This is a list of the largest known epidemics and pandemics caused by an infectious disease in humans. Widespread non-communicable diseases such as cardiovascular disease and cancer are not included. An epidemic is the rapid spread of disease to a large number of people in a given population within a short period of time; in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic. [1] Due to the long time spans, the first plague pandemic (6th century – 8th century) and the second plague pandemic (14th century – early 19th century) are shown by individual outbreaks, such as the Plague of Justinian (first pandemic) and the Black Death (second pandemic).
Infectious diseases with high prevalence are listed separately (sometimes in addition to their epidemics), such as malaria, which may have killed 50–60 billion people throughout history, or about half of all humans that have ever lived. [2]
Ongoing epidemics and pandemics are in boldface. For a given epidemic or pandemic, the average of its estimated death toll range is used for ranking. If the death toll averages of two or more epidemics or pandemics are equal, then the smaller the range, the higher the rank. For the historical records of major changes in the world population, see world population. [3]
Rank | Epidemics/pandemics | Disease | Death toll | Percentage of population lost | Years | Location |
---|---|---|---|---|---|---|
1 | Spanish flu | Influenza A/H1N1 | 17–100 million | 1–5.4% of global population [4] | 1918–1920 | Worldwide |
2 | Plague of Justinian | Bubonic plague | 15–100 million | 25–60% of European population [5] | 541–549 | North Africa, Europe, and Western Asia |
3 | HIV/AIDS pandemic | HIV/AIDS | 43 million (as of 2024 [update] ) | [a] | 1981–present [6] | Worldwide |
4 | Black Death | Bubonic plague | 25–50 million | 30–60% of European population [7] | 1346–1353 | Europe, Asia, and North Africa |
5 | COVID-19 pandemic | COVID-19 | 7–35 million [8] [9] (as of 2024 [update] ) | [a] | 2019 [b] –present [10] [11] [c] | Worldwide |
6 | Third plague pandemic | Bubonic plague | 12–15 million | – | 1855–1960 | Worldwide |
7 | Cocoliztli epidemic of 1545–1548 | Cocoliztli, caused by an unidentified pathogen | 5–15 million | 27–80% of Mexican population [12] | 1545–1548 | Mexico |
8 | Antonine Plague | Smallpox or measles | 5–10 million | 25–33% of Roman population [13] | 165–180 (possibly up to 190) | Roman Empire |
9 | 1520 Mexico smallpox epidemic | Smallpox | 5–8 million | 23–37% of Mexican population [12] | 1519–1520 | Mexico |
11 | 1957–1958 influenza pandemic | Influenza A/H2N2 | 1–4 million | – | 1957–1958 | Worldwide |
12 | Hong Kong flu | Influenza A/H3N2 | 1–4 million | – | 1968–1969 | Worldwide |
10 | 1918–1922 Russia typhus epidemic | Typhus | 2–3 million | 1–1.6% of Russian population [14] | 1918–1922 | Russia |
13 | Cocoliztli epidemic of 1576 | Cocoliztli | 2–2.5 million | 50% of Mexican population [12] | 1576–1580 | Mexico |
14 | 1772–1773 Persian Plague | Bubonic plague | 2 million | – | 1772–1773 | Persia |
15 | 735–737 Japanese smallpox epidemic | Smallpox | 2 million | 33% of Japanese population [15] | 735–737 | Japan |
16 | Naples Plague | Bubonic plague | 1.25 million | – | 1656–1658 | Southern Italy |
17 | 1889–1890 pandemic | Influenza or human coronavirus OC43 [16] [17] | 1 million | – | 1889–1890 | Worldwide |
18 | 1629–1631 Italian plague | Bubonic plague | 1 million | – | 1629–1631 | Italy |
19 | 1846–1860 cholera pandemic | Cholera | 1 million | – | 1846–1860 | Worldwide |
Not included in the above table are many waves of deadly diseases brought by Europeans to the Americas and Caribbean. Western Hemisphere populations were ravaged mostly by smallpox, but also typhus, measles, influenza, bubonic plague, cholera, malaria, tuberculosis, mumps, yellow fever, and pertussis. The lack of written records in many places and the destruction of many native societies by disease, war, and colonization make estimates uncertain. Deaths probably numbered in the tens or perhaps over a hundred million, with perhaps 90% of the population dead in the worst-hit areas. Lack of scientific knowledge about microorganisms and lack of surviving medical records for many areas makes attribution of specific numbers to specific diseases uncertain.
There have been various major infectious diseases with high prevalence worldwide, but they are currently not listed in the above table as epidemics/pandemics due to the lack of definite data, such as time span and death toll.
Events in boldface are ongoing.
Event | Years | Location | Disease | Death toll (estimate) | Ref. |
---|---|---|---|---|---|
1350 BC plague of Megiddo | c. 1350 BC | Megiddo, land of Canaan | Amarna letters EA 244, Biridiya, mayor of Megiddo complains to Amenhotep III of his area being "consumed by death, plague and dust" | Unknown | [29] |
Hittite Plague/"Hand of Nergal" | c. 1330 BC | Near East, Hittite Empire, Alashiya, possibly Egypt | Unknown, possibly Tularemia. Mentioned in Amarna letter EA 35 as the "Hand of Nergal", cause of death of Šuppiluliuma I. | Unknown | |
Plague of Athens | 430–426 BC | Greece, Libya, Egypt, Ethiopia | Unknown, possibly typhus, typhoid fever or viral hemorrhagic fever | 75,000–100,000 | [30] [31] [32] [33] |
412 BC epidemic | 412 BC | Greece (Northern Greece, Roman Republic) | Unknown, possibly influenza | 473,000 (10% of the Roman Population) | [34] |
Antonine Plague | 165–180 (possibly up to 190) | Roman Empire | Unknown, possibly smallpox | 5–10 million | [35] [36] |
Jian'an Plague | 217 | Han dynasty | Unknown, possibly typhoid fever or viral hemorrhagic fever | 2 Million | [37] [38] |
Plague of Cyprian | 249–262 | Europe | Unknown, possibly smallpox | 310,000 | [39] [40] |
Plague of Justinian (beginning of first plague pandemic) | 541–549 | Europe and West Asia | Bubonic plague | 15–100 million | [5] [41] [42] |
580 Dysentery Epidemic in Gaul | 580 | Gaul | Dysentery or possibly smallpox | 450,000 (10% of the Gaul population) | [43] |
Roman Plague of 590 (part of first plague pandemic) | 590 | Rome, Byzantine Empire | Bubonic plague | Unknown | [44] |
Plague of Sheroe (part of first plague pandemic) | 627–628 | Bilad al-Sham | Bubonic plague | 25,000+ | |
Plague of Amwas (part of first plague pandemic) | 638–639 | Byzantine Empire, West Asia, Africa | Bubonic plague | 25,000+ | [45] |
Plague of 664 (part of first plague pandemic) | 664–689 | British Isles | Bubonic plague | Unknown | [46] |
Plague of 698–701 (part of first plague pandemic) | 698–701 | Byzantine Empire, West Asia, Syria, Mesopotamia | Bubonic plague | Unknown | [47] |
735–737 Japanese smallpox epidemic | 735–737 | Japan | Smallpox | 2 million (approx. 1⁄3 of Japanese population) | [15] [48] |
Plague of 746–747 (part of first plague pandemic) | 746–747 | Byzantine Empire, West Asia, Africa | Bubonic plague | Unknown | [45] |
Black Death (start of the second plague pandemic) | 1346–1353 | Eurasia and North Africa | Bubonic plague | 75–200 million (30–60% of European population and 33% percent of the Middle Eastern population) | [49] |
Sweating sickness (multiple outbreaks) | 1485–1551 | Britain (England) and later continental Europe | Unknown, possibly an unknown species of hantavirus | 10,000+ | [50] |
1489 Spain typhus epidemic | 1489 | Spain | Typhus | 17,000 | [51] |
1510 influenza pandemic | 1510 | Asia, North Africa, Europe | Influenza | Unknown, around 1% of those infected | [52] |
1520 Mexico smallpox epidemic | 1519–1520 | Mexico | Smallpox | 5–8 million (40% of population) | [12] |
Cocoliztli epidemic of 1545–1548 | 1545–1548 | Mexico | Possibly Salmonella enterica | 5–15 million (80% of population) | [53] [54] [55] [56] |
1557 influenza pandemic | 1557–1559 | Asia, Africa, Europe, and Americas | Influenza | 2.5–5 Million (10% of the infected) | |
1561 Chile smallpox epidemic | 1561–1562 | Chile | Smallpox | 120,000–150,000 (20–25% of native population) | [57] |
1563 London plague (part of the second plague pandemic) | 1563–1564 | London, England | Bubonic plague | 20,100+ | [58] |
Cocoliztli epidemic of 1576 | 1576–1580 | Mexico | Possibly Salmonella enterica | 2–2.5 million (50% of population) | [53] [54] [55] [56] |
1582 Tenerife plague epidemic (part of the second plague pandemic) | 1582–1583 | Tenerife, Spain | Bubonic plague | 5,000–9,000 | [59] |
1592–1596 Seneca nation measles epidemic | 1592–1596 | Seneca nation, North America | Measles | Unknown | [60] |
1592–1593 Malta plague epidemic (part of the second plague pandemic) | 1592–1593 | Malta | Bubonic plague | 3,000 | [61] |
1592–1593 London plague (part of the second plague pandemic) | 1592–1593 | London, England | Bubonic plague | 19,900+ | [62] |
1596–1602 Spain plague epidemic (part of the second plague pandemic) | 1596–1602 | Spain | Bubonic plague | 600,000–700,000 | [63] |
1600–1650 South America malaria epidemic | 1600–1650 | South America | Malaria | Unknown | [ citation needed ] |
1603 London plague (part of the second plague pandemic) | 1603 | London, England | Bubonic plague | 40,000 | [64] [65] [66] |
1616 New England infections epidemic | 1616–1620 | Southern New England, British North America, especially the Wampanoag people | Unknown, possibly leptospirosis with Weil syndrome. Classic explanations include yellow fever, bubonic plague, influenza, smallpox, chickenpox, typhus, and syndemic infection of hepatitis B and hepatitis D | 1,143,000–3,429,000 (estimated 30–90% of population) | [67] [68] |
1629–1631 Italian plague (part of the second plague pandemic) | 1629–1631 | Italy | Bubonic plague | 1 million | [69] |
1632–1635 Augsburg plague epidemic (part of the second plague pandemic) | 1632–1635 | Augsburg, Germany | Bubonic plague | 13,712 | [70] |
Massachusetts smallpox epidemic | 1633–1634 | Massachusetts Bay Colony, Thirteen Colonies | Smallpox | 1,000 | [71] |
1634–1640 Wyandot people epidemic | 1634–1640 | Wyandot people, North America | Smallpox and Influenza | 15,000–25,000 | [72] |
1637 London plague epidemic (part of the second plague pandemic) | 1636–1637 | London and Westminster, England | Bubonic plague | 10,400 | [73] |
Great Plague in the late Ming dynasty (part of the second plague pandemic) | 1633–1644 | China | Bubonic plague | 200,000+ | [74] [75] |
Great Plague of Seville (part of the second plague pandemic) | 1647–1652 | Spain | Bubonic plague | 500,000 | [76] |
1648 Central America yellow fever epidemic | 1648 | Central America | Yellow fever | Unknown | [77] |
Naples Plague (part of the second plague pandemic) | 1656–1658 | Italy | Bubonic plague | 1,250,000 | [78] |
1663–1664 Amsterdam plague epidemic (part of the second plague pandemic) | 1663–1664 | Amsterdam, Netherlands | Bubonic plague | 24,148 | [79] |
Great Plague of London (part of the second plague pandemic) | 1665–1666 | England | Bubonic plague | 100,000 | [80] [81] |
1668 France plague (part of the second plague pandemic) | 1668 | France | Bubonic plague | 40,000 | [82] |
1675–1676 Malta plague epidemic (part of the second plague pandemic) | 1675–1676 | Malta | Bubonic plague | 11,300 | [83] |
1676–1685 Spain plague (part of the second plague pandemic) | 1676–1685 | Spain | Bubonic plague | Unknown | [84] |
1677–1678 Boston smallpox epidemic | 1677–1678 | Massachusetts Bay Colony, British North America | Smallpox | 750–1,000 | [85] |
Great Plague of Vienna (part of the second plague pandemic) | 1679 | Vienna, Austria | Bubonic plague | 76,000 | [86] |
1681 Prague plague epidemic (part of the second plague pandemic) | 1681 | Prague, Czech Kingdom | Bubonic plague | 83,000 | [87] |
1687 South Africa influenza outbreak | 1687 | South Africa | Unknown, possibly influenza | Unknown | [88] |
1693 Boston yellow fever epidemic | 1693 | Boston, Massachusetts Bay Colony, British North America | Yellow fever | 3,100+ | [89] |
1699 Charleston and Philadelphia yellow fever epidemic | 1699 | Charleston and Philadelphia, British North America | Yellow fever | 520 (300 in Charleston, 220 in Philadelphia) | [90] |
1702 New York City yellow fever epidemic | 1702 | New York City, British North America | Yellow fever | 500 | [91] |
1702–1703 St. Lawrence Valley smallpox epidemic | 1702–1703 | New France, Canada | Smallpox | 1,300 | [92] |
1707–1708 Iceland smallpox epidemic | 1707–1709 | Iceland | Smallpox | 18,000+ (36% of population) | [93] |
Great Northern War plague outbreak (part of the second plague pandemic) | 1710–1712 | Denmark, Sweden, Lithuania | Bubonic plague | 164,000 | [94] [95] |
1713–1715 North America measles epidemic | 1713–1715 | Thirteen Colonies and New France, Canada | Measles | Unknown | [96] [97] |
Great Plague of Marseille (part of the second plague pandemic) | 1720–1722 | France | Bubonic plague | 100,000+ | [98] |
1721 Boston smallpox outbreak | 1721–1722 | Massachusetts Bay Colony | Smallpox | 844 | [99] |
1730 Cádiz yellow fever epidemic | 1730 | Cádiz, Spain | Yellow fever | 2,200 | [100] |
1732–1733 Thirteen Colonies influenza epidemic | 1732–1733 | Thirteen Colonies | Influenza | Unknown | [101] |
1733 New France smallpox epidemic | 1733 | New France, Canada | Smallpox | Unknown | [102] |
1735–1741 diphtheria epidemic | 1735–1741 | New England, Province of New York, Province of New Jersey, British North America | Diphtheria | 20,000 | [103] |
Great Plague of 1738 (part of the second plague pandemic) | 1738 | Balkans | Bubonic plague | 50,000 | [104] |
1738–1739 North Carolina smallpox epidemic | 1738–1739 | Province of Carolina, Thirteen Colonies | Smallpox | 7,700–11,700 | [105] |
1741 Cartagena yellow fever epidemic | 1741 | Cartagena, Colombia | Yellow fever | 20,000 | [106] |
1743 Sicily plague epidemic (part of the second plague pandemic) | 1743 | Messina, Sicily, Italy | Bubonic plague | 40,000–50,000 | [107] [108] |
1759 North America measles outbreak | 1759 | North America | Measles | Unknown | [109] |
1760 Charleston smallpox epidemic | 1760 | Charleston, British North America | Smallpox | 730–940 | [110] [111] |
1762 Havana yellow fever epidemic | 1762 | Havana, Cuba | Yellow fever | 8,000 | [106] |
1763 Pittsburgh area smallpox outbreak | 1763 | North America, present-day Pittsburgh area | Smallpox | Unknown | [112] |
1770–1772 Russian plague (part of the second plague pandemic) | 1770–1772 | Russia | Bubonic plague | 50,000 | [113] |
1772 North America measles epidemic | 1772 | North America | Measles | 1,080 | [114] |
1772–1773 Persian Plague (part of the second plague pandemic) | 1772–1773 | Persia | Bubonic plague | 2 million | [115] |
1775–1776 England influenza outbreak | 1775–1776 | England | Influenza | Unknown | [116] |
1775–1782 North American smallpox epidemic | 1775–1782 | Native populations in what is now the Pacific Northwest of the United States | Smallpox | 11,000+ | [117] [118] |
1778 Spain dengue fever outbreak | 1778 | Spain | Dengue fever | Unknown | [119] |
1782 Influenza pandemic | 1782 | Worldwide | Influenza | Unknown | |
1788 Pueblo Indians smallpox epidemic | 1788 | Pueblo Indians in northern New Spain (what is now the Southwestern United States) | Smallpox | Unknown | [120] |
1789–1790 New South Wales smallpox epidemic | 1789–1790 | New South Wales, Australia | Smallpox | 125,251–175,351 (50–70% of native population) | [121] [122] |
1793 Philadelphia yellow fever epidemic | 1793 | Philadelphia, United States | Yellow fever | 5,000+ | [123] |
1800–1803 Spain yellow fever epidemic | 1800–1803 | Spain | Yellow fever | 60,000+ | [124] |
1801 Ottoman Empire and Egypt bubonic plague epidemic | 1801 | Ottoman Empire, Egypt | Bubonic plague | Unknown | [125] |
1802–1803 Saint-Domingue yellow fever epidemic | 1802–1803 | Saint-Domingue | Yellow fever | 29,000–55,000 | [126] |
1812 Russia typhus epidemic | 1812 | Russia | Typhus | 300,000 | [51] |
1812–1819 Ottoman plague epidemic (part of the second plague pandemic) | 1812–1819 | Ottoman Empire | Bubonic plague | 300,000+ | [127] |
1813–1814 Malta plague epidemic (part of the second plague pandemic) | 1813–1814 | Malta | Bubonic plague | 4,500 | [128] |
Caragea's plague (part of the second plague pandemic) | 1813 | Romania | Bubonic plague | 60,000 | [129] |
1817–1819 Ireland typhus epidemic | 1817–1819 | Ireland | Typhus | 65,000 | [130] |
First cholera pandemic | 1817–1824 | Asia, Europe | Cholera | 100,000+ | [131] |
1820 Savannah yellow fever epidemic | 1820 | Savannah, Georgia, United States | Yellow fever | 700 | [132] |
1821 Barcelona yellow fever epidemic | 1821 | Barcelona, Spain | Yellow fever | 5,000–20,000 | [133] [134] |
Second cholera pandemic | 1826–1837 | Asia, Europe, North America | Cholera | 100,000+ | [135] |
1828–1829 New South Wales smallpox epidemic | 1828–1829 | New South Wales, Australia | Smallpox | 19,000 | [136] [137] |
Groningen epidemic | 1829 | Netherlands | Malaria | 2,800 | [138] |
1829–1833 Pacific Northwest malaria epidemic | 1829–1833 | Pacific Northwest, United States | Malaria, possibly other diseases too | 150,000 | [139] [140] |
1829–1835 Iran plague outbreak | 1829–1835 | Iran | Bubonic plague | Unknown | [141] |
1834–1836 Egypt plague epidemic | 1834–1836 | Egypt | Bubonic plague | Unknown | [142] |
1837 Great Plains smallpox epidemic | 1837–1838 | Great Plains, United States and Canada | Smallpox | 17,000+ | [143] |
1841 Southern United States yellow fever epidemic | 1841 | Southern United States (especially Louisiana and Florida) | Yellow fever | 3,498 | [144] |
1847 North American typhus epidemic | 1847–1848 | Canada | Typhus | 20,000+ | [145] |
1847 Southern United States yellow fever epidemic | 1847 | Southern United States (especially New Orleans) | Yellow fever | 3,400 | [146] |
1847–1848 influenza epidemic | 1847–1848 | Worldwide | Influenza | Unknown | [147] |
1848–1849 Hawaii epidemic of infections | 1848–1849 | Hawaiian Kingdom | Measles, whooping cough, dysentery and influenza | 10,000 | [148] |
1853 New Orleans yellow fever epidemic | 1853 | New Orleans, United States | Yellow fever | 7,970 | [133] |
Third cholera pandemic | 1846–1860 | Worldwide | Cholera | 1 million+ | [149] |
1853 Ottoman Empire plague epidemic | 1853 | Ottoman Empire | Bubonic plague | Unknown | [150] |
1853 Copenhagen cholera outbreak | 1853 | Copenhagen, Denmark | Cholera | 4,737 | [151] |
1854 Broad Street cholera outbreak | 1854 | London, England | Cholera | 616 | [152] |
1855 Norfolk yellow fever epidemic | 1855 | Norfolk and Portsmouth, England | Yellow fever | 3,000 (2,000 in Norfolk, 1,000 in Portsmouth) | [153] |
Third plague pandemic | 1855–1960 | Worldwide | Bubonic plague | 12–15 million (India and China) | [154] [155] |
1855–1857 Montevideo yellow fever epidemic | 1855–1857 | Montevideo, Uruguay | Yellow fever | 3,400 (first wave; 900, second wave; 2,500) | [156] |
1857 Lisbon yellow fever epidemic | 1857 | Lisbon, Portugal | Yellow fever | 6,000 | [133] |
1857 Victoria smallpox epidemic | 1857 | Victoria, Australia | Smallpox | Unknown | [157] |
1857–1859 Europe and the Americas influenza epidemic | 1857–1859 | Europe, North America, South America | Influenza | Unknown | [158] |
1862 Pacific Northwest smallpox epidemic | 1862–1863 | Pacific Northwest, Canada and United States | Smallpox | 20,000+ | [159] [160] [161] |
1861–1865 United States typhoid fever epidemic | 1861–1865 | United States | Typhoid fever | 80,000 | [162] |
Fourth cholera pandemic | 1863–1875 | Middle East | Cholera | 600,000 | [163] |
1867 Sydney measles epidemic | 1867 | Sydney, Australia | Measles | 748 | [164] |
1871 Buenos Aires yellow fever epidemic | 1871 | Buenos Aires, Argentina | Yellow fever | 13,500–26,200 | [165] |
1870–1875 Europe smallpox epidemic | 1870–1875 | Europe | Smallpox | 500,000 | [166] [167] |
1875 Fiji measles outbreak | 1875 | Fiji | Measles | 40,000 | [168] |
1875–1876 Australia scarlet fever epidemic | 1875–1876 | Australia | Scarlet fever | 8,000 | [164] |
1876 Ottoman Empire plague epidemic | 1876 | Ottoman Empire | Bubonic plague | 20,000 | [169] |
1878 New Orleans yellow fever epidemic | 1878 | New Orleans, United States | Yellow fever | 4,046 | [126] |
1878 Mississippi Valley yellow fever epidemic | 1878 | Mississippi Valley, United States | Yellow fever | 13,000 | [126] |
Fifth cholera pandemic | 1881–1896 | Asia, Africa, Europe, South America | Cholera | 298,600 | [170] |
1885 Montreal smallpox epidemic | 1885 | Montreal, Canada | Smallpox | 3,164 | [171] |
1889–1890 pandemic | 1889–1890 | Worldwide | Influenza or Human coronavirus OC43 / HCoV-OC43 [17] [172] (disputed) | 1 million | [173] |
1894 Hong Kong plague (part of the third plague pandemic) | 1894–1929 | Hong Kong | Bubonic plague | 20,000+ | [174] |
Bombay plague epidemic (part of the third plague pandemic) | 1896–1905 | Bombay, India | Bubonic plague | 20,788 | [175] |
1896–1906 Congo Basin African trypanosomiasis epidemic | 1896–1906 | Congo Basin | African trypanosomiasis | 500,000 | [176] |
1899 Porto plague outbreak (part of the third plague pandemic) | 1899 | Porto, Portugal | Bubonic plague | 132 | [177] |
Sixth cholera pandemic | 1899–1923 | Europe, Asia, Africa | Cholera | 800,000+ | [178] |
San Francisco plague of 1900–1904 (part of the third plague pandemic) | 1900–1904 | San Francisco, United States | Bubonic plague | 119 | [179] |
1900 Sydney bubonic plague epidemic (part of the third plague pandemic) | 1900 | Australia | Bubonic plague | 103 | [180] |
1900–1920 Uganda African trypanosomiasis epidemic | 1900–1920 | Uganda | African trypanosomiasis | 200,000–300,000 | [176] |
Papua New Guinea kuru epidemic | 1901–2009 | Papua New Guinea | Kuru | 2,700–3,000+ | [181] [182] |
1903 Fremantle plague epidemic (part of the third plague pandemic) | 1903 | Fremantle, Western Australia | Bubonic plague | 4 | [183] |
1906 malaria outbreak in Ceylon | 1906–1936 | Ceylon | Malaria | 80,000 | [184] |
Manchurian plague (part of the third plague pandemic) | 1910–1911 | China | Pneumonic plague | 60,000 | [185] |
1916 United States polio epidemic | 1916 | United States | Poliomyelitis | 7,130 | [186] |
1918 influenza pandemic ('Spanish flu') | 1918–1920 | Worldwide | Influenza A virus subtype H1N1 | 17–100 million | [187] [188] [189] |
1918–1922 Russia typhus epidemic | 1918–1922 | Russia | Typhus | 2–3 million | [190] |
1919–1930 encephalitis lethargica epidemic | 1919–1930 | Worldwide | Encephalitis lethargica | 500,000 | [191] [192] [193] |
1924 Los Angeles pneumonic plague outbreak | 1924 | Los Angeles, United States | Pneumonic plague | 30 | [194] |
1924–1925 Minnesota smallpox epidemic | 1924–1925 | Minnesota, United States | Smallpox | 500 | [195] |
1927 Montreal typhoid fever epidemic | 1927 | Montreal, Canada | Typhoid fever | 538 | [196] |
1929–1930 psittacosis pandemic | 1929–1930 | Worldwide | Psittacosis | 100+ | [197] |
Croydon typhoid outbreak of 1937 | 1937 | Croydon, United Kingdom | Typhoid fever | 43 | [198] |
1937 Australia polio epidemic | 1937 | Australia | Poliomyelitis | Unknown | [199] |
1940 Sudan yellow fever epidemic | 1940 | Sudan | Yellow fever | 1,627 | [200] |
1942–1944 Egypt malaria epidemic | 1942–1944 | Egypt | Malaria | Unknown | [142] [201] |
1946 Egypt relapsing fever epidemic | 1946 | Egypt | Relapsing fever | Unknown | [142] [201] |
1947 Egypt cholera epidemic | 1947 | Egypt | Cholera | 10,277 | [142] [201] [202] |
1948–1952 United States polio epidemic | 1948–1952 | United States | Poliomyelitis | 9,000 | [186] |
1957–1958 influenza pandemic ('Asian flu') | 1957–1958 | Worldwide | Influenza A virus subtype H2N2 | 1–4 million | [187] [203] [204] |
1960–1962 Ethiopia yellow fever epidemic | 1960–1962 | Ethiopia | Yellow fever | 30,000 | [205] |
Seventh cholera pandemic | 1961–present | Worldwide | Cholera (El Tor strain) | 36,000 [ citation needed ] | [206] |
Hong Kong flu | 1968–1970 | Worldwide | Influenza A virus subtype H3N2 | 1–4 million | [187] [203] [204] |
1971 Staphorst polio epidemic | 1971 | Staphorst, Netherlands | Poliomyelitis | 5 | [207] |
1972 Yugoslav smallpox outbreak | 1972 | Yugoslavia | Smallpox | 35 | [208] |
London flu | 1972–1973 | United States | Influenza A virus subtype H3N2 | 1,027 | [209] |
1973 Italy cholera epidemic | 1973 | Italy | Cholera (El Tor strain) | 24 | [210] |
1974 smallpox epidemic in India | 1974 | India | Smallpox | 15,000 | [211] |
1977 Russian flu | 1977–1979 | Worldwide | Influenza A virus subtype H1N1 | 700,000 | [212] [213] |
Sverdlovsk anthrax leak | 1979 | Russia | Anthrax | 105 | [214] |
HIV/AIDS epidemic | 1981–present | Worldwide | HIV/AIDS | 42 million (as of 2023 [update] ) | [215] |
1984 Western Sahara plague | 1984 | Western Sahara | Bubonic plague | 64 | [ citation needed ] |
1986 Oju yellow fever epidemic | 1986 | Oju, Nigeria | Yellow fever | 5,600+ | [216] |
1987 Mali yellow fever epidemic | 1987 | Mali | Yellow fever | 145 | [217] |
1988 Shanghai hepatitis A epidemic | 1988 | Shanghai, China | Hepatitis A | 31–47 | [218] [219] [220] |
1991 Bangladesh cholera epidemic | 1991 | Bangladesh | Cholera | 8,410–9,432 | [221] |
1991 Latin America cholera epidemic | 1991–1993 | Peru, Chile, Bolivia, Ecuador, Colombia, Mexico, El Salvador, Guatemala | Cholera | 8,000 | [222] [223] |
1994 plague in India | 1994 | India | Bubonic plague and Pneumonic plague | 56 | [224] |
United Kingdom BSE outbreak | 1996–2001 | United Kingdom | Variant Creutzfeldt–Jakob disease / vCJD | 178 | [225] [226] |
1996 West Africa meningitis epidemic | 1996 | West Africa | Meningitis | 10,000 | [227] |
1998–1999 Malaysia Nipah virus outbreak | 1998–1999 | Malaysia | Nipah virus infection | 105 | [228] |
1998–2000 Democratic Republic of the Congo Marburg virus outbreak | 1998–2000 | Democratic Republic of the Congo | Marburg virus | 128 | [229] |
2000 Central America dengue epidemic | 2000 | Central America | Dengue fever | 40+ | [230] |
2001 Nigeria cholera epidemic | 2001 | Nigeria | Cholera | 400+ | [231] |
2001 South Africa cholera epidemic | 2001 | South Africa | Cholera | 139 | [232] [233] |
2002–2004 SARS outbreak | 2002–2004 | Worldwide | Severe acute respiratory syndrome / SARS | 774 | [234] |
2003–2019 Asia and Egypt avian influenza epidemic | 2003–2019 | China, Southeast Asia and Egypt | Influenza A virus subtype H5N1 | 455 | [235] |
2004 Indonesia dengue epidemic | 2004 | Indonesia | Dengue fever | 658 | [236] |
2004 Sudan Ebola outbreak | 2004 | Sudan | Ebola | 7 | [237] |
2004–2005 Angola Marburg virus outbreak | 2004–2005 | Angola | Marburg virus | 227 | [229] |
2005 dengue outbreak in Singapore | 2005 | Singapore | Dengue fever | 27 | [238] |
2006 Luanda cholera epidemic | 2006 | Luanda, Angola | Cholera | 1,200+ | [239] |
2006 Ituri Province plague epidemic | 2006 | Ituri Province, Democratic Republic of the Congo | Bubonic plague | 61 | [240] [241] |
2006 India malaria outbreak | 2006 | India | Malaria | 17 | [242] |
2006 dengue outbreak in India | 2006 | India | Dengue fever | 50+ | [243] |
2006 dengue outbreak in Pakistan | 2006 | Pakistan | Dengue fever | 50+ | [244] |
2006 Philippines dengue epidemic | 2006 | Philippines | Dengue fever | 1,000 | [245] |
2006–2007 East Africa Rift Valley fever outbreak | 2006–2007 | East Africa | Rift Valley fever | 394 | [246] |
Mweka Ebola epidemic | 2007 | Democratic Republic of the Congo | Ebola | 187 | [247] |
2007 Ethiopia cholera epidemic | 2007 | Ethiopia | Cholera | 684 | [248] |
2007 Iraq cholera outbreak | 2007 | Iraq | Cholera | 10 | [249] |
2007 Puerto Rico, Dominican Republic, and Mexico dengue fever epidemic | 2007 | Puerto Rico, Dominican Republic, Mexico | Dengue fever | 183 | [250] |
2007 Uganda Ebola outbreak | 2007 | Uganda | Ebola | 37 | [237] |
2007 Netherlands Q-fever epidemic | 2007–2018 | Netherlands | Q-fever | 95 | [251] |
2008 Brazil dengue epidemic | 2008 | Brazil | Dengue fever | 67 | [252] |
2008 Cambodia dengue epidemic | 2008 | Cambodia | Dengue fever | 407 | [253] |
2008 Chad cholera epidemic | 2008 | Chad | Cholera | 123 | [254] |
2008–2017 China hand, foot, and mouth disease epidemic | 2008–2017 | China | Hand, foot, and mouth disease | 3,322+ | [255] |
2008 India cholera epidemic | 2008 | India | Cholera | 115 | [256] |
2008 Madagascar plague outbreak | 2008 | Madagascar | Bubonic plague | 18+ | [257] |
2008 Philippines dengue epidemic | 2008 | Philippines | Dengue fever | 172 | [258] |
2008 Zimbabwean cholera outbreak | 2008–2009 | Zimbabwe | Cholera | 4,293 | [259] |
2009 Bolivian dengue fever epidemic | 2009 | Bolivia | Dengue fever | 18 | [260] |
2009 Gujarat hepatitis outbreak | 2009 | India | Hepatitis B | 49 | [261] |
Queensland 2009 dengue outbreak | 2009 | Queensland, Australia | Dengue fever | 1+ (503 cases) | [262] |
2009–2010 West African meningitis outbreak | 2009–2010 | West Africa | Meningitis | 1,100 | [263] |
2009 swine flu pandemic | 2009–2010 | Worldwide | Influenza A virus subtype H1N1 | Lab confirmed deaths: 18,449 (reported to the WHO) | [264] |
Estimated death toll: 284,000 (possible range 151,700–575,400) | [265] | ||||
2010s Haiti cholera outbreak | 2010–2019 | Haiti | Cholera (strain serogroup O1, serotype Ogawa) | 10,075 | [266] |
2010–2014 Democratic Republic of the Congo measles outbreak | 2010–2014 | Democratic Republic of the Congo | Measles | 4,500+ | [267] [268] |
2011 Vietnam hand, foot, and mouth disease epidemic | 2011 | Vietnam | Hand, foot, and mouth disease | 170 | [269] [270] |
2011 dengue outbreak in Pakistan | 2011 | Pakistan | Dengue fever | 350+ | [271] |
2012 yellow fever outbreak in Darfur, Sudan | 2012 | Darfur, Sudan | Yellow fever | 171 | [272] |
MERS outbreak | 2012–present | Worldwide | Middle East respiratory syndrome / MERS-CoV | 941 (as of 8 May 2021 [update] ) | [273] [274] |
2013 dengue outbreak in Singapore | 2013 | Singapore | Dengue fever | 8 | |
2013 Vietnam measles outbreak | 2013–2014 | Vietnam | Measles | 142 | [275] |
Western African Ebola virus epidemic | 2013–2016 | Worldwide, primarily concentrated in Guinea, Liberia, Sierra Leone | Ebola | 11,323+ | [276] [277] [278] |
2013–2014 chikungunya outbreak | 2013–2015 | Americas | Chikungunya | 183 | [279] |
2013–19 avian influenza epidemic | 2013–2019 | China | Influenza A virus subtype H7N9 | 616 | [280] |
21st century Madagascar plague outbreaks | 2014–2017 | Madagascar | Bubonic plague | 292 | [281] |
Flint water crisis | 2014–2015 | Flint, Michigan, United States | Legionnaires' disease | 12 | [282] |
2014 Odisha hepatitis outbreak | 2014–2015 | India | Primarily Hepatitis E, but also Hepatitis A | 36 | [283] |
2015 Indian swine flu outbreak | 2015 | India | Influenza A virus subtype H1N1 | 2,035 | [284] [285] [286] |
2015–16 Zika virus epidemic | 2015–2016 | Worldwide | Zika virus | 53 | [287] |
2016 Angola and Democratic Republic of the Congo yellow fever outbreak | 2016 | Angola and Democratic Republic of the Congo | Yellow fever | 498 (377 in Angola, 121 in Congo) | [288] |
2016–2022 Yemen cholera outbreak | 2016–2023 | Yemen | Cholera | 4,004 (as of June 11,2023 [update] ) | [289] |
2017 Nigeria Lassa fever epidemic | 2017–2023 | Nigeria | Lassa fever | 1103 (as of April 2023) | [290] |
2017 dengue outbreak in Peshawar | 2017 | Peshawar, Pakistan | Dengue fever | 69 | [291] |
2017 Gorakhpur hospital deaths | 2017 | India | Japanese encephalitis | 1,317 | [292] |
2017 dengue outbreak in Sri Lanka | 2017 | Sri Lanka | Dengue fever | 440 | [293] |
2018 Nipah virus outbreak in Kerala | 2018 | India | Nipah virus infection | 17 | [294] |
Kivu Ebola epidemic | 2018–2020 | Democratic Republic of the Congo and Uganda | Ebola | 2,280 | [295] [296] [297] |
2018 NDM-CRE outbreak in Italy | 2018–2019 | Italy | New Delhi metallo-beta-lactamase-producing Carbapenem-resistant enterobacteriaceae | 31 (as of September 2019) | [298] |
2019–2020 measles outbreak in the Democratic Republic of the Congo | 2019–2020 | Democratic Republic of the Congo | Measles | 7,018+ | [299] |
2019–2020 New Zealand measles outbreak | 2019–2020 | New Zealand | Measles | 2 | [300] |
2019 measles outbreak in the Philippines | 2019 | Philippines | Measles | 415 | [301] |
2019 Kuala Koh measles outbreak | 2019 | Kuala Koh, Malaysia | Measles | 15 | [302] |
2019 Samoa measles outbreak | 2019 | Samoa | Measles | 83 | [303] |
2019–2020 dengue fever epidemic | 2019–2020 | Asia-Pacific, Latin America | Dengue fever | 3,931 | [304] |
COVID-19 pandemic | 2019 [b] –present | Worldwide | COVID-19 | 7–35 million | [306] |
2020 Democratic Republic of the Congo Ebola outbreak | 2020 | Democratic Republic of the Congo | Ebola | 55 | [307] |
2020 dengue outbreak in Singapore | 2020 | Singapore | Dengue fever | 32 | [308] |
2020 Nigeria yellow fever epidemic | 2020 | Nigeria | Yellow fever | 296 (as of 31 December 2020) | [309] |
2021 South Sudan disease outbreak | 2021 | South Sudan | Unknown | 97 (as of December 2021) | [310] |
2021 India black fungus epidemic | 2021–2022 | India | Black fungus (COVID-19 condition) | 4,332 | [311] |
2022 hepatitis of unknown origin in children | 2021–2022 | Worldwide | Hepatitis by Adenovirus variant AF41 (Unconfirmed) | 18 | [312] [313] [314] |
2022–2023 mpox outbreak | 2022–2023 | Worldwide | Mpox | 280 | [315] [316] [317] [318] |
2022 Uganda Ebola outbreak | 2022–2023 | Uganda | Sudan ebolavirus | 77 | [319] |
2023 South Poland Legionellosis outbreak | 2023 | Poland | Legionnaires' disease | 41 | [320] [321] |
African mpox epidemic | 2023–present | Worldwide, primarly Africa | Mpox | 812 | [322] |
2023–2024 Bangsamoro measles outbreak | 2023–present | Bangsamoro, Philippines | Measles | 14 | |
2023–2024 Oropouche virus disease outbreak | 2023–present | Brazil | Oropouche fever | 2 | [323] [324] [325] |
2024 American dengue epidemic | 2024–present | Latin America and the Caribbean | Dengue virus | 4,500 | [326] |
A pandemic is an epidemic of an infectious disease that has a sudden increase in cases and spreads across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. 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.
Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains—particularly in the back—and headaches. Symptoms typically improve within five days. In about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problems is increased.
A zoonosis or zoonotic disease is an infectious disease of humans caused by a pathogen that can jump from a non-human vertebrate to a human. When humans infect non-humans, it is called reverse zoonosis or anthroponosis.
An epidemic is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.
Incubation period is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent. In a typical infectious disease, the incubation period signifies the period taken by the multiplying organism to reach a threshold necessary to produce symptoms in the host.
In epidemiology, an infection is said to be endemic in a specific population or populated place when that infection is constantly present, or maintained at a baseline level, without extra infections being brought into the group as a result of travel or similar means. The term describes the distribution of an infectious disease among a group of people or within a populated area. An endemic disease always has a steady, predictable number of people getting sick, but that number can be high (hyperendemic) or low (hypoendemic), and the disease can be severe or mild. Also, a disease that is usually endemic can become epidemic.
A cordon sanitaire is the restriction of movement of people into or out of a defined geographic area, such as a community, region, or country. The term originally denoted a barrier used to stop the spread of infectious diseases. The term is also often used metaphorically, in English, to refer to attempts to prevent the spread of an ideology deemed unwanted or dangerous, such as the containment policy adopted by George F. Kennan against the Soviet Union.
An emerging infectious disease (EID) is an infectious disease whose incidence has increased recently, and could increase in the near future. The minority that are capable of developing efficient transmission between humans can become major public and global concerns as potential causes of epidemics or pandemics. Their many impacts can be economic and societal, as well as clinical. EIDs have been increasing steadily since at least 1940.
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.
The International Health Regulations (IHR), first adopted by the World Health Assembly in 1969 and last revised in 2005, are legally binding rules that only apply to the WHO that is an instrument that aims for international collaboration "to prevent, protect against, control, and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks and that avoid unnecessary interference with international traffic and trade". The IHR is the only international legal treaty with the responsibility of empowering the World Health Organization (WHO) to act as the main global surveillance system.
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 that may be 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. European 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.
As of 2010, dengue fever is believed to infect 50 to 100 million people worldwide a year with 1/2 million life-threatening infections. It dramatically increased in frequency between 1960 and 2010, by 30 fold. This increase is believed to be due to a combination of urbanization, population growth, increased international travel, and global warming. The geographical distribution is around the equator with 70% of the total 2.5 billion people living in endemic areas from Asia and the Pacific. Many of the infected people during outbreaks are not virally tested, therefore their infections may also be due to chikungunya, a coinfection of both, or even other similar viruses.
John S. Marr is an American physician, epidemiologist, and author. His professional life has concerned outbreaks of infectious disease and thus his subsequent writing career has focused on that topic, particularly historical epidemics.
Neil Morris Ferguson is a British epidemiologist and professor of mathematical biology, who specialises in the patterns of spread of infectious disease in humans and animals. He is the director of the Jameel Institute, and of the MRC Centre for Global Infectious Disease Analysis, and head of the Department of Infectious Disease Epidemiology in the School of Public Health and Vice-Dean for Academic Development in the Faculty of Medicine, all at Imperial College London.
Michael Joseph Ryan is an Irish epidemiologist and former trauma surgeon, specialising in infectious disease and public health. He is executive director of the World Health Organization's Health Emergencies Programme, leading the team responsible for the international containment and treatment of COVID-19. Ryan has held leadership positions and has worked on various outbreak response teams in the field to eradicate the spread of diseases including bacillary dysentery, cholera, Crimean–Congo hemorrhagic fever, Ebola, Marburg virus disease, measles, meningitis, relapsing fever, Rift Valley fever, SARS, and Shigellosis.
The Central Epidemic Command Center is an agency of the National Health Command Center (NHCC). It has been activated by the government of Taiwan for several disease outbreaks, such as the 2009 swine flu pandemic and the COVID-19 pandemic. The head of the agency is Chen Shih-chung, the minister of health and welfare. The CECC is associated with the Taiwan Centers for Disease Control.
In 2017, there was a rise in the number of dengue fever cases reported in the island country of Sri Lanka. The peak of the outbreak occurred during the mid-year monsoon season with more than 40,000 cases reported in July alone, far exceeding historical highs. By the end of the year, the total number of dengue cases had risen to 186,101.
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