Smallpox was eradicated in 1977. This amazing, global public health achievement isn’t just a page in a history book or an entry in Wikipedia, it is highly relevant today. Understanding the significance of this piece of history highlights the importance of vaccines in present day.
Smallpox has been around for 3,000 years. It is a highly contagious disease, affecting only humans, killing 30% of those infected. It did not discriminate by age, wealth, gender or race. If you survived, you had horrible scars and likely be left blind. It is the only disease completely eradicated by vaccines.
The variola virus, an orthopoxvirus which includes cowpox and monkeypox, was found on ancient Egyptian mummies and was first written about in 4th century China. This very contagious disease spread worldwide. It was an international effort of many dedicated professionals to eradicate it.
Smallpox symptoms were said to be gruesome, and the pictures are. It starts with four days of sore throat, headaches, high fever, weakness, fatigue, back pain, vomiting, abdominal pain and no appetite. Then a terrible rash starts in the throat spreading to the face and body. Big, deep round lesions and pustules cover the entire body for about 2 weeks. Complications include brain infection, bone infection, miscarriage, stillborn, infertility in males and blindness. Mozart and Abraham Lincoln both survived it.
The process of eradicating started long ago. In ancient times, they practiced variolation by transferring material from smallpox sores to healthy people. These people had a milder case. In the 1500s, China made a powder of the scabs and blew it into the nostrils. In India in the 18th century, material from the pustules was transferred to healthy people with needles. Similar practices are documented in Europe, Turkey and Massachusetts.
In 1796, folklore said that milkmaids were immune to the virus. English Physician Edward Jenner observed that they all had cowpox previously. He carried out an experiment exposing an 8 year old boy to cowpox and found him to be immune to smallpox after this exposure. In some eras, those who were immune or survived were thought to be witches, sorcerers or influenced by evil spirits.
The last naturally occurring case of smallpox occurred in 1977 in Somalia and the WHO declared it eradicated in 1980. The estimated death toll was more than 500 million with 300 million of those in the 20th century. A massive global vaccination campaign with international participation continues to save billions of dollars by not having to treat and vaccinate for this disease. More importantly, it shows that disease eradication is possible.
The meeting of the newly appointed members of the Vaccine Advisory Committee is occurring this week. The previous 17-member panel of experts were completely replaced with many without the same qualifications and experience. Other CDC vaccine scientists have either resigned or lost their positions. The American Academy of Pediatricians is publishing its own vaccine schedule because of concerns for the credibility of recommendations coming from the new panel.
Two labs, one in the U.S. and one in Russia hold the only remaining samples of the virus. The destruction of these samples has been discussed for many years and advised by the WHO advisory committee to eliminate potential use as a biological weapon. There is no other need or use of these samples. If used in biological warfare, it would not be the first time. Blankets and handkerchiefs infected by smallpox were used as biological warfare by British officers to weaken and kill Native Americans.
Vaccines are still available. Public Health agencies have plans in place if needed. Because of the possible threat from the virus sitting in the labs, treatment for smallpox is being researched and developed. Return of this eradicated disease would by a criminal assault on all of humanity.
For almost 50 years there have been no recorded cases of one of the most feared diseases that caused devastating suffering and wiped out families, villages and large populations for 3000 years. This is strong testimony and a compelling narrative of facts for a closing argument to follow the scientific advice of vaccine experts. Smallpox is one of among many diseases that humanity has endured, and it should remain a lesson learned.
Take care of yourself and someone else.
Juanita Carnes is a nurse practitioner with 39 years of experience in a hospital emergency department and urgent care facilities. She served 30 years on the Board of Health in Westfield, Massachusetts.
