Smallpox Epidemic Quotes

Dandelion, staring into the dying embers, sat much longer, alone, quietly strumming his lute. It began with a few bars, from which an elegant, soothing melody emerged. The lyric suited the melody, and came into being simultaneously with it, the words bending into the music, becoming set in it like insects in translucent, golden lumps of amber. The ballad told of a certain witcher and a certain poet. About how the witcher and the poet met on the seashore, among the crying of seagulls, and how they fell in love at first sight. About how beautiful and powerful was their love. About how nothing - not even death - was able to destroy that love and part them. Dandelion knew that few would believe the story told by the ballad, but he was not concerned. He knew ballads were not written to be believed, but to move their audience. Several years later, Dandelion could have changed the contents of the ballad and written about what had really occurred. He did not. For the true story would not have move anyone. Who would have wanted to hear that the Witcher and Little Eye parted and never, ever, saw each other again? About how four years later Little Eye died of the smallpox during an epidemic raging in Vizima? About how he, Dandelion, had carried her out in his arms between corpses being cremated on funeral pyres and buried her far from the city, in the forest, alone and peaceful, and, as she had asked, buried two things with her: her lute and her sky blue pearl. The pearl from which she was never parted. No, Dandelion stuck with his first version. And he never sang it. Never. To no one. Right before the dawn, while it was still dark, a hungry, vicious werewolf crept up to their camp, but saw that it was Dandelion, so he listened for a moment and then went on his way.

The major killers of humanity throughout our recent history—smallpox, flu, tuberculosis, malaria, plague, measles, and cholera—are infectious diseases that evolved from diseases of animals, even though most of the microbes responsible for our own epidemic illnesses are paradoxically now almost confined to humans.

It was a cruel world though. More than half of all children died before they could reach maturity, thanks to chronic epidemics and malnutrition. People dropped like flies from polio and tuberculosis and smallpox and measles. There probably weren't many people who lived past forty. Women bore so many children, they became toothless old hags by the time they were in their thirties. People often had to resort to violence to survive. Tiny children were forced to do such heavy labor that their bones became deformed, and little girls were forced to become prostitutes on a daily basis. Little boys too, I suspect. Most people led minimal lives in worlds that had nothing to do with richness of perception or spirit. City streets were full of cripples and beggars and criminals. Only a small fraction of the population could gaze at the moon with deep feeling or enjoy a Shakespeare play or listen to the beautiful music of Dowland.

The women in the kitchen sang: Sarampión toca la puerta. Viruela dice: ¿Quién es? Y Escarlatina contesta: ¡Aquí estamos los tres! The cook would sometimes shout a little madly, “Sing it again!” And the women would sing again: Measles knocks at the door. Smallpox asks, Who’s there? And Scarlet Fever replies: All three of us are here!

As it does today, malaria played a huge role in the past—a role unlike that of other diseases, and arguably larger. When Europeans brought smallpox and influenza to the Americas, they set off epidemics: sudden outbursts that shot through Indian towns and villages, then faded. Malaria, by contrast, became endemic, an ever-present, debilitating presence in the landscape. Socially speaking, malaria—along with another mosquito-borne disease, yellow fever—turned the Americas upside down. Before these maladies arrived, the most thickly inhabited terrain north of Mexico was what is now the southeastern United States, and the wet forests of Mesoamerica and Amazonia held millions of people. After malaria and yellow fever, these previously salubrious areas became inhospitable. Their former inhabitants fled to safer lands; Europeans who moved into the emptied real estate often did not survive a year.

Who would have wanted to hear that the Witcher and Little Eye parted and never, ever, saw each other again? About how four years later Little Eye died of the smallpox during an epidemic raging in Vizima? About how he, Dandelion, had carried her out in his arms between corpses being cremated on funeral pyres and had buried her far from the city, in the forest, alone and peaceful, and, as she had asked, buried two things with her: her lute and her sky blue pearl. The pearl from which she was never parted. No,

Throughout world history, the greatest killers have not been wars but plagues and epidemics. Unfortunately, it is possible that nations have kept secret stockpiles of deadly diseases, such as smallpox, which could be weaponized using biotechnology to create havoc.

Smallpox epidemics had devastated Massachusetts at regular intervals in the ninety years since its founding. A 1677 outbreak wiped out seven hundred people, 12 percent of the population. During the epidemic of 1702, during which three of his children were stricken but survived, Cotton Mather began studying the disease. A few years later, he was introduced to the practice of inoculation by his black slave, who had undergone the procedure in Africa and showed Mather his scar. Mather checked with other blacks in Boston and found that inoculation was a standard practice in parts of Africa.

The bitter irony was that Franklin had become a fervent advocate of smallpox vaccinations after they had been ridiculed in the New England Courant when Franklin worked there for his brother. In the years preceding Franky’s birth, he had editorialized in the Pennsylvania Gazette in support of inoculations and published statistics showing how effective they were. In 1730, for example, he wrote an account of a Boston epidemic in which most people who had been vaccinated were spared.

Some of us adults, and even more of our children, pick up infectious diseases from our pets. Usually they remain no more than a nuisance, but a few have evolved into something far more serious. The major killers of humanity throughout our recent history—smallpox, flu, tuberculosis, malaria, plague, measles, and cholera—are infectious diseases that evolved from diseases of animals, even though most of the microbes responsible for our own epidemic illnesses are paradoxically now almost confined to humans.

The major killers of humanity throughout our recent history—smallpox, flu, tuberculosis, malaria, plague, measles, and cholera—are infectious diseases that evolved from diseases of animals, even though most of the microbes responsible for our own epidemic illnesses are paradoxically now almost confined to humans. Because diseases have been the biggest killers of people, they have also been decisive shapers of history. Until World War II, more victims of war died of war-borne microbes than of battle wounds.

In contrast, the crowd diseases, which we discussed earlier, could have arisen only with the buildup of large, dense human populations. That buildup began with the rise of agriculture starting about 10,000 years ago and then accelerated with the rise of cities starting several thousand years ago. In fact, the first attested dates for many familiar infectious diseases are surprisingly recent: around 1600 B.C. for smallpox (as deduced from pockmarks on an Egyptian mummy), 400 B.C. for mumps, 200 B.C. for leprosy, A.D. 1840 for epidemic polio, and 1959 for AIDS.

Ancient foragers also suffered less from infectious diseases. Most of the infectious diseases that have plagued agricultural and industrial societies (such as smallpox, measles and tuberculosis) originated in domesticated animals and were transferred to humans only after the Agricultural Revolution. Ancient foragers, who had domesticated only dogs, were free of these scourges. Moreover, most people in agricultural and industrial societies lived in dense, unhygienic permanent settlements – ideal hotbeds for disease. Foragers roamed the land in small bands that could not sustain epidemics.

Ancient foragers also suffered less from infectious diseases. Most of the infectious diseases that have plagued agricultural and industrial societies (such as smallpox, measles and tuberculosis) originated in domesticated animals and were transferred to humans only after the Agricultural Revolution. Ancient foragers, who had domesticated only dogs, were free of these scourges. Moreover, most people in agricultural and industrial societies lived in dense, unhygienic permanent settlements – ideal hotbeds for disease. Foragers roamed the land in small bands that could not sustain epidemics. The

But when Cortés’s next onslaught came, the Aztecs were no longer naive and fought street by street with the utmost tenacity. What gave the Spaniards a decisive advantage was smallpox, which reached Mexico in 1520 with one infected slave arriving from Spanish Cuba. The resulting epidemic proceeded to kill nearly half of the Aztecs, including Emperor Cuitláhuac. Aztec survivors were demoralized by the mysterious illness that killed Indians and spared Spaniards, as if advertising the Spaniards’ invincibility. By 1618, Mexico’s initial population of about 20 million had plummeted to about 1.6 million.

It was a cruel world, though. More than half of all children died before they could reach maturity, thanks to chronic epidemics and malnutrition. People dropped like flies from polio and tuberculosis and smallpox and measles. There probably weren’t very many people who lived past forty. Women bore so many children, they became toothless old hags by the time they were in their thirties. People often had to resort to violence to survive. Tiny children were forced to do such heavy labor that their bones became deformed, and little girls were forced to become prostitutes on a daily basis. Little boys, too, I suspect. Most people led minimal lives in worlds that had nothing to do with richness of perception or spirit. City streets were full of cripples and beggars and criminals. Only a small fraction of the population could gaze at the moon with deep feeling or enjoy a Shakespeare play or listen to the beautiful music of Dowland.

The assassination of President Kennedy killed not only a man but a complex of illusions. It demolished the myth that hate and violence can be confined in an airtight chamber to be employed against but a few. Suddenly the truth was revealed that hate is a contagion; that it grows and spreads as a disease; that no society is so healthy that it can automatically maintain its immunity. If a smallpox epidemic had been raging in the South, President Kennedy would have been urged to avoid the area. There was a plague afflicting the South, but its perils were not perceived. Negroes tragically know political assassination well. In the life of Negro civil-rights leaders, the whine of the bullet from ambush, the roar of the bomb have all too often broken the night's silence. They have replaced lynching as a political weapon. More than a decade ago, sudden death came to Mr. and Mrs. Harry T. Moore, N.A.A.C.P. leaders in Florida. The Reverend George Lee of Belzoni, Mississippi, was shot to death on the steps of a rural courthouse. The bombings multiplied. Nineteen sixty-three was a year of assassinations. Medgar Evers in Jackson, Mississippi; William Moore in Alabama; six Negro children in Birmingham—and who could doubt that these too were political assassinations? The unforgivable default of our society has been its failure to apprehend the assassins. It is a harsh judgment, but undeniably true, that the cause of the indifference was the identity of the victims. Nearly all were Negroes. And so the plague spread until it claimed the most eminent American, a warmly loved and respected president. The words of Jesus "Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me" were more than a figurative expression; they were a literal prophecy. We were all involved in the death of John Kennedy. We tolerated hate; we tolerated the sick stimulation of violence in all walks of life; and we tolerated the differential application of law, which said that a man’s life was sacred only if we agreed with his views. This may explain the cascading grief that flooded the country in late November. We mourned a man who had become the pride of the nation, but we grieved as well for ourselves because we knew we were sick.

In a conversation at the Rollins School of Public Health at Emory University in Atlanta, he told us how, after the Japanese attack on Pearl Harbor on December 7, 1941, the entire country and much of the world seemed to come together overnight. Since then, he wondered, has there been anything that could trigger a similar coalition of the righteous and committed? The September 11, 2001, terrorist attacks did that initially, many would argue. But the reaction didn’t last long, muddled and dissipated as it was by military action that arguably had nothing to do with the attack or threat. An alien invasion, though, that threatened the entire planet and forced human beings to set aside their differences would do it, the Durants believed. “Infectious diseases turn out to be a surrogate for an alien invasion,” Bill declared. “It’s why we were able to do smallpox eradication in the midst of the Cold War. Both sides could see this was an important thing to do.” To take the alien invasion analogy one step further, we would first have to convince the public that extraterrestrials had, in fact, landed on earth. Look at climate change: The science is well established and yet a large percentage of the population refuses to believe it. The same holds true for infectious diseases. Our task is to convince world leaders, corporate heads, philanthropic organizations, and members of the media that the threat of pandemics and regional epidemics is real and will only continue to grow. Ignoring these threats until they blow up in our faces is not a strategy.

The foragers’ secret of success, which protected them from starvation and malnutrition, was their varied diet. Farmers tend to eat a very limited and unbalanced diet. Especially in premodern times, most of the calories feeding an agricultural population came from a single crop – such as wheat, potatoes or rice – that lacks some of the vitamins, minerals and other nutritional materials humans need. The typical peasant in traditional China ate rice for breakfast, rice for lunch and rice for dinner. If she was lucky, she could expect to eat the same on the following day. By contrast, ancient foragers regularly ate dozens of different foodstuffs. The peasant’s ancient ancestor, the forager, may have eaten berries and mushrooms for breakfast; fruits, snails and turtle for lunch; and rabbit steak with wild onions for dinner. Tomorrow’s menu might have been completely different. This variety ensured that the ancient foragers received all the necessary nutrients. Furthermore, by not being dependent on any single kind of food, they were less liable to suffer when one particular food source failed. Agricultural societies are ravaged by famine when drought, fire or earthquake devastates the annual rice or potato crop. Forager societies were hardly immune to natural disasters, and suffered from periods of want and hunger, but they were usually able to deal with such calamities more easily. If they lost some of their staple foodstuffs, they could gather or hunt other species, or move to a less affected area. Ancient foragers also suffered less from infectious diseases. Most of the infectious diseases that have plagued agricultural and industrial societies (such as smallpox, measles and tuberculosis) originated in domesticated animals and were transferred to humans only after the Agricultural Revolution. Ancient foragers, who had domesticated only dogs, were free of these scourges. Moreover, most people in agricultural and industrial societies lived in dense, unhygienic permanent settlements – ideal hotbeds for disease. Foragers roamed the land in small bands that could not sustain epidemics. The wholesome and varied diet, the relatively short working week, and the rarity of infectious diseases have led many experts to define pre-agricultural forager societies as ‘the original affluent societies’.

Smallpox has an incubation period of about twelve days, during which time sufferers, who may not know they are sick, can infect anyone they meet. With its fine roads and great population movements, Tawantinsuyu was perfectly positioned for a major epidemic. Smallpox radiated throughout the empire like ink spreading through tissue paper. Millions of people simultaneously experienced its symptoms: high fever, vomiting, severe pain, oozing blisters everywhere on the body. Unable to number the losses, the Jesuit Martín de Murúa said only that the toll was “infinite thousands.

Virgin-soil death rates for smallpox are hard to establish because for the last century most potential research subjects have been vaccinated. But a study in the early 1960s of seven thousand unvaccinated smallpox cases in southern India found that the disease killed 43 percent of its victims. Noting the extreme vulnerability of Andean populations—they would not even have known to quarantine victims, as Europeans had—Dobyns hypothesized that the empire’s population “may well have been halved during this epidemic.” In about three years, that is, as many as one out of two people in Tawantinsuyu died. The human and social costs are beyond measure.

Europeans won military victories in New England, historians say, partly because they were divided among themselves. Indians were unwilling, too, to match the English tactic of massacring whole villages. But another, bigger part of the reason for the foreigners’ triumph was that by the 1670s the newcomers outnumbered the natives. Groups like the Narragansett, which had been spared by the epidemic of 1616, were crushed by a smallpox epidemic in 1633. A third to half of the remaining Indians in New England died. The People of the First Light could avoid or adapt to European technology but not European disease. Their societies were destroyed by weapons their opponents could not control and did not even know they had.

When the last nationwide smallpox epidemic began in 1898, some people believed that whites were not susceptible to the disease. It was called “Nigger itch,” or, where it was associated with immigrants, “Italian itch” or “Mexican bump.” When

Almost every major infectious epidemic, such as smallpox, polio, and the plague, happened after the Agricultural Revolution began. In addition, studies of recent hunter-gatherers show that although they don’t enjoy surpluses of food, they rarely suffer from famines or serious malnutrition. Modern lifestyles have also fostered new noncommunicable but widespread illnesses such as heart disease, certain cancers, osteoporosis, type 2 diabetes, and Alzheimer’s, as well as scores of other lesser ailments, such as cavities and chronic constipation. There is good reason to believe that modern environments contribute to a sizeable percentage of mental illnesses, such as anxiety and depressive disorders.2 The

Wayna Qhapaq died in the first smallpox epidemic. The virus struck Tawantinsuyu again in 1533, 1535, 1558, and 1565. Each time the consequences were beyond the imagination of our fortunate age. “They died by scores and hundreds,” recalled one eyewitness to the 1565 outbreak. “Villages were depopulated. Corpses were scattered over the fields or piled up in the houses or huts.… The fields were uncultivated; the herds were untended [and] the price of food rose to such an extent that many persons found it beyond their reach. They escaped the foul disease, but only to be wasted by famine.

Several years later, Dandelion could have changed the contents of the ballad and written about what had really occurred. He did not. For the true story would not have moved anyone. Who would have wanted to hear that the Witcher and Little Eye parted and never, ever, saw each other again? About how four years later Little Eye died of the smallpox during an epidemic raging in Vizima? About how he, Dandelion, had carried her out in his arms between corpses being cremated on funeral pyres and had buried her far from the city, in the forest, alone and peaceful, and, as she had asked, buried two things with her: her lute and her sky blue pearl. The pearl from which she was never parted. No, Dandelion stuck with his first version. And he never sang it. Never. To no one. Right before the dawn, while it was still dark, a hungry, vicious werewolf crept up to their camp, but saw that it was Dandelion, so he listened for a moment and then went on his way.

Look folks, our founders and framers fought a war during a smallpox epidemic, and we gave away our freedoms in four short months because we were scared to catch a bad cold.  Speaking

For example, in England, prior to the introduction of mandatory vaccinations in 1953, there were two smallpox deaths per 10,000 inhabitants per year. But at the beginning of the 1970s, nearly 20 years after the introduction of mandatory vaccinations, which had led to a 98 percent vaccination rate,195 England suffered 10 smallpox deaths per 10,000 inhabitants annually; five times as many as before. “The smallpox epidemic reached its peak after vaccinations had been introduced,“ summarizes William Farr, who was responsible for compiling statistics in London.

Several years later, Dandelion could have changed the contents of the ballad and written about what had really occurred. He did not. For the true story would not have moved anyone. Who would have wanted to hear that the Witcher and Little Eye parted and never, ever saw each other again? About how four years later Little Eye died of the smallpox during an epidemic raging in Vizima? About how he, Dandelion, had carried her out in his arms between corpses being cremated on funeral pyres and had buried her far from the city, in the forest, alone and peaceful, and, as she had asked, buried two things with her: her lute and her sky blue pearl. The pearl from which she never parted. No, Dandelion stuck with his first version.

As we consider the unprecedented bludgeoning of our Constitution over the past two years, it’s worth pausing to remember the smallpox epidemic that stalled Washington’s army during the Revolution and the malaria contagion that culled the Army of Virginia. Though both alerted the Framers to the deadly and disruptive potential of infectious disease epidemics, the Framers nevertheless opted to include no pandemic exception to the United States Constitution.

The Tibetans, in practice, are very simple in their applications of medical remedies. Rubbing with butter is their great panacea. They have a dread of small-pox, and instead of burning its victims they throw them into their rapid torrents. If an isolated case occur, the sufferer is carried to a mountain-top, where he is left to recover or die. If a small-pox epidemic is in the province, the people of the villages in which it has not yet appeared place thorns on their bridges and boundaries, to scare away the evil spirits which are supposed to carry the disease.

It takes two weeks after someone is exposed to smallpox before doctors can detect it or someone shows symptoms. But by then, it’s too late. The sick are already highly infectious, spreading the virus to anyone within ten feet,” Dragan said. “So the epidemic moves in waves, with the number of sick growing exponentially. The only way to stop it is to quarantine the sick and vaccinate everyone else. So that is what the government did. The army sealed off entire towns. Public gatherings were banned across the nation. Ten thousand people suspected of being infected were herded up and quarantined in apartment buildings encircled by barbed wire and armed soldiers. Eighteen million people were vaccinated. The epidemic was over in eight weeks. In the end, only about two hundred people were infected and thirty-five died. It could have been much worse.

In time, it proved possible to vaccinate against not only smallpox, anthrax, and rabies, but also, for example, polio, measles, diphtheria, tetanus, mumps, pertussis, and rubella in a seemingly ever-lengthening cascade. The strategy has eradicated smallpox, and the campaign against polio is presently at its critical moment.

By 1959 WHO embarked on a global eradication attempt against smallpox, and as we have seen, the program achieved success in 1977 when the world’s last case of variola major occurred.

As a consequence of this international effort, smallpox became the first, and thus far the only, infectious human disease to have been eradicated by intentional action.

Edward Jenner had pioneered the first vaccine nearly a century earlier through his work on smallpox. Pasteur developed a methodology that enabled him to produce an array of vaccines against diseases.

As early as the 1830s, missionaries in the Society Islands were already beginning to speak of depopulation. There were major epidemics in Tahiti of smallpox in 1841, dysentery in 1843, scarlet fever in 1847, measles in 1854. Much the same story can be told of Hawai‘i, which was also subject to wave after wave of imported disease. In 1848 and 1849, when Pinao was pregnant with her first child, a series of devastating epidemics struck the Hawaiian Islands. Measles, arriving from Mexico on an American frigate, and whooping cough, on a ship from California, hit at the same time, killing an estimated ten thousand people. Whole villages were prostrate, wrote one observer, “there not being persons enough in health to prepare food for the sick,” while “a large portion of the infants born in the Islands in 1848, even as large a proportion as nine-tenths in some parts, are supposed to be already in their graves.” No doubt there were other diseases in the mix as well; mumps, which had been in the islands some years earlier, was reported again, as were “pleurisy,” “bilious fever,” and something that was probably dysentery. The combined assault was especially hard upon the very young and the very old. “The aged,” wrote one observer, “have almost all disappeared from among us.

In medieval times, one-third of Europe’s population was decimated by the bubonic plague. Within a few centuries of Columbus’s arrival in the New World, 95 percent of the indigenous population of the Americas had been wiped out by smallpox, measles, influenza, and other germs brought in by European invaders and colonists. More people died in the 1918 Spanish flu epidemic than were killed in the trenches of World War I. Malaria, presently among the most deadly infectious agents on the planet, is arguably the greatest mass murderer of all time. Experts estimate the disease has killed half of all people who have roamed the planet since the Stone Age.

In retrospect, Fenn told me, “One of George Washington’s most brilliant moves was to inoculate the army against smallpox during the Valley Forge winter of ’78.” Without inoculation, she said, the smallpox epidemic could easily have handed the colonies back to the British.

Societies, especially in the developed world, were thought to be on the verge of becoming invulnerable to new plagues. Unfortunately, this expectation has proved to be spectacularly misplaced. Well into the twenty-first century smallpox remains the only disease to have been successfully eradicated. Worldwide, infectious diseases remain leading causes of death and serious impediments to economic growth and political stability. Newly emerging diseases such as Ebola, Lassa fever, West Nile virus, avian flu, Zika, and dengue present new challenges, while familiar afflictions such as tuberculosis and malaria have reemerged, often in menacing drug-resistant forms. Public health authorities have particularly targeted the persisting threat of a devastating new pandemic of influenza such as the “Spanish lady” that swept the world with such ferocity in 1918 and 1919.

Europeans won military victories in New England, historians say, partly because they were divided among themselves. Indians were unwilling, too, to match the English tactic of massacring whole villages. But another, bigger part of the reason for the foreigners’ triumph was that by the 1670s the newcomers outnumbered the natives. Groups like the Narragansett, which had been spared by the epidemic of 1616, were crushed by a smallpox epidemic in 1633. A third to half of the remaining Indians in New England died. The People of the First Light could avoid or adapt to European technology but not European disease.

Whatever their place of origin, diseases came in waves, one after the other, with deadly results. Smallpox, the most lethal, killed up to 90% of infected peoples during epidemics in the 1770s, 1800–1801, 1838 and 1862–1803.94 Malaria took a comparable death toll along the lower Columbia and Willamette Valley in 1830–1833, followed by outbreaks of measles, flu, and dysentery.

On the American side, the shock of incomprehension was registered more brutally, by a devastating loss of population. It is impossible to estimate safely the numbers living in the Americas before European contact. Estimates vary between 13 million and 180 million. But everywhere there is evidence of a massive fall in the early years after the Europeans arrived. First of all, the Spaniards complained of depopulation in the first islands they colonised, Cuba and Hispaniola, and the figures bear them out: a census of Hispaniola in 1496 gave a figure of 1.1 million, but just eighteen years later the repartimiento of 1514 listed 22,000. Mexico witnessed a series of epidemics, beginning with the Spanish visit to their capital Tenochtitlán, which carried off most of the native population, and spread southward into Guatemala. Of the whole Caribbean, Joseph de Acosta was writing in the 1580s: ‘the habitation of which coasts is…so wasted and condemned that of thirty parts of the people that inhabit it there wants twenty-nine; and it is likely that the rest of the Indians will in short time decay’.3 Hernando de Soto led an expedition through Florida and the North American south-east in the mid-sixteenth century, finding a thick population of Indians, clustered in small cities, on the Mississippi river near modern Memphis. In 1682, when the area was next visited by white men (this time French), it was deserted. The diseases travelled faster than the spearheads of Spanish conquest: smallpox arrived in Peru in 1525, Francisco Pizarro in 1532. It had already killed Huayna Capac, the Inca, and many of his relations, and precipitated the dynastic struggle that the Spaniards were to turn to their own advantage. Thereafter, as everywhere, further epidemics, of typhus, influenza, diphtheria and measles as well as more smallpox, ravaged the population. The Spanish were not notably humane conquerors, but they had no interest in genocide.

Smallpox, for example, when it did not kill, maimed, disfigured, and frequently blinded its sufferers.

So by the 1950s scientific discoveries had provided effective tools against many of the most prevalent infectious diseases. Extrapolating from such dramatic developments, many concluded that it was reasonable to expect that communicable diseases could be eliminated one at a time until the vanishing point was reached. Indeed, the worldwide campaign against smallpox provided just such an example when WHO announced in 1979 that the disease had become the first ever to be eradicated by intentional human action.

One of George Washington’s most brilliant moves was to inoculate the army against smallpox during the Valley Forge winter of ’78.” Without inoculation, she said, the smallpox epidemic could easily have handed the colonies back to the British.

Indeed, smallpox was directly responsible for a dynastic change in England when it extinguished the House of Stuart. The last Stuart heir, eleven-year-old Prince William, died of smallpox in 1700. The

This catastrophe accompanied European expansion to the Americas, Australia, and New Zealand. In these settings, smallpox had a transformative importance in clearing the land of its inhabitants and thereby promoting settlement by Europeans who possessed a robust immunity.

The “Columbian exchange” is the term used to describe the process by which the European encounter with the Americas brought about the large-scale transfer of flora, fauna, culture, and people from each side of the Atlantic to the other. That movement involved plants such as the potato, maize, and the tree bark from which quinine is made moving from the Americas to Europe, but microbes also moved in the reverse direction. Europeans, in other words, introduced smallpox and measles to the Americas. The momentous impact of the Columbian exchange in microbial guise is well illustrated by the experience of Hispaniola, where it first occurred.

British Army officer Sir Jeffery Amherst, who introduced genocide to North America when he deliberately gave blankets infected with smallpox to Native Americans in order to “reduce” them.

Since smallpox was ever-present, it was considered almost “normal,” especially since it was like other familiar diseases in claiming its victims primarily among infants and children.

After 1798, Jenner devoted the rest of his life to the smallpox vaccination crusade. In the process he rapidly made influential converts who established vaccination as a major instrument of public health—Pope Pius VII at Rome, Luigi Sacco in Italy, Napoleon in France, and Thomas Jefferson in the United States. Unlike inoculation, which used the smallpox virus, vaccination had a low risk of serious complications for the individual and posed no risk to the community because it involved cowpox rather than smallpox. It did, however, pose problems that made the campaign against smallpox a difficult and protracted one. It was feared that Jenner’s initial technique of arm-to-arm vaccination of live virus could increase the danger of spreading other diseases, especially syphilis. In addition, Jenner made it a dogmatic article of faith that the immunity derived from vaccination was lifelong, steadfastly refusing to consider conflicting data. In fact, the immunity provided by vaccination proved to be of limited duration. The irrefutable evidence of disease among patients who had previously been vaccinated went a long way toward discrediting the procedure and promoting skepticism. (It has subsequently been demonstrated that smallpox immunity following vaccination lasts up to twenty years and that revaccination is required in order to guarantee lifelong protection.)

One of George Washington’s most brilliant moves was to inoculate the army against smallpox during the Valley Forge winter of ’78.” Without inoculation, she said, the smallpox epidemic could easily have handed the colonies back to the British. Even