Microbes are scary. Responsible for more deaths than weapons of war, we are unable to see them with our naked eyes except for their horrific effects upon the world around them. History is littered with the consequences of disease epidemics, with some regions taking centuries to recover from severe outbreaks of fatal infections. Felling kings and peasants alike, the advent of modern medicine was supposed to rid humanity of these plagues. However, whether due to evolution on the part of bacteria or our own unwillingness to accede to medical expertise, an increasing number of deadly diseases that we prematurely thought were going, or indeed gone, are beginning to reemerge to torment us once more.
Here are 16 potentially fatal diseases that were historically in decline, but are now making a terrifying comeback (Warning: This article contains distressing or unsuitable images and content of a medical nature that might be upsetting to some readers):
16. Despite almost total eradication by the end of the 20th century, polio has re-emerged in troubled regions of the planet where vaccination efforts have stalled due to conflict and civil unrest
Poliomyelitis, commonly known as polio, is an infectious disease that results in muscle fatigue and weakness. In the most extreme cases, polio renders infected individuals paralyzed, as in the case of Franklin Roosevelt, whilst historically between 15 and 30 percent of adults who contracted the disease ultimately being killed. Plaguing humanity throughout history, with references to the illness present in ancient Egyptian paintings, polio was not properly identified by physicians until the late-18th century. Exploding during the 20th century, polio epidemics began in both Europe and the United States. In 1952 there were 58,000 reported new cases; of these, at least 3,145 proved fatal and 21,269 victims were left paralyzed.
In the wake of these pandemics, grassroots fundraising campaigns began to emerge to finance revolutionary treatments to combat polio. Successful in their objective, by the late-1950s and 1960s a vaccine against polio had been invented, whilst methods of treatment were vastly improved. However, despite the Global Polio Eradication Initiative inoculating more than 2.5 billion children since 1988, polio has in recent years began to rear its head once more. In states undergoing persistent turmoil, notably Afghanistan, Pakistan, Nigeria, and Ukraine, new cases of polio have been reported in the 2010s and without widespread and sustained vaccination efforts might spread even further.
15. Whilst the discovery of penicillin, among other treatments, significantly reduced instances of scarlet fever during the 20th century, the 21st has seen worrying increases in Europe and Asia of the potentially fatal bacterial infection
Scarlet fever is a disease caused by a bacterial infection commonly spread by sneezing and coughing, resulting in rashes, headaches, and swollen lymph nodes. Typically affecting children between the ages of five and fifteen, the fever can result in kidney disease, heart problems, and was recorded as the leading cause of death in children during the early 20th century. Believed to have been first recorded by Hippocrates in approximately 400 BCE, the condition endured through the Middle Ages, appearing in several medical textbooks. With the scientific advances of the late-19th and early-20th centuries, the root causes of scarlet fever were successfully identified and treatments devised.
In 1924, an anti-toxin was developed to combat the disease, whilst the application of penicillin to fight the fever has significantly reduced the mortality rate of the previously deadly illness. However, to date, no vaccine has been successfully synthesized, rather only more effective modes of treatment and prevention. Consequently, recent years have seen a resurgence in cases of scarlet fever. Rising from levels of just 8 per 100,000 children in 2013, England has seen that figure rise to 33 per 100,000 by 2016. Similar increases have been observed in China, with more than 100,00 new cases over five years, as well in Vietnam, South Korea, and Hong Kong.
14. Leptospirosis, suggested to have been one of the key diseases responsible for the annihilation of the native populations of the east coast of North America, can result in the bleeding of the lungs and now infects almost ten million people per year in the developing world
Leptospirosis is a bacterial infection that causes symptoms ranging from mild, including headaches, muscular fatigue, and fevers, to critical, such as bleeding from the lungs, kidney failure, and meningitis. Transmitted by animals, most commonly rodents, to humans, it is frequently imparted through urine making contact with human skin or porous points of entry. First described in 1886 as an “acute infectious disease”, leptospirosis was identified in 1907 and the connection to animals; recognized in 1916. It has since been theorized that leptospirosis was the disease responsible for the exterminating epidemic that swept along the coastline of Massachusetts prior to the Pilgrim’s landing in 1620.
Although vaccinations exist to inoculate animals and prevent the spread of infection, humans are forced to resort to antibiotic modes of treatment. Even with these advanced methods, should the condition lead to more serious symptoms, death rates remain higher than 10 percent. Prominent during the early 20th century, notably in the trenches of World War I, it had been believed that leptospirosis had naturally diminished in frequency due to effective treatment. However, recent years have seen dramatic increases in diagnosis, with an estimated seven to ten million infected annually, typically in sub-Saharan Africa and Southeast Asia, with varying chances of survival.
13. Rubella, an infectious rash responsible for pregnancy complications and infant mortality, still affects hundreds of thousands of mothers each year despite being eliminated in the Americas
Rubella, also known as German measles, is caused by the highly infectious rubella virus. With symptoms not emerging until weeks after exposure, an itchy rash spreads throughout the body in conjunction with joint pain, nerve inflammation. In extreme cases, particularly during pregnancy, the condition can prove fatal to both mother and fetus. Spreading through the air, infected carriers are most contagious prior to symptoms emerging, making tracking rubella immensely difficult, whilst infected infants remain capable of spreading rubella for more than a year after transmission. Originally thought to be measles or scarlet fever, it was not until the mid-19th century that rubella was identified as a unique illness.
Following a pandemic outbreak of rubella in the United States during the 1960s, with more than 12.5 million cases of rubella in the U.S. alone in 1964 and 1965, resulting in more than 11,000 miscarriages and thousands of infant deaths, an effort to discover a vaccine became urgent. Succeeding, by 2006 it was estimated that cases of rubella in the Americas had reached fewer than 3000 per year. However, despite the eradication of the infection in the Americas, rubella remains at large in south-east Asia and Africa, with more than 110,000 afflicted babies born each year from mothers suffering from rubella.
12. Leprosy, largely eradicated in the developed world, has been unintentionally reintroduced to the United States through the armadillo population in southern states
Leprosy, also known as Hansen’s disease, is a sustained bacterial infection that causes inflammation of the nerves, skin, eyes, and throat. Although transmitted between humans via bodily fluids, contrary to popular opinion leprosy is not highly contagious. The oldest known case of leprosy dates to 2000 BCE, with evidence of the infection present in skeletal remains discovered in modern-day Pakistan. Persisting throughout history, it is believed that modern strains of leprosy were spread worldwide through imperial trading routes and the endemic practice of slavery during the Age of Enlightenment, with leprosy not considered native to the Americas prior to European colonization.
Despite the longevity of leprosy, effective treatments did not become available until the 1940s and 1950s, with the condition historically treated using poisonous mercury during the Middle Ages and exile to isolated “leper colonies”. Although treatable with modern medicine, with 16 million cured in the last twenty years, there remains no vaccine for the infection and leprosy has begun to reemerge as a medical concern even among advanced nations. The United States still identifies approximately 200 new cases each year, particularly in the southern states after transmission believed to stem from infected armadillos.
11. Rickets, caused by vitamin deficient diets and lifestyles, is beginning to make a return in the developed world due to our increasingly unhealthy modern lifestyles
Rickets, commonly appearing in children suffering from a vitamin D deficiency, is a medical condition wherein the bones of the victim become soft, weak, and develop abnormally. Spanning bowed legs, stunted growth, misshapen skulls, muscle spasms, and even, in extreme cases, brain or spinal injuries. First detailed in the ancient world among the infants of Rome, it was not recognized in England until the 17th century. By the mid-19th, however, rickets was sufficiently widespread that an estimated 80-90 percent of all children in Britain suffered from the condition. Although initially thought to be caused by the inclusion of harmful substances in food preparation, the true cause was identified by the turn of the 20th century.
Treated with a combination of ultraviolet light and high vitamin diets, by 1945 rickets had been, generally speaking, eliminated in the United States, with the remainder of the developed world soon following. Whilst remaining a plight in developing countries, albeit increasing less prominently so, recent years has seen a worrisome rise in reported cases of rickets in the developed world once more. Changes to modern diets, with a decrease in healthy eating in conjunction with a growing lack of time spent outdoors by young persons today, has resulted in a dramatic increase in diagnosed cases of rickets in both contemporary Europe and North America for the first time in nearly a century.
10. Resulting in the deaths of between 5 to 10 percent of those infected, diphtheria had been nearly eradicated in the developed world until opposition to vaccinations allowed the condition to survive into the 21st century
A bacterial infection, diphtheria is a highly contagious condition spread between humans through the air, direct contact, and even via contaminated objects. With symptoms beginning gradually two to five days after infection, starting with a sore throat and fever, diphtheria, if left untreated, can result in a blockage growing in the throat, kidney failure, and heart problems. Unlike many harmful illnesses, prior exposure to diphtheria does not preclude future recurrences. Appearing throughout modern history, with Spain suffering an epidemic in 1613 and New England in 1735, in 1878 Queen Victoria’s daughter, Prince Alice, in addition to her own daughter Princess Marie, died from diphtheria.
During the 1910s, spurred by rising death tolls, a vaccine was discovered after a mass public appeal. Nonetheless, in the 1920s more than 200,000 cases resulting in 15,000 deaths per year were still reported in the United States. However, despite a prolonged period of sustained decline, due to increasing opposition by parents to vaccination diphtheria is beginning to make a comeback. In 2015, Spain saw the first case of diphtheria since 1986, with fatal instances also appearing in Venezuela, Belgium, and Indonesia. In 2011, more than 5,000 cases of diphtheria were diagnosed globally, with an average fatality rate of between 5 to 10 percent.
9. Killing as many as half of those infected, cholera continues to affect millions each year with new cases periodically recurring across the world after more than a century of absence in these countries
Cholera is a serious bacterial infection of the small intestine, most commonly identified by the symptomatic inducement of chronic diarrhea and vomiting. Within mere hours of these symptoms starting, the infected patient can be rendered dangerously dehydrated and resulting in muscle cramps. Spread predominantly via unsafe water and food that has become contaminated by human feces, the disease is prevalent in areas lacking adequate sanitation and access to clean drinking water. Believed to originate from the Indian subcontinent, due in part to poor living conditions and ideal bacterial conditions, the disease had spread to Russia by the early 19th century and the rest of the world soon after.
Seven cholera pandemics have occurred in the last two hundred years, with estimates of the dead surpassing ten million. Although a vaccine was ultimately developed, it only offers protection for approximately six months, precluding the total eradication of the disease. Today, an estimated three to five million people are afflicted by cholera, resulting in roughly 100,000 deaths per year. Reflecting the potential for sudden revitalization, in the aftermath of the 2010 Haiti earthquake UN peacekeepers from Nepal unintentionally reintroduced cholera to the island for the first time in 100 years; the outbreak killed more than 10,000 Haitians, and cholera remains at large on the devastated island.
8. The “rich man’s disease”, gout now affects more than one percent of the western population leading to heart failure, diabetes, and early death
A form of inflammatory arthritis, gout is caused by excessive levels of uric acid in the human bloodstream. Commonly a byproduct of diet, including the over-consumption of meat and fatty foods, gout results in the painful swelling of joints, particularly in the toes. Over time, gout significantly decreases the chances of long life among those affected, with as many as half dying noticeably earlier than otherwise. Historically regarded as the “rich man’s disease“, as only the wealthy were able to overindulge to the levels of excess required to develop gout, the first documented case is dated to 2600 BCE in Egypt.
Facing the threat of heart disease, diabetes, and kidney failure, available modern treatments typically revolves around anti-inflammatory steroids in conjunction with a radical change in diet and lifestyle. Today, gout affects between one and two percent of the entire Western population and is becoming increasingly common over recent decades. An estimated 5.8 million people were afflicted with gout as of 2013, with the rates of diagnosis more than doubling between 1990 and 2010. This resurgence of the outdated condition is widely ascribed to modern sedentary lifestyles and junk diets.
7. With a mortality rate in excess of 50 percent if left untreated, after a period of decline in late late-20th century millions of new cases of syphilis are now being diagnosed each year
Most commonly spread by sexual activity, although also transmittable during pregnancy to an unborn infant, syphilis is a four-stage infection-causing tremendous medical complications in those afflicted. Beginning with sores and rashes, including on the genitalia, the infection develops slowly until, after three to fifteen years, if left untreated syphilis begins to attack the brain and other vital organs. The precise origin of syphilis is uncertain, with some physicians theorizing that it might have been native to the Americas and transported to Europe after 1492. Nevertheless, between the 16th and 19th centuries, syphilis remained among the largest public health crises in existence.
Originally treated with mercury and other poisonous substances, in 1943 it was finally verified that high doses of penicillin successfully combated the early stages of syphilis and resulted in a dramatic decline in the infection worldwide. However, since the turn of the millennium rates of transmission and diagnosis have steadily risen. It is believed that increased promiscuity and prostitution, without the use of protection, in conjunction with the increased spread of other sexually transmitted infections, notably HIV, have spurred this increase. In 2015, an estimated 45.4 million people suffered from syphilis, with at least six million new cases in the same year and 107,000 deaths.
6. Whooping cough, forcing those infected to cough so hard that they risk breaking their ribs, has not been eradicated despite the discovery of a vaccine in 1942 and continues to kill more than 50,000 people each year
Whooping cough, also known as pertussis, is a highly contagious airborne disease possessing symptoms, at least initially, similar to the common cold. However, following a mild cough and runny nose, the infected person suffers through weeks of harsh coughing fits. Lasting for potentially longer than ten weeks, the disease causes the individual to cough so hard that they become greatly fatigued, vomit, and risk even breaking ribs. Since 1942, prevention of whooping cough has primarily been fought by vaccination, with medical opinion recommending inoculating children within six to eight weeks after birth. If infected, individuals can be treated with modern antibiotics if the condition is identified within three weeks.
The first recorded outbreaks of the disease stem from the 16th century, with the frequency steadily declining during the 20th century. However, even with advanced medical treatment approximately 50 percent of infected children less than one-year-old require hospitalization, with 1 in 200 dying as a result of the condition. Since the turn of the millennium, and the associated emergence of organized opposition to vaccinations in contravention of medical advice, instances of infection have risen. In 2015, an estimated 16.3 million people were infected, resulting in 58,700 deaths, whilst in 2010 California suffered its worst outbreak for sixty years.
5. Famous for killing roughly half the population of Europe during the 14th century, bubonic plague has not disappeared and recent years have seen an increasing number of cases reported in the United States
Entering the body via a flea bite, bubonic plague remains one of the most notorious diseases in history. Causing the body’s lymph nodes to swell and the patient to develop severe fevers and vomit profusely, the condition is most famous for eradicating between 25 to 60 percent of the European population, more than 50 million people, in the mid-14th century. Not the first occurrence of the bubonic plague, appearing during the 6th century to kill between 25 and 50 million people, the condition returned in the mid-19th century. Regarded as the first modern pandemic, the late-19th and early-20th centuries saw more than 10 million people die in India alone whilst modern transportation trafficked the condition throughout the globe.
No vaccination exists that effectively combats the disease, but with managed medical care mortality rates can be lowered to between 1 and 15 percent; in contrast, if left untreated mortality lingers between 40 and 60 percent. Despite advances in the developed world, the developing world continues to suffer from the bubonic plague, with more than a thousand cases reported each year in central Africa. Recent years have even seen a return of the disease to North America, with at least 1,036 cases reported between 1990 and 2015 in the United States – a number rising in frequency over time.
4. Responsible for the death of American President William Henry Harrison just thirty-two days into his term of office, typhoid fever continues to afflict humanity due to poor hygiene and opposition to vaccinations
Typhoid fever, taking between six and thirty days after infection to indicate symptoms, is a bacterial infection caused by a strain of salmonella. Spread by eating food or drinking fluids contaminated with infected feces, the condition causes extreme fevers, abdominal pain, headaches, rashes, vomiting, and constipation. Without appropriate treatment, typhoid is capable of lasting for months and carries a mortality rate as high as 20 percent. First identified in the 19th century, in 1896 an early vaccination was introduced in Great Britain to combat the prevalence of the infection in soldiers fighting the Boer War in South Africa.
Today, vaccinations are capable of preventing contraction for up to seven years and, in conjunction with concurrent improvements in public sanitation and hygiene, the 20th century saw a marked decline in instances of typhoid in the developed world. However, typhoid remains at large in the developing world, particularly India. In 2015, an estimated 12.5 million new cases were diagnosed worldwide, resulting in approximately 149,000 deaths. Modern modes of travel and exposure to these infected regions have reintroduced typhoid to the developed world, with roughly 400 cases identified in the United States each year including an outbreak in Oklahoma in 2015.
3. Plaguing humanity since prehistoric times, tuberculosis continues to inflict suffering as the infection grows resistant to modern medicine and refuses to be consigned to history
Tuberculosis, commonly abbreviated to TB, is a bacterial infection that attacks the lungs. With symptoms including the chronic coughing of blood, fevers, and organ failure, if left untreated TB is highly fatal, killing in approximately half of active cases. Spreading through the air on fluid residue expelled from the human body, it is estimated that as many as one-quarter of the human population is currently infected with latent forms of TB; however, of this sizeable proportion less than 2.5 percent progress to active infections. Dating to at least 17,000 years ago, with evidence of TB found in the remains of ancient bison in Wyoming, it remains one of the oldest still existing infections in the world.
The isolation of TB in 1882 would win Robert Kock the Nobel Prize in Medicine, although it would take until 1921 for a vaccine to be first administered. In 1918, an estimated one in six deaths in France was a product of TB, a figure that substantially declined during the mid-20th century. By the 1950s, mortality rates had decreased by more than 90 percent in Europe. Despite this considerable progress, TB persists in the developing world and continues to affect the developed more than commonly recognized. In 2014, in the United States, nearly 10,000 cases were reported, with 555 deaths resulting from the condition in 2013. Worldwide, between two to three million succumb each year, with the bacteria growing ever resistant to antibiotic treatments.
2. Dengue fever, transmitted by tropical mosquitoes, affects tens, if not hundreds, of millions of people per year, with limited treatment and vaccination options available
A mosquito-borne tropical disease, dengue fever induces an extreme fever, vomiting, muscular spasms, and severe skin rashes. Taking between three and fourteen days for symptoms to appear, in a small percentage of cases the disease compounds into dengue hemorrhagic fever, causing bleeding, blood leakage, and dangerously low blood pressure. First recorded in China during the Jin Dynasty (265-420 CE), the present strains of the disease are believed to have originated in Africa before proliferating throughout the globe via the slave trade between the 15th and 19th centuries. Despite being prevalent during and after the Second World War, a vaccine, only partially effective, was not discovered until 2016.
Due to the lack of preventative medicine concerning dengue fever, the disease continues to ravage the developing tropics. An estimated 50 to 528 million people are infected by dengue fever each year. Of these, a significant proportion requires medical attention and approximately ten to twenty thousand die as a direct consequence. Recommended treatments are limited and mostly palliative, including fluid replenishment and paracetamol. Even the developed world has not escaped the long-lasting disease. Hawaii, in the United States, is experiencing the largest outbreak of dengue fever since it obtained statehood in 1959, with 261 confirmed cases on the islands.
1. Responsible for approximately 200 million deaths between 1855 and 2005, in addition to devastating the Inca civilization, measles had been eradicated in the United States before opposition to vaccinations permitted a fatal resurgence
Lasting for between seven to ten days, the measles virus typically inflicts upon its victims an intense fever, inflammation of the eyes, and painful spots and rashes. Extreme cases of measles can also lead to diarrhea, ear infections, pneumonia, blindness, and even seizures. An airborne disease spreads via the coughs and sneezes of infected persons, it is rare, but not impossible for an individual who has already contracted the condition to contract it again. Once infected, there is no curative or specific treatment for measles, but supportive care, including re-hydration and antibiotics, can improve prognoses.
First emerging some time after 500 CE, a susceptible population of approximately 500,000 is required to sustain the measles virus. Consequently, after the discovery of a vaccine in 1963 a concerted effort to immunize populations began to eradicate the disease. Initially successful in this goal, measles was declared extinct in the United States by the turn of the millennium. However, due to opposition to vaccinations in contemporary America, measles has been allowed the opportunity to return. In 2014, at least 667 individuals across 14 states were freshly diagnosed with measles, whilst in 2016 a fresh epidemic begun in Arizona after 22 cases were confirmed.
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