On January 30, 2020, the World Health Organization declared the outbreak of the coronavirus epidemic 2019-nCoV an emergency of international concern. All states must be prepared to fight it. Moreover, at the time of writing this article, about seven hundred people worldwide died from the new virus, and eight thousand die from normal flu in one season, and this is only in the United States.
But the WHO decision gives hope that humanity is still learning from its mistakes. We will talk about the worst epidemics in history – the experience of which now forces us to take emergency measures.
The first major epidemic in the known history of mankind was named after Emperor Marcus Aurelius Antoninus. It broke out during his reign, and claimed his life. Another epidemic is called the plague of Galen by the name of a Greek doctor who left notes about her.
What kind of illness it was is still not known exactly. Most likely, smallpox or measles – it is called a plague by tradition. Troops brought it back to Rome from a campaign in the Middle East. The plague of Antoninus reached the Rhine, killing five million people. It devastated Rome and killed the majority of the army. The golden age of the empire ended there.
The epidemic that devastated the Eastern Roman Empire is considered the first recorded outbreak of bubonic plague in Europe. It is believed that it began in Egypt or Ethiopia and ended up in Constantinople along with the grain in which infected rats were hiding. According to various estimates, from 25 to 100 million people became victims of the plague. It is believed that 66% of the inhabitants of Constantinople died.
This epidemic significantly weakened Byzantium, especially its economy, and did not allow the emperor Justinian to unite the Eastern and Western Roman empires. In addition, the apocalyptic mood that prevailed during the epidemic contributed to the spread of Christianity.
The peak of this epidemic, the most famous in history, occurred in 1346-1353. According to various estimates, the bubonic plague destroyed from 30% to 60% of the population of Europe – a total of 75 to 200 million people.
Most likely, it began in the Gobi Desert – about where Mongolia now borders on China. Due to the abnormal drought, rodents, including patients, crowding together, moved in search of food closer to human housing. Beginning among animals, the epidemic quickly spread to people. Infection was inevitable: marmots in those parts were considered a delicacy, and they did not escape ailments. Soon, the Mongol troops and merchants suffered a plague along the Great Silk Road.
The disease has been rampant in the East since about 1320. It destroyed up to 90% of the population of the Chinese province of Hebei, affected India and Central Asia, but Japan bypassed. Then the plague devastated the lower reaches of the Volga and the Don, penetrated into the Crimea, from there to Genoa, and gradually spread throughout Europe.
The death of a huge part of the population has greatly affected European countries. Cattle breeding received a powerful impetus because, in comparison with agriculture, it required fewer workers. Previously closed workshops began to accept people from the outside. Taxes increased, inflation intensified, laws appeared to preserve the disappearing estate border. The epidemic naturally pushed the development of medicine, and also mechanics, again due to lack of hands. It even intervened in the gene pool of the inhabitants of Europe: studies show that the owners of different blood groups also have different probability of surviving after plague infection.
In the 16th century, in New Spain (modern Mexico), about fifteen million local residents died from a mysterious disease – with a total of twenty two million. They called this disease “cococolitzli,”, which means “great pestilence.” Its main symptoms were fever, bleeding, hallucinations, ulcers, and headache. The Aztecs died in a few days, but Europeans, including doctors (from whose notes we know this story), were rarely infected, and their illness was mild.
The epidemic almost destroyed the Aztec people and helped the Spaniards conquer their lands. Modern researchers, studying the skeletons of people who died from “cococolitzli,” found traces of the bacteria Salmonella enterica in their DNA, which indicates an intestinal infection. Scientists suggest that the Spaniards themselves brought the disease to America.
Indians and smallpox
Smallpox is highly contagious and kills about a third of those affected. If it’s Europeans. Among the Cherokee, Mandan and Pikani, the mortality rate was much higher – up to 80–90%, according to the Cambridge Encyclopedia of Paleopathologies.
A total of European diseases, including smallpox, measles and typhoid, claimed the lives of approximately one and a half million Native Americans. This obviously helped the Europeans win the war for the continent.
History does not remember a single outbreak of cholera, comparable in number of victims to any of the epidemics described here, but this disease cannot be ignored.
Cholera is well known from antiquity; Hippocrates wrote about it, but until the 19th century, it was mainly found in southern Asia. There is a version that cholera pandemics began due to a pathogen mutation that occurred in Bengal due to an extremely cold year (the so-called “year without summer”). In total, it is customary to distinguish seven pandemics of this disease: the first broke out in 1817, and the last ended in 1975. Until now, WHO has recorded 3-5 million cases of infection per year, of which one hundred thousand end in death. Without treatment, you can die in a matter of hours.
Cholera played an important role in the development of modern epidemiology and public health, born mainly from the studies of the English physician John Snow (who knew quite a lot). The epidemic in Soho in 1854 helped him refute the then prevailing theory of miasma – according to her, rot products are to blame for diseases, which evaporate from water and soil, enter the air and infect a person inhaling them. In addition, that outbreak of cholera gave impetus to the development of sewage networks and water supply. Having compiled a map of cases of the disease, Snow found out that the source of the disease was a single standpipe. It was turned off, and the epidemic quickly subsided.
In the 19th century, there was another major epidemic of plague, the third largest after the Black Death and Justinian plague – the number of victims reached twelve million. It began in the Chinese province of Yunnan and in several decades spread throughout the world.
Just during this pandemic, in 1894, the bacteriologist Alexander Yersen discovered a plague stick. Soon, early antibiotics (streptomycin) appeared, which helped to defeat the disease.
The Manchu epidemic of 1910-1911, killing from sixty to one hundred thousand people, is considered the last major plague outbreak in history.
By 1918, World War I had already claimed the lives of millions of people. But the “Spanish” flu epidemic outnumbered it in terms of the number of victims. The disease appeared in August 1918 in several port cities at once – in Boston (USA), Brest (France) and Freetown (Sierra Leone). Ships and trains quickly spread the virus around the world. 550 million people were infected – about a third of the world population, and from 50 to 100 million, that is, about 5% of the world’s inhabitants, died. This epidemic is considered one of the most widespread both in the total number of cases and in the number of deaths.
The “Spanish” flu was called either because 39% of the population of Spain became ill, or because in this country, which was not a participant in the war, there was no censorship, and the epidemic could be freely written in newspapers.
The “Asian” flu pandemic has killed more than two million people worldwide. It began in Guizhou Province, wild ducks became a source of infection. Within a few months, the flu spread to China, the USA, India, Australia, the Philippines, Great Britain and continental Europe – transport by the middle of the 20th century had developed to such an extent that the disease flared up in different countries almost simultaneously. The first wave of the disease affected many schoolchildren: in the UK 50% of children were infected, and in closed schools – up to 90%.
An effective vaccine was developed against this type of flu, but over the next ten years the virus mutated, and in 1968 the next epidemic began. This flu was called “Hong Kong” – it was in Hong Kong that the first cases of infection were recorded. The virus took three months to spread throughout the world. Despite the relatively low mortality rate (about 0.5%), about a million people died from the “Hong Kong” flu, half of them in Hong Kong itself. The city lost 15% of the population.
Ebola hemorrhagic fever is a rare, but extremely dangerous disease. It kills an average of 50% of those infected, although in some cases mortality has reached 90%. Many laboratories around the world are developing a vaccine for the virus, but so far only one has been approved, and then in Europe. Treatment in most cases comes down to fighting the symptoms.
The largest epidemic began in February 2014 in Guinea. From there, the disease spread throughout West Africa, and also affected the United States and Spain. Since the Ebola virus came to West Africa for the first time, doctors in the affected countries had no experience dealing with it. The population was in a panic. The spread of the fever was facilitated by local funeral traditions, involving contact with the deceased during farewell.
The epidemic in West Africa lasted almost two years and killed about twelve thousand people. Airlines stopped flying to countries where the disease manifested, neighbors closed their borders with them. In the Democratic Republic of the Congo, the epidemic continues today.
It is not possible to determine when and where a human immunodeficiency virus appeared. It can exist for a long time in the body and not manifest itself in any way. It is generally accepted that people were infected by monkeys (let’s hope that they were simply eaten) – most likely, this happened in the Belgian colony of the Congo around 1920. Gradually, the virus spread throughout Africa, and by the 1970s it came to the United States. It was there that, in 1981, the disease and its symptoms were first described. Since then, the virus claimed the lives of 32 million people.
HIV infection develops very slowly. It gradually destroys the immune system and leads to death from secondary diseases. It is the last stage called AIDS. Medicine cannot completely cure an infected person, but timely diagnosis and therapy help slow down the development of infection and prevent the spread of the virus.
For a long time, society ignored the problem, since it was believed (and in some places is still believed) that HIV infection was the lot of marginalized people. Now more than 40 million HIV-infected people are registered in the world, specifically in Russia – more than a million.
Measles and anti-vaccination
Measles is one of the most contagious diseases in the world. Each carrier infects 12-18 people (for comparison, the carrier of Ebola fever – two to three). A quarter face complications, many of which can lead to disability. Most often, children suffer from measles, but it happens that adults become infected, and their disease is very difficult.
In 1963, an effective vaccine was created – and since then, countries that have universal vaccinations have had measles. More precisely, they were ill.
The anti-vaccination movement has led to more and more children not getting measles vaccines. In 2018−2019, in many countries there were major outbreaks of the disease, the number of infected people increased at times. WHO has included deliberate abandonment of vaccination in the list of ten major threats to human health, along with the emergence of bacteria that can resist antibiotics.
From a historical perspective, it is clear that people sooner or later dealt with most deadly diseases. However, we must not forget that viruses and bacteria develop, mutate, and only time will tell who will win this race.