EPIDEMICS AND PANDEMICS Plague of Athens (430 BC) Peloponnesian War between Athens and Sparta Plague lasted 3 years Killed ~25% of Athens population Including Pericles Likely Typhoid fever or a Hemorrhagic Fever like Ebola Caused a withdraw of the Spartans because they feared contact with the sick Plague of Justinian (541-542 BC) Eastern Europe First major Bubonic Plague (Black Death) outbreak ~5000 people per day died in Constantanople (Istanbul) Lasted 2 years Killed tens of millions of people Played a key role in keeping the Byzantine Empire from expanding Black Death (1347-1350) Arguably the worst pandemic in history Killed 1/3 of the population of Europe (75-200 million people) Caused by the Bubonic Plague Carried by fleas that lived on rats So many people died that the pandemic came to an end
Spanish Flu (1918-1920) H1N1 (swine flu) Spread worldwide because of the travel of soldiers during WWI Called the Spanish Flu because many thought Spain was hit hardest Other countries were under wartime censor and could not report things that were bad Spain was not at war, so they did not have this censor and reported the outbreak when others were not Infected over 500 million people Killed 3-5% of the worlds population (50-100 million people) Estimated that of the US soldiers that died during WWI died of the flu Killed more people than the Bubonic Plague Smallpox Americas (1633-1634) Brought to the New World by Europeans Killed 70-90% of the Native American population There have been multiple epidemics all over the globe of smallpox Smallpox has been eradicated due to world wide vaccination campaigns Smallpox caused many epidemics from (430 BC 1979 AD) Killed 5 monarchs Cholera (1817 - present) 8 pandemics ~2-6 people died each day in the USA from 1832-1866 Because it spreads through infected water, it easily spreads through a
community quickly. Kills over 100,000 people each year Typhus (430 BC Present) Generally occurs after wars and natural disasters Can be carried by lice, and also transmitted through fecal matter Outbreaks in the US after the Civil War, World War I Major outbreaks in concentration camps during World War II Vaccines have greatly reduced this disease Ebola (2014 - 2016) Began in Western Africa in 2014 Killed 5 times more people than any previous Ebola outbreak Ebola deaths - Figures up to 13 January 2016 11,315 Deaths - probable, confirmed and suspected 4,809 Liberia 3,955 Sierra Leone 2,536 Guinea 8 Nigeria 6 Mali 1 United States
Researchers from the New England Journal of Medicine traced the outbreak to a two-year-old toddler, who died in December 2013 in Meliandou, a small village in south-eastern Guinea. In March, hospital staff alerted Guinea's Ministry of Health and then medical charity Medecins Sans Frontieres (MSF). They reported a mysterious disease in the south-eastern regions of Gueckedou, Macenta, Nzerekore, and Kissidougou. It caused fever, diarrhoea and vomiting. It also had a high death rate. Of the first 86 cases, 59 people died. Later determined by WHO to be Ebola Epidemic A disease affecting an unusually large number of people in a community at the same time How are Epidemics Caused Infected food and water Infected local water supplies affects a large population quickly Increased virulence Disease mutates and becomes more virulent Introduction of new disease Population has no resistance built to new disease Lower resistance to disease Natural disasters, famine, etc. can weaken a population and lower their resistance to a disease Natural disasters and wars Infected water, bringing new diseases, lowering resistance
World travel Spread of Disease Insects Bubonic Plague, Malaria Airborne Transmission Spread from person to person by sneezes or coughs Influenza, Measles, Tuberculosis Foods and Water Cholera, Dysentery, Typhoid Fever Ending Epidemics Fewer Hosts many die, others survive and become resistant Vaccines to make resistant Quarantine keep other potential hosts away Seasonal Some diseases spread more easily during certain seasons Fewer Carriers Diseases carried by other organisms (mosquitoes, etc) can be stopped by A) getting rid of the carriers B) inactivity of the carriers due to seasons (mosquitoes are not active when it is cold) When an Epidemic Becomes Pandemic
Pandemic - Epidemic has spread across a large region, typically across multiple continents or worldwide WHO World Health Organization Present in over 150 nations Directs and coordinates international health within the United Nations system Outbreak Investigations Develop questionnaires Conduct surveys Analyze data Trace contacts Identify causes of disease outbreaks and other health threats Recommend control measures Devise strategies to prevent future occurrences. During public health emergencies Deploys scientific experts Coordinates delivery of supplies and equipment to the incident site Monitors response activities Provides resources to state and local public health departments Six Stages of a Pandemic - WHO 1. 2. 3. 4.
Disease is found in animals but not in humans Disease is found in humans Small clusters of the disease found, but is not spreading rapidly Disease is being passed from human-to-human and there are community outbreaks 5. Disease has spread to at least two countries A full fledged pandemic is imminent 6. Disease is now classified as a full-fledged pandemic Current Outbreaks Cholera Yemen Measles Romania Belgium Italy Germany Indonesia Guinea Meningitis
Liberia Yellow Fever Brazil MERS Arabian Peninsula Malaria South Africa Burundi Guinea Indonesia Dengue Fiji Avian (Bird) Flu H7N9 China Chikungurya
Central America South America Mexico Fiji Caribbean ZIKA American Samoa Cayman Islands Guatemala Paraguay Uganda
Angola Central African Republic Guinea-Bissau Peru United States of America Anguilla Chile Easter Island
Guyana Philippines United States Virgin Islands Antigua and Barbuda Colombia Haiti Puerto Rico
Vanuatu Argentina Cook Islands Honduras Saint Barthelemy Venezuela Aruba
Costa Rica Indonesia Saint Kitts Vietnam Bahamas Cte d'Ivoire Jamaica Saint Lucia
Bangladesh Cuba Lao People's Democratic Republic Saint Martin Barbados Curaao Malaysia
Saint Vincent and the Grenadines Belize Dominica Maldives Samoa Bolivia Dominican Republic Areas
Marshall Islands Senegal Bonaire Ecuador Mexico Singapore Brazil
El Salvador Micronesia Sint Maarten British Virgin Fiji Montserrat Solomon Islands Burkina Faso
France Martinique Nicaragua Suriname Burundi France Guyane Nigeria Thailand
Cambodia Gabon Palau Tonga Cameroon Grenada Panama
Trinidad and Tobago Cape Verde Guadeloupe Papua New Guinea Turks and Caicos islands
