What were the biggest pandemics in history?
This article is a timeline of the biggest pandemics and epidemics in history. We especially focus on those where the mortality is over 50,000 people.
Pandemics are not new. They have occurred throughout human history, and long before we came into existence. They are described in the Bible and Koran.
Our earliest ancestors experienced communicable disease, but prior to the development of communities, disease spread was limited. As cities developed and trade routes connected them, the capacity for disease spread increased dramatically – creating epidemics and pandemics.
We will now go through the major pandemics that have occurred throughout history, up to the most recent pandemic declared on March 11, 2020: SARS-CoV-2 (COVID-19).
So. Here goes .. a major pandemic and epidemic timeline,
430 BC: The Plague of Athens
A plague struck Athens in 430 BC while it was under siege by Sparta during the Peloponnesian War.
Pathogen: Salmonella enterica serovar Typhi
Outcome: 75,000 to 100,000 deaths
165: The Antonine Plague (Plague of Galen)
The plague began during the reign of Marcus Aurelius and continued under the rule of his son Commodus. It was described by the physician Galen.
Pathogen: unconfirmed, smallpox (Variola virus) or measles (Rubeola virus) suspected
Outcome: 5-10 million deaths (25–33% of Roman population)
249: Cyprian Plague
Bishop St. Cyprian documented the suffering, and claimed the plague signified the end of the world.
Pathogen: unconfirmed, smallpox (variola virus) or measles (Rubeola virus) suspected
Outcome: over 5,000 deaths per day in Rome
541: The Justinianic Plague
The first of three plague pandemics. Bubonic plague is a virulent disease that is transmitted by flea bites, and by person-to-person transmission when it is in its pneumonic form. New research is beginning to challenge current assumptions and suggests the Justinianic Plague’s high mortality rate may be exaggerated.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: between 15 and 100 million deaths
735: Japanese Smallpox Epidemic
(天平の疫病大流行, Tenpyō no ekibyō dairyūkō, ‘Epidemic of the Tenpyō era’) occurred in 735–737, and was a major smallpox epidemic that afflicted much of Japan. The epidemic had significant social, economic, and religious repercussions throughout the country.
Pathogen: smallpox (Variola virus)
Outcome: 2 million deaths (33% of Japanese population)
1346: Black Death
The second plague pandemic. It decimated Kipchak khan Janibeg’s army in the Genoese trading port, Kaffa, and spread via Genoese ships to Mediterranean ports.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: 75-200 million deaths in Europe
1520: Mexico Smallpox Epidemic
Arrived in Mexico when Spanish forces landed in what is now Veracruz. It began to spread when Spanish troops entered the capital of the Aztec Empire (Tenochtitlán).
Pathogen: smallpox (Variola virus)
Outcome: 5-8 million deaths (23–37% of Mexican population)
1545: Cocoliztli Epidemic
The Cocoliztli Epidemic (or Great Pestilence; 1545-48) was an outbreak of a mysterious illness characterised by high fevers and bleeding which caused 5-15 million deaths in New Spain (Mexico) during the 16th century. The Aztec people called it cocoliztli, Nahuatl for pestilence. Because of the proportion of the population that died (27-80%), some say it was the worst pandemic in history.
Pathogen: unidentified pathogen
Outcome: 5-15 million deaths (27–80% of Mexican population)
1576: Cocoliztli Epidemic
Occurred in 1576–1580, and was similar to previous outbreak. in fact there were at least 12 epidemics that are attributed to cocoliztli, with the largest occurring in 1545, 1576, 1736, and 1813.
Pathogen: unidentified pathogen
Outcome: 2-2.5 million deaths (50% of Mexican population)
1629: Italian Plague
The Italian Plague of 1629–1631, also referred to as the Great Plague of Milan, was part of the second plague pandemic that began with the Black Death in 1348 and ended in the 18th century.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: 1 million deaths
1656: Naples Plague
A plague epidemic in Kingdom of Naples, 1656-1658. It affected mostly central and southern Italy. In Naples alone, approximately 150,000-200,000 people died in 1656 due to the plague, accounting for more than half of the population.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: 1.25 million deaths
1665: The Great Plague of London
The plague continued to create small epidemics, and in 1665, a major outbreak occurred in Europe and England.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: over 100,000 deaths (68,596 recorded) in London, England
1772: Persian Plague
Persian Plague was one of the most devastating Plague epidemics in recorded human history. The outbreak resulted in the introduction of several quarantine measures for the first time in the Persian Gulf region.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: 2 million deaths
1817: The First Cholera Pandemic
The first cholera pandemic originated in the Ganges River in India, and disease broke out near Calcutta before spreading to other parts of the world. The seventh cholera pandemic occurred in 1961, beginning in Indonesia and spreading to other countries in Asia, Europe, Africa, and Latin America.
Pathogen: Vibrio cholerae
Outcome: 10,000 recorded deaths among British troops suggest hundreds of thousands of deaths across India.
1846: The Third Cholera Pandemic
The third cholera pandemic (1846–1860) was the third major outbreak of cholera originating in India in the 19th century that reached far beyond its borders. Some researchers believe it may have started as early as 1837 and lasted until 1863. In the Russian Empire, more than one million people died of cholera. In 1853-1854, the epidemic in London claimed over 10,000 lives, and there were 23,000 deaths in all of the UK.
Pathogen: Vibrio cholerae
Outcome: 1 million+ deaths
1855: Third Plague Pandemic
The plague re-emerged in the Chinese province of Yunnan in 1855. It continued to spread, reaching Hong Kong in 1894 and Bombay in 1896. By 1900 it reached every continent, and finally ended in 1959. At least 10 million Indians were killed in British Raj India alone, making the Third Plague Pandemic (1855-1959) one of the deadliest pandemics in history. According to the World Health Organization, the pandemic was considered active until 1959-60 when worldwide casualties dropped to 200 per year.
Pathogen: Bubonic plague (Yersinia pestis)
Outcome: over 15 million deaths
1875: Measles in the Fiji Islands
Measles has a high mortality rate when introduced to isolated populations. In 1847, Fiji signed an article of cession to the British Empire. As part of the process, the most senior chief Cakobau visited Sydney, Australia, where he contracted measles. One of his sons also became ill on the return voyage. Upon their return, all high chiefs of Fiji attended a meeting and subsequently spread the measles virus throughout Fiji.
Pathogen: measles (Rubeola virus)
Outcome: over 40,000 deaths
1889: The Russian Flu
The 1889–1890 pandemic, often referred to as the ‘Russian flu’ or ‘Asiatic flu’ was a worldwide respiratory viral (influenza) pandemic. The Russian Flu was the last great pandemic of the 19th century, and is among the deadliest pandemics in history. It first peaked in St. Petersburg, Russia, and only 70 days later, peaked in the United States. The rapid spread has been attributed to the vast railway networks throughout Europe and more rapid transatlantic boat travel.
Pathogen: influenza, possibly H3N8
Outcome: over 1 million deaths
1918: ‘Spanish Flu’
The ‘Spanish Flu’ (1918-20) was an influenza pandemic, and the most severe in recent history. It was first identified in military personnel in the United States in the spring of 1918 and spread worldwide. A unique feature was its high mortality rate in young, healthy people.
Pathogen: H1N1 virus with genes of avian origin
Outcome: 50 million deaths worldwide
1918: Russia typhus epidemic
During and shortly after the war, the Russian typhus epidemic typhus (1918-22) led to 2-3 million deaths in Russia; and several million citizens also died in Poland and Romania. Since 1914, many troops, prisoners and even doctors were infected, and at least 150,000 died from typhus in Serbia, 50,000 of whom were prisoners.
Pathogen: Typhus
Outcome: 2-3 million deaths (1–1.6% of Russian population)
1957: Asian Flu
First identified in East Asia, subsequently spreading to countries around the world. It is considered the least severe of the three influenza pandemics of the 20th century.
Pathogen: influenza A subtype H2N2
Outcome: 1-2 million deaths worldwide
1968: Hong Kong flu
The third influenza pandemic of the 20th century, believed to have evolved from the 1957 Asian flu virus (influenza A subtype H2N2) via antigenic shift. Those exposed to the 1957 virus demonstrated immunity to the new virus, as H3N2 retained the neuraminidase antigen N2.
Pathogen: influenza A subtype H3N2
Outcome: 1-4 million deaths
1981: HIV/AIDS
Acquired Immune Deficiency Syndrome (AIDS) was first recognized in 1981. It is one of the most devastating infectious diseases, with developing countries suffering the greatest morbidity and mortality.
Pathogen: human immunodeficiency virus type 1 (HIV-1) retrovirus
Outcome: more than 40 million deaths worldwide
2002: SARS
Severe Acute Respiratory Syndrome (SARS) is thought to have spread from an animal reservoir, possibly bats, to civet cats, and first infected humans in Guangdong province in China in 2002. Most cases of human-to-human transmission occurred in the health care setting.
Pathogen: SARS coronavirus (SARS-CoV)
Outcome: 774 deaths
2009: Swine Flu
The novel influenza virus was first detected in the United States, spreading quickly to the rest of the world. The virus was different from other H1N1 viruses circulating, as few young people had existing immunity, while many people over 60 years of age had antibodies. It is estimated that 80 percent of deaths occurred among patients under 65 years of age.
Pathogen: various strains of swine influenza virus (SIV)
Outcome: Lab-confirmed deaths: 18,449 (WHO); estimated death toll: 284,000 (possible range 151,700–575,400) worldwide (12,469 in the United States)
2019: COVID-19
On December 31, 2019, the WHO China Country Office was informed of pneumonia of unknown cause, detected in the city of Wuhan in Hubei province. The disease was determined to be the result of a novel coronavirus, later named COVID-19. On March 11, 2020, the WHO declared COVID-19 a pandemic.
Pathogen: SARS coronavirus 2 (SARS-CoV-2)
Outcome: nearly 7 million deaths globally in May 2023 (WHO latest data).
What’s the difference between a pandemic and epidemic?
The WHO distinguishes pandemics and epidemics, based on a disease’s rate of spread. Thus, the difference between an epidemic and a pandemic is not the severity of the disease, but the rate and degree to which it has spread.
A pandemic cuts across international boundaries, as opposed to regional epidemics. This wide geographical reach is what makes pandemics lead to large-scale social disruption, economic loss, and general hardship.
Note. Infectious diseases with high prevalence (sometimes in addition to their epidemics), such as malaria, may have killed 50-60 billion people throughout history, or about half of all humans that have ever lived.
Summary
We have described what were the biggest pandemics in history. We hope you have found it interesting.
Other resources
There is a more extensive timeline on wikipedia.
Differences between pandemics and epidemics
