When was the last smallpox outbreak?
1972 Yugoslav smallpox outbreak
The 1972 Yugoslav smallpox outbreak was the last major outbreak of smallpox in Europe. It was centred in Kosovo and Belgrade (both then part of the Socialist Federal Republic of Yugoslavia). A Muslim pilgrim had contracted the smallpox virus in the Middle East. Upon returning to his home in Kosovo, he started the epidemic in which 175 people were infected, 35 of whom died. The epidemic was efficiently contained by enforced quarantine and mass vaccination. The 1982 film "Variola Vera" is based on the event.
History of smallpox in Mexico
There were sporadic outbreaks until 1826 when smallpox appeared in Yucatán, Tabasco and Veracruz brought by North American ships. In 1828, there were reported cases in Hidalgo, Oaxaca, State of Mexico, Guerrero, Chiapas, Chihuahua and Mexico City.
New Orphan Houses, Ashley Down, Bristol
In 1862, an outbreak of smallpox was confirmed in the local area which lasted for two years before the infection spread to the Orphanage. Although there were 320 children in No 1 House, only 10 at any one time were taken ill, and then only mildly. The disease then manifested itself in No 2 House, where there were 400 children but only 11 suffered a light touch of the pox. No 3 House did not escape and of the 450 children, 15 were taken ill but, again, none seriously. None of the children died and the disease disappeared in December 1864.
Smallpox vaccine
The US Centers for Disease Control and Prevention (CDC) kept a stockpile for use in case of emergency. In 2003 this supply helped contain an outbreak of monkeypox in the United States. In February 2008 the CDC disposed of the last of its 12 million doses of Dryvax. Its supply is being replaced by ACAM2000, a more modern product manufactured in laboratories by Acambis, now a division of Sanofi Pasteur.
Thymidine kinase
After smallpox was declared eradicated by WHO in December 1979, vaccination programs were terminated. A re-emergence of the disease either by accident or as a result of biological warfare would meet an unprotected population and could result in an epidemic that could be difficult to control. Mass vaccination would be unethical, as the only efficient vaccines against smallpox include live vaccinia virus with severe adverse effects on rare occasions. As one protective measure, large amounts of vaccine are kept in stock, but an efficient drug against smallpox has high priority. One possible approach would be to use the specificity of the thymidine kinase of poxvirus for the purpose, in a similar way that it is used for drugs against herpesvirus. One difficulty is that the poxvirus thymidine kinase belongs to the same family of thymidine kinases as the human thymidine kinases and thereby is more similar chemically. The structure of poxvirus thymidine kinases has therefore been determined to find potential antiviral drugs. The search has, however, not yet resulted in a usable antiviral drug against poxviruses.
Smallpox
U.S. Presidents George Washington, Andrew Jackson, and Abraham Lincoln all contracted and recovered from the disease. Washington became infected with smallpox on a visit to Barbados in 1751. Jackson developed the illness after being taken prisoner by the British during the American Revolution, and though he recovered, his brother Robert did not. Lincoln contracted the disease during his Presidency, possibly from his son Tad, and was quarantined shortly after giving the Gettysburg address in 1863.
William Foege
William Herbert Foege M.D., M.P.H.
(; born March 12, 1936) is an American epidemiologist who is credited with "devising the global strategy that led to the eradication of smallpox in the late 1970s".
Smallpox
By the end of 1975, smallpox persisted only in the Horn of Africa. Conditions were very difficult in Ethiopia and Somalia, where there were few roads. Civil war, famine, and refugees made the task even more difficult. An intensive surveillance and containment and vaccination program was undertaken in these countries in early and mid-1977, under the direction of Australian microbiologist Frank Fenner. As the campaign neared its goal, Fenner and his team played an important role in verifying eradication. The last naturally occurring case of indigenous smallpox ("Variola minor") was diagnosed in Ali Maow Maalin, a hospital cook in Merca, Somalia, on 26 October 1977. The last naturally occurring case of the more deadly "Variola major" had been detected in October 1975 in a two-year-old Bangladeshi girl, Rahima Banu.
1775–82 North American smallpox epidemic
One of the worst tragedies of the pandemic was the massive toll it took on the indigenous population of the Americas. The disease was likely spread via the travels of the Shoshone Indian tribes. Beginning in 1780 it reached the Pueblos of the territory comprising present day New Mexico. It also showed up in the interior trading posts of the Hudson's Bay Company in 1782. It affected nearly every tribe on the continent, including the northwestern coast. It is estimated to have killed nearly 11,000 Native Americans in the Western area of present-day Washington, reducing the population from 37,000 to 26,000 in just seven years.
Fall of Tenochtitlan
While Cortés was rebuilding his alliances and garnering more supplies, a smallpox epidemic struck the natives of the Valley of Mexico, including Tenochtitlan. The disease was probably carried by a Spanish slave from Narváez's forces, who had been abandoned in the capital during the Spanish flight. Smallpox played a crucial role in the Spanish success during the Siege of Tenochtitlan from 1519–1521, a fact not mentioned in some historical accounts. The disease broke out in Tenochtitlan in late October 1520. The epidemic lasted sixty days, ending by early December.
Coast Salish
The first smallpox epidemic to hit the region was in the 1680s, with the disease travelling overland from Mexico by intertribal transmission. Among losses due to diseases, and a series of earlier epidemics that had wiped out many peoples entirely, e.g. the Snokomish in 1850, a smallpox epidemic broke out among the Northwest tribes in 1862, killing roughly half the affected native populations, in some cases up to 90% or more. The smallpox epidemic of 1862 started when an infected miner from San Francisco stopped in Victoria on his way to the Cariboo Gold Rush. As the epidemic spread, police, supported by gunboats, forced thousands of First Nations people living in encampments around Victoria to leave and many returned to their home villages which spread the epidemic. Some consider the decision to force First Nations people to leave their encampments an intentional act of genocide.
Mean population decline 1774–1874 was about 66%. Though the Salish peoples together are less numerous than the Cherokee or Navajo, the numbers shown below represent a small fraction of the group.Neighboring peoples, whether villages or adjacent tribes, were related by marriage, feasting, ceremonies, and common or shared territory. Ties were especially strong within the same waterway or watershed. There existed no breaks throughout the south Coast Salish culture area and beyond. There existed no formal political institutions.
Cotton Mather
Smallpox was a serious threat in colonial America, most devastating to Native Americans, but also to Anglo-American settlers. New England suffered smallpox epidemics in 1677, 1689–90, and 1702. It was highly contagious, and mortality could reach as high as 30 percent. Boston had been plagued by smallpox outbreaks in 1690 and 1702. During this era, public authorities in Massachusetts dealt with the threat primarily by means of quarantine. Incoming ships were quarantined in Boston harbor, and any smallpox patients in town were held under guard or in a "pesthouse".
Conservation biology of parasites
Naturally, medical and veterinary sciences have attempted to exterminate parasites and pathogens living in humans and in domesticated animals. In the case of a few highly host-specific pathogens, this means the extinction of the entire pathogen species. Throughout human history, however, only one species, the smallpox virus, has been wholly eradicated. The last reported cases of smallpox occurred 1978. However, secure samples are known to still exist in the United States and Russia, purportedly for defensive purposes such as developing new vaccines, antiviral drugs, as well as for diagnostic tests. It is not known, but is speculated that these countries may have shared their samples with some of their allies during the Cold War.
History of smallpox
Smallpox is exogenous to Australia. The first recorded outbreak, in 1789, devastated the Aboriginal population; while the extent of this outbreak is disputed, some sources claim that it killed about 50% of coastal Aboriginal populations on the east coast. There is an ongoing historical debate concerning two rival and irreconcilable theories about how the disease first entered the continent. The central hypotheses of these theories suggest that smallpox was transmitted to indigenous Australians by either:
Social history of viruses
The eradication campaign led to the death of Janet Parker (c. 1938–1978) and the subsequent suicide of the smallpox expert Henry Bedson (1930–1978). Parker was an employee of the University of Birmingham who worked in the same building as Bedson's smallpox laboratory. She was infected by a strain of smallpox virus that Bedson's team had been investigating. Ashamed of the accident and having blamed himself for it, Bedson committed suicide.
1974 smallpox epidemic in India
Smallpox was eradicated due to the WHO's smallpox eradication program. This program was formally established in 1958, but because of logistics disagreements between the WHO and the Indian government, did not progress rapidly. Headway only began to take place in India after the reorganization of the WHO in the mid 1960s. Donald Henderson, who was a U.S. Public Health Services Officer stationed in New Delhi, said that "If this interest and concern about ending smallpox can be maintained for the next few months, it's all over. We don't think we're overconfident, but everything looks good. By June of 1975, we hope we'll be finished with smallpox in Asia."
History of smallpox
There is evidence that smallpox reached the Philippine islands from the 4th century CE onwards – linked possibly to contact between South East Asians and Indian traders.
University of Birmingham Medical School
In 1966, an outbreak of smallpox originated at University of Birmingham Medical School. In 1978, Janet Parker contracted the disease while working as medical photographer in the anatomy department. She was the last person to die of smallpox in the world.
1978 smallpox outbreak in the United Kingdom
On 6 September 1978, Henry Bedson, then Head of the Microbiology Department at the University of Birmingham Medical School and son of Sir Samuel Phillips Bedson, committed suicide while in quarantine at his home in Cockthorpe Close, Harborne. He cut his throat in the garden shed and died at Birmingham Accident Hospital a few days later. His suicide note read "I am sorry to have misplaced the trust which so many of my friends and colleagues have placed in me and my work." In 1977, the World Health Organization (WHO) had told Henry Bedson that his application for his laboratory to become a Smallpox Collaborating Centre had been rejected. This was partly because of safety concerns; the WHO wanted as few laboratories as possible handling the virus.
Catherine-de-Barnes Isolation Hospital
In 1978, Janet Parker, the last known victim of smallpox in the world, was treated and died at Catherine-de-Barnes Isolation Hospital following an outbreak that originated at the University of Birmingham Medical School. The ward in which she died was still sealed off five years after her death, all the furniture and equipment inside left untouched. Janet Parker's father, 71-year-old Frederick Witcomb, had died at Catherine-de-Barnes Hospital a week before his daughter after he had suffered a cardiac arrest while visiting her. No post-mortem was carried out on his body because of the risk of smallpox infection.
History of smallpox in Mexico
In 1803, Spanish doctor Francisco Javier Balmis started a vaccination program against smallpox in New Spain, better known as Balmis Expedition, which reduced the severity and mortality in the epidemics that followed. Before Balmis, Dr José María Arboleyda started a vaccination campaign in 1801 but this was not successful.
Isao Arita
After Henderson left WHO in 1976 or 1977, Arita went on to direct the unit. Under his leadership an outbreak of variola minor in the Horn of Africa during the Ethiopian–Somali war was successfully contained, and the final case of naturally transmitted smallpox occurred in October 1977. He administered the process by which smallpox was formally certified by WHO as having been eradicated globally in May 1980. After certification, he managed the implementation of the certifying commission's recommendations. He continued to direct the unit's international surveillance activities. He was also involved in formulating policies on issues including ongoing vaccination and laboratory stocks of variola virus, and in archiving WHO's data on the eradication programme. In 1999, he was one of several scientists to argue for the destruction of the remaining stocks of variola virus.
Edward Jenner
In 1979, the World Health Organization declared smallpox an eradicated disease. This was the result of coordinated public health efforts, but vaccination was an essential component. Although the disease was declared eradicated, some pus samples still remain in laboratories in Centers for Disease Control and Prevention in Atlanta in the US, and in State Research Center of Virology and Biotechnology VECTOR in Koltsovo, Novosibirsk Oblast, Russia.
Frank Fenner
Fenner was Director of the John Curtin School from 1967 to 1973. In 1977, he was named the chairman of the Global Commission for the Certification of Smallpox Eradication. The last known case of naturally transmitted smallpox occurred in Somalia in 1977. Professor Fenner announced the eradication of the disease to the World Health Assembly on 8 May 1980. This success story is regarded as the greatest achievement of the World Health Organization. Before its eradication, smallpox was one of the world's most virulent viruses, responsible for millions of deaths, and leaving many of the victims who survived with disfiguring scars for life.
Stewart Simonson
D.A. Henderson, a public health expert who led the effort to wipe out smallpox in the late '60s and '70s: "The general feeling was this is someone who may be here because of political reasons, but this is a dedicated person who has the interests of the country at heart." Dr. Henderson, who joined HHS after Sept.11, 2001, and left in 2002, says Mr. Simonson was instrumental in helping him do everything from finding office space to working on an early HHS purchase of smallpox vaccine (Wall Street Journal, December 12, 2005). In his recent book, Dr. Henderson described Simonson's role in launching the post-9/11 public health preparedness program at the U.S. Department of Health and Human Services: "Another important figure was Stewart Simonson, special counsel and long-time confidante of the secretary. He was comparatively young and new to government but a quick learner and determined to allow neither bureaucracy nor red tape to stand in the way of getting the job done. Little would have been achieved without both of them" (referring to Simonson and Dr. William Raub) D.A Henderson, MD, "Smallpox: The Death of a Disease", Prometheus Books (2009), Page 191.
William C. C. Claiborne
When a smallpox epidemic broke out in the spring of 1802, Claiborne's actions resulted in the first recorded mass vaccination in the territory and saved Natchez from the disease.
Rijk Gispen
Subsequent to experiences with the measures to control yellow fever and malaria, it became apparent that the eradication of smallpox relied upon the knowledge that no animal reservoir existed. Hence, the search for a reservoir continued. Up until 1968, seven suspected smallpox cases in monkeys were reported, but Gispen’s case was the only one that confirmed the disease by isolating the virus in 1949. Two orangutans in a Djakarta zoo became unwell during a smallpox epidemic amongst humans. It was concluded that human-to-orangutan transmission had taken place and not animal-to-animal.
Smallpox
The earliest credible clinical evidence of smallpox is found in the smallpox-like disease in medical writings from ancient India (as early as 1500 BCE), Egyptian mummy of Ramses V who died more than 3000 years ago (1145 BCE) and China (1122 BCE). It has been speculated that Egyptian traders brought smallpox to India during the 1st millennium BCE, where it remained as an endemic human disease for at least 2000 years. Smallpox was probably introduced into China during the 1st century CE from the southwest, and in the 6th century was carried from China to Japan. In Japan, the epidemic of 735–737 is believed to have killed as much as one-third of the population. At least seven religious deities have been specifically dedicated to smallpox, such as the god Sopona in the Yoruba religion. In India, the Hindu goddess of smallpox, Sitala Mata, was worshiped in temples throughout the country.
Maskepetoon
During the time of the smallpox epidemic, the Rocky Mountain Cree did not come into contact with it until it was nearing its end. The disease eventually reached them in the winter of 1837-1838 but during this time, a majority of the Cree were away from the camps trapping. The Cree outside of the camp, including Maskepetoon, were told of deaths occurring amongst the Rocky Mountain Cree and on the plains but stayed safe by continuing to live in the woods and working. The result of this was Maskepetoon and his fellow Cree emerging unscathed from the danger which had all but passed them by.
Smallpox
In July 2018, the Food and Drug Administration approved tecovirimat, the first drug approved for treatment of smallpox. Antiviral treatments have improved since the last large smallpox epidemics, and studies suggest that the antiviral drug cidofovir might be useful as a therapeutic agent. The drug must be administered intravenously, and may cause serious kidney toxicity.
World Health Organization
In 1958, Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox, resulting in Resolution WHA11.54. At this point, 2 million people were dying from smallpox every year.
History wars
Australian virologist Frank Fenner (1988) – who in 1977–80 led the successful World Health Organization (WHO) campaign to eradicate smallpox and was the principal author of a 1988 WHO report, "Smallpox and its Eradication" – pointed out that no cases of smallpox were reported amongst convicts, sailors, military personnel, or free settlers, on the First Fleet. The virus was also not reported among British or Aboriginal people at Port Jackson over the following 15 months. It was, therefore, unlikely that a person suffering from smallpox and travelling with the First Fleet had caused the 1789 outbreak.
Donald Henderson
Donald Ainslie Henderson (September 7, 1928 – August 19, 2016) was an American medical doctor, educator, and epidemiologist who directed a 10-year international effort (1967–1977) that eradicated smallpox throughout the world and launched international childhood vaccination programs. From 1977 to 1990, he was Dean of the Johns Hopkins School of Public Health. Later, he played a leading role in instigating national programs for public health preparedness and response following biological attacks and national disasters. At the time of his death, he was Professor and Dean Emeritus of the Johns Hopkins Bloomberg School of Public Health, and Professor of Medicine and Public Health at the University of Pittsburgh, as well as Distinguished Scholar at the UPMC Center for Health Security.
Globalization and disease
Smallpox was a common disease in Eurasia in the 15th century, and was spread by explorers and invaders. After Columbus landed on the island of Hispaniola during his second voyage in 1493, local people started to die of a virulent infection. Before the smallpox epidemic started, more than one million indigenous people had lived on the island; afterward, only ten thousand had survived.
History of smallpox
During the 20th century, it is estimated that smallpox was responsible for 300–500 million deaths. In the early 1950s an estimated 50 million cases of smallpox occurred in the world each year. As recently as 1967, the World Health Organization estimated that 15 million people contracted the disease and that two million died in that year. After successful vaccination campaigns throughout the 19th and 20th centuries, the WHO certified the global eradication of smallpox in December 1979. Smallpox is one of two infectious diseases to have been eradicated, the other being rinderpest, which was declared eradicated in 2011.
Wangal
In April 1789, just over a year after the establishment of the British settlement, smallpox broke out. There is speculation as to whether the disease was released deliberately or not but in any case the result was catastrophic.
Smallpox
Smallpox was highly contagious, but generally spread more slowly and less widely than some other viral diseases, perhaps because transmission required close contact and occurred after the onset of the rash. The overall rate of infection was also affected by the short duration of the infectious stage. In temperate areas, the number of smallpox infections was highest during the winter and spring. In tropical areas, seasonal variation was less evident and the disease was present throughout the year. Age distribution of smallpox infections depended on acquired immunity. Vaccination immunity declined over time and was probably lost within thirty years. Smallpox was not known to be transmitted by insects or animals and there was no asymptomatic carrier state.
Smallpox
Given these risks, as smallpox became effectively eradicated and the number of naturally occurring cases fell below the number of vaccine-induced illnesses and deaths, routine childhood vaccination was discontinued in the United States in 1972, and was abandoned in most European countries in the early 1970s. Routine vaccination of health care workers was discontinued in the U.S. in 1976, and among military recruits in 1990 (although military personnel deploying to the Middle East and Korea still receive the vaccination). By 1986, routine vaccination had ceased in all countries. It is now primarily recommended for laboratory workers at risk for occupational exposure.
Immunogenetics
Its origin is usually attributed to Edward Jenner, who discovered in 1796 that cowpox, or vaccinia, induced protection against human smallpox.
It took two centuries before the World Health Organization announced in 1979 that smallpox had been eradicated.
History of smallpox
It has been suggested that smallpox was a major component of the Plague of Athens that occurred in 430 BCE, during the Peloponnesian Wars, and was described by Thucydides. Galen's description of the Antonine Plague, which swept through the Roman Empire in 165–180, indicates that it was probably caused by smallpox. Returning soldiers brought the disease home with them to Syria and Italy, where it raged for fifteen years and greatly weakened the Roman empire, killing up to one-third of the population in some areas. Total deaths have been estimated at 5 million. A second major outbreak of disease in the Roman Empire, known as the Plague of Cyprian (251–266), was also either smallpox or measles. Although some historians believe that many historical epidemics and pandemics were early outbreaks of smallpox, contemporary records are not detailed enough to make a definite diagnosis.
History of smallpox in Mexico
During the colonial period, smallpox remained a scourge, especially on the indigenous population. There was a major epidemic between 1790 and 1791 that started in Valley of Mexico, principally affecting children. More people recovered than died. In Mexico City, of 5400 cases admitted to the hospital, 4431 recovered and 1,331 died. This epidemic coincided with the rise of prices of corn and a typhus epidemic, which caused a slight demographic decrease in central Mexico.
Vaccination
Smallpox was most likely the first disease people tried to prevent by inoculation and was the first disease for which a vaccine was produced. The smallpox vaccine was invented in 1796 by English physician Edward Jenner and although at least six people had used the same principles years earlier he was the first to publish evidence that it was effective and to provide advice on its production. Louis Pasteur furthered the concept through his work in microbiology. The immunization was called "vaccination" because it was derived from a virus affecting cows ( 'cow'). Smallpox was a contagious and deadly disease, causing the deaths of 20–60% of infected adults and over 80% of infected children. When smallpox was finally eradicated in 1979, it had already killed an estimated 300–500 million people in the 20th century.
Smallpox
WHO first recommended destruction of the virus in 1986 and later set the date of destruction to be 30 December 1993. This was postponed to 30 June 1999. Due to resistance from the U.S. and Russia, in 2002 the World Health Assembly agreed to permit the temporary retention of the virus stocks for specific research purposes. Destroying existing stocks would reduce the risk involved with ongoing smallpox research; the stocks are not needed to respond to a smallpox outbreak. Some scientists have argued that the stocks may be useful in developing new vaccines, antiviral drugs, and diagnostic tests; a 2010 review by a team of public health experts appointed by WHO concluded that no essential public health purpose is served by the U.S. and Russia continuing to retain virus stocks. The latter view is frequently supported in the scientific community, particularly among veterans of the WHO Smallpox Eradication Program.
Eradication of infectious diseases
Smallpox (variola) occurred in two clinical varieties: "variola major", with a mortality rate of up to 40 percent, and "variola minor", also known as alastrim, with a mortality rate less than one percent. The last naturally occurring case of "Variola major" was diagnosed in October 1975 in Bangladesh. The last naturally occurring case of smallpox ("Variola minor") was diagnosed on 26 October 1977, on Ali Maow Maalin, in the Merca District, of Somalia. The source of this case was a known outbreak in the nearby district of Kurtuware. All 211 contacts were traced, revaccinated, and kept under surveillance.
History of smallpox
Early in history, it was observed that those who had contracted smallpox once were never struck by the disease again. Thought to have been discovered by accident, it became known that those who contracted smallpox through a break in the skin in which smallpox matter was inserted received a less severe reaction than those who contracted it naturally. This realization led to the practice of purposely infecting people with matter from smallpox scabs in order to protect them later from a more severe reaction. This practice, known today as variolation, was first practiced in China in the 10th century. Methods of carrying out the procedure varied depending upon location. Variolation was the sole method of protection against smallpox other than quarantine until Jenner's discovery of the inoculating abilities of cowpox against the smallpox virus in 1796. Efforts to protect populations against smallpox by way of vaccination followed for centuries after Jenner's discovery. Smallpox has since been completely eradicated since 1979, because of the mass vaccination efforts of the World Health Organization.
History of smallpox
In 1900 starting in New York City, smallpox reared its head once again and started a sociopolitical battle with lines drawn between the rich and poor, white and black. In populations of railroad and migrant workers who traveled from city to city the disease had reached an endemic low boil. This fact did not bother the government at the time, nor did it spur them to action. Despite the general acceptance of the germ theory of disease, pioneered by John Snow in 1849, smallpox was still thought to be mostly a malady that followed the less-distinct guidelines of a "filth" disease, and therefore would only affect the "lower classes".
Global health
The 19th century held major discoveries in medicine and public health. The Broad Street cholera outbreak of 1854 was central to the development of modern epidemiology. The microorganisms responsible for malaria and tuberculosis were identified in 1880 and 1882, respectively. The 20th century saw the development of preventive and curative treatments for many diseases, including the BCG vaccine (for tuberculosis) and penicillin in the 1920s. The eradication of smallpox, with the last naturally occurring case recorded in 1977, raised hope that other diseases could be eradicated as well.
ACAM2000
Smallpox works in the following way:"Smallpox spreads from one person to another by infected saliva droplets. The incubation period is 7 to 17 days. The symptoms begin with severe headache, backache, and fever up to 40 °C, all beginning abruptly. Then a rash appears on the face and spreads, the spots become watery blisters containing pus that form scabs and leave pitted scars when they fall off. The infected person is contagious until the last smallpox scab has fallen off, although most of the transmission occurs in the first week. Most people with smallpox recover, but some do die and the risk depends on the strain of virus." In 1980, the World Health Organization certified that the naturally occurring smallpox disease was eradicated. According to the FDA, "Until ACAM2000 was licensed, Dryvax, manufactured by Wyeth Laboratories, Inc., was the only vaccine licensed by FDA. Routine vaccination of the American public was stopped in 1972 after the disease was eradicated from the United States. However, smallpox has the potential to be deliberately used as a weapon by terrorists. A large proportion of the population has no immunity and fatality rates could be higher than 25% if smallpox were to be released as a bioterrorist weapon."
R. A. Shooter
Reginald Arthur Shooter (4 April 1916 – 24 December 2013) was a British microbiologist. He led the enquiry into the last death of smallpox, that of Janet Parker and was appointed a CBE in the 1980 Birthday Honours. He retired in 1981.
Isao Arita
Arita's work for the WHO smallpox eradication programme started in 1962. He spent around 2 years working on eradication in Liberia, Africa. When American epidemiologist Donald A. Henderson joined the programme in 1966, Arita was the only remaining WHO technical staff member. He was a part of the WHO Smallpox Eradication Unit from its inception in 1966, serving as its deputy director under Henderson's leadership. He was responsible for developing the programme's "surveillance and containment" strategy (which replaced the unsuccessful strategy of attempting to vaccinate at least 80% of the population), as well as for increasing the supply of smallpox vaccine used by the eradication programme, and for monitoring and improving vaccine quality. He also undertook research into poxviruses, particularly monkeypox virus.
1978 smallpox outbreak in the United Kingdom
On 11 August 1978, Parker (who had been vaccinated against smallpox in 1966, but not since) fell ill; she had a headache and pains in her muscles. She developed spots that were thought to be a benign rash, or chickenpox. On 20 August at 3pm, she was admitted to East Birmingham (now Heartlands) Hospital and a clinical diagnosis of "Variola major", the most serious type of smallpox, was made by consultant Alasdair Geddes.
Mark Pallen
In 2018, Pallen wrote a book on the 1978 smallpox outbreak in the United Kingdom, "The Last Days of Smallpox: Tragedy in Birmingham",
History of smallpox
Elsewhere in the Pacific, smallpox killed many indigenous Polynesians. Nevertheless, Alfred Crosby, in his major work, "" (1986) showed that in 1840 a ship with smallpox on it was successfully quarantined, preventing an epidemic amongst Māori of New Zealand. The only major outbreak in New Zealand was a 1913 epidemic, which affected Māori in northern New Zealand and nearly wiped out the Rapa Nui of Easter Island ("Rapa Nui"), was reported by Te Rangi Hiroa (Dr Peter Buck) to a medical congress in Melbourne in 1914.
Smallpox
The English physician Edward Jenner demonstrated the effectiveness of cowpox to protect humans from smallpox in 1796, after which various attempts were made to eliminate smallpox on a regional scale. In Russia in 1796, the first child to receive this treatment was bestowed the name "Vaccinov" by Catherine the Great, and was educated at the expense of the nation. The introduction of the vaccine to the New World took place in Trinity, Newfoundland in 1800 by Dr. John Clinch, boyhood friend and medical colleague of Jenner. As early as 1803, the Spanish Crown organized the Balmis expedition to transport the vaccine to the Spanish colonies in the Americas and the Philippines, and establish mass vaccination programs there. The U.S. Congress passed the Vaccine Act of 1813 to ensure that safe smallpox vaccine would be available to the American public. By about 1817, a very solid state vaccination program existed in the Dutch East Indies. In British India a program was launched to propagate smallpox vaccination, through Indian vaccinators, under the supervision of European officials. Nevertheless, British vaccination efforts in India, and in Burma in particular, were hampered by stubborn indigenous preference for inoculation and distrust of vaccination, despite tough legislation, improvements in the local efficacy of the vaccine and vaccine preservative, and education efforts. By 1832, the federal government of the United States established a smallpox vaccination program for Native Americans. In 1842, the United Kingdom banned inoculation, later progressing to mandatory vaccination. The British government introduced compulsory smallpox vaccination by an Act of Parliament in 1853. In the United States, from 1843 to 1855 first Massachusetts, and then other states required smallpox vaccination. Although some disliked these measures, coordinated efforts against smallpox went on, and the disease continued to diminish in the wealthy countries. In Northern Europe a number of countries had eliminated smallpox by 1900, and by 1914, the incidence in most industrialized countries had decreased to comparatively low levels. Vaccination continued in industrialized countries, until the mid to late 1970s as protection against reintroduction. Australia and New Zealand are two notable exceptions; neither experienced endemic smallpox and never vaccinated widely, relying instead on protection by distance and strict quarantines.
Bioterrorism
In 1980 the World Health Organization (WHO) announced the eradication of smallpox, a highly contagious and incurable disease. Although the disease has been eliminated in the wild, frozen stocks of smallpox virus are still maintained by the governments of the United States and Russia. Disastrous consequences are feared if rogue politicians or terrorists were to get hold of the smallpox strains. Since vaccination programs are now terminated, the world population is more susceptible to smallpox than ever before.
1775–82 North American smallpox epidemic
It is not known where the outbreak began, but the epidemic was not limited to the colonies on the Eastern seaboard, nor to the areas ravaged by hostilities. The outbreak spread throughout the North American continent. In 1775 it was already raging through British-occupied Boston and among the Continental Army's invasion of Canada. During Washington's siege of Boston the disease broke out among both Continental and British camps. Many escaped slaves who had fled to the British lines in the South likewise contracted smallpox and died. In the South, it reached Texas, and from 1778–1779, New Orleans was especially hard hit due to its densely populated urban area. By 1779 the disease had spread to Mexico and would cause the deaths of tens of thousands. At its end the epidemic had crossed the Great Plains, reaching as far west as the pacific coast, as far north as Alaska and as far south as Mexico, infecting virtually every part of the continent.
Rijk Gispen
“Silent monkeypox virus infections” were observed on three separate occasions during the 1964 and 1965 outbreaks in cynomolgus colonies in the Netherlands. In 1964, Gispen isolated two viruses from the kidneys of laboratory monkeys that were not unwell. The monkeys remained without symptoms. These viruses appeared identical to smallpox. A number of further discoveries of the smallpox-like virus were later isolated from chimpanzees in West Africa and in well sun-squirrels. Despite ultimately finding that this was a mutant monkeypox virus, these incidents gave cause for concern and provided the impetus to continue WHO field research into the potential existence of a smallpox reservoir. A personal correspondance from Gispen's colleague, J. G. Kapsenberg in the early 1980s, revealed that the cases of silent monkeypox were probably a result of contamination.
Poxviridae
Diseases caused by pox viruses, especially smallpox, have been known about for centuries. One of the earliest suspected cases is that of Egyptian pharaoh Ramses V who is thought to have died from smallpox circa 1150 years BCE. Smallpox was thought to have been transferred to Europe around the early 8th century and then to the Americas in the early 16th century. It is widely accepted that the main defeat of the Aztecs was due to a smallpox epidemic and within two years over 3.2 million Aztecs died. This death toll can be attributed to the American population's complete lack of exposure to the virus over millennia. A century after Edward Jenner showed that the less potent cow pox could be used to effectively vaccinate against the more deadly smallpox, a worldwide effort to vaccinate everyone against smallpox began with the ultimate goal to rid the world of the plague-like epidemic. The last case of endemic smallpox occurred in Somalia in 1977. Extensive searches over two years detected no further cases, and in 1979 the World Health Organization (WHO) declared the disease officially eradicated. In 1986, all virus samples were destroyed or transferred to two approved WHO reference labs: at the headquarters of the federal Centers for Disease Control and Prevention (the C.D.C.) in Atlanta, Georgia (the United States) and at the Institute of Virus Preparations in Moscow. Post September 11, 2001 the American and UK governments have had increased concern over the use of smallpox, or a smallpox like disease, in bio-terrorism.
Smallpox virus retention controversy
The smallpox virus retention controversy is a debate that has been ongoing among international scientists and other officials since smallpox was declared eradicated by the World Health Organization (WHO) in 1980. It centers on whether to finally and irreversibly destroy the two last remnants of the virus that causes smallpox, which reside in government laboratories in the United States and Russia. Advocates of final destruction maintain that there is no longer any valid rationale for retaining the samples, which represent a hazard, while opponents of it maintain that the samples are needed for further research as smallpox virus may still exist in the world outside of the two labs, and thus may re-emerge, particularly as a bio-weapon.
1978 smallpox outbreak in the United Kingdom
A similar outbreak had occurred at the University of Birmingham Medical School in 1966, when Tony McLennan, who was also a medical photographer and worked in the same laboratory later used by Parker, contracted smallpox. He had a milder form of the disease, which was not diagnosed for eight weeks. He was not quarantined and there were at least twelve further cases in the West Midlands, five of whom were quarantined in Witton Isolation Hospital in Birmingham. There are no records of any formal enquiries on the source of this earlier outbreak despite concerns expressed by the then head of the laboratory, Peter Wildy.
1837 Great Plains smallpox epidemic
Smallpox has afflicted Native Americans since it was carried to the western hemisphere by the Spanish conquerors, with credible accounts of epidemics dating back to at least 1515. Smallpox was particularly deadly in the plains because no one in these communities had been exposed, and developed immunity before. This is why mortality rates were so high. By the 1730s smallpox had made its way west in Canada and northern United States. The Assiniboine First Nation had controlled much of this territory, but were forced to give it up as their population decreased dramatically. Along the Missouri River the Arikara population was reduced by half by the end of the 1730s. Other communities that were decimated in the 1730s by smallpox include the Lower Loup, Pawnee of Nebraska, Cherokee, and the Kansa. In short, smallpox in the 1730s created major population changes Indigenous communities living on the North American plains.
Aral smallpox incident
According to Soviet General Pyotr Burgasov (Peter Burgasov), field testing of 400 grams of smallpox at Aralsk-7 caused an outbreak on 30 July 1971. Burgasov, former Chief Sanitary Physician of the Soviet Army, former Soviet Vice-Minister of Health and a senior researcher within the Soviet BW program, described the incident:
Aral smallpox incident
The Aral smallpox incident was a July 30, 1971 outbreak of the viral disease which occurred as a result of a field test at a Soviet biological weapons (BW) facility on an island in the Aral Sea. The incident sickened ten people, of whom 3 died, and came to widespread public notice only in 2002.
Monkeypox
The virus was first discovered in monkeys (hence the name) in 1958, and in humans in 1970. Between 1970 and 1986, over 400 cases in humans were reported. Small viral outbreaks with a death rate in the range of 10% and a secondary human-to-human infection rate of about the same amount occur routinely in equatorial Central and West Africa. The primary route of infection is thought to be contact with the infected animals or their bodily fluids. The first reported outbreak outside of the African continent occurred in the United States in 2003 in the Midwestern states of Illinois, Indiana, and Wisconsin, with one occurrence in New Jersey. The outbreak was traced to a prairie dogs infected from an imported Gambian pouch rat. No deaths occurred.
Social history of viruses
References to influenza infections date from the late 15th and early 16th centuries, but infections almost certainly occurred long before then. In 1173, an epidemic occurred that was possibly the first in Europe, and in 1493, an outbreak of what is now thought to be swine influenza, struck Native Americans in Hispaniola. There is some evidence to suggest that source of the infection was pigs on Columbus's ships. During an influenza epidemic that occurred in England between 1557 and 1559, five per cent of the population – about 150,000 – died from the infection. The mortality rate was nearly five times that of the 1918–19 pandemic. The first pandemic that was reliably recorded began in July 1580 and swept across Europe, Africa, and Asia. The mortality rate was high – 8,000 died in Rome. The next three pandemics occurred in the 18th century, including that during 1781–82, which was probably the most devastating in history. This began in November 1781 in China and reached Moscow in December. In February 1782 it hit Saint Petersburg, and by May it had reached Denmark. Within six weeks, 75 per cent of the British population were infected and the pandemic soon spread to the Americas.
The Americas and Australia remained free of measles and smallpox until the arrival of European colonists between the 15th and 18th centuries. Along with measles and influenza, smallpox was taken to the Americas by the Spanish. Smallpox was endemic in Spain, having been introduced by the Moors from Africa. In 1519, an epidemic of smallpox broke out in the Aztec capital Tenochtitlan in Mexico. This was started by the army of Pánfilo de Narváez, who followed Hernán Cortés from Cuba and had an African slave suffering from smallpox aboard his ship. When the Spanish finally entered the capital in the summer of 1521, they saw it strewn with the bodies of smallpox victims. The epidemic, and those that followed during 1545–1548 and 1576–1581, eventually killed more than half of the native population. Most of the Spanish were immune; with his army of fewer than 900 men it would not have been possible for Cortés to defeat the Aztecs and conquer Mexico without the help of smallpox. Many Native American populations were devastated later by the inadvertent spread of diseases introduced by Europeans. In the 150 years that followed Columbus's arrival in 1492, the Native American population of North America was reduced by 80 per cent from diseases, including measles, smallpox and influenza. The damage done by these viruses significantly aided European attempts to displace and conquer the native population.
1775–82 North American smallpox epidemic
Smallpox is a dangerous disease caused by the variola major virus. The most common type of smallpox, ordinary, historically has devastated populations with a 30% death rate. The smallpox virus is transmittable through bodily fluids and materials contaminated with infected materials. Generally, face-to-face contact is required for an individual to contract smallpox as a result of an interaction with another human. Unlike some viruses, humans are the only carriers of variola major. This limits the chances of the virus being unknowingly spread through contact with insect or other animal populations. Persons infected with smallpox are infectious to others for about 24 days of their infection time. However, there is a period of time in which individuals are contagious but have only begun to experience minor symptoms such as fever, headaches, body aches and sometimes vomiting.
Little Bay, New South Wales
The Little Bay area was first used as a sanitation camp during Sydney's smallpox outbreak in 1881–82, to isolate the healthy contacts of sufferers of the disease. At first, a "tent city" was established on the beach, but as well the government decided to build a permanent hospital here to treat infectious diseases. Little Bay was an ideal location because it was isolated from settlements but still close enough to Sydney. The Coast Hospital was particularly valuable during the bubonic plague in Sydney of 1900 and then again when soldiers returning from Europe brought the influenza virus back in 1919. The Coast Hospital became Prince Henry Hospital in 1934. In 2001 services were transferred to Prince of Wales Hospital, Sydney and the hospital site became available for residential use.
Tsilhqot'in
The isolated position of the Tsilhqot’in may have protected them from the first of the smallpox epidemics, which spread up from Mexico in the 1770s. They may have been spared the smallpox epidemic of 1800 and the measles of the 1840s. Furniss in "The Burden of History" states that "there is no direct evidence that these smallpox epidemics reached the central interior of British Columbia or the Secwepemc, Carrier, or Tsilhqot'in". However, in the epidemic of 1836–38, the disease spread to Ootsa Lake and killed an entire Carrier band. Oral history of the bands has continued to recount the effects of the many deaths in these epidemics.
Variolation
France was the last European country to embrace variolation. It was not until an outbreak of smallpox in Paris in 1752 nearly killed the heir to the French throne that the public embraced the practice after seeing the prince variolated. Similarly in Japan, Chinese merchant Li Jen-Shan proposed the method of traditional Chinese intranasal variolation after a severe smallpox outbreak in Nagasaki in 1744. This led Japanese physician to variolate children using a human smallpox vaccination method during an outbreak in Chikuzen Province from 1789 to 1790. There were no deaths among the children, and they all appeared to be protected.
Thomas Henry Flewett
Janet Parker was the last person to die from smallpox. The diagnosis was made by Professor A. Geddes at East Birmingham Hospital where she had been admitted. Before the diagnosis had been confirmed, a member of Flewett’s laboratory had collected fluid from Janet Parker’s vesicles and taken it across the grounds of the hospital for examination in the virus laboratory. Flewett ordered his staff to fumigate the laboratory with formaldehyde. The ward in which Janet Parker had been initially cared for was also fumigated. The building housing wards 31 and 32 were later demolished. Two members of Flewett’s team were subsequently quarantined but apart from Janet Parker’s mother, no further cases of smallpox occurred. This tragedy led to the suicide of Professor Henry Bedson a friend and colleague of Flewett.
1972 Yugoslav smallpox outbreak
In early 1972, a 38-year-old Kosovo Albanian Muslim clergyman named Ibrahim Hoti, from Damnjane near Đakovica, Kosovo, Serbia, undertook the pilgrimage to Mecca. He also visited holy sites in Iraq, where there were known cases of smallpox. He returned home on February 15. The following morning he felt achy and tired, but attributed this to the long bus journey. Hoti soon realised that he had some kind of infection, but, after feeling feverish for a couple of days and developing a rash, he recovered - probably because he had been vaccinated two months earlier.
735–737 Japanese smallpox epidemic
The 735–737 Japanese smallpox epidemic was a major smallpox epidemic that afflicted much of Japan and had a lasting historic impact. Overall adult mortality from the disease has been estimated to be at least 25-35% of Japan's population, with some regions suffering much higher losses. The disease first took hold on Japan's southwestern island of Kyushu and eventually spread to the east to central Honshu, including Japan's capital at Nara. All classes of society were affected, and there was significant resulting social, economic, and religious repercussions at the national level.
Smallpox virus retention controversy
In 1986, the WHO first recommended destruction of all virus, and later set the date of destruction to be 30 December 1993. This was postponed to 30 June 1999, then again to 30 June 2002. Due to resistance from the U.S. and Russia, in 2002 the World Health Assembly agreed to permit the temporary retention of the virus stocks for specific research purposes. Destroying existing stocks would reduce the risk involved with ongoing smallpox research; the stocks are not needed to respond to a smallpox outbreak. Some scientists have argued that the stocks may be useful in developing new vaccines, antiviral drugs, and diagnostic tests; A 2010 review by a team of public health experts appointed by the WHO, however, concluded that no essential public health purpose is served by the U.S. and Russia continuing to retain virus stocks. The latter view is frequently supported in the scientific community, particularly among veterans of the WHO Smallpox Eradication Program (1958–79).
Ali Maow Maalin
Smallpox is an infectious disease caused by two strains of virus, "Variola major" and "V. minor". "V. minor" is the rarer of the two strains, and causes a much less severe disease (sometimes called alastrim), with a fatality rate of around 1%. No treatment is available, and the only protection is vaccination. The virus is usually transmitted by prolonged face-to-face contact with a person showing symptoms. The incubation period averages 12–14 days. One of the most feared diseases of human history, smallpox was still causing an estimated 2 million deaths every year as late as 1967.
The global effort to eradicate smallpox from endemic areas such as Africa began in 1959 with a mass vaccination campaign. This approach met with little success, and a more effective targeted approach was developed in the late 1960s. This involved active surveillance by case hunting, combined with rapid containment of infection in areas reporting outbreaks by intensive vaccination. The majority of African countries were free from smallpox by 1972. By the end of 1975, the virus had been eradicated worldwide except in Ethiopia and Somalia in the Horn of Africa, and their neighbour Kenya. The nomadic people of the Ogaden Desert retained endemic smallpox with an unusually mild form of the disease, which facilitated persistence in the population. From 1975, WHO efforts were concentrated on this region. Ethiopia saw its last case in August 1976 and Kenya in February 1977.
Isao Arita
Isao Arita (born 1926) is a Japanese physician, virologist and vaccination specialist who headed the World Health Organization (WHO) Smallpox Eradication Unit in 1977–85. During this period, smallpox became the first infectious disease of humans to be eradicated globally. For this work, he and his colleagues were awarded the Japan Prize in 1988. He also advised the successful programme to eradicate poliovirus from the Western Pacific region.
Aptos, California
In the mid to late 1800s, a series of major epidemics hit the area. A particularly bad one occurred in the early winter of 1868. Cases of smallpox were reported among the poor of San Juan Bautista. Efforts were made to localize the rapidly spreading disease, such as, barricading the roads leading in and out of San Juan Bautista. These efforts failed however, and when cases appeared in Watsonville, Santa Cruz citizens attempted to again quarantine the disease by destroying the Aptos Bridge. These efforts again failed and only created a rift between the two cities. The death toll of the smallpox epidemic lead to the local press publishing of the latest remedies available for home use as well as methods to prevent the spread of smallpox and inoculations.
Abraham Ulrikab
The five survivors were vaccinated against smallpox on January 1, 1881, but it was too late. The group was exhibited at the Jardin d'Acclimation in the Bois de Boulogne for about a week. Then, on January 9, 1881, they were admitted to Hôpital Saint-Louis, where they all died within the next week. Maria died on January 10, 1881. Tigianniak on January 11. Tobias and Abraham died on January 13, and Ulrike, the last to live, died January 16, 1881.
Smallpox
The British used smallpox as a biological warfare agent at the Siege of Fort Pitt during the French and Indian Wars (1754–1763) against France and its Native American allies. The actual use of smallpox had official sanction. British officers, including the top British commanding generals, ordered, sanctioned, paid for and conducted the use of smallpox against the Native Americans. As described by historians, "there is no doubt that British military authorities approved of attempts to spread smallpox among the enemy", and "it was deliberate British policy to infect the Indians with smallpox". On 24 June 1763, William Trent, a local trader and commander of the Fort Pitt militia, wrote, "Out of our regard for them, we gave them two Blankets and an Handkerchief out of the Small Pox Hospital. I hope it will have the desired effect." The effectiveness of this effort to broadcast the disease is unknown. There are also accounts that smallpox was used as a weapon during the American Revolutionary War (1775–1783).
Heartlands Hospital
After joining the National Health Service as Little Bromwich Hospital in 1948, it became a general hospital in 1953. It was renamed East Birmingham Hospital in 1963 and saw considerable expansion in the 1970s. The world's last smallpox patient, Janet Parker, was treated at the hospital during the smallpox outbreak in 1978. It became Heartlands Hospital in 1993.
Globalization and disease
In 1617, smallpox reached Massachusetts, probably brought by earlier explorers to Nova Scotia, Canada.” By 1638 the disease had broken out among people in Boston, Massachusetts. In 1721 people fled the city after an outbreak, but the residents spread the disease to others throughout the thirteen colonies. Smallpox broke out in six separate epidemics in the United States through 1968.
Disease in colonial America
A particularly virulent sequence of smallpox outbreaks took place in Boston, Massachusetts. From 1636 to 1698, Boston endured six epidemics. In 1721, the most severe epidemic occurred. The entire population fled the city, bringing the virus to the rest of the Thirteen Colonies.
William Tomison
At the beginning of the 1780s there was an outbreak of smallpox in the Western Canada, the Northern Great Plains which severely affected the villages and the population reduced drastically in size by about 70-80%. William Tomison is greatly known for the records that he made of this epidemic, he recorded in his diary in great detail concerning this. Giving thorough detail and updates regarding Cree Indians who were struck by smallpox, he also journalled about those that came to him to seek help. His journal contained great detail about this outbreak and it brought clarity about the epidemic. From records and accounts from the time it is clear that the British employees did not suffer from smallpox as they were in contact with it or had smallpox or a similar disease when they were infants. The British employees of HBC did not contract or catch this disease because they had smallpox, cowpox or chicken pox when they were infants. This led to them being immune to the disease when it spread in Western Canada Employees that were Hudson Bay Company and Canadians (despite sexual activity between Indigenous women and employees being banned) were sensitive to the disease, however some individuals did not contract the disease. Unfortunately, there is no concrete evidence to show that the Aboriginal people blamed the British or French traders for this incident.
1837 Great Plains smallpox epidemic
The smallpox infection spiked in 1780s, as persisted up to the 1837 epidemic. In what is now Canada, fur trade strengthened communities such as the Mushego Cree, Anishinabe, and Ottawa. The Mandan tribe had previously experienced a major smallpox epidemic in 1780-81 which severely reduced their numbers down to less than a few thousand. Many other bands along the Missouri river suffered smallpox epidemics during 1801-02 and 1831. Sporadic efforts were made to promote vaccination among the Indigenous peoples since the turn of the nineteenth century. Later, the Indian Removal Act the U.S. Congress took its first step in 1832 to generate public support for vaccination of the Native Americans. But shortly after passage of this congressional act to extend vaccinations to Indians, Secretary Cass stated that no effort would be made "under any circumstances" to send surgeons to vaccinate Indians up the Missouri River beyond the Arickaree tribe. This Great Plains epidemic spanned thousands of miles, reaching California, the northwestern coast and central Alaska before finally subsiding in 1840.
Great Plague of London
The Great Plague of 1665/1666 was the last major outbreak of bubonic plague in Great Britain. The last recorded death from plague came in 1679, and it was removed as a specific category in the Bills of Mortality after 1703. It spread to other towns in East Anglia and the southeast of England but fewer than ten percent of parishes outside London had a higher than average death rate during those years. Urban areas were more affected than rural ones; Norwich, Ipswich, Colchester, Southampton and Winchester were badly affected, while the West of England and areas of the Midlands escaped altogether.
History of smallpox
In 1519 Hernán Cortés landed on the shores of what is now Mexico and was then the Aztec empire. In 1520 another group of Spanish arrived in Mexico from Hispaniola, bringing with them the smallpox which had already been ravaging that island for two years. When Cortés heard about the other group, he went and defeated them. In this contact, one of Cortés's men contracted the disease. When Cortés returned to Tenochtitlan, he brought the disease with him.
Vaccination
In modern times, the first vaccine-preventable disease targeted for eradication was smallpox. The World Health Organization (WHO) coordinated this global eradication effort. The last naturally occurring case of smallpox occurred in Somalia in 1977. In 1988, the governing body of WHO targeted polio for eradication by 2000. Although the target was missed, eradication is very close.
Richard Preston
"The Demon in the Freezer" (2002) covers the story of the eradication of smallpox, perhaps the most destructive virus to have plagued mankind. It details the survival of the virus in research labs and bio-weapon programs of Russia and other nations, despite its eradication in the human population. The narrative continues with anthrax, a bacterial disease of cattle and humans, used in the 2001 anthrax attacks.
Smallpox
Famous historical figures who contracted smallpox include Lakota Chief Sitting Bull, Ramses V of Egypt, the Kangxi Emperor (survived), Shunzhi Emperor and Tongzhi Emperor (refer to the official history) of China, Emperor Komei of Japan (died of smallpox in 1867), and Date Masamune of Japan (who lost an eye to the disease). Cuitláhuac, the 10th tlatoani (ruler) of the Aztec city of Tenochtitlan, died of smallpox in 1520, shortly after its introduction to the Americas, and the Incan emperor Huayna Capac died of it in 1527. More recent public figures include Guru Har Krishan, 8th Guru of the Sikhs, in 1664, Peter II of Russia in 1730 (died), George Washington (survived), king Louis XV in 1774 (died) and Maximilian III Joseph, Elector of Bavaria in 1777.
Danville, New Hampshire
The Tuckertown smallpox epidemic, one of the most memorable and saddest events in Hawke's history, occurred in the winter of 1781-82. The Reverend John Page willingly went to the "pest house" to care for those afflicted, only to eventually succumb himself.
Social history of viruses
Following mass vaccinations, disease detection and containment were central to the eradication campaign. As soon as cases were detected, the victims were isolated as were their close contacts, who were vaccinated. Successes came quickly; by 1970 smallpox was no longer endemic in western Africa, nor, by 1971, in Brazil. By 1973, smallpox remained endemic only in the Indian sub-continent, Botswana and Ethiopia. Finally, after 13 years of coordinated disease surveillance and vaccination campaigns throughout the world, the World Health Organization declared smallpox eradicated in 1979. Although the main weapon used was vaccinia virus, which was used as the vaccine, no one seems to know exactly where vaccinia virus came from; it is not the strain of cowpox that Edward Jenner used, and it is not a weakened form of smallpox.
Smallpox
The timing of the arrival of smallpox in Europe and south-western Asia is less clear. Smallpox is not clearly described in either the Old or New Testaments of the Bible or in the literature of the Greeks or Romans. While some have identified the Plague of Athens – which was said to have originated in "Ethiopia" and Egypt – or the plague that lifted Carthage's 396 BCE siege of Syracuse – with smallpox, many scholars agree it is very unlikely such a serious disease as variola major would have escaped being described by Hippocrates if it had existed in the Mediterranean region during his lifetime. While the Antonine Plague that swept through the Roman Empire in 165180 CE may have been caused by smallpox, Saint Nicasius of Rheims became the patron saint of smallpox victims for having supposedly survived a bout in 450, and Saint Gregory of Tours recorded a similar outbreak in France and Italy in 580, the first use of the term "variola"; other historians speculate that Arab armies first carried smallpox from Africa into Southwestern Europe during the 7th and 8th centuries. In the 9th century the Persian physician, Rhazes, provided one of the most definitive descriptions of smallpox and was the first to differentiate smallpox from measles and chickenpox in his "Kitab fi al-jadari wa-al-hasbah" ("The Book of Smallpox and Measles"). During the Middle Ages, smallpox made periodic incursions into Europe but did not become established there until the population increased and population movement became more active during the era of the Crusades. By the 16th century smallpox had become well established across most of Europe. With its introduction into populated areas in India, China and Europe, smallpox affected mainly children, with periodic epidemics that killed as many as 30 percent of those infected. The settled existence of smallpox in Europe was of particular historical importance, since successive waves of exploration and colonization by Europeans tended to spread the disease to other parts of the world. By the 16th century it had become an important cause of morbidity and mortality throughout much of the world.
History of smallpox
The last major smallpox epidemic in the United States occurred in Boston, Massachusetts throughout a three-year period, between 1901-1903. During this three-year period, 1596 cases of the disease occurred throughout the city. Of those cases, nearly 300 people died. As a whole, the epidemic had a 17% fatality rate.
History of smallpox
During the 18th century, there were many major outbreaks of smallpox, driven possibly by increasing contact with European colonists and traders. There were epidemics, for instance, in the Sultanate of Banjar (South Kalimantan), in 1734, 1750–51, 1764–65 and 1778–79; in the Sultanate of Tidore (Moluccas ) during the 1720s, and in southern Sumatra during the 1750s, the 1770s and in 1786.
Edward Cutbush
The smallpox visited St. Louis, Missouri, in 1801 about the time that the city became an American town. "In 1803 the doctors of Philadelphia, including Cutbush, had issued a circular to the whole profession, inculcating the virtue and duty of vaccination on April 12, 1803." "We, the subscribers, physicians of Philadelphia, having carefully considered the nature and effects of the newly-discovered means of preventing, by vaccination, the fatal consequence of the smallpox, think it is a duty thus publicly to declare our opinion that inoculation for the kine or cowpox is a certain preventive of the smallpox, that it is attended with no danger, may be practiced at all ages and seasons of the year, and we do, therefore, recommend it for general use."
1947 New York City smallpox outbreak
Twelve cases of smallpox were confirmed—9 in Manhattan and 3 in Millbrook. Seven were adults and 5 were children, the latter group all age 5 and under. The oldest patient was the 62-year-old nun. The youngest patient was the 22-month-old baby girl.
History of smallpox
During the 1770s, smallpox killed at least 30% of the West Coast Native Americans. The smallpox epidemic of 1780–1782 brought devastation and drastic depopulation among the Plains Indians. This epidemic is a classic instance of European immunity and non-European vulnerability. It is probable that the Indians contracted the disease from the ‘Snake Indians’ on the Mississippi. From there it spread eastward and northward to the Saskatchewan River. According to David Thompson’s account, the first to hear of the disease were fur traders from the Hudson’s House on October 15, 1781. A week later, reports were made to William Walker and William Tomison, who were in charge of the Hudson and Cumberland Hudson’s Bay Company posts. By February, the disease spread as far as the Basquia Tribe. Smallpox attacked whole tribes and left few survivors. E. E. Rich described the epidemic by saying that “Families lay unburied in their tents while the few survivors fled, to spread the disease.” After reading Tomison’s journals, Houston and Houston calculated that, of the Indians who traded at the Hudson and Cumberland houses, 95% died of smallpox. Paul Hackett adds to the mortality numbers suggesting that perhaps up to one half to three quarters of the Ojibway situated west of the Grand Portage died from the disease. The Cree also suffered a casualty rate of approximately 75% with similar effects found in the Lowland Cree. By 1785 the Sioux Indians of the great plains had also been affected. Not only did smallpox devastate the Indian population, it did so in an unforgiving way. William Walker described the epidemic stating that “the Indians [are] all Dying by this Distemper … lying Dead about the Barren Ground like a rotten sheep, their Tents left standing & the Wild beast Devouring them.”
Pandemic
Smallpox was a contagious disease caused by the variola virus. The disease killed an estimated 400,000 Europeans per year during the closing years of the 18th century. During the 20th century, it is estimated that smallpox was responsible for 300–500 million deaths. As recently as the early 1950s, an estimated 50 million cases of smallpox occurred in the world each year. After successful vaccination campaigns throughout the 19th and 20th centuries, the WHO certified the eradication of smallpox in December 1979. To this day, smallpox is the only human infectious disease to have been completely eradicated, and one of two infectious viruses ever to be eradicated.
Witton Isolation Hospital
Witton Isolation Hospital was used sporadically during the 20th century, particularly during the outbreak of smallpox that occurred in the city in 1962. The last cases quarantined there were during January and February 1966, following an outbreak that originated at the University of Birmingham Medical School. Witton Isolation Hospital was eventually superseded by the UK's first National Isolation Hospital, established at nearby Catherine-de-Barnes in 1966.
ACAM2000
According to the Cochrane Library, smallpox was eradicated in 1980. However, there has been interest in the development of vaccines due to is possible use as a bioterrorism weapon.
Smallpox
Famous theologian Jonathan Edwards died of smallpox in 1758 following an inoculation.
Wolfgang Joklik
Joklik's research on vaccinia viruses led to his selection as one of two United States representatives to the World Health Organization's Smallpox Eradication Committee in the 1970s, whose efforts came to a close in 1980 when natural smallpox infections were declared to be eradicated and research stocks retained only by the United States Centers for Disease Control and the State Research Center of Virology and Biotechnology VECTOR in the then-Soviet Union. Joklik was a highly vocal opponent of efforts in the 1990s to destroy the remaining stocks, delivering talks and writing several papers on the topic.