definition,
although these factors have previously been
included.(3) The changing patterns of
infectious disease such as: (1)Antibiotic
International Journal of Health Sciences & Research (www.ijhsr.org) 166
Vol.4; Issue: 2; February 2014
resistance (2) Emerging and reemerging
infectious disease (3)Change of niche such
as from animal to human (4) Non infectious
diseases are getting discovered with an
infectious origin and the epidemiological
transitions contribute a lot to several forms
of epidemics.
HIV/AIDS: AIDS is the end result that
occurs after several years of infection with
HIV. The disease was first detected in 1981
and the name AIDS was coined in the next
year. New HIV infections have been
reduced by 17% over the past eight years.
Since 2001, when the United Nations
Declaration of Commitment on HIV/AIDS
was signed, the number of new infections in
sub-Saharan Africa is approximately 15%
lower, which are about 400 000 fewer
infections in 2008. In East Asia HIV
incidence has declined by nearly 25% and in
South and South East Asia by 10% in the
same time period. In Eastern Europe, after a
dramatic increase in new infections among
injecting drug users, the epidemic has
leveled off considerably. However, in some
countries there are signs that HIV incidence
is rising again.(4)
Plague: Plague is a zoonotic infection
primarily affecting the rodents caused by a
gram negative rod like cocco-bacillus called
Yersinia pestis. It is transmitted to house rats
from wild rodents such as marmots in
Mongolia and Siberia, ground squirrels in
California and field rodents such as
Bandicoot, gunomyskok, Tatera indica and
Rattus norvegicus in India. The common
vectors responsible for the spread of the
disease include Xenopsylla cheopis, X. astia,
X. braziliensis and Nasopsylla fasciatus. The
control of Plague involves Notification,
Isolation, Quarantine, Diagnosis, Treatment,
Disinfection, Immunization, Health
Education and International measures.
Epidemics or pandemics of plague could be
disastrous as had happened in India in 1994
which was not an incidence by chance rather
favored by all epidemiological features such
as reservoir in the form of wild rats, vector
in the form of fleas, nonimmune population
etc.(5) The following table shows a list of
pandemic events occurred worldwide:
Table No1, Calendar of Plague and disease Pandemic Events Occurred Worldwide.
Sl No.
Name of the Pandemic event
Year of the Event
Place of the Event
Catastrophe
PLAGUE AND OTHER DISEASES
1(6)
Plague of Athens(Typhoid
Fever)
430 BC
Athens
A quarter of the Athenian troops and
a quarter of the population over four years.
2 (7)
Antonine Plague (Small pox)
165-180
Italian
peninsula
Killed a quarter of those infected, and
up to five million in all.
3(8)
Plague of Cyprian
252-256
Rome
5,000 people a day were said to be dying
4(8)
Plague of Justinian
(Bubonic Plague)
541-750
Egypt and
Constantinople
10,000 a day at its height, and perhaps
40% of the city's inhabitants
5 (9)
Black Death
14th Century
Worldwide
75 million people died
6(10)
Third Pandemic (Plague)
19th Century
Started in China and
grabbed many continent
10 Million People died in India only.
Smallpox: Smallpox was one of the major
killers of mankind and was responsible for
the death of one out of every five children
below five years of age till the vaccine could
be discovered. This disease is no more a
public health problem and has been
eradicated from the world by October 1979
as declared by WHO. The epidemiological
basis of smallpox eradication is as follows:
Absence of an animal reservoir.
Absence of human carrier stage.
Absence of subclinical cases.
Rarity of second attack.
Easy clinical identification.
Slow transmission which helps in
containment.
Availability of a potent, safe and
effective vaccine.
International cooperation.(5)
International Journal of Health Sciences & Research (www.ijhsr.org) 167
Vol.4; Issue: 2; February 2014
The following table shows a list of
pandemics events of Smallpox occurred
worldwide:
Table No.2, Calendar of Smallpox Pandemic Events Occurred Worldwide.
Sl
No.
Name of the
Pandemic event
Year of the Event
Place of the Event
Catastrophe
SMALLPOX
1(11)
Smallpox
1518
Hispaniola (Dominican
Republic and Haiti)
Half of native population
if Hispaniola
2(11)
Smallpox
1520
Mexico
Killed 150,000 in Tenochtitlan
alone including the Emperor
3(11)
Smallpox
1618-1619
Massachusetts Bay
90% Native Americans
4(11)
Smallpox
1770
Pacific Northwest
30% of Native Americans
5(11)
Smallpox
1780-1782 &
1837-1838
Indians
Drastic Depopulation
Cholera: Cholera is water borne disease
caused by Vibrio cholera characterized by
three classical clinical stages, such as stage
of profuse watery evacuations, stage of
collapse, stage of recovery or death. The
prevention and control measures include
Verification, Notification, Isolation,
Diagnosis, Treatment, Disinfection, Antifly
measures, Immunization, Health education,
personal protection and Surveillance. The
incidence of cholera around the world has
been divided in to three phases and the first
phase (pre-1817) was limited to India
especially to Bengal. The second phase
(1817-1823), known as pandemic phase,
witnessed six pandemics, all of which
started in India and disseminated to several
continents including South East Asia, China,
Middle East, USSR, Europe and Africa. The
third phase which started in 1923 was again
confined to India and East. The fourth phase
of cholera pandemic started in 1961 and
continued with the seventh phase of
pandemic. The seventh phase of the
pandemic was started in 1961 from an
endemic focus on an island in Indonesia.
The worst part of this pandemic was that it
affected some portions of all the continents
except America in 1970. From 1948
onwards 98% of all cases of cholera were
occurred in Indian subcontinent such as
India, Pakistan and Bangladesh. The
classical more sever forms of cholera are
now uncommon and are usually present with
diarrhea as a presenting feature.(5,12)
Table No.3, Calendar of Cholera Pandemic Events Occurred Worldwide.
Sl
No.
Name of the
Pandemic event
Year of
the Event
Place of the Event
Catastrophe
CHOLERA
1(12)
1st Cholera Pandemic
1816–1826
Started in Indian Subcontinent, later
spread to China, Indonesia and Caspian Sea
10,000 British troops and countless Indians died
2(12)
2nd Cholera Pandemic
1829–1851
Russia, Hungary, Germany, London, France,
Canada, US, Pacific coast of North America
Hungary (about 100,000 deaths), more than 55,000
persons died in the UK and many more in different
parts of the globe.
3(12)
3rd Cholera Pandemic
1852–1860
Mainly Russia
over a million deaths
4(12)
4th Cholera Pandemic
1863–1875
Mostly in Europe and Africa
At least 30,000 of the 90,000 Mecca pilgrims fell
victim to the disease
5(12)
An Outbreak of Cholera
1866
North America
50,000 Americans were died
6(12)
5th Cholera Pandemic
1881–1896
Europe, America, Russia, Spain,
Japan, Persia
250,000 lives in Europe, at least 50,000 in Americas,
267,890 lives in Russia, 120,000 in Spain, 90,000 in
Japan, 60,000 in Persia were lost
7(12)
6th Cholera Pandemic
1899–1923
Russia
more than 500,000 people died of cholera during the
first quarter of the 20th century
8(12)
7th Cholera Pandemic
1962–66
Indonesia, Bangladesh, India, USSR
-----
International Journal of Health Sciences & Research (www.ijhsr.org) 168
Vol.4; Issue: 2; February 2014
Influenza: Influenza is an infectious disease
of birds and mammals caused by RNA
viruses of the family Orthomyxoviridae. The
most common symptoms are chills, fever,
runny nose, sore throat, muscle pains,
headache (often severe), and coughing,
weakness/fatigue and general discomfort.
The 2009 pandemic of H1N1 is a real
scourge. The recent estimate of global
mortality published in Lancet shows a death
of 151,700 to 575,400 people in the world.
This study estimated that 80% of 2009
H1N1 deaths were in people younger than
65 years of age which differs from typical
seasonal influenza epidemics during which
80-90% of deaths are estimated to occur in
people 65 years of age and older. To
illustrate the impact of the shift in the age
distribution of influenza deaths to younger
age groups during the pandemic, researchers
calculated the number of years of life lost
due to 2009 H1N1-associated deaths. They
estimated that 3 times as many years of life
were lost during the first year of 2009 H1N1
virus circulation than would have occurred
for the same number of deaths during a
typical influenza season.(13) Development
strategies for mitigating new influenza
pandemic is a top global public heath
priority.(14) Influenza prevention and
containment strategies can be considered
under the broad categories of antiviral,
vaccine and nonpharmaceutical (case
isolation, household quarantine, school or
workplace closure, restrictions on travel)
measures.(15)
Table No.4, Calendar of Influe nza Pandemic Events Occurred Worldwide.
Sl
No.
Name of the
Pandemic event
Year of the
Event
Place of the Event
Catastrophe
INFLUENZA
1(17)
Russian Flu
1889-1890
Uzbekistan and other parts of North America
About 1 million people died in this pandemic
2(18)
Spanish Flue
1918-1919
Worldwide pandemic of all continents
500 million people were affected
3(19)
Asian Flue
1957-1958
Started in China and then other parts
of the globe including US
2 million deaths globally
4(20)
Hong Kong Flue
1968-1969
First detected in Hong Kong and then
disseminated to other parts of the globe
Killed one million people worldwide
5(13)
H1N1
2009
Many parts of the globe
151,700 to 575,400 people perished from
world and a disproportionate number of deaths
occurred in Southeast Asia and Africa
CONCLUSION
Exploring history of pandemic is a
hard-hitting job as the same cannot be easily
reproduced in a short article. Many
researchers believe that the 1918 influenza
pandemic is the mother of all pandemics.
Though the world has progressed
substantially in mitigating many epidemics
from time to time owing to the improved
public health measures but the occurrence of
an epidemic in a large scale cannot be
denied fully. This is because of the changing
pattern of infectious diseases and the
epidemiological transition. Many controlled
diseases are getting reemerged and new
emerging infectious diseases are evolving
creating challenge among the global public
health intelligencia. The recent pandemic of
influenza is a wake up slap to the public
health realm and development of strategies
for mitigating new influenza pandemic is a
top global public heath priority. Proper
surveillance is one of the key factors behind
mitigating some of the important scourges
besides the disease specific strategies.
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How to cite this article: Samal J. A historical exploration of pandemics of some selected diseases in
the world. Int J Health Sci Res. 2014;4(2):165-169.