History of Vaccines: Smallpox
The Threat of Smallpox and Early Treatments
"The most terrible minister of death." "The Speckled Monster." Smallpox was a lethal disease that haunted humankind from as early as 400 B.C.E. The disease produced a burning fever and pustules on its victim's skin. While survivors often ended up with scarring or even blindness, smallpox claimed the lives of about thirty percent of people infected.
Early efforts to curb the disease took the form of a treatment called variolation or inoculation. Variolation was an effort to expose patients to a mild case of smallpox often by taking scabs from someone infected with smallpox, powdering the scabs, and having the patient inhale the scabs through the nose or injected into the arm. The practice is mentioned as far back as the 15th century in China. By the 16th century, variolation was a common treatment in Africa, India, and the Ottoman Empire. Lady Mary Wortley Montagu was an early advocate for variolation in Britain after learning about the procedure in Constantinople. Variolation was introduced to the United States after Cotton Mather learned about it from his slave, Onesimus. Unfortunately, while variolation reduced the rate of infected dying of smallpox from around 30% to 2%, those treated by variolation could still spread the disease.
Smallpox as represented in art and religion: Japanese print rendering Minamoto no Tametomo, a samurai general of Heian period, who punishes two gods of smallpox.
Source: The National Library of Medicine Image License: The National Library of Medicine believes this item to be in the public domain.
Sources:
The College of Physicians of Philadelphia. (n.d.). History of Smallpox. Timeline | History of Vaccines. https://historyofvaccines.org/history/smallpox/timeline
National Institutes of Health, History of Medicine Division. (2013, July 30). Smallpox: A Great and Terrible Scourge. U.S. National Library of Medicine. https://www.nlm.nih.gov/exhibition/smallpox/index.html
Hsu, Jennifer. "A Short History of Vaccines: Smallpox to Present." in The Story of Immunization. South Dakota Medicine Special Edition. The Journal of the South Dakota Medical Association.
- A History of Vaccination, PBSA short video covering the history of the treatment of smallpox from inoculation to vaccination.
- Smallpox: A Great and Terrible ScourgeAn overarching history of Smallpox from the National Library of Medicine
Books
The Vaccination Controversy: the rise, reign, and fall of compulsory vaccination for smallpox by
Smallpox was for several centuries one of the most deadly, most contagious and most feared of diseases. Williamson's extraordinary study charts the history of one of the most controversial techniques in medical history that raises much debate to this day. Originating probably in Africa, smallpox progressed via the Middle and Near East, where it was studied around the end of the first millennium by Arab physicians. It arrived in Britain during the Elizabethan times and was well established by the seventeenth century. During the closing years of the 18th Century a most far reaching and ultimately controversial development took place when Edward Jenner developed an inoculation for Smallpox based on a culture from Cowpox. The Vaccination Controversy examines the astonishing speed at which Jenner's technique of 'vaccination' was taken up, culminating in the 'Compulsory Vaccination Act of 1853'. The Act made a painful and sometimes fatal medical practice for all children obligatory and as a result set an important precedent for governmental regulation of medical welfare. The Act remained in force until 1946 and was only ended after decades of intense pressure from the National Anti-vaccination League, but the issues raised by Williamson's accessible text remain current today in debates about vaccination programs. Meticulously researched, The Vaccination Controversy highlights the social, political and ethical consequences of compulsory vaccination and the massive repercussions that followed the ending of a policy through argued by many to be the most major medical resistance campaign in European medical history.
ISBN: 9781846310867Publication Date: 2007-12-01
The Speckled Monster : a historical tale of battling smallpox by
A timely book about history's first desperate efforts to conquer the spotted beast of smallpox. What is it like to be caught in the terror and chaos of a smallpox epidemic when you and those you love are unprotected? What is it like to get smallpox, or to watch your children battle the disease? The Speckled Monstertells the dramatic story-both historical and timely-of two parents who dared to fight back against the disease. After barely surviving the agony of smallpox themselves, they both flouted eighteenth-century European medical tradition by borrowing folk knowledge from African slaves and eastern women in frantic bids to protect their children. From their heroic struggles stem the modern science of immunology as well as the vaccinations that remain our only hope should the disease ever be unleashed again. Jennifer Lee Carrell transports readers back to the early eighteenth century to tell the tales of Lady Mary Wortley Montagu and Dr. Zabdiel Boylston: two iconoclastic figures who helped save the cities of London and Boston from the deadliest disease mankind has known.
Call Number: RA644 .S6 C37 2003ISBN: 0525947361Publication Date: 2003-06-02Jenner and vaccination : a strange chapter of medical history. by
Call Number: WCH C915 1889Publication Date: 1889
Angel of Death : the story of smallpox by
The story of the rise and fall of smallpox, one of the most savage killers in the history of mankind, and the only disease ever to be successfully exterminated (30 years ago next year) by a public health campaign.
Call Number: RC183 .W55 2010ISBN: 9780230274716Publication Date: 2010-05-17The Global Eradication of Smallpox by The Global Commission for the Certification of Smallpox Eradication met in December 1978 to review the program in detail and to advise on subsequent activities and met again in December 1979 to assess progress and to make the final recommendations that are presented in this report. Additionally, the report contains a summary account of the history of smallpox, the clinical, epidemiological, and virological features of the disease, the efforts to control and eradicate smallpox prior to 1966, and an account of the intensified program during the 1967-79 period. The report describes the procedures used for the certification of eradication along with the findings of 21 different international commissions that visited and reviewed programs in 61 countries. These findings provide the basis for the Commission's conclusion that the global eradication of smallpox has been achieved. The Commission also concluded that there is no evidence that smallpox will return as an endemic disease. The overall development and coordination of the intensified program were carried out by a smallpox unit established at the World Health Organization (WHO) headquarters in Geneva, which worked closely with WHO staff at regional offices and, through them, with national staff and WHO advisers at the country level. Earlier programs had been based on a mass vaccination strategy. The intensified campaign called for programs designed to vaccinate at least 80% of the population within a 2-3 year period. During this time, reporting systems and surveillance activities were to be developed that would permit detection and elimination of the remaining foci of the disease. Support was sought and obtained from many different governments and agencies. The progression of the eradication program can be divided into 3 phases: the period between 1967-72 when eradication was achieved in most African countries, Indonesia, and South America; the 1973-75 period when major efforts focused on the countries of the Indian subcontinent; and the 1975-77 period when the goal of eradication was realized in the Horn of Africa. Global Commission recommendations for WHO policy in the post-eradication era include: the discontinuation of smallpox vaccination; continuing surveillance of monkey pox in West and Central Africa; supervision of the stocks and use of variola virus in laboratories; a policy of insurance against the return of the disease that includes thorough investigation of reports of suspected smallpox; the maintenance of an international reserve of freeze-dried vaccine under WHO control; and measures designed to ensure that laboratory and epidemiological expertise in human poxvirus infections should not be dissipated.
Call Number: WC 588 W928G 1980ISBN: 9789241560658Publication Date: 1980-01-01
Creating a Vaccine and Eliminating Smallpox
One of the first known attempts to derive a vaccine for smallpox was in 1774 when a farmer, Benjamin Jesty, inoculated his family using a cowpox sore from one of his cows. However, Jesty did not publish his findings so his efforts were widely forgotten. A more well-known attempt to create a vaccine occurred in 1796 when Edward Jenner experimented with cowpox to see if he could provide protection to patients from smallpox. Jenner noticed that milkmaids who contracted the mild cowpox did not seem to catch the more deadly variant of smallpox. He inoculated an eight-year-old boy named James Phillips with matter taken from a cowpox sore of a milkmaid, Sarah Nelmes. Jenner was able to prove that exposure to cowpox provided protection from smallpox. Since this first vaccine used cowpox, the origin of the word vaccine comes from the Latin name of cowpox "Vaccinia" ("Vacca" is the Latin word for cow).
Vaccination dramatically reduced the death toll from smallpox around the world. In 1967 the World Health Organization began an intensive eradication of smallpox program mainly aimed at countries in central Africa, Asia, and South America where smallpox was endemic. Throughout the 1970s more countries became "zero-pox" zones and in 1980 the WHO declared that smallpox had been eradicated from the world.
Sources:
The College of Physicians of Philadelphia. (n.d.). History of Smallpox. Timeline | History of Vaccines. https://historyofvaccines.org/history/smallpox/timeline
National Institutes of Health, History of Medicine Division. (2013, July 30). Smallpox: A Great and Terrible Scourge. U.S. National Library of Medicine. https://www.nlm.nih.gov/exhibition/smallpox
Hsu, Jennifer. "A Short History of Vaccines: Smallpox to Present." in The Story of Immunization. South Dakota Medicine Special Edition. The Journal of the South Dakota Medical Association.
Anti-vaccine cartoon
Source: Library of Congress. Image License: No known restrictions on publication
Some people remained skeptical of Jenner's vaccine breakthrough. This anti-vaccine illustration from 1802 depicts cows sprouting from people they are inoculated using cox pox.