In December 2019 the World Health Organization commemorated the 40th anniversary of smallpox eradication. Smallpox had plagued humanity for at least 3000 years, killing 300 million people in the 20th century alone. The last known endemic case of smallpox was reported and the outbreak promptly contained in Somalia in 1977. The smallpox eradication programme led to the development of stronger national immunization programmes worldwide, underpinning the establishment of primary health care in many countries and creating momentum toward Universal Health Coverage. link
3rd Century BC : Smallpox is thought to date back to the Egyptian Empire around the 3rd century BCE (Before Common Era), based on a smallpox-like rash found on three mummies.
4th Century : The earliest written description of a disease that clearly resembles smallpox appeared in China in the 4th century CE (Common Era).
6th Century : Smallpox spreads to Japan through trade links with China and Korea. Folk tales around the world advised that red light would cure smallpox. In Japan, families who fell sick with smallpox set up shrines to the “smallpox demon” in their homes with the hope they would appease the demon and be cured.
7th Century : Early written descriptions also appeared in India in the 7th century and in Asia Minor in the 10th century. link
10th Century : Maps show smallpox travelling along major trade routes such as the Silk Road to Turkey, Greece Hungary, Bulgaria, Romania, Northern Africa and the Middle East.
11th Century : Smallpox arrived in Europe being spread by European Christian crusades moving to and from the Middle East for the next two centuries.
13th Century : Smallpox now moves to Central and Northern Europe with severe epidemics as far north as Iceland. This was due to population growth and frequent travelling.
15th Century : Smallpox is now in many European countries. The Portuguese expeditions to Africa now sees the disease spread to both east and west Africa.
16th Century : European colonisation and the African slave trade import smallpox into the Caribbean and Central and South America.
Variolation is the grinding up of dried smallpox scabs from a smallpox patient and inhaling them or scratching them into an arm of an uninfected person. This method is being used in China (inhalation technique) and India (cutaneous technique) to control smallpox. Variolation is to inoculate with the smallpox virus and is not interchangeable with vaccination, which was developed by Edward Jenner in the 1800’s derived from cowpox.
17th Century : Variolation is now widespread through many parts of the world. Smallpox arrived in America via European settlers
18th Century : Variolation is brought to England via the wife of the British Ambassador to Turkey. Lady Wortley Montague had survived small pox and ensured that both of her children were variolated.
Edward Jenner, an English country doctor administers the world’s first vaccination as a preventive treatment for smallpox.
20th Century : In 1979 the World Health Organisation declares the world is free from smallpox.
Smallpox was a ravaging disease. There was an approximate mortality rate of 30%. Survivors were usually left with scars, which were sometimes severe.
See our blog posts about smallpox
After eradication of smallpox
Scientists and public health officials decided that there was still a need to perform ongoing research using the variola virus. They agreed to reduce the number of laboratories holding stocks to four locations. In 1981, the four countries that either served as a WHO collaborating center or were actively working with variola virus were the United States, England, Russia, and South Africa. By 1984, England and South Africa had either destroyed their stocks or transferred them to other approved labs. There are now only two locations where variola virus is officially stored and handled under WHO supervision: the Centers for Disease Control and Prevention in Atlanta, Georgia, and the State Research Center of Virology and Biotechnology (VECTOR Institute) in Koltsovo, Russia. link