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Bio-Terror Agents

    PANDEMICS

    BIOTERRORBIBLE.COM: Based on the ancient and recent history of worldwide pandemics, there will likely be another one in the very near future.

    Title: Pandemic
    Date: 2012
    Source: Wikipedia

    Abstract: A pandemic (from Greek πᾶν pan "all" + δῆμος demos "people") is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu. Throughout history there have been a number of pandemics, such as smallpox and tuberculosis. More recent pandemics include the HIV pandemic and the H1n1 pandemic.

    Definition and Stages

    The World Health Organization (WHO) produce a six-stage classification that describes the process by which a novel influenza virus moves from the first few infections in humans through to a pandemic. This starts with the virus mostly infecting animals, with a few cases where animals infect people, then moves through the stage where the virus begins to spread directly between people, and ends with a pandemic when infections from the new virus have spread worldwide.

    A disease or condition is not a pandemic merely because it is widespread or kills many people;it must also be infectious. For instance, cancer is responsible for many deaths but is not considered a pandemic because the disease is not infectious or contagious.

    In a virtual press conference in May 2009 on the influenza pandemic Dr Keiji Fukuda, Assistant Director-General ad Interim for Health Security and Environment, WHO said "An easy way to think about pandemic ... is to say: a pandemic is a global outbreak. Then you might ask yourself: “What is a global outbreak”? Global outbreak means that we see both spread of the agent ... and then we see disease activities in addition to the spread of the virus."

    In planning for a possible influenza pandemic the WHO published a document on pandemic preparedness guidance in 1999, revised in 2005 and in February 2009, defining phases and appropriate actions for each phase in an aide memoir entitled WHO pandemic phase descriptions and main actions by phase. The 2009 revision, including definitions of a pandemic and the phases leading to its declaration, were finalized in February 2009. The pandemic H1N1 2009 virus, was neither on the horizon at that time nor mentioned in the document. All versions of this document refer to influenza. The phases are defined by the spread of the disease; virulence and mortality are not mentioned in the current WHO definition, although these factors have previously been included (Wikipedia, 2012).

    Title: Summary Of WHO Global Pandemic Phases (WHO Global Influenza Preparedness Plan, 2005)
    Date: 2005
    Source:
    WHO(World Health Organization)

    Abstract:

    Interpandemic Period
    Phase 1. No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused
    human infection may be present in animals. If present in animals, the risk of human infection or disease is
    considered to be low

    Phase 2. No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza
    virus subtype poses a substantial risk of human disease

    Pandemic Alert Period
    Phase 3. Human infection(s) with a new subtype but no human-to-human spread or at most rare instances of spread to a close contact

    Phase 4. Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that
    the virus is not well adapted to humans

    Phase 5. Larger cluster(s) but human-to-human spread is still localized, suggesting that the virus is becoming
    increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk)
    Pandemic Period

    Phase 6. Pandemic phase: increased and sustained transmission in the general population

    Postpandemic Period
    Return to the Interpandemic Period (Phase 1)
    (WHO, 2005).

    Title: Current WHO Phase Of Pandemic Alert For Pandemic (H1N1) 2009
    Date: 2009
    Source:
    WHO(World Health Organization)

    Abstract: In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

    In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

    In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

    Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

    Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

    Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

    During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

    Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

    In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required (WHO, 2009).

    World Timeline & History of Pandemics
    :

    1. Plaugue of Athens
    (430-426 BC)
    Title: Plaugue of Athens
    Date: 430-426 BC
    Agent: Unknown
    Location: Athens (Greece)
    Deaths: Unknown
    Source: Wikipedia

    Abstract: The Plague of Athens was a devastating epidemic which hit the city-state of Athens in ancient Greece during the second year of the Peloponnesian War (430 BC), when an Athenian victory still seemed within reach. It is believed to have entered Athens through Piraeus, the city's port and sole source of food and supplies. The city-state of Sparta, and much of the eastern Mediterranean, was also struck by the disease. The plague returned twice more, in 429 BC and in the winter of 427/6 BC (Wikipedia, 2012).

    2. Antonine Plague (165–180 AD)
    Title: Antonine Plague
    Date: 165-180 AD
    Agent: Unknown
    Location: Rome (Italy)
    Deaths: 5 Million
    Source: Wikipedia

    Abstract: The Antonine Plague, AD 165–180, also known as the Plague of Galen, who described it, was an ancient pandemic, either of smallpox or measles, brought back to the Roman Empire by troops returning from campaigns in the Near East. The epidemic may have claimed the life of Roman emperor Lucius Verus, who died in 169 and was the co-regent of Marcus Aurelius Antoninus, whose family name, Antoninus, was given to the epidemic. The disease broke out again nine years later, according to the Roman historian Dio Cassius, and caused up to 2,000 deaths a day in Rome, one quarter of those infected. Total deaths have been estimated at five million. The disease killed as much as one-third of the population in some areas and decimated the Roman army (Wikipedia, 2012).

    3. Plague of Justinian (541-750 AD)
    Title: Plague of Justinian
    Date: 541-750 AD
    Agent: Yersinia Pestis
    Location: Constantinople (Turkey)
    Deaths: 25 Million
    Source: Wikipedia

    Abstract: The Plague of Justinian was a pandemic that afflicted the Eastern Roman Empire (Byzantine Empire), including its capital Constantinople, in 541–542 AD. It was one of the greatest plagues in history. The most commonly accepted cause of the pandemic is bubonic plague, which later became infamous for either causing or contributing to the Black Death of the 14th century. However, recent genetic studies of the bubonic plague germ, carried out from samples taken from skeletal remains in London by researchers from the University of Tübingen, suggest that the Justinian Plague (and others from antiquity) arose from either now-extinct strains of Yersinia pestis genetically distinct from the strain that broke out in the 14th century pandemic, or from pathogens entirely unrelated to bubonic plague. The plagues' social and cultural impact during this period is comparable to that of the Black Death. In the views of 6th century Western historians, it was nearly worldwide in scope, striking central and south Asia, North Africa and Arabia,[citation needed] and Europe as far north as Denmark and as far west as Ireland. Genetic studies point to China being the primary source of the contagion (Wikipedia, 2012).

    4. Black Death
    (1348-1350)
    Title: Black Death
    Date: 1348-1350
    Agent: Yersinia Pestis
    Location: Europe
    Deaths: 75-100 Million
    Source: Wikipedia

    Abstract: The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. While there were several competing theories as to the etiology of the Black Death it has been conclusively proven via analysis of ancient DNA from plague victims in northern and southern Europe that the pathogen responsible is the Yersinia pestis bacteria. The Black Death is estimated to have killed 30–60 percent of Europe's population, reducing world population from an estimated 450 million to between 350 and 375 million in the 14th century. The aftermath of the plague created a series of religious, social and economic upheavals, which had profound effects on the course of European history. It took 150 years for Europe's population to recover. The plague returned at various times, killing more people, until it left Europe in the 19th century (Wikipedia, 2012).

    5. English Sweat (1485-1551)

    Title: Sweating Sickness
    Date:
    1485-1551
    Agent: Unknown
    Location: Europe
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract: Sweating sickness, also known as "English sweating sickness" or "English sweate" (Latin: sudor anglicus), was a mysterious and highly virulent disease that struck England, and later continental Europe, in a series of epidemics beginning in 1485. The last outbreak occurred in 1551, after which the disease apparently vanished. The onset of symptoms was dramatic and sudden, with death often occurring within hours. Its cause remains unknown (Wikipedia, 2012).

    6. Crusades Typhus Pandemic (1489)
    Title: Crusades Typhus Pandemic
    Date: 1489
    Agent: Typhus
    Location: Europe
    Deaths: 20,000
    Source: Wikipedia

    Abstract: Emerging during the Crusades, it had its first impact in Europe in 1489, in Spain. During fighting between the Christian Spaniards and the Muslims in Granada, the Spanish lost 3,000 to war casualties, and 20,000 to typhus (Wikipedia, 2012).

    7. South American Smallpox Pandemic
    (1518-1530)
    Title: South American Smallpox Pandemic
    Date: 1518-1530
    Agent: Smallox
    Location: Mexico & Peru
    Deaths: 150,000
    Source: Wikipedia

    Abstract:
    Half the native population of Hispaniola in 1518 was killed by smallpox. Smallpox also ravaged Mexico in the 1520s, killing 150,000 in Tenochtitlán alone, including the emperor, and Peru in the 1530s, aiding the European conquerors (Wikipedia, 2012).

    8. Fench Typhus Pandemic (1528)
    Title: French Typhus Pandemic
    Date: 1528
    Agent: Typhus
    Location: Italy
    Deaths: 18,000
    Source: Wikipedia

    Abstract: In 1528, the French lost 18,000 troops in Italy, and lost supremacy in Italy to the Spanish (Wikipedia, 2012).

    9. Cuba Measles Pandemic (1529) 
    Title: Cuba Measles Pandemic
    Date: 1529
    Agent: Measles
    Location: Cub
    Deaths: 2/3 of Cuban Population 
    Source: Wikipedia

    Abstract In 1529, a measles outbreak in Cuba killed two-thirds of the natives who had previously survived smallpox (Wikipedia, 2012).

    10. Balkans Typhus Pandemic (1542)
    Title: Balkans Typhus Pandemic
    Date: 1542
    Agent: Typhus
    Location: Blakans (Easten Europe)
    Deaths: 30,000
    Source: Wikipedia

    Abstract: In 1542, 30,000 soldiers died of typhus while fighting the Ottomans in the Balkans (Wikipedia, 2012).

    11. South American Measles Pandemic (1600-1699)
    Title: South American Measles Pandemic
    Date: 1600-1699
    Agent: Measles
    Location: Mexico 
    Deaths: 2 Million
    Source: Wikipedia

    Abstract: Measles killed a further two million Mexican natives in the 17th century. (Wikipedia, 2012).

    12. Native American Smallpox Pandemic
    (1618-1619)
    Title: Native American Smallpox Pandemics
    Date: 1618-1619
    Agent: Smallpox
    Location: North America
    Deaths: Millions
    Source: Wikipedia

    Abstract: In 1618–1619, smallpox wiped out 90% of the Massachusetts Bay Native Americans (Wikipedia, 2012).

    13. Thirty Years War (1618-1648)
    Title: Thirty Years War
    Date: 1618-1648
    Agent: Yersinia Pestis & Typhus
    Location: Germany
    Deaths: 8 Million 
    Source: Wikipedia

    Abstract: During the Thirty Years' War (1618–1648), about 8 million Germans were killed by bubonic plague and typhus fever. Pestilence of several kinds raged among combatants and civilians in Germany and surrounding lands from 1618 to 1648. Many features of the war spread disease. These included troop movements, the influx of soldiers from foreign countries, and the shifting locations of battle fronts. In addition, the displacement of civilian populations and the overcrowding of refugees into cities led to both disease and famine. Information about numerous epidemics is generally found in local chronicles, such as parish registers and tax records, that are often incomplete and may be exaggerated. The chronicles do show that epidemic disease was not a condition exclusive to war time, but was present in many parts of Germany for several decades prior to 1618. However, when the Danish and Imperial armies met in Saxony and Thuringia during 1625 and 1626, disease and infection in local communities increased. Local chronicles repeatedly referred to "head disease", "Hungarian disease", and a "spotted" disease identified as typhus. After the Mantuan War, between France and the Habsburgs in Italy, the northern half of the Italian peninsula was in the throes of a bubonic plague epidemic (see Italian Plague of 1629–1631). During the unsuccessful siege of Nuremberg, in 1632, civilians and soldiers in both the Swedish and Imperial armies succumbed to typhus and scurvy. Two years later, as the Imperial army pursued the defeated Swedes into southwest Germany, deaths from epidemics were high along the Rhine River. Bubonic plague continued to be a factor in the war. Beginning in 1634, Dresden, Munich, and smaller German communities such as Oberammergau recorded large numbers of plague casualties. In the last decades of the war, both typhus and dysentery had become endemic in Germany (Wikipedia, 2012)

    14. Italian Plague (1629–1631)

    Title: Italian Plague
    Date: 1629–1631
    Agent: Yersinia Pestis
    Location: Milan (Italy)
    Deaths: 280, 000
    Source: Wikipedia

    Abstract: The Italian Plague of 1629–1631 was a series of outbreaks of bubonic plague which occurred from 1629 through 1631 in northern Italy. This epidemic, often referred to as Great Plague of Milan, claimed the lives of approximately 280,000 people, with the cities of the Lombardy and Veneto regions experiencing particularly high death rates. This episode is considered one of the last outbreaks of the centuries-long pandemic of bubonic plague which began with the Black Death. German and French troops carried the plague to the city of Mantua in 1629, as a result of troop movements associated with the Thirty Years' War (1618–1648).[citation needed] Venetian troops, infected with the disease, retreated into northern and central Italy, spreading the infection.  In October 1629, the plague reached Milan, Lombardy's major commercial center. Although the city initiated effective public health measures, including quarantine and limiting the access of German soldiers and trade goods, the plague smoldered. A major outbreak in March 1630 was due to relaxed health measures during the carnival season. This was followed by a second wave in the spring and summer of 1631. Overall, Milan suffered approximately 60,000 fatalities out of a total population of 130,000. East of Lombardy, the Republic of Venice was infected in 1630–31. The city of Venice was severely hit, with recorded casualties of 46,000 people out of a population of 140,000. Some historians believe the drastic loss of life, and its impact on commerce, ultimately resulted in the downfall of Venice as a major commercial and political power. The papal city of Bologna lost an estimated 15,000 citizens to the plague, with neighboring smaller cities of Modena and Parma also being heavily affected. This outbreak of plague also spread north into Tyrol, an alpine region of western Austria and northern Italy. Later outbreaks of bubonic plague in Italy include the city of Florence in 1630–33 and the areas surrounding Naples, Rome and Genoa in 1656–57 (Wikipedia, 2012).

    15. The Great Plague of London
    (1665–1666)
    Title: Great Plague of London
    Date: 1665-1666
    Agent: Yersinia Pestis
    Location: England (United Kingdom)
    Deaths: 100, 000
    Source: Wikipedia

    Abstract: The Great Plague was the last major epidemic of the bubonic plague to occur in the Kingdom of England (modern day United Kingdom). It happened within the centuries-long time period of the Second pandemic, an extended period of intermittent bubonic plague epidemics which began in Europe in 1347, the first year of the "Black Death" and lasted until 1750. The Great Plague killed an estimated 100,000 people, about 20% of London's population. Bubonic plague is a disease caused by the Yersinia pestis bacterium which is usually transmitted through the bite of an infected flea, the prime vector for Y. pestis (Wikipedia, 2012).

    16. Great Plague of Marseille (1720)
    Title:
    Great Plague of Marseille
    Date:
    1720
    Agent: Yersinia Pestis
    Location: France
    Deaths: 100,000
    Source: Wikipedia

    AbstractThe Great Plague of Marseille was the last of the significant European outbreaks of bubonic plague. Arriving in Marseille, France in 1720, the disease killed 100,000 people in the city and the surrounding provinces. However, Marseille recovered quickly from the plague outbreak. Economic activity took only a few years to recover, as trade expanded to the West Indies and Latin America. By 1765, the growing population was back at its pre-1720 level.(Wikipedia, 2012).

    17. Australia & New Zealand Smallpox Pandemics (1770)
    Title:
    Australia & New Zealand Smallpox Pandemics
    Date: 1770
    Agent: Smallpox
    Location: Australia & New Zealand
    Deaths: 1/2 of Native Population (Admitted)
    Source: Wikipedia

    Abstract: Smallpox devastated the native population of Australia, killing around 50% of Indigenous Australians in the early years of British colonisation.[33] It also killed many New Zealand Māori (Wikipedia, 2012).

    18. Russian Plague (1770-1772
    )

    Title: Russian Plague
    Date:
    1770-1772
    Agent: Yersinia Pestis
    Location:
    Rrussia
    Deaths:
    1/3 of Moscow
    Source:
    Wikipedia

    AbstractThe Russian plague epidemic of 1770—1772, also known as the Plague of 1771, was the last massive outbreak of plague in central Russia, claiming between 52 and 100 thousand lives in Moscow alone (1/6 to 1/3 of its population). The bubonic plague epidemic that originated in the Moldovan theatre of the 1768–1774 Russian-Turkish war in January 1770 swept northward through Ukraine and central Russia, peaking in Moscow in September 1771 and causing the Plague Riot. The epidemic reshaped the map of Moscow, as new cemeteries were established beyond the 18th century city limits (Wikipedia, 2012).

    19. North American Smallpox Epidemic (1775-1782)
    Title: North American Smallpox Epidemic
    Date: 1775-1782
    Agent: Smallpox
    Location: North America
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract:The 1775–1782 North American smallpox epidemic was a smallpox epidemic that spread across most of the continent of North America. The epidemic coincided with the years of the American Revolutionary War (1775–1782), which was gripping much of the continent from the colonies, western frontiers, and southern Canada. By its end the epidemic had spread as far west as the pacific coast, as far north as Alaska and as far south as Mexico, infecting virtually every part of the continent. Though no certain statistics exist it is estimated to have killed more than 145,000 people.

    It is not known how or where the outbreak began, but in 1775 it was already raging through British-occupied Boston and among the Continental Army invasion of Canada. During Washington's siege of Boston the disease broke out among both Continental and British camps. Many escaped slaves who had fled to the British lines in the South likewise contracted the virus and died.

    The epidemic was not limited to the colonies on the Eastern seaboard, nor to the areas ravaged by hostilities. The outbreak spread deep into the South, including Texas. From 1778-1779 New Orleans was especially hard hit due to its densely populated urban area. By 1779 the disease had spread to Mexico and would cause the deaths of tens of thousands. The epidemic spread through the Great Plains, likely through the travels of the Shoshone Indian tribes. Beginning in 1780 it had reached the Pueblos of the territory comprising present day New Mexico. It also showed up in the interior trading posts of the Hudson's Bay Company in 1782. It reached nearly every corner of the Continent, including the Far West and northwestern coast, Western Canada, and even Alaska. It is estimated to have killed nearly 11,000 Native Americans in the Western area of present-day Washington, reducing the population from 37,000 to 26,000 in just seven years (Wikipedia, 2012).

    20. Yellow Fever Epidemic of 1793 (1793)
    Title: Yellow Fever Epidemic
    Date: 1793
    Agent: Yellow Fever
    Location: Philadelphia, Pennsylvania
    Deaths: 4,044
    Source: Wikipedia

    Abstract: During the Yellow Fever Epidemic of 1793 in Philadelphia, Pennsylvania, there were 4044 people listed in the official register of deaths between August 1 and November 9. The vast majority of them died of the fever, making the epidemic in the city of 50,000 people one of the most severe in United States' history (Wikipedia, 2012).

    21. Spanish Yellow Fever Pandemic (1800-1899)
    Title: Spanish Yellow Fever Pandemic
    Date: 1800-1899
    Agent: Yellow Fever
    Location: Spain
    Deaths: 300, 300
    Source: Wikipedia

    Abstract: Approximately 300,000 people are believed to have died from yellow fever in Spain during the 19th century (Wikipedia, 2012).

    22. Worldwide Tuberculosis Pandemic (1800-1899)

    Title: Worldwide Tuberculosis Pandemic
    Date: 1800-1899
    Agent: Tuberculosis
    Location: Worldwide
    Deaths: 1/4 of Europe (Hundreds of Millions)
    Source: Wikipedia

    Abstract: In the 19th century, tuberculosis killed an estimated one-quarter of the adult population of Europe;by 1918 one in six deaths in France were still caused by TB. By the late 19th century, 70 to 90% of the urban populations of Europe and North America were infected with M. tuberculosis, and about 40% of working-class deaths in cities were from TB (Wikipedia, 2012).

    23. Napoleonic Wars (
    1812-1813)
    Title: Napoleonic Wars
    Date: 1812-1813
    Agent: Typhus
    Location: France & Russia
    Deaths: 1 Million?
    Source: Wikipedia

    Abstract: Typhus played a major role in the destruction of Napoleon's Grande Armée in Russia in 1812. Felix Markham thinks that 450,000 soldiers crossed the Neman on 25 June 1812, of whom less than 40,000 recrossed in anything like a recognizable military formation. In early 1813 Napoleon raised a new army of 500,000 to replace his Russian losses. In the campaign of that year over 219,000 of Napoleon's soldiers were to die of typhus (Wikipedia, 2012).

    24. First Cholera Pandemic (1816-1826)
    Title: First Cholera Pandemic
    Date:
    1817-1824
    Agent: Cholera
    Location: Asia
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract: Previously restricted to the Indian subcontinent, the pandemic began in Bengal, then spread across India by 1820. 10,000 British troops and countless Indians died during this pandemic. It extended as far as China, Indonesia (where more than 100,000 people succumbed on the island of Java alone) and the Caspian Sea before receding. Deaths in India between 1817 and 1860 are estimated to have exceeded 15 million persons. Another 23 million died between 1865 and 1917. Russian deaths during a similar period exceeded 2 million. The first cholera pandemic (1817-1824), also known as the first Asiatic cholera pandemic or Asiatic cholera, began near Calcutta and spread throughout Southeast Asia to the Middle East, eastern Africa and the Mediterranean coast. While cholera had spread across India many times previously, this outbreak went further; it reached as far as China and the Mediterranean Sea before receding. Hundreds of thousands of people died as a result of this pandemic, including many British soldiers, which attracted European attention. This was the first of several cholera pandemics to sweep through Asia and Europe during the 19th and 20th centuries. This first pandemic spread over an unprecedented range of territory, affecting almost every country in Asia (Wikipedia, 2012).

    25. Second Cholera Pandemic (1829-1849)
    Title: Second Cholera Pandemic
    Date: 1829-1849
    Agent: Cholera
    Location: India, Europe & North America
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract: The second cholera pandemic (1829-1849), also known as the Asiatic Cholera Pandemic, was a cholera pandemic that reached from India to Europe, Great Britain and the Americas. This pandemic began, like the first, with outbreaks along the Ganges River delta in India. From there the disease spread along trade routes to cover most of India. By 1828 the disease had traveled to China and reached the southern tips of the Ural Mountains in 1829. It reached England in December 1831: appearing in Sunderland, Gateshead and Newcastle. In London, the disease claimed 6,536 victims; in Paris, 20,000 died (out of a population of 650,000), with about 100,000 deaths in all of France. In 1832 the epidemic reached Russia (see Cholera Riots), Quebec, Ontario, Detroit and New York. It reached the Pacific coast of North America between 1832 and 1834. The Second Cholera Pandemic reached Russia (see Cholera Riots), Hungary (about 100,000 deaths) and Germany in 1831, London in 1832 (more than 55,000 persons died in the United Kingdom), France, Canada (Ontario), and United States (New York) in the same year, and the Pacific coast of North America by 1834. A two-year outbreak began in England and Wales in 1848 and claimed 52,000 lives. It is believed that over 150,000 Americans died of cholera between 1832 and 1849 (Wikipedia, 2012).

    26. North American Smallpox Epidemic (1837–1838)
    Title: N. American Smallpox Epidemic
    Date: 1837–1838
    Agent: Smallpox
    Location: North America
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract: The smallpox epidemic that ravaged the people of the Great Plains in 1837 and 1838 was believed to have begun in spring of 1837 when a deckhand became ill aboard an American Fur Company steamboat, the S.S. St. Peter. The steamboat traveling up the Missouri River to Fort Union from St. Louis, docked at Fort Clark near the two earth-lodge villages of the Mandan people on June 18, 1837. The disease spread to the Mandan people.[2] In July 1837, the Mandan numbered no more than 2,000, by October that number had dwindled to 138. On August 11, Francis Chadron, a trader at Fort Clark, wrote,“I Keep no a/c of the dead, as they die so fast it is impossible." By the time the S.S. St. Peter made it to Fort Union several deck hands had died, but only Jacob Halsey, an American Fur Company clerk, showed visible signs of the disease. In an attempt to stop the spread of the disease fort personnel performed primitive inoculations. Pus from Halsey's skin eruptions were used to inoculate approximately thirty Native American women and several white men living in or around the fort. Within two weeks, the women who received the inoculations began dying from the disease. As the disease reached a peak at Fort Union bands of Native Americans continued to arrive at the fort for trade. Later, a longboat was sent to Fort McKenzie via the Marias River. At Fort McKenzie the disease spread among the Blackfoot people housed there. The epidemic continued to spread into the Great Plains killing thousands during the fall of 1837, but largely died out that winter. In the end, it is estimated that two-thirds of the Blackfoot population died along with half of the Assiniboines and Arikaras, a third of the Crows, and a quarter of the Pawnees. Later, a longboat was sent to Fort McKenzie via the Marias River. At Fort McKenzie the disease spread among the Blackfoot people housed there The epidemic continued to spread into the Great Plains killing thousands during the fall of 1837, but largely died out that winter. In the end, it is estimated that jgfkfg  two-thirds of the Blackfoot population died along with half of the Assiniboines and Arikaras, a third of the Crows, and a quarter of the Pawnees.

    Claims by Churchill
    The Investigative Committee of the Standing Committee on Research Misconduct at the University of Colorado at Boulder reviewed a claim by Ward Churchill, comparing to the cited source his claim that in 1837 the United States Army deliberately infected Mandan Indians by distributing blankets that had been exposed to smallpox, and reported "Professor Churchill therefore misrepresents what Thornton says." Most other historians who have looked at the same event disagree with Churchill's interpretation of the historical evidence, and believe no deliberate introduction of smallpox occurred at the time and place Churchill claimed it had (Wikipedia, 2012).

    27. Canadian Typhus Epidemic (1847)
    Title: Typhus Epidemic of 1847
    Date: 1847
    Agent: Typhus
    Location: Canada
    Deaths: 20,000+
    Source: Wikipedia

    Abstract: The typhus epidemic of 1847 was an outbreak of epidemic typhus caused by a massive Irish emigration in 1847, during the Great Famine, aboard crowded and disease-ridden "coffin ships". In Canada, more than 20 000 people died from 1847 to 1848, with many quarantined in fever sheds in Grosse Isle, Montreal, Kingston, Ontario, Toronto and St. John, New Brunswick (Wikipedia, 2012).

    28. Hawaiian Pandemics (1848-1849)
    Title: Hawaiian Pandemics 
    Date: 1848-1849
    Agent: Measles, Whooping Cough & Yersinis Pestis
    Location: Hawaii (South Pacific)
    Deaths: 40,000
    Source: Wikipedia

    Abstract: As late as 1848–49, as many as 40,000 out of 150,000 Hawaiians are estimated to have died of measles, whooping cough and influenza(Wikipedia, 2012).

    29. Third Cholera Pandemic (1852-1860)
    Title: Third Cholera Pandemic
    Date: 1852-1860
    Agent: Cholera
    Location: North America, Europe, Middle East, India & Asia
    Deaths: Unknonw (Likely Millions)
    Source: Wikipedia

    Abstract: The Third Cholera Pandemic (1852-1860) was the third major outbreak of cholera originating in India in the nineteenth century that reached far beyond its borders. In Russia, more than one million people died of cholera. In 1853-1854, the epidemic in London claimed over 10,000 lives, and there were 23,000 deaths for all of Great Britain. This pandemic was considered to have the highest fatalities of the 19th-century epidemics. Like the earlier pandemics, cholera spread from the Ganges delta of India. It had high fatalities among populations in Asia, Europe, Africa and North America. In 1854, which was considered the worst year, 23,000 people died in Great Britain. That year, the British physician John Snow, who was working in a poor area of London, identified contaminated water as the means of transmission of the disease. He had mapped the cases of cholera in the Soho area in London, and noted a cluster of cases near a water pump in one neighborhood. To test his theory, he convinced officials to remove the pump handle, and the number of cholera cases in the area immediately declined. His breakthrough helped eventually bring the epidemic under control. Because of his insight and patient testing, he is considered the father of epidemiology. The Third Cholera Pandemic mainly affected Russia, with over a million deaths. In 1852, cholera spread east to Indonesia and later invaded China and Japan in 1854. The Philippines were infected in 1858 and Korea in 1859. In 1859, an outbreak in Bengal again led to the transmission of the disease to Iran, Iraq, Arabia and Russia. Throughout Spain, cholera caused more than 236,000 deaths in 1854–55. It claimed 200,000 lives in Mexico (Wikipedia, 2012).

    30. Third Plague Pandemic (1855-1959)
    Title: Third Plague Pandemic
    Date: 1855-1959
    Agent: Yersinia Pestis
    Location: China & India
    Deaths: 12 Million
    Source: Wikipedia

    Abstract: Third Pandemic is the designation of a major Bubonic plague pandemic that began in the Yunnan province in China in 1855. This episode of bubonic plague spread to all inhabited continents, and ultimately killed more than 12 million people in India and China alone. According to the World Health Organization, the pandemic was considered active until 1959, when worldwide casualties dropped to 200 per year. Bubonic plague is an infectious disease that is widely thought to have caused several epidemics or pandemics throughout history, including two previous pandemics commonly designated as the Plague of Justinian and the Black Death (Wikipedia, 2012).

    31. Fourth Cholera Pandemic (1863-1879)
    Title: The Fourth Cholera Pandemic
    Date: 1863-1879
    Agent: Cholera
    Location: Europe & Africa
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    AbstractThe Fourth Cholera Pandemic (1863-1879) was the fourth major pandemic of cholera in the century. It began in the Ganges delta of the Bengal region, from where Muslim pilgrims carried it to Mecca. That year 30,000 of the 90,000 Mecca pilgrims died in the epidemic. Cholera spread throughout the Middle East. It also was carried to Russia, Europe, Africa and North America, in each case spreading from port cities and along inland waterways.
    The Fourth Cholera Pandemic spread mostly in Europe and Africa. At least 30,000 of the 90,000 Mecca pilgrims fell victim to the disease. Cholera claimed 90,000 lives in Russia in 1866. In 1866, there was an outbreak in North America. It killed some 50,000 Americans (Wikipedia, 2012).

    32. Fiji Measles Pandemic (1875)
    Title: Fiji Measles Pandemic
    Date: 1875
    Agent: Measles
    Location: Fiji (South Pacific)
    Deaths: 40,000
    Source: Wikipedia

    Abstract: In 1875, measles killed over 40,000 Fijians (Wikipedia, 2012).

    33. Fifth Cholera Pandemic (1881-1896)
    Title: Fifth Cholera Pandemic
    Date: 1881-1896
    Agent: Cholera
    Location: India, Asia, Africa & Europe
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract: The fifth cholera pandemic (1881-1896) was the fifth major international outbreak of cholera in the nineteenth century starting in India. It spread throughout Asia and Africa, and reached parts of France, Germany, Russia, and South America. The 1892 outbreak in Hamburg, Germany was the only major European outbreak; about 8,600 people died in that city. Although many residents held the city government responsible for the virulence of the epidemic, it continued with practices largely unchanged. This was the last serious European cholera outbreak of the century. The epidemic was so serious in Rome that Pope Leo XIII authorized building a hospice inside the Vatican for afflicted residents. That building was torn down in 1996 to make way for construction of the Domus Sanctae Marthae. The Fifth Cholera Pandemic cost 250,000 lives in Europe and at least 50,000 in Americas. Cholera claimed 267,890 lives in Russia (1892); 120,000 in Spain; 90,000 in Japan and 60,000 in Persia. In 1892, cholera contaminated the water supply of Hamburg, and caused 8606 deaths (Wikipedia, 2012).

    34. Asiatic Flu (1889-1890)
    Title: Asiatic Flu
    Date: 1889-1890
    Agent: Influenza
    Location: Asia & North America
    Deaths: 1 Million
    Source: Wikipedia

    Abstract: The "Asiatic Flu", 1889–1890, was first reported in May 1889 in Bukhara, Uzbekistan. By October, it had reached Tomsk and the Caucasus. It rapidly spread west and hit North America in December 1889, South America in February–April 1890, India in February–March 1890, and Australia in March–April 1890. It was purportedly caused by the H2N8 type of flu virus. It had a very high attack and mortality rate. About 1 million people died in this pandemic" (Wikipedia, 2012).

    35. Sixth Cholera Pandemic (1899-1923)
    Title: Sixth Cholera Pandemic
    Date: 1899-1923
    Agent: Cholera
    Location: India, Middle East, North Africa, Europe & Russia
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    Abstract: Sixth Cholera Pandemic(1899-1923) was a major outbreak of cholera beginning in India, where it killed more than 800,000 people, and spreading to the Middle East, North Africa, Eastern Europe and Russia. The last cholera outbreak in the United States was in 1910-1911 when the steamship Moltke brought infected people to New York City from Naples. Vigilant health authorities isolated the infected on Swinburne Island, built in the nineteenth century as a quarantine facility. Eleven people died, including a health care worker at the island hospital. The Sixth Cholera Pandemic had little effect in Europe because of advances in public health, but Russia was badly affected again (more than 500,000 people dying of cholera during the first quarter of the 20th century). The sixth pandemic killed more than 800,000 in India. The 1902-1904 cholera epidemic claimed over 200,000 lives in the Philippines. 27 epidemics were recorded during pilgrimages to Mecca from the 19th century to 1930, and more than 20,000 pilgrims died of cholera during the 1907–08 Hajj (Wikipedia, 2012).

    36. Worldwide Tuberculosis Pandemic (1900-1999)
    Title: Worldwide Tuberculosis Pandemic
    Date: 1900-1999
    Agent: Tuberculosis
    Location: Worldwide
    Deaths: 100 Million
    Source: Wikipedia

    Abstract: During the 20th century, tuberculosis killed approximately 100 million people (Wikipedia, 2012).

    37. World War I (1914-1918)
    Title: World War I Typhus Pandemic
    Date: 1914-1918
    Agent: Typhus
    Location: Europe
    Deaths: 150,000
    Source: Wikipedia

    Abstract: During World War I, typhus epidemics killed over 150,000 in Serbia (Wikipedia, 2012).

    38. Russian Typhus Pandemic (1918-1922)
    Title: Russian Typhus Pandemic
    Date: 1918-1922
    Agent: Typhus
    Location: Russia
    Deaths: 3 Million
    Source: Wikipedia

    Abstract: There were about 25 million infections and 3 million deaths from epidemic typhus in Russia from 1918 to 1922. Typhus also killed numerous prisoners in the Nazi concentration camps and Soviet prisoner of war camps during World War II. More than 3.5 million Soviet POWs died in the Nazi custody out of 5.7 million (Wikipedia, 2012).

    39. The Spanish Flu (1918-1919)
    Title: 1918 Flu Pandemic
    Date:
    1918-1919
    Agent: Influenza
    Location: North America, Pacific Islands & Artic
    Deaths: 50-100 Million
    Source: Wikipedia

    Abstract: The 1918 flu pandemic (the "Spanish flu") was an influenza pandemic, and the first of the two pandemics involving H1N1 influenza virus (the second was the 2009 flu pandemic, an outbreak of swine flu). It was an unusually severe and deadly pandemic that spread across the world. Historical and epidemiological data are inadequate to identify the geographic origin. Most victims were healthy young adults, in contrast to most influenza outbreaks, which predominantly affect juvenile, elderly, or weakened patients. The flu pandemic was implicated in the outbreak of encephalitis lethargica in the 1920s. The pandemic lasted from June 1918 to December 1919, spreading even to the Arctic and remote Pacific islands. Between 50 and 100 million died, making it one of the deadliest natural disasters in human history. Even using the lower estimate of 50 million people, 3% of the world's population (which was 1.86 billion at the time) died of the disease. Some 500 million, or 27%, were infected. Tissue samples from frozen victims were used to reproduce the virus for study. This research concluded, among other things, that the virus kills through a cytokine storm (overreaction of the body's immune system), which perhaps explains its unusually severe nature and the concentrated age profile of its victims. The strong immune system reactions of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults resulted in fewer deaths. The "Spanish flu", 1918–1919. First identified early in March 1918 in US troops training at Camp Funston, Kansas. By October 1918, it had spread to become a worldwide pandemic on all continents, and eventually infected about one-third of the world's population (or 500 million persons). Unusually deadly and virulent, it ended nearly as quickly as it began, vanishing completely within 18 months. In six months, some 50 million were dead; some estimates put the total of those killed worldwide at over twice that number. About 17 million died in India, 675,000 in the United States and 200,000 in the UK. The virus was recently reconstructed by scientists at the CDC studying remains preserved by the Alaskan permafrost. The H1N1 virus has a small, but crucial structure that is similar to the Spanish Flu (Wikipedia, 2012).

    40. Asian Flu (1957-1958)
    Title: Influenza A Virus Subtype H2N2
    Date:
    1957-1958
    Agent: Influenza
    Location: North America & Asia
    Deaths: 2 Million
    Source: Wikipedia

    Abstract: The "Asian Flu", 1957–58. An H2N2 virus caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957. It caused about 2 million deaths globally. The category 2 Asian flu pandemic outbreak of influenza A virus originated in China in early 1956, and lasted until 1958. Some authors believe it originated from a mutation in wild ducks combining with a pre-existing human strain. Other authors are less certain. The virus was first identified in Guizhou. It spread to Singapore in February 1957,[9] reached Hong Kong by April, and the US by June. The death toll in the US was about 69,800. Estimates of worldwide deaths caused by this pandemic varies widely depending on source, ranging from one to four million, with WHO settling on "about two million". Asian flu was of the H2N2 subtype (a notation that refers to the configuration of the hemagglutinin and neuraminidase proteins in the virus) of type A influenza, and an influenza vaccine was developed in 1957 to contain its outbreak. The Asian flu strain later evolved via antigenic shift into H3N2, which caused a milder pandemic from 1968 to 1969. Both the H2N2 and H3N2 pandemic strains contained avian influenza virus RNA segments. "While the pandemic human influenza viruses of 1957 (H2N2) and 1968 (H3N2) clearly arose through reassortment between human and avian viruses, the influenza virus causing the 'Spanish flu' in 1918 appears to be entirely derived from an avian source (Belshe 2005)" (Wikipedia, 2012).

    41. Seventh Cholera Pandemic (1961-1991)
    Title: Seventh Cholera Pandemic
    Date: 1961-1991
    Agent: Cholera
    Location: India, North Africa, Europe & Russia
    Deaths: Unknown (Likely Millions)
    Source: Wikipedia

    AbstractThe seventh cholera pandemic was the seventh major outbreak of cholera and occurred from the years 1961 to the 1970s and has continued (though much diminished) to the present. The outbreak began in Indonesia, called El Tor after the strain, and reached Bangladesh in 1963, India in 1964, and the USSR in 1966. From North Africa it spread into Italy by 1973. In the late 1970s, there were small outbreaks in Japan and in the South Pacific. There were also many reports of a cholera outbreak near Baku in 1972, but information about it was suppressed in the USSR. In 1971, the number of reported cases reported worldwide was 155,000. In 1991, it reached 570,000. The spread of the disease was helped by modern transportation and mass migrations. Mortality rates, however, dropped markedly as governments began modern curative and preventative measures. The usual mortality rate of 50% dropped to 10% by the 1980s and less than 3% by the 1990s.The Seventh Cholera Pandemic was the seventh major outbreak of cholera and occurred from the years 1961 to the 1970s and has continued (though much diminished) to the present. The outbreak began in Indonesia, called El Tor after the strain, and reached Bangladesh in 1963, India in 1964, and the USSR in 1966. From North Africa it spread into Italy by 1973. In the late 1970s, there were small outbreaks in Japan and in the South Pacific. There were also many reports of a cholera outbreak near Baku in 1972, but information about it was suppressed in the USSR. In 1971, the number of reported cases reported worldwide was 155,000. In 1991, it reached 570,000 (Wikipedia, 2012).

    42. Hong Kong Flu (1968-1969)
    Title: Hong Kong Flu
    Date: 1968-1969
    Agent: Influenza
    Location: Hong Kong (China)
    Deaths: 1 Million
    Source: Wikipedia

    Abstract: The Hong Kong Flu was a category 2 flu pandemic whose outbreak in 1968 and 1969 killed an estimated one million people worldwide. It was caused by an H3N2 strain of the influenza A virus, descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes reassorted to form a new virus. The first record of the outbreak in Hong Kong appeared on 13 July 1968. By the end of July 1968, extensive outbreaks were reported in Vietnam and Singapore. Despite the fatality of the 1957 Asian Flu in China, little improvement had been made regarding the handling of such epidemics. The Times newspaper was actually the first source to sound alarm regarding this new possible pandemic. By September 1968, the flu reached India, Philippines, northern Australia and Europe. That same month, the virus entered California from returning Vietnam War troops but did not become widespread in the US until December 1968. It would reach Japan, Africa and South America by 1969. The outbreak in Hong Kong, where density is about 500 people per acre, reached maximum intensity in 2 weeks, lasting 6 weeks in total from July to December 1968, however worldwide deaths from this virus peaked much later, in December 1968 and January 1969. By that time, public health warningsand virus descriptions were issued in the scientific and medical journals. In comparison to other pandemics, the Hong Kong flu yielded a low death rate, with a case-fatality ratio below 0.5% making it a category 2 disease on the Pandemic Severity Index. The pandemic infected an estimated 500,000 Hong Kong residents, 15% of the population.  In the United States, approximately 33,800 people died. The same virus returned the following years: a year later, in late 1969 and early 1970, and in 1972. The "Hong Kong Flu", 1968–69. An H3N2 caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968, and spread to the United States later that year. This pandemic of 1968 and 1969 killed approximately one million people worldwide. Influenza A (H3N2) viruses still circulate today (Wikipedia, 2012).

    43. Swine Flu Pandemic (2009)
    Title:
    2009 Flu Pandemic
    Date:
    2009
    Agent:
    Influenza
    Location:
    Worldwide
    Deaths:
    14, 286
    Source:
    Wikipedia

    Abstract: The 2009 flu pandemic or swine flu was an influenza pandemic, and the second of the two pandemics involving H1N1 influenza virus (the first of them was the 1918 flu pandemic), albeit in a new version. First described in April 2009, the virus appeared to be a new strain of H1N1 which resulted when a previous triple reassortment of bird, swine and human flu viruses further combined with a Eurasian pig flu virus, leading to the term "swine flu" to be used for this pandemic. Unlike most strains of influenza, H1N1 does 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 very healthy persons, a small percentage will develop pneumonia or acute respiratory distress syndrome (ARDS). This manifests itself as increased breathing difficulty and typically occurs 3–6 days after initial onset of flu symptoms.[5][6] The pneumonia caused by flu can be either direct viral pneumonia or a secondary bacterial pneumonia. In fact, a November 2009 New England Journal of Medicine article recommends that flu patients whose chest X-ray indicates pneumonia receive both antivirals and antibiotics. In particular, it is a warning sign if a child (and presumably an adult) seems to be getting better and then relapses with high fever, as this relapse may be bacterial pneumonia. Initially coined an "outbreak", the stint began in the state of Veracruz, Mexico, with evidence that there had been an ongoing epidemic for months before it was officially recognized as such. The Mexican government closed most of Mexico City's public and private facilities in an attempt to contain the spread of the virus; however, it continued to spread globally, and clinics in some areas were overwhelmed by infected people. In June, the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) stopped counting cases and declared the outbreak a pandemic. Despite being informally called "swine flu", the H1N1 flu virus cannot be spread by eating pork or pork products;similar to other influenza viruses, it is typically contracted by person to person transmission through respiratory droplets. Symptoms usually last 4–6 days. Antivirals (oseltamivir or zanamivir) were recommended for those with more severe symptoms or those in an at-risk group. The pandemic began to taper off in November 2009, and by May 2010, the number of cases was in steep decline. On 10 August 2010, the Director-General of the World Health Organization, Margaret Chan, announced the end of the H1N1 pandemic, and announced that the H1N1 influenza event has moved into the post-pandemic period. According to the latest WHO statistics (July 2010), the virus has killed more than 18,000 people since it appeared in April 2009, however they state that the total mortality (including deaths unconfirmed or unreported) from the H1N1 strain is "unquestionably higher". Critics claimed the WHO had exaggerated the danger, spreading "fear and confusion" rather than "immediate information".The WHO began an investigation to determine whether it had "frightened people unnecessarily". A flu followup study done in September 2010, found that "the risk of most serious complications was not elevated in adults or children." In an August 5, 2011 PLoS ONE article, researchers estimated that the 2009 H1N1 global infection rate was 11% to 21%, lower than what was previously expected (Wikipedia, 2012).