Smallpox

Smallpox. Smallpox, a highly contagious, often fatal viral disease marked by high fever and skin eruptions that leave survivors severely disfigured, was one of the most deadly diseases that Europeans unwittingly brought to the Americas. Native Americans, lacking both immunity and experience with its ravages, succumbed quickly when it swept through Mexico and Central America in the 1520s. The first pandemic established a pattern of devastation that persisted into the twentieth century. From New England to the Pacific, smallpox routinely killed at least 30 percent of the Native Americans exposed to it. Epidemics wiped out villages, uprooted tribes, and undermined resistance to European territorial incursions. In the 1760s, during Pontiac's Rebellion, the British military commander in America, Sir Jeffrey Amherst, advocated efforts to deliberately spread smallpox among the Indians.

Smallpox epidemics also severely affected English colonists in the eighteenth century, forcing them to develop rules of notification, isolation, and quarantine—the first systems of organized public‐health law in America. Colonists also sought to minimize the virulence of smallpox through the practice of inoculation, a method of inducing mild smallpox that usually left patients alive, unscathed, and immune to further attacks. In 1721, the minister Cotton Mather and the physician Zabdiel Boylston (1679–1766) introduced inoculation in Boston, but controversy greeted their experiment. Townspeople reasonably feared that uncontrolled inoculation could start epidemics. Further refining their health regulations, most towns allowed inoculation only after an epidemic was already under way. By the late eighteenth century, widespread inoculation had greatly reduced smallpox mortality.

In 1798, the English physician Edward Jenner (1749–1823) announced that vaccination (inoculation with cowpox virus) could prevent smallpox altogether. Benjamin Waterhouse (1754–1846), professor of physic (a branch of medicine) at Harvard, performed the first American vaccination in 1800. American physicians soon were vaccinating routinely. Smallpox did not disappear, however, and vaccination was not risk free. Vaccine purity and technique varied widely and vaccination occasionally led to infection or even death. These hazards convinced some people—antivaccinationists—to avoid it at all cost.

As epidemics periodically erupted throughout the nineteenth century, many cities instituted compulsory vaccination laws. Antivaccinationists refused to comply, arguing that these laws abridged their civil liberties and endangered their health. Although they won repeal in some states and routed health departments in Milwaukee, Wisconsin, and New York City in the 1890s, they lost in the Supreme Court. In Jacobson v. Massachusetts (1905), Justice John Marshall Harlan's majority opinion declared compulsory‐vaccination statutes constitutional, providing the legal foundation for sweeping twentieth‐century state authority over individuals to protect public health. Health departments realized, however, that persuasion was more effective than compulsion. By the early twentieth century, cities, states, and the federal government were addressing objections against vaccination by ensuring its safety. The Biologics Control Act of 1902 set production and quality standards for vaccines that became a model for the world. By 1947, confidence in vaccination was such that more than six million citizens avidly sought it when an epidemic threatened New York City. Smallpox last appeared in the United States in 1949, but the World Health Organization (WHO) did not declare it eradicated globally until 1980. Two sites currently hold samples of the virus: the Centers for Disease Control in Atlanta and the Russian State Research Center of Virology and Biotechnology in Siberia. Although WHO slated these samples for destruction on 30 June 1999, both the American and Russian governments postponed it in order to conduct research on defenses against the disease should it ever be used as a weapon of bioterrorism.
See also Colonial Era; Indian History and Culture: From 1500 to 1800; Mather, Increase and Cotton; Medicine.

Bibliography

John B. Blake , Public Health in the Town of Boston 1630–1822, 1959.
Judith W. Leavitt , Be Safe. Be Sure’: New York City's Experience with Epidemic Smallpox, in Hives of Sickness: Public Health and Epidemics in New York City, ed. David Rosner, 1995, pp. 95–114.
Elizabeth A. Fenn , Pox Americana: The Great Smallpox Epidemic of 1775–82, 2001.

Karen Walloch