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 27 Apr 2022.
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|Global pandemics||Worst Pandemic Type||Origin||Period||Pandemic timelines / spread||Estimated deaths||World population||Population / Deaths %||Pandemic deadliness (CFR/PSI)||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%
1 – 30%
|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:
||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:
||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:
||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:
||1,550,000,000||0.058||Less than 1% to 2.24%|
|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:
||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:
||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:
||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:
||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
|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
|Wuhan City, Hubei province, China.||2019 – present||COVID-19 Worldwide Spread Timeline:
||COVID-19 Total Deaths Timeline:
||Deaths as % of World Population Timeline:
||Case Fatality Rate (CFR) Timeline:
- Notes: ADDucation’s list of pandemics in history in order is published for information only and is NOT medical nor lifestyle advice.
-  Deaths as a percentage of population is calculated by dividing the estimated world population at that time in history by the estimated number of deaths. This indicates the most deadly and worst pandemics in history.
-  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.
-  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) 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.
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.
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