worst pandemics list

Worst Pandemics in History 🦠

Worst Pandemics in History 🦠 Global Pandemics All-Time List

How does the COVID-19 coronavirus global pandemic compare with history’s worst pandemics? ADDucation’s list of the worst pandemics in history reveals the answers. From history we know epidemics and even the worst pandemics will eventually subside and life goes on but what can we learn from earlier global pandemics? With total daily births still more than double deaths we still have a population crisis to solve. In the meantime wash your hands regularly, maintain social distancing and wear face masks where appropriate.

  • ADDucation’s biggest pandemics in history list was compiled by Joe Connor and last updated Nov 7, 2022 @ 11:09 am

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Global pandemics Worst Pandemic Type Origin Period Pandemic timelines / spread Estimated deaths World population Population / Deaths %[1] Pandemic deadliness (CFR/PSI[2]) Worst Pandemics transmission & key facts
Antonine Plague, Plague of Galen Smallpox (Variola), Measles (Morbillivirus) Near East (Western Asia, Turkey, Egypt). 165 – 180 AD 165 Egypt to Rome, Italy then spread across the Roman Empire. 174 re-occurrence. 5 million deaths. Reports include: Rome 2000 deaths daily. 185,000,000 2.7 ~90%
(Smallpox)
1 – 30%
(Measles)		 The various outbreaks were most likely smallpox or measles. Smallpox is transmitted from person to person through droplet infection (cough, sneeze) and direct contact with infected bodily fluids. Measles is transmitted from person to person through droplet infection (cough, sneeze) and direct contact with secretions.
Plague of Justinian Plague (bubonic) Yersinia pestis Central Asia (probably Qinghai, China). 541 – 542 AD and recurrences until 750. 541 Pelusim, Egypt, Constantinople (Istanbul) Eastern Roman Empire (Byzantium), Sasanian Empire (Iranian) and Mediterranean port cities. Via Gaul 547 Britain, 549 Ireland 25 million deaths in initial outbreak, totaling up to 100 million deaths over two centuries. Reports include Constantinople: 5,000 daily. 200,000,000 12.5 25% Bubonic plague was transmitted by plague carrying fleas on infested rodents (rats) which transmit the bacterium Yersinia pestis to humans. Named after Roman Emperor Justinian, who contracted the disease and survived. The plague of Justinian was the worst pandemic in history as a percentage of the world population at the time and because it spanned two centuries and around eight generations.
Black Death, Great Bubonic Plague, Great Plague Plague (bubonic) Yersinia pestis China, Inner Asia. 1346 – 1353 1343 central Asia, eastern Asia and Black Sea area. 1347 Crimea, Turkey, Greece and Sicily. 1348-49 Italy then across Europe to southern England and northern Africa. 1350-53 northern Europe, Baltic and Russia. Over 25 million maybe 50 million or even more. 355,000,000 7.042 Up to 80% in urban areas. Bubonic plague was transmitted by plague carrying fleas on infested rodents (rats) which transmit the bacterium Yersinia pestis to humans. At least one third of the population of Europe at that time died.
First cholera pandemic, Asiatic cholera Cholera River Ganges, Kolkata (Calcutta). 1817 – 1824 Bengal, India, Thailand, Indonesia, Philippines, Java, Oman, China, Japan, Persian Gulf, Iraq, Syria, Transcaucasia, Astrakhan (Russia), Zanzibar, Mauritius and the Caspian Sea. Over 100,000 deaths worldwide. Reports include 30,000 deaths estimate for Bangkok. 1,100,000,000 0.009 Less than 1% to 2.24% Asiatic cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens. This pandemic is the first of six cholera pandemics in history.
Second cholera pandemic, Asiatic cholera Cholera Probably Ganges Delta, India. 1829 – 1837 1829 India, 1835 China, 1829 Afghanistan, Iran, 1829 Ural Mountains, 1830 Russia, 1830 Finland, Poland and East Prussia, 1831 Great Britain, France Hungary, Germany and Japan, 1832-1834 Canada and North America Pacific coast, 1833 Mexico, Cuba, Latin America. Over 500,000 deaths worldwide. Reported deaths include:
  • 1831 Hungary: 100,000
  • Egypt: 130,000
  • 1831 London, UK: 55,000
  • 1831 France: 100,000.
 1,200,000,000 0.042 Less than 1% to 2.24% Cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens.
Third cholera pandemic, Asiatic cholera Cholera Probably Ganges Delta, India. 1846 – 1860 1846 Mecca, 1847-1851 Russia, 1848 England & Wales, 1849 Ireland & France. USA, 1851 Gran Canaria, 1852 Indonesia, 1854 China & Japan, 1858 Philippines, 1859 Korea, Asia, Europe, Africa and North America. Over 1,000,000 deaths worldwide. Reported deaths include:
  • 1846 Mecca: 15,000
  • 1847-1851 Russia: >1,000,000
  • 1848 England & Wales: 52,000
  • 1851 Gran Canaria: 6,000
  • 1858-1860 Tokyo up to 200,000
 1,200,000,000 0.083 Less than 1% to 2.24% Cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens.
Fourth cholera pandemic, Asiatic cholera Cholera Probably Ganges Delta, India. 1863 – 1875 1863 Mecca, Middle East, 1865 Africa, 1866 Russia, 1866 Austrian Empire, Hungary, Belgium, the Netherlands, England, 1867 Italy, Europe, 1870’s North America. Around 678,000 deaths worldwide. Reported deaths include:
  • 1863 Mecca: 30,000
  • 1866 Russia: 90,000
  • 1869-70 Zanzibar 70,000
  • 1866 Austro-Prussian War: 165,000
  • 1866 Hungary: 30,000
  • 1866 Belgium: 30,000
  • 1866 Netherlands: 20,000
  • 1867 Italy: 113,000
  • 1867 Algeria: 80,000
  • 1870s USA: 50,000
 1,250,000,000 0.054 Less than 1% to 2.24% Cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens.
Fifth cholera pandemic, Asiatic cholera Cholera India. 1881 – 1896 Asia, Africa, parts of Germany, 1892 Hamburg and the surrounding area, France, Russia and South America. Around 900,000 deaths worldwide. Reported deaths include:
  • 1883-1887 Europe: 250,000
  • 1883-1887 The Americas: 50,000
  • 1892 Germany, Hamburg: 8,600
  • 1892 Russia: 267,890
  • 1892 Spain: 120,000
  • 1892 Japan: 90,000
  • 1892 Persia: 60,000
  • 1892 Egypt: 58,000
 1,550,000,000 0.058 Less than 1% to 2.24% Cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens.
Asiatic flu pandemic, Russian flu Influenza A virus subtype H3N8 Bukhara, Uzbekistan. Athabasca, north west Canada. Greenland. 1889 – 1890 May 1889 Bukhara, Athabasca and Greenland. Nov 1889 Saint Petersburg. Dec 1889 Europe, USA then rest of northern hemisphere by Feb 1890. By May 1890 most of the Southern hemisphere. Over 1 million deaths worldwide. 1,500,000,000 0.067 Between 0.10 – 0.28% Asiatic flu was spread from person to person through droplet infection (coughing, sneezing). Originally thought to be H2N2. Asiatic flu was the world’s first media pandemic and one of the worst pandemics of the 19th century.
Sixth cholera pandemic, Asiatic cholera Cholera India. 1899 – 1923 India, Ottoman Empire, 1900 Russia, 1902 Philippines, 1900 Mecca from the 19th century to 1930. 1,500,000. Reported deaths include:
  • 1900-1930 India: 800,000
  • 1900-1925 Russia: 500,000
  • 1902-1904 Philippines: 200,000
 1,750,000,000 0.086 Less than 1% to 2.24% Cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens. This was arguably the worst of the cholera pandemics in history.
Spanish flu pandemic Influenza A virus subtype H1N1 Haskell County, Kansas, USA. 1918 – 1920 Worldwide 50 to 100 million. 1,750,000,000 2.85 – 5.71 Between 2 – 10% Spanish flu was transmitted from person to person through droplet infection (coughing, sneezing). The virus spread from Haskell County, Kansas, USA in early 1918 through the US Army Training Camp Funston in the European trenches. It was first reported in Spain, which is how it got the name Spanish flu, one of the worst pandemics in modern history.
Asian flu, Swine flu, novel H1N1, Mexican flu Influenza A virus subtype H2N2 Guizhou, south west China. 1957 – 1958 Early 1956 China. Feb 1957 Singapore, April 1957 Hong Kong, June 1957 USA. 1 to 4 million. 2,900,000,000 0.34 – 1.36 Around 0.1% Asian flu was spread from person to person through droplet infection (cough, sneeze). A mutation in wild ducks combined with a pre-existing human strain. The elderly were particularly vulnerable.
Seventh cholera pandemic, Asiatic cholera Cholera, El Tor and Vibrio cholerae O139 Bengal Celebes island, Indonesia. 1961 – present 1961 Indonesia, 1963 East Pakistan (Bangladesh), 1964 India, 1966 Soviet Union, 1970 Odessa, Turkey, Ukraine and North Africa. 1971 Cameroon. 1972 Baku, Azerbaijan, 1973 Italy, late 1970s, Japan and South Pacific. 1991 Peru. 1992-93 Bangladesh and India. 2000s Mozambique, Democratic Republic of the Congo and Tanzania. 2007-08 Iraq, 2008-09 Zimbabwe. 2010-11 Haiti. Tens of thousands. Reported deaths include:
  • 1991 Peru: 10,000
  • 2008-09 Zimbabwe: 4,200
  • 2010-11 Haiti: 6,631.
 3,091,843,507 0.001 Less than 1% to 2.24% Asiatic cholera is transmitted by fecal-oral transmission, usually as a result of poor sanitation. Typically drinking water contaminated by feces and eating food contaminated with pathogens. By 1991 570,000 cholera cases had been reported worldwide.
Hong Kong flu, 1968 flu pandemic Influenza A virus subtype H3N2 13 July 1968 Hong Kong. 1968 – 1970 Spread within 2 weeks to Vietnam and Singapore. Sep 1968 India, Philippines, northern Australia, Europe and California, USA (by returning Vietnam war troops). Dec 1968 rest of USA. 1969 Japan, Africa and South America. The virus returned in late 1969, early 1970 and in 1972. Around 1 million deaths worldwide. Reported deaths include:
  • Germany 30,000.
  • USA 100,000.
 3,750,000,000 0.027 Around 0.1% Hong Kong flu was spread from person to person through droplet infection (cough, sneeze). The new virus was formed by reassortment of multiple sub-types. The death rate was highest in over 65’s.
HIV/AIDS (Acquired Immune Deficiency Syndrome) Human Immunodeficiency Virus Early 20th century, west-central Africa. 1980 – present 1959 Zaire (now DR Congo) when worldwide. Likely to reach 90-100 million by 2025. Deaths peaked in 1997 with 3.3 million deaths/year. Reported deaths include:
  • 1997-2005: 2.6 million/year.
  • 2018: 770,000 deaths (Male 57%, Female 43%).
 4,458,003,514 0.017 Between 80 – 90% (untreated) AIDS is spread from person to person in bodily fluids including blood, sperm, vaginal secretions and breast milk. Most commonly through sexual intercourse, primarily heterosexual but also homosexual. Though NOT via saliva, sweat, tears or droplet infection. The first HIV infection was in 1959 in Zaire (now DR Congo). Most deaths are through flu, pneumonia and other respiratory diseases because of immunodeficiency.
SARS (Severe Acute Respiratory Syndrome) Human coronaviris
(SARS-CoV)		 Cave-dwelling horseshoe bats in China’s Yunnan province. 2002 – 2003 Nov 2002 Guangdong, China, Feb 2003 other provinces of China and Vietnam. Mar 2003 Taiwan, Hong Kong, San Francisco in US, Toronto and Ottawa in Canada, Manila in Philippines, Singapore, Ulaanbaatar in Mongolia. Approximately 774 deaths. 6,400,000,000 <0.001 10% SARS is spread by droplet infection via the mucous membranes with respiratory droplets (via coughing and sneezing). The SARS virus can survive up to 24 hours outside the human body on surfaces.
2009 Swine flu pandemic Influenza A virus subtype H1N1/09 Veracruz, Mexico. 2009 – 2010 Worldwide. First Mexico, USA and Canada, then Europe, Russia, Asia, China, Central and South America, the Middle east and the Caribbean, Oceania and Africa from June. Between 203,000 and 579,000 deaths worldwide. 6,900,000,000 0.003 – 0.008 Between 0.1 – 1.5% Swine flu is not an animal disease like bird flu. The transmission also does not take place through the consumption of infected pork, but only from person to person through droplet infection (coughing, sneezing).
COVID-19 (SARS-CoV-2, 2019-nCoV) Human coronavirus. (novel coronavirus
SARS-CoV-2, 2019-nCoV)		 Wuhan City, Hubei province, China. 2019 – present COVID-19 Worldwide Spread Timeline:
  • 17 Nov 2019:
    Wuhan, China
  • January 2020:
    Japan, South Korea and Thailand, USA, Philippines
  • February 2020:
    Iran, Latin America, 14 European countries including Italy, France, Germany, the UK, Switzerland, Belarus, Estonia, and Lithuania. Sub-saharan Africa, Nigeria
  • 11 March 2020:
    WHO declares COVID-19 a pandemic and it’s already proven to be one of the worst pandemics in history
  • 25 April 2020:
    The worldwide CFR average peaked at ~7.29
  • October 2020:
    Alpha (B.1.1.7) variant) found in southeast England is around 82%  more transmissable and 59% more lethal
  • December 2020:
    Beta (B.1.351 South African variant) is around 52% more transmissibile.
  • January 2021:
    Gamma (P.1 Brazilian variant) is around 161% more transmissable and around around 50% more lethal.
  • March 2021:
    Vaccination programs got underway on all continents.
  • April 2021:
    Delta (B.1.617 Indian variant) is around 97% more transmissable and around 137% more lethal.
  • November 2021:
    Omicron (B.1.1.529 South African variant) in circulation.
  • September 2022:
    Omicron (B.1.1.529 South African variant) is possibly more transmissable with a higher reinfection rate than the Delta variant with ~57% lower hospitalization and is ~63% less lethal.
 COVID-19 Total Deaths Timeline:
  • ~ 88,100
    08 Apr 2020
  • ~ 253,388
    9 May 2020
  • ~ 386,784
    4 Jun 2020
  • ~ 524,198
    3 Jul 2020
  • ~ 734,098
    12 Aug 2020
  • ~ 853,437
    31 Aug 2020
  • ~ 887,550
    9 Sep 2020
  • ~ 961461
    23 Sep 2020
  • ~ 1,037,467
    3 Oct 2020
  • ~ 1,086,700
    13 Oct 2020
  • ~ 1,218,315
    3 Nov 2020
  • ~ 1,324,025
    16 Nov 2020
  • ~ 1,466,320
    2 Dec 2020
  • ~ 1,643,970
    16 Dec 2020
  • ~ 1,841,395
    2 Jan 2021
  • ~ 2,007,925
    15 Jan 2021
  • ~ 2,352,846
    12 Feb 2021
  • ~ 2,544,373
    8 Mar 2021
  • ~ 2,778,818
    27 Mar 2021
  • ~ 3,010,711
    5 Apr 2021
  • ~ 3,458,945
    22 May 21
  • ~ 3,884,000
    21 Jun 21
  • ~ 4,136,698
    21 Jul 21
  • ~ 5,183,003
    28 Nov 21
  • ~ 5,534,099
    12 Jan 22
  • ~ 6,249,400
    27 Apr 22
  • ~ 6,521,114
    14 Sep 22
 World Population:
  • 7,788,957,000
    4 Jun 2020
  • 7,791,085,000
    17 Jun 2020
  • 7,795,477,000
    3 Jul 2020
  • 7,799,305,000
    20 Jul 2020
  • 7,801,730,000
    31 Jul 2020
  • 7,803,949,000
    12 Aug 2020
  • 7,810,131,000
    9 Sep 2020
  • 7,813,866,100
    23 Sep 2020
  • 7,816,118,000
    3 Oct 2020
  • 7,818,257,000
    13 Oct 2020
  • 7,823,011,000
    3 Nov 2020
  • 7,825,702,000
    16 Nov 2020
  • 7,828,911,000
    2 Dec 2020
  • 7,832,464,638
    16 Dec 2020
  • 7,836,357,600
    2 Jan 2020
  • 7,839,207,000
    15 Jan 2021
  • 7,844,939,000
    12 Feb 2021
  • 7,850,758,000
    8 Mar 2021
  • 7,854,873,000
    27 Mar 2021
  • 7,859,532,000
    5 Apr 2021
  • 7,867,414,000
    22 May 21
  • 7,874,123,900
    21 Jun 21
  • 7,880,807,000
    21 Jul 21
  • 7,909,649,000
    28 Nov 21
  • 7,920,034,630
    12 Jan 22
  • 7,943,122,000
    27 Apr 22
  • 7,974,325,000
    14 Sep 22
 Deaths as % of World Population Timeline[1]:
  • 0.0011
    08 Apr 20
  • 0.0032
    9 May 20
  • 0.0050
    4 June 20
  • 0.0067
    3 July 20
  • 0.0078
    31 July 20
  • 0.0108
    31 Aug 20
  • 0.0114
    9 Sep 20
  • 0.0123
    23 Sep 20
  • 0.0133
    3 Oct 20
  • 0.0156
    3 Nov 20
  • 0.0169
    2 Dec 20
  • 0.0209
    16 Dec 20
  • 0.0235
    2 Jan 21
  • 0.0256
    12 Feb 21
  • 0.0324
    8 Mar 21
  • 0.0354
    27 Mar 21
  • 0.0383
    5 Apr 2021
  • 0.044
    22 May 21
  • 0.044
    21 Jun 21
  • 0.0525
    21 Jul 21
  • 0.0655
    28 Nov 21
  • 0.0699
    12 Jan 22
  • 0.0787
    27 Apr 22
  • 0.0818
    14 Sep 22
 Case Fatality Rate (CFR) Timeline:
  • ~5.85%
    08 Apr 20
  • ~7.08
    9 May 20
  • ~6.0
    4 Jun 20
  • 3.7
    12 Aug 20
  • 3.3
    9 Sep 20
  • 3.1
    23 Sep 20
  • 3.0
    3 Oct 20
  • 2.9
    13 Oct 20
  • 2.6
    3 Nov 20
  • 2.3
    2 Dec 20
  • 2.2
    16 Dec 20
  • 2.2
    2 Jan 21
  • 2.1
    12 Feb 21
  • 2.2
    8 Mar 21
  • 2.15
    8 Mar 21
  • 2.15
    22 May 21
  • 2.17
    21 Jun 21
  • 2.17
    21 Jul 21
  • 1.99
    28 Nov 21
  • 1.76
    12 Jan 22
  • 1.22
    27 Apr 22
  • 1.07[3]
    14 Sep 22
  • Spread: Covid-19 is spread by droplet infection via the mucous membranes with respiratory droplets (via coughing and sneezing) and by direct contact with surface areas (fomites).
  • Fomites include: Human skin cells, hair, contaminated clothing, bedding, towels, cups, cutlery (knives, forks, spoons), bath/shower faucet/tap handles and products, toilet flush levers, buttons, brushes, door knobs, light switches, handrails, elevator/lift buttons, cellphones/mobiles/telephones, TV remote controls, pens/pencils, touch screens, keyboards, computer mice/trackpads, cupboard and appliance handles (fridge, freezer, dishwasher, coffee, tea pots etc.) worktops/countertops and any shared objects.
  • The COVID-19 virus can survive on surfaces from a few hours up to several days, research continues.
  • In general corona viruses survive longer on non-porous surfaces compared to porous surfaces, which help trap the contagion.

See Also: 🆒 Key Facts About Human Body Organs | 🆕 Fascinating Facts About Humans

  • Notes: ADDucation’s list of pandemics in history in order is published for information only and is NOT medical nor lifestyle advice.
  • [1] Deaths as a percentage of population is calculated by dividing the estimated number of deaths by the the estimated world population at that time in history expressed as a percentage. This indicates the most deadly and worst pandemics in history.
  • [2] Case Fatality Rate (CFR) is the proportion of people diagnosed with a disease who die, during the course of the disease, within a specified time. The CFR is also used to determine the Pandemic Severity Index (PSI) which ranges from category 1 to 5 for the biggest pandemics in history.
  • [3] The COVID-19 CFR worldwide average. During an outbreak the CFR can fluctuate wildly and isn’t a good measure of the mortality risk as explained and discussed here.

Pandemic Severity Index:

The Pandemic Severity Index (PSI) was developed by the Centers for Disease Control and Prevention (CDC) to help report and plan for pandemics. The Covid-19 pandemic is a category 5 pandemic, and one of the worst pandemics in modern history, because the Case Fatality Rate (CFR[2]) of the first wave peaked around 7.29% (worldwide average) and is currently between 2 and 3% during the second wave. In 2014 the PSI was replaced by the Pandemic Severity Assessment Framework (PSAF) which assesses the impact of pandemic taking into account clinical severity and transmissibility.

Category
CFR[2]
Example Pandemic(s)
1
< 0.1%
2009 swine flu
2
0.1 – 0.5%
Asian flu, Hong Kong flu
3
0.5 – 1%
2009 Swine flu
4
1.0 – 2.0%
Cholera pandemics
5
2.0% +
Covid-19, 1918 Spanish flu

Shocking Pandemics Facts

  • Most of the measures taken to prevent the spread of the current COVID-19 outbreaks today are not new. The same measures were carried out during the 14th century Black Death pandemic in London and most of worst pandemics in history right back to Roman times!
  • Although Covid-19 is the worst global pandemic there have been deadlier and longer lasting pandemics throughout history. For example the plague of Justinian from 541 AD killed over 12% of the population over two centuries, spanning eight generations.

worst pandemics in 20th century

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