Cholera, smallpox, 'spanish': the most terrible pandemics in human history

Already 563 people have become victims of the new coronavirus 2019-nCoV. But the spread of the disease has not yet reached a level to declare a pandemic, according to the World Health Organization (WHO). Over the past century, three pandemics have been officially marked in the world. TUT.BY looked when disease outbreaks crossed a critical threshold, writes Tut..

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A pandemic is considered a global epidemic when an infection spreads across the country and neighboring states, and sometimes many countries at once, threatening the entire population.

Over the past hundred years, the causes of pandemics have been the flu, or rather its various serotypes (species).

"Spaniard": every third on the earth was ill

According to the WHO, the “Spanish flu” (or “Spanish flu”) caused by virus A - H1N1 became the most destructive. The disease broke out during the First World War and claimed, according to various estimates, the lives of 20-50 million people in just two years, in 1918-1919.

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People began to get sick in the spring, but in the newspapers they wrote about military events, and not about the flu. By autumn, the virus mutated and became extremely virulent, that is, it was very widespread. Severely infected died in a couple of hours, a maximum of a couple of days. For this reason, in the UK she was nicknamed "three-day fever."

Since the warring parties hid the epidemic for propaganda reasons, the first news appeared in the newspapers of neutral Spain. In April 1918, 39% of the population was infected there, including the king. Hence the “Spanish” name of the virus. But it is still not known exactly where the disease actually came from.

The victims were not only elderly people or children: 9 out of 10 were people in their prime. For several months, the disease spread throughout the world, even to the most distant points. And although many public places were closed, shops sold goods only on the street, entertainment was canceled, but transport contributed to the spread: trains, airships and high-speed ships. Many settlements died out completely, cities were empty - sometimes there was not a single healthy doctor, and there were no grave diggers at all. In addition, the “trench” conditions of the First World War, the massive movement of troops influenced.

Just imagine: then 550 million people fell ill, almost a third of the population of the whole Earth.

Symptoms started with blue skin and bloody cough. Pneumonia developed, and in later stages, bleeding began in the lungs - people literally choked with their blood.

In 2005, American scientists using tissue samples from the "Spanish woman" were able to recreate its gene structure and finally found out why this flu was so deadly.

It turned out that the virus caused a “cytokine storm”, an uncontrolled reaction of the immune system when the body produces too many cytokines to fight the “enemy”. These substances are toxic and begin to kill the body itself. Since an adult healthy person has stronger immunity, the immune “response” was stronger and more destructive.

According to some reports, the “Spanish disease” in our area first appeared in Kiev, and on August 13, 1918, in the Belarusian city of Mstislavl (Mogilev region) and immediately became the cause of a large-scale epidemic. Over the year, the disease spread throughout the Mogilev (31 thousand cases) and Vitebsk province (20 thousand).

"Asian" and "Hong Kong" flu

After 40 years, the pandemic caused the so-called Asian flu caused by the influenza A virus - H2N2. For a year, from 1957 to 1958, for two waves, the disease claimed the lives of 1 to 4 million people.

As the name implies, the disease came from Asia, and in a couple of months it covered almost all the countries of this region. In the USSR, the disease broke out in waves in March, April and May 1957. Mostly children under the age of 3 years and people over 40 died. What is characteristic, the disease developed very quickly, in a day or two, and sometimes in a couple of hours.

The mortality rate of the virus was less than 0,2%. Ten years later, in 1968, the same mutated virus, already H3N2, broke out in Hong Kong. The Hong Kong influenza pandemic developed in three waves, mostly older people over 65 years old.

The virus first appeared in mid-July 1968, two weeks later it was in Vietnam and Singapore, and by the fall it reached India, the Philippines, Northern Australia, Europe and the USA. By 1969, the virus was noted in Japan, Africa, and South America.

Compared to previous pandemics, the Hong Kong flu was low in mortality (below 0,2%). But all the same, at least a million people died and still “raised” their heads in the early 1970s.

Scientists suggest that the relatively smaller casualties can be explained by the presence of some immunity in the population after the outbreak of "Asian flu", as well as the emergence of more effective drugs.

By the way, both strains of “Asian” and “Hong Kong” influenza contained the genes of bird flu viruses. It is assumed that a kind of incubator for their appearance became pigs that were infected by both the bird and human viruses and in whose organisms the new virus matured.

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XNUMXst Century Pandemic: Swine Flu

The last pandemic occurred in 2009, it was swine flu caused by the influenza A virus - H1N1. According to WHO estimates, only in the first year the disease claimed the lives of 100 to 400 thousand people around the world.

It is believed that this virus also appeared in the body of pigs, where the viruses of bird and human flu “mixed”, giving rise to a new one.

“The problem is that such a“ new ”mutated virus can be more easily transmitted from person to person or can cause a more acute disease in humans than the original viruses,” explains WHO.

Although, I must say, the first outbreak occurred in 1976, at a military base in the United States in New Jersey, but then the pandemic was avoided. A vaccine was found, and every fifth resident of the country from a total of 200 million people was vaccinated.

However, the current version of H1N1 is changing and shows the ability for multi-stage transmission from person to person, experts say.

“It is impossible to predict influenza pandemics; they can be mild or cause serious illness or death, notes WHO. - Influenza pandemics, whether mild, moderate or severe, affect a significant part of the population <...>. Because an influenza pandemic can last for months or even years, this requires a sustained health sector response. ”

The swine flu pandemic began in the spring of 2009 in Mexico and the United States, and for four months there were already about 255 thousand infected and more than 2,6 thousand deaths. Often people died from complications in the form of pneumonia.

In June of that year, WHO declared a pandemic - for the first time in 50 years - and assigned the highest, sixth degree of threat. It should be noted: in terms of the frequency of complications and deaths, this type of flu does not exceed the average for seasonal flu. Mortality of the virus did not exceed 0,2%, and with proper treatment, people often recovered without consequences for their future health.

But doctors were worried about the speed of the spread of the virus (after Mexico it came to 213 countries), as well as the novelty of the strain, which could mutate into even more aggressive variants.

When pandemics are announced

In 2005, the World Health Organization, using bird flu as an example, developed a framework for determining the risk of a pandemic.

It includes six phases. So, in the first phase of human diseases, new types of influenza were not detected, but animals can be infected with a species whose transmission to humans has already been noted. The risk to the population is rated as low.

In the second phase, the virus can actively circulate among animals and threaten to switch to humans, and in the third - there are already cases of human infection (but there is no transmission from person to person, only occasionally with close contacts).

In the fourth phase, groups of up to 25 people are infected, but the virus is not transmitted from person to person infrequently. It is assumed that he has not yet fully adapted to the human body. In the fifth phase, groups of 25-50 people are infected, the virus is more adapted. The sixth phase is considered a pandemic: the number of cases of infection is growing significantly.

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Did pandemics happen before?

In general, documented pandemics have occurred in the world at intervals of 10 to 50 years since the sixteenth century.

In the 300th century, a pandemic of smallpox worldwide claimed the lives of, according to various estimates, from 500 to 40 million people. This is a very contagious disease that only people suffer. They managed to take control of it only after mass vaccination of the population. Before that, the lethality of the virus reached XNUMX%.

And the bubonic plague three times became the cause of pandemics, which claimed millions of lives. An acute infectious disease then was characterized by high mortality - over 90% (now - no more than 10% with proper treatment). Pandemics have occurred since 514 in Egypt and ending with a 10-year pandemic in China and India in 1894-1904.

Finally, cholera is an absolute record holder for the number of pandemics. From 1816 to 1966, that is, for exactly 150 years, she developed seven times into a massive disease all over the world. At least 20 million people have died.

Over the past century, according to official WHO data, pandemics have flared up four times. But diseases such as typhoid, tuberculosis, malaria, leprosy, HIV, globally in terms of the number of victims can also be attributed to pandemics. Just their distribution is more blurry in time.

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