This episode is brought to you by American, Express let's go shop small. I pelusium things off of my plate this summer to make more free time so that I can rediscover my own neighborhood from shouting to that amazing type place around the corner, to a quick update to my look at the family owned salon. That is right up the street, where I discovered that my stylist shares my love of deep sea fishing connecting with small businesses close to gives me not just a great meal or one of the best haircuts I've ever had. It gives me a sense of community shop small this weekend and all summer long, let's go shop. Small with annex in old full of smart devices. Isn't it about time your printer about smart, too, now print is smart with HP plus and the aid p, smart app is how it all happens. You can print your phone with just a tat? No matter where you are even from

Your garage, slash home office, Slash yoga studio, then he's smart hp, plus more about smart printing at HP, dotcom, slash, smart enough, full of smart devices. Isn't it about time your printer about smart, too? Now print is smart with HP plus and the p smart app is how it all happens. You can print your phone with just a tat, no matter where you are even from your garage, slash home office, Slash yoga studio, then he's smart HP plus more about smart printing at HP, dotcom, slash, smart welcome to stuff you, Minister three glass, a production of Iheart Radio hello and welcome the pod cast Tracy bewilderment and I'm home.

Fry in late March of last year. I researched and wrote, are episode on the eradication of render pass because in that moment it just felt really weird to me to work on episodes that were not about the pandemic somehow, because I was dominating everything in a car wives, but at the same time I wanted to work on something that felt kind of optimistic because the pandemic was dominating our lives. So now it's almost too here and a half later here in the U S, we had a pretty hopeful spring time regarding the progress of the pandemic. I know that was not the case in the whole world, but we had what was looking like improve situations that obviously has taken a turn once again for the worst north, at least

worse, maybe not the worst of ever, but definitely worth. I wanted to go to return to the idea of wiping disease off the face of the earth. So render pest of smallpox with only two diseases that have been eradicated through human activity. Neither one of them is technically extinct because there are some samples of both viruses that still exist in labs there no longer circulating out in the wild, though, and we ve talked about smallpox a bit on the show before we had our episode on Edward Jenner and the smallpox vaccine and how the vaccine was developed and than generous efforts to try to make it. More widely available. More recently, we did that episode, the royal philanthropic vaccine expedition, and that was all about Spain's efforts to transport the smallpox vaccine to the Americas, which required a chain

living human hosts. We merchants pretty briefly the eradication of smallpox and both of those episodes, but we have not gone into detail about how that happened. That's what we're gonna talk about today and when Tracy mentioned it to me, I say we ve covered by no coming up for just keeps coming up. We ve set him like a sentence how it was done, but it's more than a sentence worth of explanation. Maria do insist: it's been just peppered him enough that brain was like get up with. That was an episode right now. You know so smallpox is well disease that has existed for millennia when it was regulating in the wild. It spread from person to person through the air usually through face to face contact, and it can also be spread through contact with contaminated objects and services. People who contracted smallpox

typically developed a high fever and body aches, and that was followed by a distinctive rash. There are two different story: the aims of the very Ola virus that were causing smallpox burial a major and burial, a minor that name Jests Burial, a major caused, more serious illnesses as many as a third of people who were infected with very all a major died as many as ninety percent of babies died. It was also particularly lethal any time it was introduced somewhere that it hadn't existed, for such as when European started arriving in the Americas and in those cases smallpox usually killed about half the people who contracted it? Among the people who survived the disease, smallpox could also be both billing and disfiguring. There was and is no cure for smallpox, so even s, Hence in medicine progressed it continued to be deadly

but it also had some trades that made it a good candidate for a worldwide eradication campaign. Smallpox was easy to read. Nice and diagnose. Unlike say, the flu skin resemble a lot of other respiratory infections smallpox pass directly from person to person and only infected human, so there were no hidden reservoirs of the virus that could potentially start a new outbreak. That's different from something like yellow fever, which also infects other primates and is transmitted by Mosquitos another plus, once a person had recovered from smallpox, they were immune for life. For a number of reasons, smallpox outbreaks also tended to develop relatively slowly. Once people were contagious, they were usually also too sick to really leave home. So outbreaks tended to cluster around members of the same household and their immediate neighbourhood, and then once an outbreak was identified, swift action could keep it from spreading. Very

are and, most importantly, there was a way to disrupt transmission of the disease. In this case a vaccine in terms of the smallpox vaccine, at first people prevented smallpox using a technique called deregulation that involved in essentially introducing material from one person smallpox sore or scab into another person. Commissioners in Asia we're doing this as early as the eleventh century and the technique spread from their then. In the late eighteenth century, people started to make a connection between some parks and another much milder disease. That was called cow pox, the smallpox and cow pox. Viruses are both in the genus orthodox virus, and people who had contracted cow box seemed immune to

more box, several people, including Edward Jenner, tried deliberately exposing people to cow pox as a way to prevent Smallpox Jenner, Cuba's vaccination after the latin word for cow, so both very elation and vaccination could prevent smallpox, but since very elation could also cause full blown smallpox vaccine she was a lot safer. At the same time, though, vaccination in its earliest forms carried some of the same risks that violation did including the potential for transmitting other illnesses like syphilis and hepatitis from person to person during these persons and vaccination. James sometime in the nineteenth century, people shifted from using cow pox to using vexed the virus, which is another orthodox virus, to make smallpox vaccine

the origins of the vaccine virus are unclear. It is possible that it's actually some kind of hybrid of cow box and smallpox or that it develop, over time. As cow Pox virus was passed through multiple hosts in the process of making vaccines event leave ex ante a virus replaced cow pox virus for vaccination purposes, just as vaccination with cow pox had previously replaced variation with smallpox itself. I first vaccines made with Ex Ante a virus were grown in the skin of live animals like calves, sheep and rabbits, eventually that shifted to growing the virus in tissue cultures or in chicken eggs. These methods replaced those arm to arm back the nation James that we talked about an hour episode on the royal philanthropic vaccine exe

Asian countries actually started to outlaw arm to arm vaccinations in the late nineteenth century. Many of the vaccine strains used to make vaccines were attenuated or weakened by repeatedly passing through a non human host. Things like pick embryo cells, eggs or mice, this process result in a virus that produced an immune response when a person was vaccinated with it, but couldn't reproduce in that person's body and make them sick. So, while vaccination with count virus, with safer than violation with smallpox virus vaccination with an attenuated version, a vaccine virus was also safer than vaccination with live on attenuated cow pox. There were still potentials for various complications, but this was an improvement overall. It really didn't take long after the development of that

themes for people to wonder whether vaccines could be used to eliminate smallpox entirely? But early attempts to do this based a lad of obstacles? As we talked about an hour episode on the rail philanthropic vat seen expedition, early versions of smallpox, vaccine lost their potency really quickly, especially in hot weather, and that continued to be true after Vaccinium replaced cow parks as the preferred virus for smallpox vaccines, but then in the nineteen forties, people started working on dehydrated and freeze dried versions of the vaccine. The vaccine institute in Paris produced a freeze, dried vacuum pact, vaccine that had a longer shelf life nineteen fifties. Leslie Harold Collyer at the Lister Institute study the preservation methods they were in use and how effective they were, and he developed a process that didn't require refrigeration, even in tropical temperatures.

Once the vaccine was reconstituted, it still had a short shelf life, but until that point it can survive in the field for months it also protected people from smallpox. Infection for at least ten years and offered protection against dying of smallpox for Time after that, collars method eventually became the World Health Organization standard for vaccine used for the eradication campaign smallpox.

Eliminated in North America, in nineteen fifty two and in Europe in nineteen fifty three, and that was done primarily through mass vaccination campaigns, especially ones that were done in response to outbreaks, and this success came in spite of increasing resistance to vaccines into compulsory vaccine programmes and the United States. This resistance led to a Supreme Court case in nineteen o five. The city of Cambridge Massachusetts had been trying to stop a smallpox outbreak and had ordered all adults to be vaccinated or to pay a five dollar fine heading a Yak Ibsen refused to be vaccinated and then being fine. He took the matter to court in the words of the court's decision quote. The liberty secured by the constitution of the United States does not import an absolute right in each person to be at all times and in all circumstances, wholly freed from restraint

Nor is it an element in such liberty that one person or a minority of persons residing in any case unity and enjoying the benefits of local government should have power to do Many, the majority, when supported in their action by the authority of the state. It is within the police our of a state to enact a compulsory vaccination law, and it is for the ledge Fletcher and not for the courts to determine, in the first instance whether vaccination is or is not the best mood for the prevention of Smallpox and the protection of the public health or get some more I'm a campaign to eradicate smallpox in the rest of the world and after a sponsor break hi, I'm home Safety, Morgan, inviting you to listen to equal to a new podcast about achieving, disability equality with the Paralympic. Aims happening in Tokyo. We're asking: why should they Dorothy, go next with my

producers in aid, but will explore big themes, like legislation, rhetoric patient access, unemployment. Will seek out big solutions and rethink was possible along the way, will speak to athletes, activists and allies from around The exciting thing is we Don T yet know whether story will take us, but with gas like Committee, in Geneva, Gmail Conversation is going to be compelling so come along with us. Maybe like me, your disabled, maybe you're not either way. This story is for you, two is brought to bear by the Emmy Award winning team that created rising Phoenix the film about the Paralympic Games and made possible by the support of procuring gambled, listen to equal to that equal tee. Part of seneca conversations on the eye.

Radio, apple plot costs or wherever you get. Your portcullises transcripts will be available. This episode of stuff, you missed in history classes, brought to you by Quisling whether you plan or cram quisling helps. You find your study jam, whatever your studies, style, quisling, plastics, the guesswork out of her coursework with personalized study path that adapt to your goals and saving time, as well as custom sets to suit your study style. Quivered plus will get you ready to conquer your next test by mastering any subject. One step at a time, quisling plus now feature step by step explanations to help you own your toughest classes. Quisling explanations has millions of textbooks, solutions, written and double checked by experts quiz. Let explanations help you learn how to complete tough problems that some subjects like Maths, science

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is there it's in you, it's in all of us that strength, but sometimes we just need a little push. Listen the moment that pain starts. You have two choices, you can let it stop or you can take it on Anville targets, the source of your pain, to help you feel so for unbeatable relief. Look for Abbeville at your nearest local retailer pain says you can't Anville says you can World Health Organization's decision making body is called the World Health Assembly and in nineteen fifty three, the W h h, didn't consider smallpox to be a candidate for global eradication. It just wasn't a priority, but five years later, a delegate

to the W h, I proposed a ten year eradication plan. That delegate was professor. Victor is down off, who was deputy health minister of the Soviet Union, and this proposal included vaccine, though nations that would be provided by the USSR, but even with the promise of donated vaccines. This proposal still didn't pass by the time the World Health Organization was working on an anti malaria. Graham, and that was really just drawing most of the focus in nineteen fifty nine. The Soviet Union's proposal was reintroduced, and this time it was passed as a voluntary global vaccine campaign. Countries where smallpox was endemic that is freely circulating, were asked to institute mass vaccine programmes with the goal of vaccinating. Eighty percent

their populations and the countries where it was in which were generally richer were asked to contribute funding or vaccines toward the efforts. At that point, smallpox was being reported in sixty three countries and together those countries reported seventy seven thousand five hundred fifty five cases of the disease, but it became obvious really fast that that number was way way too low. For one thing, those sixty three countries only included the ones that were members of the World Health Organization and some countries where smallpox was endemic were not members at that point, and that is looted China, which had a population of more than six hundred and sixty million people, but even in those sixty three countries, reporting was all over the place in countries without a lot of public health infrastructure, smaller cases. What would we being tracked, but even in this is where that wasn't the case. Sometimes the only smallpox infections being reported were the ones that ended up in hospital.

In reality the countries are smallpox, was still endemic in nineteen. Fifty nine were home to more than half the world's population and Total number of annual cases was probably more like fifty million, not seventy, seven thousand this voluntary. Programme was focused on national vaccine campaigns. Men at least in theory. Each nation's campaign would be tailored for its own. Culture needs resources and infrastructure, but that also met. There was really no central strategy at work. The World Health organization's role was mostly just making sure that there was enough vaccine available and providing assistance. If nations asked for it, it was a really coordinating. Efforts are doing a lot of tracking and monitoring and because, under reporting of cases, continued to be a huge problem, it was almost impossible to tell whether

national programmes or even working that made it much harder to secure funding or to rally support from nations that had already eradicated smallpox within their own borders and for the most are these early? National campaigns were not working, at least not very well. In many places Ass was measured by how many vaccines were administered. Sometimes this led back made to go after the easiest targets. First leg: vaccinating all the students at a school but that meant that children in more outlying areas who were not attending school were not being vaccinated. Since then, often weren't clear records. It wasn't unheard of four vaccinated to go back to the same school and vaccinate children again. Even though a successful smallpox vaccine we left a recognisable scar because of issues like this At one point, India was reporting a vaccination rate of a hundred and four percent, because so many people were

vaccinated more than once, things moved pretty slowly with all this for about five years, but then in nineteen sixty four doktor corral Russia of Czechoslovakia, who was a huge advocate of smallpox eradication, became director of the division of communicable diseases at the World Health Organization and nineteen sixty five, the World Health Organization a stable. A dedicated smallpox eradication unit and that same year President Lyndon Johnson announced that the United States would start supporting the global smallpox eradication programme. Soon the: U S was supporting the work of the PAN American Health Organization and South America, and also funding major vaccine efforts in western and central Africa. Busy We also saw improvements in house smallpox. Vaccines were administered most vaccines, that people received they are administered as shots, they go into the muscle or the subcutaneous skill,

you're, using a needle but smallpox vaccine. Goes into the skins superficial layers by the mid nineteen sixty there were a few different methods for doing this. One was this: Rach, a person skin with a needle or lancet in another was to repeatedly press the Tipp of the needle into a person skin. Neither of these methods, with very precise, depending on how skilled the vaccinate her wise, they might press the needle too far into the scan, are not far enough. The amount of vaccine on the needle mutually dependent on things like how deeply it had been inserted into the vaccine. Vile excess vaccine was often left behind on persons skin and left her either dry there or be wiped away kind of wasteful. It's so fascinating to me to think about this when I think most of the vaccine, received or like those pre, measured very carefully like you open the dose and that sets yeah so the

margin for error of it is a little bit mind. Boggling yeah and there are four share vaccines that are not administered with shots at this point, but the shots, at least here in the: U S are the majority of them the standard jet injector devices were made to try to address some of this and to make vaccinating more efficient. In theory, these could vaccinate one thousand people and our, but in practice they were limited, some required electricity to work and others were operated with a foot pedal

that was clunky. So these were only really practical in places where you could bring huge groups of people to one location to be vaccinated. Plus these devices were expensive and they were hard to clean and they were prone to breaking down a bet: Ben Doktor, Benjamin, a Reuben developed the by four created needle, which was patented in July of nineteen sixty five. This was a simple needle and when it was inserted into a vaccine vile, it picked up one measure dose of liquid in between the two prongs. The prongs themselves were designed to keep the needle at the correct angle and death with a person's skin and the two pronged structure. Meant that it needed fewer presses into the skin. To administer each vaccine thus made everything way more efficient, one vile. A vaccine can be used to vaccinate four times as much

people and people could be trained to administer the vaccine with the vibrated needle and about fifteen minutes, even if they had no previous medical experience, plus the bifocals needle were cheap to produce, although they were originally intended to be disposable at the World Health Organization's request, they were made from a steel outweigh they can hold up to boiling or flaming they could be sterilised in re used over and over before they started to dull boiling containers were designed so that vaccinated could drop use needles into the container as they and and boil the whole thing at the end of a shift. Also, it was standard practice to clean a person's arm with paths that we're soaked in alcohol or soap before giving them the vaccine. I know every time I've gotten ashore Here is a pathetic little alcohol white down on the injection site, but studies had suggested that this wasn't actually work,

moving bacteria or other contaminants. It was just sort of moving things. Around studies confirms that the number of complications and secondary infections after smallpox, vaccination was the same regardless of whether the vaccine fight was wiped down beforehand or not so most vaccination programs, especially in like more impoverished areas, dropped this step and together. All of this brought the cost for smallpox. Vaccination down to about zero dollars and ten cents a person by one thousand nine hundred and sixty six smallpox was endemic in thirty one countries that was down from the sixty three or more reported back in nineteen. Fifty nine, the number of estimated worldwide cases had dropped from about fifty million to somewhere between ten and fifteen million. Although the officially reported tally was still much lower somewhere between one point, five and two million people were still dying of smallpox,

This was better, obviously, but it was also clear that a voluntary vaccination program wasn't going to be enough to eradicate smallpox. So the World Health Assembly back to proposal for an intensified smallpox eradication program which would start on January. First, one thousand nine hundred and sixty seven. Its goal was to eradicate smallpox worldwide within ten years, with the last naturally occurring case being found in isolated by December 31st. One thousand nine hundred and seventy six. The intensified program was given an initial budget of two point: five million dollars- and this was more money than before, but there's thirty one countries for smallpox was still endemic also,

neighbours that needed to be protected from introduced cases. So this only worked out too about fifty thousand dollars per country. Donald, a Henderson who was chief of the centres for Disease Control, smallpox eradication programme was made chief medical officer of the intensified eradication programme and, in his account this. Near goal was pretty arbitrary. It had been inspired by John F Kennedy declaration that the? U S could land a man on the moon within ten years. He also disk the World Health Organization as pessimistic about the chances of success w each director general doktor marketing candle was from Brazil and thought smallpox eradication would be in possible just in the Amazon Basin, much less anywhere else, according Henderson. The World Health organization wanted an American to head the programme so that, if it failed the, U S would shoulder some of the blame, rather than all of it. Falling on the double

Rachel. I read or write up Henderson Route briefly about this. This campaign- and he had sort of spelled out how it sort of seemed like things, were happening almost on a whim and he was like I'm. I'm writing this to disabuse you of the notion that there may have been extensive planning involved in the out. We will get to how this intensified programme, even though it still seemed a little haphazard how it successfully eradicated smallpox. After Another quick sponsor break. This episode is brought you buy, audible, plus from audible dot. Com. Audible plus gives you full access to the popular plus catalogue. That means you can listen to thousands and thousands of audio books, original entertainment and podcast, including an free versions of your favorite, shows an exclusive series and if you need guided fitness-

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on social media. To find your creative community when the World Health Organization established the intensified smallpox eradication program. Smallpox was still endemic in multiple countries in Asia, South America and Sub Saharan Africa, and especially at first a lot of the financial support and a lot of the vaccines for the program were coming from. Wealthier nations were smallpox had already been eradicated. Nations, like the you states and for these countries their motive was not just humanitarian. There was also a lot of money, and politics involves, for example, if smallpox was eradicated worldwide, these nations would not mean to fund vaccination programmes and other

countries or spend money vaccinating their own populations anymore for wealthier countries. These smallpox vaccination programmes also served as opportunities to vaccinate people for other diseases and to try to build political influence and good will in the places where the programmes were operating. Also countries where smallpox had been eradicated, still occasionally faced outbreaks that were usually introduced through travel, although the tended to be very small and quickly contained. They were still disruptive an expensive and sometimes sparked a public panic.

Global smallpox eradication would mean not having to deal with any of that any more than there is a lot of self interest involved in the wealthier nations he gave money and vaccine and other support to this whole programme. Although each nation still needed a plan that was customize to its own needs, there also needed to be a better unifying strategy behind this whole programme, something beyond a target of vaccinating. Eighty percent of the population That number I feel like keeps getting repeated today is like the standard for what is needed, but it has not really been based on epidemiology or on public health data. It had just seemed like a reasonable operational goal for the Voluntary programme, and it has also become clear

but the number of vaccines administered did not really work as the goal. Since teams might wind up vaccinating the same people more than once deriving up their vaccination numbers without actually vaccinating more of the population. One big gap that needed to be filled with this was surveillance. Reporting methods were still all over the place and eradication was only possible if health officials, surely knew when and where outbreaks were happening. This was something that just wired a ton of communication from the World Health Organization and all three every level of a nation's governments, all the way down the individual doctors, hospitals and community leaders who needed to report any suspected cases in order for this to work, another gap was standards for the vaccine, itself, the Soviet Union and the United States, where the two biggest donors of vaccines with the Eu

that's our donating. A hundred and forty million doses a year and the United States donating forty million doses other countries donated as well, but in smaller amounts in nineteen sixty seven, the World Health Organization asked vaccine manufacturers to submit samples of their smallpox vaccine, and only thirty percent of them met W H our standards for quality and potency some other submitted vaccine samples did not contain any vaccine virus at all. Others were contaminated, bacteria. This led to the W H, YO, establishing more stringent standards for the vaccines and then monitoring them to make sure the vaccines actually met those standards, as all of was happening. Of course, wars and other unwrast were making vaccination programmes difficult in some places where smallpox was still circulating the Nigeria,

civil war began in nineteen sixty seven, which made things more dangerous for health workers and their patience, and it also lead vaccines shortage, but this short also lead to a shift in how smallpox vaccinations were prioritized, since there wasn't enough vaccine available for the whole population, health officials focused on vaccinating family members and other close contacts of anyone who developed smallpox. This turned out to be an effective way to stop the spread of the Disease and Nigeria's last smallpox case was reported in May of nineteen. Seventy, the focus on monitoring and reporting cases that was so necessary for the programme. Success also made it easier to see tat,

and in how and where smallpox outbreaks developed vaccinated, started taking better advantage of seasonal variations. They would use all that surveillance work, to trace people's contacts and to vaccinate more people at the start of the season when the smallpox case numbers were lower to contain those outbreak. Before they spread by nineteen. Seventy three smallpox existed in only five countries- Bangladesh, India, Nepal, Pakistan in Ethiopia, Bangladesh previously been free of the disease, but it had been reintroduced there as refugees fled the Indo Pakistani WAR and by this point, Eighty per cent of the vaccines being used for this effort were being made in the countries where they were being administered and at least ninety five. Percent of vaccines that the World Health organization tested met its standards having only five km freeze remaining was obviously a huge accomplishment, but at the same time, more

seven hundred million people lived in Bangladesh, India, Pakistan and Nepal. They were all neighbouring countries and it has come really obvious that a mass vaccination programme just wasn't going to be able to eradicate the disease in this region. He's. The neighbouring nations had been trying to vaccinate their whole populations for years there were a hundred and twenty thousand health staff working on the programme and India alone So the strategy shifted to mirror what had actually worked in Nigeria in the late nineteenth sixties, health officials, nineteen to anyone who contracted smallpox and used extensive contact tracing too. Turban, who else might have been exposed they vaccinated there media families and the surrounding communities. This big

known as the ring method, basically making a ring of vaccinated people around each active smallpox case, so that the disease just could not spread. Monitoring and surveillance were critically important to this process. Since health workers could only make a vaccinated ring around cases of smallpox that they knew about, so health workers travelled from place to place, educating local doctors, healers leaders and officials about smallpox, reporting and seeking out and isolating active smallpox cases and then vaccinating any one who may have come into contact with these patients. Using this method, Pakistan saw its lead ass reported case of smallpox in October of nineteen. Seventy four nepal in April of nineteen, seventy five india in May of nineteen, seventy five and Bangladesh in October of nineteen. Seventy five

Fortunately, although Ethiopia's last case of smallpox was reported in August of nineteen, seventy six by that point it had been, reintroduced into neighbouring Somalia, which was still experiencing active cases in ninety seventy seven Donald Henderson resigned as the head of the intensified eradication programme here replaced by a sour Rita who had been medical officer of infectious disease control in the Ministry of Health and well in Japan before joining the World Health organization that same year, nineteen, seventy seven authority has started to to contain an outbreak of various LE minor among nomadic peoples in the desert region that spans parts of Ethiopia, Somalia in Kenya, smallpox was reintroduced into Kenya, but that introduction was quickly contained and Kenya report at its last case and February of nineteen. Seventy seven Angela

I of nineteen, seventy seven, Somalia and Ethiopia whence a war over control of part of this region and then that hampered efforts to control this ongoing outbreak in Somalia, Somalia actually reported three hundred cases of smallpox and nineteen. Seventy seven, the last one was the case of Alima O Marleen, who was a cook it Mark Hospital on October, twelve nineteen, seven. Seven a driver carrying two smallpox patients to an isolation camp stopped at the hospital to ask for directions. Marleen got into the car and rode with them for fifteen minutes or less. He did that, so he good Guy them to wear the leader of the smallpox surveillance team, lived these two pages. Were siblings, six and one years old and when authorities trace their cause, Tax Marleen was overlooked or

Molly worked in a hospital he wasn't vaccinated against smallpox. In an interview later in his life, he said that he had been afraid of the vaccine. There are a couple of accounts that said that he had been vaccinated, but his vaccine hadn't taken, and that disagrees with the interview that he gave later. These started feeling sick on October, twenty second nineteenth, Seventy seven and at first doctors thought he had malaria. Then he developed a rash on October, twenty sixth and he was initially diagnosed with chicken pox. He started to worry that he had smallpox on October. Twenty ninth end on October thirtieth. Somebody reported to health officials that he had a potential smallpox case. His diagnosis, was confirmed through lab test that day, the effort to prevent Mullins Smallpox case from sparking another outbreak, really demons it's what was involved in all of this contact tracing identified. One hundred sixty one possible exposures, some of them as food

is a hundred and twenty kilometers away. This included hospital staff, family and friends. Many had visited him while he was ill authorities identified thirty three face to face contacts who had no evidence of prior smallpox infection and had not been vaccinated within the pass through years and twelve of those had no prior evidence of smallpox infection or wreck seen all all those people were vaccinated along, with all known and possible contacts and their families. During an eighteen days, surveillance period, health workers made multiple in person visits to each person who had potentially been exposed. The number and frequency of theirs visits depended on the person's relative level of exposure and their risks. If they had been around him a long time and were not vaccinated, they got multiple different visits from

the health staff, but if they had been vaccinated and it was a shorter time they might get to check seconds in the end, though, none of those hundred and sixty one contacts develop smallpox, but it did not stop with those hundred and sixty one contacts. The warning signs were posted. It murky hospital. Which was placed under twenty four hour, guard vaccines or administered everyone who worked at the hospital and all of the patience, patience in the surgical ward were quarantined until November thirteenth and in the medical word they were quarantined until November. Seventeenth The hospital also suspended all non emergency care referred: outpatient procedures, other facilities and required daily temperature checks for patients and staff. It was also a mass vaccination campaign and the word of the city where Moline lived at the hospital was this

a multi faith process with vaccinated going house to house to vaccinate everyone and to look for any signs of smallpox cases and then returning to vaccinate anybody who had arrived since the last pass or whose first vaccines showed no evidence of a vaccine scar once that ward of the city was done, health workers did the same for the rest of the city. Check points were established at all the roads and foot path leading into marker, and anyone who was coming and going was advised this possible outbreak. They back they did everybody who was passing through and that, on top of all of that, there was a massive public information campaign with a reward for reporting smallpox cases. In Alima O Moline was the last person to contract naturally occurring smallpox. That was. Ten years, nine months and twenty six days after the start of the intensified eradication campaign

so it just barely miss that ten year goal, even if it had been arbitrator after recovering from smallpox, Marleen later became part of the effort to eradicate polio, working as a vaccinated and organizing thwarted or campaigns. He would share his own story about how he had been afraid to be vaccinated for smallpox and then had ultimately become the law. Asked smallpox patient Somalia was declared free of polio in two thousand seven, but it reemerged therein. Twenty thirteen, when that happened, Moline went back to his vaccinating work. He suddenly became will not long afterward and he died on July twenty. Second, twenty thirteen of what was diagnosed as malaria, but the last person to die of smallpox contracted it after Moline did that was JANET Parker, a medical photographer who is infected on the job at England's Birmingham, University medical School

in nineteen seventy aim. The microbiology lab was one floor below her dark room in the office. That she's, who make phone calls. It is not clear, Here exactly how she came into contact with smallpox virus from the lab at the time, the pros doing theory was that it was through a shared air vent, but later study suggested that battle actually unlikely Parker had been vaccinated for smallpox

but every mentioned earlier, the vaccines protection was expected to last for about ten years and she had been vaccinated back and nineteen sixty six. The strain she was exposed to was also a particularly deadly one. Her mother, Hilda Whitcomb contracted smallpox, while caring for her, but she recovered, but JANET's father, Frederick died of an apparent heart attack, while in quarantine held a mist both his and JANET's funerals because of her own illness. Health workers quarantined hundreds of people who had possibly been exposed and it these two five hundred people were vaccinated to keep this outbreak from spreading any further. This lab had been scheduled to close, as the World Health organization tried to reduce the number of facilities that had samples of the virus. Although the law

had previously been inspected and was allowed to continue operation. It didn't have a lot of basic safety measures in place to contain deadly pathogens. Things like changing nobody's, dedicated showers and air locks. It also had been the source of another smallpox case, also involving a medical photographer back in nineteen. Sixty six really seems like when they inspected the lab and they were like it doesn't have all these things that we recommend to control potential spread of pathogens, but like only three people work here, so it's probably fine. I just became a huge scandal. Later the lab's director, Dr Henry Bedson, had been trying to finish as much of his work as possible before the lab was closed. He blames himself for Parker's illness and took his own life a few days before her death, which is on September 11th, one thousand nine hundred and seventy eight

happening health officials were still closely monitoring other countries to confirm that smallpox was no longer circulating there. On October, twenty six nineteen, seventy nine ceremony was held in Nairobi to announce that smallpox had been eradicated in the Horn of Africa. That was to you after Alima Almah Lean had first developed smallpox rash on a summer night, Nineteen, seventy nine, the global Commission for the certification of smallpox eradication declared smallpox eradicate and I made a nineteen eighty, the World Health Organization confirmed the disease eradication. There's been

stuff floating around social media lately about how this was only possible because everyone did their part either implying or just flat out saying that everybody accepted the vaccine during this process. That is just not true. There was a lot of resistance and hesitancy, especially in campaigns to vaccinate children. A lot appearance just didn't want to do something that might hurt their child or make I'm sick, a process of administering the vaccine also evolved over the years, and some parents had had like pretty traumatic vaccine experiences that they didn't want repeated with their child anti vaccine activists such as Lily load, who worked for the National Anti Vaccination League and edited its journal, distributed. Literature against vaccines in general and against the smallpox vaccine specifically

El into this eradication effort aside from man, because earlier versions of the smallpox vaccine were grown in the skin of live animals, animal rights ACT mists and anti vivisection is objected to their use when methods progressed to using tissue cultures, Mistrust of science led people to objected this method as well. In places like India, smallpox vaccination had been a routine part of the public health service since one thousand nine hundred and forty seven, and yet there were still outbreaks for decades after that has led people to claim that the vaccine was worthless or even that it was what had been causing the smallpox She stopped vaccinating people for smallpox once the disease had been eradicated from within their borders and in some people this just reinforced that perception like there were no vote, seems happening any more. That must be why there's no small box happening anymore. There.

Also religious objections to smallpox vaccinations various peoples and cultures interpreted smallpox as coming. From divine will or interpreted existing methods of smallpox prevention or treatment as religiously significant and most of the last nations to eradicate smallpox were the same ones that had a long history being colonized unexploited by european powers, so people were understandably suspicious of this. Largely western led public health effort, so the global

revocation of smallpox happened in spite of hesitancy and resistance, not in the absence of it, so that its how smallpox was finally eradicated. It does filling was the couple labs there ve been ongoing conversations about destroying those remaining stocks and it keeps getting postpones. I would really like it if we, as the global society, could get control of the Cove nineteen pandemic, because unless the Carter better programme successfully and eradicate guinea worm disease in the immediate future, we don't have any more eradication of diseases of around the show. When I meet an optimistic story related to all this, pray. Were there will be a great to report as a history in the making, but

his fingers crossed. Do you have some listener mail for ass? I do have listener male business from Alex and Alex wrote after our deportation of the occasions episode and Alex Throat, high Tracy and Holly. How surprised I was I opened my podcast player yesterday and found finally an episode on the akkadian deportation. I am nearly broke my rule of listening episodes. In order, as I was a few episodes behind, I am a long time listener and have suggested myself an episode, I'm subject a few years back. I do not know if it was on purpose or a lucky coincidence, but the release of the episode coincides with national akkadian day, which is August fifteenth on this day occasions from communities in the maritime provinces and Cabuc celebrate akkadian culture. This event is usually marked by a tenth mar where people walk in the street. At her,

and six p m and start making noise by banging on pots and pans in a way to remind the rest of the world of our ongoing presence and resilience. Today, New Brunswick is about forty percent francophone, mostly of akkadian heritage. New Brunswick is still the only officially bilingual province in Canada, both English and french speaking communities coexist harmoniously. Although some friction, occasionally flares up with them in the political arena. Blaming the bilingual status of the province is a reason to explain the economic problems of the province outside the maritime cabuc is probably the region with the most akkadian descent, with, as researchers proved over the year

over a million of the seven million inhabitants are advocating descent and the United States many occasions what assimilate into american culture, with most of them angle sizing their name. For example, some little blocks became whites and so on. Alex ends with a personal note about family genealogy and an akkadian descent so, Thank you. So much Alex a couple of people wrote in about two things: one about New Brunswick being the only officially bilingual canadian province and a couple of people wrote an about August, fifteenth being national akkadian day. That was a hundred percent. Coincidentally, not even coincidental it like there. It was actually told this episode was originally gonna, come out a little bit later, but we had a very, very last minute schedules. Witchery

this is the only recently akkadian episode actually came out before August. Fifty was that of afterwards, so happy coincidence, as happened in our calendar. Sometimes now is one of them, so thanks so much Alex for sending this email. If you would like to email asked about this or any other podcast, where history podcast, that I heard radio dot com were all over social media miss than history, that's real find our face. Twitter, pinterest and instagram- and you can subscribe to our show her radio happen anywhere else, you like to get your pod tasks. Thank you, Mr District Class. The production by heart radio for more broadcasts for my heart rate, either by her radio have added mankind's or wherever you listen to your favorite chose. This episode is brought

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