Throughout history, disease epidemics have ravaged mankind. The Black Death of bubonic plague killed more than 20 million in Europe in the 14th century. A 17th-century outbreak of the dreaded disease in England killed more than 70,000 of London's 600,000 inhabitants.

Modern vaccines and advancements in global hygiene were thought to bring these disease epidemics under control. Yet the last century witnessed the influenza epidemic of 1918, in which the H1N1 virus killed an estimated 70 to 100 million people worldwide. Estimates of death from the much more recent AIDS epidemic of the 1980s exceed 30 million, according to the World Health Organization.

Clearly the scourge of disease epidemics has not been eradicated. In fact, bubonic plague just killed 47 people in Madagascar in November (Daily Mail, Nov. 26, 2014). And now there's a devastating new menace on the world scene, Ebola.

This virus-born disease is not really new; the sporadic minor outbreaks of the past 40 years have been quickly brought under control. But a new strain that has ravaged West Africa since the summer of 2014 has brought back the specter of death tolls in the tens of thousands and threatens to spread from Africa to the rest of the world.

Spread by a virus native to the African fruit bat, patients contract the disease within 2 to 21 days after exposure. Victims suffer high fevers, muscle pain and severe headaches, usually accompanied by vomiting and diarrhea that lead to hemorrhaging and death.

In pondering these developments we ought to ask: What is the outlook for the world in the years ahead on the disease front? Does the Bible have anything to say about it?

Increasing pandemics prophesied

Students of Bible prophecy are familiar with the "four horsemen of the Apocalypse" found in Revelation 6. Putting these together with Jesus Christ's outline of future events in His lengthy prophecy on the Mount of Olives (Matthew 24:3-8, Mark 13:3-8 and Luke 21:7-11), we can see that the four horsemen symbolize a series of terrible conditions that would beset the world.

Mankind has been ravaged by the white horse of religious deception (Revelation 6:1), the red horse of warfare (Revelation 6:4) and the black horse of famine (Revelation 6:5).

When we continue reading, we also see a fourth horseman: "When He opened the fourth seal, I heard the voice of the fourth living creature saying, 'Come and see.' So I looked, and behold, a pale horse. And the name of him who sat on it was Death, and Hades followed with him" (Revelation 6:7-8).

Who or what is signified by this fourth horseman? The next conditions Jesus described were terrible plagues of pestilences (disease epidemics) and natural disasters.

Notice that the pale horse carried a rider, referred to as Death, accompanied by Hades, the Greek word for the grave. The Expositor's Bible Commentary has this to say about the color of that horse: "'Pale' (chloros) denotes a yellowish green, the light green of a plant, or the paleness of a sick person in contrast to a healthy appearance. This cadaverous color blends well with the name of the rider—'Death'" (Vol. 12, 1981).

So the world has seen increasing epidemics, and it will yet see more. The recent Ebola outbreak, then, is a preview of worse things to come. Yet it is the disease now on the rise, and we need to pay attention to it.

Most recent U.S. Ebola patient

In the United States, the head of the Centers for Disease Control (CDC) in Atlanta, Dr. Thomas Frieden, warned Americans that Ebola would likely jump the Atlantic to America. "The spread of Ebola to the U.S. is inevitable," he testified before Congress in August (Fox News, Aug. 9, 2014). 

Frieden was correct in his prediction. Since that time, all but one of the 10 who have contracted the disease, mostly from traveling to or working in affected areas of Guinea, Sierra Leone and Liberia, have recovered due to intensive treatment in U.S. hospitals.

But in mid-November Ebola claimed its second U.S. victim. Dr. Martin Salia, a surgeon who contracted the disease while working in Sierra Leone to treat other Ebola patients, died within 36 hours of being admitted to a Nebraska hospital. Dr. Phil Smith, who leads the Nebraska Medical Center's bio-containment unit, had said the 44-year old Salia was "extremely ill," adding that his condition was much worse than other patients treated successfully in the United States.

Despite fewer than a dozen U.S. cases, Ebola dominated American headlines in late 2014. Calls for the total elimination of flights from affected nations in West Africa were met with objections from those who saw the travel restrictions as a rejection of America's traditions of open borders. The political firestorm was somewhat quelled with a compromise that restricted travel from those areas to five U.S. airports where patients are screened on arrival.

"Could affect world economy"

As of early December the deadly virus had killed more than 6,000 people in West Africa, mostly in Liberia, Guinea and Sierra Leona. At present rates, thousands more are affected every month. The mortality rate has held steady at a consistent 50 to 70 percent, and researchers are desperately racing to find an effective vaccine.

The CDC publicized sobering statistics in October about the possible spread of the disease. "The worst-case scenario tops a million cases within a relatively short period of time, and not only would affect West Africa, but would inevitably spread to other countries," Frieden said. Although the CDC later scaled back its projections, infections anywhere near that level could have widespread impacts.

While the CDC does not foresee a "significant health risk" in the United States, Frieden admitted that in an interconnected economy, "it could absolutely change the way we work here." He continued: "It could change the economy of the world. It could change how we assess anyone who's traveled anywhere that might have had Ebola."

The highly contagious disease spreads from close human contact and transfer of bodily fluids. Observers have noted that often-crowded living and transportation conditions and the porous borders between many African nations further contribute to the spread of Ebola.

An ABC News story from October about the spread of the disease in Mali is revealing. "Ebola could cause many deaths here in Mali," said Aminata Samake, who works at a bank in Bamako, the capital. "We have a tradition of living closely together that could contribute to a huge contamination. Take the example of public transport—you find people crammed into a bus, one on top of the other. Large families share the same plates, even the same glasses for tea."

Responding to the threat, the CDC has issued a Level 3 travel warning for U.S. citizens to avoid nonessential travel to Guinea, Liberia and Sierra Leone. Also in place is a Level 2 alert against U.S. citizens traveling into Mali or the Republic of the Congo, where dozens of Ebola cases have been reported.

The political divide in the United States goes beyond the air travel issues mentioned above. The outbreak has fueled conservative calls for tighter border restrictions, while liberals still press for freer movement into and out of the country from all areas of the world and a greater reliance on Washington's leadership in managing the epidemic.

Some have also expressed outrage at President Obama's decision to send American troops to areas affected by the disease with little training in preventing infection.

Biblical principle of quarantine

Medical experts agree on the effectiveness of quarantine as a way to stop the Ebola advance. You may not know it, but the Bible teaches the exact same thing!

Ancient peoples did not know that most diseases are spread by microorganisms transmitted from one person to the next. They also did not know about laws of sanitation, such as making sure bodily wastes are kept away from human contact. Historians celebrate impressive achievements of the ancient Egyptians, yet those supposedly advanced people actually used animal dung as a primary ointment ingredient for all types of illnesses.

Nowhere in the first five books of the Bible—commonly called the books of Moses—did God reveal to ancient Israel that disease organisms transmit disease. But God did instruct Israel that the sick should be kept isolated from the rest of the population. Read for yourself God's specific instructions in Leviticus 13 and 15 concerning people with various types of rashes and bodily discharges. They were to separate themselves from the camp of Israel for the duration of the illness.

Just as ancient Israel used the practice of quarantine to stop disease from spreading through the crowded camp of Israel, quarantine has proven to be the best method to stop the spread of Ebola.

Laws concerning disease and bodily discharges

Again, consider the time during which Moses wrote these instructions. Ancient Egyptian medical knowledge was primitive compared to that of the 1800s. It is obvious from the Papyrus Ebers manuscript and other ancient sources that there was no sense of sanitation in Egypt whatsoever—as illustrated by the dung ointments mentioned above.

The ancient laws of the Israelites, on the other hand, show nothing but concern for sanitation. These would have protected against microscopic pathogens. Yet how could Moses have known of the existence of such germs? The Egyptians certainly did not—nor did any other ancient culture.

In fact, "until this century, all previous societies, except for the Israelites who followed God's medical laws regarding quarantine, kept infected patients in their homes—even after death, exposing family members and others to deadly disease. During the devastating Black Death of the 14th century, patients who were sick or dead were kept in the same rooms as the rest of the family.

"People often wondered why the disease was affecting so many people at one time. They attributed these epidemics to 'bad air' or 'evil spirits.' However, careful attention to the medical commands of God as revealed in Leviticus would have saved untold millions of lives.

"Arturo Castiglione wrote about the overwhelming importance of this biblical medical law, 'The laws against leprosy in Leviticus 13 may be regarded as the first model of a sanitary legislation' (Arturo Castiglione, A History of Medicine . . . , 1941, p. 71).

"Fortunately, the church fathers of Vienna finally took the biblical injunctions to heart and commanded that those infected with the plague . . . be placed outside the city in special medical quarantine compounds. Care givers fed them until they either died or survived the passage of the disease. Those who died in homes or streets were instantly removed and buried outside the city limits.

"These biblical sanitary measures quickly brought the dreaded epidemic under control for the first time. Other cities and countries rapidly followed the medical practices of Vienna until the Black Death was finally halted" (Grant Jeffrey, The Signature of God, 1996, pp. 149-150).

Of course, while taking all reasonable precautions, we should also be aware of the protections God offers to those who look to Him for protection. As Psalm 91 states: "I will say of the Lord, 'He is my refuge and my fortress, my God, in whom I trust' . . . You will not fear the terror of night, nor the arrow that flies by day, nor the pestilence that stalks in the darkness, nor the plague that destroys at midday" (verses 2, 5-6, New International Version).

What to watch for

The beginning of 2015 sees a world somewhat relieved that earlier fears of a massive Ebola outbreak have not materialized, but still nervous as it views the spread of the disease to other nations.

However, we have to ask ourselves: Could this signal that the fourth horseman is ready to begin his deadly ride? And if this horseman is not riding through the advanced Western countries, is it riding through other nations? The events of Revelation 6 can become starkly real—and indeed they already are to tens or hundreds of thousands of people in affected areas.

This is not a time for complacency or letting down our guard. All that would be required for an epidemic to begin to ravage the United States, Europe, Canada, Australia or some other Western nations is for perhaps a dozen new cases to break out while our attention is diverted elsewhere. If each of those infected people had contact with 10 other people, who had contact with 10 others, who had contact with 10 others . . .

Yes, it could happen just like that.

The media easily diverts our attention to whatever is "hot news" at the moment, keeping us attuned to their advertising messages. Yet Jesus' warnings in His Olivet prophecy and in the book of Revelation are for our time today, when a chaotic, troubled world will experience the pinnacle of misery before at last being replaced by the just reign of God through Christ over all nations.

"Be always on the watch, and pray that you may be able to escape all that is about to happen, and that you may be able to stand before the Son of Man" (Luke 21:36, NIV).

God gives His prophetic warnings for a purpose. He wants His people to see the danger coming and do what it takes to avoid it. Will you be one who heeds the warning?