By Sean T. Collins

In THE STAND: CAPTAIN TRIPS, Marvel's limited series written by Roberto Aguirre-Sacasa with art by Mike Perkins based on Stephen King's celebrated novel, a government bioweapon with a popular nickname swiped from the Grateful Dead wipes out nearly all of the world's population.

But sometimes truth can be stranger than fiction—though thankfully not quite as deadly—and lethal pandemics have long been a fact of life for humanity's fragile existence on Earth. From the Black Death that ravaged Europe during the Dark Ages to recent diseases that may one day put THE STAND to shame, here's a look at some of the most powerful plagues ever unleashed on an unsuspecting world.

THE BLACK DEATH
AKA: Bubonic plague/Yersinia pestis
THE HOT ZONE: China, India, Central Asia and Europe, 1330's-early 1350's
THE SYMPTOMS: Painfully swollen lymph nodes (known as buboes, hence "bubonic plague"); fever; vomiting blood; red spots on the skin that turn black with decay (hence "the Black Death")
THE OUTBREAK: Believed to have originated in China, this dreaded disease spread west via flourishing land and sea trade routes of the Mongol Empire, eventually reaching Sicily by ship in 1347. The plague itself was transmitted by fleas who hitched a ride on the infected rats that frequented trading ships. Its impact on society was nearly apocalyptic, killing fully one third of the population of Europe in just four years, and killing one third of China's population as well.
THE DEATH TOLL: approx. 70 million

THE 1918 INFLUENZA PANDEMIC
AKA: Spanish flu/Influenza A virus subtype H1N1
THE HOT ZONE: Worldwide, 1918-1919
THE SYMPTOMS: Internal hemorrhaging, including of the lungs; bleeding from the ears, nose, and skin; secondary, lethal bacterial pneumonia infections
THE OUTBREAK: First spotted in an Army hospital in Kansas on March 4, 1918, this incredibly virulent flu strain appeared around the world by late summer; the true extent of the threat became apparent when it ravaged Spain, giving it its popular name. Spread by troop movements during the still-raging World War I, it killed more than double the number of people slain in that conflict, including 675,000 in America alone—a higher death toll than that of all the United States' 20th century wars combined—before disappearing.
THE DEATH TOLL: approx. 50-100 million

EBOLA
AKA: Ebola hemorrhagic fever/Ebolavirus; known strains include Zaïre, Sudan, Reston, Ivory Coast, and Bundibugyo
THE HOT ZONE: Primarily central Africa, 1976-present
THE SYMPTOMS: High fever; red eyes; flu-like symptoms including fatigue, sore throat, nausea, and aches and pains; uncontrollable and bloody diarrhea and vomit; bleeding from the nose, mouth, and anus
THE OUTBREAK: First spotted in a schoolteacher in Yambuku, Zaîre in 1976, Ebola seized the public imagination due to the gruesomeness of its symptoms and its astonishingly high fatality rate—up to 90% in some outbreaks of the most lethal strain, Ebola-Zaîre. Fortunately, that level of lethality, and the fact that there is only one reported case of airborne transmission of the virus (among lab monkeys in Reston, Virginia), have kept the disease from reaching pandemic proportions.
THE DEATH TOLL: approx. 1200

HIV/AIDS
AKA: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome
THE HOT ZONE: Worldwide, now concentrated in sub-Saharan Africa, 1981-present
THE SYMPTOMS: A host of secondary infections and diseases caused by the HIV-weakened immune system, including Karposi's sarcoma (virally caused lesions on the skin, mouth, gastrointestinal and respiratory tracts) and lymphoma (cancer of the immune system, originating in the lymph nodes).
THE OUTBREAK: AIDS was first recognized by the U.S. Centers for Disease Control and Prevention in June of 1981 among a group of five men in Los Angeles. Spread by sexual contact, blood-to-blood contact (such as that arising from shared intravenous or tainted blood transfusions), and from mother to child, the disease kills by weakening the immune system through the HIV virus' attack on the helper-T cells needed to fight infections and cancers. Though prevention programs and expensive antiretroviral medications can control the spread of the disease, the poverty of sub-Saharan Africa (where the disease is thought to have originated) has seen AIDS reach pandemic proportions in countries like Malawi, where 20% of the population is believed to be infected.
THE DEATH TOLL: over 25 million

SARS
AKA: Severe Acute Respiratory Syndrome/SARS coronavirus
THE HOT ZONE: Primarily China, Hong Kong, Southeast Asia, and Canada, 2002-2003
THE SYMPTOMS: Flu-like symptoms including high fever, aches and pains, diarrhea, and coughing; shortness of breath that culminates in pneumonia
THE OUTBREAK: SARS was first seen in China's Guangdong Province in November 2002, but the Chinese government kept the lethal outbreak under wraps until spring of the following year. By that point, American James Earl Salisbury had contracted the disease on a business trip, displaying symptoms on a flight from China to Singapore and dying in a hospital in Vietnam, calling attention to the disease. The ease of worldwide travel helped spread a significant number of SARS cases as far away as Canada, crippling businesses in affected areas like Toronto until the epidemic essentially disappeared in the summer of 2003. Though nearly 10% of diagnosed cases proved fatal, SARS is spread through close contact, lessening its chances of becoming a true pandemic.
THE DEATH TOLL: 774

BIRD FLU
AKA: Avian Influenza/Influenza A virus subtype H5N1
THE HOT ZONE: primarily Southeast Asia, 2004-present
THE SYMPTOMS: Typical flu symptoms culminating in potentially fatal breathing problems and pneumonia
THE OUTBREAK: Easily spread through birds, including both migrating waterfowl like geese and domestic poultry like chickens, this virus has killed millions of birds and spurred the deliberate slaughter of millions more to stop it from spreading. So far, humans have only been able to contract the virus from contact with infected birds, rather than airborne or human-to-human transmission; 60% of diagnosed human cases have been fatal. Like most flu viruses, the H5N1 strain rapidly mutates, leading to concerns that a mutated strain could lead to human-to-human transmission and a pandemic that would rival the destruction of the 1918 influenza, itself an avian flu. One UN estimate projected 150 million potential deaths should this occur.
THE DEATH TOLL: 245

THE STAND: CAPTAIN TRIPS #4 hits stands December 17!

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