A Killer Held at Bay
PHARAOH Ramses V of Egypt died some three thousand years ago. No one knew for sure the cause of his death, but down to this day, his mummified corpse bears telltale marks of a strange assassin. This same fiend also left its devastating mark in ancient India, China, Greece, and virtually every other nation.
This was a killer so powerful that it has changed the course of history. According to one source, in the lower Indus Valley, it even dealt the mighty army of Alexander the Great a severe blow. Accompanying explorer Cortés to Mexico, it decimated the native population to such an extent that it almost guaranteed the conquistador an easy victory. In 18th-century Europe, some years saw as many as 600,000 dead in the clutches of the killer. All of them were victims of a foe they could not see—a tiny, brick-shaped virus, the smallpox virus.
Even in modern times, mention of smallpox has struck fear into the hearts of many. For example, in 1947, because 12 cases were reported in New York City, over 6 million of its inhabitants were vaccinated. And it has been estimated that as recently as 1967, smallpox took two million lives. Why is this disease so fearsome? Is it still a threat today?
A Killer to Be Feared
For most of us, our only acquaintance with the disease is the sight of the characteristic scars on a stranger, whose pitted face tells the story of his having survived a visit from the killer. Many, however, did not survive. In some localities as many as 1 in every 2 persons infected died.
Yet, to many, as frightening as the high mortality rate were the ugly symptoms. Usually, within two weeks of a person’s contracting the virus, it would have multiplied sufficiently to start causing real problems. Very high fevers, headaches, and chills would begin, followed shortly by convulsions and stabbing pains in the spine. A few days later, tiny reddish spots would become visible, first on the face, then on the arms, chest, back, and finally on the legs. These would rapidly enlarge to become pus-filled blisters, or pustules, giving the sufferer a frightening appearance. Even more serious would be the attack on the body’s vital organs. If the body’s immune system was not able to muster its defenses sufficiently, one or more of these organs would break down, leading to the patient’s death.
Although not considered highly contagious, the ability of smallpox to survive for a considerable period of time outside the human host meant that it could easily be spread to those in close contact with the sufferer or to others who handled contaminated bedding and clothing. The murderous virus, released from the erupted blisters of its last casualty, would ride on dust particles or water droplets and could easily enter the throat or respiratory tract of another victim and start its infectious cycle all over again.
There was no known chemical or drug—and there still is none—that could arrest the spread of smallpox. Doctors and nurses would simply try to make the patient as comfortable as possible and give medication to reduce the risk of spreading the infection. The only hope of cure was from the wonderfully designed immune system within the human body itself. And that was where one of the greatest discoveries of modern medicine was made, thus providing the weapon to curb this ruthless killer.
A Weapon to Slay the Killer
“Future nations will know by history only that the loathsome smallpox has existed,” wrote Thomas Jefferson, then president of the United States, in 1806. He was writing to congratulate Edward Jenner, a British country physician and naturalist, on his discovery of a means to wipe out smallpox. Jenner’s treatment, later called vaccination, is basically the same process that travelers in this century have become familiar with.
Centuries before Jenner’s investigations, a somewhat similar form of treatment for smallpox was already in use. For example, in Bengal, India, it had been a custom of the ancient priests of Shitala Mata (the smallpox goddess) to collect infected material from milder cases of smallpox and in a controlled way introduce this to healthy persons. A less severe form of the disease often resulted from this primitive type of inoculation. But once the recipient’s immune system overcame the disease, the individual would be left completely resistant to further attacks.
In spite of its inherent dangers, this form of treatment was introduced into Europe in the pre-Jenner period. In 1757, as a small boy of eight, Jenner himself had become vividly aware of these perils when his guardians, anxious to protect him from the then common scourge, ushered him off to one of the “inoculation stables” common in that day. Tied to a rope leash to restrict his movement, he was bedded down, as were the other inmates, on a simple straw-covered pallet. There he suffered the distressing effects of inoculation-induced smallpox, under only the most primitive form of nursing care.
Although Jenner survived, he did not fully recover for many years. This experience to some extent explains his zeal in later life to find a better system of immunization. The opportunity for this came when he began to practice as a doctor in rural Sodbury, England. He was struck by the truth of an old country saying that milkmaids who caught a disease known as cowpox would never catch smallpox. In 1796, after years of case studies, he tested his findings by deliberately infecting a young boy, James Phipps, with the very mild cowpox virus. His theory was that James would recover with only minimal discomfort and then be immune to the deadly smallpox.
Not all shared Jenner’s conviction. Local villagers protested that he would begin a terrible new plague or that children he treated would develop bovine characteristics. Jenner weathered the storm, and when James recovered with no problems and, best of all, was completely immune to smallpox, local opposition died down. Research continued until 1798, when Jenner published his findings to the world. His theory had been vindicated. At last the weapon for slaying the killer was at hand.
Closing In for the Kill
Following Jenner’s pioneering work, other scientists continued the research. Better methods of producing and administering the vaccine were developed, sharpening the effectiveness of this new weapon for the kill. In spite of the progress, however, the smallpox virus continued to claim its victims. Even in 1966, cases of smallpox were still reported in 44 countries, and frightening epidemics were common in developing nations.
It was later that same year, at the 19th World Health Assembly, that the nations finally decided to unite in positive action to catch and destroy the killer. Success depended on the fact that the smallpox virus would die once outside the human body. In other words, humans were its only carrier. If it was prevented from being passed from human to human, the virus would die out. Thus, a ten-year smallpox-eradication plan was launched. This consisted of surveillance to watch for any outbreak, including urging the public to report any cases, and mass vaccination to keep the villain at bay, unable to spread.
Encouraging results were achieved almost immediately even in countries with limited health-service facilities. In West and Central Africa, for example, when equipment, advisers, and vaccines were made available, 20 nations were able to eradicate the disease in just three and a half years. Spurred on by success in Africa, Asia intensified its eradication efforts. By October 16, 1975, the last naturally occurring case was isolated in Bangladesh.
This though was not the finale, for in 1976 one of the two milder forms of the virus was still being reported in Somalia. A 13-month struggle ensued; health officials chased and blocked the rogue until finally, in October 1977, they had it cornered. Its last victim was a native named Ali Maow Maalin. When Ali recovered, the last case of naturally occurring smallpox was over. At last, nearly 200 years later, Jenner’s dream was realized. “The annihilation of smallpox—the most dreadful scourge of the human race”—had been accomplished.
Could It Strike Again?
In 1980 the world was declared officially free from smallpox. Compulsory vaccination has ceased, and a new generation is growing up without the need for protection against the virus. Yet, what would happen if the killer were to return to such an unvaccinated population? Fears that it could decimate entire continents move us to ask if such a comeback is possible.
“There are two possibilities,” explained a virologist at Calcutta’s School of Tropical Medicine. “One is through laboratory leakage; the other is human malice.”
The reality of the first of these threats was demonstrated in 1978, when in a brief resurrection, smallpox once again made the headlines, this time in Birmingham, England. A photographer, working on the floor above a laboratory where the virus was being kept for research, contracted the disease and later died therefrom, but not before infecting her elderly mother. Fortunately, swift action by British authorities once again trapped the virus and prevented further casualties. To reduce the likelihood of further incidents like that, smallpox has now been confined to only two high-security research institutions, one in Atlanta, Georgia, U.S.A., and the other in Moscow, U.S.S.R.
‘But,’ you may ask, ‘why is this killer not executed to prevent such risks?’ Fear of human malice is the answer. As hideous as it may seem, there is always the possibility that smallpox could be used for biological warfare. History has shown that man is capable of such a thing. To assist their plans to settle in North America during the 17th century, certain residents deliberately spread the disease among the native Indians. Optimistically, many feel that we have progressed beyond that stage and that the chance of such ‘smallpox warfare’ is remote. We can only hope that this is so. We can only hope, too, that smallpox has really been eradicated and that for some now-unknown reason, it will not have a resurgence in the future.
Because of Dr. Jenner’s discovery, for the first time in history, man has hopefully succeeded in removing one of his deadly viral enemies. Medical science, now equipped with sophisticated tools and understanding far beyond that of Jenner, strives for victories over other infectious diseases. Will it prevail? Scientists admit that in spite of the tremendous strides forward, the overall goal seems as remote as ever. It is evident that wisdom beyond that of man will be needed to bring about a world where “no resident will say: ‘I am sick.’”—Isaiah 33:24.
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Immunization for smallpox began with the work of Dr. Edward Jenner
WHO photo by J. Abcede
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