How COVID-19 Compares to Other Outbreaks

How COVID-19 Compares to Other Outbreaks

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Planet earth from outer space with Coronavirus map expansion in Europe, COVID-19 in 2020.

Since its first appearance in Wuhan, China, in December 2019, more than 39 million cases of COVID-19 have been confirmed worldwide, with more than 1.1 million deaths as of October 16, 2020. While these statistics are alarming, the coronavirus pandemic is, sadly, not the first of its kind. In fact, since the beginning of time, there have been contagious diseases that have disrupted life and wreaked havoc on the world’s human population.

Smallpox: 3rd Century BCE – 1980

Caused by the variola virus, smallpox was an infectious disease characterized by a progressive skin rash and fever. Although the origin is unknown, it’s believed smallpox was detected as far back as the Egyptian Empire around the 3rd Century BCE.

  • Number of infections: Unknown
  • Worldwide deaths: 3 out of every 10 people with the disease
  • How it stopped: Vaccination for smallpox began as early as 1796, though the disease remained widespread through 1966. In 1967, the World Health Organization initiated the Intensified Eradication Program to deliver vaccines worldwide. On May 8, 1980, the 33rd World Health Assembly stated smallpox had been eradicated around the world.

Bubonic plague: Mid-1330s – Early-1350s, and 1924-1925

Characterized by swollen, painful lymph nodes, fever, chills, headache and fatigue, bubonic plague is a bacterial infection usually transmitted by the bite of an infected flea that contracted the disease from an infected rodent. Plague in the lungs spreads person to person. Also called Black Death, bubonic plague was rampant during medieval times in Europe and Asia. It arrived in the United States in 1900, reaching epidemic status in Los Angeles between 1924 and 1925.

  • Number of infections: Unknown worldwide; between 1900 and 2012, 1,006 cases reported in the United States
  • European deaths: More than 20 million
  • How it stopped: Initially, there were no medications to treat bubonic plague, so isolation and quarantine were implemented to slow the spread of the disease. Today, bubonic plague still affects 1,000 to 3,000 people each year worldwide, with an average of seven cases annually in the western United States. Antibiotics are available to cure the disease when treatment begins early.

Cholera: 1817-1823, 1829-1851

Although there is some evidence of cholera as far back as the 4th Century BCE, the first pandemic began in 1817 in India. An acute diarrheal illness caused by bacteria, cholera spread rapidly along trade routes, eventually reaching modern-day Turkey, Syria and southern Russia.

Another pandemic sprang up in 1829, again in India, following a similar path as the first pandemic. This time, however, it spread throughout Europe, the United States, Canada, Mexico and Cuba.

Four more cholera pandemics occurred between 1852 and 1923, though most have been reduced thanks to cleaner water and sanitation systems. Unfortunately, cholera outbreaks and pandemics continue, particularly in areas where clean drinking water and improved sanitation is not available.

  • Number of infections: Each year, an estimated 2.9 million cases are reported worldwide
  • Worldwide deaths: Each year, there are approximately 95,000 deaths around the globe
  • How it stopped: The initial 1817 pandemic ended abruptly in 1823, possibly as a result of a severe winter from 1823 to 1824 that killed the bacteria in the water supplies. The best cure for cholera is clean drinking water and improved sanitation systems. Patients diagnosed with cholera are treated with an oral rehydration solution of sugar and salts mixed with water. If necessary patients also may receive antibiotics.

Spanish Flu pandemic: 1918-1919

Sparked by an H1N1 virus with genes of avian origin, the 1918 influenza pandemic, also known as the Spanish flu pandemic, was first identified in the United States in military personnel in March 1918. The worldwide spread of the virus was credited in large part to overcrowding and global troop movement taking place during World War I.

  • Number of infections: Estimated 500 million people worldwide
  • United States deaths: Approximately 675,000
  • Worldwide deaths: At least 50 million
  • How it stopped: Control and eradication were limited to non-pharmaceutical interventions including isolation, quarantine, use of disinfectants, good personal hygiene, and limitations of public gatherings.

Malaria: Paleolithic period – today

A mosquito-transmitted illness caused by a parasite, malaria is characterized by high fever, chills and other flu-like symptoms. This disease has a long history, dating back to the Paleolithic period, also called the Old Stone Age, and continues to be very prevalent around the globe today. In 1914, the U.S. Public Health Service implemented many activities to research and fight malaria, which resulted in reduced cases of malaria.

From 1942 to 1945, Malaria Control in War Areas worked to reduce malaria at military training bases in the southern United States and its territories. Following on the heels of the MCWA, on July 1, 1946, the Communicable Disease Center, as the U.S. Centers for Disease Control and Prevention was originally named, set out to combat and eliminate malaria in the United States. By 1947, the disease was, for the most part, eliminated in the United States. Currently, approximately 2,000 cases of malaria are diagnosed each year, with the majority originating outside the United States.

  • Number of infections: In 2018, approximately 228 million cases of malaria occurred worldwide
  • Worldwide deaths: 405,000 (2018)
  • How it stopped: The World Health Organization implemented an eradication program in 1955 that involved house spraying with residual insecticides, antimalarial drug treatment with such drugs as chloroquine and hydroxychloroquine, and monitoring of the disease to keep it under control. However, implementation of the program was not universal worldwide, and that, along with such factors as massive population movements, wars, drug resistance, and lack of funding led to the program’s abandonment. Today, efforts continue to reduce the transmission of malaria, but case numbers remain high, many in sub-Saharan Africa and South Asia.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 14
  1. Coronavirus disease (COVID-19) Outbreak Situation. World Health Organization.
  2. Cases in U.S. Centers for Disease Control and Prevention.
  3. 1918 Pandemic Influenza Historic Timeline. Centers for Disease Control and Prevention.
  4. What is Smallpox? Centers for Disease Control and Prevention.
  5. History of Smallpox. Centers for Disease Control and Prevention.
  6. Plague Symptoms. Centers for Disease Control and Prevention.
  7. Black Death.
  8. Map and Statistics: Plague in the United States. Centers for Disease Control and Prevention.
  9. Cholera.
  10. Cholera: General Information. Centers for Disease Control and Prevention.
  11. Malaria. Centers for Disease Control and Prevention.
  12. A Brief History of Malaria. National Center for Biotechnology Information.
  13. The History of Malaria, an Ancient Disease. Centers for Disease Control and Prevention.
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