Nobody knows exactly when smallpox (Variola) began affecting the human population, though the oldest recorded case was that of the Egyptian Pharoah Ramses V in 1155 B.C.E. By the Middle Ages it was endemic across Asia and Europe, as well as the Middle East and Africa, and after the arrival of Colombus in the New World it was quickly transmitted there as well. According to the smallpox film shown in class, traditional remedies varied from potions of horse dung to bursting the pox with a golden needle. Some of the most popular were bloodletting (“bled to the point of fainting” read some remedies) and heat or red therapies, where patients were placed close to fires and surrounded by the color red (red blankets, food/drinks, even red UV light in more modern quack treatments). Many cultures also had deities, commonly goddesses, who represented smallpox and were prayed to in times of outbreak.

According to the text (Power of Plagues by Sherman, copyright 2017), prevention measures considered effective by modern medicine did not appear until 1675, in a letter from a physician to the king of Denmark and Norway. In 1715 Lady Montague brought to England the method of variolation (rubbing material from the pustule of a sick person into a scratch on a healthy person’s arm) from the Turks, which became popular even in the English colonies with the help of physician Cotton Mather. As discussed in class, the Chinese had their own alternative to variolation in the form of insufflation, which consisted of inhaling powder of dried scabs.

Near the end of the 18th century, physician Edward Jenner observed and tested the rural folk remedy of purposely infecting people with cowpox to confer immunity against smallpox. He was the first to use the term “vaccine”, and from his work the modern smallpox vaccine (using not cowpox, but a similar virus, vaccinae) was developed. By 1801, the use of a vaccine was widely accepted by the scientific community and quickly became compulsory in some European states, though its political association in the US (according to the text) meant that it did not gain widespread popularity there until the 1900s. Though vaccination greatly decreased incidences of smallpox and proved especially useful in times of war (such as for Germany in the Franco-Prussian War, losing a fraction of the men that France did to smallpox), it also led to difficulties about two percent of the time. Furthermore, in the US, there had been outbreaks of the far less fatal Variola minor, leading citizens to believe that smallpox was not a serious disease and ignore the strong suggestion to be vaccinated, despite the established 30% mortality of Variola major.

As discussed in class and in the smallpox film, eradication of the smallpox virus was achieved using a method called surveillance and containment. Since smallpox did not have an animal reservoir, doctors were able to travel across the globe and identify cases, then use contact tracers to track down and vaccinate those they interact with. The long incubation period of smallpox (1-2 weeks) greatly assisted in eradication efforts, and in 1980 smallpox was officially declared eradicated by the World Health Organization (WHO). Vaccination was halted, and plans were made to dispose of all remaining stores of the virus. However, after rumors that the Soviet Union was developing the virus to be used as a bioweapon, the stores of the virus have been retained. Particularly since the 9/11 terrorist attack on the US, stores have been retained for research purposes and in case of future bioterrorism.

HR: References as listed in text, class discussion, Microsoft Word for spelling/grammar check