Transcript The Seven Pandemics

The Seven Pandemics
The Seven Deadly Pandemics
“Pan” = All “Demos” = People
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Peloponnesian Plague 430 BC
Antonine Plague 165
Plague of Justinian 541
The Black Death 1347
Cholera Epidemics (7) 1800’s
The Spanish Flu 1918
The Asian Flu 1957-58 and 1968-69
Peloponnesian
Plague
430 BC /Anthrax
• Began in Ethiopia
• At its Height During Athens War With
Sparta
• Fatal After 7-8 Days
• Killed 33% of the Athenian Population
Peloponnesian Plague
– "As a rule, however, there was no ostensible cause; but
people in good health were all of a sudden attacked by
violent heats in the head, and redness and inflammation in
the eyes, the inward parts, such as the throat or tongue,
becoming bloody and emitting an unnatural and fetid
breath."
– "These symptoms were followed by sneezing and
hoarseness, after which the pain soon reached the chest,
and produced a hard cough. When it fixed in the stomach,
it upset it; and discharges of bile of every kind named by
physicians ensued, accompanied by very great distress."
– "In most cases also an ineffectual retching followed,
producing violent spasms, which in some cases ceased
soon after, in others much later."
– "Externally the body was not very hot to the touch,
nor pale in its appearance, but reddish, livid, and
breaking out into small pustules and ulcers. But
internally it burned so that the patient could not
bear to have on him clothing or linen even of the
very lightest description; or indeed to be otherwise
than stark naked. What they would have liked best
would have been to throw themselves into cold
water; as indeed was done by some of the
neglected sick, who plunged into the rain-tanks in
their agonies of unquenchable thirst; though it
made no difference whether they drank little or
much."
– "Besides this, the miserable feeling of not
being able to rest or sleep never ceased to
torment them. The body meanwhile did not
waste away so long as the distemper was at
its height, but held out to a marvel against its
ravages; so that when they succumbed, as in
most cases, on the seventh or eighth day to
the internal inflammation, they had still some
strength in them.
– But if they passed
this stage, and the
disease descended
further into the
bowels, inducing a
violent ulceration
there accompanied
by severe diarrhea,
this brought on a
weakness which was
generally fatal."
– "For the disorder first settled in the head, ran its
course from thence through the whole of the body,
and even where it did not prove mortal, it still left
its mark on the extremities; for it settled in the
privy parts, the fingers and the toes, and many
escaped with the loss of these, some too with that
of their eyes. Others again were seized with an
entire loss of memory on their first recovery, and
did not know either themselves or their friends."
Thucydides
Antonine Plague
165 / Smallpox
• Carried by Roman Soldiers Returning
From Campaign
• 25% Mortality Rate
Antonine Plague
• In 166, during the epidemic, the
Greek physician and writer Galen
traveled from Rome to his home
in Asia Minor. He returned to
Rome in 168 when summoned.
• Galen's observations and
description of the epidemic, found
in the treatise "Methodus
Medendi", is brief.
• He mentions fever, diarrhea, and inflammation
of the pharynx, as well as a skin eruption,
sometimes dry and sometimes pustular,
appearing on the ninth day of the illness.
• The information provided by Galen does not
clearly define the nature of the disease, but
scholars have generally preferred to diagnose it
as smallpox.
Justinian Plague
541/ Bubonic Plague
• The disease was first noticed in an Egyptian
harbor town, which was infected with a huge
rat problem (as was most of Europe at this
time).
• It then ripped through Alexandria on its
northern invasion towards Syria and
Palestine via ships.
• 40%-60% Mortality Rate
• Procopius wrote "From there it seemed to
spread all over the world, this catastrophe was
so overwhelming that the human race appeared
close to annihilation."
• The problem with this plague was that no one
was sure of what caused it.
• In later years we have found out that the disease
was caused by bacteria and parasites that used
rats as hosts. These rats would then infect our
drinking and eating sources, thus spreading the
bacteria to hundreds of thousands of people.
• It was written by Procopius that all victims
appeared to experience similar symptoms.
"They had a sudden fever, some while
sleeping, some while walking, and others
while engaged without any regard of what
they were doing."
Soon after, the symptoms would escalate into
a type of swelling. The abdomen, armpits,
thighs, and ears were the most common body
parts affected. The lymph glands were also
commonly affected. They were called buboes
and for this part of the body the illness was
named.
• Modern scholars believe that the plague killed
up to 5,000 people per day in Constantinople at
the peak of the pandemic. It ultimately killed
perhaps 40 percent of the city's inhabitants. The
initial plague went on to destroy up to a quarter
of the human population of the eastern
Mediterranean.
The Black Death /
1347 Bubonic Plague
• Coming out of the East, the Black Death
reached the shores of Italy in the spring of 1348
unleashing a rampage of death across Europe
unprecedented in recorded history. By the time
the epidemic played itself out three years later,
anywhere between 25% and 50% of Europe's
population had fallen victim to the pestilence.
• "The symptoms were not the same as in the East,
where a gush of blood from the nose was the plain
sign of inevitable death; but it began both in men
and women with certain swellings in the groin or
under the armpit. They grew to the size of a small
apple or an egg, more or less, and were vulgarly
called tumours. In a short space of time these
tumours spread from the two parts named all over
the body. Soon after this the symptoms changed
and the black or purple spots appeared on the arms
or thighs or any other part of the
body, sometimes a few large
ones, sometimes many little ones.
These spots were a certain sign of
death, just as the original tumour
had been and still remained.
• No doctor's advice, no medicine
could overcome or alleviate this
disease, An enormous number of
ignorant men and women set up as
doctors in addition to those who were
trained. Either the disease was such
that no treatment was possible or the
doctors were so ignorant that they did
not know what caused it, and
consequently could not administer
the proper remedy. In any case very
few recovered; most people died
within about three days of the
appearance of the tumours described
above.
A plague victim reveals
the telltale buboe on
his leg. From a
14th century illumination
• The violence of this disease was such that the
sick communicated it to the healthy who came
near them, just as a fire catches anything dry or
oily near it. And it even went further. To speak to
or go near the sick brought infection and a
common death to the living; and moreover, to
touch the clothes or anything else the sick had
touched or worn gave the disease to the person
touching. “
• "One citizen avoided another, hardly any
neighbor troubled about others, relatives never
or hardly ever visited each other. Moreover,
such terror was struck into the hearts of men
and women by this calamity, that brother
abandoned brother, and the uncle his nephew,
and the sister her brother, and very often the
wife her husband. What is even worse and
nearly incredible is that fathers and mothers
refused to see and tend their children, as if they
had not been theirs.
Giovanni Boccaccio
Italian Writer Who Lived Through the Plague
A physician visits a
patient with the
plague.
Notice how he and
others are holding
their noses.
Carrying Out
the Dead
Excavated Mass Graves Dating From the Black Death in London
Cholera
7 Separate Pandemics with 6
Occurring During the 1800’s
• Endemic in India
• Spread Along Trade
Routes
• Hit Every Continent
Except Antarctica
• Most Recent in 1961
Chicago Epidemic
• In 1849 the disease was brought to the city on
the emigrant boat John Drew April 29 and raged
until late October. That year 678 persons died, a
rate of 2,897 per 100,000. This is the worst
death rate for any cause since Chicago began
keeping health statistics.
• Although the germ theory of disease was still
unknown, Chicago did undertake a number of
sanitary improvements which markedly reduced
cholera and other diseases.
• The entire city was quarantined.
In the 1850's, a
piped Lake
Michigan water
supply was
introduced
cutting reliance
upon unsanitary
wells and
buckets of
water from the
sewage filled
Chicago River.
• An expanded drinking water tunnel--two miles out
into the lake – was built in 1867 and effectively
reduced the amount of sewage from the river in the
water supply.
• Sewers were constructed starting in 1856 and
expanded after the cholera epidemic of 1866.
As sanitation
efforts increased,
the epidemic
decreased.
As Cemeteries Filled, Bodies
Were Burned Not Buried
Some, looking for a point of origin of the so-called Spanish
influenza that would eventually take the lives of 600,000
Americans, point to Monday, March 11, 1918. Company cook
Albert Gitchell (Fort Riley, Kansas) reported to the camp
infirmary with complaints of a "bad cold." Right behind him came
Corporal Lee W. Drake voicing similar complaints. By noon,
camp surgeon Edward R. Schreiner had over 100 sick men on
his hands, all apparently suffering from the same malady.
The Spanish
Flu
1918
• The 1918 flu pandemic (commonly referred to as
the Spanish flu) was a category 5 influenza
pandemic that started in the United States,
appeared in West Africa and France and then
spread to nearly every part of the globe. It was
caused by an unusually severe and deadly
Influenza A virus strain of subtype H1N1.
• Many of its victims were healthy young
adults, in contrast to most influenza
outbreaks which predominantly affect
juvenile, elderly, or otherwise weakened
patients.
• The Spanish flu pandemic came in three waves
(March 1918 to June 1920), spreading even to the
Arctic and remote Pacific islands.
• While older estimates put the number of killed at
40–50 million people, current estimates are that 50
million to 100 million people worldwide died,
possibly more than that taken by the Black Death,
and higher than the number killed in World War I.
• This extraordinary toll resulted from the extremely
high infection rate of up to 50% and the extreme
severity of the symptoms.
When Hospitals filled in the area, nurses set up in the Oakland Municipal
Auditorium and used it as a temporary hospital.
Street car conductor
in Seattle not
allowing passengers
aboard without a
mask. 1918.
• While possible origins of this influenza were
debated and investigated, one fact remained
inescapable: it was deadly. Lacking reliable
medical defenses against influenza, public health
officials and private citizens poured their energies
into taking preventative measures.
• The United States
Public Health Service
faced the challenge of
educating the public
about an illness that
was largely a mystery.
• To that end, the Red
Cross, Post Office, and
Federal Railroad
administration all did
their part to assure that
instructive posters
adorned the entire
nation.
• Surgeon General
Rupert Blue, the
nation's Chief Public
Health Officer,
ordered the printing
and distribution of
pamphlets with titles
like, "Spanish
Influenza," "ThreeDay-Fever," and
"The Flu."
• The Colgate
company pitched in
by placing ads
detailing twelve
steps to prevent
influenza.
• Among the
recommendations:
chew food carefully
and avoid tight
clothes and shoes.
• Alfred Crosby, in "Epidemic and Peace,
1918," his definitive history of Spanish
influenza, observed that if influenza could
have been smothered by paper, many lives
would have been spared.
A doctor stationed at Camp Devens, a
military base just west of Boston, writes to
a friend, and fellow physician, of the
conditions to be found there as influenza
was making its presence felt.
“…This epidemic started about four weeks
ago, and has developed so rapidly that the
camp is demoralized and all ordinary work
is held up till is has passed. All
assemblages of soldiers taboo. These men
start with what appears to be an attack of
la grippe or influenza, and when brought to
the hospital they very rapidly develop the
most viscous type of pneumonia that has
ever been seen. Two hours after admission
they have the mahogany spots over the
cheek bones, and a few hours later you
can begin to see the cyanosis extending
from their ears and spreading all over the
face, until it is hard to distinguish the
coloured men from the white.
It is only a matter of a few hours then until death
comes, and it is simply a struggle for air until
they suffocate. It is horrible. One can stand it to
see one, two or twenty men die, but to see these
poor devils dropping like flies sort of gets on
your nerves. We have been averaging about
100 deaths per day, and still keeping it up.
There is no doubt in my mind that there is a new
mixed infection here, but what I don't know. My
total time is taken up hunting rales, rales dry or
moist, sibilant or crepitant or any other of the
hundred things that one may find in the chest,
they all mean but one thing here--pneumonia-and that means in about all cases death.
• The normal number of doctors here is about 25
and that has been increased to over 250, all of
whom (of course excepting me) have temporary
orders-- "Return to your proper station on
completion of work"--Mine says, "Permanent
Duty," but I have been in the Army just long
enough to learn that it doesn't always mean
what it says. So I don't know what will happen to
me at the end of this. We have lost an
outrageous number of nurses and doctors, and
the little town of Ayer is a sight. It takes special
trains to carry away the dead. For several days
there were no coffins and the bodies piled up
something fierce, we used to go down to the
morgue (which is just back of my ward) and look
at the boys laid out in long rows. It beats any
sight they ever had in France after a battle.
• An extra long barracks has been vacated for the
use of the morgue, and it would make any man
sit up and take notice to walk down the long
lines of dead soldiers all dressed up and laid out
in double rows. We have no relief here; you get
up in the morning at 5:30 and work steady till
about 9:30 p.m., sleep, then go at it again. Some
of the men of course have been here all the
time, and they are tired. I write this in piecemeal
fashion. It may be a long time before I can get
another letter to you, but will try.
Good-by old Pal,
God be with you till we meet again”
The Asian Flu 1957 & 1968
• In 1957, the Ford Motor Co. rolled out its infamous
Edsel sedan; the world was in the midst of an
escalating Cold War; the Soviet Union launched the
first man-made satellite, Sputnik, into orbit; and
President Eisenhower sent troops to Arkansas to
protect African-American students while a Little
Rock high school was being integrated.
• In 1957, the world was also in the grip of a
deadly influenza pandemic, known as the Asian
flu. Although less severe than the 1918 Spanish
flu that killed an estimated 50 million people, the
1957 Asian flu was ultimately responsible for
70,000 deaths in the United States and nearly 2
million deaths worldwide over the next year.
Normal activities
were halted in
order to restrict
the spread of
the flu.
Will There Be An Eighth?
Dire case of flu in Hong Kong
September 23, 2008
• Primary and secondary schools in Hong Kong have been
temporarily closed down because of an illness with
symptoms similar to flu. None of the experts can
recognize what the virus is just yet.
• Closing the schools was mainly to stop parents worrying,
and the schools are being disinfected. Experts hope that
this will stop the illness spreading.
• People in Hong Kong are worried because they had
S.A.R.S in 2003, which killed almost 300 people. This
stands for severe acute respiratory syndrome.
Bird Flu
• Estimates predict 40%
of the population will
become infected.
• Of those infected
approximately 50-55%
will probably die.
Why should we worry?
• On Sept. 29 2005, David Nabarro the
newly appointed Senior U.N. System
Coordinator for Avian and human
influenza stated that if an outbreak
reaches pandemic proportions then expect
death toll from 5 million to 150 million
people.
• Scientists estimate 1 to 1.2 billion deaths
VHA Report 2006 on Hospital
Preparedness
• Disaster Plans are in Place
• Inadequate Inventories of Critical
Supplies
No Problem – We just get more stuff
from the manufacturers.
Now Where are the Manufacturers?
• Supply chain
experts believe
that interruptions in
Asian
manufacturing
centers due to
avian flue could
severely impact
replenishment
options here.
But Is There Really a Threat?
• In 2007, the number of human cases of avian flu
dropped rather than rose for the first time -- from
115 in 2006 to an even more insignificant 86 in
2007.
• Frightening headlines warning of a pandemic
that could kill 150 million people have all but
vanished.
• Most of the people who acquire the infection
were, and still are, bird handlers in
continuous contact with sick birds.
• How does this endanger workers in the
United States? Research like this would
typically be thrown in the trash if it did not
strongly support some ulterior purpose.
• What might that purpose have been?
• Greed?
Who Profited?
• At $100 per dose, the U.S. used taxpayer’s
dollars to purchase some 20 million doses of
the highly questionable Tamiflu from Gilead
Sciences.
20,000,000 x $100 = $2,000,000,000
• They earned over
seven billion dollars
worldwide.
• The president of
Gilead Sciences
when they created
the drug was then
Defense Secretary
Donald Rumsfeld.
And Tamiflu Isn’t 100% Safe
• Since the purported “outbreak” of bird flu,
the Tamiflu vaccine has been linked to the
deaths of 14 Japanese children, some of
which suddenly jumped out of buildings.
• Neuropsychiatric incidents in children,
including seizures, loss of consciousness,
and delirium were linked to the vaccine.
• Tamiflu is now banned in Japan.
Who Shouldn’t Take Tamiflu?
Do Not Take
• if you are pregnant, planning to become
pregnant, or are breast-feeding
• if you are taking any prescription or
nonprescription medicine, herbal
preparation, or dietary supplement
• if you have allergies to medicines, foods,
or other substances
• if you have kidney problems
Here’s the Kicker!
• When Tamiflu is used as directed (twice daily for
5 days) it can ONLY reduce the duration of
your influenza symptoms by 1 to 1 ½ days,
according to the official data.
• Why on earth would anyone want to take a drug
that has a chance of killing you, was banned in
Japan, is loaded with side effects that mimic the
flu itself, costs over $100, and AT BEST can
only provide 36 hours of SYMPTOM relief.
• President Obama declared the swine flu outbreak
a national emergency empowering the health
secretary to suspend federal requirements and
speed up treatment.
• His declaration authorized Health and Human
Services to bypass normal federal regulations so
health officials could respond more quickly to the
outbreak.
• As of June 12, 2009, there had been only
145 deaths in the ENTIRE world from this
illness. The United States had 27 deaths.
Mexico had the majority of the deaths at 108.
More People Died From the
Vaccine Than From the Flu!
• CNN and the CDC report that nearly 3,900
people, including about 540 children, are
believed to have died from the H1N1 flu
vaccine in the first six months of the
epidemic.
• In a normal flu
season the total
number of deaths for
children is about 100
from the vaccine.
Adverse Effects of the
Vaccine
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Guillian-Barre syndrome
Brain Disorders
Gastrointestinal Disorders
Immune System Disorders Including
Anaphylactic Reaction
• Convulsions
• ~ 3,587 Miscarriages
• The creators of the vaccine refused to take
the vaccine.
• 50% of all health care workers refused to
take the vaccine.
2011 Study Results
• A shocking report from the National
Coalition of Organized Women (NCOW)
presented data from two different sources
demonstrating that the 2009/10 H1N1
vaccines contributed to an estimated
1,588 miscarriages and stillbirths. A
corrected estimate may be as high as
3,587 cases.
• NCOW also
highlights the
disturbing fact
that the CDC
failed to inform
their vaccine
providers of the
incoming data of
the reports of
suspected H1N1
vaccine related
fetal demise.
August 2, 2010
• The US Food and Drug Administration
(FDA) has approved vaccines for the 2010
to 2011 flu season that protect against 3
strains of influenza, including the 2009
H1N1 pandemic swine flu virus.