A Timeline of Pandemics

A Timeline of Pandemics

How pathogens have shaped our history

Our earliest ancestors experienced communicable disease, but prior to the development of communities, disease spread was limited. As cities developed and trade routes connected them, the capacity for disease spread increased dramatically, creating epidemics and pandemics. Here we explore numerous pandemics that have occurred throughout history, up to the most recent pandemic declared on March 11, 2020: SARS-CoV-2 (COVID-19).

430 BC: The Plague of Athens

A plague struck Athens in 430 BC while it was under siege by Sparta during the Peloponnesian War.

Pathogen: Salmonella enterica serovar Typhi
 Outcome: 75,000 to 100,000 deaths

165: The Antonine Plague (Plague of Galen)

The plague began during the reign of Marcus Aurelius and continued under the rule of his son Commodus. It was described by the physician Galen.

Pathogen: unconfirmed, smallpox (variola virus) or measles (Rubeola virus) suspected
Outcome: mortality rate of approximately 25 percent

249: Cyprian Plague

Bishop St. Cyprian documented the suffering, and claimed the plague signified the end of the world.

Pathogen: unconfirmed, smallpox (variola virus) or measles (Rubeola virus) suspected
Outcome: over 5,000 deaths per day in Rome

541: The Justinianic Plague

The first of three plague pandemics. Bubonic plague is a virulent disease that is transmitted by flea bites, and by person-to-person transmission when it is in its pneumonic form. New research is beginning to challenge current assumptions and suggests the Justinianic Plague’s high mortality rate may be exaggerated.  

Pathogen: Yersinia pestis
Outcome: between 15 and 100 million deaths

1347: Black Death

The second plague pandemic. It decimated Kipchak khan Janibeg’s army in the Genoese trading port, Kaffa, and spread via Genoese ships to Mediterranean ports. 

Pathogen: Yersinia pestis
Outcome: 25 million deaths in Europe

1520: Smallpox

Arrived in Mexico when Spanish forces landed in what is now Veracruz. It began to spread when Spanish troops entered the capital of the Aztec Empire (Tenochtitlán).

Pathogen: smallpox (variola virus)
Outcome: 50,000 to 300,000 deaths

1665: The Great Plague of London

The plague continued to create small epidemics, and in 1665, a major outbreak occurred in Europe and England.

Pathogen: Yersinia pestis
Outcome: over 100,000 deaths (68,596 recorded) in London, England

1817: The First Cholera Pandemic

The first cholera pandemic originated in the Ganges River in India, and disease broke out near Calcutta before spreading to other parts of the world. The seventh cholera pandemic occurred in 1961, beginning in Indonesia and spreading to other countries in Asia, Europe, Africa, and Latin America.

Pathogen: Vibrio cholerae
Outcome: 10,000 recorded deaths among British troops suggest hundreds of thousands of deaths across India

1855: Third Plague Pandemic

The plague re-emerged in the Chinese province of Yunnan in 1855. It continued to spread, reaching Hong Kong in 1894 and Bombay in 1896. By 1900 it reached every continent, and finally ended in 1959.

Pathogen: Yersinia pestis
Outcome: over 15 million deaths

1875: Measles in the Fiji Islands

Measles has a high mortality rate when introduced to isolated populations. In 1847, Fiji signed an article of cession to the British Empire. As part of the process, the most senior chief Cakobau visited Sydney, Australia, where he contracted measles. One of his sons also became ill on the return voyage. Upon their return, all high chiefs of Fiji attended a meeting and subsequently spread the measles virus throughout Fiji.

Pathogen: measles
Outcome: over 40,000 deaths

1889: The Russian Flu

The influenza pandemic first peaked in St. Petersburg, Russia, and only 70 days later, peaked in the United States. The rapid spread has been attributed to the vast railway networks throughout Europe and more rapid transatlantic boat travel. 

Pathogen: influenza, possibly H3N8
Outcome: over 1 million deaths

1918: Influenza

The 1918 influenza pandemic was the most severe in recent history. It was first identified in military personnel in the United States in the spring of 1918 and spread worldwide. A unique feature was its high mortality rate in young, healthy people. 

Pathogen: H1N1 virus with genes of avian origin 

Outcome: 50 million deaths worldwide

1957: Asian Flu

First identified in East Asia, subsequently spreading to countries around the world. It is considered the least severe of the three influenza pandemics of the 20th century.

Pathogen: influenza A subtype H2N2
Outcome: 1-2 million deaths worldwide

1968: Hong Kong flu

The third influenza pandemic of the 20th century, believed to have evolved from the 1957 Asian flu virus (influenza A subtype H2N2) via antigenic shift. Those exposed to the 1957 virus demonstrated immunity to the new virus, as H3N2 retained the neuraminidase antigen N2.

Pathogen: influenza A subtype H3N2
Outcome: 1-4 million deaths

1981: HIV/AIDS

Acquired Immune Deficiency Syndrome (AIDS) was first recognized in 1981. It is one of the most devastating infectious diseases, with developing countries suffering the greatest morbidity and mortality.

Pathogen: human immunodeficiency virus type 1 (HIV-1) retrovirus
Outcome: more than 25 million deaths worldwide

2002: SARS

Severe Acute Respiratory Syndrome (SARS) is thought to have spread from an animal reservoir, possibly bats, to civet cats, and first infected humans in Guangdong province in China in 2002. Most cases of human-to-human transmission occurred in the health care setting. 

Pathogen: SARS coronavirus (SARS-CoV)
Outcome: 774 deaths

2009: Swine Flu

The novel influenza virus was first detected in the United States, spreading quickly to the rest of the world. The virus was different from other H1N1 viruses circulating, as few young people had existing immunity, while many people over 60 years of age had antibodies. It is estimated that 80 percent of deaths occurred among patients under 65 years of age.

Pathogen: various strains of swine influenza virus (SIV)

Outcome: between 151,700 and 575,400 deaths worldwide (12,469 in the United States) 

2019: COVID-19

On December 31, 2019, the WHO China Country Office was informed of pneumonia of unknown cause, detected in the city of Wuhan in Hubei province. The disease was determined to be the result of a novel coronavirus, later named COVID-19. On March 11, 2020, the WHO declared COVID-19 a pandemic.

Pathogen: SARS coronavirus 2 (SARS-CoV-2)
 Outcome: 8,272 deaths globally, as of March 18, 2020