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Public health pandemics that could strike in the future

A guest blog by Charlotte Kellogg

7th November 2012

Although public health officials may suggest that pandemics are at worst manageable – and at best, things of the past – the world is not too far from experiencing its next public health crisis. In today's guest post, Charlotte Kellogg explores five of the most serious disease threats which have, and still could, decimate the world's population.

 

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Since the H1N1 scare, many people feel duped by the massive amount of media hype that went along with the virus and the seeming overreaction. However, the containment of one virus does not make the threat of another outbreak any less real.

Pandemics deserve a decent amount of fear and caution. A pandemic normally occurs when a new, deadly disease forms or mutates and spreads quickly throughout populations. If and when this happens, physicians may find it difficult to create a vaccine or find a cure, allowing the virus to spread freely, leaving untold casualties in its wake. Here are some of the most recent examples, some of which could return at any time.

The Spanish Flu

In the last century alone, a number of pandemics have caused innumerable fatalities, even in the developed world. Unlike many others, the Spanish Flu did not spread due to a lack of sanitation, making it a threat to industrialised nations.

Virologists estimate that as many as 50 million people died (3% of the global population at the time) before the virus was finally contained. Some 500 million were infected. Spanish Flu rose to prominence in the last years of World War I. More recently, it has been identified as a strain of H1N1. While the virus, itself, does not pose a direct threat, virologists constantly look for signs of a mutation, which could be far more difficult to treat and inoculate for.

For researchers, the flu is one of the most intimidating illnesses because of its ability to evolve and continually reinvent itself. For this reason, it never really goes away, it just changes. This is why public health officials fear a widespread flu pandemic is likely to occur again in the future, wreaking havoc in many nations.

According to the Centers for Disease Control and Prevention (CDC), the best methods of flu prevention are vaccinations, diligent hand washing and, if someone comes down with the illness, taking the prescribed antiviral drugs.

Cholera

Cholera did most of its damage through seven pandemics in the 19th and early 20th centuries. Spread through commonly shared water sources, it can affect whole communities very quickly. Most frequently occurring in crowded places lacking sanitation, cholera remains an active threat, particularly in areas that have recently suffered a natural disaster, such as Haiti after its 2010 earthquake. In a future world of collapsing economies and deteriorating infrastructure, this deadly disease could strike again.

According to the National Center for Biotechnology, the best method of prevention is to take precautions and ensure food and water are sanitary. One promising new concept beginning to emerge is nano-filtration technology, such as the LifeSaver bottle. This has already been used to fight cholera in Sierra Leone and could be in widespread use within a few years. It can filter out objects just 15 nanometres in size. It is relatively expensive, however, at $150 per unit.

Typhus

Typhus is a bacterial disease that is quickly spread by lice and fleas, which are often carried by stray dogs and rats. This pandemic has historically occurred along the front lines of large-scale wars, where sanitation and public health measures are lacking. Napoleon's army suffered from it during the failed invasion of Russia. It affected millions of German people during the Thirty Years' War, and caused many deaths in the Nazi concentration camps of World War II.

Since then, epidemics have occurred in Eastern Europe, Asia, the Middle East and parts of Africa. In 2012, Travis County in the state of Texas reported its first typhus-related death. Presently, a typhus vaccine exists, thus mitigating the spread of typhus in areas where inoculation is likely, but it nevertheless remains a threat.

Bubonic Plague

Bubonic Plague – also known as the Black Death – is the most recognised pandemic in human history. It wiped out between 30-60% of Europe's population in the 1300s. Sanitation was a primary facilitator of its deadly swathe, as it was spread by fleas and most European cities at that time lacked proper drainage and waste systems. The last major outbreak occurred in London during the 1660s.

Bubonic plague is unlikely to recur naturally. It could, however, be used as a man-made bio-weapon in a future terrorist attack. The destruction it caused in the past continues to serve as an important warning.

 

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Smallpox

Another Medieval disease, smallpox, was largely responsible for European victories over the ‘untamed’ Americas. European explorers and settlers – who were more or less immune to the disease they carried – spread smallpox to native populations. Before then, Spanish soldiers who sailed with Cortés spread the disease to Aztecs and Incas in both Central and South America.

Historians estimate that before the arrival of Cortés, up to 18 million indigenous peoples were living in the region. Less than 530,000 remained by 1900. Within four centuries, smallpox, war, and other diseases literally decimated the Native American populations.

During the 20th century, smallpox caused an estimated 300-500 million deaths globally. Though the virus was declared eradicated in 1979, many fear that – like bubonic plague – it could return in the future as a biological weapon. Since the disease is easily spread through bed sheets and saliva, the speed and scale of its effects could be devastating, especially in regions with insufficient vaccine supplies.

As the world becomes ever more connected and globalised, the threat from these kinds of pandemics is feared partly for the swiftness with which they can spread. The damage a new outbreak could wreak is magnified by increased rates of travel. Genetic modification of viruses could make them deadlier still. During the next major pandemic, instead of hundreds of millions, the number of fatalities could potentially reach the billions before it is stopped.

 

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