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My List of the Five Deadliest Communicable Diseases

I was reading a very interesting article titled “The Five Deadliest Diseases in History” where the author looked at the deadliest diseases in history in terms of the number of deaths over time.

I wanted to do something similar but from a different angle. My list includes 5 diseases that are always or almost always fatal.

Some of these diseases are quite rare, others are well known. Some have no treatment options available, and some have antibiotics, vaccinations, or other treatment, but death is certain without adequate and timely treatment.

The dictionary definition of case fatality rate is the proportion of individuals who contract a disease who die from that disease. The following communicable diseases have a fatality rate of one hundred or almost 100 percent.

Prion disease

Prion diseases or transmissible spongiform encephalopathies (TSEs) are characterized by progressive deterioration of the brain. Human prion diseases are always fatal.

TSEs include Creutzfeldt-Jakob disease and all its variants, kuru and Gerstmann-Staussler-Scheinker syndrome.

Although not fully characterized, a prion is an abnormally folded protein that can have long incubation times of many years.

Human prion disease can be acquired through diet, medical treatment, surgery, or blood transfusion, and some are considered genetic. There is no treatment for human prion disease.

Naegleria fowleri

Infection with this free-living amoeba known as primary amoebic meningoencephalitis (PAM) is nearly 100 percent fatal even with treatment.

The amoeba invades the brain through the nose while people participate in aquatic recreational activities in warm, fresh water. The amoeba reaches the brain when water runs through the nose and destroys brain tissue.

The symptoms of this very rare disease include severe frontal headache, hallucinations, fever and death occurs within 10 days.

Untreated rabies

This viral disease that people contract from the bite of an infected animal is almost 100% fatal in the absence of timely vaccination and rabies immune globulin.

Headache, fever, hydrophobia, delirium and occasionally convulsions are the symptoms observed before coma and death occur.

Rabies is not a rare disease and 55,000 people die this horrible death worldwide, mostly in developing countries because of inadequate or no post-exposure treatment.

Untreated septicemic and pneumonic plague

While untreated bubonic plague has a fatality rate of up to 60%, untreated septicemic and pneumonic plague are invariably fatal.

Plague is caused by infection with the bacterium Yersinia pestis. People usually get this disease from the bite of a plague-infected flea. With timely and appropriate antibiotic treatment, all forms of plague can be countered.

Untreated African sleeping sickness

This disease which is restricted to certain areas of Africa is fatal without proper treatment. This parasitic disease of the Trypanosoma species is transmitted to people through the bite of the tsetse fly.

This disease begins with fever, headache and joint pain that later invades the central nervous system.

At this point confusion begins and a disrupted sleep cycle and without treatment, coma and death will result.

The following communicable diseases receive honorable mention for being close to having a 100 percent fatality rate:

Up to 90% lethality: Ebola virus

Up to 85% fatality: untreated inhalation anthrax

Up to 80% lethality: Marburg virus

More than 70% lethality: Herpes B virus

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