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        S.-Epidemics">
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        Updated March 19, 2020 | Logan Chamberlain

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        A lot of people are concerned about the definition of epidemic, and how it differs from a pandemic. An epidemic is when an infectious disease has spread rapidly through a community. An epidemic disease like cholera, measles, or influenza will crop up and spread across a geographic area, infecting a large number of people.

        A pandemic is an epidemic that spreads beyond individual communities to affect large parts of the world. Neither the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have any hard numbers to distinguish an epidemic vs. pandemic. E.g. there isn't a threshold number of cases of a disease that tips it into "pandemic" territory. After the outbreak of a disease spreads beyond a geographical area, epidemiologists (people who study the spread of disease) will make a judgement call.

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        We've limited the scope of this article to diseases that had epidemic outbreaks in the United States, which might exclude some diseases that?are?epidemics elsewhere. That might even exclude some diseases that came to the United States as the result of an epidemic, like the Zika virus or Ebola.

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        • During the very earliest days of colonial contact in New England, disease swept the Northeast. European fishermen, while sailing along the coast or interacting with locals, carried European diseases that devastated the region. Anywhere between 30% and 90% of the local population died, possibly from leptospirosis.

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        • Early American cities and towns had poor health infrastructure, poor public sanitation, and little to no measures to control the spread of disease. As the Colonies grew bigger, there was more grounds for infection to spread. There were several outbreaks of smallpox, measles, and influenza that spread throughout major cities like New York and Boston.?

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        • Starting in 1793, the city of Philadelphia (already one of the largest and most influential cities in America) suffered a massive outbreak of yellow fever. Up to 5,000 people died from the disease out of a total population of 50,000. On top of the deaths, up to 20,000 people fled. The epidemic spread to other cities. Despite the immense cost, American cities continued to grow during this time. City officials responded by limiting access to rivers, where the disease spread most, causing more inland development.

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        • After fading from the public eye for a while, yellow fever sweeps the South. Yellow fever is believed to originate from Africa, and is carried by several types of mosquito. The 1820 epidemic hits Savannah, Georgia the hardest. Savannah, one of the largest slave ports in the country, likely brought over mosquitoes carrying the disease.

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        • After the initial boom in industry, larger numbers of people started moving into the cities. At this period of time there weren't comprehensive sewer systems, nor were people aware of germs. The sudden increase in population overwhelmed city sanitation. The biggest problem was human waste getting in the water supply, which causes cholera. The disease would become a constant presence in dirtier parts of town.?Over 10,000 people died in New York, and over 4,000 died in New Orleans.?

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        • Yellow fever spreads across the South once again, with at least three major disease outbreaks. During this period of time, there are at least 20 outbreaks across the Americas.

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        • Over 13,000 people died from yellow fever in lower Mississippi Valley; people living along the river are especially susceptible to the illness.

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        • The U.S. Army starts implementing public health measures like putting up mosquito nets. Through a concerted effort, they are able to nearly eradicate mosquito-borne illnesses from Panama and Cuba. Other groups would go on to perform similar projects in Brazil and Mexico.

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        • U.S. health officials in Kansas note a disease spreading in several military camps where troops are training for deployment to Europe. Little is done to contain the disease and it spread across the country.

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        • There are wildly conflicting estimates about how many people caught the flu and how many people died from it. The lack of records from the time (either due to wartime censorship or shortages) makes it hard to tell. The smallest estimate is that 17 million people died. The highest estimate is that 100 million people died, or 5% of the global population. The flu pandemic is believed to have infected 500 million people, or over a quarter of the world.

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        • Over 6,000 people die from polio in the United States, out of a reported 100,000 cases. This, followed by the development of the polio vaccine, prompts one of the first major drives to inoculate children in the U.S.

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        • The "Hong Kong Flu" is the third of the three influenza pandemics of the 1900s. This flu had a much lower mortality rate than the other two, but still resulted in 33,000 deaths in the U.S.

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        • Several retroviruses discovered across the country are confirmed to be a single disease, which will go on to be named HIV.

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        • Many high-profile celebrities, including Eazy-E and Freddie Mercury, die of AIDS. Other living celebrities, like Magic Johnson, come forward with the disease. New treatments for the disease become available, and there is a major cultural shift in how people approach safety during sex. The rate of infection in the U.S. drops off.

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        • One of Milwaukee's water treatment plants became contaminated with cryptosporidium and killed more than 100; 403,000 cases reported.

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        • In response to the growing number of cases in Wuhan, the World Health Organization (WHO) declares the novel coronavirus outbreak a public health emergency.

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        • The coronavirus outbreak reaches the United States; the first victim dies to the disease in the U.S., prompting widespread panic.

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        • The coronavirus outbreak in the U.S. is officially declared a national emergency. The Director-General of the WHO, Tedros Adhanom Ghebreyesus, declares the disease to have grown from epidemic proportions to a pandemic. At the urging of health officials, different states begin enforcing restrictions on businesses and public gatherings to contain the disease.
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