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From Cyprian to Bubonic plague: Pandemics That Changed World History

Human beings are infected by various communicable infectious diseases, which take a heavy toll on lives. Infectious diseases are associated with morbidity and mortality and childhood infections like pneumonia and diarrhea are major causes for mortality

Post by on Sunday, June 20, 2021

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Human beings are infected by various communicable infectious diseases, which take a heavy toll on lives. Infectious diseases are associated with morbidity and mortality and   childhood infections like pneumonia and diarrhea are major causes for mortality in under five years of age particularly during early days and months of life. Among the spectrum of infectious diseases, a pandemic is always the worst case scenario, where a huge population across the globe gets infected within a short span of time and subsequently overburdening the public health sector.


Therefore, pandemics always result in humanitarian crises, tragedies, death and devastation. Whenever a disease occurs more than its expected frequency and incidence, it is known as epidemic. The unusual occurrence in a community or region of disease, specific health related behaviour clearly in excess of expected frequency. When an epidemic affects a large population and occurs over a wide geographic area involving an entire nation and spreads beyond a country’s borders, that’s when the disease officially becomes a pandemic.


Infectious and communicable diseases existed during humankind’s hunter gatherer days, but the shift of mankind to agrarian life some 10,000 years ago created communities that made epidemics more possible. The rate of transmission of communicable infectious diseases increases with overcrowding and poor public health measures, poor sanitation and hand hygiene. 


250 A.D: Cyprian Plague


Plague is often seen as a problem of the past or ancient that is unlikely to reappear. 

Named after the first known victim, the Christian bishop of Carthage, the Cyprian plague entailed diarrhea, vomiting, throat ulcers, fever and gangrenous hands and feet.

City dwellers fled to the country to escape infection but instead spread the disease further. Possibly starting in Ethiopia, it passed through Northern Africa, into Rome, then onto Egypt and northward.


541 A.D: Justinian Plague


First appearing in Egypt, the Justinian plague spread through Palestine and the  Byzantine Empire, and then throughout the Mediterranean.

The plague changed the course of the empire, squelching Emperor Justinian's plans to bring the Roman Empire back together and causing massive economic struggle. 

Recurrences over the next two centuries eventually killed about 50 million people, 26 percent of the world population.


The data shows that in 2013 a total of 783 cases of human plague, including 126 deaths were reported globally. In 2004, India reported a localized outbreak of bubonic plague (8 cases and 3 deaths) in the Dangund Village, district of Uttarkashi. 


The causative agent for plague is a gram negative organism Yersina Pestis. Wild rodents like field mice, gerbils are the natural reservoirs of plague. Plague is primarily a disease of rodents in which man becomes accidentally involved. Approximately, 1700 species of rodents are known, of which 200 species are associated  with plague. There are three main clinical forms of plague in human beings namely Bubonic plague, Pneumonic plague and Septicemic plague. The typical symptoms are fever, chills, headache and painful enlarged lymphnodes. 


11th Century: Leprosy


Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The disease manifests in two polar forms, namely Lepromatous Leprosy and Tuberculoid Leprosy. 

Though it had been around for ages, leprosy grew into a pandemic in Europe in the middle ages, resulting in the building of numerous leprosy-focused hospitals to accommodate the vast number of victims.


Over the past 20 years, more than 16 million people suffering from leprosy have been cured. The global leprosy strategy 2016-2020, "Accelerating towards a leprosy free world" was released in April 2016. 


1350: The Black Death, The second wave of Bubonic Plague


This second wave of bubonic plague possibly started in Asia and moved to the West was responsible for the death of one-third of the world population. This wave spread throughout Europe rapidly, was very fatal and dead bodies became so prevalent that many remained rotting on the ground and created a constant stench in cities.

The England and France were so incapacitated by the plague that these countries called a truce to their war. This wave of plague was responsible for the collapse of British feudal system. The pandemic changed the world order, economic circumstances and demographics. 


1665: The Great Plague of London


In another devastating appearance, the bubonic plague led to the deaths of 20 percent of London’s population. As human death tolls mounted and mass graves appeared, hundreds of thousands of cats and dogs were slaughtered as the possible cause and the disease spread through ports along the Thames. The worst of the outbreak tapered off in the fall of 1666, around the same time as another destructive event—the Great Fire Of London.


1817: First Cholera Pandemic


The first cholera pandemic (1817–1824), also known as the first Asiatic cholera pandemic or Asiatic cholera, began near the city of Calcutta and spread throughout South and 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 subsiding. 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.

Cholera is an acute diarrhoeal disease caused by V. Cholrea O1 and O139. Cholera is both an epidemic and endemic disease. The number of cholera cases reported to WHO continue to rise. For 2015 alone, a total of 172,454 cases were notified from 42 countries, including 1304 deaths. Cholera remains a global threat to public health and a key indicator of lack of social and public health development. 


The first of seven Cholera pandemics happened in1817. This wave of the small intestine infection originated in Russia, where one million people died. The Cholera spreads through feces-infected water and food, from man to man. Ingestion of contaminated food and water have been associated with outbreaks of Cholera. The bacterium was passed along to British soldiers who brought it to India where millions more died. A vaccine was created in 1885, but pandemics continued.


1855: The Third Wave of Plague Pandemic


The third plague pandemic was a major bubonic plague pandemic that began in Yunnan, China, in 1855 during the fifth year of the Xianfeng Emperor of the Qing dynasty. This episode of bubonic plague spread to all inhabited continents, and ultimately led to more than 12 million (perhaps 15 million) deaths in India and China, with about 10 million killed in India alone, making it one of the deadliest pandemics in history. According to the World Health Organization, the pandemic was considered active until 1960, when worldwide casualties dropped to 200 per year. Plague deaths have continued at a lower level for every year since.


Starting in China and moving to India and Hong Kong, the bubonic plague claimed 15 million victims.  The pandemic was considered active until 1960 when cases dropped below a couple hundred.

Dr Suhail Naik
Consultant Pediatrician
G B Pant Children Hospital

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