Pandemik

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Pandemik (dari Greek πᾶν pan "semua" + δῆμος demos "orang") ialah epidemik penyakit berjangkit yang merebak melalui populasi manusia menyeberangi kawasan luas; sebagai contoh benua, malah seluruh dunia. Penyakit endemik meluas yang stabil dari segi berapa ramai orang jatuh sakit akibatnya bukanlah satu pandemik. Tambahan lagi, pandemik selsema tidak termasuk selsema bermusim. Sepanjang sejarah terdapat sejumlah pandemik, seperti cacar dan penyakit Batuk Kering. Pandemik baru termasuk pandemik HIV dan pandemik selsema 2009.

Takrif[sunting | sunting sumber]

Mengikut Pertubuhan Kesihatan Sedunia (WHO), pandemik bermula apabila tiga syarat telah dipenuhi:[1]

  • Kemunculan penyakit baru dalam populasi
  • Ia menjangkiti manusia, menyebabkan sakit yang serius
  • Ia merebak dengan mudah di kalangan manusia.

Sesuatu penyakit atau keadaan bukanlah pandemik hanya kerana ia menular atau membunuh ramai manusia. Pandemik mestilah juga sesuatu yang berjangkit. Contohnya, barah bertanggungjawab bagi banyak kematian tetapi tidak dianggap pandemik kerana ia bukanlah penyakit berjangkit.

Pandemik kini[sunting | sunting sumber]

2009 influenza A/H1N1[sunting | sunting sumber]

Wabak 2009 jenis baru Influenza A virus subtype H1N1 menimbulkan kebimbangan bahawa pandemik baru sedang berlaku. Pada separuh akhir April, 2009, aras amaran pandemik oleh Pertubuhan Kesihatan Sedunia ditingkatkan dari tiga kepada lima sehingga diumumkan pada 11 Jun 2009 bahawa aras pandemik telah ditingkatkan kepada tahap tertinggi, tahap enam. [2] Ini merupakan pandemik pertama pada tahap ini sejak 1968. Dr Margaret Chan, Director-General bagi Pertubuhan Kesihatan Sedunia (WHO), memberi kenyataan pada 11 Jun 2009 mengesahkan bahawa strain H1N1 merupakan pandemik, dengan hampir 30,000 kes disahkan seluruh dunia.

HIV dan AIDS[sunting | sunting sumber]

HIV merebak secara langsung dari Afrika ke Haiti, kemudian merebak ke Amerika Syarikat dan kebanyakan bahagian dunia sekitar 1969.[3] HIV, tah virus yang menyebabkan AIDS, kini merupakan pandemik, dengan kadar jangkitan setinggi 25% di selatan dan timur Afrika. Pada 2006 kadar jangkitan HIV dikalangan wanita mengandung di Afrika Selatan adalah 29.1%.[4] Pendidik berkesan mengenai latihan berjaga-jaga amalan seksual dan jangkitan bawaan darah telah membantu mengurangkan kadar jangkitan di beberapa negara Afrika yang menaja program pendidikan kebangsaan. Kadar jangkitan kembali meningkat di Asia dan Amerika. AIDS mampu membunuh 31 juta manusia di India dan 18 juta di China menjelang 2025, menurut unjuran oleh penyelidik populasi U.N.[5] Jumlah kematian akibat AIDS di Afrika mungkin mencecah 90-100 juta menjelang 2025.[6]

Pandemik dan epidemik penting sepanjang sejarah[sunting | sunting sumber]

Terdapat sejumlah besar pandemik direkodkan dalam sejarah manusia, terutamanya berkait dengan "zoonosis" yang seiring dengan ternakan haiwan, seperti influenza dan batuk kering ("tuberculosis"). Terdapat sejumlah epidemik yang agak penting sehinggakan ia patut disebut melebihi "sekadar" memusnahkan bandar-bandar:

  • Wabak Athens, 430 BC. demam kepialu membunuh suku daripada tentera Athen, dan suku daripada penduduk sepanjang empat tahun. Penyakit membunuh ini melemahkan sepenuhnya penguasaan Athens, tetapi kadar membunuh penyakit ini menghalang penyebarannya lebih meluas; contoh. ia membunuh hosnya pada kadar lebih pantas ia mampu merebak. Punca wabak ini tidak diketahui selama beberapa tahun. Pada Januari 2006, penyelidik dari Universiti Athens menganalisa gigi yang diambil dari kubur besar-besaran di bawah bandar, dan mengesahkan kehadiran bakteria yang bertanggungjawab bagi penyakit demam kepialu.[7]
  • Wabak Antonine, 165–180. Kemungkinannya cacar di bawa ke semenanjung Itali oleh tentera yang kembali dari Timur Dekat ("Near East"); ia membunuh suku dari mereka yang dijangkiti, dan sehingga lima juta kesemuanya.[8] At the height of a second outbreak, the Plague of Cyprian (251–266), which may have been the same disease, 5,000 people a day were said to be dying in Rome.
  • Wabak Justinian, dari 541 hingga 750, merupakan kali pertama wabak bubonic dirakamkan. Ia bermula di Mesir, dan sampai ke Constantinople pada musim bunga berikutnya, membunuh (menurut penghikayat Byzantine Procopius) 10,000 sehari pada kemuncaknya, dan kemungkinan 40% daripada penduduk bandarnya. Wabak itu berterusan untuk menghapuskan separuh dari penduduk manusia yang dijangkitinya sepanjang dunia yang diketahui. [9][10] It caused Europe's population to drop by around 50% between 550 and 700.[11]
  • Black Death, started 1300s. The total number of deaths worldwide is estimated at 75 million people.[12] Eight hundred years after the last outbreak, the plague returned to Europe. Starting in Asia, the disease reached Mediterranean and western Europe in 1348 (possibly from Italian merchants fleeing fighting in the Crimea), and killed an estimated 20 to 30 million Europeans in six years;[13] a third of the total population,[14] and up to a half in the worst-affected urban areas.[15] It was the first of a cycle of European plague epidemics that continued until the 18th century.[16] During this period, more than 100 plague epidemics swept across Europe.[17] In England, for example, epidemics would continue in 2- to 5-year cycles from 1361 to 1480.[18] By the 1370s, England's population was reduced by 50%.[19] The Great Plague of London of 1665–66 was the last major outbreak of the plague in England. The disease killed an estimated 100,000 people, 20% of London's population.[20]
  • Third Pandemic, started in China in the middle of the 19th century, spreading plague to all inhabited continents and killing 10 million people in India alone.[21] During this pandemic, the United States saw its first case of plague in 1900 in San Francisco.[22] Today, isolated cases of plague are still found in the western United States.[23]

Encounters between European explorers and populations in the rest of the world often introduced local epidemics of extraordinary virulence. Disease killed the entire native (Guanches) population of the Canary Islands in the 16th century. Half the native population of Hispaniola in 1518 was killed by smallpox. Smallpox also ravaged Mexico in the 1520s, killing 150,000 in Tenochtitlán alone, including the emperor, and Peru in the 1530s, aiding the European conquerors.[24] Measles killed a further two million Mexican natives in the 1600s. In 1618–1619, smallpox wiped out 90% of the Massachusetts Bay Native Americans.[25] During the 1770s, smallpox killed at least 30% of the Pacific Northwest Native Americans.[26] Smallpox epidemics in 1780–1782 and 1837–1838 brought devastation and drastic depopulation among the Plains Indians.[27] Some believe that the death of up to 95% of the Native American population of the New World was caused by Old World diseases such as smallpox, measles, and influenza.[28] Over the centuries, the Europeans had developed high degrees of immunity to these diseases, while the indigenous peoples had no such immunity.[29]

Smallpox devastated the native population of Australia, killing around 50% of Indigenous Australians in the early years of British colonisation.[30] It also killed many New Zealand Māori.[31] As late as 1848–49, as many as 40,000 out of 150,000 Hawaiians are estimated to have died of measles, whooping cough and influenza. Introduced diseases, notably smallpox, nearly wiped out the native population of Easter Island.[32] In 1875, measles killed over 40,000 Fijians, approximately one-third of the population.[33] The disease decimated the Andamanese population.[34] Ainu population decreased drastically in the 19th century, due in large part to infectious diseases brought by Japanese settlers pouring into Hokkaido.[35]

Researchers concluded that syphilis was carried from the New World to Europe after Columbus' voyages. The findings suggested Europeans could have carried the nonvenereal tropical bacteria home, where the organisms may have mutated into a more deadly form in the different conditions of Europe.[36] The disease was more frequently fatal than it is today. Syphilis was a major killer in Europe during the Renaissance.[37] Disease killed more British soldiers in India than war. Between 1736 and 1834 only some 10% of East India Company's officers survived to take the final voyage home.[38]

As early as 1803, the Spanish Crown organized a mission (the Balmis expedition) to transport the smallpox vaccine to the Spanish colonies, and establish mass vaccination programs there.[39] By 1832, the federal government of the United States established a smallpox vaccination program for Native Americans.[40] From the beginning of the 20th century onwards, the elimination or control of disease in tropical countries became a driving force for all colonial powers.[41] The sleeping sickness epidemic in Africa was arrested due to mobile teams systematically screening millions of people at risk.[42] In the 20th century, the world saw the biggest increase in its population in human history due to lessening of the mortality rate in many countries due to medical advances.[43] The world population has grown from 1.6 billion in 1900 to an estimated 6.7 billion today.[44]

Cholera[sunting | sunting sumber]

  • First cholera pandemic 1816-1826. Previously restricted to the Indian subcontinent, the pandemic began in Bengal, then spread across India by 1820. 10,000 British troops and countless Indians died during this pandemic.[45] It extended as far as China, Indonesia (where more than 100,000 people succumbed on the island of Java alone) and the Caspian Sea before receding. Deaths in India between 1817 and 1860 are estimated to have exceeded 15 million persons. Another 23 million died between 1865 and 1917. Russian deaths during a similar time period exceeded 2 million.[46]
  • Second cholera pandemic 1829–1851. Reached Russia (see Cholera Riots), Hungary (about 100,000 deaths) and Germany in 1831, London in 1832 (more than 55,000 persons died in the United Kingdom),[47] France, Canada (Ontario), and United States (New York) in the same year,[48] and the Pacific coast of North America by 1834. A two-year outbreak began in England and Wales in 1848 and claimed 52,000 lives.[49] It is believed that over 150,000 Americans died of cholera between 1832 and 1849.[50]
  • Third pandemic 1852–1860. Mainly affected Russia, with over a million deaths. In 1852, cholera spread east to Indonesia and later invaded China and Japan in 1854. The Philippines were infected in 1858 and Korea in 1859. In 1859, an outbreak in Bengal once again led to the transmission of the disease to Iran, Iraq, Arabia and Russia.[51]
  • Fourth pandemic 1863–1875. Spread mostly in Europe and Africa. At least 30,000 of the 90,000 Mecca pilgrims fell victim to the disease. Cholera claimed 90,000 lives in Russia in 1866.[52]
  • In 1866, there was an outbreak in North America. It killed some 50,000 Americans.[50]
  • Fifth pandemic 1881-1896. The 1883-1887 epidemic cost 250,000 lives in Europe and at least 50,000 in Americas. Cholera claimed 267,890 lives in Russia (1892);[53] 120,000 in Spain[54]; 90,000 in Japan and 60,000 in Persia.
  • In 1892, cholera contaminated the water supply of Hamburg, Germany, and caused 8606 deaths.[55]
  • Sixth pandemic 1899–1923. Had little effect in Europe because of advances in public health, but Russia was badly affected again (more than 500,000 people dying of cholera during the first quarter of the 20th century).[56] The sixth pandemic killed more than 800,000 in India. The 1902-1904 cholera epidemic claimed over 200,000 lives in the Philippines.[57]
  • Seventh pandemic 1962-66. Began in Indonesia, called El Tor after the strain, and reached Bangladesh in 1963, India in 1964, and the USSR in 1966.

Influenza[sunting | sunting sumber]

Rencana utama: Influenza pandemic
World Health Organization influenza pandemic alert phases
  • The Greek physician Hippocrates, the "Father of Medicine", first described influenza in 412 BC.[58]
  • The first influenza pandemic was recorded in 1580 and since then influenza pandemics occurred every 10 to 30 years.[59][60][61]
  • Influenza pandemics in 1729-1730, 1732-1733, 1781-1782, 1830, 1833-1834, 1847-1848.[62]
  • The "Asiatic Flu", 1889–1890, was first reported in May 1889 in Bukhara, Uzbekistan. By October, it had reached Tomsk and the Caucasus. It rapidly spread west and hit North America in December 1889, South America in February–April 1890, India in February-March 1890, and Australia in March–April 1890. It was purportedly caused by the H2N8 type of flu virus. It had a very high attack and mortality rate. About 1 million people died in this pandemic."[63]
  • The "Spanish flu", 1918–1919. First identified early in March 1918 in US troops training at Camp Funston, Kansas. By October 1918, it had spread to become a world-wide pandemic on all continents, and eventually infected an estimated one third of the world's population (or ≈500 million persons).[64] Unusually deadly and virulent, it ended nearly as quickly as it began, vanishing completely within 18 months. In six months, some 50 million were dead;[64] some estimates put the total of those killed worldwide at over twice that number.[65] An estimated 17 million died in India, 675,000 in the United States[66] and 200,000 in the UK. The virus was recently reconstructed by scientists at the CDC studying remains preserved by the Alaskan permafrost. They identified it as a type of H1N1 virus.[perlu rujukan]
  • The "Asian Flu", 1957–58. An H2N2 virus caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957. It caused about 2 million deaths globally.[67]
  • The "Hong Kong Flu", 1968–69. An H3N2 caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968, and spread to the United States later that year. This pandemic of 1968 and 1969 killed an estimated one million people worldwide.[68] Influenza A (H3N2) viruses still circulate today.

Typhus[sunting | sunting sumber]

Typhus is sometimes called "camp fever" because of its pattern of flaring up in times of strife. (It is also known as "gaol fever" and "ship fever", for its habits of spreading wildly in cramped quarters, such as jails and ships.) Emerging during the Crusades, it had its first impact in Europe in 1489, in Spain. During fighting between the Christian Spaniards and the Muslims in Granada, the Spanish lost 3,000 to war casualties, and 20,000 to typhus. In 1528, the French lost 18,000 troops in Italy, and lost supremacy in Italy to the Spanish. In 1542, 30,000 soldiers died of typhus while fighting the Ottomans in the Balkans.

During the Thirty Years' War (1618–1648), an estimated 8 million Germans were wiped out by bubonic plague and typhus fever.[69] The disease also played a major role in the destruction of Napoleon's Grande Armée in Russia in 1812. Felix Markham thinks that 450,000 soldiers crossed the Neman on 25 June 1812, of whom less than 40,000 recrossed in anything like a recognizable military formation.[70] In early 1813 Napoleon raised a new army of 500,000 to replace his Russian losses. In the campaign of that year over 219,000 of Napoleon's soldiers were to die of typhus.[71] Typhus played a major factor in the Irish Potato Famine. During the World War I, typhus epidemics have killed over 150,000 in Serbia. There were about 25 million infections and 3 million deaths from epidemic typhus in Russia from 1918 to 1922.[71] Typhus also killed numerous prisoners in the Nazi concentration camps and Soviet prisoner of war camps during World War II. More than 3.5 million Soviet POWs died in the Nazi custody out of 5.7 million.[72]

Cacar ("Smallpox")[sunting | sunting sumber]

Cacar adalah penyakit mudah berjangkit yang disebabkan oleh virus Variola. Penyakit ini membunuh sekitar 400,000 orang Eropah setiap tahun semasa tahun terakhir abad ke-18.[73] Semasa abad ke-20, dianggarkan bahawa cacar bertanggung jawab bagi 300–500 juta kematian.[74][75] Sehingga awal 1950-an dianggarkan 50 juta kes cacar berlaku diseluruh dunia setiap tahun.[76] Selepas kempen pengvaksinan yang berjaya sepanjang abad ke-19 dan abad ke-20, WHO mengesahkan penghapusan cacar pada Disember 1979. Sehingga hari ini, cacar merupakan satu-satunya penyakit berjangkit manusia yang dihapuskan sepenuhnya.[77]

Measles[sunting | sunting sumber]

Historically, measles was very prevalent throughout the world, as it is highly contagious. According to the National Immunization Program, 90% of people were infected with measles by age 15. Before the vaccine was introduced in 1963, there were an estimated 3-4 million cases in the U.S. each year.[78] In roughly the last 150 years, measles has been estimated to have killed about 200 million people worldwide.[79] In 2000 alone, measles killed some 777,000 worldwide. There were some 40 million cases of measles globally that year.[80]

Measles is an endemic disease, meaning that it has been continually present in a community, and many people develop resistance. In populations that have not been exposed to measles, exposure to a new disease can be devastating. In 1529, a measles outbreak in Cuba killed two-thirds of the natives who had previously survived smallpox.[81] The disease had ravaged Mexico, Central America, and the Inca civilization.[82]

Batuk kering ("Tuberculosis")[sunting | sunting sumber]

Satu pertiga daripada penduduk dunia telah dijangkiti oleh Mycobacterium tuberculosis, dan jangkitan baru berlaku pada kadar satu setiap saat.[83] Sekitar satu dari sepuluh jangkitan pendam ini akan akhirnya berkembang kepada penyakit aktif, yang mana, jika dibiarkan tanpa rawatan, akan membunuh lebih dari separuh mangsanya. Setiap tahun, 8 juta orang jatuh sakit akibat penyakit Batuk kering, dan 2 juta orang mati akibat penyakit tersebut seluruh dunia.[84] Pada abad ke-19, penyakit batuk kering membunuh anggaran suku daripada penduduk dewasa Eropah;[85] dan pada tahun 1918 satu dari enam kematian di Perancis masih disebabkan oleh TB. Menjelang akhir abd ke-19, 70 hingga 90% penduduk bandar di Eropah dan Amerika dijangkiti oleh M. tuberculosis, dan sekitar 40% kelas pekerja di bandar adalah akibat TB.[86] Semasa abad ke-20, penyakit batuk kering membunuh anggaran 100 juta orang.[79] TB masih merupakan salah satu masaalah kesihatan utama di negara membangun.[87]

Kusta ("Leprosy")[sunting | sunting sumber]

Kusta, juga dikenali sebagai Penyakit Hansen, disebabkan oleh bacilus, Mycobacterium leprae. Ia adalah penyakit kronik dengan tempoh pengeraman sehingga lima tahun. Sejak 1985, 15 juta orang seluruh dunia telah disembuhkan dari kusta.[88] Pada 2002, 763,917 kes baru dikesan. Ia dianggarkan bahawa antara satu dan dua juta orang cacat seumur hidup akibat kusta.[89]

Dalam sejarah, kusta telah menjangkiti manusia sejak sekurang-kurangnya 600 BC, dan diketahui meluas dalam tamadun China kuno, Mesir Purba dan India.[90] Semasa Tempoh Pertengahan Tinggi ("High Middle Ages"), Eropah Barat menyaksikan wabak kusta yang tidak pernah dilihat.[91][92] Banyak leprosaria, atau hospital kusta, muncul pada Middle Ages; Matthew Paris menganggarkan bahawa pada awal abad ke-13 terdapat 19,000 buah hospital kusta di Eropah.[93]

Malaria[sunting | sunting sumber]

Malaria luas merebak di kawasan tropika dan subtropika, termasuk sebahagian Amerika, Asia, dan Afrika. Setiap tahun, terdapat sekitar 350–500 kes malaria.[94] Ketahanan dadah merupakan masaalah semakin besar dalam rawatan malaria pada abad ke-21, disebabkan ketahanan kini adalah perkara biasa terhadap kesemua kelas dadah malaria, dengan pengecualian artemisinins.[95]

Malaria pada satu masa adalah biasa dikebanyakan Eropah dan Amerika Utara, di mana ia untuk dianggap tidak wujud.[96] Malaria mungkin menyumbang kepada kejatuhan Empayar Rom.[97] The disease became known as "Roman fever".[98] Plasmodium falciparum menjadi ancaman sebenar kepada koloni dan penduduk tempatan apabila ia diperkenalkan ke Amerika sepanjang perdagangan hamba abadi. Malaria memusnahkan koloni pendudukan Jamestown dan menyerang secara berkala Selatan dan Tengahbarat. Menjelang 1830 ia telah sampai sehingga Timur laut Pasifik.[99] Semasa Perang Saudara Amerika, terdapat 1.2 juta kes malaria dikalangan tentera kedua pihak.[100] Selatan U.S. terus dijangkiti dengan jutaan kes malaria sehingga 1930-an.[101]

Demam Kuning[sunting | sunting sumber]

Demam kuning telah menjadi sumber beberapa epidemik yang merosakkan.[102] Bandar sejauh ke utara sehingga New York, Philadelphia, dan Boston diserang epidemik ini. Pada 1793, epidemik demam kuning 1793 terbesar dalam sejarah U.S. membunuh sehingga 5,000 orang di Philadelphia—sekitar 10% penduduk.[103] Sekitar separuh penduduk lari dari bandar, termasuk Presiden George Washington. Sekitar 300,000 dipercayai mati akibat demam kuning di Sepanyol semasa abad ke-19.[104] Ketika zaman koloni, Afrika Barat terkenal sebagai "kubur orang kulit putih" disebabkan malaria dan demam kuning.[105]

Punca tidak diketahui[sunting | sunting sumber]

Terdapat juga beberapa penyakit yang tidak diketahui yang amat serius tetapi kini lenyap, dengan itu etiologi penyakit tersebut tidak dapat ditentukan. Punca Penyakit Berpeluh pada abad ke-16 di England, yang menyerang seseorang dengan serta merta dan amat ditakuti melebihi wabak bubonic, sehingga kini masih tidak diketahui.

Rujukan[sunting | sunting sumber]

Nota[sunting | sunting sumber]

  1. ^ "Avian influenza frequently asked questions" (dalam bahasa Inggeris). World Health Organization. December 5, 2005. Diarkibkan daripada asal pada 2004-04-02. Dicapai 2009-02-13. A pandemic can start when three conditions have been met: a new influenza virus subtype emerges; it infects humans, causing serious illness; and it spreads easily and sustainably among humans. 
  2. ^ "AWHO 'declares swine flu pandemic'". BBC News. June 11, 2009.
  3. ^ The virus reached the U.S. by way of Haiti, genetic study shows.. Los Angeles Times. October 30, 2007.
  4. ^ The South African Department of Health Study, 2006
  5. ^ AIDS Toll May Reach 100 Million in Africa. Washington Post. June 4, 2006.
  6. ^ Aids could kill 90 million Africans, says UN
  7. ^ "Ancient Athenian Plague Proves to Be Typhoid". Scientific American. January 25, 2006.
  8. ^ Past pandemics that ravaged Europe. BBC News, November 7. 2005
  9. ^ Cambridge Catalogue page "Plague and the End of Antiquity"
  10. ^ Quotes from book "Plague and the End of Antiquity" Lester K. Little, ed., Plague and the End of Antiquity: The Pandemic of 541-750, Cambridge, 2006. ISBN 0-521-84639-0
  11. ^ "Plague, Plague Information, Black Death Facts, News, Photos[[:Templat:–]] National Geographic". Science.nationalgeographic.com. Dicapai 2008-11-03.  Konflik URL–wikilink (bantuan)
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  13. ^ Death on a Grand Scale. MedHunters.
  14. ^ Stéphane Barry and Norbert Gualde, in L'Histoire n° 310, June 2006, pp.45–46, say "between one-third and two-thirds"; Robert Gottfried (1983). "Black Death" in Dictionary of the Middle Ages, volume 2, pp.257–67, says "between 25 and 45 percent".
  15. ^ Plague - LoveToKnow 1911. 1911encyclopedia.org.
  16. ^ "A List of National Epidemics of Plague in England 1348-1665"
  17. ^ Jo Revill. "Black Death blamed on man, not rats | UK news | The Observer". The Observer. Dicapai 2008-11-03. 
  18. ^ "Texas Department of State Health Services, History of Plague". Dshs.state.tx.us. Dicapai 2008-11-03. 
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  23. ^ Human Plague -- United States, 1993-1994, Centers for Disease Control and Prevention
  24. ^ Smallpox: Eradicating the Scourge
  25. ^ Smallpox The Fight to Eradicate a Global Scourge, David A. Koplow
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  28. ^ The Story Of... Smallpox – and other Deadly Eurasian Germs
  29. ^ Stacy Goodling, "Effects of European Diseases on the Inhabitants of the New World"
  30. ^ Smallpox Through History
  31. ^ New Zealand Historical Perspective
  32. ^ How did Easter Island's ancient statues lead to the destruction of an entire ecosystem?, The Independent
  33. ^ Fiji School of Medicine
  34. ^ Measles hits rare Andaman tribe. BBC News. May 16, 2006.
  35. ^ Meeting the First Inhabitants, TIMEasia.com, 8/21/2000
  36. ^ Genetic Study Bolsters Columbus Link to Syphilis, New York Times, January 15, 2008
  37. ^ Columbus May Have Brought Syphilis to Europe, LiveScience
  38. ^ "Sahib: The British Soldier in India, 1750-1914 by Richard Holmes"
  39. ^ Dr. Francisco de Balmis and his Mission of Mercy, Society of Philippine Heath History
  40. ^ Lewis Cass and the Politics of Disease: The Indian Vaccination Act of 1832
  41. ^ Conquest and Disease or Colonialism and Health?, Gresham College | Lectures and Events
  42. ^ WHO Media centre (2001). "Fact sheet N°259: African trypanosomiasis or sleeping sickness".
  43. ^ The Origins of African Population Growth, by John Iliffe, The Journal of African HistoryVol. 30, No. 1 (1989), pp. 165-169
  44. ^ World Population Clock - Worldometers
  45. ^ Cholera- Biological Weapons
  46. ^ The 1832 Cholera Epidemic in New York State
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  48. ^ The Cholera Epidemic Years in the United States
  49. ^ Cholera's seven pandemics, cbc.ca, December 2, 2008
  50. ^ a b The 1832 Cholera Epidemic in New York State - Page 2. By G. William Beardslee
  51. ^ Asiatic Cholera Pandemic of 1846-63 . UCLA School of Public Health.
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Bibliografi[sunting | sunting sumber]

Bacaan lanjut[sunting | sunting sumber]

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