Smallpox is a contagious viral disease, marked by fever and skin eruptions leaving pitted scars.
There were two forms of smallpox. Variola major was the severe and most common form, with a more extensive rash and higher fever. Variola minor was a less common presentation, and a much less severe disease, with historical death rates of 1 percent or less
The disease was endemic in Europe until the development of vaccination and in Asia until a World Health Organization campaign resulted in the eradication of smallpox.
The transmission electron micrograph below depicts a number of smallpox virus virions magnetized approximately 370,000 times. The “dumbbell-shaped” structure inside the smallpox virion is the viral core, which contains the viral DNA. This DNA acts as the blueprint by which the virus replicates itself once it is released into the host cell.
The first known victim of smallpox in the Mediterranean world was Pharaoh Rameses V of Egypt in 1157BC.
In ancient times, only the more densely populated areas of China and India were susceptible to major out breaks of smallpox. The Chinese and Indians had various procedures in their attempts to immune themselves from the infectious disease. One involved transferring some fluid from the spots of an infected person to a small cut made in the arm of an uninfected person. Alternatively they might sniff the drying scabs of smallpox victims.
Until the middle of the sixth century AD. the Japanese seemed to have escaped the epidemic diseases that had long scourged mainland populations. However, when the Buddhist missionaries from Korea visited the Japanese court, they bought with them smallpox, which reached epidemic proportions.
A treatment for smallpox in medieval Europe was being sewn up in a pink woolen garment in front of a roaring fire.
The term "smallpox" was first used in Britain in the 15th century to distinguish the disease from syphilis, which was then known as the "great pox".
Within 40 years of Columbus' discovery of America, most of the indigenous population had died of diseases brought by the Europeans, mainly smallpox, measles and influenza.
In 1562 Queen Elizabeth I of England contacted smallpox and was saved by the skill of a German doctor. She recovered without a mark on her face.
Smallpox was a scourge of the eighteenth century, killing in Europe alone sixty million and all but five percent of those who survived suffered facial pockmark scarring.
You were more likely to get work if you had smallpox scars in the 18th century. The scars proved that you already had smallpox and could not pass it on to your employers.
Variolation or inoculation was the method first used to immunize an individual against smallpox (Variola is the medical name for smallpox.) The patient was inoculated against smallpox by deliberately causing a mild case of the disease using material taken from another patient or a recently variolated individual.
Variolation was first used in China and the Middle East before it was introduced into England and North America in the 1720s in the face of some opposition.
The British used smallpox as a biological weapon at the Siege of Fort Pitt in Pennsylvania in 1763 against France and its Native American allies.
In 1767, a smallpox epidemic in Siberia wiped out some 20,000 people. Voltaire suggested to Catherine the Great that she should summon the English Quaker and inoculator Thomas Dimsdale to inoculate her and her son against smallpox to prove to the people that variolation was a safe and effective procedure. He inoculated them successfully along with 200 other Russians.
Maria Theresa of Austria had her children inoculated against smallpox after the epidemic of 1767. This changed the negative perception of inoculation among Austrian physicians. Maria Theresa also held a dinner in her palace for the first 65 children who had been inoculated in Austria.
George Washington inoculated his troops against smallpox during the American Revolution, reducing a 17% death rate from the disease down to 1%.
It was a common observation in late 18th century England that milkmaids were generally immune to smallpox. English country doctor Edward Jenner thought that the pus in the blisters that milkmaids received from cowpox (a disease similar to smallpox, but much less virulent) protected them from smallpox.
On 14 May 1796, Jenner tested his hypothesis on an eight-year-old boy, the son of his gardener. In 1796, Jenner decided to test his theory. He took some pus from a cowpox blister on the fingers of a farmer's daughter, Sarah Nelmes and scratched it with a lancet into the skin of the left arm of an eight-year-old boy named James Phipps, who at first showed signs of a light fever but quickly recovered. Two months later he exposed the child to smallpox, but the boy did not get the disease. Jenner successfully tested his hypothesis on 23 more subjects.
In 1798 Jenner published a paper explaining his work. He named the process in which he used the cowpox sore, vaccination, which came from the Latin vaccinus, meaning "from cows."
Below is an 1802 cartoon of the early controversy surrounding Edward Jenner's vaccination theory, showing using his cowpox-derived smallpox vaccine causing cattle to emerge from patients.
Thomas Jefferson was one of the first prominent American men to submit for inoculation for smallpox. He has had his children inoculated as well.
To combat the spread of smallpox during the Civil War, soldiers would find someone with cowpox, cut open their pustules, and infect themselves with it. The less harmful cowpox made them immune to smallpox, but they sometimes confused cowpox with syphilis and gave themselves an STD instead.
During the 1870-71 Franco-Prussian War vaccination was not compulsory for the French army and over 23,000 died of smallpox. However vaccination was compulsory in the Prussian army and less than 300 have died of the same disease.
The World Health Organization announced a global vaccination campaign against smallpox in 1967.
In 1975 Rahima Banu, a 2-year old girl from the village of Kuralia in Bangladesh, was the last known person to be infected with the more severe Variola major form of smallpox. The World Health Organization team arrived and cared for Banu, who recovered fully.
The last natural case of the less severe Variola minor form of smallpox was discovered in Merca district, Somalia on October 26, 1977 when Somalian hospital cook Ali Maow Maalin began displaying symptoms.
Janet Parker, a British medical photographer, became the last recorded person to die from smallpox on September 11, 1978. She often worked above professor Henry Bedson's laboratory at University of Birmingham Medical School where research on smallpox viruses was being conducted. In 1978, a year after smallpox was eradicated worldwide, the virus escaped from the lab. It infected two last patients, including Parker. Bedson, who had been working to rid the world of smallpox, killed himself the next day.
Her illness and death led to a debate on whether the virus should be preserved and eventually all known stocks of smallpox virus were destroyed or transferred to World Health Organisation laboratories.
In 1980 it was agreed that the global vaccination campaign announced thirteen years earlier by the World Health Organization had succeeded in completely eradicating smallpox. However, live copies of smallpox are still kept in different maximum-security laboratories around the world.
The WHO and the CDC consider October 26th to be the anniversary of the eradication of smallpox, the most spectacular success of vaccination the world has known.
Smallpox is the first infectious disease to have been completely eradicated. The second was rinderpest in 2011.
In July 2014, six sealed glass vials of smallpox dated 1954 were discovered by chance in a storage room in an FDA laboratory at the NIH in Maryland. Upon transfer to the CDC in Atlanta, two of the vials had virus which proved to be viable in culture. They were destroyed seven months later.
There were two forms of smallpox. Variola major was the severe and most common form, with a more extensive rash and higher fever. Variola minor was a less common presentation, and a much less severe disease, with historical death rates of 1 percent or less
The disease was endemic in Europe until the development of vaccination and in Asia until a World Health Organization campaign resulted in the eradication of smallpox.
The transmission electron micrograph below depicts a number of smallpox virus virions magnetized approximately 370,000 times. The “dumbbell-shaped” structure inside the smallpox virion is the viral core, which contains the viral DNA. This DNA acts as the blueprint by which the virus replicates itself once it is released into the host cell.
 |
| By Photo Credit:Content Providers(s): CDC/ Dr. Fred Murphy; Sylvia Whitfield |
The first known victim of smallpox in the Mediterranean world was Pharaoh Rameses V of Egypt in 1157BC.
In ancient times, only the more densely populated areas of China and India were susceptible to major out breaks of smallpox. The Chinese and Indians had various procedures in their attempts to immune themselves from the infectious disease. One involved transferring some fluid from the spots of an infected person to a small cut made in the arm of an uninfected person. Alternatively they might sniff the drying scabs of smallpox victims.
Until the middle of the sixth century AD. the Japanese seemed to have escaped the epidemic diseases that had long scourged mainland populations. However, when the Buddhist missionaries from Korea visited the Japanese court, they bought with them smallpox, which reached epidemic proportions.
 |
| A young girl in Bangladesh who was infected with smallpox in 1973. |
A treatment for smallpox in medieval Europe was being sewn up in a pink woolen garment in front of a roaring fire.
The term "smallpox" was first used in Britain in the 15th century to distinguish the disease from syphilis, which was then known as the "great pox".
Within 40 years of Columbus' discovery of America, most of the indigenous population had died of diseases brought by the Europeans, mainly smallpox, measles and influenza.
In 1562 Queen Elizabeth I of England contacted smallpox and was saved by the skill of a German doctor. She recovered without a mark on her face.
Smallpox was a scourge of the eighteenth century, killing in Europe alone sixty million and all but five percent of those who survived suffered facial pockmark scarring.
You were more likely to get work if you had smallpox scars in the 18th century. The scars proved that you already had smallpox and could not pass it on to your employers.
Variolation or inoculation was the method first used to immunize an individual against smallpox (Variola is the medical name for smallpox.) The patient was inoculated against smallpox by deliberately causing a mild case of the disease using material taken from another patient or a recently variolated individual.
Variolation was first used in China and the Middle East before it was introduced into England and North America in the 1720s in the face of some opposition.
 |
| Comparison of smallpox (left) and cowpox (right) inoculations 16 days after administration |
The British used smallpox as a biological weapon at the Siege of Fort Pitt in Pennsylvania in 1763 against France and its Native American allies.
In 1767, a smallpox epidemic in Siberia wiped out some 20,000 people. Voltaire suggested to Catherine the Great that she should summon the English Quaker and inoculator Thomas Dimsdale to inoculate her and her son against smallpox to prove to the people that variolation was a safe and effective procedure. He inoculated them successfully along with 200 other Russians.
Maria Theresa of Austria had her children inoculated against smallpox after the epidemic of 1767. This changed the negative perception of inoculation among Austrian physicians. Maria Theresa also held a dinner in her palace for the first 65 children who had been inoculated in Austria.
George Washington inoculated his troops against smallpox during the American Revolution, reducing a 17% death rate from the disease down to 1%.
It was a common observation in late 18th century England that milkmaids were generally immune to smallpox. English country doctor Edward Jenner thought that the pus in the blisters that milkmaids received from cowpox (a disease similar to smallpox, but much less virulent) protected them from smallpox.
On 14 May 1796, Jenner tested his hypothesis on an eight-year-old boy, the son of his gardener. In 1796, Jenner decided to test his theory. He took some pus from a cowpox blister on the fingers of a farmer's daughter, Sarah Nelmes and scratched it with a lancet into the skin of the left arm of an eight-year-old boy named James Phipps, who at first showed signs of a light fever but quickly recovered. Two months later he exposed the child to smallpox, but the boy did not get the disease. Jenner successfully tested his hypothesis on 23 more subjects.
In 1798 Jenner published a paper explaining his work. He named the process in which he used the cowpox sore, vaccination, which came from the Latin vaccinus, meaning "from cows."
Below is an 1802 cartoon of the early controversy surrounding Edward Jenner's vaccination theory, showing using his cowpox-derived smallpox vaccine causing cattle to emerge from patients.
Thomas Jefferson was one of the first prominent American men to submit for inoculation for smallpox. He has had his children inoculated as well.
To combat the spread of smallpox during the Civil War, soldiers would find someone with cowpox, cut open their pustules, and infect themselves with it. The less harmful cowpox made them immune to smallpox, but they sometimes confused cowpox with syphilis and gave themselves an STD instead.
During the 1870-71 Franco-Prussian War vaccination was not compulsory for the French army and over 23,000 died of smallpox. However vaccination was compulsory in the Prussian army and less than 300 have died of the same disease.
 |
| Components of a modern smallpox vaccination kit |
The World Health Organization announced a global vaccination campaign against smallpox in 1967.
In 1975 Rahima Banu, a 2-year old girl from the village of Kuralia in Bangladesh, was the last known person to be infected with the more severe Variola major form of smallpox. The World Health Organization team arrived and cared for Banu, who recovered fully.
The last natural case of the less severe Variola minor form of smallpox was discovered in Merca district, Somalia on October 26, 1977 when Somalian hospital cook Ali Maow Maalin began displaying symptoms.
Janet Parker, a British medical photographer, became the last recorded person to die from smallpox on September 11, 1978. She often worked above professor Henry Bedson's laboratory at University of Birmingham Medical School where research on smallpox viruses was being conducted. In 1978, a year after smallpox was eradicated worldwide, the virus escaped from the lab. It infected two last patients, including Parker. Bedson, who had been working to rid the world of smallpox, killed himself the next day.
Her illness and death led to a debate on whether the virus should be preserved and eventually all known stocks of smallpox virus were destroyed or transferred to World Health Organisation laboratories.
In 1980 it was agreed that the global vaccination campaign announced thirteen years earlier by the World Health Organization had succeeded in completely eradicating smallpox. However, live copies of smallpox are still kept in different maximum-security laboratories around the world.
The WHO and the CDC consider October 26th to be the anniversary of the eradication of smallpox, the most spectacular success of vaccination the world has known.
Smallpox is the first infectious disease to have been completely eradicated. The second was rinderpest in 2011.
In July 2014, six sealed glass vials of smallpox dated 1954 were discovered by chance in a storage room in an FDA laboratory at the NIH in Maryland. Upon transfer to the CDC in Atlanta, two of the vials had virus which proved to be viable in culture. They were destroyed seven months later.
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