Smallpox Eradication DayThe COVID-19 pandemic showed the global community the gaps in the efficacy of health care. With misinformation about the virus and the vaccine, many people’s faith in health care dropped. May 8, 2023, marked the 40th anniversary of the eradication of smallpox. In 1980, the 33rd World Health Assembly declared “The world and all its peoples have won freedom from smallpox.” The victory over smallpox is regarded by many as the most monumental achievement in international public health.

History of Smallpox

The declaration marked the end of a battle against the disease that lasted more than 3,000 years. The Centers for Disease Control and Prevention (CDC) traces the earliest known cases of smallpox back to ancient Egypt, with remnants of smallpox pustules found on mummies from the third century BCE. As the ancient world became more interconnected, smallpox rapidly spread, with the first written documentation of the disease originating in fourth-century CE China.

Over the next 1500 years, smallpox continued to spread. Advancements in international trade and travel facilitated the global reach of the disease. European colonization introduced smallpox to previously unexposed communities in the Americas and Australia, leading to the tragic loss of millions of indigenous lives. The expanding world brought with it the expanding reach of smallpox.

Early Methods of Control

Before the invention of a vaccine, approximately three out of 10 people infected with smallpox died. To fight the disease, smallpox patients practiced a preventative measure called variolation. According to the CDC, variolation is “a process of grinding up dried smallpox scabs from a smallpox patient and inhaling them or scratching them into an arm of an uninfected person.” The practice originated in 16th century CE Asia and became global commonplace by the turn of the 18th century.

In 1796, an English doctor named Edward Jenner began work on the first vaccine. After witnessing an increase in smallpox immunity in those who had successfully battled cowpox, another virus that produces pustules and sores, Jenner experimented with the variolation of cowpox into a healthy immune system as a preventative measure against smallpox. Jenner’s 1801 publication, “On the Origin of the Vaccine Inoculation,” introduced the world to vaccines and thus began the eradication of smallpox.

Global Vaccination Efforts

With the practice of variolation replaced with vaccination, the world slowly began to snuff out smallpox. In 1813, the United States Congress passed legislation to make the smallpox vaccine widely available and by the end of the 19th century, wealthier parts of the world began to only suffer the occasional outbreak. These improvements in wealthier nations began the process of eradication, but Vox explains that in poorer countries, where vaccines were far less available, smallpox was still killing tens of millions.

Global cooperation was necessary to end smallpox for everyone. An underfunded 1959 WHO effort to eradicate the disease was unsuccessful, but the 1967 Intensified Smallpox Eradication Program ultimately ended smallpox outbreaks globally. The CDC explains the program aided, “Laboratories in many countries where smallpox occurred regularly to produce more, higher-quality freeze-dried vaccines.”

Successful Eradication and Global Solidarity

Due to the diligent work of WHO and other global healthcare organizations, smallpox was officially eradicated globally in 15 years, beginning with the North American eradication in 1952 and ending in 1977 with African elimination. WHO attributes the elimination of smallpox, “to an incredible demonstration of global solidarity and because it had a safe and effective vaccine.”

The global elimination of smallpox was no small feat. The disease claimed more than 300 million lives in the 20th century before its eradication. In the years since the global victory over smallpox, UNICEF and the WHO partnered to create the Expanded Programme on Immunization, which has vaccinated 85% of children globally. The Expanded Programme on Immunization was launched in 1974 and initially focused on six childhood diseases that are preventable by vaccines. As the WHO program has grown, it “has increased the breadth of protection provided by immunization, to include vaccinations for protection of older children, adolescents and adults.”

Looking Ahead

The eradication of smallpox stands as a remarkable testament to the power of global cooperation and effective vaccination programs. Also, this victory serves as a beacon of hope in the face of current health challenges. The lessons learned from the eradication of smallpox continue to guide efforts to combat other diseases and promote immunization, ensuring a healthier and more resilient global community.

– Annika Nelson
Photo: Flickr

What the Pandemics of History Can Teach
As the Global Report for Research on Infectious Diseases of Poverty by the World Health Organization (WHO) explained, “Poverty creates conditions that [favor] the spread of infectious diseases and prevents affected populations from obtaining adequate access to prevention and care. Ultimately, these diseases…disproportionately affect people living in poor or [marginalized] communities.” This is what the pandemics of history can teach all countries.

While the number of people living in extreme poverty worldwide has dropped over the last 20 years, research has suggested that poverty will grow for the first time since 1999 due to the COVID-19 pandemic. Despite the many lives this disease has affected, hope exists that the world will be able to overcome this global setback.

A Quick Lesson in Terminology

In simple terms, infectious disease epidemiology is the study of the spread and burden of communicable diseases over time and, to understand pandemics of history, it is important to first know a few epidemiologic terms. The COVID-19 pandemic is an epidemic that has spread across national and continental borders. An epidemic marks a particularly sudden increase in the spread of a specific disease. Diseases are endemic when present within a population at steady levels.

The notable scientific and technological advancements that occur through the lessons of diseases past and present are of course vital to global health. However, a look through these histories can also provide context and even comfort in the face of COVID-19. Here are three examples of defeated plagues from history.

3 Defeated Pandemics of History

  1. The Black Plague: The Black Plague caused great destruction in Asia and Europe during the mid-1300s. It is a prime example of what the pandemics of history can teach. The movement of sailors from port to port was a significant influence on the spread of the bubonic plague—rats that were aboard ships, as well as sailors themselves, transmitted the disease, leading port officials to eventually restrict passengers from leaving ships for 30-40 days. This practice, known as quarantine, has of course played an important role in mitigating the spread of COVID-19.
  2. The Spanish Flu: Despite the comparisons between the 1918 influenza pandemic and COVID-19, there remain key differences. The Spanish flu primarily struck younger people who were otherwise healthy. Meanwhile, COVID-19 deaths have disproportionately included older populations. Many countries put public health measures in place in 1918. They bear an obvious resemblance to those deployed against COVID-19. Many can also be thankful for the many scientific and technological innovations of the last 100 years. The COVID-19 pandemic will hopefully end before killing 50 million people.
  3. Smallpox: Smallpox waxed and waned in many areas of the world as early as the 4th century and WHO eradicated it in 1980. Nonetheless, from the years of tragedy and struggle came lessons and innovations serving the world today. For perspective, over a millennium passed between the first cases of smallpox and Edward Jenner’s scientific discovery of a smallpox vaccine, and it was nearly another two centuries before the disease underwent eradication.

Light at the End of the COVID-19 Tunnel

Public health officials have continued to utilize the lessons of the past. What the pandemics of history can teach has informed the public health measures and campaigns of today.

– Amy Perkins
Photo: Pixabay