How epidemics changed the world

Published January 29, 2022
Illustration by Ziauddin
Illustration by Ziauddin

The fifth wave of the Covid-19 pandemic (the Omicron variant) is playing havoc with the lives of people across the world. Who knew we would face such a terrible cold/flu in this advanced era? No one was ready. Yes, the masks, sanitisers and lockdowns all seem to be the plot elements of a sci-fi flick but, unfortunately, they have become the reality today.

Until further research is done on the SARS-CoV-2 virus and how to nip it, let’s agree to accept and live with it by taking all the health safety measures, not just for ourselves, but for humanity at large.

It is not the first time our world has seen a pandemic. In fact, the world has faced

many epidemics and pandemics in the past. Many of these doomed entire civilisations and even brought powerful nations to their knees, while killing millions in their wake. These terrible diseases’ outbreaks still threaten humanity, but thanks to the advances in epidemiology, we are hopeful that soon we will gain control of the current pandemic and no longer face the same dire consequences as our ancestors once did.

Let us look at some of these deadly diseases that affected countless people in the past.

Prehistoric epidemic: circa 3000 BCE

About five thousand years ago, an epidemic hit a prehistoric village in China and wiped out the whole village. On exploring the site, researchers found bodies of the dead piled up inside a house that was later burnt down. This archaeological site is called ‘Hamin Mangha’.

Archaeological and anthropological studies indicate that the epidemic spread so quickly that people had no time to give proper burials, thus they dumped the dead in a house, and burnt it down in order to stop the spread of the virus. The site was not inhabited again. As for the cause, it is suspected that there was an outbreak of an acute infection which caused the mass deaths.

A ward full of Spainish flu patients
A ward full of Spainish flu patients

Plague of Athens: 430 BCE

The plague which struck Athens was the most lethal episode of illness in the history of classical Greece. It is estimated that the death toll was as high as 100,000.

According to the Greek historian Thucydides (460-400 BCE), “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,” (translation by Richard Crawley from the book The History of the Peloponnesian War, London Dent, 1914).

The real nature of the epidemic has remained a source of debate among scientists, but a number of diseases have been put forward as possibilities, including typhoid fever and Ebola.

An polio patient
An polio patient

Antonine plague: 165-180 CE

The Antonine Plague, often referred to as the Plague of Galen, was an ancient pandemic that affected Asia Minor, Egypt, Greece and Italy.

Galen (129-c. 216 CE), a Greek physician and author of Methodus Medendi, not only witnessed the outbreak, but described its symptoms and course. Among the more common symptoms were fever, diarrhoea, vomiting, thirstiness, swollen throat and coughing.

This unknown disease was brought back to Rome by soldiers returning from Mesopotamia, around 165CE, and ended up killing over five million people and decimating the Roman army. Based on Galen’s description, modern researchers have concluded that the disease affecting the empire was most likely smallpox.

The Antonine Plague epidemic contributed to the end of the Pax Romana (the Roman Peace), a period from 27BCE to CE180, when Rome was at the height of its power.

Plague of Justinian: CE541-542

This was the first major outbreak of the first plague pandemic — also called the first Old World Pandemic of Plague, this contagious disease was caused by the bacterium Yersinia pestis present in the black rat (Rattus rattus).

North Africa was the primary source of grain for the empire in those days, along with a number of different commodities including paper, oil, ivory and slaves. Stored in vast warehouses, thus the grain provided a perfect breeding ground for fleas and rats, crucial to the transmission of plague.

The disease spread like wildfire. People died faster than they could be buried. Constantinople came to a standstill, food started to run out and law and order broke down. By the time the plague had run its course, nearly half the city’s population was dead.

The plague of Justinian is also referred as the bubonic plague. The disease earned its name from Justinian, the ruler of the Byzantine Empire at the time. This pandemic became the main reason behind the decline of Byzantine Empire.

A photo from the 1940s or ‘50s shows a ward at Rancho Los Amigos Hospital in Downey filled with polio victims in iron lungs
A photo from the 1940s or ‘50s shows a ward at Rancho Los Amigos Hospital in Downey filled with polio victims in iron lungs

The Black Death: 1346-1353CE

Historically, the Black Death is considered a devastating global epidemic of bubonic plague that struck Europe and Asia in the mid-1300s.

It is said that the plague arrived in Europe in October 1347, when 12 ships from the Black Sea docked at the Sicilian port of Messina. Most sailors aboard the ships were dead, and those still alive were gravely ill and covered in black boils that oozed blood and pus. So over the next five years, Black Death killed more than 20 million people in Europe — almost one-third of the continent’s population.

According to scientists, the bubonic plague attacked the lymphatic system, causing swelling in the lymph nodes. If untreated, the infection could spread to the blood or lungs. The Black Death was terrifyingly, indiscriminately contagious: “the mere touching of the clothes,” wrote Giovanni Boccaccio, (Italian writer) “appeared to itself to communicate the malady to the toucher.”

Great plague of London: 1665-1666

This is considered the worst outbreak of plague in England since the Black Death in 1348. London lost roughly 15 per cent of its population. While 68,596 deaths were recorded in the city, the true number was probably over 100,000. It was recorded that the death rate began to rise during the hot summer months and peaked in September when 7,165 Londoners died in one week.

Once again, this plague was caused by rats carrying the fleas. The poorest areas of the city, with lack of sanitation, cleanliness and rubbish lying everywhere, became the breeding grounds for rats.

All trade with London and other plague towns was stopped. The Council of Scotland declared that the border with England would be closed. There were to be no fairs or trade with other countries. This lead to joblessness — from servants to shoemakers to those who worked on the River Thames.

The affluent and those who could, such as most doctors, lawyers and merchants, fled the city, leaving the poor and those who had the plague. It is said that watchmen locked and kept guard over infected houses. Parish officials provided food. Searchers looked for dead bodies and took them at night to plague pits for burial.

The third cholera pandemic: 1852–1860

Cholera is a bacterial infection and is mainly contracted through food and water. There have been seven cholera pandemics that occurred in the past 200 years, with the first and the largest originating in India, spreading from the Ganges River Delta to Asia, Europe, North America and Africa, and ending the lives of over a million people.

It is believed that the third one was way too deadly of the seven and lasted from 1852 to 1860. The cause of the pandemic was unknown until 1854 when John Snow, a British physician, researched and eventually succeeded in identifying contaminated water as the means of transmission of the disease. In the same year, as his discovery (1854), the pandemic already took lives of 23,000 people in just Great Britain.

There have been many documented cholera outbreaks, such as a 1991–1994 outbreak in South America and, more recently, the 2016–2021 Yemen cholera outbreak.

The flu over the centuries: 1889-1890

In the modern industrial age, new transport links made it easier for influenza viruses to wreak havoc. In just a few months, the disease spanned the globe, killing one million people. It took just five weeks for the epidemic to reach peak mortality.

The earliest cases were reported in Russia. The virus spread rapidly throughout St Petersburg before it quickly made its way throughout Europe and the rest of the world, despite the fact that air travel didn’t exist.

In 1918, the Spanish flu came to surface and resulted in 50 million deaths worldwide. Because there were no effective drugs or vaccines to treat this killer flu strain, it spread and its lethality was enhanced by the cramped conditions of soldiers and poor wartime nutrition that many people were experiencing during World War I.

Despite the name Spanish flu, the disease likely did not start in Spain. Spain was a neutral nation during the war and did not enforce strict censorship of its press, which could therefore freely publish early accounts of the illness. As a result, people falsely believed the illness was specific to Spain, and the name Spanish flu stuck.

In 1957, Asian flu started from Hong Kong, spreading through China and then to the US. It became widespread in England where, in over six months, 14,000 people died and overall the disease claimed more than one million lives. The virus that caused the pandemic was a blend of avian flu viruses.

HIV: 1981 — present

Human Immunodeficiency Virus (HIV) destroys a person’s immune system, resulting in eventual death by diseases that the body would usually fight off. Those infected by the HIV virus encountered fever, headache and enlarged lymph nodes upon infection. When symptoms subside, carriers become highly infectious through blood and other fluid, and the disease destroys the t-cells.

HIV is believed to have crossed from chimpanzee to humans in the 1920s in what is now the Democratic Republic of Congo. This was probably as a result of chimps carrying the Simian Immunodeficiency Virus (SIV), a virus closely related to HIV, being hunted and eaten by people living in the area. Treatments have been developed to slow the progress of the disease, but 35 million people worldwide have died since its discovery, and a cure is yet to be found.

American polio epidemic: 1916

An evidence indicates that polio is an ancient disease. A stele from the 18th dynasty of ancient Egypt (1570–1342 BCE) depicts a priest with a tell-tale paralysis and withering of his lower right leg and foot. The mummy of the Pharaoh Siptah from the late 19th dynasty (1342–1197 BCE) shows a similar characteristic deformity of the left leg and foot.

There have been many similar reported cases in the history, but all sporadic. But a polio epidemic that started in New York City alone caused 27,000 cases and 6,000 deaths in the US. The disease mainly affects children and sometimes leaves survivors with permanent disabilities.

Polio epidemics occurred occasionally in the US until the Salk vaccine was developed in 1954. So when the vaccine became widely available, cases in the US declined. The last polio case was reported in 1979. Worldwide vaccination efforts have greatly reduced the disease, although it is not yet completely eradicated. The polio virus has been eradicated in all continents except Asia, and as of 2020, Afghanistan and Pakistan are the only two countries where the disease is still classified as endemic.


Epidemics

The Centres for Disease Control and Prevention (CDC) describes an epidemic as an unexpected increase in the number of disease cases in a specific geographical area. Yellow fever, smallpox, measles and polio are prime examples of epidemics. Notably, an epidemic disease doesn’t necessarily have to be contagious.

Endemic

An endemic is a disease outbreak that is consistently present, but limited to a particular region. This makes the disease spread and rates predictable. Malaria, for example, is considered an endemic in certain countries and regions.

Pandemics

The World Health Organisation (WHO) declares a pandemic when a disease’s growth is exponential. This means growth rate skyrockets, and each day cases grow more than the day prior.

In being declared a pandemic, the virus has nothing to do with virology, population immunity, or disease severity. It means a virus covers a wide area, affecting several countries and populations.

Published in Dawn, Young World, January 29th, 2022

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