Smallpox and the start of vaccinations

“Good old days”?! Not if you talk about infectious diseases. Being an infectious disease specialist before the last century would have been a dramatically frustrating profession. Even the simplest of infections could not be effectively treated.

In the 16th century there was an impressing global epidemic of smallpox, which is caused by the variola virus. This disease had been causing problems on and of for quite some time already and never failed to cause multiple deaths among the infected patients. The Inca population in South America was hit pretty bad in those days, the mortality among these people was 60-90%, and this was at the same time that the Spanish conquistadors were attacking them. So perhaps we could say that almost the entire continent of South America speaks Spanish not due to those Spanish horsemen, but in fact as a result of the variola virus.

The difficult situation with the smallpox is that the symptoms are very vague, some muscle aches, fatigue and fever. In this first stage of the disease patients are actually really contagious, so not recognizing the symptoms in time results in major problems and spread of the virus. After about 2 weeks the patient can get the classic skin leasions.

The only thing that the people in the 16th century could do to try to decrease the severity of the disease was a so called “inoculation with variola” (variolation). This meant that an attenuated virus was put on the skin in the hope that your body would start an immune response without actually killing you. In the work up for this “treatment”, children would be starved and about a liter of blood taken from them (don’t ask me why). After the variolation, the child would be locked in a barn until the disease had subsided or the child had died. Congrats for the ones that survived, I hope they had some good psychiatrists to regain their trust in humanity…

On a beautiful day in 1798 (don’t really know if it was, just sounds nicer), an English doctor called Edward Jenner was fed up with this torture of children. He too had undergone the variolation “treatment” and probably never got over the horror (again, total speculation). There had to be another way!

He noticed that the milkmaids of that time appeared to be immune to the smallpox. He thought that this might be due to the fact that they had probably been exposed to the, not so sickening, cow-pox. He decided to test this theory. He found a “volunteer” named James Phipps -the 8 years old son of his gardner- and injected him with the pus he had scraped from a cow-pock blister from a milkmaid. I mean, that just sounds like a brilliant idea, doesn’t it? Anyway, after some time he tried to infect the child with variola using the old “variolation” method but our little James didn’t get sick.

I can’t say that this was the most ethical way of investigating, but it was effective and had huge consequences for the world as we know it. Dr Jenner has written everything down in his book “An inquiry into the causes and effects of the Variolae vaccinae; a disease discovered in some of the Western Counties of England, particularly Gloucestershire, and known by the name of the cow pox”. Which is, like the title suggests, a real briefly written page turner…

From that day forward the procedure to prevent small pox would be to infect somebody with the cow-pox virus called “inoculation with vaccinia”, later “vaccination” after the word vacca that means cow in Latin. This particular vaccination could be terminated in 1980 when, thanks to intensive effort of the WHO, small pox was eradicated. OK, truth be told, it’s still present in 2 laboratories in Russia and the USA so maybe we should continue to take good care of our cows, just to be sure…

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