Smallpox Timeline

1000: Early inoculation and outbreaks As early as 1000, the Chinese recorded methods of fighting the disease. Some of these consisted of scratching smallpox scabs into an uninfected person's skin. But colonization played one of the largest roles in the spread of smallpox. 1545: The effect of colonization A smallpox outbreak in India, likely coming from Portugal, claimed the lives of over 8,000 children. 1633: Smallpox in the Americas Settlers in Massachusetts, who had come across on the Mayflower, and some local Native Americans contracted the disease, which killed over 20, including the ship's physician. 1694: The push for prevention Following the death England's Queen Mary II Dec. 28, and as the result of constant outbreaks throughout the Western world, many in the West began to look for ways to prevent smallpox. 1721: Variolation comes to England Lady Mary Montagu brought the practice of variolation to England after observing it a few years prior in Turkey. This was the practice of infecting a person with a substance made from the pustules of a person sick with a weaker strain of smallpox. Commonplace already in Africa and the Middle East, this reduced the risk greatly in those treated, but in 2-3 percent of cases the inoculations were fatal. 1738: The effects of variolation Variolation did reduce the risks of death. During an epidemic in South Carolina, only 4 percent of those variolated died, compared to 18 percent in those who had not received the inoculation. This lead to an increased push for inoculation. 1751: London hit hard by smallpox The inoculations did not slow smallpox as fatalities reach a high in London, with 3,538 recorded deaths. 1777: Mandatory inoculation for soldiers With inoculation by variolation becoming more accepted, General George Washington made inoculation mandatory for all troops who had not previously survived a case of smallpox. 1798: Edward Jenner develops smallpox vaccine

Jenner, an English doctor, demonstrated that inoculation with cowpox could prevent against smallpox. Jenner developed his idea from speaking with a milkmaid who believed she developed an immunity from contracting cowpox from a cow. This brought the first hopes of being able to control the disease, and Jenner believed that successful vaccination would bring lifelong immunity. Two years after Jenner's discovery, Benjamin Waterhouse, a Harvard professor, brought the vaccination to the United States. In the decade prior to Jenner's vaccine (1791-1800), London had 18,447 deaths from smallpox. Between 1811 and 1820, the recorded deaths from smallpox in London had decreased to 7,858. 1967: The World Health Organization (WHO) campaign The WHO launched a plan to eradicate the virus, which at the time threatened 60 percent of the world's population. Referred to as the "ancient scourge," smallpox killed one out of four people infected and caused severe scarring and blindness to most survivors. Over a period of 10 years, this campaign targeted smallpox on a global scale by vaccinating populations in every country. The campaign finally contained the virus to the horn of Africa. 1977: The beginning to an end The last naturally occurring case of smallpox was located in Somalia. A cook who had once worked as a vaccinator but had never received the vaccine himself contracted the minor form of the virus. He later made a full recovery. 1978: The United Kingdom case A fatal case was contracted by Janet Parker, an employee at a medical school in Great Britain. Parker worked above a lab that had previously failed to meet WHO standards and the head of the medical microbiology department was found to have lied about the work that was being done in the lab. The incident caused 300 of her friends and associates to be quarantined. The department head committed suicide following the incident. 1980: Smallpox is eradicated The WHO campaign is found to have been successful following intense global verification activities by a commission of scientists in December 1979. The World Health Assembly endorses the results of the commission. 1986: Vaccination is stopped The WHO called for an end to routine vaccinations globally in 1979. Other countries had already stopped previously, such as the United States, which stopped its vaccinations in 1972. By 1980, vaccination had officially stopped in a vast majority of the 158 WHO member nations. By 1986, all of the member nations had stopped routine vaccinations and the WHO recommended the

destruction of all remaining samples of the virus. The U.S. military didn't stop routine vaccinations of recruits until 1990. 2001 and on: A resurgence in vaccination Following the anthrax attacks in 2001, the U.S. military begins to vaccinate service members. A program for civilian public health workers followed shortly after. Between December 2002 and October 2009, over 1.8 million service members received the vaccine. In 2002, the WHO advised against destroying the remaining samples of the disease. 2010: An end in sight The only known remaining samples are located at WHO reference labs in Russia and the United States.