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Volume 27 Number 4

What is a Virus?

What is a pandemic?

Why do we care?

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

There are currently a lot of concerns about infectious disease and the risk of another worldwide pandemic. This is being driven by the current Ebola scare. Over the course of human history, there have been many pandemics that did have a major impact on human populations and history itself.

In our most recent history, there was and still is, the Human Immunodeficiency Virus (HIV) pandemic. When HIV was first described in the mid 1980’s, there was a great outcry that it was the next great pandemic. Experts at the time estimated that it would kill upwards to 20% of the world population in 10 years and a much higher percentage in developing nations. HIV never became as serious as estimated because of dedication to good research, medical science, and excellent education. Today HIV remains a very serious illness, but it is very well understood, and excellent antiviral medications have been developed. As a result, it is under good control, at least in developed nations.

The last major, true worldwide pandemic was the Spanish Flu Pandemic in 1918.

From 1918-1919 the Spanish Flu raced around the globe, the worst influenza pandemic to date. Caused by an H1N1 flu virus, it was responsible for more than 500,000 U.S. deaths, as compared to 50,000 US servicemen who died in WWWI the previous two years. The worldwide death estimates range from 20 million to 100 million.

This Spanish Flu pandemic occurred before the invention of antibiotics. Antibiotics are essential in treating the secondary bacterial infections that often kill flu-weakened patients. So, that number would most likely be much lower today with the use of antibiotics to treat the potentially life-threatening secondary respiratory infections and pneumonias.


Major Worldwide Pandemics: (only the largest pandemics are noted.)

Date                        Number of Deaths and Location                                    Cause

165-180                  30% of Europe, Asia, and North Africa                               Smallpox

541-542                  40% of the European population                                          Bubonic plague

1346-1350              30%-70% of the European population                                Plague

1629-1631              280,000 deaths worldwide                                                    Plague

1665-1666              100,000 deaths in England,(Great Plague of London)    Plague

1816-1826              >100,000 deaths in Europe and Asia                                   Cholera #1 epidemic

1829-1851              >100,000 – Asia, Europe, and North America                   Cholera #2 epidemic

1852-1860              1,000,000 deaths in Russia                                                   Cholera #3 epidemic

1875                         40,000 deaths in Fiji                                                               measles

1889-1890             1,000,000 deaths world from influenza                              influenza

1899-1923              >800,000 Europe, Asia, Africa                                             Cholera #6 epidemic

1918-1920              75,000,000 deaths worldwide – the Spanish flu               influenza

1957-1958              2,000,000 deaths worldwide – the Asian flu                      influenza

1968-1969              1,000,000 deaths worldwide – the Hong Kong flu           influenza

1960 – now            >30,000,000 deaths from HIV/AIDS pandemic             HIV/AIDS

2009-2010             14,286 deaths from viral influenza                                      influenza

2013-2014            6,000+ deaths from Ebola virus                                    Ebola virus


In regard to pandemics, smallpox is no longer a threat, declared eliminated as of 1974 through the efforts of worldwide vaccination programs. A similar program is currently being undertaken by Rotary International in an attempt to eliminate the poliovirus as well.

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ISSN-1059-6518 Volume 27 Number 3

By Frank Hubbell, DO

What is Ebola Virus Disease?

Ebola virus disease (EVD), also known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans caused by the Ebola Virus.

The mortality rate is about 90%.

The virus is transmitted to people from wild animals by the body fluids and organs of infected animals. This occurs from hunting the animals, butchering them, and consuming them.

In Africa, EVD has been spread by infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines that were either hunted or found dead in the rainforest. It is probable that if the meat had been cooked thoroughly, the virus would have been killed.

Once in the human population, the virus is contagious and can spread via human-to-human transmission through contact with body fluids.

It is stated by the researchers that the Ebola virus cannot be spread airborne, but I humbly disagree. If the virus is in body fluids, when the patient coughs, the virus is going to be expelled and potentially spread by the airborne droplets. The point being, you have to protect your airway as well as using all BSI when working with any patients with a potentially contagious disease.

Currently the EVD outbreaks have occurred in remote villages in Central and West Africa: Sierra Leone, Nigeria, Guinea, and Liberia.

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