The Spread of Smallpox

Smallpox is widely considered one of the most devastating illnesses to have ever occurred in human history. It has, singlehandedly, shaped and destroyed entire civilizations and paralyzed people with fear.

Historians believe the infection originated roughly 3,000 years ago and was one of the main reasons for the decline of both the Aztec Empire and the Inca population. In the 18th century in Europe, smallpox claimed up to 60 million people and in the 20th century, the virus killed an estimated 300 million people globally.

The infection is highly contagious and manifests itself in bumps, almost like chickenpox, over one’s face, body, and internal organs. The virus would kill roughly thirty percent of those who transmitted it.

The Miracle of Vaccination

Incredible strides were made in Europe and the United States in the 1700s to inoculate populations from the infection. Cotton Mather (1663 —1728), a prominent reverend from Boston had “learned of those in London who were attempting to protect their children from the ravages of smallpox by intentionally infecting them in a process called inoculation.” Mather was one of the very first advocates for this process of inoculation in the United States. A key breakthrough in discovering the vaccine “came in 1796 when an experiment by English doctor Edward Jenner showed that inoculation using closely related cowpox could protect against smallpox. Jenner's discovery paved the way for later vaccination programs.”

Painting of Dr. Edward Jenner and his early vaccination process

By the mid 1800s in America, smallpox, however, was still quite common. New York officials felt it imperative to construct the Smallpox Hospital, which would be the first U.S. hospital dedicated to the disease. The hospital was located apart from the island of Manhattan, on what is now known as Roosevelt Island, in order to help contain the virus and prevent its spread. After the vaccine became more widely used in America and the virus became more contained, the Smallpox Hospital began to serve a broader population of the infirm. The hospital changed its name to Riverside Hospital.

World Health Organization

Many years later, in 1967, a year when roughly 10 to 15 million people contracted the virus in countries around the world, the World Health Organization launched a successful worldwide eradication campaign with the vaccine in hand.

The last occurrence of the disease was in Somalia in 1977. While there is no cure for the disease, this highly accessible vaccine provides total immunity from it.

A Timeline of Smallpox and its Eradication

Published by the World Health Organization in 1980

1519 AD

The ships of Hernan Cortes landed in Mexico, carrying something more deadly than 500 Conquistadores and 23 cannons: the smallpox virus. More than three million people died when a series of epidemics erupted, finally toppling the centuries-old Aztec Empire.

1694

Queen Mary II of England fell a victim to smallpox and died at the age of 32.

1721

Deliberate inoculation (variolation) with smallpox virus had been practiced in Africa, China and India for centuries, before being introduced to Europe and North America by Lady Mary Wortley Montagu. The wife of the British ambassador in Turkey, she had observed variolation in Constantinople. The Reverend Cotton Mather learned of the practice from his African slaves and introduced it in Boston.

1774

King Louis XV of France died of smallpox, aged 64. Benjamin Jesty, an English farmer, inoculated his wife and two sons with cowpox to protect them against a smallpox outbreak.

1796

An English country doctor, Edward Jenner, took material from a cowpox sore on the hand of a milkmaid and inoculated it into the arm of an eight-year-old boy on May 14, 1796. Two months later he tried to inoculate the boy with smallpox—and the infection did not take. He announced his findings in 1798: by 1801 more than 100,000 persons had been vaccinated in England and Jenner's pamphlet on the subject had been translated into five languages.

1801

Jenner predicted that "the annihilation of the smallpox—the most dreadful scourge of the human species— must be the final result of this practice."

1803

Efforts were made to promote vaccination throughout the world. One of the most spectacular efforts was made by Charles IV of Spain who, in 1803, dispatched vaccines to his dominions around the globe by means of children vaccinated arm-to-arm in succession during the voyages.

1807

Five Red Indian Chiefs wrote a letter of thanks to Dr. Jenner. It said: "Brother: Our Father has delivered to us the book you sent to instruct us how to use the discovery which the Great Spirit made to you, whereby the smallpox, that fatal enemy of our tribe, may be driven from the earth.... We send with this a belt and string of wampum (beads used for money) in token of our acceptance of your precious gift."

1870

During the Franco-Prussian war in Europe a smallpox epidemic broke out. The French army lost 23,400 soldiers to the disease. But the German army had been vaccinated, and only 278 died.

1948

At its first meeting in July 1948, the World Health Assembly (WHA) paid special attention to the problem of smallpox in its deliberations.

1958

The Eleventh WHA, following a motion by the Soviet delegation, decided to step up efforts to eradicate smallpox. The Soviet resolution pointed out that the funds devoted to vaccination against smallpox throughout the world exceeded those necessary for the eradication of the disease.

1967

The World Health Organization (WHO) launched an intensified smallpox eradication program. A unit set up at WHO'S Geneva headquarters began work with WHO Regional Office teams and with national smallpox programs.

1971

In South America between 1950 and 1967, endemic smallpox was eradicated in all countries except Brazil. In Brazil a huge program of mass vaccination and case searching, which included the vast Amazon basin, culminated in victory over smallpox in 1971.

1975

In Asia, the campaign strategy had evolved from the concept of mass vaccination to an even more successful approach based on improved case investigation and searches and containment of outbreaks. The last case on the vast Indian subcontinent was Rahima Banu, a three-year-old girl in Bangladesh.

1977

From Asia the focus of the campaign shifted to the Horn of Africa, the last foothold of the disease in Africa and in the world. The last endemic case in Africa, and worldwide, was located in Somalia on October 26, 1977. The patient, 23-year-old hospital cook Ali Maow Maalin, made a complete recovery.

1979

In December, the Global Commission for Certification of Smallpox Eradication—an independent body which consisted of scientists from 19 nations—confirmed that smallpox eradication had been achieved throughout the world.

1980

The thirty-third World Health Assembly meeting in Geneva officially declares that smallpox has been completely eradicated from the planet.

Additional Research comes from:

Brown University's Smallpox in the Americas 1492 to 1815: Contagion and Controversy by Stanley M. Aronson and Lucile Newman

National Geographic's Conquered Killer