The Worst US Epidemics in Modern History

Epidemics have clung onto the underbelly of human existence for as long as time cares to remember. They've steered the course of history, brought populations together and torn them apart - but which ones have had the biggest effect on the US?

The US has been witness to its fair share of medical epidemics throughout the decades - from Polio to Typhoid, Smallpox to Typhus. Irrespective of age, social stature or ethnicity, one thing has always reigned true when it comes to epidemics both past and future: their ability to sweep indiscriminately through entire populations of people has never faltered - and most probably never will.

Yet rather ironically, since the days of modern medicine, trying to keep one step ahead of the game when it comes to epidemic predictions and vaccinations has, on occasion, actually had detrimental effects. So, in an effort to highlight both the over-hyped and under-estimated epidemics of years gone by, EHM has put forward its front-runners.

Polio epidemic: 1940-1953

With its presence being announced as far back as 1916 in Brooklyn, New York, it wasn't until the 1940's that the Polio epidemic really sunk its teeth into the American population. Although around 90 percent of polio infections caused no symptoms at all, if the virus entered the blood stream then it meant severe and crippling disabilities for the carrier, which unfortunately ended up as the usual precursor to the expiration of life.

Spanning just longer than a decade at its peak, the worst polio epidemic in US history came in 1952, where almost 58,000 cases were reported. Out of those figures, 3145 died and a further 21,269 were left with varying degrees of paralysis. The virus also managed to single-handedly introduce the world to the macabre yet life-saving iron lung that filled the wards of US hospital wards in the mid 90s and breathed for thousands of patients, hundreds of times a day.

Spanish Flu epidemic: 1918-1920

Although the exact geographical origin of the Spanish flu is still unknown, what is known is that the large majority of its victims were healthy young adults, which stands in stark contrast to most influenza outbreaks that predominantly affect juvenile, elderly or weakened patients. Lasting just over two years, the epidemic spread as far as the Arctic and remote Pacific islands. While estimates vary, between 50 million and 100 million people died, with a further 500 million - or a third of the world's population at the time - being infected with the disease.

Tissue samples from frozen victims were used to reproduce the virus for study in the latter half of the 1900s with modern techniques, which concluded that the virus most likely took hold by a cytokine storm - an overreaction of the body's immune system - which would go a long way in explaining the concentrated age profile of its victims.

Smallpox epidemic in Native Americans: 1663-1900

There are no credible descriptions of smallpox-like disease in the Americas before the westward exploration in the 15th Century AD. It introduced itself to the Caribbean and then the mainland in 1520, before working its way into the Amerindian population, and turned out to be a pivotal factor in the conquest of the Aztecs and Incas by the Spaniards. The subsequent settlement of the east coast of North America in 1633 was the precursor to devastating outbreaks of smallpox within the Native American population and subsequent native-born colonists.

Some estimates indicate that case fatality rates rocketed into the 80 to 90 percent zone in Native American populations during the smallpox epidemics, with many fearing to return to their homelands for many years. A unique disease to humans, fortunately today smallpox is one of only two diseases to have been eradicated by humans, with the other - Rinderpest - expected to be given an official declaration in 2011.

Russian Flu: 1889-1890 and 1977-1978

The first ever detailed recording of a flu pandemic, the Russian flu began - rather unsurprisingly - in Russia in 1889, before spreading rapidly throughout Europe. It reached North America late in 1889 and set up shop as a hub to work its way down towards Latin America before settling in Asia in early 1890. It took the lives of roughly one million people at the time, with many believing that would be the last of it.

Unfortunately, it resurfaced again in 1977 in the form of an H1N1 strain, mostly targeting children and young adults under the age of 23, as a similar strain had substantially immunized the remaining adult community in 1947. Fortunately, the virus was included in the 1978-1979 influenza vaccine, minimizing fatality levels and future outbreaks.

Typhoid fever: 1920-1950

Before the advent of public sewage systems, typhoid was common in the US, occurring in 100 out of every 100,000 people in 1920 - that number had reduced significantly to 33.8 per 100,000 people in 1950 with the introduction of better sanitation and infrastructure. But perhaps the most famous outbreak of typhoid fever in the US came in the early 1900s from a chef called Mary Mallon. Given the title "Typhoid Mary", she was taken into custody in 1907 by local health officials when it was shown that a number of typhoid cases in the area could be traced to kitchens where she worked.

She was held for three years on Brother Island in New York's East River and then released on the condition that she never again worked as a cook. She didn't take heed, and five years later was detained again after further outbreaks were traced back to kitchens she had worked in. She spent the rest of her life in Brother Island until her death in 1938.

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