Portal:Pandemics
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The Pandemics and Epidemics Portal
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A pandemic (/pænˈdɛmɪk/ pan-DEM-ik) 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.
Throughout human history, there have been a number of pandemics of diseases such as smallpox. The Black Death, caused by the Plague, caused the deaths of up to half of the population of Europe in the 14th century. The term pandemic had not been used then, but was used for later epidemics, including the 1918 H1N1 influenza A pandemic—more commonly known as the Spanish flu—which is the deadliest pandemic in history. The most recent pandemics include the HIV/AIDS pandemic, the 2009 swine flu pandemic and the COVID-19 pandemic. Almost all these diseases still circulate among humans though their impact now is often far less.
In response to the COVID-19 pandemic, 194 member states of the World Health Organization began negotiations on an International Treaty on Pandemic Prevention, Preparedness and Response, with a requirement to submit a draft of this treaty to the 77th World Health Assembly during its 2024 convention. Further, on 6 May 2024, the White House released an official policy to more safely manage medical research projects involving potentially hazardous pathogens, including viruses and bacteria, that may pose a risk of a pandemic. (Full article...)
An epidemic (from Greek ἐπί epi "upon or above" and δῆμος demos "people") 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.
Epidemics of infectious disease are generally caused by several factors including a change in the ecology of the host population (e.g., increased stress or increase in the density of a vector species), a genetic change in the pathogen reservoir or the introduction of an emerging pathogen to a host population (by movement of pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium and the transmission threshold is exceeded.
An epidemic may be restricted to one location; however, if it spreads to other countries or continents and affects a substantial number of people, it may be termed as a pandemic. The declaration of an epidemic usually requires a good understanding of a baseline rate of incidence; epidemics for certain diseases, such as influenza, are defined as reaching some defined increase in incidence above this baseline. A few cases of a very rare disease may be classified as an epidemic, while many cases of a common disease (such as the common cold) would not. An epidemic can cause enormous damage through financial and economic losses in addition to impaired health and loss of life. (Full article...)
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The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began with an outbreak of COVID-19 in Wuhan, China, in December 2019. It spread to other areas of Asia, and then worldwide in early 2020. The World Health Organization (WHO) declared the outbreak a public health emergency of international concern (PHEIC) on 30 January 2020, and assessed the outbreak as having become a pandemic on 11 March.
COVID-19 symptoms range from asymptomatic to deadly, but most commonly include fever, sore throat, nocturnal cough, and fatigue. Transmission of the virus is often through airborne particles. Mutations have produced many strains (variants) with varying degrees of infectivity and virulence. COVID-19 vaccines were developed rapidly and deployed to the general public beginning in December 2020, made available through government and international programs such as COVAX, aiming to provide vaccine equity. Treatments include novel antiviral drugs and symptom control. Common mitigation measures during the public health emergency included travel restrictions, lockdowns, business restrictions and closures, workplace hazard controls, mask mandates, quarantines, testing systems, and contact tracing of the infected. (Full article...) -
Smallpox was (is) an infectious disease caused by variola virus (often called smallpox virus), which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980, making smallpox the only human disease to have been eradicated to date.
The initial symptoms of the disease included fever and vomiting. This was followed by formation of ulcers in the mouth and a skin rash. Over a number of days, the skin rash turned into the characteristic fluid-filled blisters with a dent in the center. The bumps then scabbed over and fell off, leaving scars. The disease was transmitted from one person to another primarily through prolonged face-to-face contact with an infected person or rarely via contaminated objects. Prevention was achieved mainly through the smallpox vaccine. Once the disease had developed, certain antiviral medications could potentially have helped, but such medications did not become available until after the disease was eradicated. The risk of death was about 30%, with higher rates among babies. Often, those who survived had extensive scarring of their skin, and some were left blind. (Full article...) -
Example of an epidemic showing the number of new infections over time.
An epidemic (from Greek ἐπί epi "upon or above" and δῆμος demos "people") 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.
Epidemics of infectious disease are generally caused by several factors including a change in the ecology of the host population (e.g., increased stress or increase in the density of a vector species), a genetic change in the pathogen reservoir or the introduction of an emerging pathogen to a host population (by movement of pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium and the transmission threshold is exceeded. (Full article...) -
The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. It is a preventable disease. There is no vaccine or cure for HIV. It can be managed with treatment and become a manageable chronic health condition. While there is no cure or vaccine, antiretroviral treatment can slow the course of the disease and enable people living with HIV to lead long and healthy lives. An HIV-positive person on treatment can expect to live a normal life, and die with the virus, not of it. Effective treatment for HIV-positive people (people living with HIV) involves a life-long regimen of medicine to suppress the virus, making the viral load undetectable. Without treatment it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS).
Treatment is recommended as soon as the diagnosis is made. An HIV-positive person who has an undetectable viral load as a result of long-term treatment has effectively no risk of transmitting HIV sexually. Campaigns by UNAIDS and organizations around the world have communicated this as Undetectable = Untransmittable. Without treatment the infection can interfere with the immune system, and eventually progress to AIDS, sometimes taking many years. Following initial infection an individual may not notice any symptoms, or may experience a brief period of influenza-like illness. During this period the person may not know that they are HIV-positive, yet they will be able to pass on the virus. Typically, this period is followed by a prolonged incubation period with no symptoms. Eventually the HIV infection increases the risk of developing other infections such as tuberculosis, as well as other opportunistic infections, and tumors which are rare in people who have normal immune function. The late stage is often also associated with unintended weight loss. Without treatment a person living with HIV can expect to live for 11 years. Early testing can show if treatment is needed to stop this progression and to prevent infecting others. (Full article...) -
The 1957–1958 Asian flu pandemic was a global pandemic of influenza A virus subtype H2N2 that originated in Guizhou in Southern China. The number of excess deaths caused by the pandemic is estimated to be 1–4 million around the world (1957–1958 and probably beyond), making it one of the deadliest pandemics in history. A decade later, a reassorted viral strain H3N2 further caused the Hong Kong flu pandemic (1968–1969). (Full article...)
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Melchiorre Gherardini, Piazza S. Babila, Milan, during the plague of 1630: plague carts carry the dead for burial.
The Italian plague of 1629–1631, also referred to as the Great Plague of Milan, was part of the second plague pandemic that began with the Black Death in 1348 and ended in the 18th century. One of two major outbreaks in Italy during the 17th century, it affected northern and central Italy and resulted in at least 280,000 deaths, with some estimating fatalities as high as one million, or about 35% of the population. The plague may have contributed to the decline of Italy's economy relative to those of other Western European countries. (Full article...) -
An outbreak of cholera began in Yemen in October 2016. The outbreak peaked in 2017 with over 2,000 reported deaths in that year alone. In 2017 and 2019, war-torn Yemen accounted for 84% and 93% of all cholera cases in the world, with children constituting the majority of reported cases. As of November 2021, there have been more than 2.5 million cases reported, and more than 4,000 people have died in the Yemen cholera outbreak, which the United Nations deemed the worst humanitarian crisis in the world at that time. However, the outbreak has substantially decreased by 2021, with a successful vaccination program implemented and only 5,676 suspected cases with two deaths reported between January 1 and March 6 of 2021.
Vulnerable to water-borne diseases before the conflict, 16 months went by before a program of oral vaccines was started. The cholera outbreak was worsened as a result of the ongoing civil war and the Saudi Arabian-led intervention in Yemen against the Houthi movement that began in March 2015. Airstrikes damaged hospital infrastructure, and water supply and sanitation in Yemen were affected by the ongoing conflict. The government of Yemen stopped funding public health in 2016; sanitation workers were not paid by the government, causing garbage to accumulate, and healthcare workers either fled the country or were not paid. (Full article...) -
The Naples Plague was an epidemic of plague in the Kingdom of Naples, lasting from 1656 to 1658. The epidemic affected mostly Central Italy and Southern Italy, killing up to 1,250,000 people throughout the Kingdom of Naples according to some estimates.
In the city of Naples alone, approximately 150,000–200,000 people died in 1656 due to the plague, accounting for more than half of the population. The epidemic had a severe impact on the economic and social structure of Naples and some other affected areas. (Full article...) -
The global pandemic of HIV/AIDS (human immunodeficiency virus infection and acquired immunodeficiency syndrome) began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), by 2023, HIV/AIDS had killed approximately 40.4 million people, and approximately 39 million people were infected with HIV globally. Of these, 29.8 million people (75%) are receiving antiretroviral treatment. There were about 630,000 deaths from HIV/AIDS in 2022. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2023, there are about 1.3 million new infections of HIV per year globally.
According to the WHO, the prevalence of HIV in the Africa Region was estimated at 1.1 million people as of 2018. The African Region accounts for two thirds of the incidence of HIV around the world. Sub-Saharan Africa is the region most affected by HIV. As of 2020, more than two thirds of those living with HIV are living in Africa. HIV rates have been decreasing in the region: From 2010 to 2020, new infections in eastern and southern Africa fell by 38%. Still, South Africa has the largest population of people with HIV of any country in the world, at 8.45 million, 13.9% of the population as of 2022. (Full article...) -
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 being the 1918–1920 Spanish flu pandemic and the second being the 1977 Russian flu). 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".
Unlike most strains of influenza, the pandemic H1N1/09 virus did not disproportionately infect adults older than 60 years; this was an unusual and characteristic feature of the H1N1 pandemic. Even in the case of previously healthy people, a small percentage develop pneumonia or acute respiratory distress syndrome (ARDS). This manifests itself as increased breathing difficulty and typically occurs three to six days after initial onset of flu symptoms. The pneumonia caused by flu can be either direct viral pneumonia or a secondary bacterial pneumonia. A November 2009 New England Journal of Medicine article recommended that flu patients whose chest X-ray indicates pneumonia receive both antivirals and antibiotics. In particular, it is a warning sign if a child seems to be getting better and then relapses with high fever, as this relapse may be bacterial pneumonia. (Full article...) -
A plague doctor and his typical apparel during the 17th century
The second plague pandemic was a major series of epidemics of plague that started with the Black Death, which reached medieval Europe in 1346 and killed up to half of the population of Eurasia in the next four years. It followed the first plague pandemic that began in the 6th century with the Plague of Justinian, but had ended in the 8th century. Although the plague died out in most places after 1353, it became endemic and recurred regularly. A series of major epidemics occurred in the late 17th century, and the disease recurred in some places until the late 18th century or the early 19th century. After this, a new strain of the bacterium gave rise to the third plague pandemic, which started in Asia around the mid-19th century.
Plague is caused by the bacterium Yersinia pestis, which exists in parasitic fleas of several species in the wild and of rats in human society. In an outbreak, it may kill all of its immediate hosts and thus die out, but it can remain active in other hosts that it does not kill, thereby causing a new outbreak years or decades later. (Full article...) -
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 subtype of the 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.
The pandemic broke out near the end of World War I, when wartime censors in the belligerent countries suppressed bad news to maintain morale, but newspapers freely reported the outbreak in neutral Spain, creating a false impression of Spain as the epicenter and leading to the "Spanish flu" misnomer. Limited historical epidemiological data make the pandemic's geographic origin indeterminate, with competing hypotheses on the initial spread. (Full article...) -
The 735–737 Japanese smallpox epidemic (天平の疫病大流行, Tenpyō no ekibyō dairyūkō, "Epidemic of the Tenpyō era") was a major smallpox epidemic that afflicted much of Japan. Killing approximately one third (around 1 million individuals) of the entire Japanese population, the epidemic had significant social, economic, and religious repercussions throughout the country. (Full article...)
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Epidemic typhus, also known as louse-borne typhus, is a form of typhus so named because the disease often causes epidemics following wars and natural disasters where civil life is disrupted. Epidemic typhus is spread to people through contact with infected body lice, in contrast to endemic typhus which is usually transmitted by fleas.
Though typhus has been responsible for millions of deaths throughout history, it is still considered a rare disease that occurs mainly in populations that suffer unhygienic extreme overcrowding. Typhus is most rare in industrialized countries. It occurs primarily in the colder, mountainous regions of central and east Africa, as well as Central and South America. The causative organism is Rickettsia prowazekii, transmitted by the human body louse (Pediculus humanus corporis). Untreated typhus cases have a fatality rate of approximately 40%. (Full article...) -
The Plague of Athens (Ancient Greek: Λοιμὸς τῶν Ἀθηνῶν, Loimos tôn Athênôn) was an epidemic that devastated the city-state of Athens in ancient Greece during the second year (430 BC) of the Peloponnesian War when an Athenian victory still seemed within reach. The plague killed an estimated 75,000 to 100,000 people, around 25% of the population, and is believed to have entered Athens through Piraeus, the city's port and sole source of food and supplies. Thucydides, an Athenian survivor, wrote that much of the eastern Mediterranean also saw an outbreak of the disease, albeit with less impact.
The war, along with the plague, had lasting effects on Athenian society. Short-term, there was civil disorder, and violations of usual funerary practices. Thucydides describes a decrease in traditional religious practices and increase in superstitious explanations. He estimates that it took 15 years for the Athenian population to recover. Long-term, the high death toll drastically redistributed wealth within Athenian society, and weakened Athens politically. (Full article...)
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General images -
The following are images from various pandemic- and epidemic-related articles on Wikipedia.
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Possibilities for zoonotic disease transmissions (from Epidemic) -
The difference between the influenza mortality age-distributions of the 1918 epidemic and normal epidemics. Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line). (from Influenza pandemic) -
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The Plague of Athens (c. 1652–1654) by Michiel Sweerts, illustrating the devastating epidemic that struck Athens in 430 BC, as described by the historian Thucydides (from Epidemic) -
Patients suffering from cholera in 1854 (from History of cholera) -
Scaled examples of past influenza pandemics and past influenza seasons. Color scheme included to represent corresponding estimates of hypothetical influenza deaths in the 2010 US population, with the same color scale as the previous figure. (from Pandemic Severity Assessment Framework) -
By 12 February 2009, the number of cases of infection by cholera in sub-Saharan Africa had reached 128,548 and the number of fatalities, 4,053. (from History of cholera) -
Structure of the influenza viron. The hemagglutinin (HA) and neuraminidase (NA) proteins are shown on the surface of the particle. The viral RNAs that make up the genome are shown as red coils inside the particle and bound to Ribonuclear Proteins (RNPs). (from Influenza pandemic) -
First cholera pandemic (from History of cholera) -
A pump memorializing John Snow for his study of contaminated water as a likely source of cholera during the 1854 Broad Street Cholera outbreak (from History of cholera) -
Example of an epidemic showing the number of new infections over time. (from Epidemic) -
Bodies of Rwandan refugees who died during the cholera epidemic, October 1994 (from History of cholera) -
Influenza intervals in the CDC's Pandemic Intervals Framework (from Influenza pandemic) -
Estimates of hypothetical influenza deaths in the 2010 United States population (308,745,538 persons) across varying values of case-fatality ratio and the cumulative incidence of infection in the population. Selected estimated numbers of deaths are indicated with a black line, across each relevant combination of case-fatality ratio and cumulative incidence. In addition, the background color transitions from blue to yellow to red as the estimated absolute number of deaths increases. Case-fatality ratio is an example of a clinical severity measure and cumulative incidence of infection is an example of a transmissibility measure in the Pandemic Severity Assessment Framework. (from Pandemic Severity Assessment Framework) -
Disposal of dead bodies during the cholera epidemic in Palermo in 1835 (from History of cholera) -
The various types of influenza viruses in humans. Solid squares show the appearance of a new strain, causing recurring influenza pandemics. Broken lines indicate uncertain strain identifications. (from Influenza pandemic) -
Anopheles mosquito, the vector of malaria (from Epidemic) -
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. (from History of cholera) -
1892 cholera outbreak in Hamburg, hospital ward (from History of cholera) -
Register of Patients Gosport Naval Hospital August 1832 cholera cases (from History of cholera) -
Influenza ward at Walter Reed Hospital, in Washington, D.C., during the 1918 flu pandemic (from Influenza pandemic)
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