Through the pages of history

Disease and death have plagued humanity since the earliest days. Ancient humans ascribed them to divine wrath and other supernatural forces. However, there have been occasional suggestions that diseases may result from invasion of body by external contagion.  It was not until the marked shift to globalisation that the scale and spread of these diseases increased dramatically.  Widespread trade created new opportunities for human and animal interactions that sped up such epidemics. Malaria, tuberculosis, leprosy, influenza, smallpox, and others first appeared during these early years.

The more civilized humans become – with larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems – the more likely pandemics would occur.

Coronavirus Pandemic and its impact on human life made me to turn back pages in history, to study such dreaded Pandemics, which appeared in different periods and places and recorded heavy death tolls.

The earliest recorded pandemic happened during the Peloponnesian war (430 BC:Athens). The disease spread through Libya, Ethiopia and Egypt, it crossed the Athenian walls and as much as two-thirds of the population died.  The symptoms included fever,  throat, tongue, and skin lesions. The disease, suspected to have been typhoid fever, weakened the powerful  Athenians significantly and the Spartans registered a victory.

Deadliest Pandemic dating back to ancient Rome as recorded was Antonine plague (165 – 180 AD) taking roughly 5 million deaths. It swept Rome during the reign of Marcus Aurelius and the fall of Roman Empire is linked to it, as per records of historians. Galen a Physician recorded symptoms in patients as fever, diarrhoea, sore throat and skin lesions, strongly suggesting probable possibilities of small pox and measles (killed 2000 people per day).

Era of 541 -542 AD records dreaded Plague of Justinian which killed 30 – 50 million people probably half of population of Europe, disease has been related to rats and fleas and  is thought to be world’s first bubonic plague during the period Byzantine emperor, the event has been recorded by a noted historian Procopius of ancient times. This pandemic killed 5000 people per day.

The Black Death Pandemic (1346 – 1353 AD) records,  in  an out break of bubonic plague caused by rats and fleas, 75 – 200 million deaths. It has been referred to as the greatest catastrophe ever thought to have started in Asia and it ravaged Africa and Europe too, spreading through trading ports via merchants ships.

dates back to 1520 AD to  1525 AD, 55 million deaths occurred during this pandemic. Traders and explorers transported small pox and measles viruses to newly explored lands including American subcontinent. It is estimated that more than 80 – 90% of native American population vanished within 100 – 150 years after 1492 AD. Historian and demographer, David Cook has recorded the above facts in a paper published in 2010 AD in a journal of Economic perspectives.

Great Plague of London (1665 AD) estimated 75000 to 100000 deaths, due to rats and fleas. Records in history ( National Archives in England) show that the poor were hit badly, infected areas were sealed as there were no treatments available. The rich and the Royal fled to safer zones.

So far world was ravaged by deadly pandemics, which were of  viral origin. Pages in history record the deadly cholera pandemic (1817 – 1923 AD) caused by vibrio cholera bacteria.    First, second and third cholera pandemics originated in India, starting from Ganges river delta and spreading through Asia, Europe, North America and  Africa. Third Pandemic killed about a million people all over the world. British physician John Snow succeeded in identifying contaminated water as mode of spread of disease. Sixth cholera Pandemic (1910 – 1911 AD) also originated in India killing over 80000 before spreading to middle east, North Africa, East Europe, Russia and America.

Yellow fever pandemic (1800 AD). This viral infection is transmitted  by female mosquitoes and it spread through South America and Sub – Saharan Africa killing 150,000. In 1793 AD, yellow fever swept through Philadelphia killing about 10% of its population. In 1900, US Army researchers identified and discovered mosquitoes as vectors to this disease.

Flu Pandemic (1889 – 1890 AD) caused by Influenza (A) Virus (Subtype H2N2) killed about one million people. It was named Asiatic Flu or Russian Flu, first started in May 1889 AD in Bukhara in Central Asia (Turkestan),spread to  Athabasca in North – Western Canada and Green land.

Flu Pandemic (1918) also called the Spanish Flu pandemic, caused by Influenza virus (H1N1) was the most dreaded one and it tore across the globe infecting about a third of  world population killing about 50 million people and rendering about  500 million infected in 1918 AD. This Flu outbreak made patients in all age groups as victims.The present day Covid – 19 Pandemic has comparisons linked to 1918 Spanish Flu.

Asian Flu pandemic (1956 – 1958 AD) was a pandemic outbreak of Influenza A virus (H2N2) killed over 2 million people, originating in China, Singapore and spreading to united states where deaths toll was 70000. Dr. Maurice Hilleman’s immediate intervention in getting vaccine ready at walter Reed Army Institute of Research saved US, otherwise millions would have vanished.

In 1968 AD another Flu pandemic named as Hong Kong Flu caused by H3N2 type influenza A virus killed over a million people and spreading from Hong Kong right across Singapore, Vietnam, Philippines, India, Australia, Europe and United States within 3 months only.

Swine Flu pandemic (2009 AD) caused by H1N1 Influenza virus is considered as the most recent pandemic before Covid – 19. It resulted in infecting 21 percent of world population and killing about 200,000 people. Most of those infected were children and elderly.

HIV/ AIDS Pandemic (At its peak caused by HIV/ AIDS virus (2005 – 2012 AD) was first identified in Congo in 1976 AD. It has proven itself as global pandemic taking a death toll of 36 Million people all over the world since 1981 AD. Presently 31- 35 million people are living with HIV infection, vast majority of these are in Sub–Saharan Africa, where 5% of population is infected. Awareness programmes and treatments have been developed that make HIV as for more manageable. Between 2005 to 2012 AD,  annual global deaths from HIV/ AIDS dropped from 2.2 million to 1.6 million.

Coronavirus pandemic also named as COVID – 19 pandemic started in December 2019 in Wuhan region of China, it is caused by novel Coronavirus (SARS-CoV-2)  which is rapidly spreading throughout the world shifting its epicentre from china to Europe to America. No drug or vaccine is available so for. It has put all the nations in a lockdown position. It has created a widespread havoc all over the world with almost 1.57 million people infected and 1.6 lakh deaths so far, and the number is rising very fast.

In ancient times, pandemics and diseases were believed to be punishments from God. People believed that spirits and gods inflicted disease and destruction upon those that deserved their wrath. This often led to disastrous responses and limitless deaths. With the advent of scientific reasoning and widespread research, pandemics are dealt with logic and reasoning. All the countries have moved their administrative machinery for saving precious lives. Tremendous research is being conducted all over the world for developing appropriate drugs and vaccination for the disease. I hope that in near future we will overcome this pandemic with a message for future that such pandemics can visit again and we have to plan our health policies in an eco-friendly way .

Dr. J.B. Singh (Associate Professor), Dept of Pathology, SKIMS Medical College, Sgr.