A Global History of Disease
The coronavirus pandemic has everyone on edge, with many worried about the future. We all wonder what the future contains. These are interesting times, but a historical perspective will help us to better understand the significance of the present.
This short overview of global epidemics does not even skim the surface of historical epidemics. Hundreds of smaller epidemics have flared up throughout the world. It may not be a pleasant survey to read (be warned). But by reviewing this survey, two lessons will stand out. First, epidemics and infectious disease are a major part of the human experience. The modern world has little experience with such disease, but that is an oddity in human history. Second, the current pandemic is by no means one of the worst diseases. While we do not know how many will die, it is not terribly lethal by historic standards.
Why is this important? Because it reminds us that this current pandemic could be much worse. And for that, we may give thanks to God. Here is a reminder that while death is certain and possible at any time, we still have much to be thankful for.
The Plague of Justinian
Between 541-542 AD, the Mediterranean world (and much else) was rocked by a horrifying outbreak of the bacteria Yersinia Pestis – the plague. It is likely that the plague originated in the region of central Asia, travelling throughout Persia and the Mediterranean world, before it continued into the rest of Europe. At its height, around 5000 individuals died daily in Constantinople; around 25 million died worldwide. According to one source, “Procopius, in his Secret History, describes victims as suffering from delusions, nightmares, fevers and swellings in the groin, armpits, and behind their ears. Procopius recounts that, while some sufferers lapsed into comas, others became highly delusional. Many victims suffered for days before death, while others died almost immediately after the onset of symptoms.”
The Black Death
The worst pandemic in human history peaked in Europe around 1347-1351 AD. It was also caused by Yersinia Pestis. The infection had a mortality rate of around 50-100%, depending on where the bacteria settled in the body. The plague formed egg-like swellings caused ‘buboes’ which erupted on the body. Death generally came within 2 days – and often within 12 hours – preceded by fever and bloody vomit.
The plague moved slowly throughout Europe, and while officials imposed restrictions and quarantines, the infection continued to spread. It was fueled by massive migrations of thousands of terrified individuals, who sought to flee the plague but unwittingly spread it. Between 30-60% of Europe’s population died during the plague (and that does not count the many tens of millions more who died outside Europe). With such a dramatic body count, the plague permanently reshaped European society and economy.
New World Epidemics
After Columbus sailed to the New World, native populations in North and South America suffered horrendously from Old World diseases. Europeans, used to living in densely populated communities, had gradually developed varying levels of immunity from the worst diseases, such as influenza, measles, and smallpox. New World residents had no such immunity. While some Europeans were notoriously violent in their conquests of the New World, it was disease that killed the vast majority of natives.
The population of Mexico and the former Aztec empire dropped from 22 million to 2 million following the European conquest and colonization. While part of this is attributable to warfare, most of these deaths came from disease. In the Masschusetts Bay area, smallpox killed 90% of native Americans. While we don’t know for sure – due to a lack of records – possibly as many as 95% of native Americans would die from old world diseases. These diseases spread far faster than the European colonizers, leaving the Americas as vast, nearly uninhabited continents by the time that European colonizers entered the interiors.
The Great Plague of Marseille
The plague did not leave Europe after the Black Death – it continued to flare up in smaller epidemics in various places. The final major flare-up occurred in Marseille, France between 1720-1721. With a 40-50% mortality rate, the officials quarantined the city, but the disease managed to ravage the surrounding areas. The disease killed around 100,000 individuals.
Smallpox
In addition to massive worldwide pandemics and smaller terrifying epidemics, some diseases have continuously ravaged humanity for generations. Smallpox was one of the most terrifying, and common, disease of Europe and the rest of the world. The skin was covered with hundreds of large lesions affecting every part of the body. If the individual healed (the disease had a 30% mortality rate), the lesions left permanent scars.
In the 18th century, smallpox is estimated to have killed 400,000 Europeans a year. As late as the 1950s, smallpox continued to ravage the world at a rate of 50 million cases a year. Following a massive, worldwide vaccination program, smallpox was finally eradicated throughout the world in 1979.
Tuberculosis
An other deadly disease of the past (and present), tuberculosis has been around since ancient times. It killed one quarter of adult Europeans in the 19th century. The bacteria (mycobacterium tuberculosis) settle in the lungs, but it often lies dormant and does not cause the infection of tuberculosis.
Around 25% of the modern world is currently infected with the bacteria. Around 10% of those infected will eventually develop tuberculosis. With modern treatment and medications, the mortality rate around the beginning of the 21st century is around 4-8% – but significantly higher in earlier times.
Cholera Pandemics
Cholera is an easily treatable disease in modern times, but it was deadly in times past. During the 19th century, multiple cholera pandemics from the far east swept across Eurasia, killing tens of millions. The ‘Asiatic Cholera’ would also jump across the Atlantic to decimate American cities. Among the millions of others who died, the disease killed 10,000 individuals in London between 1853-1854.
The Spanish Flu of 1918
The Spanish flu was a worldwide pandemic that spread in part by the movement of populations during World War One. The disease may have originated in Leavenworth, Kansas, but it spread rapidly around the globe. Wartime censoring minimized reports of the disease at the front lines, but neutral countries (such as Spain) accurately reported the numbers. This led to the false impression that Spain was more seriously infected.
The Spanish flu had a mortality rate of around 2.5% (though this rate is not certain), and it killed between 17-100 million people worldwide. It was especially dangerous for those with strong immune systems, because it triggered an overactive immune response (‘cytokine storm’) in which the body essentially attacked itself. No region of the globe escaped.
Conclusion
This is only a brief survey of global disease. Hundreds of other epidemics and pandemics have swept the globe. While coronavirus is a serious public health emergency, this review of diseases reminds us that it is not an oddity in human history, and that it could be much worse.
