Following a global eradication effort which started in the 1960s, success was achieved and verified in 1979. The last naturally known case of smallpox occurred in Somalia on the African continent in 1977. It‘s been eliminated as a worry for the past quarter-century, but for 3,000 years prior, it was known as one of the most devastating diseases to humanity. For centuries, repeated epidemics swept across continents, decimating populations, according to the World Heath Organization (WHO).
In some ancient cultures, smallpox was such a major killer of infants that custom forbade the naming of a newborn until the infant had caught the disease and proved it would survive.
As late as the 18th century, smallpox killed every 10th child born in Sweden and France, the WHO said. During the same century, every seventh child born in Russia died from smallpox.
The breakthrough the world had awaited for centuries came in 1798, when it was shown that inoculation with cowpox could protect against smallpox. It was the first hope that the disease could be controlled. Still, by the early 1950s, 150 years later, an estimated 50 million cases of smallpox occurred in the world each year. The aggressive vaccination program reduced the number of cases in the following three decades until the disease was declared eradicated in 1979.
If it’s gone, why the worry?
Right about the time smallpox was declared eradicated, the virus was actually being harvested in the Soviet Union. Reports indicate that the Soviets had a bioweapons program underway which was producing tons of the virus for possible use in bombs and intercontinental ballistic missiles. And while they haven’t yet been used as a weapon, those stockpiles, like many other Soviet weapons program products, were never fully accounted for in the aftermath of the fall of the Communist regime.
If any of those virus cultures got out of Russia -- and in the chaos that followed the fall of Communism that is highly probable -- then it is reasonable to assume that the terrorist network which seems to have cells all over the globe has gotten its collective hands on them.
This is why the Bush Administration is paying attention to a disease which hasn’t occurred naturally in the United States for more than a half-century.
Symptoms of smallpox don’t become evident until about a week or two after first exposure, according to the WHO. During this period, the person looks and feels healthy and cannot infect others. Following the incubation period is the sudden onset of flu-like symptoms including fever, malaise, headache, severe back pain and sometimes abdominal pain and vomiting. Two to three days later, the temperature falls and the infected person feels somewhat better, at which time the characteristic rash appears, first on the face, hands and forearms and then after a few days progressing to the trunk. The rash is telltale because the raised lesions are white, and appear mostly on the face and extremities. It also develops in the mucous membranes of the nose and mouth, and it is during this time that transmission is most frequent by face-to-face contact, the WHO said.
Vaccination within the first four days after exposure is the only known treatment, but it is not a cure. The only sure-fire way to avoid serious complications from the virus is to be vaccinated prior to exposure. But population-wide vaccination was stopped in the United States in 1972 and in most other countries by 1979 when the eradication was certified.
Vaccinations were stopped because there are frequent and sometimes very severe side-effects. The Center for Disease Control estimates that 15 out of every one million first-time vaccinees can suffer life-threatening reactions, and that is the primary reason why the plans being considered by the administration are mostly voluntary. How can you force someone to receive a vaccination which has a chance of killing them, particularly against a disease that has been eradicated?
Reports indicate that there is enough smallpox vaccine available to inoculate every American if necessary. And the administration is working on plans to quickly mobilize clinics to provide mass immunizations if there is evidence of a bioattack. Anything more than that, such as mandatory vaccinations, is too much.
If the administration tells us that a smallpox attack is inevitable, then perhaps we’d have to consider risking a life-threatening reaction. But until then, we shouldn’t be forced to risk our lives to defend against a ghost.
This column was written October 6, 2002, and published in several print publications across the country.
Thoughtful commentary on current events without the wait!