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A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. A widespread endemic disease with a stable number of infected individuals is not a pandemic. Widespread endemic diseases with a stable number of infected individuals such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.
In epidemiology, an outbreak is a sudden increase in occurrences of a disease when cases are in excess of normal expectancy for the location or season. It may affect a small and localized group or impact upon thousands of people across an entire continent. The number of cases varies according to the disease-causing agent, and the size and type of previous and existing exposure to the agent. Outbreaks include many epidemics, which term is normally only for infectious diseases, as well as diseases with an environmental origin, such as a water or foodborne disease. They may affect a region in a country or a group of countries. Pandemics are near-global disease outbreaks when multiple and various countries around the Earth are soon infected.
The 1972 Yugoslav smallpox outbreak was the largest outbreak of smallpox in Europe after the Second World War. It was centered in SAP Kosovo and Belgrade, a province of and the capital city respectively of Yugoslavia. A Kosovar Albanian Muslim pilgrim had contracted the smallpox virus in the Middle East. Upon returning to his home in Kosovo, he started the epidemic in which 175 people were infected, killing 35. The epidemic was efficiently contained by enforced quarantine and mass vaccination. The 1982 film Variola Vera is based on the event.
The New World of the Western Hemisphere was devastated by the 1775–1782 North American smallpox epidemic. Estimates based on remnant settelments say 30,000,000 people were estimated to have died in the epidemic that started in 1775.
Disease surveillance is an epidemiological practice by which the spread of disease is monitored in order to establish patterns of progression. The main role of disease surveillance is to predict, observe, and minimize the harm caused by outbreak, epidemic, and pandemic situations, as well as increase knowledge about which factors contribute to such circumstances. A key part of modern disease surveillance is the practice of disease case reporting.
Globalization, the flow of information, goods, capital, and people across political and geographic boundaries, allows infectious diseases to rapidly spread around the world, while also allowing the alleviation of factors such as hunger and poverty, which are key determinants of global health. The spread of diseases across wide geographic scales has increased through history. Early diseases that spread from Asia to Europe were bubonic plague, influenza of various types, and similar infectious diseases.
Typhus, also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus, and murine typhus. Common symptoms include fever, headache, and a rash. Typically these begin one to two weeks after exposure.
The history of smallpox extends into pre-history. Genetic evidence suggests that the smallpox virus emerged 3,000 to 4,000 years ago. Prior to that, similar ancestral viruses circulated, but possibly only in other mammals, and possibly with different symptoms. Only a few written reports dating from about 500 AD to 1000 AD are considered reliable historical descriptions of smallpox, so understanding of the disease prior to that has relied on genetics and archaeology. However, during the 2nd millennium AD, especially starting in the 16th century, reliable written reports become more common. The earliest physical evidence of smallpox is found in the Egyptian mummies of people who died some 3,000 years ago. Smallpox has had a major impact on world history, not least because indigenous populations of regions where smallpox was non-native, such as the Americas and Australia, were rapidly and greatly reduced by smallpox during periods of initial foreign contact, which helped pave the way for conquest and colonization. During the 18th century the disease killed an estimated 400,000 Europeans each year, including five reigning monarchs, and was responsible for a third of all blindness. Between 20 and 60% of all those infected—and over 80% of infected children—died from the disease.
Although a variety of infectious diseases existed in the Americas in pre-Columbian times, the limited size of the populations, smaller number of domesticated animals with zoonotic diseases, and limited interactions between those populations hampered the transmission of communicable diseases. One notable infectious disease of American origin is syphilis. Aside from that, most of the major infectious diseases known today originated in the Old World. The American era of limited infectious disease ended with the arrival of Europeans in the Americas and the Columbian exchange of microorganisms, including those that cause human diseases. Eurasian infections and epidemics had major effects on Native American life in the colonial period and nineteenth century, especially.
The social history of viruses describes the influence of viruses and viral infections on human history. Epidemics caused by viruses began when human behaviour changed during the Neolithic period, around 12,000 years ago, when humans developed more densely populated agricultural communities. This allowed viruses to spread rapidly and subsequently to become endemic. Viruses of plants and livestock also increased, and as humans became dependent on agriculture and farming, diseases such as potyviruses of potatoes and rinderpest of cattle had devastating consequences.
Seven cholera pandemics have occurred in the past 200 years, with the first pandemic originating in India in 1817. The seventh cholera pandemic is officially a current pandemic and has been ongoing since 1961, according to a World Health Organization factsheet in March 2022. Additionally, there have been many documented major local cholera outbreaks, such as a 1991–1994 outbreak in South America and, more recently, the 2016–2021 Yemen cholera outbreak.
During the Great Northern War (1700–1721), many towns and areas around the Baltic Sea and East-Central Europe had a severe outbreak of the plague with a peak from 1708 to 1712. This epidemic was probably part of a pandemic affecting an area from Central Asia to the Mediterranean. Most probably via Constantinople, it spread to Pińczów in southern Poland, where it was first recorded in a Swedish military hospital in 1702. The plague then followed trade, travel and army routes, reached the Baltic coast at Prussia in 1709, affected areas all around the Baltic Sea by 1711 and reached Hamburg by 1712. Therefore, the course of the war and the course of the plague mutually affected each other: while soldiers and refugees were often agents of the plague, the death toll in the military as well as the depopulation of towns and rural areas sometimes severely impacted the ability to resist enemy forces or to supply troops.
The history of smallpox in Mexico spans approximately 520 years from the arrival of the Spanish to the official eradication in 1951. It was brought to Mexico by those in Spanish ships, then spread to the center of Mexico, where it became a significant factor in the fall of Tenochtitlan. During the colonial period, there were major epidemic outbreaks which led to the implementation of sanitary and preventive policy. The introduction of smallpox vaccination in New Spain by Francisco Javier de Balmis and the work of Ignacio Bartolache reduced the mortality and morbidity of the disease.
Diseases and epidemics of the 19th century included long-standing epidemic threats such as smallpox, typhus, yellow fever, and scarlet fever. In addition, cholera emerged as an epidemic threat and spread worldwide in six pandemics in the nineteenth century. The third plague pandemic emerged in China in the mid-nineteenth century and spread worldwide in the 1890s.
Globally about 600 cases of plague are reported a year. In 2017 and November 2019 the countries with the most cases include the Democratic Republic of the Congo, Madagascar, and Peru.
The 735–737 Japanese smallpox epidemic was a major smallpox epidemic that afflicted much of Japan. Killing approximately one third of the entire Japanese population, the epidemic had significant social, economic, and religious repercussions throughout the country.
In 1721, Boston experienced its worst outbreak of smallpox. 5,759 people out of around 10,600 in Boston were infected and 844 were recorded to have died between April 1721 and February 1722. The outbreak motivated Puritan minister Cotton Mather and physician Zabdiel Boylston to variolate hundreds of Bostonians as part of the Thirteen Colonies' earliest experiment with public inoculation. Their efforts would inspire further research for immunizing people from smallpox, placing the Massachusetts Bay Colony at the epicenter of the Colonies' first inoculation debate and changing Western society's medical treatment of the disease. The outbreak also altered social and religious public discourse about disease, as Boston's newspapers published various pamphlets opposing and supporting the inoculation efforts.
The 1924–1925 Minnesota smallpox epidemic was the deadliest outbreak of smallpox in the U.S. state of Minnesota. 500 people died—400 of them in the Minneapolis–Saint Paul metropolitan area. Almost 90 percent of the Twin Cities deaths took place in Minneapolis.
The 1675–1676 Malta plague epidemic was a major outbreak of plague on the island of Malta, then ruled by the Order of St John. It occurred between December 1675 and August 1676, and it resulted in approximately 11,300 deaths, making it the deadliest epidemic in Maltese history. Most deaths were in the urban areas, including the capital Valletta and the Three Cities, which had a mortality rate of about 41%. In the rural settlements, the mortality rate was 6.9%.
The 1862 Pacific Northwest smallpox epidemic was a smallpox outbreak that started in Victoria on Vancouver Island and spread among the indigenous peoples of the Pacific Northwest Coast and into the indigenous peoples of the Northwest Plateau, killing a large portion of natives from the Puget Sound region to Southeast Alaska. Two-thirds of British Columbia natives died—around 20,000 people. The death rate was highest in southeast Alaska and Haida Gwaii—over 70% among the Haida and 60% among the Tlingit. Almost all native nations along the coast, and many in the interior, were devastated, with a death rate of over 50% for the entire coast from Puget Sound to Sitka, Alaska, part of Russian America at the time. In some areas the native population fell by as much as 90%. The disease was controlled among colonists in 1862 but it continued to spread among natives through 1863.
References
- 1 2 3 Hays, J. N. (2005). Epidemics and Pandemics: Their Impacts on Human History. Santa Barbara, California: ABC-CLIO. p. 131. ISBN 978-1-85109-658-9.
- ↑ G. Guðmundsson, Eiríkur (2015). The 1703 Census - Our Heritage. Reykjavik: Þjóðskjalasafn Íslands. p. 22.
- ↑ Eugene, Foster; Griffin, E. L.; DeWolf, Oscar C.; Homen, George; Abbot, Saml. W.; James, E. H.; Wood, Thomas F. (1884). "Efficiency and Safety of Vaccinations". Public Health Papers and Reports. American Public Health Association. 9: 255–256 – via Google Books.