![]() ![]() Death usually occurred within eight to 16 days. The more serious strain, Variola major, killed about 30 percent of people infected with it, with even higher death rates in infants. It caused fever, then a rash, which over the course of a few days developed into the skin-covering lumps that are the disease’s trademark. Smallpox was spread by a virus (technically, two viruses: Variola major and the significantly less common Variola minor ). Henderson, former director of disease surveillance at the Centers for Disease Control and Prevention, wrote in his 2009 book Smallpox: The Death of a Disease, noting that even the most devastating wars of the 20th century - World War I and World War II - had a combined death toll much smaller than that of smallpox. “In the contest of Smallpox versus War, War lost,” D.A. Its toll throughout history is hard to measure, but in the 20th century alone it is estimated to have killed between 300 million and 500 million people. It altered the course of the Revolutionary War, with outbreaks in New England that cost the Continental Army the Battle of Quebec. It devastated the Americas in the early 1500s after being introduced through contact with Europe. It’s believed that pharaohs died of it in ancient Egypt. Smallpox has been around for a very long time. ![]() As we learn how to address current and future pandemics, it is worth understanding what we learned from the great infectious disease fights of the past. With luck, aggressive vaccination, and ambitious international coordination, we made the toll of infectious disease lower than at any point in history, and though it won’t be easy, we can do it again. And there’s something reassuring about the fact that, at least in the case of smallpox, humanity eventually rose to the challenge. It’s not minimizing the suffering wrought by the coronavirus pandemic - or forgiving the negligence that made the Covid-19 death toll so much higher than it needed to be - to take a step back and realize that diseases can be much more contagious, and much deadlier, than this one. Its gradual eradication meant ending the needless suffering and death of millions and millions of people every year. The World Health Assembly declared on May 8th, 1980 that it was gone for good. Over the course of the 20th century, country after country fought it back. Smallpox eradication was a major part of that. But humanity only made the transition into that new world fairly recently. It’s easy to take for granted now that very few babies in rich countries die of disease in infancy, that most infectious diseases are treatable, and that there are vaccines available when we need them. The horrors of the past year have given us a brief glimpse into what it’s like to live in a world ravaged by infectious disease. This image contains sensitive or violent content Tap to display To encourage the public to vaccinate against smallpox in the 1940s, the New York State Board of Health used this photograph with the caption, “This man was never vaccinated against smallpox.” AP
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