Outbreak vs. Epidemic vs. Pandemic: All three words politically charged

Crystal skull at the Musée du quai Branly, Paris. Eugène Boban, a controversal antique dealer, sold this piece to Alphonse Pinart, a young explorer. Pinart donated it to the Museum of Ethnography at Trocadéro, Paris.

An outbreak is a term that refers to the initial, sudden appearance of a particular disease. The disease does not have to be new or unusual. The term is usually applied to the first detection of the disease in a limited population. If the disease spreads to a larger population in a short period of time, the terminology changes to refer to the disease outbreak as an epidemic. 

The word "epidemic" is defined as a widespread occurrence of an infectious disease in a community at a particular time. An epidemic usually involves a relatively short period of time and a large number of people in a defined population. Once the occurrences of the disease increase across larger populations, at some point, the terminology shifts to refer to the disease as a pandemic. The World Health Organization (WHO) has the following list of Pandemic, epidemic diseases on its website as of the date of this blog post. See https://www.who.int/emergencies/diseases/en/

• Chikungunya
• Cholera
• Crimean-Congo hemorrhagic fever
• Ebola virus disease
• Hendra virus infection
• Influenza (pandemic, seasonal, zoonotic)
• Lassa fever
• Marburg virus disease
• Meningitis
• MERS-CoV
• Monkeypox
• Nipah virus infection
• Novel coronavirus (2019-nCoV)
• Plague
• Rift Valley fever
• SARS
• Smallpox
• Tularaemia
• Yellow fever
• Zika virus disease

Because of my interest in history and particularly in genealogy, I have been interested in historic pandemics. These occurrences usually result in blank spaces on a pedigree chart with few records that help to fill the gaps. The most recent historical pandemic occurred in 1918 and 1919 and resulted in the death of an estimated 1/3 of the world's population. See the following:

Taubenberger, Jeffery K., and David M. Morens. “1918 Influenza: The Mother of All Pandemics - Volume 12, Number 1—January 2006 - Emerging Infectious Diseases Journal - CDC.” Accessed March 4, 2020. https://doi.org/10.3201/eid1201.050979.

Here is a quote from the above article about the 1918 pandemic:

An estimated one third of the world's population (or ≈500 million persons) were infected and had clinically apparent illnesses (1,2) during the 1918–1919 influenza pandemic. The disease was exceptionally severe. Case-fatality rates were >2.5%, compared to <0 .1="" 100="" and="" arguably="" as="" at="" blockquote="" deaths="" estimated="" high="" in="" influenza="" million="" other="" pandemics="" total="" were=""> If you were to review a list of what are considered to be the worst pandemics in history, you might be surprised to realize that you lived through some of them without buying a surgical mask and/or rushing to the stores to buy toilet paper. Here is a link to one such list: https://www.mphonline.org/worst-pandemics-in-history/

 While doing genealogical research, it is not unusual to find multiple deaths in the same family at the same time. These deaths can sometimes be connected to a local epidemic or a larger pandemic. If you look at the list above, you will see some diseases that are still prevalent in the world today and one or two that have disappeared from most of the countries of the world.

When we think of a major pandemic in history, we often think about the "Black Death" or Bubonic Plague of the Middle Ages from 1347 to 1351 that killed from 75 to 200 million people. See "Black Death." You might also be surprised to find out that the Plague is still endemic in the Southwestern United States. See the following:

Eisen, Rebecca J., Russell E. Enscore, Brad J. Biggerstaff, Pamela J. Reynolds, Paul Ettestad, Ted Brown, John Pape, et al. “Human Plague in the Southwestern United States, 1957–2004: Spatial Models of Elevated Risk of Human Exposure to Yersinia Pestis.” Journal of Medical Entomology 44, no. 3 (May 1, 2007): 530–37. https://doi.org/10.1093/jmedent/44.3.530.

There are several diseases on the list that are still lurking out there waiting for the right conditions to reappear in the general population. For example, smallpox has been eradicated in most of the world but currently few people have has the vaccination and a smallpox epidemic today would affect a large population before it was controlled.

It is certain that epidemics and even pandemics will continue to occur. The Novel coronavirus is only one of a number of possible pandemic diseases.