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In some areas the toes of pahoehoe flows can pick up pieces of scoria and other pieces of basalt that cover the ground that it is flowing across, and via a "reverse caterpillar motion" place these pieces on top of flow itself. This results in a phenonenon called "reverse stratigraphy " with older rock ending up above the younger rock. Such activity is localized. But in these limited areas, pre existing loose basaltic material ends up on top of flow instead of underneath. The black pieces in this photo lie on top of a pahoehoe toe and are the results of such a process. This photo was taken in pahoehoe flows near the current end of Chain of Craters Road.

Some localized rain squalls are seen in the Takhini River Valley just north west of Whitehorse in Southern Yukon. A beautiful spring day!

This bridge is localized in Santos, it makes a connection between the continent and Ilha das Palmas, Palm Island I believe be in English.

In this island is situated The Club of fishery of Santos .

I don't know say if this bridge is still used for persons or no ..I taken this shot when I was in schooner other day ..

 

www.clubedepescadesantos.com.br/historico.asp#ilha

 

This is localized nearby of Port of Santos . I was there too ..very cool !!

 

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Seems my problems with my account finished .. I'm Pro again !

Thanks for all support that i received on these days !

Thanks Flickr to restored my account !

 

Your comments and visit are well appreciated !! Thanks !

 

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This Japanese garden is localized in the Ibirapuera Park. This place is a tribute to the friendship between Brazil and Japan .

It's a private place , where you need to pay to enter .

This place is very tranquil and silent too.

Looks like you are in another place in the world.

I have several pics of this place .

I'll posting a little by little..

I wish a wonderful week to all of you !

Sorry for not commenting a lot lately.

I'm very busy with work and now I'm wanting to learn more about studio lighting.

Thank you all ! ; )

 

If you want ... View On Black ...thanks !

Shy but really sweet birds! When they have seen us, they have kept a very low profile, just sitting or moving very slow. I think they were thinking they were very well camouflaged and maybe we weren't seeing them :)))

Endemic birds and very uncommon and localized.

 

Kruger National Park - South Africa

Lr 5 allows for localized exposures with feathering control. You can suggest painterly light with it which is particularly handy for landscapes.

The effects of Cyclone Debbie are being felt in Brisbane today.

 

Forecast: Becoming windy with thunderstorms likely. A few could contain very heavy rain, especially this afternoon. High near 25C. Winds NE at 30 to 50 km/h. Chance of rain 100%. 80 to 150mm of rain expected. (Over 200mm so far!) Localized flooding is expected.

 

I went into the city to go to my U3A class, only to find one other person as silly as myself outside the door with a 'classes cancelled' notice. Mind you, despite having an umbrella, my shoes and back were soaked so I was going to return home anyway. Everything seemed to be shutting down and public transport became free.

 

This was my view through the windscreen at the street lights while driving home from the train station.

 

Our Daily Challenge - Abstract

Scavenge Challenge - Own choice: "Keeping it simple"- well, sort of simple.

Nice to see again. Rose chafers can be found in southern and central Europe and in the southern part of the United Kingdom, where they sometimes seem to be very localized

Another Cargojet aircraft kicked up a snowstorm while leaving the cargo ramp for the deice bay, leaving its sibling sitting in a small snowstorm.

Rally: 7. Rajdowe Kryterium Ustronia 2023

Date: 26.08.2023

Localization: Poland, Ustroń

Driver: Hubert Laskowski

Car: Ford Fiesta Rally3

Class: Gość

Snow Geese (Anser Caerulescens), near Socorro, New Mexico. Very localized, but abundant where they occur, Snow Geese typically are seen in large numbers or not at all. Included under this heading is the "Blue Goose," long considered a separate species, now known to be only a color morph of the smaller race of Snow (Lesser Snow Goose). The two color forms mate with each other, and may produce young of either or both colors. A larger race, Greater Snow Goose, nests in far eastern regions of Canada and winters on the Atlantic Coast.

Moon at night

Date: 15.06.2019

Localization: Poland, Sławilów

Description: Ruins of the Palace in Slawików.

The localized filter is tested in this picture. Sorry for the imperfection.

Very localized rainfall in Tucson. Arizona

"Do Not Disturb" tag on hotel door. Invermere, British Columbia, Canada.

These perennials are endemic to Hawaiʻi, occurring only on the islands of Maui and Hawaiʻi in an extremely localized distribution. They are primarily found above 1,500 m (4,900 ft) in elevation in alpine deserts or bogs, indicating an adaptation to low-nutrient soils. The Kaʻū or Mauna Loa Silversword (A. kauense) is the most adaptable: it can be found in rocky lava flows, bogs, and open forest.(Wikipedia)

The great egret (Ardea alba), also known as the common egret, large egret or (in the Old World) great white heron, is a large, widely distributed egret. Distributed across most of the tropical and warmer temperate regions of the world, in southern Europe it is rather localized. In North America it is more widely distributed, and it is ubiquitous across the Sun Belt of the United States and in the Neotropics. The Old World population is often referred to as the great white egret. This species is sometimes confused with the great white heron of the Caribbean, which is a white morph of the closely related great blue heron (A. herodias).

 

Source: Wikipedia

Landings on 28L/R.

 

Actually I have no idea how the pilots get to the runway at SFO under these conditions. The plane trails are best seen at original size. Sort of an experiment, wasn't sure what I was going to get here. I don't think this is quite what I was hoping for, as the trails aren't nicely spread out or tightly overlapping.

 

San Mateo. Composite of about ten exposures.

© 2010 Servalpe. Photos are copyrighted. All rights reserved. Pictures can not be used without explicit permission by the creator.

 

Localization:

 

Santa María la Real de La Almudena is a Catholic cathedral in Madrid.

 

When the capital of Spain was transferred from Toledo to Madrid in 1561, the seat of the Church in Spain remained in Toledo; so the new capital – unusually for a Catholic country – had no cathedral. Plans were discussed as early as the 16th century to build a cathedral in Madrid dedicated to the Virgin of Almudena, but construction did not begin until 1879.

 

Francisco de Cubas, the Marquis of Cubas, designed and directed the construction in a Gothic revival style. Construction ceased completely during the Spanish Civil War, and the project was abandoned until 1950, when Fernando Chueca Goitia adapted the plans of de Cubas to a neoclassical exterior to match the grey and white façade of the Palacio Real, which stands directly opposite. The cathedral was not completed until 1993, when it was consecrated by Pope John Paul II. On May 22, 2004, the marriage of Felipe, Prince of Asturias to Letizia Ortiz Rocasolano (known thereafter as Letizia, Princess of Asturias) took place at the cathedral.

 

The Neo-Gothic interior is uniquely modern, with chapels and statues of contemporary artists, in heretogeneous styles, from historical revivals to "pop-art" decor.

 

The Neo-Romanesque crypt houses a 16th century image of the Virgen de la Almudena. Nearby along the Calle Mayor excavations have unearthed remains of Moorish and medieval city walls.

 

On the 28th of April 2004, Cardinal Antonio María Rouco Varela, Archbishop of Madrid blessed the new paintings in the apse, painted by Kiko Arguello, founder of the Neocatechumenal Way. The cathedral is the seat of the Patriarch of the Indies and the Ocean Sea, an honorific patriarchate created in the sixteenth century, and subsequently an honorific title for the Spanish court's chaplain.

 

Gear:

 

Canon EOS 450D + Sigma 10-20 mm + Mafrotto 055XPROB + 322RC2

 

HDR picture from 3 exposures: -2..0..+2:

 

Processing:

 

Lightroom for catalog > Photoshop to generate HDR file > Tonemapped at Photomatix > Topaz Adjust and Detail + Noiseware + Smart Sharpen treatment at PS.

 

Follow me on:

 

Twiter | Facebook

 

Localized and near-endemic

 

Etosha National Park

Namibia

A localized dust storm kicks up particles hundreds and hundreds of feet into the air in this view looking south towards Tucki Mountain with a snow packed Telescope Peak rising thousands of feet taller in the background. At the base of a broad alluvial fan behind the dust the off-white buildings of Stovepipe Wells at elevation -190 feet are dwarfed by the 6,726 ft Tucki just behind. Dust storms are not uncommon in the windy desert, though I have never been sure what it is that causes the dust to jump off the ground on some days compared to other terribly windy days. I suspect it has to do with the moisture content of the air, which on this day was a surprise with some scattered rain in places. I’d estimate the dust here is over 1,000 feet into the air as it blows towards the Mesquite Sand Dunes a little further south.

This is another image from the snow storm’s deposit the other day. That storm was localized to the city of Hamilton, Ontario, a fact we found out for ourselves as we drove into Hamilton. Consisting of large clusters of heavy, wet flakes, the snow covered and clung to every branch and created a storybook winter look to the area, although the conditions were such that about 90 minutes after this was shot, most had fallen to the ground. Here we see a pair of red Muskoka chairs (as we call them in Canada, although other countries/regions have their own label for similarly made chairs). The chairs are a left-over from a federal government (Parks Canada) sponsored project to place similar chairs (in a variety colours) across the country in tourist-frequented places as part of the 2017 Canada 150 celebrations. These chairs look over Cootes Paradise, a small, shallow lake located just west of Burlington Bay, itself at the Western end of Lake Ontario. Cootes Paradise is part of the Royal Botanical Gardens. Although you might think this is a selective colour image, it is, in fact, a full colour image. In case you were wondering. - JW

 

Date Taken: 2020-03-06

 

Tech Details:

 

Taken using a tripod-mounted Nikon D800 fitted with an AF-S Nikkor 24-120mm 1:4.0 lense set to 58mm, ISO100, Auto WB, Aperture Priority Mode, f/8.0, 1/160 sec. PP in free Open Source RAWTherapee from Nikon RAW/NEF source file: brighten the image overall by setting exposure compensation to EV+0.47, slightly boost contrast and Chromaticity in L-A-B mode, boost Vibrance slightly, enable Tone Mapping at default levels, enable Shadows/Highlights and recover both highlight and shadow details, sharpen (edges only), save PP in free Open Source GIMP:adjust contrast and brightness to get a more natural tonal range, use the Hue-Saturation-Brightness tool on the red channel only to brighten and boost the saturation of the red chairs, do some localized darkening of a light area at the base of the tree at the right side of the frame, sharpen, save, scale image to 6000px wide, sharpen, save, add fine black-and-white frame, add bar and text on left, save, scale image to 2048 px wide for posting online, sharpen very slightly, save.

Niagara Falls. Raincoats/ponchos always required

People love to say that photography is all about the light, but actually it's often the localized lack of light that creates the contrasts we are so drawn to. Taken together you could still call it "the light", but it's important to remember that when we talk about light in photography, we're often talking about contrast. Contrast is king when it comes to creating compelling images PS. If you love photography, it would mean the world if you checked out this amazing opportunity to grow your craft and do some good: geni.us/5DayDeal ift.tt/2dgIF5x - uploaded from ift.tt/Zaxgq2

Place: Guangzhou, Guangdong Province

 

Chinese name: 莲花L3 (liánhuā L3)

Year of launch: 2007 (localized from 2009)

 

In 2007 Youngman and Proton started selling the Gen-2 hatchback as Europestar RCR (Jingsu) 'engineered by Lotus' in China, later followed by the Persona sedan (Jingyue). They were brought in as a CKD, thus prices weren't competitive and sales were poor. Youngman paid $50 badge royalty for the 'Engineered by Lotus' stickers. From late 2009 a localized version entered the market, which sold in much better numbers thanks to much lower prices. Later models include the L5 hatchback, L5 sedan and the T6 crossover, which was never finalized. These models were all based on the Proton Gen-2/Persona platform, but had unique styling. On February 25 Proton made a deal with Goldstar for the production of cars and engines, which meant Proton terminated the relationship with Youngman and the production of all cars stopped in the Summer of 2016 and finally resulted in the end of Proton cars in China, since the deal with Goldstar has had no results so far. There was another problem with Youngman, because the China Association of Automobile Manufacturers apparently stopped reporting Youngman Lotus sales numbers because they were "way off" from registration numbers.

Motography trip August 2014 at Steptoe Butte in the Palouse area of Southeastern Washington. We rode to the top and spent about an hour watching the localized rain squalls roll by. The lighting wasn't very interesting at first, but as the clouds went by the sun came out in spots and provided some interesting lighting situations.

Afternoon broken clouds produce localized rain showers onto Georgia Strait with the Gulf Islands and Vancouver Island in the background. Freighters from around the globe are anchored facing into the prevailing wind in Vancouver's English Bay harbour awaiting their turn in port. _MG_7366 2014-04-04 www.anthonymaw.com

Instrument Landing System (ILS) antenna for runway 7R

 

Phoenix Sky Harbor International Airport (PHX / KPHX)

Phoenix, Arizona

 

Instrument Landing System (Wikipedia):

en.wikipedia.org/wiki/Instrument_landing_system

  

Last week, a very localized snowstorm dropped a layer of heavy, wet snow isolated to the city of Hamilton, Ontario and seemed to have missed any areas outside its limits. I took the opportunity to walk out to the Royal Botanical Gardens woods along the area around Princess Point on Cootes Paradise (a small, shallow lake at the Western end of Burlington Bay/Lake Ontario). The wet flakes had coated everything creating a spectacular winter scene. However, the fly in the ointment was that the temperature was just above freezing. By the time I got out, the trees were dropping snow faster than it was accumulating. This image was taken as I hiked out on the Princess Point Trail to a large open field with a line of trees separating it from the parking lot. The effect was like a pen and ink drawing or possibly even an oriental-inspired scene. BTW, the image is full colour, not black-and-white. About 90 minutes after this was taken, much of the snow on the trees had fallen off, thanks to the temperature and a light breeze. - JW

 

Date Taken: 2020-03-06

 

Tech Details:

 

Taken using a tripod-mounted Nikon D800 fitted with an AF Nikkor 70-210mm 1:4.0-5.6 lense set to 116mm, ISO100, Auto WB, Aperture Priority Mode, f/8.0, 1/125 sec. PP in free Open Source RAWTherapee from Nikon RAW/NEF source file: slightly brighten the image overall by setting exposure compensation to EV+0.18, enable Tone Mapping at default levels, slightly boost contrast in L-A-B mode, enable the Graduated Neutral Density/GND tool and rotate as well as shift it to cover and darken only the foreground snowy field, enable Shadows/Highlights and recover highlight details, sharpen (edges only), save, scale image to 6000px wide, sharpen, save, add fine black-and-white frame, add bar and text on left, save, scale image to 2048 px wide for posting online, sharpen very slightly, save.

A shaft of localized sunlight illuminates Freight Extra 315 as she emerges from the shadows of the Animas Canyon at MP 495.25, and crosses the river for a final time before entering Silverton. DRGW 315 is a C-18 Class Consolidation, built in 1895 by the Baldwin Locomotive Works for the Florence & Cripple Creek Railroad. Shortly after that railroad closed down in 1915, she was acquired by the D&RG, where she worked in various roles until 1949. She then spent 50 years alternating in roles ranging from movie prop to park engine before being restored to life by the Durango Railroad Historical Society. She now operates on special occasions, such as this appearance at "Railfest" 2010 on the Durango & Silverton Narrow Gauge Railroad.

© 2010 Servalpe. Photos are copyrighted. All rights reserved. Pictures can not be used without explicit permission by the creator.

 

Localization:

 

Picture taken at Barajas Airport (Madrid, Spain) Terminal 4.

 

Terminal 4 houses all Iberia flights and all Oneworld alliance member airlines including British Airways, American Airlines, LAN Airlines, among others. Terminals T1, T2, and T3 handle Air Europa and Spanair, as well as all member airlines of Skyteam and Star Alliance.

 

Terminal 4, designed by Antonio Lamela and Richard Rogers (winning team of the 2006 Stirling Prize), and TPS Engineers, (winning team of the 2006 IStructE Award for Commercial Structures) was built by Ferrovial and inaugurated on February 5, 2006.

 

Terminal 4 is one of the world's largest airport terminals in terms of area, with 760,000 square meters (8,180,572 square feet) in separate landside and airside structures. It consists of a main building, T4 (470,000 m²), and a satellite building, T4S (290,000 m²), which are approximately 2.5 km apart. The new Terminal 4 is meant to give passengers a stress-free start to their journey. This is managed through careful use of illumination, available by glass panes instead of walls and numerous domes in the roof which allow natural light to pass through. With the new addition, Barajas is designed to handle 70 million passengers annually.

 

During the construction of Terminal 4, two more runways (15L/33R and 18L/36R) were constructed to aid in the flow of air traffic arriving and departing from Barajas. These runways were officially inaugurated on February 5, 2006 (together with the terminals), but had already been used on several occasions beforehand to test flight and air traffic manoeuvres. Thus, Barajas came to have four runways: two on a north-south axis and parallel to each other (separated by 1.8 km) and two on a northwest-southeast axis (and separated by 2.5 km). This allowed simultaneous takeoffs and landings into the airport, allowing 120 operations an hour (one takeoff or landing every 30 seconds).

 

Exif Data:

 

Canon EOS 450D + Sigma 10-20 mm

 

HDR picture from 3 handheld exposures: -2..0..+2.

 

Processing:

 

Lightroom for catalog > Photoshop to generate HDR file > Tonemapped at Photomatix > Topaz Adjust and Detail + Noiseware + Smart Sharpen at PS.

 

The great egret (Ardea alba), also known as the common egret, large egret or (in the Old World) great white heron, is a large, widely distributed egret. Distributed across most of the tropical and warmer temperate regions of the world, in southern Europe it is rather localized.

 

The Old World population is often referred to as the great white egret. This species is sometimes confused with the great white heron of the Caribbean, which is a white morph of the closely related great blue heron.

 

The great egret is a large heron with all-white plumage. Standing up to 1 m (3.3 ft) tall, this species can measure 80 to 104 cm (31 to 41 in) in length and have a wingspan of 131 to 170 cm (52 to 67 in). Body mass can range from 700 to 1,500 g (1.5 to 3.3 lb), with an average of around 1,000 g (2.2 lb). It is thus only slightly smaller than the great blue or grey heron (A. cinerea).

 

Apart from size, the great egret can be distinguished from other white egrets by its yellow bill and black legs and feet, though the bill may become darker and the lower legs lighter in the breeding season. In breeding plumage, delicate ornamental feathers are borne on the back.

 

Males and females are identical in appearance; juveniles look like non-breeding adults. Differentiated from the intermediate egret (Mesophoyx intermedius) by the gape, which extends well beyond the back of the eye in case of the great egret, but ends just behind the eye in case of the intermediate egret.

 

It has a slow flight, with its neck retracted. This is characteristic of herons and bitterns, and distinguishes them from storks, cranes, ibises, and spoonbills, which extend their necks in flight.

 

The great egret is not normally a vocal bird; it gives a low hoarse croak when disturbed, and at breeding colonies, it often gives a loud croaking cuk cuk cuk and higher-pitched squawks.

 

This image was taken a least two hundred miles off the coast of Brazil in the Atlantic Ocean. There were a group of nine Great Egrets trying to land on the CMV Magellan which may have been on a migration route but only one of them managed to have a rest for about 30 minutes before it flew off too. As these birds cannot take off from water, if they did not find another ship to land on, they may have perished before reaching land.

Rally: 68. Rajd Wisły 2023

Competition: Historyczne Rajdowe Samochodowe Mistrzostwa Polski (HRSMP)

Date: 29.09.2023

Localization: Poland, Wisła

Stage: Partecznik (SS 2)

Driver: Artur Skrabalak

Co-driver: Dawid Potępa

Car: Volvo Amazon

Class: 1

No: 107

Final position: 1 (in class)

Localize the mask on the rocks. Use your imagination

The localizing of fools is common to most countries, and there are many other reputed imbecile centres in different countries. In the Netherlands it is (among others) the people of Kampen, were a "Kamper onion" is a name for spot and plague story in which the pretensions and stupidity of its residents are depicted.

 

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HIT THE 'L' KEY FOR A BETTER VIEW! Thanks for the favs and comments. Much Appreciated.

 

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All of my photographs are under copyright ©. None of these photographs may be reproduced and/or used in any way without my permission.

 

© VanveenJF Photography

Great Egret

 

The Great Egret (Ardea alba), also known as the Common Egret, Large Egret or (in the Old World) Great White Heron, is a large, widely distributed Egret. Distributed across most of the tropical and warmer temperate regions of the world, in southern Europe it is rather localized. In North America it is more widely distributed, and it is ubiquitous across the Sun Belt of the United States and in the Neotropics. The Old World population is often referred to as the Great White Egret. This species is sometimes confused with the Great White Heron of the Caribbean, which is a white morph of the closely related Great Blue Heron (A. herodias).

 

It is only slightly smaller than the Great Blue or Grey Herons. It has all white plumage. Apart from size, it can be distinguished from other white egrets by its yellow bill and black legs and feet. It also has a slow flight, with its neck retracted. This is characteristic of herons and bitterns, and distinguishes them from storks, cranes and spoonbills, which extend their necks.

 

For more info: en.wikipedia.org/wiki/Great_egret

  

Edwin B. Forsythe National Wildlife Refuge

 

The Edwin B. Forsythe National Wildlife Refuge is a United States National Wildlife Refuge located in southern New Jersey along the Atlantic coast north of Atlantic City, in Atlantic and Ocean counties. The refuge was created in 1984 out of two existing refuge parcels created to protect tidal wetland and shallow bay habitat for migratory water birds. The Barnegat Division (established in 1967) is located in Ocean County on the inland side of Barnegat Bay. The Brigantine Division (established in 1939) is located approximately 10 miles (16 km) north of Atlantic City along the south bank of the mouth of the Mullica River. The two divisions are separated by approximately 20 miles (32 km). The refuge is located along most active flight paths of the Atlantic Flyway, making it an important link in the network of national wildlife refuges administered nationwide by the U.S. Fish and Wildlife Service. Forsythe Refuge is a part of the Hudson River/New York Bight Ecosystem and The New Jersey Coastal Heritage Trail Route. The refuge is named for Edwin B. Forsythe, conservationist Congressman from New Jersey.

The 1918–20 "Spanish flu" influenza pandemic resulted in dramatic mortality worldwide.

A pandemic (from Greek πᾶν, pan, 'all' and δῆμος, demos, 'people') is an epidemic of disease that has spread across a large region, for instance multiple continents, or worldwide. A widespread endemic disease with a stable number of infected people is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu.

 

Throughout history, there have been a number of pandemics of diseases such as smallpox and tuberculosis. One of the most devastating pandemics was the Black Death (also known as The Plague), which killed an estimated 75–200 million people in the 14th century. Other notable pandemics include the 1918 influenza pandemic (Spanish flu) and the 2009 flu pandemic (H1N1). Current pandemics include HIV/AIDS and the 2019–20 coronavirus pandemic.

  

Contents

1Definition and stages

2Management

3Current pandemics

3.1HIV/AIDS

3.2Coronavirus disease 2019 (COVID-19)

4Notable outbreaks

4.1Cholera

4.2Influenza

4.3Typhus

4.4Smallpox

4.5Measles

4.6Tuberculosis

4.7Leprosy

4.8Malaria

4.9Yellow fever

5Concerns about future pandemics

5.1Antibiotic resistance

5.2Viral hemorrhagic fevers

5.3Coronaviruses

5.4Influenza

5.5Zika virus

6Economic consequences

7Biological warfare

8In popular culture

9See also

10Notes

11References

12Further reading

13External links

Definition and stages[edit]

 

The World Health Organization's former influenza pandemic alert phases—WHO no longer uses this old system of six phases

A pandemic is an epidemic occurring on a scale that crosses international boundaries, usually affecting people on a worldwide scale.[1] Pandemics can also occur in important agricultural organisms (livestock, crop plants, fish, tree species) or in other organisms.[citation needed] A disease or condition is not a pandemic merely because it is widespread or kills many people; it must also be infectious. For instance, cancer is responsible for many deaths but is not considered a pandemic because the disease is neither infectious nor contagious.[2]

 

The World Health Organization (WHO) previously applied a six-stage classification to describe the process by which a novel influenza virus moves from the first few infections in humans through to a pandemic. This starts with the virus mostly infecting animals, with a few cases where animals infect people, then moves through the stage where the virus begins to spread directly between people and ends with a pandemic when infections from the new virus have spread worldwide. In February 2020, a WHO spokesperson clarified that "there is no official category [for a pandemic]".[a][3]

 

In a virtual press conference in May 2009 on the influenza pandemic, Dr. Keiji Fukuda, Assistant Director-General ad interim for Health Security and Environment, WHO said "An easy way to think about pandemic ... is to say: a pandemic is a global outbreak. Then you might ask yourself: 'What is a global outbreak'? Global outbreak means that we see both spread of the agent ... and then we see disease activities in addition to the spread of the virus."[4]

 

In planning for a possible influenza pandemic, the WHO published a document on pandemic preparedness guidance in 1999, revised in 2005 and in February 2009, defining phases and appropriate actions for each phase in an aide-mémoire titled WHO pandemic phase descriptions and main actions by phase. The 2009 revision, including definitions of a pandemic and the phases leading to its declaration, were finalized in February 2009. The pandemic H1N1 2009 virus was neither on the horizon at that time nor mentioned in the document.[5][6] All versions of this document refer to influenza. The phases are defined by the spread of the disease; virulence and mortality are not mentioned in the current WHO definition, although these factors have previously been included.[7]

 

Management[edit]

See also: Mathematical modelling of infectious disease

 

The goals of community mitigation: (1) delay outbreak peak; (2) reduce peak burden on healthcare, known as flattening the curve; and (3) diminish overall cases and health impact.[8][9]

The basic strategies in the control of an outbreak are containment and mitigation. Containment may be undertaken in the early stages of the outbreak, including contact tracing and isolating infected individuals to stop the disease from spreading to the rest of the population, other public health interventions on infection control, and therapeutic countermeasures such as vaccinations which may be effective if available.[10] When it becomes apparent that it is no longer possible to contain the spread of the disease, it will then move on to the mitigation stage, when measures are taken to slow the spread of disease and mitigate its effects on the health care system and society. In reality, a combination of both containment and mitigation measures may be undertaken at the same time to control an outbreak.[11]

 

A key part of managing an infectious disease outbreak is trying to decrease the epidemic peak, known as flattening the epidemic curve.[8] This helps decrease the risk of health services being overwhelmed and providing more time for a vaccine and treatment to be developed.[8] Non-pharmaceutical interventions may be taken to manage the outbreak; for example in a flu pandemic, these actions may include personal preventive measures such as hand hygiene, wearing face-masks and self-quarantine; community measures aimed at social distancing such as closing schools and cancelling mass gathering events; community engagement to encourage acceptance and participation in such interventions; as well as environmental measures such as cleaning of surfaces.[9]

 

Another strategy, suppression, requires more extreme long-term non-pharmaceutical interventions so as to reverse the pandemic by reducing the basic reproduction number to less than 1. The suppression strategy, which include stringent population-wide social distancing, home isolation of cases and household quarantine, was undertaken by China during the 2019–20 coronavirus pandemic where entire cities were placed under lockdown, but such strategy carries with it considerable social and economic costs.[12]

 

Current pandemics[edit]

HIV/AIDS[edit]

Main article: AIDS pandemic

 

Estimated HIV/AIDS prevalence among young adults (15-49) by country as of 2008

HIV originated in Africa, and spread to the United States via Haiti between 1966 and 1972.[13] AIDS is currently a pandemic, with infection rates as high as 25% in southern and eastern Africa. In 2006, the HIV prevalence rate among pregnant women in South Africa was 29%.[14] Effective education about safer sexual practices and bloodborne infection precautions training have helped to slow down infection rates in several African countries sponsoring national education programs.[citation needed]

 

Coronavirus disease 2019 (COVID-19)[edit]

Main article: 2019–20 coronavirus pandemic

 

People queueing outside a Wuhan pharmacy to buy face masks and medical supplies

A new coronavirus was first identified in Wuhan, Hubei province, China, in late December 2019,[15] as causing a cluster of cases of an acute respiratory disease, referred to as coronavirus disease 2019 (COVID-19). According to media reports, more than 200 countries and territories have been affected, with major outbreaks in the United States, central China, Italy, Spain, and Iran.[16][17] On 11 March 2020, the World Health Organization characterized the spread of COVID-19 as a pandemic.[18][19] As of 3 April 2020, the number of SARS-CoV-2 infected persons reached one million, the death toll was 55,132 and the number of patients recovered was 225,335.[20]

 

Notable outbreaks[edit]

See also: List of epidemics, Columbian Exchange, and Globalization and disease

There have been a number of significant epidemics and pandemics recorded in human history, generally zoonoses such as influenza and tuberculosis, which came about with domestication of animals. There have been a number of particularly significant epidemics that deserve mention above the "mere" destruction of cities:

 

Plague of Athens, from 430 to 426 BCE. During the Peloponnesian War, typhoid fever killed a quarter of the Athenian troops, and a quarter of the population over four years. This disease fatally weakened the dominance of Athens, but the sheer virulence of the disease prevented its wider spread; i.e. it killed off its hosts at a rate faster than they could spread it. The exact cause of the plague was unknown for many years. In January 2006, researchers from the University of Athens analyzed teeth recovered from a mass grave underneath the city, and confirmed the presence of bacteria responsible for typhoid.[21]

 

Contemporary engraving of Marseille during the Great Plague of Marseille in 1720–1721

Antonine Plague, from 165 to 180 AD. Possibly smallpox brought to the Italian peninsula by soldiers returning from the Near East; it killed a quarter of those infected, and up to five million in all.[22] At the height of a second outbreak, the Plague of Cyprian (251–266), which may have been the same disease, 5,000 people a day were said to be dying in Rome.

Plague of Justinian, from 541 to 750, was the first recorded outbreak of the bubonic plague. It started in Egypt, and reached Constantinople the following spring, killing (according to the Byzantine chronicler Procopius) 10,000 a day at its height, and perhaps 40% of the city's inhabitants. The plague went on to eliminate a quarter to half the human population of the known world.[23][24] It caused Europe's population to drop by around 50% between 550 AD and 700 AD.[25]

Black Death, from 1331 to 1353. The total number of deaths worldwide is estimated at 75 to 200 million people.Black Death#cite ref-ABC/Reuters 1-1 Eight hundred years after the last outbreak, the plague returned to Europe. Starting in Asia, the disease reached Mediterranean and western Europe in 1348 (possibly from Italian merchants fleeing fighting in Crimea), and killed an estimated 20 to 30 million Europeans in six years;[26] a third of the total population,[27] and up to a half in the worst-affected urban areas.[28] It was the first of a cycle of European plague epidemics that continued until the 18th century.[29] There were more than 100 plague epidemics in Europe in this period.[30] The disease recurred in England every two to five years from 1361 to 1480.[31] By the 1370s, England's population was reduced by 50%.[32] The Great Plague of London of 1665–66 was the last major outbreak of the plague in England. The disease killed approximately 100,000 people, 20% of London's population.[33]

The third plague pandemic started in China in 1855, and spread to India, where 10 million people died.[34] During this pandemic, the United States saw its first outbreak: the San Francisco plague of 1900–1904.[35] Today, isolated cases of plague are still found in the western United States.[36]

Spanish flu, from 1918 to 1920. It infected 500 million people around the world,[37] including people on remote Pacific islands and in the Arctic, and resulted in the deaths of 50 to 100 million people.[37][38] Most influenza outbreaks disproportionately kill the very young and the very old, with higher survival rate for those in between, but the Spanish flu had an unusually high mortality rate for young adults.[39] Spanish flu killed more people than World War I did and it killed more people in 25 weeks than AIDS did in its first 25 years.[40][41] Mass troop movements and close quarters during World War I caused it to spread and mutate faster; the susceptibility of soldiers to Spanish flu might have been increased due to stress, malnourishment and chemical attacks.[42] Improved transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease.[43]

 

Aztecs dying of smallpox, Florentine Codex (compiled 1540–1585)

Encounters between European explorers and populations in the rest of the world often introduced local epidemics of extraordinary virulence. Disease killed part of the native population of the Canary Islands in the 16th century (Guanches). Half the native population of Hispaniola in 1518 was killed by smallpox. Smallpox also ravaged Mexico in the 1520s, killing 150,000 in Tenochtitlán alone, including the emperor, and Peru in the 1530s, aiding the European conquerors.[44] Measles killed a further two million Mexican natives in the 17th century. In 1618–1619, smallpox wiped out 90% of the Massachusetts Bay Native Americans.[45] During the 1770s, smallpox killed at least 30% of the Pacific Northwest Native Americans.[46] Smallpox epidemics in 1780–1782 and 1837–1838 brought devastation and drastic depopulation among the Plains Indians.[47] Some believe the death of up to 95% of the Native American population of the New World was caused by Old World diseases such as smallpox, measles, and influenza.[48] Over the centuries, the Europeans had developed high degrees of immunity to these diseases, while the indigenous peoples had no such immunity.[49]

 

Smallpox devastated the native population of Australia, killing around 50% of Indigenous Australians in the early years of British colonisation.[50] It also killed many New Zealand Māori.[51] As late as 1848–49, as many as 40,000 out of 150,000 Hawaiians are estimated to have died of measles, whooping cough and influenza. Introduced diseases, notably smallpox, nearly wiped out the native population of Easter Island.[52] Measles killed more than 40,000 Fijians, approximately one-third of the population, in 1875,[53] and in the early 21st century devastated the Andamanese population.[54] The Ainu population decreased drastically in the 19th century, due in large part to infectious diseases brought by Japanese settlers pouring into Hokkaido.[55]

 

Researchers concluded that syphilis was carried from the New World to Europe after Columbus' voyages. The findings suggested Europeans could have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions of Europe.[56] The disease was more frequently fatal than it is today. Syphilis was a major killer in Europe during the Renaissance.[57] Between 1602 and 1796, the Dutch East India Company sent almost a million Europeans to work in Asia. Ultimately, fewer than a third made their way back to Europe. The majority died of diseases.[58] Disease killed more British soldiers in India and South Africa than war.[59]

 

As early as 1803, the Spanish Crown organized a mission (the Balmis expedition) to transport the smallpox vaccine to the Spanish colonies, and establish mass vaccination programs there.[60] By 1832, the federal government of the United States established a smallpox vaccination program for Native Americans.[61] From the beginning of the 20th century onwards, the elimination or control of disease in tropical countries became a driving force for all colonial powers.[62] The sleeping sickness epidemic in Africa was arrested due to mobile teams systematically screening millions of people at risk.[63] In the 20th century, the world saw the biggest increase in its population in human history due to lessening of the mortality rate in many countries due to medical advances.[64] The world population has grown from 1.6 billion in 1900 to an estimated 6.8 billion in 2011.[65]

 

Cholera[edit]

Main article: Cholera outbreaks and pandemics

Since it became widespread in the 19th century, cholera has killed tens of millions of people.[66]

 

1817–1824 cholera pandemic. Previously restricted to the Indian subcontinent, the pandemic began in Bengal, then spread across India by 1820. 10,000 British troops and countless Indians died during this pandemic.[67] It extended as far as China, Indonesia (where more than 100,000 people succumbed on the island of Java alone) and the Caspian Sea before receding. Deaths in the Indian subcontinent between 1817 and 1860 are estimated to have exceeded 15 million persons. Another 23 million died between 1865 and 1917. Russian deaths during a similar period exceeded 2 million.[68]

1826–1837 cholera pandemic. Reached Russia (see Cholera Riots), Hungary (about 100,000 deaths) and Germany in 1831, London in 1832 (more than 55,000 persons died in the United Kingdom),[69] France, Canada (Ontario), and United States (New York City) in the same year,[70] and the Pacific coast of North America by 1834. It is believed that more than 150,000 Americans died of cholera between 1832 and 1849.[71]

1846–1860 cholera pandemic. Deeply affected Russia, with more than a million deaths. A two-year outbreak began in England and Wales in 1848 and claimed 52,000 lives.[72] Throughout Spain, cholera caused more than 236,000 deaths in 1854–55.[73] It claimed 200,000 lives in Mexico.[74]

1863–75 cholera pandemic. Spread mostly in Europe and Africa. At least 30,000 of the 90,000 Mecca pilgrims fell victim to the disease. Cholera claimed 90,000 lives in Russia in 1866.[75]

In 1866, there was an outbreak in North America. It killed some 50,000 Americans.[71]

1881–96 cholera pandemic. The 1883–1887 epidemic cost 250,000 lives in Europe and at least 50,000 in the Americas. Cholera claimed 267,890 lives in Russia (1892);[76] 120,000 in Spain;[77] 90,000 in Japan and 60,000 in Persia.

In 1892, cholera contaminated the water supply of Hamburg, and caused 8,606 deaths.[78]

1899–1923 cholera pandemic. Had little effect in Europe because of advances in public health, but Russia was badly affected again (more than 500,000 people dying of cholera during the first quarter of the 20th century).[79] The sixth pandemic killed more than 800,000 in India. The 1902–1904 cholera epidemic claimed more than 200,000 lives in the Philippines.[80]

1961–75 cholera pandemic. Began in Indonesia, called El Tor after the new biotype responsible for the pandemic, and reached Bangladesh in 1963, India in 1964, and the Soviet Union in 1966. Since then the pandemic has reached Africa, South America, and Central America.

Influenza[edit]

Main article: Influenza pandemic

 

Advice for travelers (in French and English) on the risks of epidemics abroad; posters from the Charles De Gaulle airport, Paris

The Greek physician Hippocrates, the "Father of Medicine", first described influenza in 412 BC.[81]

The first influenza pandemic was recorded in 1580, and since then, influenza pandemics occurred every 10 to 30 years.[82][83][84]

The 1889–1890 flu pandemic, also known as Russian Flu, was first reported in May 1889 in Bukhara, Uzbekistan. By October, it had reached Tomsk and the Caucasus. It rapidly spread west and hit North America in December 1889, South America in February–April 1890, India in February–March 1890, and Australia in March–April 1890. The H3N8 and H2N2 subtypes of the Influenza A virus have each been identified as possible causes. It had a very high attack and mortality rate, causing around a million fatalities.[85]

The "Spanish flu", 1918–1919. First identified early in March 1918 in U.S. troops training at Camp Funston, Kansas. By October 1918, it had spread to become a worldwide pandemic on all continents, and eventually infected about one-third of the world's population (or ≈500 million persons).[37] Unusually deadly and virulent, it ended almost as quickly as it began, vanishing completely within 18 months. Within six months, some 50 million people were dead;[37] some estimates put the total number of fatalities worldwide at over twice that number.[86] About 17 million died in India, 675,000 in the United States,[87] and 200,000 in the United Kingdom. The virus that caused Spanish flu was also implicated as a cause of encephalitis lethargica in children.[88] The virus was recently reconstructed by scientists at the CDC studying remains preserved by the Alaskan permafrost. The H1N1 virus has a small but crucial structure that is similar to the Spanish flu.[89]

The "Asian Flu", 1957–58. A H2N2 virus first identified in China in late February 1957. It caused about two million deaths globally.[90] The Asian flu spread to the United States by June 1957 and caused about 70,000 deaths in the U.S.

The "Hong Kong Flu", 1968–69. A H3N2 virus first detected in Hong Kong in early 1968, and spread to the United States later that year. This pandemic of 1968 and 1969 killed approximately one million people worldwide.[91] It caused about 34,000 deaths in the United States.

The "Swine Flu", 2009–10. An H1N1 virus first detected in Mexico in early 2009, and spread to the United States later that year. This pandemic was estimated to have killed around 284,000 people worldwide.[92][failed verification] It was estimated to have caused about 12,000 deaths in the United States alone.

Typhus[edit]

Typhus is sometimes called "camp fever" because of its pattern of flaring up in times of strife. (It is also known as "gaol fever" and "ship fever", for its habits of spreading wildly in cramped quarters, such as jails and ships.) Emerging during the Crusades, it had its first impact in Europe in 1489, in Spain. During fighting between the Christian Spaniards and the Muslims in Granada, the Spanish lost 3,000 to war casualties, and 20,000 to typhus. In 1528, the French lost 18,000 troops in Italy, and lost supremacy in Italy to the Spanish. In 1542, 30,000 soldiers died of typhus while fighting the Ottomans in the Balkans.

 

During the Thirty Years' War (1618–1648), about eight million Germans were killed by bubonic plague and typhus.[93] The disease also played a major role in the destruction of Napoleon's Grande Armée in Russia in 1812. During the retreat from Moscow, more French military personnel died of typhus than were killed by the Russians.[94] Of the 450,000 soldiers who crossed the Neman on 25 June 1812, fewer than 40,000 returned. More military personnel were killed from 1500–1914 by typhus than from military action.[95] In early 1813, Napoleon raised a new army of 500,000 to replace his Russian losses. In the campaign of that year, more than 219,000 of Napoleon's soldiers died of typhus.[96] Typhus played a major factor in the Irish Potato Famine. During World War I, typhus epidemics killed more than 150,000 in Serbia. There were about 25 million infections and 3 million deaths from epidemic typhus in Russia from 1918 to 1922.[96] Typhus also killed numerous prisoners in the Nazi concentration camps and Soviet prisoner of war camps during World War II. More than 3.5 million Soviet POWs died out of the 5.7 million in Nazi custody.[97]

 

Smallpox[edit]

 

A child with smallpox infection, c. 1908

Smallpox was a contagious disease caused by the variola virus. The disease killed an estimated 400,000 Europeans per year during the closing years of the 18th century.[98] During the 20th century, it is estimated that smallpox was responsible for 300–500 million deaths.[99][100] As recently as the early 1950s, an estimated 50 million cases of smallpox occurred in the world each year.[101] After successful vaccination campaigns throughout the 19th and 20th centuries, the WHO certified the eradication of smallpox in December 1979. To this day, smallpox is the only human infectious disease to have been completely eradicated,[102] and one of two infectious viruses ever to be eradicated along with rinderpest.[103]

 

Measles[edit]

Historically, measles was prevalent throughout the world, as it is highly contagious. According to the U.S. National Immunization Program, 90% of people were infected with measles by age 15. Before the vaccine was introduced in 1963, there were an estimated three to four million cases in the U.S. each year.[104] Measles killed around 200 million people worldwide over the last 150 years.[105] In 2000 alone, measles killed some 777,000 worldwide out of 40 million cases globally.[106]

 

Measles is an endemic disease, meaning it has been continually present in a community, and many people develop resistance. In populations that have not been exposed to measles, exposure to a new disease can be devastating. In 1529, a measles outbreak in Cuba killed two-thirds of the natives who had previously survived smallpox.[107] The disease had ravaged Mexico, Central America, and the Inca civilization.[108]

 

Tuberculosis[edit]

 

In 2007, the prevalence of TB per 100,000 people was highest in Sub-Saharan Africa, and was also relatively high in Asian countries like India.

One-quarter of the world's current population has been infected with Mycobacterium tuberculosis, and new infections occur at a rate of one per second.[109] About 5–10% of these latent infections will eventually progress to active disease, which, if left untreated, kills more than half its victims. Annually, eight million people become ill with tuberculosis, and two million die from the disease worldwide.[110] In the 19th century, tuberculosis killed an estimated one-quarter of the adult population of Europe;[111] by 1918, one in six deaths in France were still caused by tuberculosis. During the 20th century, tuberculosis killed approximately 100 million people.[105] TB is still one of the most important health problems in the developing world.[112]

 

Leprosy[edit]

Leprosy, also known as Hansen's disease, is caused by a bacillus, Mycobacterium leprae. It is a chronic disease with an incubation period of up to five years. Since 1985, 15 million people worldwide have been cured of leprosy.[113]

 

Historically, leprosy has affected people since at least 600 BC.[114] Leprosy outbreaks began to occur in Western Europe around 1000 AD.[115][116] Numerous leprosoria, or leper hospitals, sprang up in the Middle Ages; Matthew Paris estimated that in the early 13th century, there were 19,000 of them across Europe.[117]

 

Malaria[edit]

 

Past and current malaria prevalence in 2009

Malaria is widespread in tropical and subtropical regions, including parts of the Americas, Asia, and Africa. Each year, there are approximately 350–500 million cases of malaria.[118] Drug resistance poses a growing problem in the treatment of malaria in the 21st century, since resistance is now common against all classes of antimalarial drugs, except for the artemisinins.[119]

 

Malaria was once common in most of Europe and North America, where it is now for all purposes non-existent.[120] Malaria may have contributed to the decline of the Roman Empire.[121] The disease became known as "Roman fever".[122] Plasmodium falciparum became a real threat to colonists and indigenous people alike when it was introduced into the Americas along with the slave trade. Malaria devastated the Jamestown colony and regularly ravaged the South and Midwest of the United States. By 1830, it had reached the Pacific Northwest.[123] During the American Civil War, there were more than 1.2 million cases of malaria among soldiers of both sides.[124] The southern U.S. continued to be afflicted with millions of cases of malaria into the 1930s.[125]

 

Yellow fever[edit]

Yellow fever has been a source of several devastating epidemics.[126] Cities as far north as New York, Philadelphia, and Boston were hit with epidemics. In 1793, one of the largest yellow fever epidemics in U.S. history killed as many as 5,000 people in Philadelphia—roughly 10% of the population. About half of the residents had fled the city, including President George Washington.[127] In colonial times, West Africa became known as "the white man's grave" because of malaria and yellow fever.[128]

 

Concerns about future pandemics[edit]

See also: Pandemic prevention

Antibiotic resistance[edit]

Main article: Antibiotic resistance

Antibiotic-resistant microorganisms, sometimes referred to as "superbugs", may contribute to the re-emergence of diseases which are currently well controlled.[129] For example, cases of tuberculosis that are resistant to traditionally effective treatments remain a cause of great concern to health professionals. Every year, nearly half a million new cases of multidrug-resistant tuberculosis (MDR-TB) are estimated to occur worldwide.[130] China and India have the highest rate of multidrug-resistant TB.[131] The World Health Organization (WHO) reports that approximately 50 million people worldwide are infected with MDR TB, with 79 percent of those cases resistant to three or more antibiotics. In 2005, 124 cases of MDR TB were reported in the United States. Extensively drug-resistant tuberculosis (XDR TB) was identified in Africa in 2006, and subsequently discovered to exist in 49 countries, including the United States. There are about 40,000 new cases of XDR-TB per year, the WHO estimates.[132]

 

In the past 20 years, common bacteria including Staphylococcus aureus, Serratia marcescens and Enterococcus, have developed resistance to various antibiotics such as vancomycin, as well as whole classes of antibiotics, such as the aminoglycosides and cephalosporins. Antibiotic-resistant organisms have become an important cause of healthcare-associated (nosocomial) infections (HAI). In addition, infections caused by community-acquired strains of methicillin-resistant Staphylococcus aureus (MRSA) in otherwise healthy individuals have become more frequent in recent years.

 

Viral hemorrhagic fevers[edit]

Viral hemorrhagic fevers such as Ebola virus disease, Lassa fever, Rift Valley fever, Marburg virus disease and Bolivian hemorrhagic fever are highly contagious and deadly diseases, with the theoretical potential to become pandemics.[133] Their ability to spread efficiently enough to cause a pandemic is limited, however, as transmission of these viruses requires close contact with the infected vector, and the vector has only a short time before death or serious illness. Furthermore, the short time between a vector becoming infectious and the onset of symptoms allows medical professionals to quickly quarantine vectors, and prevent them from carrying the pathogen elsewhere. Genetic mutations could occur, which could elevate their potential for causing widespread harm; thus close observation by contagious disease specialists is merited.[citation needed]

 

Coronaviruses[edit]

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A new strain of coronavirus (SARS-CoV-2) causes Coronavirus disease 2019, or COVID-19.[134]

 

COVID-19 was declared a pandemic by the WHO on 11 March 2020.

 

Some coronaviruses are zoonotic, meaning they are transmitted between animals and people. Detailed investigations found that SARS-CoV was transmitted from civet cats to humans, and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans. Common signs of infection include respiratory symptoms, fever, cough, shortness of breath, and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. Standard recommendations to prevent the spread of infection include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs, and avoiding close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing. The recommended distance from other people is 6 feet, a practice more commonly called social distancing.

 

Severe acute respiratory syndrome[edit]

In 2003 the Italian physician Carlo Urbani (1956–2003) was the first to identify severe acute respiratory syndrome (SARS) as a new and dangerously contagious disease, although he became infected and died. It is caused by a coronavirus dubbed SARS-CoV. Rapid action by national and international health authorities such as the World Health Organization helped to slow transmission and eventually broke the chain of transmission, which ended the localized epidemics before they could become a pandemic. However, the disease has not been eradicated and could re-emerge. This warrants monitoring and reporting of suspicious cases of atypical pneumonia.[135]

 

Influenza[edit]

Main article: Influenza pandemic

 

President Barack Obama is briefed in the Situation Room about the 2009 flu pandemic, which killed as many as 17,000 Americans.[136]

Wild aquatic birds are the natural hosts for a range of influenza A viruses. Occasionally, viruses are transmitted from these species to other species, and may then cause outbreaks in domestic poultry or, rarely, in humans.[137][138]

 

H5N1 (Avian flu)[edit]

Main article: Influenza A virus subtype H5N1

In February 2004, avian influenza virus was detected in birds in Vietnam, increasing fears of the emergence of new variant strains. It is feared that if the avian influenza virus combines with a human influenza virus (in a bird or a human), the new subtype created could be both highly contagious and highly lethal in humans. Such a subtype could cause a global influenza pandemic, similar to the Spanish flu or the lower mortality pandemics such as the Asian Flu and the Hong Kong Flu.

 

From October 2004 to February 2005, some 3,700 test kits of the 1957 Asian Flu virus were accidentally spread around the world from a lab in the U.S.[139]

 

In May 2005, scientists urgently called upon nations to prepare for a global influenza pandemic that could strike as much as 20% of the world's population.[140]

 

In October 2005, cases of the avian flu (the deadly strain H5N1) were identified in Turkey. EU Health Commissioner Markos Kyprianou said: "We have received now confirmation that the virus found in Turkey is an avian flu H5N1 virus. There is a direct relationship with viruses found in Russia, Mongolia and China." Cases of bird flu were also identified shortly thereafter in Romania, and then Greece. Possible cases of the virus have also been found in Croatia, Bulgaria and the United Kingdom.[141]

 

By November 2007, numerous confirmed cases of the H5N1 strain had been identified across Europe.[142] However, by the end of October, only 59 people had died as a result of H5N1, which was atypical of previous influenza pandemics.

 

Avian flu cannot be categorized as a "pandemic" because the virus cannot yet cause sustained and efficient human-to-human transmission. Cases so far are recognized to have been transmitted from bird to human, but as of December 2006 there had been few (if any) cases of proven human-to-human transmission.[143] Regular influenza viruses establish infection by attaching to receptors in the throat and lungs, but the avian influenza virus can attach only to receptors located deep in the lungs of humans, requiring close, prolonged contact with infected patients, and thus limiting person-to-person transmission.

 

Zika virus[edit]

Main articles: 2015–16 Zika virus epidemic, Zika virus, and Zika fever

An outbreak of Zika virus began in 2015 and strongly intensified throughout the start of 2016, with more than 1.5 million cases across more than a dozen countries in the Americas. The World Health Organization warned that Zika had the potential to become an explosive global pandemic if the outbreak was not controlled.[144]

 

Economic consequences[edit]

In 2016, the Commission on a Global Health Risk Framework for the Future estimated that pandemic disease events would cost the global economy over $6 trillion in the 21st century—over $60 billion per year.[145] The same report recommended spending $4.5 billion annually on global prevention and response capabilities to reduce the threat posed by pandemic events.

 

Biological warfare[edit]

Further information: Biological warfare

In 1346, according to secondhand and uncorroborated accounts by Mussi, the bodies of Mongol warriors who had died of plague were thrown over the walls of the besieged Crimean city of Kaffa (now Theodosia). After a protracted siege, during which the Mongol army under Jani Beg was suffering the disease, they catapulted the infected corpses over the city walls to infect the inhabitants. It has been speculated that this operation may have been responsible for the arrival of the Black Death in Europe. However, historians believe it would have taken far too long for the bodies to become contagious.[146]

 

The Native American population was devastated after contact with the Old World by introduction of many fatal diseases.[147][148][149] In a well documented case of germ warfare involving British commander Jeffery Amherst and Swiss-British officer Colonel Henry Bouquet, their correspondence included a proposal and agreement to give smallpox-infected blankets to Indians in order to "Extirpate this Execrable Race". During the siege of Fort Pitt late in the French and Indian War, as recorded in his journal by sundries trader and militia Captain, William Trent, on 24 June 1763, dignitaries from the Delaware tribe met with Fort Pitt officials, warned them of "great numbers of Indians" coming to attack the fort, and pleaded with them to leave the fort while there was still time. The commander of the fort refused to abandon the fort. Instead, the British gave as gifts two blankets, one silk handkerchief and one linen from the smallpox hospital to two Delaware Indian dignitaries.[150] The dignitaries were met again later and they seemingly hadn't contracted smallpox.[151] A relatively small outbreak of smallpox had begun spreading earlier that spring, with a hundred dying from it among Native American tribes in the Ohio Valley and Great Lakes area through 1763 and 1764.[151] The effectiveness of the biological warfare itself remains unknown, and the method used is inefficient compared to respiratory transmission and these attempts to spread the disease are difficult to differentiate from epidemics occurring from previous contacts with colonists,[152] as smallpox outbreaks happened every dozen or so years.[153] However historian Francis Jennings believes that the attempt at biological warfare was "unquestionably effective at Fort Pitt".[154]

 

During the Sino-Japanese War (1937–1945), Unit 731 of the Imperial Japanese Army conducted human experimentation on thousands, mostly Chinese. In military campaigns, the Japanese army used biological weapons on Chinese soldiers and civilians. Plague fleas, infected clothing, and infected supplies encased in bombs were dropped on various targets. The resulting cholera, anthrax, and plague were estimated to have killed around 400,000 Chinese civilians.

 

Diseases considered for or known to be used as a weapon include anthrax, ebola, Marburg virus, plague, cholera, typhus, Rocky Mountain spotted fever, tularemia, brucellosis, Q fever, machupo, Coccidioides mycosis, Glanders, Melioidosis, Shigella, Psittacosis, Japanese B encephalitis, Rift Valley fever, yellow fever, and smallpox.[155]

 

Spores of weaponized anthrax were accidentally released from a military facility near the Soviet closed city of Sverdlovsk in 1979. The Sverdlovsk anthrax leak is sometimes called "biological Chernobyl".[155] In January 2009, an Al-Qaeda training camp in Algeria was reportedly wiped out by the plague, killing approximately 40 Islamic extremists. Some experts said the group was developing biological weapons,[156] however, a couple of days later the Algerian Health Ministry flatly denied this rumour stating "No case of plague of any type has been recorded in any region of Algeria since 2003".[157]

 

In popular culture[edit]

 

This section contains a list of miscellaneous information. Please relocate any relevant information into other sections or articles. (March 2020)

 

Pieter Bruegel's The Triumph of Death (c. 1562) reflects the social upheaval and terror that followed the plague that devastated medieval Europe.

Pandemics appear in multiple fiction works. A common use is in disaster films, where the protagonists must avoid the effects of the plague, for example zombies.[clarification needed]

 

Literature

 

The Decameron, a 14th-century writing by Italian author Giovanni Boccaccio, circa 1353

The Last Man, an 1826 novel by Mary Shelley

The Betrothed, an 1842 historical novel by Alessandro Manzoni describing the plague that struck Milan around 1630.

Pale Horse, Pale Rider, a 1939 short novel by Katherine Anne Porter

The Plague, a 1947 novel by Albert Camus

Earth Abides, a 1949 novel by George R. Stewart

I Am Legend, a 1954 science fiction/horror novel by American writer Richard Matheson

The Andromeda Strain, a 1969 science fiction novel by Michael Crichton

The Last Canadian, a 1974 novel by William C. Heine

The Black Death, a 1977 novel by Gwyneth Cravens describing an outbreak of the Pneumonic plague in New York[158]

The Stand, a 1978 novel by Stephen King

And the Band Played On, a 1987 non-fiction account by Randy Shilts about the emergence and discovery of the HIV / AIDS pandemic

Doomsday Book, a 1992 time-travel novel by Connie Willis

The Last Town on Earth, a 2006 novel by Thomas Mullen

World War Z, a 2006 novel by Max Brooks

Company of Liars (2008), by Karen Maitland

The Passage trilogy by Justin Cronin with The Passage (2010), The Twelve (2012), and The City of Mirrors (2016)

Station Eleven, a 2014 novel by Emily St. John Mandel

Film

 

The Seventh Seal (1957), set during the Black Death

The Last Man on Earth (1964), a horror/science fiction film based on the Richard Matheson novel I Am Legend

Andromeda Strain (1971), a U.S. science fiction film based on the 1969 science fiction novel by Michael Crichton.

The Omega Man (1971), an English science fiction film, based on the Richard Matheson novel I Am Legend

And the Band Played On (film) (1993), a HBO movie about the emergence of the HIV / AIDS pandemic; based on the 1987 non-fiction book by journalistRandy Shilts

The Stand (1994), based on the eponymous novel by Stephen King about a worldwide pandemic of biblical proportions

The Horseman on the Roof (Le Hussard sur le Toit) (1995), a French film dealing with an 1832 cholera outbreak

Twelve Monkeys (1995), set in a future world devastated by a man-made virus

Outbreak (1995), fiction film focusing on an outbreak of an Ebola-like virus in Zaire and later in a small town in California.

Smallpox 2002 (2002), a fictional BBC docudrama

28 Days Later (2002), a fictional horror film following the outbreak of an infectious 'Rage' virus that destroys all of mainland Britain

Yesterday (2004), a movie about the social aspects of the AIDS crisis in Africa.

End Day (2005), a fictional BBC docudrama

I Am Legend (2007), a post-apocalyptic action thriller film film starring Will Smith based on the Richard Matheson novel I Am Legend

28 Weeks Later (2007), the sequel film to 28 Days Later, ending with the evident spread of infection to mainland Europe

The Happening (2008), a fictional suspense film about an epidemic caused by an unknown neurotoxin that induces human suicides to reduce population and restore ecological balance

Doomsday (2008), in which Scotland is quarantined following an epidemic

Black Death (2010) action horror film set during the time of the first outbreak of bubonic plague in England

After Armageddon (2010), fictional History Channel docudrama

Contagion (2011), American thriller centering on the threat posed by a deadly disease and an international team of doctors contracted by the CDC to deal with the outbreak

How to Survive a Plague (2012), a documentary film about the early years of the AIDS epidemic

World War Z (2013) American apocalyptic action horror film based on the novel by Max Brooks

The Normal Heart (2014), film depicts the rise of the HIV-AIDS crisis in New York City between 1981 and 1984

Television

 

Spanish Flu: The Forgotten Fallen (2009), a television drama

Helix (2014–2015), a television series that depicts a team of scientists from the Centers for Disease Control and Prevention (CDC) who are tasked to prevent pandemics from occurring.

The Last Man on Earth (2015–2018), a television series about a group of survivors after a pandemic has wiped out most life (humans and animals) on Earth

12 Monkeys (2015–2018), a television series that depicts James Cole, a time traveler, who travels from the year 2043 to the present day to stop the release of a deadly virus.

Survivors (1975–1977), classic BBC series created by Terry Nation. The series follows a group of people as they come to terms with the aftermath of a world pandemic.

Survivors (2008), BBC series, loosely based on the Terry Nation book which came after the series, instead of a retelling of the original TV series.

The Last Train 1999 written by Matthew Graham

World Without End (2012), chronicles the experiences of the medieval English town of Kingsbridge during the outbreak of the Black Death, based on Ken Follett's 2007 novel of the same name.

The Hot Zone (2019), a television series based on the 1994 non-fiction book of the same name by Richard Preston.

Pandemic: How to Prevent an Outbreak (2020), Netflix's docuseries

The Walking Dead (2010–), a virus appears that kills people and then revives them by turning them into zombies. An Atlanta group will try to survive in this new, post-apocalyptic world

Games

 

Resident Evil series (1996-2020), video game series focusing on T-virus pandemic and eventual zombie apocalypse as part of a bioterrorism act. The video games later evolved to be focusing on parasites and bioweapons.

Deus Ex, A World Wide Plague known as grey death infects the world created by Majestic 12 to bring about population reduction and New World order.

Pandemic (2008), a cooperative board game in which the players have to discover the cures for four diseases that break out at the same time.

Plague Inc. (2012), a smartphone game from Ndemic Creations, where the goal is to kill off the human race with a plague.

The Last of Us (2013), a post-apocalyptic survival game centred around an outbreak of a Cordyceps-like fungal infection.

Tom Clancy's The Division (2015) A video game about a bioterrorist attack that has devastated the United States and thrown New York into anarchy.

See also[edit]

Pandemic portal

iconViruses portal

List of epidemics

Biological hazard

Bushmeat

Compartmental models in epidemiology

Crowdmapping

Disease X

European Centre for Disease Prevention and Control (ECDC)

Mathematical modelling of infectious disease

Medieval demography

Mortality from infectious diseases

Pandemic severity index

Public health emergency of international concern

Super-spreader

Syndemic

Tropical disease

Timeline of global health

WHO pandemic phases

Notes[edit]

^ For clarification, WHO does not use the old system of six phases—ranging from phase 1 (no reports of animal influenza causing human infections) to phase 6 (a pandemic)—that some people may be familiar with from H1N1 in 2009.

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