Throughout the 2023-24 school year, I have been sharing my love of diseases and pandemics1 with a group of high schoolers, who come to campus for an enrichment program. It occurred to me while teaching these high schoolers about measles, syphilis, Hep A, HIV/AIDS, and more that they have lived through (and had their worlds turned upside-down) by a host of pandemics.
The current group of high schoolers has experienced so many pandemics in their short lives.
Since 2006 (when current high school seniors were born), there have been 9 different pandemics. The most seen in a generation. EVER.
I made this realization (coincidentally?!?) in the midst of Taylor Swift’s Eras Tour. When you put pandemics together with Taylor Swift, you get (obviously) Pandemics: The Eras Tour.
Are you ready for it…?
The first recorded pandemic spread across Africa and then into Athens in 430 BCE during the Peloponnesian War (Athens vs. Sparta). As the Spartans marched toward Athens, many Athenians fled to the city of Athens for protection. The city quickly became overcrowded and disease spread with ease. According to the Athenian general and historian, Thucydides, the disease that killed ~25% of Athenians caused a pustular rash (aka skin lesions), high fever, and diarrhea. It is suspected that either typhus or smallpox was the cause of this first pandemic.
The next recorded pandemic — the Antonine Plague — took place in 165 CE (nearly 600 years later). An outbreak of (what we think was) smallpox began in Mesopotamia and then spread to the Roman Empire (the Huns infected the Germans and the Germans infected the Romans). It is believed that 5 million people died during this pandemic; approximately one-third of the population in the affected areas.
Nearly 400 years later, the Justinian Plague occurred (541 CE). The Justinian Plague was the first reported global spread of bubonic plague. The disease first appeared in Egypt and then spread through Palestine, the Byzantine Empire, and the Mediterranean region.
Five hundred years later (in the 11th century), in the Middle Ages, leprosy grew into a pandemic that spread across Europe.
In 1350 — the Black Death, clinically bubonic plague, spread from Asia to Europe killing one-third of the world’s population. Plague is spread when humans are bitten by infected fleas carried by rats, guinea pigs, or prairie dogs. Transcontinental trade and travel combined with crowded, unsanitary cities allowed plague to spread out of control in the 1300s. NOTE: we shouldn’t blame the rats for spreading plague during the Middle Ages. Read this.
Nearly 500 years later (1817) the First (of seven) Cholera Pandemic began. The first wave of infection originated in Russia, where millions of people died. British soldiers transmitted the disease (which is spread through feces-infected water and food) globally. Millions of individuals in India died of cholera as did 150,000 in America.
While flu, cholera, measles, smallpox, and plague continued to spread throughout the world in the 1800s, the next big pandemic didn’t occur until 1918 — an avian influenza (H1N1) that killed more than 50 million people worldwide.
My grandmother was born in 1917. She was not sick with flu in 1918, but she did live through the pandemic. Both of her parents survived the pandemic, too.
My grandmother did not experience another pandemic until 1957 — another flu pandemic. This time caused by H2N2, another avian influenza. The outbreak began in Hong Kong and quickly spread to China, the United States, and England. Millions died.
This flu pandemic was my father’s first pandemic.
He wouldn’t see another pandemic (his second; my grandmother’s third) until after I was born — 1981: HIV/AIDS.
I have countless childhood memories of HIV — news articles and made-for-TV movies about Ryan White. The popular TV show Life Goes On introduced an HIV+ character, bringing the reality of the disease into our living rooms each week. There was also the epic AIDS quilt that was displayed on The Mall in Washington DC.
I wouldn’t experience another pandemic until 2002 (21 years later) when the SARS pandemic started in Hong Kong and made its way around the globe.
By the time I turned 30 — I had lived through two pandemics. That same year, my grandmother turned 90. And she had experienced just four pandemics.
My daughter — a current high school sophomore — was born in 2008. News of the 2009 H1N1 flu pandemic started to spread about a month before her first birthday (in September 2009).
It was the first flu outbreak of the 21st century. And many of us in public health were thinking — it’s been a long time coming…
H1N1 came and went in 2009.
But it was followed by MERS (2012), Ebola (2014), Zika (2015), loneliness (2017), COVID (2020), an infodemic (2021), mpox (2022), and measles (2024).
We are living through an unprecedented PANDEMIC ERA.
Over the next nine weeks, we are going to explore each of these pandemics (the eras) to understand why so many pandemics have occurred in such a short period of time. And what we need to do collectively to rewrite history before it happens to prevent future pandemics from occurring.
Be sure you are subscribed so you do not miss a single era/pandemic.
And be sure to share this post with your friends & family, especially those who are Taylor Swift fans (because there will be song quotes, eras references, and so much more — public health and Taylor Swift go together all too well).
Are you ready for it…?
Epi(demiology) Matters is written by Dr. Becky Dawson, PhD MPH — an epidemiologist, teacher, mom, wife, and dedicated yogi. She is a tenured professor at Allegheny College, Research Director at a community hospital, and an exclusive contributor (all things health & medicine) at Erie News Now (NBC/CBS). Her goal is to create healthy communities for all. She writes Epi Matters — first & foremost because epidemiology does matter (to all of us) and she hopes that each post will help to educate and empower readers to be healthy and create healthy communities.
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What I was reading on May 22, 2019… premonition? foreshadowing? preparation?