Pandemics

What are Pandemics?

A pandemic is a global disease outbreak. It is different from an outbreak or epidemic because it affects a wider geographical area (often worldwide, infects a greater number of people than an epidemic, is often caused by a new virus or strain of a virus that has not circulated among people for a long time, humans usually have little to no immunity against it, it spreads quickly from person-to-person worldwide, causes a higher number of deaths than epidemics, and often creates social disruption, economic loss, and general hardship.

Here are 10 of the worst pandemics in history.

The Face of Aids, photographed by Therese Frare, 1990. David Kirby died surrounded by his family. But Therese Frare’s photograph of the 32-year-old man on his deathbed did more than just capture the heartbreaking moment. It humanized AIDS, the disease that killed Kirby, at a time when it was ravaging victims largely out of public view. The image helped create critical awareness about AIDS when the disease was still uncontrolled and sufferers were lobbying the federal government to speed the development of new drugs (Time 100 Photos "The Face of AIDS").

HIV/AIDS Pandemic (at its peak, 2005-2012)
Death Toll: 36 million
Cause: HIV/AIDS
“First identified in Democratic Republic of the Congo in 1976, HIV/AIDS has truly proven itself as a global pandemic, killing more than 36 million people since 1981. Currently there are between 31 and 35 million people living with HIV, the vast majority of those are in Sub-Saharan Africa, where 5% of the population is infected, roughly 21 million people. As awareness has grown, new treatments have been developed that make HIV far more manageable, and many of those infected go on to lead productive lives. Between 2005 and 2012 the annual global deaths from HIV/AIDS dropped from 2.2 million to 1.6 million” (“Outbreak: 10 of the Worst Pandemics in History”).

Flu Pandemic (1968)
Death Toll: 1 million
Cause: Influenza
“A category 2 Flu pandemic sometimes referred to as “the Hong Kong Flu,” the 1968 flu pandemic was caused by the H3N2 strain of the Influenza A virus, a genetic offshoot of the H2N2 subtype. From the first reported case on July 13, 1968 in Hong Kong, it took only 17 days before outbreaks of the virus were reported in Singapore and Vietnam, and within three months had spread to The Philippines, India, Australia, Europe, and the United States. While the 1968 pandemic had a comparatively low mortality rate (.5%) it still resulted in the deaths of more than a million people, including 500,000 residents of Hong Kong, approximately 15% of its population at the time” (“Outbreak: 10 of the Worst Pandemics in History”).

Restrictions on visits to Cleveland’s Grace Hospital and others were among the measures taken to slow the spread of the Hong Kong flu in 1968. BETTMANN ARCHIVE (Wallstreet Journal "Forgotten Pandemic Offers Contrast to Today’s Coronavirus Lockdowns")
Flu-struck students rest in the Naval Armory at Georgia Tech in October 1957 after the school infirmary became too crowded with other patients (The Washington Post "In 1957, a new flu appeared in Asia. The world watched and waited for it to spread.").

Asian Flu (1956-1958)
Death Toll: 2 million
Cause: Influenza
“Asian Flu was a pandemic outbreak of Influenza A of the H2N2 subtype, that originated in China in 1956 and lasted until 1958. In its two-year spree, Asian Flu traveled from the Chinese province of Guizhou to Singapore, Hong Kong, and the United States. Estimates for the death toll of the Asian Flu vary depending on the source, but the World Health Organization places the final tally at approximately 2 million deaths, 69,800 of those in the US alone” (“Outbreak: 10 of the Worst Pandemics in History”).

Flu Pandemic (1918)
Death Toll: 20-50 million
Cause: Influenza
“Between 1918 and 1920 a disturbingly deadly outbreak of influenza tore across the globe, infecting over a third of the world’s population and ending the lives of 20 – 50 million people. Of the 500 million people infected in the 1918 pandemic, the mortality rate was estimated at 10% to 20%, with up to 25 million deaths in the first 25 weeks alone. What separated the 1918 flu pandemic from other influenza outbreaks was the victims; where influenza had always previously only killed juveniles and the elderly or already weakened patients, it had begun striking down hardy and completely healthy young adults, while leaving children and those with weaker immune systems still alive” (“Outbreak: 10 of the Worst Pandemics in History”).

Boston Red Cross Volunteers assembling gauze masks for use at hard-hit Camp Devens, Massachusetts (CDC "1918 Historical Image Gallery").
A cholera ward during the sixth cholera pandemic (Wikipedia Commons).

Sixth Cholera Pandemic (1910-1911)
Death Toll: 800,000+
Cause: Cholera
“Like its five previous incarnations, the Sixth Cholera Pandemic originated in India where it killed over 800,000, before spreading to the Middle East, North Africa, Eastern Europe and Russia. The Sixth Cholera Pandemic was also the source of the last American outbreak of Cholera (1910–1911). American health authorities, having learned from the past, quickly sought to isolate the infected, and in the end only 11 deaths occurred in the U.S. By 1923 Cholera cases had been cut down dramatically, although it was still a constant in India” (“Outbreak: 10 of the Worst Pandemics in History”).

Flu Pandemic (1889-1890)
Death Toll: 1 million
Cause: Influenza
“Originally the “Asiatic Flu” or “Russian Flu” as it was called, this strain was thought to be an outbreak of the Influenza A virus subtype H2N2, though recent discoveries have instead found the cause to be the Influenza A virus subtype H3N8. The first cases were observed in May 1889 in three separate and distant locations, Bukhara in Central Asia (Turkestan), Athabasca in northwestern Canada, and Greenland. Rapid population growth of the 19th century, specifically in urban areas, only helped the flu spread, and before long the outbreak had spread across the globe. Though it was the first true epidemic in the era of bacteriology and much was learned from it. In the end, the 1889-1890 Flu Pandemic claimed the lives of over a million individuals” (“Outbreak: 10 of the Worst Pandemics in History”).

Artist rendition of a hospital ward during the flu pandemic of 1889. (History "The Russian Flu of 1889: The Deadly Pandemic Few Americans Took Seriously") 7 Continents History/Everett Collection
Hand bill from the New York City Board of Health, 1832. The outdated public health advice demonstrates the lack of understanding of the disease and its actual causative factors (Wikipedia "Cholera outbreaks and pandemics").

Third Cholera Pandemic (1852-1860)
Death Toll: 1 million
Cause: Cholera
“Generally considered the most deadly of the seven cholera pandemics, the third major outbreak of Cholera in the 19th century lasted from 1852 to 1860. Like the first and second pandemics, the Third Cholera Pandemic originated in India, spreading from the Ganges River Delta before tearing through Asia, Europe, North America and Africa and ending the lives of over a million people. British physician John Snow, while working in a poor area of London, tracked cases of cholera and eventually succeeded in identifying contaminated water as the means of transmission for the disease. Unfortunately the same year as his discovery (1854) went down as the worst year of the pandemic, in which 23,000 people died in Great Britain” (“Outbreak: 10 of the Worst Pandemics in History”).

The Black Death (1346-1353)
Death Toll: 75-200 million
Cause: Bubonic Plague
“From 1346 to 1353 an outbreak of the Plague ravaged Europe, Africa, and Asia, with an estimated death toll between 75 and 200 million people. Thought to have originated in Asia, the Plague most likely jumped continents via the fleas living on the rats that so frequently lived aboard merchant ships. Ports being major urban centers at the time, were the perfect breeding ground for the rats and fleas, and thus the insidious bacterium flourished, devastating three continents in its wake” (“Outbreak: 10 of the Worst Pandemics in History”).

A drawing of a plague doctor mask. Foul-smelling air was combatted with sweet herbs and spices like camphor, mint, cloves, and myrrh, stuffed into a mask with a curved, bird-like beak. The mask was intended to protect the doctors from the plague, but was often ineffective because of the airholes poked into the beak (All That's Interesting "Inside The Terrifying But Necessary Job Of A Medieval Plague Doctor").
Renaissance depiction of the Plague of Justinian (History of Yesterday "The Pandemic That Nearly Brought Down An Empire").

Plague of Justinian (541-542)
Death Toll: 25 million
Cause: Bubonic Plague
“Thought to have killed perhaps half the population of Europe, the Plague of Justinian was an outbreak of the bubonic plague that afflicted the Byzantine Empire and Mediterranean port cities, killing up to 25 million people in its year long reign of terror. Generally regarded as the first recorded incident of the Bubonic Plague, the Plague of Justinian left its mark on the world, killing up to a quarter of the population of the Eastern Mediterranean and devastating the city of Constantinople, where at its height it was killing an estimated 5,000 people per day and eventually resulting in the deaths of 40% of the city’s population” (“Outbreak: 10 of the Worst Pandemics in History”).

Antonine Plague (165 AD)
Death Toll: 5 million
Cause: Unknown
“Also known as the Plague of Galen, the Antonine Plague was an ancient pandemic that affected Asia Minor, Egypt, Greece, and Italy and is thought to have been either Smallpox or Measles, though the true cause is still unknown. This unknown disease was brought back to Rome by soldiers returning from Mesopotamia around 165AD; unknowingly, they had spread a disease which would end up killing over 5 million people and decimating the Roman army” (“Outbreak: 10 of the Worst Pandemics in History”).

An engraving by Levasseur after Jules-Elie Delaunay depicts the angel of death at the door during the 165 A.D. Antonine plague in Rome (Smithsonian Magazine "What Rome Learned From the Deadly Antonine Plague of 165 A.D.").

“1918 Historical Image Gallery.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Mar. 2018, www.cdc.gov/flu/pandemic-resources/1918-commemoration/historical-images.htm. 

“Cholera Outbreaks and Pandemics.” Wikipedia, Wikimedia Foundation, 16 Nov. 2020, en.wikipedia.org/wiki/Cholera_outbreaks_and_pandemics. 

Daugherty, Greg. “The Russian Flu of 1889: The Deadly Pandemic Few Americans Took Seriously.” History.com, A&E Television Networks, 23 Mar. 2020, www.history.com/news/1889-russian-flu-pandemic-in-america. 

“The Face of AIDS | 100 Photographs | The Most Influential Images of All Time.” Time, Time, 100photos.time.com/photos/therese-frare-face-aids. 

Kelly, John. “Perspective | In 1957, a New Flu Appeared in Asia. The World Watched and Waited for It to Spread.” The Washington Post, WP Company, 17 Mar. 2020, www.washingtonpost.com/local/in-1957-a-new-flu-appeared-in-asia-the-world-watched-and-waited-for-it-to-spread/2020/03/17/9f5205b4-685f-11ea-b313-df458622c2cc_story.html.

“Outbreak: 10 of the Worst Pandemics in History By Staff.” Outbreak: 10 of the Worst Pandemics in History, www.mphonline.org/worst-pandemics-in-history/.

“Outbreaks, Epidemics and Pandemics-What You Need to Know.” APIC, apic.org/monthly_alerts/outbreaks-epidemics-and-pandemics-what-you-need-to-know/.

Pancevski, Bojan. “Forgotten Pandemic Offers Contrast to Today’s Coronavirus Lockdowns.” The Wall Street Journal, Dow Jones & Company, 24 Apr. 2020, www.wsj.com/articles/forgotten-pandemic-offers-contrast-to-todays-coronavirus-lockdowns-11587720625. 

Piper, Grant. “The Pandemic That Nearly Brought Down An Empire.” Medium, History of Yesterday, 12 Aug. 2020, medium.com/history-of-yesterday/the-pandemic-that-nearly-brought-down-an-empire-c8a32bdb3d. 

Rennie, Daniel. “Behind The Beaked Mask: The Terrifying Job Of A Medieval Plague Doctor.” All That’s Interesting, All That’s Interesting, 23 Jan. 2020, allthatsinteresting.com/plague-doctors. 

“What Rome Learned From the Deadly Antonine Plague of 165 A.D.” Smithsonian.com, Smithsonian Institution, 28 Apr. 2020, www.smithsonianmag.com/history/what-rome-learned-deadly-antonine-plague-165-d-180974758/.