The bodies of bubonic plague victims in Manchuria in 1912 are burned on a huge pyre as was the custom from the Middle Ages on. (Hulton Archive/Getty Images)

A policeman in Surat, India, covers his mouth and nose in 1994 during a plague outbreak. (Raveendran/AFP/Getty Images)

Deadly infectious diseases such as tuberculosis, bubonic plague and polio have been nearly eradicated in Western society thanks to vaccinations, but these killers of the past still linger in some pockets of the world.

Here's a look at how tuberculosis, polio, bubonic plague, leprosy, yellow fever, smallpox and the measles and the mumps stack up today.

Smallpox

Smallpox is a vaccination success story, as the World Health Assembly in 1980 declared the infectious, rash- and fever-causing disease eradicated.

The disease, which is believed to have originated more than 3,000 years ago in India or Egypt, swept around the world for centuries, killing as many as 30 per cent of those infected and leaving survivors scarred, blind or both. In the 18^th century, the disease killed one in every 10 children born in Sweden and France, and one in seven in Russia.

An inoculation was created in 1798, but the scourge continued well into the 20^th century. In the 1950s, there were still an estimated 50 million cases of smallpox worldwide each year.

An aggressive immunization campaign launched in 1967 by the Geneva-based World Health Organization eventually eliminated the disease, with the last naturally occurring case in the world reported in Somalia in 1977. The last case of laboratory-acquired smallpox occurred in the United Kingdom a year later, in 1978.

Bubonic plague

The bubonic plague has been responsible for more than 200 million deaths, most notably in the 14^th century, when the "Black Death" was blamed for wiping out nearly a quarter of Europe's population.

Today, the World Health Organization says, nearly 3,000 cases of the plague — spread by wild animals and causing painful swollen lymph nodes, or buboes, in the armpit, groin and neck — are still reported every year, mostly in Africa. However, cases are also reported in Asia and the Americas, including in the United States and Peru. The Public Health Agency of Canada says there are an estimated 10 to 15 cases of bubonic plague in the U.S. every year.

According to the WHO, five African countries accounted for nearly 99 per cent of the cases of bubonic plague worldwide in 2003. These hot spots were:

• Democratic Republic of Congo: 1,092 cases.
• Madagascar: 993 cases.
• Mozambique: 31 cases.
• Uganda: 24 cases.
• Algeria: 11 cases.

Tuberculosis

Tissue samples from graves and an examination of an Egyptian mummy suggest that tuberculosis infections started more than 5,400 years ago, but scientists believe the bacteria is probably three times as old.

The airborne bacteria, which has also been known as the White Plague, Pott's disease and consumption, normally targets the lungs and causes symptoms including tiredness, weight loss, fever, night sweats, coughing and chest pain.

The Global Tuberculosis Control Report 2008 reported 9.2 million new cases of TB in 2006, including 400,000 cases of multi-drug-resistant tuberculosis, a form of the disease that is resistant to most modern medications. Approximately 1.5 million people died of the disease in 2006, the report says. The disease is prevalent around the world, with hot spots focused in Africa and southeast Asia.

Tuberculosis also continues to be a problem in Canada, where 1,434 new and relapse cases of the disease were reported in 2006. On average, there are 1,600 new cases of TB reported in the country each year, Health Canada says.

TB hot spots in 2006 were:

• India: 1,228,827 new and relapse cases.
• China: 940,889 new and relapse cases.
• South Africa: 303,114 new and relapse cases.
• Indonesia: 277,589 new and relapse cases.
• Pakistan: 176,678 new and relapse cases.

Polio

Indonesian nurses vaccinate a baby against polio in November 2007 in Jakarta as part of an international, mostly U.S., effort to immunize Indonesian infants against common childhood diseases. (Tatan Syuflana/Associated Press)

Polio dates back to ancient times, with supporting evidence including an Egyptian carving portraying a priest with a withered leg and a staff. Until the introduction of effective vaccines in the late 1950s and early 1960s, the disease crippled thousands of children in industrialized countries every year.

An immunization campaign launched by the World Health Assembly in the 1970s has helped stem the disease in less developed countries, which were slower to inoculate their populations.

The Global Polio Eradication Initiative (GPEI), a combined effort of several governments, the World Health Organization, the U.S. Centers for Disease Control and Prevention, and UNICEF, reports that since 1988 the incidence of polio has been reduced by more than 99 per cent — from 350,000 cases in 1988 to 1,308 in 2007.

By 2007, only four countries remained where polio was still prevalent — Afghanistan, India, Nigeria and Pakistan — but other Asian and African countries are still at risk of reinfection.

Polio hot spots:

• Afghanistan: Four new cases in 2008, as of March 18. Reported 17 new cases in 2007.
• India: 132 new cases of polio in 2008, as of March 18, accounting for the bulk of the year's 191 cases. Reported 866 cases in 2007.
• Nigeria: 26 new cases in 2008, as of March 18. Reported 286 cases in 2007.
• Niger: Three new cases of polio in 2008, as of March 18, and 11 cases in 2007.
• Pakistan: Two new cases in 2008, as of March 18. Reported 32 cases in 2007.

Yellow fever

Yellow fever dates back more than 400 years and can cause epidemics with a fatality rate exceeding 50 per cent in unvaccinated populations. Symptoms of the disease, which is transmitted by mosquitoes, include fever, a slow pulse, muscle pain, a headache, shivers, nausea and vomiting.

Outbreaks of yellow fever occurred in Africa, Europe, the Caribbean and Central and North America until the start of the 20^th century. The last epidemic of yellow fever in North America was in New Orleans in 1905.

Today, the World Health Organization estimates there are 200,000 cases each year, causing 30,000 deaths, predominantly in Africa and South America.

Yellow fever hot spots:

• Ivory Coast: 92 cases and four deaths in 2004.
• Peru: 61 cases and 31 deaths in 2004.
• Colombia: 30 cases and 11 deaths in 2004.
• Paraguay: 24 cases and eight deaths in 2008.
• Bolivia: 10 cases and four deaths in 2004.

Leprosy

A woman suffering from leprosy in Adzope in southern Ivory Coast is being treated by an international team of doctors in 2005. (Issouf Sanogo/AFP/Getty Images)

In the ancient civilizations of China, Egypt and India, those afflicted with leprosy were ostracized by their communities and families. The disease, which causes progressive and permanent damage to skin, nerves, limbs and eyes, is spread by contact with droplets from the nose and mouth. Today it is curable and early treatment can help curb the damage.

The number of leprosy sufferers has dropped from 5.2 million in 1985 to roughly 296,000 in 2005. Countries in Africa, Southeast Asia and Central America account for the bulk of the illness.

Leprosy hot spots (2005):

• India: 161,457 cases.
• Brazil 38,410 cases.
• Indonesia: 19,695 cases.
• Democratic Republic of Congo: 10,737 cases.
• Nepal: 6,150 cases.

Measles and mumps

Cases of the measles and the mumps, once common childhood diseases, have been greatly diminished through vaccination. Both diseases can cause severe complications, including pneumonia, deafness and death.

The World Health Organization estimates that more than 30 million people are affected by the measles each year. In 2003, the WHO said there were 530,000 deaths associated with the measles. Symptoms include fever, sore throat, cough and a rash.

Mumps, meanwhile, occurs worldwide, with epidemics every two to five years. Symptoms include swelling of the salivary glands, fever and headache.

Recent outbreaks:

• United States: 11 cases of measles among unvaccinated children in San Diego in 2008. Mumps outbreak in Midwest states in 2006, with 4,000 cases.
• Canada: More than 450 cases of mumps were reported among university students in spring 2007.
• United Kingdom: More than 100,000 cases in a mumps epidemic from 2004 to 2005.
• Japan: Reported more than 1,121 cases of the measles in 2007.
• Switzerland: Reports a continuing measles outbreak that started in November 2006 and had been linked to 1,405 cases as of February 2008.

Sources: World Health Organization, United States Centers for Disease Control and Prevention, Health Canada and the Public Health Agency of Canada

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