The Smallpox, The Vaccine, and The Eradication

The Happy-Ending of the Eradicated Smallpox

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Pragnya Keerthivasan, Journalist/Editor

After the long two years we’ve had with the coronavirus, you may think that diseases never end, and even if the cases go significantly down, they still lurk in the shadows, popping out when you’re off guard. Well… there is one disease that can end your doubts. Let’s look into the history of the smallpox.

The first traces of the rashes of smallpox were on a mummy living 3,000 years ago in Egypt. Early written descriptions on the pox were first recorded in China, back in the 4th century CE (Common Era). Then in India (7th century), then the Asia Minor (10th century). Soon, trade and expansion carried the smallpox virus- the variola virus -around the world by the 18th century, and became a pandemic.

Smallpox was a terrible disease, and everyone who lived through the pandemic will definitely agree. I guess there were no pandemics that people didn’t hate. The smallpox symptoms include flu-like symptoms. Patients also experience a rash that appears first on the face, hands and forearms, and then later appears on the trunk. If you survive, the rash left from the smallpox would still be there as scars. The rash can be from a variola minor (little rashes that won’t be so visible as scars if you survive the wrath of the smallpox) to a variola major (large rashes everywhere in your face. Few chances of surviving, but if you do, the scars will be hideous). It was highly contagious. To put it into ratios, 3 out of 10 people who got smallpox died.

The ancient method for preventing smallpox was a process called variolation. People who had never had smallpox were exposed to material from smallpox sores (pustules) by scratching the material into their arm or inhaling it through the nose. It sounds gross, but it made a negligible difference. Fewer people died with this method than getting it naturally, but it still wasn’t enough to stop the smallpox spread. But that was going to change soon.

In 1796, the basis of the first vaccination began. Edward Jenner observed that milkmaids that got cowpox were immune to smallpox. To prove this, Jenner put a cowpox sore from a milkmaid and put it on the arm of a 9-year-old. Months later, the 9-year-old got intentionally exposed multiple times to the variola virus, but never got smallpox.

In 1801, Jenner published his treatise “On the Origin of the Vaccine Inoculation.” In this work, he summarized his discoveries and expressed hope in his treatise that, “the annihilation of the smallpox, the most dreadful scourge of the human species, must be the ultimate result of this practice.” This means the result of the smallpox vaccine must be the eradication of smallpox. Did Edward Jenner just predict the future?

Vaccination became widely accepted(perhaps from the significant decline of negative social media rumors), and gradually replaced the practice of variolation. In the 1800s, the virus used to make the smallpox vaccine changed from cowpox to vaccinia virus. In 1959, the World Health Organization (WHO) started a plan to rid the world of smallpox. Unfortunately, this global eradication campaign suffered from a lack of funds, personnel, and commitment from countries, and a shortage of vaccine donations. And despite their best efforts, smallpox was still widespread in 1966, causing regular outbreaks across South America, Africa, and Asia. So they started the Intensified Eradication Program.

The Intensified Eradication Program started in 1967 with a promise to do better to end this. Laboratories in many countries where smallpox occurred regularly could produce more, higher-quality freeze-dried vaccines. By the time the Intensified Eradication Program began in 1967, smallpox was already eliminated in North America (1952), Europe (1953), South America (1971), Asia (1975), Africa (1977), and never widespread in Australia.

Almost two centuries after Jenner hoped that vaccination could annihilate smallpox, the 33rd World Health Assembly declared the world free of this disease on May 8, 1980. Many people consider smallpox eradication to be the biggest achievement in international public health. And indeed it was!

It’s amazing how with the right motivation and view in the world, you can literally do anything! Solve a hard math problem? Yup! Invent something? Sure! Eradicate a dangerous disease? If you examine carefully, and have 101% dedication, why not?! This type of mindset could and should be used for the coronavirus. We already have an effective vaccine, we just have to keep going! Even when the next rough wave comes to drown us once more, keep on persevering to the shore. When the times get rough in the pandemic, just remember this: Smallpox was just as dangerous as COVID-19, but it’s dark history finally had a happy ending because we never stopped trying.