Top of the list is smallpox. Historically it's had a mortality rate of 30 to 35 percent, although it was much higher, sometimes 90 percent, in populations that were never exposed to it, such as Native Americans.
Smallpox is an airborne virus, which means it can be caught easily from infected people who cough or sneeze, but can also be transmitted through touch. The disease creates a fever, malaise, head and body aches and sometimes vomiting. Two to four days later, a rash develops in the mouth and throat and sores break out on the skin. This is the most contagious period. Usually the rash spreads to the entire body in 24 hours. Ironically, most people feel better at this point. The rash becomes the classic pox after about three days, in which bumps are filled with fluid. The fever rises again at this time. Over the course of another week or two the pustules scab over, and when the last one is gone, the patient is no longer contagious.
Smallpox has four varieties; three are often fatal. The last naturally occurring case of the disease was in 1975, in Bangladesh. However, the virus is still in cold storage at two labs, one in the United States and the other in Russia. For now, most people in their 20s and 30s might have no immunity at all. This is especially true in developing nations whose populations are generally younger.
"A new outbreak in India or South Africa, for example, would be beyond terrible," said Tara Smith, an assistant professor of epidemiology at the University of Iowa.