Human infectious diseases may be characterized by their case fatality rate (CFR), the proportion of people diagnosed with a disease who die from it ( cf. mortality rate). It should not be confused with the infection fatality rate (IFR), the estimated proportion of people infected by a disease-causing agent, including asymptomatic and undiagnosed infections, who die from the disease. IFR cannot be higher than the CFR and is often much lower, but is also much harder to calculate. This data is based on optimally treated patients and exclude isolated cases or minor outbreaks, unless otherwise indicated.
Disease | Type | Treatment stage[ clarification needed ] | CFR | Notes | Reference(s) |
---|---|---|---|---|---|
Transmissible spongiform encephalopathy | Prion | No treatment and no cure [1] | 100% [2] | Includes Creutzfeldt–Jakob disease and all its variants, fatal insomnia, kuru, Gerstmann–Sträussler–Scheinker syndrome, Variably protease-sensitive prionopathy and others. | [3] No cases of survival, invariably fatal. |
Rabies | Viral | Unvaccinated | >99% [4] | Preventable with vaccine and PEP but once symptoms manifest, there is no cure and the CFR is greater than 99%. 4 known people who survived were simply vaccinated too late, [5] after symptoms started; more recently, at least 3 individuals have survived after being placed in a medically induced coma, however this protocol has since been disputed. [6] | 29 known cases of survival |
Plague, pneumonic | Bacterial | Unvaccinated and untreated | ≈100% | [7] : 58 | |
African trypanosomiasis | Parasitic (protozoan) | Untreated | >99% | Without treatment this disease is nearly invariably fatal due to its parasitic and extremely debilitating nature [8] | [9] |
Visceral leishmaniasis | Parasitic (protozoan) | Untreated | >99% | [10] | |
Naegleriasis | Amoebic infection | Untreated | ≈98.5% | From 1962 to 2022 there have been 157 recorded cases of the infection in United States, only 4 of those 157 individuals survived the disease. A combination of drugs have shown effectiveness in survivors. | [11] |
Glanders, septicemic | Bacterial | Untreated | 95% | The rate drops significantly to >50% with treatment. | [12] |
Smallpox Variola major – specifically the malignant (flat) or hemorrhagic type | Viral | Untreated | ≈95% | The rate dropped significantly to 10% with effective treatments. Eradicated. | [7] : 28 [13] |
Granulomatous amoebic encephalitis | Amoebic infection | No cure [14] | 90% | 150 cases worldwide, only < 10 survivors have been identified. | [15] [16] |
AIDS/HIV infection | Viral | Untreated | 90% | [17] : 1 | |
Anthrax, pulmonary | Bacterial | Unvaccinated and untreated | > 85% | Early treatments lower the CFR to 45% as seen in the 2001 AMERITHRAX letter attacks. Monoclonal antibodies (Obilotoxaximab & Raxibacumab) could lower this further. | [7] : 88 |
Lujo virus | Viral | 80% | |||
B virus | Viral | Untreated | ≈80% | Early treatment including aciclovir can improve prognosis. | [18] |
Aspergillosis, invasive pulmonary form | Fungal | Opportunistic w/COPD, Tuberculosis and Immuno- compromised | [50–90]% | [19] | |
Smallpox, Variola major – in pregnant women | Viral | Unvaccinated | > 65% | Eradicated. | [7] : 88 |
Influenza A virus subtype H5N1 | Viral | ≈53% | [20] | ||
Mucormycosis (Black fungus) | Fungal | [40–80]% | [21] | ||
Tularemia, pneumonic | Bacterial | Untreated | ≤ 60% | [7] : 78 | |
Ebola – specifically EBOV | Viral | Unvaccinated and untreated | [25–90]% | Prognosis improved by early supportive treatments as seen in the West African epidemic and the Kivu outbreak. | [22] [23] |
Marburg virus disease – all outbreaks combined | Viral | Untreated | [23–90]% | 23% in 1967 when it was first identified and 90% in 2004-2005 when the worst outbreak of the disease occurred. Galidesivir has shown promise in treating Filoviridae | [24] [25] |
Cryptococcal meningitis | Fungal | Co-infection with HIV | [40–60]% | 6 month mortality is >=60% with fluconazole-based therapy and 40% with amphotericin-based therapy in research studies in low and middle income countries. | [26] |
Anthrax, gastrointestinal type | Bacterial | Unvaccinated and untreated | > 50% | [7] : 27 | |
Tetanus, Generalized | Bacterial | Unvaccinated and untreated | 50% | CFR drops to [10–20]% with effective treatment. | [27] |
Tuberculosis, HIV Negative | Bacterial | Vaccinated | 43% | Vaccines have been developed but have been frequently dismissed for having received controversial and improper testing on African populations. | [28] |
Plague, septicemic | Bacterial | Unvaccinated and untreated | [30–50]% | [7] : 58 | |
Baylisascariasis | Parasitic (helminthous) | ≈40% | With occurrence of Neural Larva Migrans; early, aggressive treatment necessary for survival, but only 2 full recoveries from NLM ever documented | [29] | |
Hantavirus infection | Viral | 36% | Ribavirin may be a drug for HPS and HFRS but its effectiveness remains unknown, still, spontaneous recovery is possible with supportive treatment. | ||
Middle Eastern Respiratory Syndrome (MERS) | Viral | 34% | Galidesivir has shown promise in treating Coronaviridae | [30] | |
Eastern equine encephalitis | Viral | ≈33% | [31] | ||
Bubonic plague | Bacterial | Unvaccinated and untreated | [5–60]% | [7] : 57 | |
Anthrax, gastrointestinal, oropharyngeal type | Bacterial | [10–50]% | [7] : 27 | ||
Smallpox, Variola major | Viral | Unvaccinated | 30% | [7] : 88 | |
Varicella (chickenpox), in newborns | Viral | Untreated | ≈30% | Where the mothers develop the disease between 5 days prior to, or 2 days after delivery. | [17] : 110 |
Dengue haemorrhagic fever (DHF) | Viral | Untreated | 26% | Dengue haemorrhagic fever is also known as severe dengue. [32] | [33] |
Murray Valley encephalitis (MVE) | Viral | No cure | [15–30]% | No specific treatment; usually involves supportive care. | [34] |
Hantavirus pulmonary syndrome (HPS) | Viral | Untreated | ≈21% | Galidesivir has shown promise in treating Bunyavirales | [35] |
Tularemia, typhoidal | Bacterial | Untreated | [3–35]% | [7] : 77 | |
Leptospirosis | Bacterial | <[5–30]% | [17] : 352 | ||
Meningococcal disease | Bacterial | Unvaccinated and untreated | [10–20]% | [36] | |
Typhoid fever | Bacterial | Unvaccinated and untreated | [10–20]% | [17] : 665 | |
Legionellosis | Bacterial | ≈15% | [17] : 665 | ||
Severe acute respiratory syndrome (SARS) | Viral | 11% | Galidesivir has shown promise in treating Coronaviridae. | [37] | |
Intestinal capillariasis | Parasitic (helminthous) | Untreated | ≈10% | [38] | |
Visceral leishmaniasis | Parasitic (protozoan) | ≈10% | [39] | ||
Botulism | Bacterial toxin | Treated | < 10% | Untreated foodborne botulism is thought to be ≈50% | [40] |
Diphtheria, respiratory | Bacterial | Unvaccinated and untreated | ≈[5-10]% | [41] | |
Yellow fever | Viral | Unvaccinated | 7.5% | [42] | |
Pertussis (whooping cough), infants in developing countries | Bacterial | Unvaccinated | ≈3.7% | [17] : 456 | |
Smallpox, Variola major | Viral | Vaccinated | 3% | [7] : 88 | |
Cholera, in Africa | Bacterial | ≈[2–3]% | With proper treatment, may be less than 1%, while without treatment may reach 50% | [43] [44] [45] [46] [47] | |
1918 (Spanish) flu | Viral | Treated | [2.5-9.7]% | varies with population, up to 22% in Western Samoa | [48] [49] [50] |
Angiostrongyliasis | Parasitic (helminthous) | ≈2.4% | From Hawaiian cases. | [51] | |
Measles (rubeola), in developing countries | Viral | Unvaccinated | ≈[1–3]% | May reach [10–30]% in some localities. | [17] : 431 |
Brucellosis | Bacterial | Untreated | ≤ 2% | [17] : 87 | |
Hepatitis A, adults > 50 years old | Viral | Unvaccinated | ≈1.8% | [17] : 278 | |
Coronavirus disease 2019 (COVID-19) | Viral | Unvaccinated & Treated with unspecific treatments | 0.5-1% | Depends largely on the age group of the person. [52] | [53] |
Lassa fever | Viral | Treated | ≈1% | 15% in hospitalized patients; higher in some epidemics. | [54] |
Mumps encephalitis | Viral | Unvaccinated | ≈1% | [17] : 431 | |
Pertussis (whooping cough), children in developing countries | Bacterial | Unvaccinated | ≈1% | For children 1–4 years old. | [17] : 456 |
Smallpox, Variola minor | Viral | Unvaccinated | 1% | [7] : 87–88 | |
Venezuelan Equine Encephalitis (VEE) | Viral | < 1% | [7] : 97–98 | ||
Anthrax, cutaneous | Bacterial | < 1% | [7] : 27 | ||
Seasonal Influenza, Worldwide | Viral | Largely unvaccinated, Treated | < 0.1–0.5%[ failed verification ] | Depends largely on the age group of the people. | [55] |
Malaria | Parasitic (protozoan) | ≈0.3% | [56] | ||
Hepatitis A | Viral | Unvaccinated | [0.1–0.3]% | [17] : 278 | |
Polio | Viral | Without artificial breathing support | ≈0.1%, varies by age: 2-5% for children and up to 15-30% for adults | 0.5% of all infected become paralysed. Of those, about [10–20]% die. | [57] [58] |
Asian (1956–58) flu | Viral | ≈0.1% | [59] | ||
Hong Kong (1968–69) flu | Viral | ≈0.1% | [59] | ||
Influenza A, typical pandemics | Viral | < 0.1% | [48] | ||
Varicella (chickenpox), adults | Viral | Unvaccinated | 0.02% | [17] : 110 | |
Hand, foot and mouth disease, children < 5 years old | Viral | 0.01% | [60] | ||
Varicella (chickenpox), children | Viral | Unvaccinated | 0.001% | [17] : 110 |
Lassa fever, also known as Lassa hemorrhagic fever, is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not develop symptoms. When symptoms occur they typically include fever, weakness, headaches, vomiting, and muscle pains. Less commonly there may be bleeding from the mouth or gastrointestinal tract. The risk of death once infected is about one percent and frequently occurs within two weeks of the onset of symptoms. Of those who survive, about a quarter have hearing loss, which improves within three months in about half of these cases.
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. 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.
Encephalitis is inflammation of the brain. The severity can be variable with symptoms including reduction or alteration in consciousness, headache, fever, confusion, a stiff neck, and vomiting. Complications may include seizures, hallucinations, trouble speaking, memory problems, and problems with hearing.
Measles is a highly contagious, vaccine-preventable infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes. Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea, middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression. Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles. Both rubella, also known as German measles, and roseola are different diseases caused by unrelated viruses.
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.
The 1918–1920 flu pandemic, also known as the Great Influenza epidemic or by the common misnomer Spanish flu, was an exceptionally deadly global influenza pandemic caused by the H1N1 influenza A virus. The earliest documented case was March 1918 in the state of Kansas in the United States, with further cases recorded in France, Germany and the United Kingdom in April. Two years later, nearly a third of the global population, or an estimated 500 million people, had been infected in four successive waves. Estimates of deaths range from 17 million to 50 million, and possibly as high as 100 million, making it one of the deadliest pandemics in history.
Mpox is an infectious viral disease that can occur in humans and some other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild and most of those infected will recover within a few weeks without treatment. The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.
Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.
Influenza vaccines, colloquially known as flu shots, are vaccines that protect against infection by influenza viruses. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes. While their effectiveness varies from year to year, most provide modest to high protection against influenza. Vaccination against influenza began in the 1930s, with large-scale availability in the United States beginning in 1945.
Swine influenza is an infection caused by any of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) refers to any strain of the influenza family of viruses that is endemic in pigs. As of 2009, identified SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3.
Nipah virus is a bat-borne, zoonotic virus that causes Nipah virus infection in humans and other animals, a disease with a very high mortality rate (40-75%). Numerous disease outbreaks caused by Nipah virus have occurred in South East Africa and Southeast Asia. Nipah virus belongs to the genus Henipavirus along with the Hendra virus, which has also caused disease outbreaks.
Tick-borne encephalitis (TBE) is a viral infectious disease involving the central nervous system. The disease most often manifests as meningitis, encephalitis or meningoencephalitis. Myelitis and spinal paralysis also occurs. In about one third of cases sequelae, predominantly cognitive dysfunction, persist for a year or more.
Flu season is an annually recurring time period characterized by the prevalence of an outbreak of influenza (flu). The season occurs during the cold half of the year in each hemisphere. It takes approximately two days to show symptoms. Influenza activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about three weeks to reach its pinnacle, and another three weeks to significantly diminish.
An influenza pandemic is an epidemic of an influenza virus that spreads across a large region and infects a large proportion of the population. There have been six major influenza epidemics in the last 140 years, with the 1918 flu pandemic being the most severe; this is estimated to have been responsible for the deaths of 50–100 million people. The 2009 swine flu pandemic resulted in under 300,000 deaths and is considered relatively mild. These pandemics occur irregularly.
In epidemiology, case fatality rate (CFR) – or sometimes more accurately case-fatality risk – is the proportion of people who have been diagnosed with a certain disease and end up dying of it. Unlike a disease's mortality rate, the CFR does not take into account the time period between disease onset and death. A CFR is generally expressed as a percentage. It is a measure of disease lethality, and thus may change with different treatments. CFRs are most often used for with discrete, limited-time courses, such as acute infections.
B-virus, Herpesvirus simiae, or Herpes virus B is the Simplexvirus infecting macaque monkeys. B virus is very similar to HSV-1, and as such, this neurotropic virus is not found in the blood.
The 2009 swine flu pandemic, caused by the H1N1/swine flu/influenza virus and declared by the World Health Organization (WHO) from June 2009 to August 2010, was the third recent flu pandemic involving the H1N1 virus. The first identified human case was in La Gloria, Mexico, a rural town in Veracruz. The virus appeared to be a new strain of H1N1 that resulted from a previous triple reassortment of bird, swine, and human flu viruses which further combined with a Eurasian pig flu virus, leading to the term "swine flu".
A Nipah virus infection is a viral infection caused by the Nipah virus. Symptoms from infection vary from none to fever, cough, headache, shortness of breath, and confusion. This may worsen into a coma over a day or two, and 50 to 75% of those infected die. Complications can include inflammation of the brain and seizures following recovery.