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Endemic, Epidemic & Pandemic

"Pandemic" is probably the most frequently uttered word among people globally from 2020 to 2023 due to Covid 19, and we're still talking about it when we refer to the shift in the landscapes across different arenas like global economy, medicine, science & technology and many more.

The Covid-19 pandemic has shone light on various matters such as the developments that need to take place to be better prepared for similar outbreaks in the near future, and that mental health crisis need to be taken care of as soon as possible since us humans are unable to handle even temporary isolation and uncertainty.



On the bright side, the scientific breakthroughs made thus far has enabled us to be better equipped with handling these sticky situations since the standard of care has increased and medical attention has also reached out to people across the globe in every corner with easy accessibility with the help of globalisation.


Although we've used the word "pandemic" so often, many of us are confused about the difference between the terms, "endemic", "epidemic" and "pandemic". We've had similar encounters in the past where deadly organisms have claimed millions of lives and medical management had been in a more primitive stage, being unable to save many from the hands of death. To illustrate what each of these terms mean, let's have a quick look at the history of humanity.



EPIDEMIC


The term is derived from Greek "epi" meaning "upon or above" and "demos" meaning "people". The Centers for Disease Control and Prevention (CDC) describes an epidemic as an unexpected increase in the number of disease cases in a specific geographical area, which doesn't necessarily have to be contagious. Even the rapid increase in obesity rates is also considered an epidemic.


Essentially, epidemics can refer to a disease or other specific health-related behavior (e.g., smoking) with rates that are clearly above the expected occurrence in a community or region.


AN EXAMPLE

In the early 20th century, polio was paralysing hundreds of thousands of children every year in different parts of the world in different time periods. Infectious diseases are generally believed to arise from the interplay of drastic changes occurring over a short period of time, such as urbanisation, large number of people settling in new areas, crowding (which results in poor hygiene), food shortages due to a rise in global demand and many more.


In 1955, Dr Jonas Salk developed the first vaccine against polio –an injectable, inactivated (killed) polio vaccine (IPV), and in 1961 Dr Albert Sabin developed a “live” oral vaccine against polio (OPV). In many countries, soon enough, polio was starting to become eradicated. Today, we actively prevent children from contracting this debilitating disease.



ENDEMIC

A disease outbreak is endemic when it is consistently present but limited to a particular geographic area, which makes the disease spread easily and rates remain predictable. Malaria, for example, is considered endemic in some places.


Here are some facts about Malaria:

  • It is a parasitic infection transmitted by the Anopheles mosquito that leads to acute life-threatening disease and poses a significant global health threat.

  • The Plasmodium parasite has a multistage lifecycle, which leads to characteristic cyclical fevers.

  • Five Plasmodium species possess the ability to infect humans: P. falciparum, P. ovale, P. vivax, P. malariae, and P. knowlesi.

  • The gold standard for malaria diagnosis is a microscopic evaluation of Giemsa-stained thick and thin smears of a free-flowing venipuncture blood specimen.

  • Tu Youyou had her attention on Chinese medical texts from the Zhou, Qing, and Han Dynasties to find a traditional cure for malaria, extracting the compound– artemisinin. She was awarded the 2015 Nobel Prize in Physiology or Medicine.

  • The chief antimalarials are chloroquine, hydroxychloroquine, primaquine, artemisinin-based combination therapy (ACT), and atovaquone-proguanil.



PANDEMIC

Let's take a break from Covid-19, travel back in time further to talk about another pandemic of the past: The Spanish Flu.

The Spanish Flu pandemic of 1918-1919 (caused by H1N1 influenza A virus) is estimated to have infected one-third of the world's population and had caused deaths of approximately 50 million people worldwide, making it one of the deadliest pandemics in history.

Here are some facts about the Spanish Flu:

  • Deadly clusters of symptoms were recorded, including nasal haemorrhage (bleeding), pneumonia, encephalitis, temperatures of up to 40°C, nephritis-like blood-streaked urine, and coma.

  • The Spanish flu hit different age-groups, displaying a so-called “W-trend”, with infections typically peaking in children and the elderly, with an intermediate spike in healthy young adults.

  • At that time, medical professionals advised patients to take up to 30 grams of aspirin per day, a dose now known to be toxic. (It is now known that going beyond 4g is unsafe). Many deaths had also unfortunately resulted in aspirin poisoning, symptoms includes pulmonary edema, which results in severe lung congestion and difficulty in breathing.



THE FUTURE

We can never accurately predict what the future entails, but history has taught us to expect the unexpected. History also teaches us to learn from our mistakes to be better prepared for the curveballs that nature may throw at us. Medical advancements has eradicated so many infectious diseases and NGOs, Government efforts, as well as humanitarian aid workers have catalysed the progress in delivering medical care in many corners of the world.


While we may not know what is in store for us, it is our duty to raise the next generation to be proactive, informed and attentive global citizens to tackle anything that may stand before humanity.


 
 
 

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