By: Dave Roos

How 5 of History’s Worst Pandemics Finally Ended

While some of the earliest pandemics faded by wiping out parts of the population, medical and public health initiatives were able to halt the spread of other diseases.

How 5 of History's Worst Pandemics Finally Ended

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Published: March 17, 2020

Last Updated: February 18, 2025

As human civilizations flourished, so did infectious diseases. Large numbers of people living in close proximity to each other and to animals, often with poor sanitation and nutrition, provided fertile breeding grounds for disease. And new overseas trading routes spread the novel infections far and wide, creating the first global pandemics.

Here’s how five of the world’s worst pandemics finally ended.

1.

Plague of Justinian—No One Left to Die

Three of the deadliest pandemics in recorded history were caused by a single bacterium, Yersinia pestis, a fatal infection otherwise known as the plague.

The Plague of Justinian arrived in Constantinople, the capital of the Byzantine Empire, in 541 CE. It was carried over the Mediterranean Sea from Egypt, where plague-ridden fleas hitched a ride on black rats that snacked on grain.

The plague decimated Constantinople and spread like wildfire across Europe, Asia, North Africa and Arabia killing an estimated 30 to 50 million people, perhaps half of the world’s population.

“People had no real understanding of how to fight it other than trying to avoid sick people,” says Thomas Mockaitis, a history professor at DePaul University. “As to how the plague ended, the best guess is that the majority of people in a pandemic somehow survive, and those who survive have immunity.”

Yersinia pestis

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2.

Black Death—The Invention of Quarantine

The plague never really went away, and when it returned 800 years later, it killed with reckless abandon. The Black Death, which hit Europe in 1347, claimed an astonishing 25 million lives in just four years. Some historians estimate the disease led to even higher death tolls—up to 200 million.

As for how to stop the disease, people still had no scientific understanding of contagion, says Mockaitis, but they knew that it had something to do with proximity. That’s why forward-thinking officials in the Venetian-controlled port city of Ragusa decided to keep newly arrived sailors in isolation until they could prove they weren’t sick.

At first, sailors were held on their ships for 30 days, which became known in Venetian law as a trentino. As time went on, the Venetians increased the forced isolation to 40 days or a quarantino, the origin of the word quarantine and the start of its practice in the Western world.

“That definitely had an effect,” says Mockaitis.

Gilles de Muisit's annals, The plague at Tournai, 1349, France, Brussels, Bibliothèque royale.

The people of Tournai bury victims of the Black Death circa 1353. 

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3.

The Great Plague of London—Sealing Up the Sick

London never really caught a break after the Black Death. The plague resurfaced roughly every 10 years from 1348 to 1665—40 outbreaks in just over 300 years. And with each new plague epidemic, 20 percent of the men, women and children living in the British capital were killed.

By the early 1500s, England imposed the first laws to separate and isolate the sick. Homes stricken by plague were marked with a bale of hay strung to a pole outside. If you had infected family members, you had to carry a white pole when you went out in public. Cats and dogs were believed to carry the disease, so there was a wholesale massacre of hundreds of thousands of animals.

The Great Plague of 1665 was the last and one of the worst of the centuries-long outbreaks, killing 100,000 Londoners in just seven months. All public entertainment was banned and victims were forcibly shut into their homes to prevent the spread of the disease. Red crosses were painted on their doors along with a plea for forgiveness: “Lord have mercy upon us.”

As cruel as it was to shut up the sick in their homes and bury the dead in mass graves, it may have been the only way to bring the last great plague outbreak to an end.

Scenes in the streets of London during the Great Plague of 1665.

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4.

Smallpox—A European Disease Ravages the New World

Smallpox was endemic to Europe, Asia and Arabia for centuries, a persistent menace that killed three out of ten people it infected and left the rest with pockmarked scars. But the death rate in the Old World paled in comparison to the devastation wrought on native populations in the New World when the smallpox virus arrived in the 15th century with the first European explorers.

The indigenous peoples of modern-day Mexico and the United States had zero natural immunity to smallpox and the virus cut them down by the tens of millions.

“There hasn’t been a kill off in human history to match what happened in the Americas—90 to 95 percent of the indigenous population wiped out over a century,” says Mockaitis. “Mexico goes from 11 million people pre-conquest to one million.”

Centuries later, smallpox became the first virus epidemic to be ended by a vaccine. In the late 18th century, a British doctor named Edward Jenner discovered that milkmaids infected with a milder virus called cowpox seemed immune to smallpox. Jenner famously inoculated his gardener’s 8-year-old son with cowpox and then exposed him to the smallpox virus with no ill effect.

“[T]he annihilation of the smallpox, the most dreadful scourge of the human species, must be the final result of this practice,” wrote Jenner in 1801.

And he was right. It took nearly two more centuries, but in 1980 the World Health Organization announced that smallpox had been completely eradicated from the face of the Earth.

5.

Cholera—A Victory for Public Health Research

In the early- to mid-19th century, cholera tore through England, killing tens of thousands. The prevailing scientific theory of the day said that the disease was spread by foul air known as a “miasma.” But a British doctor named John Snow suspected that the mysterious disease, which killed its victims within days of the first symptoms, lurked in London’s drinking water.

Snow acted like a scientific Sherlock Holmes, investigating hospital records and morgue reports to track the precise locations of deadly outbreaks. He created a geographic chart of cholera deaths over a 10-day period and found a cluster of 500 fatal infections surrounding the Broad Street pump, a popular city well for drinking water.

“As soon as I became acquainted with the situation and extent of this irruption (sic) of cholera, I suspected some contamination of the water of the much-frequented street-pump in Broad Street,” wrote Snow.

With dogged effort, Snow convinced local officials to remove the pump handle on the Broad Street drinking well, rendering it unusable, and like magic, the infections dried up. Snow’s work didn’t cure cholera overnight, but it eventually led to a global effort to improve urban sanitation and protect drinking water from contamination.

While cholera has largely been eradicated in developed countries, it’s still a persistent killer in third-world countries lacking adequate sewage treatment and access to clean drinking water.

A satirical cartoon showing the River Thames and its offspring cholera, scrofula and diptheria, circa 1858.

Hulton Archive/Getty Images

Leprosy

Though it had been around for ages, leprosy grew into a pandemic in Europe in the Middle Ages. A slow-developing bacterial disease that causes sores and deformities, leprosy was believed to be a punishment from God that ran in families.

De Agostini/Getty Images

Black Death

The Black Death haunts the world as the worst-case scenario for the speed of disease’s spread. It was the second pandemic caused by the bubonic plague, and ravaged Earth’s population. Called the Great Mortality as it caused its devastation, it became known as the Black Death in the late 17th Century.Read more: Social Distancing and Quarantine Were Used in Medieval Times to Fight the Black Death

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The Great Plague of 1665 to 1666 graph

In another devastating appearance, the bubonic plague led to the deaths of 20 percent of London’s population. The worst of the outbreak tapered off in the fall of 1666, around the same time as another destructive event—the Great Fire of London. Read more: When London Faced a Pandemic—And a Devastating Fire

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Cholera epidemic

The first of seven cholera pandemics over the next 150 years, this wave of the small intestine infection originated in Russia, where one million people died. Spreading through feces-infected water and food, the bacterium was passed along to British soldiers who brought it to India where millions more died. Read more: How 5 of History’s Worst Pandemics Finally Ended

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The first significant flu pandemic started in Siberia and Kazakhstan, traveled to Moscow, and made its way into Finland and then Poland, where it moved into the rest of Europe. By the end of 1890, 360,000 had died.Read more: The Russian Flu of 1889: The Deadly Pandemic Few Americans Took Seriously

National Library of Medicine

Spanish Flu, 1918

The avian-borne flu that resulted in 50 million deaths worldwide, the 1918 flu was first observed in Europe, the United States and parts of Asia before spreading around the world. At the time, there were no effective drugs or vaccines to treat this killer flu strain. Read more: How U.S. Cities Tried to Halt the Spread of the 1918 Spanish Flu

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Starting in Hong Kong and spreading throughout China and then into the United States, the Asian flu became widespread in England where, over six months, 14,000 people died. A second wave followed in early 1958, causing about 1.1 million deaths globally, with 116,000 deaths in the United States alone.Read more: How the 1957 Flu Pandemic Was Stopped Early in Its Path

Ed Clark/The LIFE Picture Collection/Getty Images

HIV/AIDS Epidemic

First identified in 1981, AIDS destroys a person’s immune system, resulting in eventual death by diseases that the body would usually fight off. AIDS was first observed in American gay communities but is believed to have developed from a chimpanzee virus from West Africa in the 1920s. Treatments have been developed to slow the progress of the disease, but 35 million people have died of AIDS since its discoveryRead more: The History of AIDS

Acey Harper/The LIFE Images Collection/Getty Images

SARS Virus, 2003

First identified in 2003, Severe Acute Respiratory Syndrome is believed to have started with bats, spread to cats and then to humans in China, followed by 26 other countries, infecting 8,096 people, with 774 deaths.Read more: SARS Pandemic: How the Virus Spread Around the World in 2003

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COVID-19, Coronavirus

COVID-19 is caused by a novel coronavirus, the family of viruses that includes the common flu and SARS. The first reported case in China appeared in November  2019, in the Hubei Province. Without a vaccine available, the virus has spread to more than 163 countries. By March 27, 2020, nearly 24,000 people had died.Read more: 12 Times People Confronted a Crisis With Kindness

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About the author

Dave Roos

Dave Roos is a journalist and podcaster based in the U.S. and Mexico. He's the co-host of Biblical Time Machine, a history podcast, and a writer for the popular podcast Stuff You Should Know. Learn more at daveroos.com.

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Citation Information

Article title
How 5 of History’s Worst Pandemics Finally Ended
Author
Dave Roos
Website Name
History
Date Accessed
March 21, 2025
Publisher
A&E Television Networks
Last Updated
February 18, 2025
Original Published Date
March 17, 2020

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