The Most Deadly Pandemic Threaten the World by Dr. Mohamed Labib Salem

The Most Deadly Pandemic
Threaten the World
Dr. Mohamed Labib Salem, PhD
Prof. of Immunology, Faculty of Science
Director, Center of Excellence in Cancer
Research, Tanta University, Egypt
February 3, 2022
‫بدعوة‬
‫من‬ ‫كريمة‬
:
‫الشباب‬ ‫أكاديمية‬ ‫مجموعات‬ ‫أحد‬ ‫والمجتمع‬ ‫العلم‬ ‫مجموعة‬
‫المصري‬
–
‫أكاديمية‬
‫والتكنولوجيا‬ ‫العلمي‬ ‫البحث‬

‫يخ‬‫ر‬‫التا‬
‫نعيش‬ ‫كيف‬ ‫يعلمنا‬
‫ونتوقع‬‫الحاضر‬
‫املستقبل‬
.‫د‬
.
‫لبيب‬ ‫محمد‬

Talk outlines
•Historical Pandemic outbreaks
•Basics of Coronavirus and COVID-19
•Immune Responses to the new
Coronavirus
•Anti-Coronavirus treatments
•My contribution

INFECTIOUS AGENTS
1. Viruses Non-Living
2. Bacteria Living (Unicellular)
3. Fungus Living (Multicellular)
4. Parasites
• Protozoa Living (Unicellular)
• Helminths Living (Multicellular)

Transmission Routes
of INFECTIOUS AGENTS
1. Air
2. Water
3. Food
4. Soil
5. Animals (from Uni. to multi.)
6. Human

Global Waves of Human
Death: World Wars
• World War 1 (22m)
• World War 2 (85m)

• 9-11m military death
• 11m civilian death
• 8m death due to war-related diseases
• 3m due to military actions and war
crimes.
• The 1918 flu pandemic caused 5m of
total military deaths.
Toll Death of World War I (22m)
Military and Civilian

1. 1m dead: The British Empire, France, Italy,
Austria-Hungary, Germany, and
neutral Persia.
2. 3.6m dead: The Russian Empire
3. 4m dead: The Central Powers.
4. 4m dead: The Ottoman Empire, which suffered
the highest death toll with over,
around 20% of its prewar population.
5. 6m dead: The Allies.
Toll Death of World War I (22m)
Military and Civilian

Douaumont
French
military
cemetery
which contains
remains of
French and
German
soldiers who
died during
the Battle of
Verdun in 1916

Toll Death of World War II (85m)
•70–85m death: (3% of the 1940 world
population; 2.3b)
• 50-55m death: Civilian.
• 21–25m death: Military.
• 46m death (50%): 20m death of Republic of China and
26.6m from the Soviet Union.
•19-28m deaths: from war-related disease
and famine.

Bodies of U.S.
Marines on the
beach
of Tarawa. The
Marines
secured the
island after 76
hours of
intense
fighting. Over
6,000 American
and Japanese
troops died in
the fighting.

Polish military officers
executed by the Soviet NKVD.
The photo was taken by
the Polish Red
Cross delegation in 1943.
Naked Soviet held by the
Nazis in concentration camp.
It is estimated that at least
3.3 million Soviet died in
German custody,

Pandemic
versus
Epidemic
OUTBREAK

Global Waves of Human
Death: Infectious Agents
• Black Death (Toll: 75 – 200 m)
• Tuberculosis
• CHOLERA
• Flu
• Smallpox

4 of the most lethal infectious
diseases of our time
1. Tuberculosis
2. Smallpox
3. HIV/AIDS
4. Influenza
5. SARS-Con-2

10+1 OF THE
WORST
PANDEMICS IN
HISTORY
OUTBREAK

Death Toll of the 10 historically
pandemic infection (~300 million)
1. ANTONINE PLAGUE (165 AD) 5m
2. PLAGUE OF JUSTINIAN (541-542) 25m
3. THE BLACK DEATH (1346-1353) 75-200m
4. THIRD CHOLERA PANDEMIC (1852–1860) 1m
5. FLU PANDEMIC (1889-1890) 1m
6. SIXTH CHOLERA PANDEMIC (1910-1911) 800,000+
7. FLU PANDEMIC (1918-1920) 20-50m
8. ASIAN FLU (1956-1958) 2m
9. FLU PANDEMIC (1968) 1m
10.HIV/AIDS PANDEMIC (2005-2012) 36m
11. SARS-Con-2 (2019-2021) 5.1m

ANTONINE PLAGUE (165 AD)
Death Toll: 5m
Cause: smallpox and measles??)
•It is also known as the Plague of Galen
•The plague that killed an empire
•By 180 AD it had killed 30% of the population.
•While smallpox has not been seen clinically since 1977,
and despite MMR vaccine provides immunity against
measles, mumps, and rubella, measles still
kills upwards of 85,000 people every year

•The Antonine Plague was an ancient pandemic that
affected Asia Minor, Egypt, Greece, and Italy.
•It is thought to have been either Smallpox or Measles.
•This unknown disease was brought back to Rome by
soldiers returning from Mesopotamia around 165AD
•The DISEASE SPREAD BY THE soldiers ended up killing
over 5m people and weakened the Roman army.
ANTONINE PLAGUE (165 AD)
Death Toll: 5m
Cause: smallpox and measles??)

PLAGUE OF JUSTINIAN (541-542)
Death Toll: 25 million
Cause: Bubonic Plague
•The Plague of Justinian was regarded as
the first recorded incident of the Bubonic
Plague.
•It was found to be caused by infection
with the bacteria Yersinia pestis

• The estimated killing rate was 5,000 people per day,
killing up:
•50% death of the population of Europe.
•25% of the population of the Eastern Mediterranean
•25 million people at the Byzantine Empire and
Mediterranean port cities
•40% death of the city’s of population.
•Devastating the city of Constantinople
PLAGUE OF JUSTINIAN (541-542)
Death Toll: 25 million
Cause: Bubonic Plague

Recent research has confirmed that the cause of the pandemic
was Yersinia pestis, the bacterium responsible for bubonic plague. The
plague's social and cultural impact during the period of Justinian has been
compared to that of the similar Black Death that devastated Europe 600
years after the last outbreak of Justinian plague. Genetic studies point to
China as having been the primary source of the contagion.

THE BLACK DEATH (1346-1353)
Death Toll: 75-200m (Bubonic)
•The outbreak of the Plague ravaged Europe,
Africa, and Asia, with an estimated death toll
between 75 and 200 million people.
•The Plague is thought to have originated in Asia.

Death Toll: 75-200m (Bubonic)
• Most likely its jumped continents via the fleas living on
the rats aboard merchant ships.
• Ports were the perfect breeding ground for the rats and
fleas.
• The insidious bacterium flourished, devastating three
continents in its wake.
• In 1894, Alexandre Yersin discovered the bacterium
responsible for causing plague:
Yersinia pestis Xenopsylla cheopis
BRWON RATS

Death Toll: 75-200m (Bubonic) Yersinia
pestis

•Generally considered the most deadly of
the 7th cholera pandemics
•Like the 1st and 2nd pandemics, the 3rd
Cholera Pandemic originated in India to
Asia, Europe, North America, and Africa.
3RD CHOLERA PANDEMIC (1852–1860)
Death Toll: 1m (Cause: Cholera)

3RD CHOLERA PANDEMIC (1852–1860)
Death Toll: 1m (Cause: Cholera)
•Dr. John Snow, a British physician, while working
in a poor area of London, tracked cases of cholera
and eventually succeeded in identifying
contaminated water as the means of transmission
for the disease.
•The same year as his discovery (1854) was the
worst year of the pandemic, in which 23,000
people died in Great Britain.

THE 3RD CHOLERA
PANDEMIC (1852–1860)
Death Toll: 1m

FLU PANDEMIC (1889-1890)
Death Toll: 1m (Cause: Influenza)
• It is called the “Asiatic Flu” or “Russian Flu”
• The first cases were observed in May 1889 in three separate
and distant locations, Bukhara in Central Asia (Turkestan),
Athabasca in northwestern Canada, and Greenland.
• Originally, this strain was thought to be an outbreak of the
Influenza A virus subtype H2N2 (now is known as subtype
H3N8.
• Rapid population growth of the 19th century, specifically in
urban areas, helped the flu to spread across the globe.

FLU PANDEMIC (1889-1890): Death Toll: 1m
(Cause: Influenza)

THE 6TH CHOLERA PANDEMIC (1910-1911)
Death Toll: 800,000+ (Cause: Cholera)
•The Sixth Cholera Pandemic originated in India
where it killed over 800,000, before spreading to
the Middle East, North Africa, Eastern Europe and
Russia.
•The Sixth Cholera Pandemic was also the source of
the last American outbreak of Cholera (1910–
1911).

•American health authorities, having learned
from the past, quickly sought to isolate the
infected.
•In the end, only 11 deaths occurred in the U.S.
•By 1923 Cholera cases had been cut down
dramatically, although it was still a constant
in India.
THE 6TH CHOLERA PANDEMIC (1910-1911)
Death Toll: 800,000+ (Cause: Cholera)

Death Toll: 20 -50 million
Cause: Influenza
•This deadly outbreak of influenza tore across the
globe, infecting over 30% of the world’s population
•In the end, it killed the lives of 20 – 50 million
people.
•Of the 500 million people infected in the 1918
pandemic, the mortality rate was 10% - 20%, with
up to 25 million deaths in the first 25 weeks alone.

•The 1918 flu pandemic is different from other
influenza outbreaks was the victims:
•Influenza had always previously only killed juveniles
and the elderly or already weakened patients.
•The 1918 flu striking down hardy and completely
healthy young adults, while leaving children and
those with weaker immune systems still alive.
Death Toll: 20 -50 million
Cause: Influenza

FLU PANDEMIC (1889-1890): Death Toll: 1m (Cause: Influenza)

ASIAN FLU (1956-1958)
Death Toll: 2 million (Cause: Influenza)
• Asian Flu was a pandemic outbreak of Influenza A of the
H2N2 subtype, that originated in China in 1956 and lasted
until 1958.
• In its two-year spree, Asian Flu traveled from the Chinese
province of Guizhou to Singapore, Hong Kong, and the
United States.
• Estimates for the death toll of the Asian Flu vary depending
on the source, but the WHO places the final tally at
approximately 2 million deaths, 69,800 of those in the US
alone

FLU PANDEMIC (1968)
Death Toll: 1 million (Cause: Influenza)
• A category 2 Flu pandemic or “the Hong Kong Flu,”.
• The 1968 flu pandemic was caused by the H3N2 strain of the
Influenza A virus, a genetic offshoot of the H2N2 subtype.
• From the first reported case on July 13, 1968 in Hong Kong, it took
only 17 days before outbreaks of the virus were reported in
Singapore and Vietnam, and within three months had spread to The
Philippines, India, Australia, Europe, and the United States.
• While the 1968 pandemic had a comparatively low mortality rate
(.5%) it still resulted in the deaths of more than a million people,
including 500,000 residents of Hong Kong, approximately 15% of its
population at the time.

HIV/AIDS PANDEMIC (AT ITS PEAK,
2005-2012): Death Toll: 38 million
• First identified in Congo in 1976, HIV/AIDS has truly proven itself as a
global pandemic, killing more than 36 million people since 1981.
• Currently there are between 31 and 35 million people living with HIV,
the vast majority of those are in Sub-Saharan Africa, where 5% of the
population is infected, roughly 21 million people.
• As awareness has grown, new treatments have been developed that
make HIV far more manageable, and many of those infected go on to
lead productive lives.
• Between 2005 and 2012 the annual global deaths from HIV/AIDS
dropped from 2.2 million to 1.6 million.

https://onlinedegrees.und.edu/blog/types-of-viruses/

• SARS-Cov-2 is a new strain of
coronavirus that hasn't been
previously identified in humans.
• First originated in Wuhan, China
and spread around the world
(from epidemic to pandemic)
• Up to 4 March 2021, more than
115 million cases have been
reported across 188 countries.
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
COVID-19
is the diseases
caused by the
virus

• Most coronaviruses infect
animals (bats, birds and
mammals).
• Animals act as an
intermediate host
reservoir.
• Sometimes they change
host and infect humans.
Hosts for
Coronaviruses

Yang et al. The signal pathways and treatment of cytokine
storm in COVID-19. Sig Transduct Target Ther 6, 255
Cytokine
Storm
during
COVID-19
phases
Disseminated intravascular coagulation

Coronaviruses (CoV) family: first identified as human pathogens in the 1960s
Outbreak Virus type Deaths
2003 severe acute respiratory syndrome outbreak. SARS-CoV 774
2012 Middle East respiratory syndrome coronavirus
outbreak
MERS-CoV Over 400
outbreak
MERS-CoV 36
outbreak
MERS-CoV 41
2019–20 coronavirus outbreak SARS-CoV2 2.57,836
till now*
History of Coronaviruses Outbreaks

SARS‐CoV‐2 carriers and spreaders
Allergy, Volume: 75, Issue: 7, Pages: 1564-1581, First published: 12 May 2020, DOI: (10.1111/all.14364)

SARS-CoV-2
invades
cellular
mechanisms

Distinct response to high‐ and low‐dose
virus exposure and infection

Phases of Anti-viral Immune Responses

COVID-19 clinical and
Immunological spectrum
Clinical stages of
COID-19
Protective
immunity
and
inflammatory
spectra
Frontiers
in
Immunology

Specific antibody response to
SARS‐CoV‐2

Anti-viral Cytotoxic CD8+ T cells Response

Both
attack
by
bodies
and
T
cells
are
needed

NO clinically
proven
therapeutic
regimen to
prevent and
eradicate
SARS-CoV-2
infection
Treatment
Approaches
COVID-19:
the
role
of
excessive
cytokine
release
and
potential
ACE2
down-regulation
in
promoting
hypercoagulable
state
associated
with
severe
illness,
2020

https://covid-101.org/science/what-is-convalescent-plasma-treatment-for-covid-19/
Convalescent Plasma Therapy

Continuous blood purification:
Is an essential technology to control
inflammatory factors, cytokine storm, electrolyte
imbalance, and acid-base balance for severe
COVID-19 patient
Auxiliary Blood Purification Treatment

Vaccine
Development against
CoV2-19

(https://www.who.int/topics/vaccines/en/).
Towards effective COVID-19 vaccines: Updates, perspectives and challenges, 2020
Summary of strategy types for COVID-19
vaccine development

‫الجدي‬ ‫كورونا‬ ‫بفيروس‬ ‫والمتعلقة‬ ‫المنشورة‬ ‫مقاالتي‬
‫د‬

Thank You
Mohamed Labib Salem, PhD

The Most Deadly Pandemic Threaten the World by Dr. Mohamed Labib Salem

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