TIMELINE: History of major diseases to infect United States

Smallpox is an infectious disease caused by the variola virus. The virus is transmitted from person to person by air droplets from close contact with an infected person. Smallpox is most recognized as a severe rash of pustules throughout a person’s entire body. Many smallpox survivors have gone blind or have permanent scarring over large areas of their body.

Year peaked: 110,672 reported smallpox cases in 1920.

Death toll: The smallpox virus ravaged many parts of the world for many centuries. Historians believe that smallpox caused the Plague of Athens in 430 B.C. and the Antonine Plague of 165 to 180 A.D., which killed an estimated 3.5 million to 7 million people.

Vaccine introduced: In 1796, Edward Jenner demonstrated that inoculation of humans with live vaccinia virus (cowpox) could protect against smallpox.

Cases today: Smallpox was declared eradicated in 1980 by the 33rd World Health Assembly. It is the only infectious disease to achieve complete eradication to date.

Tetanus is an infection caused by the Clostridium tetani bacteria which causes painful tightening of the muscles. It can cause “locking” of the jaw so it makes is difficult to open the mouth or swallow.

Year peaked: Tetanus became nationally reported in 1947 with over 600 cases.

Death toll: Over 200,000 deaths were related to tetanus in the 1900s.

Vaccine introduced: The DTap was introduced in 1948. There are now four kinds of vaccines used to defend against tetanus, all in which are combined with vaccines for other diseases like diphtheria and pertussis.

Cases today: Reported tetanus cases have declined more than 95 percent, and deaths from tetanus have declined more than 99 percent in the United States since 1947.

Diphtheria is an infection caused by the bacteria, Corynebacterium diphtheriae, which can cause breathing problems, paralysis and heart failure. Before vaccines, diphtheria killed tens of thousands of children every year in the U.S.

Year peaked: In 1921, 15,520 deaths due to diphtheria and about 150,000 cases of diphtheria occurred in the United States every year.

Vaccine introduced: Emil Von Behring developed the first effective therapeutic serum against diphtheria in 1888. Today, The diphtheria, tetanus and pertussis (DTap) vaccine, which was licensed in 1949, combats the three diseases simultaneously.

Cases today: 303 deaths in the U.S. due to diptheria in 2016.

Pertussis, also known as Whooping Cough, causes severe coughing that makes it difficult for infants and children to eat, drink or even breathe. Whooping cough in infants and children can cause pneumonia, seizures, brain damage and death.

Year peaked and death toll: Pertussis was most reported in the 1930s with cases peaking at 250,000.

Vaccine introduced: The DTap was introduced in 1948 to protect individuals from pertussis, tetanus and diphtheria.

Cases today:  There are more than 18,000 reported cases of pertussis in the U.S. in 2017.

A respiratory disease caused by the rubeola virus. The first sign of measles is usually a high fever. The individual may experience a runny nose, cough, irritated eyes and small white sores inside of the cheeks. After several days, a severe rash develops.

Year peaked: 3,227 deaths were reported in the U.S. 1938

Vaccine introduced: The Measles, Mumps and Rubella (MMR) vaccine was introduced in 1963. The vaccine protects against these diseases. In 1963, John Enders and his team transformed the “Edmonston-B strain” of the measles virus into a vaccine and licensed it in the U.S. The Edmonston-Enders (formerly “Moraten”) strain has been the only measles vaccine used in the United States since 1968.

Cases today: The last measles death in the U.S. occurred in 2015. The disease was declared eradicated in the U.S. in 2000. As the national rate of vaccinations have dropped since 2008, there has been a resurgence.

Poliomyelitis, otherwise known as polio, is a potentially deadly disease, caused by the polio virus. The virus spreads from person to person and can invade an infected person’s brain and spinal cord, causing paralysis

Year peaked: The worst recorded polio epidemic in U.S. history occurred with 57,628 reported cases in 1952 and 3,145 deaths.

Vaccine introduced: Inactivated poliovirus vaccine (IPV) was introduced in 1955 by Dr. Jonas Salk.

Cases today: Today, the U.S. has been polio-free for more than 30 years. However, it only takes one person to carry the disease from another country to bring polio back to the U.S.

Tuberculosis (TB) is caused by the bacteria Mycobacterium tuberculosis, a disease that most often affect the lungs. Symptoms, like cough, fever, night sweats or weight loss, may go undetected for several months, which might lead to the delay of seeking out medical care and can increase the spread of the disease to others.

Year peaked: In 1953 there were 84,304 cases of TB

Vaccine introduced: Bacille Calmette-Guérin (BCG) is a vaccine for TB disease used mostly in foreign countries. However, BCG does not always protect people from getting TB. The disease can be treated by taking several drugs for six to nine months.  There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB.

Cases today: In 2016, there were 9,272 cases of TB and 528 deaths in the U.S. A total of 9,105 cases were reported in the United States in 2017. This is a decrease from the number of cases reported in 2016 and the lowest case count on record in the United States.

Meningococcal disease can refer to any illness caused by the type of bacteria called Neisseria meningitidis, also known as meningococcus; When someone has meningococcal meningitis, the bacteria infects the protective membranes covering their brain and spinal cord, and causes brain swelling.

Year peaked and death toll: Meningococcal diseases reportedly reached almost 150,000 cases in the 1980s.

Vaccine introduced:  The first meningococcal polysaccharide (Serogroups A, C, Y and W-135) diphtheria toxoid conjugate vaccine, called Menactra by Sanofi Pasteur was licensed in 2005. The Federal Drug Administration (FDA) approved the first vaccine, Menactra, meningococcal conjugate vaccine, in 2011 by Sanofi Pasteur to prevent meningococcal disease in infants and toddlers.

Cases today: There were 370 total cases of meningococcal disease reported in 2016. However, the rates of meningococcal diseases has been on the decline since the late 1990s.

Chickenpox is a highly contagious disease caused by the varicella-zoster virus. It causes a blister-like rash over the entire body, itching, fatigue and fever.

Year peaked: Before the availability of varicella vaccine in the U.S., almost everyone had chickenpox. As a result, an average of 4 million cases of chickenpox occured in the 1990s, with 10,500–13,000 hospitalizations and 100–150 deaths each year.

Vaccine introduced: Since the introduction of the varicella vaccination by Dr. Michiaki Takahashi in 1995, the two-dose program was enforced in 1996. Since then, chickenpox morbidity and mortality in the U.S. have significantly declined.

Cases today: Medical claims for varicella obtained by outpatient visits has shown declines of 84 percent and 93 percent, respectively, by 2012 compared to the pre-vaccination period in 1994-1995.

Influenza (flu) is a contagious respiratory illness caused by influenza viruses that infect the throat, nose and lungs.

Year peaked and death toll: It is difficult to determine the number of deaths directly caused by the flu because most people die from complications like pneumonia. However, the U.S. experienced a flu outbreak in 2009, with the H1N1, or swine flu, outbreak. Between 8,870 and 18,300 deaths were reported in 2009.

Vaccine introduced: Dr. Thomas Francis Jr., and Dr. Jonas Salk, who are also known for developing the vaccine for polio, were both integral to developing the flu vaccine, which was licensed in 1946.

Cases today: The CDC estimates that from 2010-2011 to 2017-2018 influenza-associated deaths in the United States ranged from a low of 12,000 (during 2011-2012) to a high of 79,000 (during 2017-2018).