Smallpox

• Published in: The Journal of infectious diseases Vol. 224; no. Supplement_4; pp. S379 - S386
• Main Author: Breman, Joel G
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 30.09.2021
• Subjects: Disease control; History of medicine; History, 20th Century; History, 21st Century; Humans; Immunization; Population Surveillance; Smallpox; Smallpox - epidemiology; Smallpox - prevention & control; Smallpox Vaccine - administration & dosage; Smallpox Vaccine - history; Supplement; Traditional medicine; Vaccination; Vaccines; Variola virus - genetics
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiaa588

Before knowledge and use of vaccines, protection against smallpox was practiced more than a thousand years ago by traditional approaches. Invoking the good graces of smallpox gods, goddesses, and saints by individuals and communities was common [2]. Isolation of patients was the only means known to appease and contain the bad spirits that brought and spread the disease.Traditional medical practitioners in some areas of China, India, Egypt, Ethiopia, and elsewhere collected materials from the pustules or crusts of the afflicted and inserted these into the noses or skin of healthy persons seeking protection [2]. This procedure, called inoculation or variolation, probably had little effect on curtailing epidemics because of its limited use and variability of potency of the inoculum.It is remarkable that some early inoculators inserted scabs into the nose, without understanding that smallpox is acquired via the respiratory route, and, that scratching pustular material into the skin could have the same salutary effect. Nasal inoculation or dermal variolation, using material containing live virus, resulted sometimes in mild illness and protection. However, some cases of smallpox in recipients had the potential to spread within persons and communities.