The War Against Smallpox

A history of the global spread of vaccination during the Napoleonic Wars, when millions of children were saved from smallpox.

"Like many viruses, smallpox is highly contagious. It's also dreadful, deadly, and thanks to microscopes and modern technology-now officially eradicated. This fascinating book explains how a concerted effort to produce a vaccine and distribute it around the world helped eliminate the deadly scourge by 1980"--

The astonishing, hitherto unknown truths about a disease that transformed the United States at its birth A horrifying epidemic of smallpox was sweeping across the Americas when the American Revolution began, and yet we know almost nothing about it. Elizabeth A. Fenn is the first historian to reveal how deeply variola affected the outcome of the war in every colony and the lives of everyone in North America. By 1776, when military action and political ferment increased the movement of people and microbes, the epidemic worsened. Fenn's remarkable research shows us how smallpox devastated the American troops at Québec and kept them at bay during the British occupation of Boston. Soon the disease affected the war in Virginia, where it ravaged slaves who had escaped to join the British forces. During the terrible winter at Valley Forge, General Washington had to decide if and when to attempt the risky inoculation of his troops. In 1779, while Creeks and Cherokees were dying in Georgia, smallpox broke out in Mexico City, whence it followed travelers going north, striking Santa Fe and outlying pueblos in January 1781. Simultaneously it moved up the Pacific coast and east across the plains as far as Hudson's Bay. The destructive, desolating power of smallpox made for a cascade of public-health crises and heartbreaking human drama. Fenn's innovative work shows how this mega-tragedy was met and what its consequences were for America.

“Bill Foege takes us inside the world's greatest public health triumph: the eradication of smallpox. It's a story of true determination, passion and courage. The story of smallpox should encourage all of us to continue the critical work of worldwide disease eradication.”--Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation “Bill Foege is one of the public health giants of our times. He was responsible for the design of the campaign that eradicated smallpox—the most important global health achievement in history and possibly the greatest feat in any field of international cooperation. His insights into the nature of this major event will undoubtedly help to meet the global health challenges of the 21st century.”—Julio Frenk, M.D, PhD, Dean, Harvard School of Public Health “The eradication of a disease has long been the holy grail of global health and Bill Foege found it: more than any other person, he was responsible for the eradication of smallpox from the face of the earth. This is a story told by a remarkably humble man, about the extraordinary coalition that he helped to build, and the most impressive global health accomplishment the world has ever seen.”—Mark Rosenberg, author of Real Collaboration: What It Takes for Global Health to Succeed “I am thrilled that Bill Foege, one of the great heroes of the smallpox eradication campaign, has written this important book. It tells a beautiful human story of an incredible public health triumph, and is full of lessons that could be applied to many of the global challenges we face today.”—Helene D. Gayle MD, President and CEO, CARE USA “Bill Foege’s House on Fire is the first-hand account of how a revised strategy to eradicate smallpox was tested, validated, and applied. Without the global adoption of this new surveillance strategy, the final deathblow to this longtime global menace might never have been dealt.”—Adetokunbo O. Lucas, MD, DSc, author of It Was The Best of Times: From Local to Global Health “Smallpox is the most devastating disease the world has known, as it destroyed lives and shaped history over the centuries. House on Fire provides a day-to-day account by my friend Dr. Bill Foege of the battle required to defeat this wily and diabolic virus."--President Jimmy Carter

The Supreme Court holds that the Crown has a duty of seeking reconciliation where its agents have not dealt honourably with an indigenous People. It is hard to see how there can be any true reconciliation in British Columbia where the Crown has not yet answered the teaching of knowledge keepers that Governor James Douglas prospectively reduced the cost of "Indian Wars" by executing an intentional mass killing using smallpox as a tool during 1862/63. This book explores the evidence in the written record concerning the smallpox epidemics of 1852/63. This exploration includes documenting the course of relations between Douglas and the Haida as the Haida and others resisted Douglas' first attempts to impose British rule on indigenous "nations" from 1860 to 1862. The oral tradition is that this resistance provided a motive for reducing the political power of the indigenous Peoples by reducing their number through spreading smallpox. The written record shows that the colonial community knowingly imported smallpox in 1862 and that the colonial authorities under Governor Douglas then violated British law by using each standard control measure as a means for spreading the disease. It also shows that, at each stage, these authorities concealed the criminality of their actions by supplying the public with misdirection. In addition, this book documents the role of Francis Poole as a foot soldier in advancing Douglas' smallpox policy among the Nuxalk, Tsilhqot'in and Haida. Among the Haida, Poole was employed by a company that served as a front for the colonization of Haida Gwaii, first by provoking the Haida into defending the integrity of their authority and then by introducing smallpox as an aid to displacing that authority.

The untold story of how America's Progressive-era war on smallpox sparked one of the great civil liberties battles of the twentieth century. At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century. At the dawn of the activist Progressive era and during a moment of great optimism about modern medicine, the government responded to the deadly epidemic by calling for universal compulsory vaccination. To enforce the law, public health authorities relied on quarantines, pesthouses, and "virus squads"-corps of doctors and club-wielding police. Though these measures eventually contained the disease, they also sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights. At the time, anti-vaccinationists were often dismissed as misguided cranks, but Willrich argues that they belonged to a wider legacy of American dissent that attended the rise of an increasingly powerful government. While a well-organized anti-vaccination movement sprang up during these years, many Americans resisted in subtler ways-by concealing sick family members or forging immunization certificates. Pox introduces us to memorable characters on both sides of the debate, from Henning Jacobson, a Swedish Lutheran minister whose battle against vaccination went all the way to the Supreme Court, to C. P. Wertenbaker, a federal surgeon who saw himself as a medical missionary combating a deadly-and preventable-disease. As Willrich suggests, many of the questions first raised by the Progressive-era antivaccination movement are still with us: How far should the government go to protect us from peril? What happens when the interests of public health collide with religious beliefs and personal conscience? In Pox, Willrich delivers a riveting tale about the clash of modern medicine, civil liberties, and government power at the turn of the last century that resonates powerfully today.

By the mid-twentieth century, smallpox had vanished from North America and Europe but continued to persist throughout Africa, Asia, and South America. In 1965, the United States joined an international effort to eradicate the disease, and after fifteen years of steady progress, the effort succeeded. Bob H. Reinhardt demonstrates that the fight against smallpox drew American liberals into new and complex relationships in the global Cold War, as he narrates the history of the only cooperative international effort to successfully eliminate a human disease. Unlike other works that have chronicled the fight against smallpox by offering a "biography" of the disease or employing a triumphalist narrative of a public health victory, The End of a Global Pox examines the eradication program as a complex exercise of American power. Reinhardt draws on methods from environmental, medical, and political history to interpret the global eradication effort as an extension of U.S. technological, medical, and political power. This book demonstrates the far-reaching manifestations of American liberalism and Cold War ideology and sheds new light on the history of global public health and development.

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