Pandemics

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Pandemics
By Dr. Munawar Aziz. MCPS*

Pandemics have happened in the past, killing millions of people around the world. Also, “epidemics” and “endemics” have been hitting different parts of the world at different times. Let’s first define the three categories of infectious diseases.

“Pandemic” is the spread of any disease throughout the world.
“Epidemic” is the widespread presence of a disease in a specific area.
“Endemic” is a disease that is continually present in an area. It affects a relatively small number of people.

Covid 19, the pandemic the world is facing today, which has caused havoc around the world killing more than 3.4 million people till mid May 2021, is caused by a family of coronaviruses. The acronym Covid-19 stands for Coronavirus disease 2019:

(Co - corona)
(Vi - virus)
(D...disease)
(19...the year 2019)
(Previously “D” was thought to be meant for “December”, till WHO defined it as “disease”.)

Two earlier coronavirus epidemics occurred in the recent past:
1. Severe Acute Respiratory Syndrome (SARS) happened in the year 2003, in China. It was limited to a particular area
2. Middle East Respiratory Syndrome (MERS), confined to the southeastern Arabian Peninsula, was believed to have been spread by camels in 2012-13 and was effectively controlled.

The last severe pandemic, which occurred during 1918-20, called Spanish flu, was caused by the H1N1 virus. It resulted in more than 50 million deaths worldwide. During Spanish flu, masks, quarantine, and other precautionary measures were enforced, which contributed to controlling its spread until it ended in about two years.

Seasonal flu still remains with us, killing more than 500,000 every year.

Before the Spanish flu and ongoing even now seven major pandemics occurred due to “cholera” killing millions.

Seven cholera pandemics have occurred in the past 200 years. First one was reported from India in 1817 others being.

1991-94 in South America and recently in 2016-21 in Yemen.

Seventh pandemic started in South Asia in 1961 and spread to Africa and Americas in 1971.

Till now as of last year (2020),about 59 years later, the pandemic is still going on and infects about 3-5 millions/year. Currently about three million get infected and about one third die per year.

Cholera is caused by a bacteria resulting in fever, severe diarrhea, and vomiting causing severe dehydration and the release of poisonous substances (toxins) into the body tissues of the patient leading to their death within hours or days if not treated properly. It was controlled after the causative organism was isolated and successfully treated with antibiotics, replacement of body fluids, and observing proper hygiene. Cholera is still present and often causes sporadic cases in endemic areas.

Smallpox pandemic, 1520.

Caused by a virus (variola minor), spread by droplets from mouth and nose and sores, and manifested itself in sores on the body, leaving permanent facial scars on those who survived. One-third of the infected patients died. The smallpox pandemic killed more than 300 million in the 20th century. It remained with us till the late sixties. It is now extinct because of massive inoculations.

Plague pandemic 541AD and “Black Death” pandemic in 1346-1353, which was caused by a bacteria(Yersinia pestis), rats and fleas were responsible for its spread, ships harboring infected rats were the main source, since in those days it was the main source of travel and goods transport, spreading the disease wherever they docked.

The disease caused flu-like symptoms, high fever, running nose, and swellings (called buboes)on the body. The plague is still around and is being treated with antibiotics. It caused about 2000 million deaths to date, but few die today because of available treatment.

Other worth mentioning diseases affecting the human race are:

  1. Hong kong flu of 1968. It killed over one million, and is still with us as “seasonal flu”. A version of H1N1, which infected more than one-fourth of the world population in 2009. It still might exist in a mild form.
  2. HIV/AIDS,(probable source African monkeys), starting from Africa in 1981 is still with us, though now only thousands die in contrast to millions, because of awareness and treatment options.

Nobody knows how long the present Pandemic will keep on killing people around the world, but vaccination, observing precautionary measures, and herd immunity will eventually end it, hopefully by the end of this year.

Please do not listen to conspiracy theories about covid-19, it is a reality, it is dangerous, and it can kill you and your loved ones. Therefore, vaccinate yourself and encourage people around you to do it.

An important lesson learned from this devastating pandemic is “save for the rainy days”, it might be a tired cliche’ but is true. therefore we must” save for the pandemic days”, Medical costs may be very high.

*Dr. Munawar Aziz. MCPS
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