October 3, 2023

10 Deadliest Epidemics in History

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Disease has probably killed more human beings than anything else in history, and illnesses such as the plague, malaria and cholera are still dangerous today. The most infamous epidemic in history, the Black Death, wiped out almost half the population of Europe. Could a present-day equivalent rear its head?

The battle against deadly diseases is far from over. Modern pandemics like AIDS and swine flu show that, even in the 21st century, we aren’t entirely free from the threat of disease. And there’s always the cheery possibility that the next epidemic will be our Black Death – a metaphorical grim reaper sent to Earth, and the cause of so much death and suffering that it changes the society we live in forever. Read on for the 10 most devastating epidemics in history.

10. Native American Smallpox 1500-1900

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Smallpox is a highly contagious and disfiguring disease that killed around a third of the people it infected – a third of the Europeans, that is. Amongst Native American tribes like the Piegan, Cherokee and Mandan, susceptibility and death rates were much higher, and the disease was nothing short of a devastating social catastrophe.

It’s estimated that, during the 1770s, smallpox killed 30% of the total population of the Northwest Coast of America, yielding a body count in the tens of thousands. And from 1770 to 1850, smallpox, measles and influenza killed at least two thirds of the original population of Western Washington.

All in all, from 1500 to 1900, introduced diseases like smallpox, measles and typhoid killed around 1,500,000 Native Americans. It’s therefore probably not an exaggeration to say that these epidemic diseases helped pave the way for Europeans to conquer the New World.

9. Third Cholera Pandemic 1846-1863

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Before the development of purification techniques, water supplies were frequently the source of devastating epidemics. And cholera, a water-borne bacteria originating from India, was often the culprit when it came to global outbreaks. The disease enters the body through drinking water and kills its victims through severe diarrhea, vomiting and dehydration.

One of cholera’s most devastating spells occurred from 1846 to 1863. The infection spread from India to Afghanistan in 1839, and then there were sporadic outbreaks over the next six years before it reappeared in India and the Middle East in 1845. It worked its way across the world to Russia, where it is estimated that it caused at least a million deaths. And by 1848, it was wreaking havoc on Europe. In 1854, more than 23,000 died in Britain alone. It seemed no one was safe, as the disease hit Africa and made its way through the Americas as well.

On the other hand, the London cholera outbreak also played an important role in the founding of epidemiology. In 1854, physician John Snow analyzed cholera’s fatalities and noticed that a large number of cases in Soho were clustered around the pump in Broad Street.

He concluded that the pump’s water was somehow contaminated with “cholera poison” and requested that the local authorities remove its handle. This was one of the first times that modern methods like statistics had been used to combat a disease outbreak. As such, John Snow has been dubbed the “father of modern epidemiology.”

8. Asian Flu 1856-58

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The 1956-1958 Asian flu pandemic was less lethal than the Spanish flu outbreak of 1918, but it still racked up a considerable death toll. The strain, known as H2N2 influenza, is thought to have originated from a mutation in wild ducks that mixed with a preexisting human strain. It was first reported in 1956, in a Guizhou, a province of the People’s Republic of China.

The illness made its way to Singapore in February 1957 and within months spread to Hong Kong and the US. By September it had infected India, northern Australia, the Philippines, the UK and continental Europe.

The first waves of the disease infected large numbers of school children. It was estimated that in 1957, 50% of British school children were infected with the virus. In residential schools in the UK, attack rates reached a staggering 90%, and the disease often made its way through an entire school in a couple of weeks.

Worldwide deaths from the outbreak were estimated at around two million. And the fact that a strain of common influenza could cause so many casualties illustrates just how dangerous such a simple disease can be in a global context.

7. Antonine Plague 165-180

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The Antonine Plague was a devastating epidemic that made a major contribution to the decline of the Roman Empire. This deadly disease raged for 15 years, from 165 to 180, wiping out up to one third of the population in many areas and filling the streets with bodies faster than they could be buried.

Symptoms of the disease included fever, diarrhea and inflammation of the throat, and it was frequently deadly. Although the great Greek physician Galen was present during the plague, his descriptions are sketchy and it is therefore difficult to say exactly which virus was responsible. Most historians, however, agree that the culprit was either measles or smallpox.

Total deaths from the epidemic are estimated at around five million. And due to the combined effects of other outbreaks, such as the Plague of Cyprian, the shrinking population couldn’t produce the military or economic might to sustain the Western Roman Empire. By the third century, the capital city was no longer providing strong central government, and from then on, Imperial power could only go downhill. Just to think: the disintegration of Rome’s global empire, all caused by a handful of germs.

6. Thirty Years’ War Typhus/Plague Epidemic 1618-1648

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As in many conflicts, more people died from disease in the Thirty Years’ War than on the battlefield. And events like the movement of soldiers across national boundaries and the overcrowding of refugees in cities allowed the illness to quickly infect a large number of victims.

Soldiers dealing with the unsanitary conditions of 17th-century warfare were perfect hosts for lice – parasites that spread typhus through the ranks of troops. The symptoms of the disease include shivering, chills, nausea, vomiting, and pain in the head, back and chest.

Without medical treatment, typhus was often fatal. It is estimated that around eight million Germans died either from typhus or bubonic plague during the war. Typhus is also infamous as a major cause of the deaths in Nazi concentration camps and for decimating Napoleon’s army when he invaded Russia in 1812.

5. Third Plague Pandemic 1855-1959

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This last great bubonic plague epidemic was responsible for more than 12 million deaths. The disease had been endemic in India for much of the 19th century, but it only reached disaster status when it spread to the Chinese province of Yunnan in 1855.

Tens of thousands of Chinese citizens died, and when the bacteria reached the port cities of Hong Kong and Guangzhou in 1894, it was able to spread across the world. The infected regions included cities as diverse as Bombay, Cape Town and San Francisco. India was especially badly affected and, together with China, accounted for the bulk of the fatalities.

Advances in medical understanding eventually halted the pandemic: germ theory helped doctors to isolate the virus, and early antibiotics, such as sulfa drugs and streptomycin, allowed them to treat it. It would be the final ride for the bubonic plague’s grim reaper.

4. Plague of Justinian 541-542

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Four hundred years after the disaster of the Antonine Plague, the Roman Empire (this time the Eastern Empire) was again crossed by the shadow of an epidemic. Rats in a grain shipment from Egypt brought bubonic plague into the Imperial capital of Constantinople, and around half of the population of the city was killed before the bacteria broke out and continued to spread.

As with the Antonine Plague before it, the pandemic would squelch the Byzantine Empire’s burgeoning Imperial power. The disease weakened Constantinople’s forces at a critical point and allowed the Goths to reclaim the initiative and prevent emperor Justinian from reuniting the Eastern and Western Roman kingdoms. The plague’s final death toll is estimated to have been between 25 and 100 million people in Europe and Asia.

This disease was a recurring nightmare for the Byzantine Empire, but after its last eruption in 750 AD, it seemed to be gone forever. Nevertheless, bubonic plague would reappear 600 years later in a truly nightmarish fashion…

3. HIV/AIDS 1981-Present

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A deadly epidemic is occurring right now in the Third World. HIV (Human Immunodeficiency Virus) is a mostly sexually transmitted condition that normally does not show any symptoms for a prolonged period of time. Other causes include contaminated blood, infected needles, and mother to child transmission during breastfeeding and pregnancy.

After coming out of latency, the virus causes sufferers to develop AIDS (Acquired Immunodeficiency Syndrome), which prevents the victim’s immune system from fighting disease and generally leads to death from infections or cancer.

The condition was first observed in America in 1981, but it has since spread across the world. AIDS is particularly common in Sub-Saharan Africa, where as many as 15% of the population are infected in some areas. Since its discovery, HIV/AIDS has caused between 25 and 30 million deaths. There’s a reason governments spent most of the 1980s trying to promote safe sex.

2. Spanish Flu 1918-1919

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By 1918, millions of people had died in WWI. Yet an even more devastating event was about to ravage the world – a lethal disease which would kill between 50 and 100 million people, quite a few times the number who died in combat during the war.

The so-called Spanish flu was an influenza virus, similar to the common seasonal flu but considerably more deadly. In those severely affected, it caused the skin to turn blue, violent coughing that sometimes tore abdominal muscles, bleeding from the mouth and nose, incontinence, and vomiting. The virus was particularly dangerous to the young and seemingly healthy. And in some cases, victims were reported to die in a matter of hours.

Spanish flu first appeared in force in August 1918, simultaneously attacking the port cities of Boston (USA), Brest (France) and Freetown (Sierra Leone). The virus quickly spread around the world thanks to air and ocean travel, overwhelming doctors and nurses, who were often forced to erect temporary tents to deal with the sheer number of patients. At the height of the outbreak, it is estimated that over 500 million people were infected with the disease.

1. Black Death 1338-1351

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The Black Death is far and away the most lethal epidemic in history. The statistics alone are staggering. The Plague’s 13-year reign across the world resulted in at least 75 million deaths, including at least a third of Europe.

The pandemic originated as a bubonic plague outbreak in China in the 1330s and was then spread by the fleas of infected rats. Symptoms included fever, headaches, nausea, painful buboes and rashes.

The plague was initially restricted to Asia, but trading ships brought the illness to Sicily in 1347. From there it ravaged the continent, causing thousands of deaths a day and prompting people to flee the cities to the safety of the countryside.

The disease killed so many in Europe that it created labor shortages, which increased the demand for peasant workers and therefore raised their standard of living. Ironically, then, even the most deadly epidemic of all time could be seen to have had some kind of bright side.