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By Kristin Drexler
Faculty Member, School of STEM, American Military University
This week in science history, one of the biggest achievements in global public health was announced. On May 8, 1980, the World Health Organization (WHO) declared the smallpox virus was globally eradicated. It is a good day to thank doctors, researchers and epidemiologists for their work in creating vaccinations – especially for such a virulent and tragic virus as smallpox.
The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), describes the horrific effects of smallpox. NIAID says, “Three out of 10 individuals infected with smallpox died. Many survivors have permanent scars, often on their faces, or were left blind. Through vaccination, the disease was eradicated in 1980. However, research for effective vaccines, drugs and diagnostics for smallpox continues in the event it is used as a bioterror weapon.”
How Smallpox Is Transmitted
The WHO describes smallpox as being “transmitted from person to person via infective droplets during close contact with infected symptomatic people.” For example, smallpox was transmitted through coughing and sneezing, which spread droplets that could be passed from one victim to another.
Smallpox was fatal to a third of its victims – about 300 million people in the 20th century – usually within two weeks of developing symptoms. Symptoms started with fever and body aches, then culminated in rashes and infected pustules.
Jenner Develops a Smallpox Vaccine in Late 1700s
A smallpox vaccine was created by Dr. Edward Jenner, a physician in the late 1700s who used cowpox virus in the vaccine. According to the Centers for Disease Control and Prevention (CDC) website, “Jenner observed that milkmaids who had gotten cowpox did not show any symptoms of smallpox after variolation [deliberate infection with the smallpox virus]. The first experiment to test this theory involved milkmaid Sarah Nelmes and James Phipps, the nine-year-old son of Jenner’s gardener. Dr. Jenner took material from a cowpox sore on Nelmes’ hand and inoculated it into Phipps’ arm. Months later, Jenner exposed Phipps a number of times to variola virus, but Phipps never developed smallpox.”
In Jenner’s publication “On the Origin of the Vaccine Inoculation,” Dr. Jenner is described by the CDC as stating “the annihilation of the smallpox, the most dreadful scourge of the human species, must be the final result of this practice.”
However, there are some who doubt that the milkmaid story is true. A recent researcher examined the likelihood of this vaccine story and puts Jenner’s “milkmaid story” into doubt with a likelier version of the vaccine’s development.
The Last People Infected by Smallpox before Its Eradication
According to WHO, Janet Parker, a medical photographer, was the last person to die of smallpox in September of 1978. She worked near a lab where smallpox research was being conducted. It is likely that the airborne virus traveled through the building’s air ducts.
The last known natural smallpox case, Ali Maow Maalin, was in 1977 in Somalia. Maalin recovered and worked on the polio eradication campaign decades later in Somalia.
The Smallpox Virus, Yesterday and Today
Today, there are only two highly secure laboratories that keep the smallpox virus. One is in the U.S. at the Centers for Disease Control and Prevention in Atlanta, Georgia; the other is at the State Research Center of Virology and Biotechnology (VECTOR Institute) in Koltsovo, Russia.
According to the CDC, the origin of smallpox is largely unknown. Its website notes that “The earliest written description of a disease that clearly resembles smallpox appeared in China in the 4th century CE (Common Era). Early written descriptions also appeared in India in the 7th century and in Asia Minor in the 10th century.”
How Smallpox Was Eradicated
Vaccine and surveillance were used as the primary method to eradicate smallpox. Discover magazine notes that “From 1966 to 1970, the Centers for Disease Control (CDC) worked with several west African governments to surveil and contain localized outbreaks of smallpox. Rather than using the tactic of mass vaccination within the community, surveillance of existing cases and the vaccination of close contacts and the potentially exposed was employed in a technique known as ‘ring vaccination.’ Nigeria was the birthplace of this new strategy and surely will be used again as we seek to eradicate polio.”
In the same publication, former U.S. Surgeon General Dr. C. Everett Koop was quoted in 1987 saying: “The campaign could properly be described as heroic. In 1966, smallpox was raging through South America, Asia, and Africa, [and] two and a half million people were reported as infected in 30 countries, a figure estimated to be about one percent of the actual incidence, but hundreds of public health practitioners – white and black, Arab and Jew, Russian and American – worked side by side to rid humanity of the scourge.”
Koop added that the success of the eradication was due in large part to its grassroots campaign. Indigenous public health workers needed be involved “to gain the cooperation of local people necessary for success.”
According to the CDC, “A number of other factors also played an important role in the success of the intensified efforts, including the development of the bifurcated needle, establishment of a surveillance system to detect and investigate cases, and mass vaccination campaigns, to name a few.”
For more information and a brief review of smallpox eradication, watch this TED-Ed talk.
About the Author
Kristin Drexler is a full-time faculty member of Geography and Conservation of Natural Resources for American Military University’s School of STEM. She is also a Ph.D. candidate in Educational Leadership at New Mexico State University. Kristin earned her Master of Arts degree in International Affairs from Ohio University, with an emphasis in Natural Resources Management. She has conducted numerous community surveys in Belize regarding agroforestry, conservation and sustainable agriculture.
Until she became a full-time instructor with AMU in 2009, Kristin was an environmental scientist in New Mexico, conducting field biology surveys and environmental impact analyses. She founded the Belize Field School Program at NMSU, coordinating short courses in Belize in wildlife, agroforestry, marine ecology, and documentary filmmaking (2006-2014).
Most recently, Kristin produced an award-winning short film, “Yochi,” a story about youth conservation and action against poaching and illegal wildlife trade. In the late 1990s, she served as a Peace Corps volunteer in Belize. Kristin serves on the board of directors of Full Basket Belize, a U.S. nonprofit that provides high school scholarships and community grants in Belize. She also regularly volunteers for the Mesilla Valley Film Society in Las Cruces, New Mexico.