Pandemic Review
 A pandemic is the spread
of infectious disease across
a large area.
 It has occurred more
frequently than normal
and the effects are more
dire than usual.
 A disease is not a
pandemic simply because
it kills lots of people or
occurs in a lot of places, it
has to be infectious as well.
 Cancer is not a pandemic
disease, whereas AIDS is.
And how we would treat them today…
Plague of Athens (430 B.C.E.)
 Occurred during the
Peloponnesian War between
Sparta and Athens.
 First recorded pandemic in
history.
 Killed over a quarter of
Athens troops and up to 2/3
of Athens population.
 The cause was unknown until
2006, where university
researchers analyzed teeth of
the dead and found typhoid
bacteria.
Plague of Athens (430 B.C.E.)
 Thucydides described the
disease as such "People in
good health were all of a
sudden attacked by violent
heats in the head, and redness
and inflammation in the eyes,
the inward parts, such as the
throat or tongue, becoming
bloody and emitting an
unnatural and fetid breath.
Next came coughing,
diarrhea, spasms, and skin
ulcers. A handful survived, but
often without their fingers,
sights, and even genitals!”
Plague of Athens (430 B.C.E.)
 How we would treat it
today:
1) Vaccine against the
toxin produced by the
typhoid bacteria.
2) Fluid replacement.
3) Antibiotics like
tetracycline.
 These would reduce
the chance of death to
close to zero.
The Antonine Plague (165-180 A.D.)
 Roman troops returning
from battles in the middle
east brought back with the
spoils of war, smallpox.
 It decimated the
population of Rome and is
thought to be the single
greatest cause of the
weakening of the Roman
Empire in Northern and
Eastern Europe.
 Killed the last great Roman
Emperor, Marcus Aurelius
Antoninius.
The Antonine Plague (165-180 A.D.)
 At its height, it killed
5,000 people a day!
 The famous Greek
physician Galen
described it as “a long,
cruel disease that
involved fever, diarrhea,
and inflammation of the
throat, as well as
pustules on the skin”.
The Antonine Plague (165-180 A.D.)
 How we would treat it
today:
1) Smallpox vaccine
2) Antiviral drugs like
Cidofovir.
 Thankfully smallpox
has been eradicated all
over the world since
1979.
The Justinian Plague (541-542 A.D.)
 The Byzantine Empire,
which imported most of
its grain from Egypt to
feed its people, also
imported the bubonic
plague (caused by the
bacteria Yserina pestis).
 The plague killed
between 5-10 thousand
people a day.
The Justinian Plague (541-542 A.D.)
 It eventually killed up to 40% of Constantinople’s
population and by the year 700 A.D., killed up to 60%
of Europe’s population.
The Justinian Plague (541-542 A.D.)
 How we would treat it today:
1) Antibiotics like streptomycin and tetracycline.
 85% of today’s cases are curable.
The Black Death (1347-1351 A.D.)
 The most famous and
one of the most deadly
pandemics in Earth’s
history.
 It wiped out between 3060% of Europe’s
population.
 Lowered the world’s
population by 75-200
million people!
The Black Death (1347-1351 A.D.)
 Once arriving in western Europe
via merchant ships, it spread
rampantly from city to city
creating widespread terror and
panic.
 Victims broke out in large,
oozing pustules, vomited
profusely, coughed up blood,
and contracted other conditions
such as necrosis and gangrene.
 Four out of five victims died
within eight days, and cities
were quickly overtaken by piles
of rotting corpses, vast
cemeteries, shallow mass graves,
and enormous funeral pyres.
The Black Death (1347-1351 A.D.)
 How we would treat it
today:
1) Antibiotics like
streptomycin and
tetracycline.
 The plague still occurs
in many
underdeveloped
countries today with
85% of the cases
survived.
Native American Smallpox
Epidemic (1500-1600 A.D.)
 By the time European settlers
began to move across North
America, large numbers of the
native populations had already
been killed by the advance of
European diseases, which had
preceded the settlers’ presence.
 That didn’t stop settlers, who saw
Indians as vermin, from adding
germ warfare to their methods of
wiping them out.
 Many deadly diseases were
introduced either advertently or
inadvertently among the Indians,
effectively decimating their
numbers as the natives had no
previous exposure or resistance.
Native American Smallpox
Epidemic (1500-1600 A.D.)
 The worst of them was smallpox.
This disease was made especially
notorious because of an incident
during the French and Indian War
in which British commanders at Fort
Pitt (now Pittsburg) discussed
supplying the Indians with
smallpox-infected blankets in an
attempt to reduce their numbers.
 Whether the plans were carried out
is not confirmed, but it is known
that Delaware Indians in the area
soon began spreading smallpox
rampantly.
 By the late 1800s, it and other
diseases had wiped out up to 90% of
all Indians, making the Indian
depopulation one of history’s
greatest human catastrophes.
Native American Smallpox
Epidemic (1500-1600 A.D.)
 How we would cure this
today:
1) Smallpox vaccine
2) Antiviral drugs like
Cidofovir.
 Thankfully smallpox
has been eradicated all
over the world since
1979.
 Last case was in 1977 in
Somalia.
Cholera Pandemics (1816-1994 A.D.)
 There were seven cholera
pandemics, the first six were
very deadly.
 The first six were the most
deadly, killing huge numbers of
people in Asia, India, Europe,
Russia, the Americas, the
Middle East, Egypt and Africa.
 Untreated victims died within as
little as 3 hours of the first
symptoms, literally of fluid loss
due to acute diarrhea,
accompanied by vomiting,
cramps and lowered blood
pressure.
Cholera Pandemics (1816-1994 A.D.)
 In Chicago in 1854, Cholera killed
5% of the city’s population.
 One 1853 outbreak in London was
only stopped when physician John
Snow had the handle of the Broad
Street water pump removed,
proving the source of the outbreaks
to be water contaminated by the
feces of other cholera victims.
 Still, it took over 50 years for word
to get out, and cholera continued to
be a scourge of urban areas until
the 1920s, when most countries had
updated their public health
systems.
Cholera Pandemics (1816-1994 A.D.)
 How we would treat it
today:
1) Fluid replacement
2) Antibiotics like
tetracycline.
 Still pops up in
underdeveloped
nations with poor
sanitation, however,
when treated properly,
mortality is below 1%.
Spanish Flu Pandemic (1918-1920
A.D.)
 During the height of World War
I, a shockingly virulent strain of
Influenza-A swept the world,
spreading quickly to regions as
far apart as Asia, Australia,
North America, Europe, the
Pacific islands and even Arctic
territories.
 Whereas most flu epidemics
affect weaker populations, such
as infants or the elderly, this one
involved a mutation that allowed
the virus to overtake the
immune system and turn it
against the victim’s body.
Spanish Flu Pandemic (1918-1920
A.D.)
 This resulted in a much higher
mortality rate among the otherwise
young and healthy, whose immune
systems were stronger, as well as a
devastating toll on social
productivity.
 Everyday life stopped, schools and
shops closed, and even gravediggers
were too sick to bury the dead.
 In some cases, mass graves were dug
using steam shovels, and bodies
were buried without coffins.
 The mass infection affected nearly
one third of the world’s population,
causing between 50 million and 100
million deaths – more than all the
wars of the 20th century combined!
Spanish Flu Pandemic (1918-1920
A.D.)
 How we would treat it
today:
1) Antivirals like Tamiflu
and Relenza.
2) Proper hygiene
 This was the first Swine
Flu pandemic in
history.
Homework
1) Why did these diseases become pandemics?
2) What are some of the advances in medical
technology that have prevented a reoccurrence of
many of these diseases?
3) What are some diseases that have been pandemics in
recent history (i.e. during your lifetime)? Why have
they reached pandemic status?