Epidemics of the world

Dr Shivani Vakilwala

Dr. D.Y. Patil Medical College, Navi Mumbai.

Epidemics have their existence since the pre 1500’s. With epidemics being in existence
since such a long time, it has truly been a survival of the fittest.
Let us first understand what is an epidemic?
It is an occurrence of a disease in a community in a particular period in excess of the
expected occurrence.
Let us go back in history and view the top 10 deadliest epidemics that have taken several
lives and have affected many-

Disease	Area where it first occurred.	Year of first epidemic or most famous.	Lives taken	Causative organism.
1.Tuberculosis	Europe	19^TH century	One quarter of Europe.	Mycobacterium tuberculosis.
2.Spanish Flu	Spread from country to country due to World War 1.	1918	50 TO 100 million.	Haemophilus influenza.
3. The Black Death Known as Bubonic Plague	Asia and Europe	14^th century	–	Epidemic strain is still being debated today.
4. Yellow Fever	United States Philadelphia	1793	4000 people in a span of 4 months.	Flavivirus.
5. Smallpox	America and Europe.	1500s	90 million.	Variola virus.
6. Cholera	India	–	–	Vibrio cholera.
7. Malaria	Sub Saharan Africa	4000 years ago.	350 to 500 million each year cases diagnosed each year.	Plasmodium species.
8. AIDS	San Francisco	1980	25 million people since 1980	Human Immunodefi -ciency virus
9. Epidemic Typhus/ Camp Fever	Europe	1600s	10 million	Rickettsia prowazekii.
10. Polio	United States	Peak outbreak – 1952	57,628	Polio virus member of Picornaviridae.

This was a trail through of the history of epidemics, now let us see the present scenario.
Even after such astonishing advancements and wonderful discoveries in medicine the horror
of an epidemic has not left us.
Let us take a tour to countries which have recently become “famous” for the increasing
number of lives taken due to those tiny but ferocious agents that have caused epidemics in
these countries.
These are your tiny monsters in disguise, unseen by the naked eye but the aftermath that
they cause are heart wrenching to witness.
Let us first see the “Famous Five” of the recent epidemics –
UNITED STATES HIT HARD BY HEPATITIS A –
Since September 2017, San Diego, California has been suffering from one of the biggest
hepatitis A outbreak. Majority of those who contracted the disease are either homeless or
illicit drug users.

MADAGASCAR WAS INVADED BY BY “THE BLACK DEATH”
Since August 2017 there is an outbreak of plague which has been termed to be the worst
outbreak in 50 years.

MARADOL PAPAYAS CAUSING SALMONELLA INFECTIONS
An outbreak of Salmonella occurs in 23 US states. It was caused by 5 different strains of
Salmonella.

MARBURG VIRUS POPPED UP IN UGANDA-
Marburg Haemorrhagic Fever is a rare zoonotic disease which is caused by interaction with
African fruit bats. There are no vaccines available currently for this virus.

BANGLADESH WAS HIT BY DIPHTHERIA-
Bangladesh has been struggling with this outbreak as it has spread among the Rohingya
refugees in Cox’s Bazaar.

This list though never ending, there are certain epidemics which have cropped up again at
several intervals these include –

EBOLA VIRUS – re emerging each time in the Democratic Republic of Congo .
The reason for its reappearance is that it occurs in Bokoro – a market town which is an area
where people connect, trade and travel.
It is caused by fruit bats but it is also caused by close contact with blood, organs, or other
bodily fluids of other infected animals.
There are five strains of the virus that has been identified, the deadliest being the Zaire
strain, for which there is a vaccine ready for emergency use.

MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS (MERS-CoV) – in the
United Arab Emirates

These were about the epidemics all over the world, now let us come to our very own “Mother
India” and see what has affected our beautiful land in the recent times.
2014 – Jaundice outbreak in Odisha, which primarily included Hepatitis E.
2015 – Indian Swine flu caused by the Influenza A virus subtype H1N1.
2017 – Japanese Encephalitis outbreak which occurred in Gorakhpur.

The latest entrant in this ghastly list of epidemics is the NIPAH virus. The month of May had
witnessed the news channels and the news papers being flooded with news of NIPAH virus
taking lives. So here are certain things one needs to know about this new entrant to the
family of epidemics –
AREA AFFECTED – Kozhikode, Kerala.
LIVES TAKEN – 10 till May 2018. The latest victim was nurse Lini who contracted the virus after
she attended the youth from Changorath who was suffering from the same disease.
TRANSMISSION – humans contract the virus via animals usually by eating fruits previously
bitten by fruit bats and also via body fluids.

SYMPTOMS – Fever, headache, dizziness, vomiting
WHAT IT LEADS TO – acute respiratory discomfort and fatal inflammation of the brain.

Image source (https://www.news18.com/news/india/two-suspected-cases-of-nipah-virus-reported-from-karnataka-1757177.html)

As said by Tom Friedman (MD, MPH and President and CEO of RESOLVE) “We know there will be an pandemic, we do not know where it will come from, what pathogen will it be, but it will happen and shame on us if we are not better prepared than we are today.”

Thus here are a few steps that the government needs to focus on –

Implement and strengthen disease tracking systems – this can be done by specially training epidemiologists to track and investigate diseases and outbreaks.
Supporting laboratory networks and joining hands so as to detect agents promptly.
Increasing government funds to provide better healthcare to all.

At an individual level few steps that we can take to protect ourselves from these vicious agents are-

Most importantly – HAND WASHING
Stay at home if signs of any flu, so as to prevent spread to others. Remember children and elderly are extremely susceptible.
Do not share personal items.
Do not eat fruits or other items which appear bitten or stale.
Keep your immediate surroundings clean.
And last but not the least – TRAVEL WISELY.