7 Deadliest Diseases in History: 

Where are
they now?
1. The Black Death: Bubonic Plague
The Black Death ravaged most of Europe and the Mediterranean from 1346 until
1353. Over 50 million people died, more than 60% of Europe's entire population
at the time.

Many historians believe it started in the Steppes of Central Asia, a vast area of
grassland that even today still supports one of the world's biggest plague
reservoirs - an area where rodents live in great numbers and density (also called a
plague focus).

Plague is mainly spread through the bite of a flea infected with the plague-
causing bacterium, Yersinia pestis. Fleas typically live on small animals such as
rats, gerbils, marmots and squirrels and periodically, explosive outbreaks of
plague occur among these susceptible hosts. Huge numbers of animals succumb
to infection and die. Hungry fleas turn to humans and within three to five days of
a bite, fever, headache, chills, and weakness develop. Lymph nodes closest to the
bite site swell to form a painful bubo in the variant of plague known as bubonic
plague. Infection may spread throughout the blood stream and affect respiration
in the lungs. Without prompt antibiotic treatment, 30% to 100% of infected
people die.

Is Plague Lurking In A Town Near You?

The epidemic of plague in the 14th century was not the only significant plague
outbreak recorded in human history. The first reported pandemic broke out in
Egypt in 541 and was designated “The Plague of Justinian”. The last major plague
event began in the war-torn Yunnan province of China, reaching Hong Kong in
1894.

Even today, plague has not been eradicated, although thanks to the availability of
vaccination and antibiotics, few people now die of it. Plague foci still exist in
Africa, North and South America, and Asia.
Between 2010 and 2015 there were 3248 cases of plague reported worldwide,
including 584 deaths. Most cases have occurred in Madagascar, The Democratic
Republic of Congo, and Peru, where plague is endemic.

From the 1 August through till the 30 April 2018, Madagascar experienced a
plague outbreak, with 2671 confirmed, probable and suspected cases of plague,
including 239 deaths reported. This was at least six times the usual annual
average of around 400 cases.

In the United states alone, 1040 confirmed or probable cases of plague occurred

between 1900 and 2016; 80% of which were classified as the bubonic form and
most of these cases occurred in the rural west. Between 2016 and 2019, just 11
cases have been reported.

2. The Speckled Monster: Smallpox

The origins of smallpox have been lost in prehistory but research suggests it first
appeared around 10,000 BC. Telltale pockmarks adorn the the mummified
remains of the great Egyptian Pharaoh Ramses V (dated at 1156 BC) and the
disease is described in ancient Sanskrit texts.

Smallpox is caused by the variola virus. Humans are the only natural hosts of
smallpox and transmission depends upon direct contact with an infected person
or infected bodily fluids, contaminated bedding or clothing. Airborne
transmission is rare, although is more likely in enclosed settings such as buildings,
buses, and trains.

An incubation period of up to 17 days (average 12 to 14 days) follows exposure

to the virus and people are not contagious at this time. Initial symptoms are
generally flu-like before small spots start to develop inside the mouth and on the
tongue. Within 24 hours a rash starts on the face and quickly spreads before
evolving into raised volcano-like pustules filled with a thick, opaque fluid. These
pustules may take up to two weeks to scab over, leaving marks on the skin that
eventually become pitted scars.
Yearly Death Rate In The 1800's Was 400,000 From
Smallpox
During the 18th century, over 400,000 people died annually in Europe from
smallpox. Overall fatality rates were around 30%; however, rates were much
higher in infants (80-98%), and one third of all survivors went blind.

One thing was obvious among survivors of the disease - they never caught it
again. This observation started the human fight against smallpox. First came
variolation which involved blowing dried smallpox scabs up a person's nose,
deliberately infecting them with the disease.

Inoculation used a lancet to transfer the contents of a smallpox pustule under the
skin of a non-immune person. It was a bit risky - some people developed
smallpox from the procedure or contracted other diseases such
as tuberculosis or syphilis. But fatality rates associated with inoculation were 10
times lower than those associated with naturally occurring smallpox.

In the late 1700s, at least two people acted on the observation that dairymaids
who had cowpox, never contracted smallpox. In 1774, Benjamin Jesty used
material from cows with cowpox to inoculate his wife and two young sons. In
1796, Dr Edward Jenner used matter from a cowpox-infected young dairy maid to
protect an 8-year old boy. Two months later he inoculated the same boy with
smallpox, and no disease developed. Dr Jenner's work paved the way for
vaccination as we know it today.

A Victory For Vaccination

The last known case of smallpox was in Birmingham in 1978, when 40-year-old
medical photographer Janet Parker caught the virus from the anatomy
department she worked in at Birmingham Medical School. According to the
World Health Organization (WHO), smallpox has been successfully eradicated
worldwide. This global success is attributed to a mass vaccination campaign that
began in 1967 and continued until the WHO announced that the disease had
been eliminated.
Although the disease has been eliminated, both the Centers for Disease Control
and Prevention (CDC) and the WHO have concerns that the virus could be used
for bio-terrorism. This topic has been dramatized in movies, books and TV shows.
Although the possibility of smallpox being used as a biological weapon deserves
consideration, the actual risk is likely very low. However, strategies are in place to
protect the public should this ever happen and large quantities of the smallpox
vaccine have been stockpiled.

3. Severe Acute Respiratory Syndrome (SARS)

Time Magazine, 5th May 2003

The history of SARS was short but not so sweet.

SARS generated widespread panic in 2003 and was caused by a previously

unknown coronavirus (SARS-CoV-1) - the same family of viruses that causes
Covid-19.

Symptoms of SARS began two to ten days after coming into contact with the
virus and included a high fever, headache, body aches, sometimes diarrhea. But
the main symptom of concern was the severe breathing difficulties associated
with SARS, and almost all those infected developed pneumonia. By the end of
2003, 774 people had died out of the 8,098 infected people notified to WHO.
Many more people needed to be hospitalized for breathing assistance.

SARS is spread through close contact with infectious droplets released during a
cough or sneeze. SARS started in Asia, and researchers have identified the most
likely source as wild Chinese Horseshoe bats that had been caught and brought
to market. These bats harbored a SARS-like virus that subsequently infected
civets before mutating; which meant that humans were now susceptible to the
virus. Within a year, the infection had spread to more than two dozen countries
before it was contained through public health measures.

SARS Prepared Us For MERS But Not COVID-19

One of the most concerning facts about viruses, particularly those of the
coronavirus virus family, is their ability to rapidly mutate (change).
Although surveillance is ongoing for another outbreak of SARS there have only
been a small number of cases reported; mostly from laboratory accidents or,
possibly, through animal-to-human transmission (Guangdong, China).

Middle East Respiratory Syndrome (MERS), is another coronavirus infection that

can be fatal. A total of 2574 laboratory-confirmed cases of MERS were reported
up until the end of May, 2021. This figure included 886 associated deaths (a
fatality rate of over 34%). The majority of cases were reported in Saudi Arabia and
are linked to contact with camels, their dung, milk or meat. MERS can cause
severe respiratory and kidney failure.

Late 2019, early 2020, SARS-CoV-2 started to create havoc around the world.
Initially, experts thought it was just another "flu" virus, but the speed and ease of
its spread coupled with its high fatality rates quickly proved them wrong. The
impact of the condition caused by SARS-CoV-2, called Covid-19, not only forced
unprecedented lockdowns worldwide but it's social and economic impacts will be
felt for years to come.

We should have been better prepared. Another corona-type virus was always on
the cards. But possibly SARS and MERS gave us a false sense of security that new
viruses were easy to contain and beat, even if they did have high fatality rates,
such as MERS. Here's hoping the lessons we have learned from COVID-19 will
make reactions to future animal-transferred viruses quicker and more effective.

4. Avian Influenza: Not Just One For The Birds

Just like humans, birds get the flu.

Bird flu - also called Avian influenza - is common and several major outbreaks
have occurred sporadically worldwide since the disease was first recorded in Italy
in 1878. It took until 1955 to discover that the virus causing bird flu was an
influenza type A virus.

Avian influenza occurs naturally among wild aquatic birds and can easily spread
to more susceptible farmed poultry - millions of chickens, geese, and turkeys
were destroyed to prevent further spread of the disease following the outbreaks
that occurred in 2015 and 2016. Globally, 862 cases of human infection with avian
influenza A(H5N1) have been reported from 17 countries from January 2003 to
17 June 2021. 53% (455) of these cases were fatal. Lao People's Democratic
Republic reported the last case on the 31st October 2020.

The H7N9 and H5N1 of Avian influenza are the most likely strains to infect
humans, although other strains have caused small outbreaks. H7N9 is considered
the influenza A virus with the greatest potential public health impact. As of 10
June 2021, a total of 1,568 laboratory-confirmed human infections with avian
influenza A(H7N9) virus have been reported to WHO since early 2013.

5. Ebola: On The Radar Again

Ebola is a severe, often fatal disease (death rates average 50% [range 25-90%]),
caused by the Ebola filovirus. There are five different types of ebola virus, four of
which are known to cause disease in humans.

Ebola was first discovered in 1976 and bats are thought to be the most likely
reservoir (natural permanent host) of the virus. The virus readily spreads to
humans, and from human-to-human. Direct contact (through broken skin or
mucous membranes) with an infected person or animal (either living or dead), or
with objects such as contaminated needles and syringes is the most common way
Ebola is spread. Cases of sexual transmission from people who have survived the
virus have also been reported, months after their recovery.

Symptoms may appear from two to 21 days (average 8-10 days) after exposure to
the virus and include fever, severe headache, muscle pain and weakness, diarrhea,
vomiting, bleeding and bruising, and death. Survivors develop antibodies that
protect them from further infection for at least 10 years. The most significant
outbreak of Ebola in recorded history occurred from 2014 to 2016, predominantly
in Guinea, Sierra Leone, and Liberia.

Ebola: Risk is Low As Long As Sensible Precautions Are

Taken
Reports issued by the CDC indicate that 28,616 people were infected with
confirmed or probable Ebola, and 11,310 died over the course of the 2014-2016
outbreak. In the U.S., eleven people were documented as having Ebola; four of
whom had developed symptoms once back in the Unites States. Seven of the 14
had been medically evacuated from other countries. Two died.

Even though the World Health Organization (WHO) declared the end of Ebola
outbreak in Liberia on the 9th of June, 2016, there is always a risk of Ebola in
countries with very weak health systems and where the virus is prevalent in wild
animals. Since 2018, the eastern Democratic Republic of Congo (DRC) has been
experiencing an outbreak, with efforts to contain it hampered by conflict and
violence in the area. On 1st June, 2020, a new Ebola outbreak was detected in
northwest DRC, and more recently on 7th February 2021 in Butembo, North Kivu
Province of the DRC. However the latest outbreak was swiftly brought under
control with contact tracing and vaccination of more than 2000 people at high
risk. 11 confirmed cases including 6 deaths had been reported when the outbreak
was officially declared over on the 3rd May, 2021.

In December 2019, Ervebo (Ebola Zaire Vaccine, live) was approved for adults

over the age of 18. Ervebo is administered as a single dose, intramuscularly. It is
not known how long Ervebo protects against Ebola for.

In October 2020, Inmazeb became the first treatment to be approved by the FDA

for Zaire ebolavirus. Inmazeb is a mixture of three monoclonal antibodies:
atoltivimab, maftivimab, and odesivimab-ebgn, and may be given to treat
infection in adults and children, including newborns of mothers who have tested
positive for the virus. It is administered as a single intravenous infusion (a one-off
dose) and it is not known if Inmazeb is effective for other species of Ebolavirus or
Marburgvirus.

6. Leprosy: A Feared Disease That Features In The Old

Testament
Leprosy is an infection caused by the slow growing bacterium, Mycobacterium
lepraehas. It has a long incubation period - two to five years (range 6 months to
40 years) and symptoms usually start as a numbness or loss of feeling in a
defined area of skin - reflecting the affinity of the bacterium for nerve cells.

Despite not being very contagious, leprosy has been feared and misunderstood
throughout its history. Initially thought to be a curse or a punishment from God,
leprosy sufferers were stigmatized, forced to wear special clothing or ring bells to
warn others when they were approaching. Symptoms vary from person to person,
and tend to progress with time; ranging from mild, indeterminate
hypopigmented skin lesions to blindness, deformity and severe facial
disfigurement.

Still Prevalent, But Curable With Prolonged Treatment

Leprosy is still prevalent today, but usually goes by the name Hansen's disease.
Globally, nearly 200,000 cases of Hansen's disease are reported to the World
Health Organisation (WHO) every year, and it mainly affects people living in low
lying, humid, tropical and subtropical areas near the equator, such as India. About
150-200 new cases occur annually in the U.S., most of which involve immigrants
from developing countries. However, in 2015, two people acquired leprosy after
contact with a nine-banded armadillo. Approximately 15% of armadillos in
southern Texas and Louisiana have been found to harbor the bacteria.

Drug treatment of leprosy is prolonged and complicated and usually involves a

combination of antibiotics (such as dapsone, rifampin, and clofazimine) for at
least six months, in most cases longer. In some countries, thalidomide - a drug
most famous for causing birth defects in the 1950s and 60s - is used to treat
complications of leprosy such as erythema nodosum leprosum.

Although leprosy is curable, deformities and nerve damage that occur before
treatment begins are often irreversible.

7. Polio: The Most Dreaded Childhood Disease Of The

1940-50s
Polio is a crippling infectious disease that is often fatal. Children under the age of
five are especially susceptible. Although periodic epidemics occurred during the
late 19th century, it was the spike in prevalence that occurred in the 1940s and
early 1950s that triggered the start of the worldwide campaign of polio
vaccination.

Polio is caused by the very contagious and resilient poliovirus and spreads from
person-to-person, most commonly though contact with infected feces. Feces can
remain infectious for several weeks, as can food, water, or objects contaminated
by feces. Approximately 72% of people who catch polio show no symptoms.
Twenty-five percent develop flu-like symptoms (for example, sore throat, fever,
tiredness, headache, nausea, abdominal pain) within a week or two after
infection. A small proportion of these people will go on to develop more severe
symptoms such as paresthesia (burning or prickling limb pain), meningitis
(infection of brain and spinal cord), limb weakness, and paralysis that may lead to
permanent disability and death if the respiratory muscles are affected.

Polio: Vaccination Is Key To Global Eradication

Polio can be prevented through immunization, and since 1988, the World Health
Assembly has resolved to eradicate polio worldwide. Since 1988 when the Global
Polio Eradication Initiative was launched, the annual number of wild poliovirus
cases has declined by more than 99.9% worldwide. Of the three serotypes of wild
poliovirus, type 2 was certified as eradicated in 2015 and type 3 was certified as
eradicated in 2018. Only two polio-endemic countries remain, Afghanistan and
Pakistan, since Nigeria recorded the last case of wild poliovirus type 1
transmission in September 2018.

However, in recent years there has been a spike in polio cases, with over 200
cases of wild polio being reported in 2020, mostly in Afghanistan and Pakistan.
Rogue viruses, lockdowns and the Taliban are thought to be to blame.

The U.S. has not reported a case of naturally occurring paralytic polio (wild
poliovirus) since 1979, when an outbreak occurred among the Amish in several
Midwestern states. Over the period spanning 1980 through 1999, 62 confirmed
cases of paralytic polio were reported. Eight of these were acquired outside of
the U.S. and 154 were vaccine-associated, mostly caused by contact with feces
contaminated with the live oral poliovirus vaccine (OPV).

OPV is no longer used as a polio vaccine in the U.S., although several overseas
countries still use it. The inactivated poliovirus vaccine (IPV) is now the preferred
vaccine.