50 Fun Facts About Pandemics

The word 'pandemic' comes from Greek roots meaning what?

All the populace: pan- means 'all' and demos 'people', the demos of democracy. Greek pandemos simply meant public or common, and English first tied the word to disease in the 1660s.

Which Greek-letter variant of the COVID-19 virus was first reported from South Africa in November 2021?

Omicron. The WHO skipped two Greek letters to reach it: Nu, too easily confused with 'new', and Xi, because it is a common surname.

What is the term for a disease outbreak that spreads among animals across continents or worldwide?

Panzootic. The bird flu that wild birds carried around the world from 2020 was one: it went on to kill sea lions by the thousand and infect dairy cows in the United States.

Cancer kills many people worldwide, so what keeps it from counting as a pandemic?

It is not infectious. In its strict sense a pandemic is an outbreak of a disease that passes between people, though some doctors now speak loosely of an 'obesity pandemic' as well.

What does the WHO abbreviation PHEIC stand for?

Public Health Emergency of International Concern: once the WHO declares one, its expert committee must meet again at least every three months to review whether the emergency still stands.

Which disease did the WHO declare a PHEIC in May 2014, fearing travellers would undo its near-eradication?

Polio. Cases had fallen by more than 99% since 1988, but in early 2014 the virus crossed borders from Pakistan, Syria and Cameroon, and the WHO feared the eradication drive would fail.

In which German city did the WHO open its pandemic early-warning hub in 2021?

Berlin. Germany funded the hub after COVID-19 exposed gaps in how the world detects outbreaks and shares data, and Chancellor Angela Merkel opened it alongside WHO chief Tedros.

In the WHO's old six-phase influenza scale, phase 1 meant what?

Infections in animals only: at phase 1 no animal flu virus was known to have infected people. The WHO climbed to phase 6, a full pandemic, for swine flu in 2009, then dropped the scale.

Which pandemic strategy aims to push the reproduction number below 1, so that an outbreak shrinks instead of merely slowing?

Suppression. With the number below 1, each patient infects fewer than one other person on average, so cases fall; the 2020 lockdown of Wuhan and other whole cities aimed at exactly that.

Decreasing an epidemic's peak is popularly known as what?

Flattening the curve. The 1918 flu showed why: St. Louis shut public gatherings within days, and its death rate ended up less than half that of Philadelphia, which had held a parade of 200,000.

The Plague of Athens struck in 430 BC as the city sheltered behind its walls from Sparta's army in which war?

Peloponnesian War. Thucydides, who caught the disease and survived, described it in his history of the war; a 2006 DNA study of victims' teeth pointed to typhoid fever, but the cause is still debated.

The physician Galen recorded fever and a pustular rash during Rome's Antonine Plague, suggesting which disease?

Measles or smallpox, with most scholars leaning to smallpox. It is thought to have come home with soldiers from a campaign in Mesopotamia, and it killed roughly one in ten people in the Roman Empire.

In which city did the Plague of Justinian supposedly kill 10,000 people a day?

Constantinople. Procopius, who lived through the outbreak in the Byzantine capital, gave the figure, and recorded that Emperor Justinian himself caught the plague, swollen groin and all, yet survived.

The Plague of Justinian of 541 opened two centuries of recurring outbreaks known by what name?

First Plague Pandemic. It kept returning in waves until the mid-8th century, and DNA from sixth-century graves in Bavaria later showed it was caused by the same bacterium as the Black Death.

Which 1666 disaster is popularly credited with ending London's Great Plague?

Great Fire. It gutted the old walled City in September 1666, but plague deaths were already falling, and many had been in poor parishes outside the walls that never burned.

The first cholera pandemic spread out in 1817 from the delta of which river?

Ganges. Cholera had long been endemic in its delta in Bengal; from 1817 trading ships and British troops carried it as far as Java, Japan and southern Russia.

The plague pandemic of the late 1800s began in which country before steamships carried it worldwide?

China. The outbreak smouldered in Yunnan province, reached Hong Kong in 1894 and then travelled by steamship to every inhabited continent; India suffered worst, losing more than ten million people.

Which city was the centre of the first plague epidemic in the continental United States, in 1900?

San Francisco. California's governor insisted there was no plague, even accusing federal doctors of faking it by injecting corpses with the bacteria; by 1904 it had killed more than a hundred people.

Who isolated the plague bacterium in Hong Kong in 1894 and later had it named after him?

Alexandre Yersin. Japan's Kitasato Shibasaburō spotted the bacillus in Hong Kong days before him, but Kitasato's muddled reports cost him much of the credit, and it became Yersinia pestis.

In 1898 Paul-Louis Simond reported that plague passes from rats to people through which insects' bites?

Fleas. Simond's experiments with caged rats pointed to them, but his report was not accepted at first; a British plague commission confirmed the finding about a decade later.

In which US state did a country doctor report the first known American outbreak of the 1918 flu?

Kansas. Dr Loring Miner warned federal health officials of a violent flu in rural Haskell County early in 1918, though some researchers argue the virus was already circulating in Europe.

Why did the 1918 flu become known as 'Spanish flu'?

Neutral Spain's press reported it freely, even when King Alfonso XIII fell ill, while wartime censors elsewhere hushed it up; Spaniards themselves called it the French flu.

Which 'Big Four' leader fell ill, probably with the 1918 flu, during the Paris peace talks of 1919?

Woodrow Wilson. He took to his bed with a cough and fever on 3 April 1919, when the talks were deadlocked, and the historian John Barry argues that the illness weakened him at their most crucial point.

Which age group suffered unusually high mortality in the 1918 flu?

Young adults. Nearly half of US deaths were among people aged 20 to 40; one theory is that their strong immune systems overreacted to the virus, though the reason is still not well understood.

Which Pacific territory recorded zero flu deaths in 1918 thanks to a strict quarantine?

American Samoa. Its naval governor made arriving ships sit out a quarantine, while neighbouring Western Samoa, under New Zealand rule, did not and lost about a fifth of its people.

In spring 1918 British and German soldiers both named the new flu after which region of Belgium?

Flanders. British troops spoke of 'Flanders flu' and Germans of 'Flandern-Fieber', after the front where both armies fell ill, before the name Spanish flu took hold.

Lung tissue frozen in which region's permafrost let scientists decode the 1918 flu virus?

Alaska. Pathologist Johan Hultin, aged 72, paid his own way to the village of Brevig Mission in 1997 and dug up a woman he named Lucy, whose lungs had stayed frozen since 1918.

The 1889-1890 'Russian flu' may actually have been caused by what kind of virus?

A coronavirus. Genetic clocks suggest human coronavirus OC43 jumped from cattle around 1890, and doctors' reports of lost taste and smell read like COVID-19; today OC43 just causes common colds.

Which disease spread from one Hong Kong hotel floor to Vietnam, Singapore and Canada in 2003, yet was contained within months?

SARS. A sick doctor spent one night in room 911 of the Metropole Hotel and infected guests who flew home with the virus; it reached more than two dozen countries before the WHO declared it contained in July 2003.

What is the 1957-58 flu pandemic commonly called?

Asian flu. Its H2N2 virus circulated in people for 11 years, then vanished in 1968 when a descendant that kept some of its genes, the Hong Kong flu virus, took over.

The first COVID-19 vaccine authorised in Britain and the US, in December 2020, used which technology, new to human vaccines?

Messenger RNA. Katalin Karikó, demoted in the 1990s for chasing the idea, shared the 2023 Nobel Prize in medicine with Drew Weissman for the fix that made mRNA vaccines work.

Which virus is named after a river in the Democratic Republic of the Congo?

Ebola. The scientists who identified it in 1976 chose the river's name rather than that of Yambuku, the village where the outbreak struck, to spare it the stigma.

The 1968 Hong Kong flu virus arose when flu strains abruptly swapped whole genes, a process known as what?

Antigenic shift. The 1968 virus took two genes from a bird flu strain, including a surface protein new to human immune systems, and kept others from the 1957 pandemic virus; slow yearly change is called drift.

The earliest known cases of the 2009 swine flu pandemic were traced to which country?

Mexico. A small boy in La Gloria, a Veracruz village near industrial pig farms, was the earliest confirmed patient and recovered, but the new virus was first identified in two children in California.

What was unusual about whom the 2009 H1N1 virus infected?

It spared adults over 60 because nearly a third of them already carried antibodies, probably from meeting an older H1N1 virus early in life; four in five of those who died were under 65.

Which mosquito-borne virus alarmed the world in 2016 when it was linked to babies born with unusually small heads in Brazil?

Zika. First found in a monkey in a Ugandan forest in 1947, it caused little alarm for decades; the WHO declared an emergency in February 2016 and the link to birth defects was soon confirmed.

The world's last naturally occurring case of smallpox, in 1977, was a hospital cook in which country?

Somalia. Ali Maow Maalin later said he had dodged his own vaccination for fear of the needle; he recovered and went on to urge Somali parents to vaccinate their children, telling them not to be as foolish as he had been.

In 1978 smallpox killed a British photographer after escaping from what?

A university laboratory. Janet Parker worked one floor above a smallpox lab at Birmingham's medical school; how the virus reached her was never settled, and remaining stocks were later confined to two labs.

Who introduced the modern smallpox vaccine in 1796?

Edward Jenner. He scratched matter from a milkmaid's cowpox sore into the arm of eight-year-old James Phipps, who then shrugged off smallpox; 'vaccine' comes from vacca, the Latin for cow.

Lady Mary Wortley Montagu brought smallpox inoculation to England in 1721 after watching it done in which empire?

Ottoman Empire. Scarred by smallpox herself, she had the embassy surgeon inoculate her young son there in 1718, then her daughter in London in front of court physicians, decades before the first vaccine.

About how many people did smallpox kill in the 20th century alone?

About 300 million. The dying stopped only when an intensified WHO vaccination drive, launched in 1967, hunted the disease down to its last natural case within ten years.

Which nursery rhyme is widely believed, despite folklorists' doubts, to describe the symptoms of plague?

Ring a Ring o' Roses, known in the US as Ring Around the Rosie. The rhyme first reached print in 1881 and nobody tied it to plague until the mid-20th century, so folklorists treat the story as a modern myth.

What does the word 'quarantine', born in Europe's medieval plague ports, literally mean?

Forty days, from quaranta, the Italian for forty: ships from plague ports had to wait that long offshore. In English law a quarantine was first the forty days a widow could stay in her late husband's house.

Which city opened the first permanent plague hospital, or lazaret, on an island in the 1400s?

Venice. Its hospital stood on the lagoon island of Santa Maria di Nazareth; Dubrovnik had pioneered quarantine itself in 1377, isolating newcomers on nearby islands.

Which English village famously sealed itself off during the plague of 1665-66 to stop the disease spreading?

Eyam. Persuaded by their rector, William Mompesson, the villagers stayed put and paid for food with coins left in vinegar at the boundary; about 260 of them died, but the plague spread no further.

Who linked cholera to contaminated drinking water in 1854?

John Snow. He traced the deaths to one pump on Broad Street in Soho and had its handle removed; the seventy men at the brewery next door, who drank beer rather than pump water, all escaped.

Who is usually credited with identifying the cholera bacterium, three decades after an Italian anatomist first described it?

Robert Koch. He isolated the comma-shaped germ during outbreaks in Egypt and India in 1883-84; Filippo Pacini had described it in Florence in 1854, but his name was added to the bacterium only in 1965.

Which term for an outbreak's first known case arose when the letter O was misread in an early AIDS study?

Patient zero. Researchers had labelled flight attendant Gaëtan Dugas 'Patient O', for outside California; the O was read as a zero, and he was wrongly blamed for bringing AIDS to North America.

The pandemic strain of HIV jumped to humans from which African animals?

Chimpanzees. The virus crossed over in southeastern Cameroon, probably to someone hunting or butchering an ape, then spread unnoticed for 50 to 70 years before doctors recognised AIDS in 1981.

An Alpine ice core shows which smelting pollutant almost vanishing from the air during the Black Death?

Lead. A 2017 study of a glacier on the Swiss-Italian border found it fell to undetectable levels from about 1349 to 1353, as plague silenced Europe's mines and smelters, the only such gap in 2,000 years.