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A case of the plague in Athens, Greece, circa 430 CE, has been attributed to smallpox (Littman & Littman, 1969) rather than being a true case of plague.
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Smallpox outbreaks are one of the most feared threats to existence prior to the vaccination era.
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The earliest attempts to confront the smallpox virus were based upon anecdotal observations and traditional folk medicine (Hopkins, 1983; Small & Small, 1996; Stein, 2011). In 1000 CE Tibet, it is recorded that the statesman Wang Tan had ground smallpox scabs administered by a nun with medical knowledge to his son in an attempt to save him from smallpox, which had already claimed the lives of his other children (Small & Small, 1996; CCP, 2012; Mercer, 1985).
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Early inoculation, called variolation, from the time of China in 1000 CE to the late 1700’s involved the practice of using smallpox scabs from the skin of infected individuals and scraping it into the skin of healthy individuals (Hopkins, 1983; Mercer, 1985). Unfortunately, this often led to the healthy individual developing smallpox, though because there did appear to be some protective benefit, the practice had gained in popularity (Razzell, 1974 in Mercer, 1985)
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The practice of inoculation was not known to Western civilization until the 1720’s (Mercer, 1985). In 1718 Lady Mary Wortley Montague, wife of the British Ambassador to the Ottoman Empire, purportedly had her son inoculated after learning of the Eastern practice while in Istanbul. Image retrieved from: http://www.yorkshiresfavourites.org/geisha/inc/img.php/geisha/assets/images/MS_VIS_4279.jpg/420/1/fill.jpg
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Inoculation is also now in practice in the United States by this time, with the scholar, Cotton Mather, having his children inoculated after exposure to the practice through his slave (Hopkins, 1983). Image Retrieved 12Mar2012 from: http://web.csustan.edu/english/reuben/pal/chap1/mather.gif
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1721, six prisoners at Newgate castle in London were inoculated with smallpox (Small & Small, 1996). All six survived the procedure despite a period of illness, and this marked the beginning of the practice of inoculation in England.
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Edward Jenner, began his apprenticeship with the surgeon and naturalist, John Hunter. Early in his career, Jenner became well-known for his studies of cuckoos and his reputation of a naturalist in his own right led to an invitation to join the Royal Society.
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Presented with the lore that milkmaids exposed to cowpox were immune to smallpox , in 1796 Jenner began his experiments with smallpox vaccination. In the famously recounted experiment (Hopkins, 1983; Barquet & Domingo, 1997) that would forever change medicine and harken the vaccination era, Jenner took fluid from the cowpox pustules on the hands of milkmaid, Sally Nelmes and scraped it into the skin of and eight year old child, John Phipps. http://t0.gstatic.com/images?q=tbn:ANd9GcSTuJbA7sVldf
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Jenner wrote and published “Inquiry into the Causes and Effects of the Variolae Vaccinae” in 1798: the book which spread the idea of “vaccination” to the medical world. Ironically, the work was not taken seriously for several years. Image retrieved from: http://t1.gstatic.com/images?q=tbn:ANd9GcTDvJj2PT-5fDnrex9Nm0bicoRhKlj63AQ3NCKhuSSnC3fQdne7
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During the 18th century, smallpox caused between 8-20% of all fatalities in England, Norway, and Sweden (Stein, 2011). As early as 1817, Sweden required smallpox vaccination by all citizens (Mercer, 1985; Small & Small, 1996). Image retrieved from: flaghacker.com
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Beginning in Europe, smallpox eradication is undertaken through vaccination. A country by country effort becomes the focus of the World Health Organization goal of worldwide eradication.
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In the United States, where infectious diseases were estimated to cause 40-50 percent of infant mortalities between 1870 and 1900 (Stein, 2011), smallpox vaccination remained much a state-mandate until the mid-twentieth century.
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England adopts requirement that all English citizens must receive the smallpox vaccine.
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Smallpox vaccination shifts from state to federal mandate
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In 1958, the World Health Organization began smallpox eradication efforts to support the compulsory vaccination movement, which was too slowly gaining ground.
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Expansion of vaccination programs and international efforts led to smallpox being declared eradicated in the U.S. in 1972.
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the last known case of smallpox was reported in 1977. The image shows the official smallpox eradication document.
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In 1980, the World Health Organization declared smallpox eradicated worldwide. The smallpox vaccine is no longer compulsory – in fact it is no longer administered as part of the vaccine retinue.
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Smallpox was first described around 900 CE by the Persian physician, Rhazes, who both described the disease (Meyerhof, 1935; Hopkins, 1983) and attempted to provide a distinction between smallpox and measles (The College of Physicians of Philadephia [CPP], 2012; Small & Small, 1996).
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The disease was also found in descriptions from Tibet (Hopkins, 1983; Small & Small, 1996) suggesting it was known in that country around the same time period.
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