Smallpox is a great microcosm of human interaction with diseases. We see real treatments being developed, a systematic approach to dealing with the disease, and even understanding how it spreads enough to use it as a weapon, as well as understanding of building up an immunity.

The understanding of how immunity is developed without knowing what is causing it or anything about germ theory is impressive. Slaves from Africa were brought over and were sought after because they had already had smallpox and survived. They knew that once someone was infected they had an immunity to it. So, if you buy a slave that lived through it already, you don’t have to worry about your investment dying later from smallpox. The Chinese also started insufflation in the early 1500s in where the infectious scabs were inhaled through the nose. Later the practice was perfected with vaccination in where a bifurcated needle was used to make a prick of the skin and develop a cow pox strain. This would cause a localized infection that had a higher survival rate and was invented by Edward Jenner in 1796.

Compulsory vaccination and surveillance and containment were used to completely eradicate the disease in 1980. While some people did die from the vaccination and everyone who received it had a small localized infection that might end up scarring, it was warranted due to the estimated 300 million people who died from this disease and being able to get rid of something so deadly is worth the side effects of the vaccine. To truly eradicate the disease in India, with its high population, it was going to be impossible to vaccinate everyone for smallpox, so instead what they did is surveyed the areas for active cases. They offered bounties for anyone to tell them who is infected, and then the World Health Organization vaccinated everyone in the immediate area of the person infected. With this strategy the disease was able to be contained and eventually eliminated.