Smallpox – the infectious disease now eradicated worldwide

The world is currently suffering from coronavirus pandemic which has infected 3.8 million people and killed at least 274,000 around the world. Today we also remember another pandemic which took millions of lives every year until it was finally eradicated from the world.

The World Health Organisation (WHO) is marking the 40^th anniversary of the eradication of smallpox, considered the biggest achievement in international public health.

History

Smallpox was a devastating disease. On average, 3 out of every 10 people who got it died, while those who survived were usually left with severe scars or were even blinded.

The origin of smallpox is unknown and is thought to date back to the Ancient Egyptian the 3rd century BC, based on a smallpox-like rash found on three mummies. The earliest written description of a disease that clearly resembles smallpox appeared in China in the 4th century. Early written descriptions also appeared in India in the 7th century and in Asia Minor in the 10th century.

The global spread of smallpox can be traced to the growth and spread of civilizations, exploration, and expanding trade routes over the centuries.

Symptoms

Historical accounts show that when someone was infected with the smallpox virus, they had no symptoms for between seven and 17 days. However, once the incubation period was over, the following symptoms occurred including high fever, chills, headache, severe back pain, abdominal pain, and vomiting

These symptoms would go away within two to three days and the patient would feel but then a rash would appear. The rash started on the face and then spread to the hands, forearms, and the main part of the body. The person would be highly contagious until the rash disappeared.

Within two days of appearance, the rash would develop into abscesses filled with fluid and pus. The abscesses would break open and scab over which would fall off and leave pit mark scars until which the person remained contagious. There is no cure for the smallpox virus.

In the unlikely event of an exposure to the smallpox virus occurs, vaccination within one to three days can keep the illness from being severe. In addition, antibiotics can help to reduce bacterial infections associated with the virus.

Eradication

Smallpox is the first and only disease to be permanently eradicated worldwide. Until it was wiped out, smallpox killed 300 million people in the 20th century alone or four million people annually. 

In 1959, the WHO initiated a plan to rid the world of smallpox but the global eradication campaign suffered from lack of funds, personnel, and commitment from countries, as well as a shortage of vaccine donations.

In 1967, WHO launched the 10‐year Intensified Smallpox Eradication Programme to concentrate on endemic countries. Efforts included surveillance, case finding, contact tracing, ring vaccination and communication campaigns to better inform affected populations.

By 1973, the number of countries with smallpox had declined. The last variola major infection was recorded in Bangladesh in October 1975, and the last variola minor infection occurred two years later in Merka, Somalia on 26 October 1977.

During the following two years, WHO teams searched the African continent for smallpox but no further cases were found. An unfortunate laboratory incident led to two cases in 1978, which led to global efforts for additional containment.

Vaccination

The first smallpox vaccine was created in 1758. However, the disease continued to infect and kill people on a widespread basis for another 200 years. The WHO implemented a strict vaccination standard in order to slow the infection rate.

On 9 December 1979, the members of the Global Commission for the Certification of Smallpox Eradication signed their names to the statement that “smallpox has been eradicated from the world.”

By 1980, the WHO declared that smallpox had been completely eradicated, although government and health agencies still have stashes of smallpox virus for research purposes.

At the 33rd World Health Assembly, 8 May 1980, smallpox was officially endorsed as eradicated. The total cost of the Smallpox Eradication Programme was estimated at US$ 300 million.

Significance

Commemorating the 40th anniversary of smallpox eradication is a reminder of the power of international health cooperation to do significant and lasting good.

It is also a testament to face other global pandemics such as the ongoing coronavirus crisis. The eradication of smallpox also proves that vaccination can lead to the eradication of other diseases as well such as polio. The day also shows solidarity that we can defeat COVID-19 crisis.