Childhood memories of standing in line. Smiling. Trusting. And then…the Gun. That sound. Whack! The scream. That feeling of betrayal…being shuffled along. Next!
Ask anyone of a certain age and they can show you the scar, round or oblong, jagged around the edges and just a little lower than the surrounding skin.
Between 1958 and 1977, the World Health Organization conducted a great campaign, a global effort to rid the world of the great scourge, of smallpox.
Today we face a worldwide pandemic of the COVID19 virus, calculated to produce a crude mortality rate of .28% and an Infection Fatality Rate (IFR), of 1.4%. Hat Tip worldometers.info
The four Variola virus types responsible for smallpox produce a death rate between one in ten at the low end and two – three out of four with an average of 30%.
The disease is as old as history, believed to have evolved from an African rodent virus, at least 16,000 years ago. The Egyptian Pharaoh Ramses V died of smallpox in 1145, BC.
Survivors are left with severe scarring and often blinded. Josef Stalin was famously pockmarked after acquiring the illness at age 7. Other famous survivors include Abraham Lincoln, Queen Elizabeth I and Pocahontas.
And did you know? The American Revolution was fought out, entirely in the midst of a smallpox pandemic.
How it all began, is uncertain. By the fall and winter of 1775, the disease was raging through British-occupied Boston.
In the south, escaped slaves crossed over to British lines only to contract smallpox, and die. The disease hit Texas in 1778. New Orleans was particularly hard hit with its densely populated urban areas. By 1780 it was everywhere from Mexico to the Great Plains to Alaska.
Native populations were particularly hard hit. As many as 11,000 were killed in the west of modern-day Washington state, reducing populations from 37,000 to 26,000 in just seven years.The idea of inoculation was not new. Terrible outbreaks occurred in Colonial Boston in 1640, 1660, 1677-1680, 1690, 1702, and 1721, killing hundreds, each time. At the time, sickness was considered the act of an angry God. Religious faith frowned on experimentation on the human body.
On June 26, 1721, Dr. Zabdiel Boylston in consultation with Reverend Cotton Mather, performed the first smallpox inoculations in America. Two male slaves, an adult and and a two-year-old were inoculated, along with Dr. Boylston’s 6-year-old son. All three became mildly ill but recovered, never again to be bothered by smallpox.Colonists were chary of the procedure, deeply suspicious of how deliberately infecting a healthy person, could produce a desirable outcome. John Adams submitted to the procedure in 1764 and gave the following account:
“Dr. Perkins demanded my left arm and Dr. Warren my brother’s [probably Peter Boylston Adams]. They took their Launcetts and with their Points divided the skin about a Quarter of an inch and just suffering the blood to appear, buried a thread (infected) about a Quarter of an inch long in the Channell. A little lint was then laid over the scratch and a Piece of Ragg pressed on, and then a Bandage bound over all, and I was bid go where and do what I pleased…Do not conclude from any Thing I have written that I think Inoculation a light matter — A long and total abstinence from everything in Nature that has any Taste; two long heavy Vomits, one heavy Cathartick, four and twenty Mercurial and Antimonial Pills, and, Three weeks of Close Confinement to an House, are, according to my Estimation, no small matters.”
As Supreme Commander, General Washington had a problem. An inoculated soldier would be unfit for weeks before returning to duty. Doing nothing and hoping for the best was to invite catastrophe but so was the inoculation route, as even mildly ill soldiers were contagious and could set off a major outbreak.
The northern army was especially hard hit in Quebec, with general Benedict Arnold reporting some 1,200 out of 3,200 Continentals sick in the Montreal area, most with smallpox. It was “almost sufficient to excite the pity of Brutes” he said, “Large barns [being] filled with men at the very heighth of smallpox and not the least things, to make them comfortable and medicines being needed at both Fort George and Ticonderoga.”
Major General John Thomas, Commander of the Army in Quebec was dead of the disease. John Adams complained “The smallpox is ten times more terrible than Britons, Canadians and Indians, together.”
By mid-1776, half the continentals in and around Montreal were infected. The order was given to withdraw. John Adams cited smallpox, as the cause. In February 1777 while encamped in Morristown, Washington became convinced that the benefits outweighed the risks. Washington himself had survived the dreadful disease. Martha Washington had undergone the procedure, known as variolation. He ordered his medics to cut small incisions on the arms of his troops, and to rub the pus from infected soldiers, into the wounds. Thus inoculated, soldiers were kept under strict quarantine and issued either new or “well washed, air’d and smoaked” clothing.
The program had enthusiastic support from the likes of Jefferson, Franklin and Adams. Nearly every continental soldier was inoculated before the end of the war. Had the program begun a year earlier, the US/Canadian map might look quite different, than it does today.
In Washington’s day, the method used live virus, accounting for the long sick time and high mortality rate. In the 1790s, Doctor Edward Jenner of Berkeley, Gloucestershire, England observed milkmaids developing the signature pustules of smallpox on their hands, after touching infected udders. The Orthopoxvirus responsible for “Cowpox” is very similar to that which produces smallpox but results in far milder symptoms. The implications were stunning. Orthopox could be administered in place of live Variola, virtually eliminating side effects and reducing the chance of smallpox outbreak, to zero.
On this day in 1796, Dr. Jenner administered the first modern smallpox vaccination. The new vaccine was soon being used around the world.
So it was on December 9, 1979, smallpox was officially described, as eradicated. The only infectious disease ever so declared.
Few among us born after 1980, bear the scar their parents know so well. Today, stockpiles of live Variola exist only in laboratories, and military bioweapon stockpiles. Just in case of terrorism, or some rogue nation ever resorting to biological warfare.
Today we grapple with a virus, with a 98.6% recovery rate among those infected. God help us all if that other stuff ever gets out of the lab.