Skip navigation

Smallpox

If you would like to write a summary for this topic, email phil [at] gyford [dot] com

Wikipedia

Page semi-protected
This is a good article. Click here for more information.

Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor.[1] The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple". The term "smallpox" was first used in Europe in the 15th century to distinguish variola from the "great pox" (syphilis).[2] The last naturally occurring case of smallpox (Variola minor) was diagnosed on 26 October 1977.

Smallpox localizes in small blood vessels of the skin and in the mouth and throat. In the skin, this results in a characteristic maculopapular rash, and later, raised fluid-filled blisters. V. major produces a more serious disease and has an overall mortality rate of 30–35%. V. minor causes a milder form of disease (also known as alastrim, cottonpox, milkpox, whitepox, and Cuban itch) which kills about 1% of its victims.[3][4] Long-term complications of V. major infection include characteristic scars, commonly on the face, which occur in 65–85% of survivors.[5] Blindness resulting from corneal ulceration and scarring, and limb deformities due to arthritis and osteomyelitis are less common complications, seen in about 2–5% of cases.

Smallpox is believed to have emerged in human populations about 10,000 BC.[2] The earliest physical evidence of smallpox is probably the pustular rash on the mummified body of Pharaoh Ramses V of Egypt.[6] The disease killed an estimated 400,000 Europeans per year during the closing years of the 18th century (including five reigning monarchs),[7] and was responsible for a third of all blindness.[3][8] Of all those infected, 20–60%—and over 80% of infected children—died from the disease.[9] Smallpox was responsible for an estimated 300–500 million deaths during the 20th century.[10][11][12] As recently as 1967, the World Health Organization (WHO) estimated that 15 million people contracted the disease and that two million died in that year.[13]

After vaccination campaigns throughout the 19th and 20th centuries, the WHO certified the eradication of smallpox in 1979.[13] Smallpox is one of the two infectious diseases to have been eradicated, the other being rinderpest, which was declared eradicated in 2011.[14][15][16]

Classification

There are two clinical forms of smallpox. Variola major is the severe and most common form, with a more extensive rash and higher fever. Variola minor is a less common presentation, and a much less severe disease, with historical death rates of 1% or less.[17] Subclinical (asymptomatic) infections with variola virus have been noted, but are not common.[18] In addition, a form called variola sine eruptione (smallpox without rash) is seen generally in vaccinated persons. This form is marked by a fever that occurs after the usual incubation period and can be confirmed only by antibody studies or, rarely, by virus isolation.[18]

Signs and symptoms

Child showing rash due to ordinary-type smallpox (variola major)

The incubation period between contraction and the first obvious symptoms of the disease is around 12 days. Once inhaled, variola major virus invades the oropharyngeal (mouth and throat) or the respiratory mucosa, migrates to regional lymph nodes, and begins to multiply. In the initial growth phase the virus seems to move from cell to cell, but around the 12th day, lysis of many infected cells occurs and the virus is found in the bloodstream in large numbers (this is called viremia), and a second wave of multiplication occurs in the spleen, bone marrow, and lymph nodes. The initial or prodromal symptoms are similar to other viral diseases such as influenza and the common cold: fever of at least 38.5 °C (101 °F), muscle pain, malaise, headache and prostration. As the digestive tract is commonly involved, nausea and vomiting and backache often occur. The prodrome, or preeruptive stage, usually lasts 2–4 days. By days 12–15 the first visible lesions—small reddish spots called enanthem—appear on mucous membranes of the mouth, tongue, palate, and throat, and temperature falls to near normal. These lesions rapidly enlarge and rupture, releasing large amounts of virus into the saliva.[4]

Smallpox virus preferentially attacks skin cells, causing the characteristic pimples (called macules) associated with the disease. A rash develops on the skin 24 to 48 hours after lesions on the mucous membranes appear. Typically the macules first appear on the forehead, then rapidly spread to the whole face, proximal portions of extremities, the trunk, and lastly to distal portions of extremities. The process takes no more than 24 to 36 hours, after which no new lesions appear.[4] At this point variola major infection can take several very different courses, resulting in four types of smallpox disease based on the Rao classification:[19] ordinary, modified, malignant (or flat), and hemorrhagic. Historically, smallpox has an overall fatality rate of about 30%; however, the malignant and hemorrhagic forms are usually fatal.[20]

Ordinary

Ninety percent or more of smallpox cases among unvaccinated persons are of the ordinary type.[18] In this form of the disease, by the second day of the rash, the macules become raised papules. By the third or fourth day the papules fill with an opalescent fluid to become vesicles. This fluid becomes opaque and turbid within 24–48 hours, giving them the appearance of pustules; however, the so-called pustules are filled with tissue debris, not pus.[4]

By the sixth or seventh day, all the skin lesions have become pustules. Between 7 and 10 days the pustules mature and reach their maximum size. The pustules are sharply raised, typically round, tense, and firm to the touch. The pustules are deeply embedded in the dermis, giving them the feel of a small bead in the skin. Fluid slowly leaks from the pustules, and by the end of the second week the pustules deflate, and start to dry up, forming crusts (or scabs). By day 16–20 scabs have formed over all the lesions, which have started to flake off, leaving depigmented scars.[21]

Ordinary smallpox generally produces a discrete rash, in which the pustules stand out on the skin separately. The distribution of the rash is densest on the face; denser on the extremities than on the trunk; and on the extremities, denser on the distal parts than on the proximal. The palms of the hands and soles of the feet are involved in the majority of cases. Sometimes, the blisters merge together into sheets, forming a confluent rash, which begin to detach the outer layers of skin from the underlying flesh. Patients with confluent smallpox often remain ill even after scabs have formed over all the lesions. In one case series, the case-fatality rate in confluent smallpox was 62%.[18]

This man is suffering from severe hemorrhagic-type smallpox.

Modified

Referring to the character of the eruption and the rapidity of its development, modified smallpox occurs mostly in previously vaccinated people. In this form the prodromal illness still occurs but may be less severe than in the ordinary type. There is usually no fever during evolution of the rash. The skin lesions tend to be fewer and evolve more quickly, are more superficial, and may not show the uniform characteristic of more typical smallpox.[21] Modified smallpox is rarely, if ever, fatal. This form of variola major is more easily confused with chickenpox.[18]

Malignant

In malignant-type smallpox (also called flat smallpox) the lesions remain almost flush with the skin at the time when raised vesicles form in the ordinary type. It is unknown why some people develop this type. Historically, it accounted for 5%–10% of cases, and the majority (72%) were children.[22] Malignant smallpox is accompanied by a severe prodromal phase that lasts 3–4 days, prolonged high fever, and severe symptoms of toxemia. The rash on the tongue and palate is extensive. Skin lesions mature slowly and by the seventh or eighth day they are flat and appear to be buried in the skin. Unlike ordinary-type smallpox, the vesicles contain little fluid, are soft and velvety to the touch, and may contain hemorrhages. Malignant smallpox is nearly always fatal.[18]

Hemorrhagic

Hemorrhagic smallpox is a severe form that is accompanied by extensive bleeding into the skin, mucous membranes, and gastrointestinal tract. This form develops in approximately 2% of infections and occurred mostly in adults.[18] In hemorrhagic smallpox the skin does not blister, but remains smooth. Instead, bleeding occurs under the skin, making it look charred and black,[18] hence this form of the disease is also known as black pox.[23]

In the early, or fulminating form, hemorrhaging appears on the second or third day as sub-conjunctival bleeding turns the whites of the eyes deep red. Hemorrhagic smallpox also produces a dusky erythema, petechiae, and hemorrhages in the spleen, kidney, serosa, muscle, and, rarely, the epicardium, liver, testes, ovaries and bladder. Death often occurs suddenly between the fifth and seventh days of illness, when only a few insignificant skin lesions are present. A later form of the disease occurs in patients who survive for 8–10 days. The hemorrhages appear in the early eruptive period, and the rash is flat and does not progress beyond the vesicular stage.[18] Patients in the early stage of disease show a decrease in coagulation factors (e.g. platelets, prothrombin, and globulin) and an increase in circulating antithrombin. Patients in the late stage have significant thrombocytopenia; however, deficiency of coagulation factors is less severe. Some in the late stage also show increased antithrombin.[4] This form of smallpox occurs in anywhere from 3 to 25% of fatal cases depending on the virulence of the smallpox strain.[20] Hemorrhagic smallpox is usually fatal.[18]

Cause

Post-eradication

Three former directors of the Global Smallpox Eradication Program read the news that smallpox had been globally eradicated, 1980

The last cases of smallpox in the world occurred in an outbreak of two cases (one of which was fatal) in Birmingham, UK in 1978. A medical photographer, Janet Parker, contracted the disease at the University of Birmingham Medical School and died on September 11, 1978,[75] after which the scientist responsible for smallpox research at the university, Professor Henry Bedson, committed suicide.[2] In light of this accident, all known stocks of smallpox were destroyed or transferred to one of two WHO reference laboratories which had BSL-4 facilities; the Centers for Disease Control and Prevention (CDC) in the United States and the State Research Center of Virology and Biotechnology VECTOR in Koltsovo, Russia.[76]

In 1986, the World Health Organization first recommended destruction of the virus, and later set the date of destruction to be 30 December 1993. This was postponed to 30 June 1999.[77] Due to resistance from the US and Russia, in 2002 the World Health Assembly agreed to permit the temporary retention of the virus stocks for specific research purposes.[78] Destroying existing stocks would reduce the risk involved with ongoing smallpox research; the stocks are not needed to respond to a smallpox outbreak.[79] Some scientists have argued that the stocks may be useful in developing new vaccines, antiviral drugs, and diagnostic tests,[80] however, a 2010 review by a team of public health experts appointed by the World Health Organization concluded that no essential public health purpose is served by the US and Russia continuing to retain virus stocks.[81] The latter view is frequently supported in the scientific community, particularly among veterans of the WHO Smallpox Eradication Program.[82]

In March 2004 smallpox scabs were found tucked inside an envelope in a book on Civil War medicine in Santa Fe, New Mexico.[83] The envelope was labeled as containing scabs from a vaccination and gave scientists at the Centers for Disease Control and Prevention an opportunity to study the history of smallpox vaccination in the US.

Society and culture

Biological warfare

The British at least considered using smallpox as a biological warfare agent at the Siege of Fort Pitt during the French and Indian Wars (1754–63) against France and its Native American allies.[84][85] Although it is not clear whether the actual use of smallpox had official sanction, on June 24, 1763, William Trent, a local trader, wrote, "Out of our regard for them [sc. representatives of the besieging Delawares], we gave them two Blankets and an Handkerchief out of the Small Pox Hospital. I hope it will have the desired effect." [86][87] Historians do not agree on whether this effort to broadcast the disease was successful. It has also been alleged that smallpox was used as a weapon during the American Revolutionary War (1775–83).[88][89]

During World War II, scientists from the United Kingdom, United States and Japan were involved in research into producing a biological weapon from smallpox.[90] Plans of large scale production were never carried through as they considered that the weapon would not be very effective due to the wide-scale availability of a vaccine.[88]

In 1947 the Soviet Union established a smallpox weapons factory in the city of Zagorsk, 75 km to the northeast of Moscow.[91] An outbreak of weaponized smallpox possibly occurred during testing at the factory in the 1970s. General Prof. Peter Burgasov, former Chief Sanitary Physician of the Soviet Army and a senior researcher within the Soviet program of biological weapons, described the incident:

“On Vozrozhdeniya Island in the Aral Sea, the strongest recipes of smallpox were tested. Suddenly I was informed that there were mysterious cases of mortalities in Aralsk. A research ship of the Aral fleet came to within 15 km of the island (it was forbidden to come any closer than 40 km). The lab technician of this ship took samples of plankton twice a day from the top deck. The smallpox formulation—400 gr. of which was exploded on the island—”got her” and she became infected. After returning home to Aralsk, she infected several people including children. All of them died. I suspected the reason for this and called the Chief of General Staff of Ministry of Defense and requested to forbid the stop of the Alma-Ata—Moscow train in Aralsk. As a result, the epidemic around the country was prevented. I called Andropov, who at that time was Chief of KGB, and informed him of the exclusive recipe of smallpox obtained on Vozrazhdenie Island.”[92][93]

Others contend that the first patient may have contracted the disease while visiting Uyaly or Komsomolsk-on-Ustyurt, two cities where the boat docked.[94][95]

Responding to international pressures, in 1991 the Soviet government allowed a joint US-British inspection team to tour four of its main weapons facilities at Biopreparat. The inspectors were met with evasion and denials from the Soviet scientists, and were eventually ordered out of the facility.[96] In 1992 Soviet defector Ken Alibek alleged that the Soviet bioweapons program at Zagorsk had produced a large stockpile—as much as twenty tons—of weaponized smallpox (possibly engineered to resist vaccines, Alibek further alleged), along with refrigerated warheads to deliver it. Alibek's stories about the former Soviet program's smallpox activities have never been independently verified.

In 1997, the Russian government announced that all of its remaining smallpox samples would be moved to the Vector Institute in Koltsovo.[96] With the breakup of the Soviet Union and unemployment of many of the weapons program's scientists, US government officials have expressed concern that smallpox and the expertise to weaponize it may have become available to other governments or terrorist groups who might wish to use virus as means of biological warfare.[97] Specific allegations made against Iraq in this respect, however, proved to be false.[98]

Concern has been expressed by some that artificial gene synthesis could be used to recreate the virus from existing digital genomes, for use in biological warfare.[99] Insertion of the synthesized smallpox DNA into existing related pox viruses could theoretically be used to recreate the virus.[99] The first step to mitigating this risk, it has been suggested, should be to destroy the remaining virus stocks so as to enable unequivocal criminalization of any possession of the virus.[100]

Notable cases

Famous historical figures who contracted smallpox include Lakota Chief Sitting Bull, Ramses V of Egypt,[74] the Kangxi Emperor (survived), Shunzhi Emperor and Tongzhi Emperor (refer to the official history) of China, Date Masamune of Japan (who lost an eye to the disease). Cuitláhuac, the 10th tlatoani (ruler) of the Aztec city of Tenochtitlan, died of smallpox in 1520, shortly after its introduction to the Americas, and the Incan emperor Huayna Capac died of it in 1527. More recent public figures include Guru Har Krishan, 8th Guru of the Sikhs, in 1664, Peter II of Russia in 1730 (died),[101]George Washington (survived), king Louis XV in 1774 (died) and Maximilian III Joseph, Elector of Bavaria in 1777.

Prominent families throughout the world often had several people infected by and/or perish from the disease. For example, several relatives of Henry VIII survived the disease but were scarred by it. These include his sister Margaret, Queen of Scotland, his fourth wife, Anne of Cleves, and his two daughters: Mary I of England in 1527 and Elizabeth I of England in 1562 (as an adult she would often try to disguise the pockmarks with heavy makeup). His great-niece, Mary, Queen of Scots, contracted the disease as a child but had no visible scarring.

In Europe, deaths from smallpox often changed dynastic succession. The only surviving son of Henry VIII, Edward VI, died from complications shortly after apparently recovering from the disease, thereby rendering his sire's infamous efforts to provide England with a male heir moot. (His immediate successors were all females.) Louis XV of France succeeded his great-grandfather Louis XIV through a series of deaths of smallpox or measles among those earlier in the succession line. He himself died of the disease in 1774. William III lost his mother to the disease when he was only ten years old in 1660, and named his uncle Charles as legal guardian: her death from smallpox would indirectly spark a chain of events that would eventually lead to the permanent ousting of the Stuart line from the British throne. William III's wife, Mary II of England, died from smallpox as well.

In China, the Qing Dynasty had extensive protocols to protect Manchus from the Peking's endemic smallpox. Most notably, the Kangxi Emperor was promoted to the throne because he had survived the disease, ahead of older brothers who had not yet had it.

U.S. Presidents George Washington, Andrew Jackson, and Abraham Lincoln all contracted and recovered from the disease. Washington became infected with smallpox on a visit to Barbados in 1751.[102] Jackson developed the illness after being taken prisoner by the British during the American Revolution, and though he recovered, his brother Robert did not.[102] Lincoln contracted the disease during his Presidency, possibly from his son Tad, and was quarantined shortly after giving the Gettysburg address in 1863.[102]

Famous theologian Jonathan Edwards died of smallpox in 1758 following an inoculation.[103]

U.S.S.R. leader Joseph Stalin fell ill with smallpox at the age of seven. His face was badly scarred by the disease. He later had photographs retouched to make his pockmarks less apparent.[104]

Hungarian poet Ferenc Kölcsey, who wrote the Hungarian national anthem, lost his right eye to smallpox.[105]

Gods and goddesses

As a reaction to the devastation of smallpox, smallpox gods and goddesses were invented as a mechanism to cope with the disease. Two examples of this occurred in China and India. In China, the smallpox goddess was referred to as T’ou-Shen Niang-Niang. [106] The Chinese actively worked to please the goddess and thus keep the disease at bay. For example, the Chinese referred to the smallpox pustules as “beautiful flowers”; this was an attempt to not offend the goddess and keep her happy. [107] The Chinese also took great measure to protect children from the dangers of smallpox by tricking their smallpox goddess. It was believed that the goddess enjoyed passing the disease to attractive children. This transmission was most likely to occur on the last night of the year, so children wore ugly masks to bed to trick the goddess into passing over them. [107]. If infection of smallpox did occur, shrines were set up in the homes of the victims. These shrines were worshipped and made offerings too while the victim was sick. If the victim recovered, the shrines were taken away from the home in a special handmade paper chair or boat and burned. If the patient did not recover, the shrine was destroyed and curses were used to remove the goddess from the house. [106] India’s first records of smallpox can be found in a medical book that dates back to A.D. 400. This book describes a disease that sounds exceptionally like smallpox. [107] India, like China, created a goddess in response to its exposure to smallpox. Shitala Mata was both worshipped and feared during her reign. It was believed that this goddess was both evil and kind and had the ability to inflict victims when angered, as well as calm the fevers of the already afflicted. [108] Portraits of the goddess show her holding a broom in her right hand to continue to move the disease and a pot of cool water in the other hand in an attempt to soothe victims. [107] Shrines were created where many India natives, both healthy and not, went to worship and attempt to protect themselves from this disease. Some Indian women, in an attempt to ward of Shitala Mata, placed plates of cooling foods and pots of water on the roofs of their homes. [109]

See also

Portal icon Medicine portal

References

  1. ^ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 525–8. ISBN 0838585299. 
  2. ^ a b c Barquet N, Domingo P (15 October 1997). "Smallpox: the triumph over the most terrible of the ministers of death". Ann. Intern. Med. 127 (8 Pt 1): 635–42. doi:10.1059/0003-4819-127-8_Part_1-199710150-00010 (inactive 2010-03-07). PMID 9341063. http://www.annals.org/cgi/content/full/127/8_Part_1/635. 
  3. ^ a b Behbehani AM (1 December 1983). "The smallpox story: life and death of an old disease". Microbiol Rev 47 (4): 455–509. PMC 281588. PMID 6319980. http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=6319980. 
  4. ^ a b c d e f g h i j "Smallpox". Armed Forces Institute of Pathology: Department of Infectious and Parasitic Diseases. Archived from the original on 2007-10-09. http://web.archive.org/web/20071009141639/http://www.afip.org/Departments/infectious/sp/text/1_1.htm. Retrieved 2008-10-28. 
  5. ^ Jezek Z, Hardjotanojo W, Rangaraj AG (1981). "Facial scarring after varicella. A comparison with variola major and variola minor". Am. J. Epidemiol. 114 (6): 798–803. PMID 7315828. 
  6. ^ a b Hopkins, Donald. "Ramses V:Earliest known victim?". WHO. http://whqlibdoc.who.int/smallpox/WH_5_1980_p22.pdf. Retrieved 6 July 2010. 
  7. ^ a b c J. N. Hays (2005). "Epidemics and pandemics: their impacts on human history". ABC-CLIO. p.151. ISBN 1851096582
  8. ^ "Smallpox and Vaccinia". National Center for Biotechnology Information.
  9. ^ Riedel S (2005). "Edward Jenner and the history of smallpox and vaccination". Proc (Bayl Univ Med Cent) 18 (1): 21–5. PMC 1200696. PMID 16200144. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1200696. 
  10. ^ Koplow, David A. (2003). Smallpox: the fight to eradicate a global scourge. Berkeley: University of California Press. ISBN 0-520-24220-3. http://books.google.com/books/ucpress?vid=ISBN9780520242203. 
  11. ^ "UC Davis Magazine, Summer 2006: Epidemics on the Horizon". http://ucdavismagazine.ucdavis.edu/issues/su06/feature_1b.html. Retrieved 2008-01-03. [dead link]
  12. ^ How Poxviruses Such As Smallpox Evade The Immune System, ScienceDaily, February 1, 2008
  13. ^ a b c d e f "Smallpox". WHO Factsheet. http://www.who.int/mediacentre/factsheets/smallpox/en/. Retrieved 2007-09-22. 
  14. ^ De Cock, Kevin M. (2001). "(Book Review) The Eradication of Smallpox: Edward Jenner and The First and Only Eradication of a Human Infectious Disease". Nature Medicine 7 (1): 15–6. doi:10.1038/83283. http://www.nature.com/nm/journal/v7/n1/full/nm0101_15b.html. 
  15. ^ Tognotti E. (June 2010). "The eradication of smallpox, a success story for modern medicine and public health: What lessons for the future?" (PDF). J Infect Dev Ctries 4 (5): 264–266. PMID 20539058. http://www.jidc.org/index.php/journal/article/view/1204/386. 
  16. ^ "'The world is free of rinderpest'". The Mail and Guardian. 2011-05-25. http://mg.co.za/article/2011-05-25-the-world-is-free-of-rinderpest/. 
  17. ^ a b "CDC Smallpox". Smallpox Overview. http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp. Retrieved 2007-12-26. 
  18. ^ a b c d e f g h i j k l m n o p q r s t u v Atkinson W, Hamborsky J, McIntyre L, Wolfe S (eds.) (2005). "Smallpox" (PDF). Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) (9th ed.). Washington DC: Public Health Foundation. pp. 281–306. Archived from the original on 2010-04-09. http://web.archive.org/web/20100409144819/http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/smallpox.pdf. 
  19. ^ Rao, A. R. (1972). Smallpox. Bombay: Kothari Book Depot. OCLC 723806
  20. ^ a b Hogan CJ, Harchelroad F. "CBRNE – Smallpox". eMedicine. http://www.emedicine.com/emerg/topic885.htm. Retrieved 2006-09-23. 
  21. ^ a b c d "Smallpox Disease and Its Clinical Management" (PDF). From the training course titled "Smallpox: Disease, Prevention, and Intervention" (www.bt.cdc.gov/agent/smallpox/training/overview). http://emergency.cdc.gov/agent/smallpox/training/overview/pdf/diseasemgmt.pdf. Retrieved 2007-12-26. 
  22. ^ a b c d e f g h i j Fenner, Frank (1988) (PDF). Smallpox and Its Eradication (History of International Public Health, No. 6). Geneva: World Health Organization. ISBN 92-4-156110-6. http://whqlibdoc.who.int/smallpox/9241561106.pdf. 
  23. ^ a b Preston, Richard (12 July 1999). "A reporter at large: Demon in the Freezer". The New Yorker. http://cryptome.org/smallpox-wmd.htm. Retrieved 2008-01-03. 
  24. ^ Dubochet J, Adrian M, Richter K, Garces J, Wittek R (1994). "Structure of intracellular mature vaccinia virus observed by cryoelectron microscopy". J. Virol. 68 (3): 1935–41. PMC 236655. PMID 8107253. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=236655. 
  25. ^ a b Moss B (2006). "Poxviridae: the viruses and their replication". In Fields BN, Knipe DM, Howley PM, et al. (eds). Fields Virology. Vol 2 (5th ed.). Philadelphia, PA: Lippincott-Raven. pp. 2905–46. ISBN 0781760607. 
  26. ^ Damon I (2006). "Poxviruses". In Fields BN, Knipe DM, Howley PM, et al. (eds). Fields Virology. Vol 2 (5th ed.). Philadelphia, PA: Lippincott-Raven. pp. 2947–76. ISBN 0781760607. 
  27. ^ Henderson DA, Inglesby TV, Bartlett JG, et al. (1999). "Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense". JAMA 281 (22): 2127–37. doi:10.1001/jama.281.22.2127. PMID 10367824. 
  28. ^ Riedel S (January 2005). "Smallpox and biological warfare: a disease revisited". Proc (Bayl Univ Med Cent) 18 (1): 13–20. PMC 1200695. PMID 16200143. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1200695. 
  29. ^ "Smallpox: Current, comprehensive information on pathogenesis, microbiology, epidemiology, diagnosis, treatment, and prophylaxis". Center for Infectious Disease Research & Policy. http://www.cidrap.umn.edu/cidrap/content/bt/smallpox/biofacts/smllpx-summary.html#_Criteria_for_Determining. Retrieved 2007-12-27. 
  30. ^ LeDuc JW, Jahrling PB (2001). "Strengthening national preparedness for smallpox: an update". Emerging Infect. Dis. 7 (1): 155–7. doi:10.3201/eid0701.010125. PMC 2631676. PMID 11266310. http://www.cdc.gov/ncidod/eid/vol7no1/leduc.htm. [dead link]
  31. ^ Bourzac K (2002). "Smallpox: Historical Review of a Potential Bioterrorist Tool". Journal of Young Investigators 6 (3). http://www.jyi.org/volumes/volume6/issue3/features/bourzac.html. 
  32. ^ Wujastyk, Dominik. (1995). "Medicine in India," in Oriental Medicine: An Illustrated Guide to the Asian Arts of Healing, 19–38. Edited by Serindia Publications. London: Serindia Publications. ISBN 0906026369. p. 29.
  33. ^ Temple, Robert. (1986). The Genius of China: 3,000 Years of Science, Discovery, and Invention. With a forward by Joseph Needham. New York: Simon and Schuster, Inc. ISBN 0671620282. p. 135–37.
  34. ^ "Modern History Sourcebook: Lady Mary Wortley Montagu (1689–1762): Smallpox Vaccination in Turkey". Fordham.edu. http://www.fordham.edu/Halsall/mod/montagu-smallpox.html. Retrieved 2010-10-15. 
  35. ^ "Frequently Asked Questions About Smallpox Vaccine". Centers for Disease Control and Prevention. Last reviewed February 7, 2007. http://www.bt.cdc.gov/agent/smallpox/vaccination/faq.asp. Retrieved 2010-12-28. 
  36. ^ a b c "Vaccine Overview" (PDF). Smallpox Fact Sheet. http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/vaccine-overview.pdf. Retrieved 2008-01-02. 
  37. ^ Mack TM (1972). "Smallpox in Europe, 1950–1971". J. Infect. Dis. 125 (2): 161–9. doi:10.1093/infdis/125.2.161. PMID 5007552. 
  38. ^ Pütz MM, Alberini I, Midgley CM, Manini I, Montomoli E, Smith GL (2005). "Prevalence of antibodies to Vaccinia virus after smallpox vaccination in Italy". J. Gen. Virol. 86 (Pt 11): 2955–60. doi:10.1099/vir.0.81265-0. PMID 16227216. http://vir.sgmjournals.org/cgi/content/full/86/11/2955. 
  39. ^ Questions and Answers – DoD Smallpox Vaccination Program (SVP)
  40. ^ a b Fenner, Frank (1988). "Development of the Global Smallpox Eradication Programme". Smallpox and Its Eradication (History of International Public Health, No. 6). Geneva: World Health Organization. pp. 31,125. ISBN 92-4-156110-6. http://whqlibdoc.who.int/smallpox/9241561106_chp9.pdf. 
  41. ^ Bray M, Roy CJ (2004). "Antiviral prophylaxis of smallpox". J. Antimicrob. Chemother. 54 (1): 1–5. doi:10.1093/jac/dkh286. PMID 15163655. http://jac.oxfordjournals.org/cgi/content/full/54/1/1. 
  42. ^ Esposito JJ, Sammons SA, Frace AM, Osborne JD, Olsen-Rasmussen M, Zhang M, Govil D, Damon IK, Kline R, Laker M, Li Y, Smith GL, Meyer H, Leduc JW, Wohlhueter RM (2006) Genome sequence diversity and clues to the evolution of variola (smallpox) virus. Science. 2006 Aug 11;313(5788):807-812
  43. ^ a b Li Y, Carroll DS, Gardner SN, Walsh MC, Vitalis EA, Damon IK (2007) On the origin of smallpox: correlating variola phylogenics with historical smallpox records. Proc Natl Acad Sci USA 104(40):15787-15792
  44. ^ a b Hughes AL, Irausquin S, Friedman R (2010) The evolutionary biology of pox viruses. Infect Genet Evol. 10(1):50-59
  45. ^ Shchelkunov SN (2011) Emergence and reemergence of smallpox: The need in development of a new generation smallpox vaccine. Vaccine
  46. ^ Vaccine and Serum Evils, by Herbert M. Shelton, page 5
  47. ^ a b c Hopkins DR (2002). The Greatest Killer: Smallpox in history. University of Chicago Press. ISBN 0-226-35168-8.  Originally published as Princes and Peasants: Smallpox in History (1983), ISBN 0-226-35177-7
  48. ^ Horst R. Thieme (2003). "Mathematics in population biology". Princeton University Press. p.285. ISBN 0691092915
  49. ^ Henderson, D. A.; Preston, Richard (23 June 2009). Smallpox- the Death of a Disease: The Inside Story of Eradicating a Worldwide Killer (1st ed.). Prometheus Books. p. 334. ISBN 1591027225. http://www.amazon.com/o/ASIN/1591027225/sciencefriday/#reader_1591027225. 
  50. ^ Dixon, C. W. (1962). Smallpox. London: Churchill. 
  51. ^ Past pandemics that ravaged Europe, BBC News, November 7, 2005
  52. ^ Harminder S. Dua, Ahmad Muneer Otri, Arun D. Singh (2008). "Abu Bakr Razi". British Journal of Ophthalmology (BMJ Group) 92: 1324. 
  53. ^ "Encyclopedia of North American Indians". Frederick E. Hoxie (1996). p.164. ISBN 0395669219
  54. ^ Koplow, David A. (2003). "Smallpox The Fight to Eradicate a Global Scourge". University of California Press. http://www.ucpress.edu/books/pages/9968/9968.ch01.html. Retrieved 2009-02-22. 
  55. ^ "The Cambridge encyclopedia of human paleopathology". Arthur C. Aufderheide, Conrado Rodríguez-Martín, Odin Langsjoen (1998). Cambridge University Press. p.205. ISBN 0521552036
  56. ^ Glynn, Ian; Glynn, Jenifer (2004). The life and death of smallpox. Cambridge University Press. p. 145. ISBN 0521845424. http://books.google.com/books?id=tL4W3YNMYLIC&pg=&dq#v=onepage&q=&f=false. 
  57. ^ Stanley A Plotkin, Walter A Orenstein, Donald A. Henderson, Bernard Moss. "Smallpox and Vaccinia". http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=vacc.chapter.3. Retrieved 2010-10-15. 
  58. ^ Dr. Francisco de Balmis and his Mission of Mercy, Society of Philippine Health History[dead link]
  59. ^ Against all odds: vanquishing smallpox in far-flung Japan[dead link]
  60. ^ "Smallpox History – Other histories of smallpox in South Asia". Smallpoxhistory.ucl.ac.uk. 2006-07-18. http://www.smallpoxhistory.ucl.ac.uk/Other%20Asia/ongoingwork.htm. Retrieved 2010-10-15. 
  61. ^ "Atsuko Naono, ''State of Vaccination: The Fight Against Smallpox in Colonial Burma''". Indianmedicine.eldoc.ub.rug.nl. http://indianmedicine.eldoc.ub.rug.nl/root/N2/284n/. Retrieved 2010-10-15. 
  62. ^ "Chapter 3 - Indian Health Program". Indian Health Service. http://www.ihs.gov/ihm/index.cfm?module=dsp_ihm_pc_p1c3. Retrieved 2012-02-08. 
  63. ^ "Bodily Matters: The Anti-Vaccination Movement in England, 1853–1907". Amazon.com. ASIN 0822334232. 
  64. ^ Chapin, C.V. (1913). "Variation in type of infectious disease as shown by the history of smallpox in the United States 1895–1912". Infect Dis 13 (2): 171–196. doi:10.1093/infdis/13.2.171. 
  65. ^ a b c Orenstein, Walter A.; Plotkin, Stanley A. (1999). Vaccines. Philadelphia: W.B. Saunders Co. pp. e-book. ISBN 0-7216-7443-7. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=smallpox&rid=vacc.section.45#47. 
  66. ^ Rodrigues BA (1975). "Smallpox eradication in the Americas". Bull Pan Am Health Organ 9 (1): 53–68. PMID 167890. 
  67. ^ Fenner, Frank (1988). "Development of the Global Smallpox Eradication Programme". Smallpox and Its Eradication (History of International Public Health, No. 6). Geneva: World Health Organization. pp. 366–418. ISBN 92-4-156110-6. http://whqlibdoc.who.int/smallpox/9241561106_chp9.pdf. 
  68. ^ Fenner, Frank (1988). "The Intensified Smallpox Eradication Programme" (PDF). Smallpox and Its Eradication (History of International Public Health, No. 6). Geneva: World Health Organization. pp. 422–538. ISBN 92-4-156110-6. http://whqlibdoc.who.int/smallpox/9241561106.pdf. 
  69. ^ "Karel Raška and Smallpox". Central European Journal of Public Health. March 2010. http://www1.szu.cz/svi/cejph/archiv/2010-1-10-full.pdf. Retrieved 2010-11-17. 
  70. ^ "Karel Raška — The Development of Modern Epidemiology. The role of the IEA". Central European Journal of Public Health. March 2010. http://www1.szu.cz/svi/cejph/archiv/2010-1-11-full.pdf. Retrieved 2010-11-17. 
  71. ^ "BBC – History – Smallpox: Eradicating the Scourge". http://www.bbc.co.uk/history/british/empire_seapower/smallpox_03.shtml. Retrieved 2008-11-24. 
  72. ^ Centers for Disease Control and Prevention (CDC) (1996). "International Notes—Quarantine Measures Smallpox—Stockholm, Sweden, 1963". MMWR 45 (25): 538–45. PMID 9132571. http://www.cdc.gov/MMWR/preview/mmwrhtml/00042757.htm. [dead link]
  73. ^ Grimes, William (2010-11-25). "Frank Fenner Dies at 95". NYTimes.com. http://www.nytimes.com/2010/11/26/world/26fenner.html. Retrieved 2010-11-27. 
  74. ^ a b Fenner, Frank (2006). Nature, Nurture and Chance: The Lives of Frank and Charles Fenner. Canberra, ACT 0200: Australian National University Press. ISBN 1-920942-62-9. 
  75. ^ a b Pennington H (2003). "Smallpox and bioterrorism". Bull. World Health Organ. 81 (10): 762–7. doi:10.1590/S0042-96862003001000014. PMC 2572332. PMID 14758439. http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862003001000014&lng=en&nrm=iso&tlng=en. 
  76. ^ Connor, Steve (2002-01-03). "How terrorism prevented smallpox being wiped off the face of the planet for ever". London: The Independent. http://www.independent.co.uk/news/science/how-terrorism-prevented-smallpox-being-wiped-off-the-face-of-the-planet-for-ever-672121.html. Retrieved 2008-10-03. 
  77. ^ Altman, Lawrence (1996-01-25). "Final Stock of the Smallpox Virus Now Nearer to Extinction in Labs". New York Times. http://query.nytimes.com/gst/fullpage.html?res=9800EED61639F936A15752C0A960958260&sec=&spon=&pagewanted=print. Retrieved 2007-11-23. 
  78. ^ MacKenzie, Debora (2002-01-26). "Stay of execution". New Scientist. http://www.newscientist.com/article/mg17323271.300-stay-of-execution.html. Retrieved 2007-11-23. 
  79. ^ Hammond, Edward (2007). "Should the US and Russia destroy their stocks of smallpox virus?". BMJ 334 (7597): 774. doi:10.1136/bmj.39155.695255.94. PMC 1851992. PMID 17431261. http://www.bmj.com/cgi/content/full/334/7597/774. 
  80. ^ Agwunobi, John O. (2007). "Should the US and Russia destroy their stocks of smallpox virus?". BMJ 334 (7597): 775. doi:10.1136/bmj.39156.490799.BE. PMC 1851995. PMID 17431262. http://www.bmj.com/cgi/content/full/334/7597/775. 
  81. ^ Comments on the Scientific Review of Variola Virus Research, 1999‐2010. Advisory Group of Independent Experts to review the smallpox research program (AGIES) WHO document WHO/HSE/GAR/BDP/2010.4
  82. ^ Lane, J.Michael; Poland, Gregory A. (2011). "Why not destroy the remaining smallpox virus stocks?". Vaccine (Elsevier) 29 (16): 2823–2824. doi:10.1016/j.vaccine.2011.02.081. PMID 21376120. 
  83. ^ "Century-old smallpox scabs in N.M. envelope". USA Today: Health and Behavior. 2003-12-26. http://www.usatoday.com/news/health/2003-12-26-smallpox-in-envelope_x.htm. Retrieved 2006-09-23. 
  84. ^ Peckham, Indian Uprising, 226; Anderson, Crucible of War, 542, 809n.
  85. ^ Anderson, Crucible of War, 809n; Grenier, First Way of War, 144; Nester, Haughty Conquerors", 114–15.
  86. ^ Colonial Germ Warfare, Harold B. Gill Jr., CW Journal: Spring 04
  87. ^ Anderson, Crucible of War, 541–42; Jennings, Empire of Fortune, 447n26.
  88. ^ a b "BBC – History – Silent Weapon: Smallpox and Biological Warfare". http://www.bbc.co.uk/history/worldwars/coldwar/pox_weapon_01.shtml. Retrieved 2008-01-02. 
  89. ^ Elizabeth A. Fenn. "Biological Warfare in Eighteenth-Century North America: Beyond Jeffery Amherst," The Journal of American History, Vol. 86, No. 4 (Mar., 2000), pp. 1552–1580
  90. ^ "USAMRIID's Medical Management of Biological Casualties Handbook" (PDF). http://usamriid.detrick.army.mil/education/bluebookpdf/USAMRIID%20Blue%20Book%205th%20Edition.pdf. Retrieved 2008-01-02. 
  91. ^ Alibek K, Handelman S (1999). Biohazard: The Chilling True Story of the Largest Covert Biological Weapons Program in the World—Told from Inside by the Man Who Ran It. New York: Delta. ISBN 0-385-33496-6. 
  92. ^ Shoham D, Wolfson Z (2004). "The Russian biological weapons program: vanished or disappeared?" (– Scholar search). Crit. Rev. Microbiol. 30 (4): 241–61. doi:10.1080/10408410490468812. PMID 15646399. http://www.ingentaconnect.com/content/tandf/bmcb/2004/00000030/00000004/art00002. [dead link]
  93. ^ "Smallpox – not a bad weapon" (in Russian). Interview with General Burgasov. Moscow News. http://mn.ru/issue.php?2001-46-48. Retrieved 2007-06-18. 
  94. ^ Enserink M (2002). "Biowarfare. Did bioweapons test cause a deadly smallpox outbreak?". Science 296 (5576): 2116–7. doi:10.1126/science.296.5576.2116. PMID 12077372. 
  95. ^ Bellomo, Michael; Zelicoff, Alan P. (2005). Microbe : are we ready for the next plague?. New York: American Management Association. p. 101. ISBN 9780814408650. 
  96. ^ a b Preston, Richard. The Demon in the Freezer. Fawcett. pp. 105–115. ISBN 0-345-46663-2. 
  97. ^ History and Epidemiology of Global Smallpox Eradication From the training course titled "Smallpox: Disease, Prevention, and Intervention". The CDC and the World Health Organization. Slide 16–17.
  98. ^ No evidence of smallpox No evidence of smallpox
  99. ^ a b The Genetic Engineering of Smallpox. WHO’s Retreat from the Eradication of Smallpox Virus and Why it Should be Stopped A BRIEFING PAPER BY THE SUNSHINE PROJECT. 2002.
  100. ^ Smallpox Virus Stocks at the 64th WHA – Implementing the Conclusions of the Major Review Third World Network, Briefing Paper by Edward Hammond, page 8.
  101. ^ "President Abraham Lincoln: Health & Medical History". 2007-03-24. http://www.doctorzebra.com/prez/g16.htm#25. Retrieved 2007-06-18. 
  102. ^ a b c Oldstone, Michael (2010). Viruses, Plagues, and History. Oxford University Press. pp. 65–71. ISBN 0195327314, ISBN 9780195327311. 
  103. ^ "Biography at the Edwards Center at Yale University". Yale University. http://edwards.yale.edu/research/about-edwards/biography. Retrieved 2009-09-13. 
  104. ^ Montefiore, Young Stalin, p. 61
  105. ^ Szinnyei József: Magyar írók élete és munkái, Arcanum, Budapest, 2000, ISBN 9638602996
  106. ^ a b Hopkins, Donald R. Princes and Peasants: Smallpox in History. United States of American: University of Chicago Press, 1983.
  107. ^ a b c d Giblin, James C. When Plague Strikes: The Black Death, Smallpox, AIDS. United States of America: HarperCollins Publishers, 1995.
  108. ^ Wiley, Andrea S., & Allen, John S. Medical Anthropology: A Biocultural Approach. New York: Oxford University Press, 2009.
  109. ^ Tucker, Jonathan B. Scourge: The Once and Future Threat of Smallpox. New York: Atlantic Monthly Press, 2001.

Further reading

External links

This text was last fetched from this Wikipedia page (where you can edit it) on
9 Feb 2012, 8:02pm under the terms of the GFDL.

Annotations

  • N steve h on Fri 7 Mar 2003, 03:36am. Flag this

    Smallpox was the major epidemic disease in Europe in the 17th century, when it really took off. It was a major problem in London in this period, with what seem to be a new series of epidemics from 1659 onward. Demographers believe that factors promoting the worst outbreaks smallpox in England included low temperatures in winter, low rainfall in autumn, crowding in the city, and malnutrition. Living in London was bad for your health.

  • N vincent on Sun 21 Dec 2003, 04:38am. Flag this

    who discouvered the cure first:
    The Introduction of Inoculation to the West
    http://www.foundersofscience.net/lady_mary_montagu.htm
    from letter by Letter of Lady Montegu: …… To Sarah Chiswell …….. Adrianople 1, April 1717
    They make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nutshell full of the matter of the best sort of smallpox and asks what veins you please to have opened. She immediately {ug}
    other leads [cowx-smallpox google]
    Edward Jenner learned early in his medical career of the farm worker’s’ belief that if at one time one had cowpox, one would not get smallpox

    http://www.foundersofscience.net/jenner.htm
    then man at his most ….
    An early BW attack took place in the Black Sea port of Kaffa (now Feodossia, Ukraine) in 1346. Rats and their fleas carried the disease to attacking Tatar soldiers. In spite, the Tatars catapulted the bodies of victims at the defending Genoese who contracted plague and left Kaffa. The same rats afflicting the Tatars likely brought disease to the Genoese.[5]
    Another attempted use of biological warfare occurred between 1754 and 1767 when the British infiltrated smallpox-infested blankets to unsuspecting American Indians during the French and Indian war. Smallpox decimated the Indians, but it is unclear if the contaminated blankets or endemic disease brought by the Europeans caused these epidemics.[92]
    http://www.toxicmold.org/documents/0376.html

  • N vicente on Mon 16 Aug 2004, 03:04am. Flag this

    leads for those of enquiring mind :
    More on smallpox and who dun it first. It appears not one of the begowned ones.At the time, Reverend Cotton Mather lived in Boston had known of the practice of inoculation since 1706. A slave, Onesimus, had explained to him how he had been inoculated as a child in Africa. The practice was an ancient one, and Mather was fascinated by the idea. He encouraged physicians to try it, without success. Then, at Mather’s urging, one doctor, Zabdiel Boylston, was courageous enough to use the procedure.
    ………………….
    Around the fifteenth century, a practice of applying powdered smallpox “crusts” and inserting them with a pin or

  • N dirk on Mon 16 Aug 2004, 07:13pm. Flag this

    Lady Mary Mortley Montagu

    Vincent, is she in any way related to “my Lord” - just curiosity. (I know it killed the cat!)

  • N vicente on Mon 16 Aug 2004, 08:44pm. Flag this

    interesting: she married Wortley:
    here not sorted:
    Lady Mary Wortley Montagu (1689-1762)
    Her father, Evelyn Pierrepont, was connected with the Evelyns of Wootton, and married Mary Feilding, daughter of the earl of Denbigh, from one of whose brothers Henry Fielding the novelist descended. Mary was born in May, 1689; a year later, her father became earl of Kingston and, at the whig triumph of 1715, duke of Kingston; she was brought up, carelessly enough, in a library….One of her girl friends was Anne Wortley Montagu, a granddaughter of the first earl of Sandwich (Pepys

  • N vicente on Mon 16 Aug 2004, 09:04pm. Flag this

    “Evelyn Pierrepont” Evelyns Diary: Evelyn, grand pa had 16 sons and * daughters. One daughter became mother of the ‘present’ Evelyn, Earle of Kinston and son of William Perpoint: interesting read, page 2 of DeBeers version of Kalendarium by J.E..
    Evelyn fortune was derived from Powder workes.

  • N Sjoerd on Tue 17 Aug 2004, 01:19pm. Flag this

    So to answer Dirk’s question:

    Yes, by marriage:
    This Lady Mary Wortley (not Mortley) Montagu was married to Edward Wortley Montagu, son of Edward Montagu, who adopted his wife’s name Wortley.

    This Edward Wortley Montagu was the second son of the 1st Earl of Sandwich, “Mylord”.

    See http://www.twickenham-museum.org.uk/detail.asp?ContentID=180

    and http://www.montaguemillennium.com/familyresearch/h_1762_mary.htm

  • N Sjoerd on Tue 17 Aug 2004, 01:41pm. Flag this

    Sorry, that second son was a Sidney, not an Edward. So the two sons that were first inoculated against smallpox by Lady Mary were grandsons of the Sidney that stayed overnight at the pepys household for fear of smallpox.

    See http://www.geocities.com/mbrodgers/wga77.html#I18482

    for a family tree

  • N Paul Timbrell on Fri 3 Sep 2004, 09:14am. Flag this

    It seems to me that these comments are barking up the wrong tree for 2nd September 1661. This is not a reference to smallpox but to venereal disease.The context is ” the vices of the Court “. Surely smallpox was not as common as eating and swearing. The Oxford Dictionary defines pox as syphilis.

  • N Tim Owen on Fri 3 Sep 2004, 12:27pm. Flag this

    In context this almost certainly means venereal disease. If true, given the incubation period and symptoms of syphillis it is more likely to be a less critical GU infection. However I suspect this is a comment generally critical of Court morals with minimal basis in fact - then, as now, I don’t think prominent members of society would reveal such an infection.

  • N vicente on Fri 3 Sep 2004, 10:00pm. Flag this

    pox: Pock- mark: pox on ye , cow- small- chicken-, any of the outbreak of pustles or eruptions; or animal poxes. Then the unmentionable not in polite company.

  • N Jess A on Mon 22 Nov 2004, 08:15pm. Flag this

    Hey I was wondering why did milk maids way way way back then, didn’t get small pox?

  • N guye ffalkes on Mon 22 Nov 2004, 08:58pm. Flag this

    No one put two and two to-gether to make a case of molehills out of the mountain. “didn

  • N Grahamt on Mon 22 Nov 2004, 09:38pm. Flag this

    Why milkmaids didn’t get smallpox
    Follow the links above for the full story, but:
    Edward Jenner noticed that milkmaids who developed cowpox, a less serious disease, did not develop the deadly smallpox. In 1796, Jenner took the fluid from a cowpox pustule on a dairymaid’s hand and inoculated an 8-year-old boy. Six weeks later, he exposed the boy to smallpox, and the boy did not develop any symptoms. Jenner coined the term “vaccine” from the word “vaca” which means “cow” in Latin. (more at: http://dermatology.about.com/cs/smallpox/a/smallpoxhx.htm ) variolation described above used actual smallpox matter, not cowpox, and killed 2-3% of the patients.

  • N Cumgranissalis on Sun 31 Jul 2005, 03:48am. Flag this

    For the enquiring mind on ‘pox or “The Speckled Monster ” . by Jennifer Lee Carrell PHD lit Harvard, dothe write a nice but not a best seller [maybe not enough on the famous cousen ‘pox and its means of transmission] on the Disease that killed more than the bubonic, only to be eradicated by 1980’s although some governments have been rumored to keep a few samples for future scientfic studies.
    Book going for 5$ orig 26 bucks At Barnes and Nobel. The notes and sources be worth that for those that be interested in 17C/18C doings.
    It be a nice insight to the life of the wealthy, as added plus for those wish to know the life of the betters .
    A quote from a letter of Lady Mary to Papa “… the Small Pox—-so fatal and so general amongst us —-is here rendered harmless, by the invention of engrafting {which is the term the give it}. There is a set of old women who make it their business t perform the operation. Every autumn in the month of September, when the great heat is abated,……They make parties for this purpose, and when they are met…..the old woman comes with a nutshell full of the matter of the best sort of smallpox and asks what veins you please to have opened. ….”Page 73. dated April 1 1717 Adrianople Lady Mary [Mortley]
    was this another BBC Panorama story it being the day it be.

  • N Cumgranissalis on Sun 31 Jul 2005, 04:51am. Flag this

    The poxes, there be cow, small then there be the one that will be never mention in Polite Society -The Great Pox [syphalis]

  • N Cumgranissalis on Sun 7 Aug 2005, 05:19am. Flag this

    Where are you going my prety maid?
    I’m going a-milking, Sir she said
    whats’s your fortune my pretty maid?
    My face is my fortune Sir, she said. Anon
    A good read be ” The Armies of Pestilence ” by R.S. Bray

    Virus transmission by air droplets not by touch. It came in three strengths : Haemorihagic, Purpuric, and Confluent. Kill Rate 25% to 100 %
    then their be another version, alastrum [fast spreading] death rate only 1%;
    It was known, that once had, it never to be had again.
    Strangely, it was reckoned to less contageous than Chicken pox as the droplets had to be inbedded deeper into the brachea.

    There was a cure, not fully understood or practiced way back in China [early christian era] and elsewhere , it be called practice of variopation, or putting the scabs of small pox into the nostrils of those wish to have their skin unmarked, dosage be uneven so success be uneven.
    The beginnings of story of the virus be lost by the lack of documentaion, but there be some that claim Athens and Cathage had their differences resolved by an out break of the disease.The Disease had a reputation for changeing the course of many dynasties.

  • N Cumgranissalis on Sun 7 Aug 2005, 05:27am. Flag this

    The Great pox appeared in Europe after The Discovery of the West Indies. Small pox was known as killer long before the lower brain version.

  • N Cumgranissalis on Sun 7 Aug 2005, 09:19pm. Flag this

    ref 2 sep 61: be the pox that be the one that does not kill in days of it showing only to disappear, then erode the little gray cells then the demise. This be a virus by contact, selecting ones victim by attraction, not by sleeping or convorting , needs more than a friendly kiss or rubbing noses. ‘Tis why it be called the Great pox.
    “…how the pox is so common there,…”

  • N Horst Fassl on Fri 16 Mar 2007, 07:24am. Flag this

    Most probably it was not small-pox but syphilis, signs and symptoms are rather typical. Fassl

  • N cumsalisgrano on Tue 1 May 2007, 07:27pm. Flag this

    From Ruben
    Measles [ http://www.pepysdiary.com/p/7119.php ] versus smallpox not an easy diagnosis in Pepys time.
    A famous Poster published by Thomas Thacher in the colonies explains some. See:
    http://www.countway.harvard.edu/rarebooks/exhibits/gilt/gilt3.html

    From terry F:
    “[T]he first scientific description of the [measles] and its distinction from smallpox is attributed to the Persian physician Ibn Razi (Rhazes) 860-932 who published a book entitled “Smallpox and Measles” (in Arabic: Kitab fi al-jadari wa-al-hasbah).” http://en.wikipedia.org/wiki/Measles

  • N bitter o salt on Fri 17 Aug 2007, 03:22am. Flag this

    syphilis not a word in use as a medical problem in Egland until 1718?
    OED
    Also 8 siphylis, 9 siphilis, syphylis. [mod.L. syphilis (syphilid-), orig. the title (in full, Syphilis, sive Morbvs Gallicvs) of a poem, published 1530, by Girolamo Fracastoro or Hieronymus Fracastorius (1483-1553), a physician, astronomer, and poet of Verona, but used also as the name of the disease in the poem itself; the subject of the poem is the story of a shepherd Syphilus, the first sufferer from the disease, the name Syphilis being formed on the analogy of Æneis, Thebais, etc. (The poem was translated in 1686 by Nahum Tate with the title ‘Syphilis: or, a Poetical History of the French Disease’.) The term was employed systematically by Fracastoro in his treatise De Contagione II. xi. (1546). Cf. F. syphilis, It. sifilide, Sp. sifilis, Pg., G., etc. syphilis.
    The source of the name Syphilus is disputed; it has been suggested that it is a corrupt mediæval form of Sipylus, the name of a son of Niobe (so called after a mountain) in Ovid Metam. VI. 146 ff. (See F. Boll in Neue Jahrb. f.d. klass. Altertum, 1910, XXV. 72 ff., 168.)]

    A specific disease caused by Treponema pallidum (Spirochæte pallida) and communicated by sexual connexion or accidental contact (acquired form) or by infection of the child in utero (congenital form).
    Three stages of the disease are distinguished, primary, secondary, and tertiary syphilis; the first characterized by chancre in the part infected, the second by affections of the skin and mucous membranes, the third involving the bones, muscles, and brain.
    1718 J. F. NICHOLSON (title) The Modern Siphylis: or, the true method of curing every stage and symptom of the venereal disease, etc.

Post an annotation

Before posting an annotation please read the annotation guidelines.
If your comment isn't directly relevant to this page, try the discussion group for other Pepys-related topics or the social group for general chat.

(required)

(required)

(optional)


No HTML in annotations. URLs will be turned into links. About copyright

(required)

References in the diary

A graph of all the references in the diary

1660
Jan: 9, 11, 13
Dec: 20
1661
Aug: 12, 13
Sep: 2
1663
Dec: 31
1664
Mar: 15
Apr: 29
Aug: 15
Oct: 31
1665
Jan: 15
Mar: 17
Aug: 16
1667
Jan: 28
Jul: 13, 14
Sep: 6
Nov: 10, 12, 13
Dec: 6, 17
1668
Feb: 9
Mar: 26, 30
Aug: 18, 30
1669
Jan: 12