Friday, July 31, 2020

Variola Major

Over on Twitter the other day, I saw someone who should have known better call Larry Brilliant "the man who cured smallpox." 

This is wrong on multiple counts.
  • There's no cure for smallpox. If a person was exposed to it, being vaccinated within a couple of days of the exposure had a good chance of preventing smallpox. But the treatments for smallpox were supportive, not curative. You would keep the patient hydrated and comfortable, apply whatever cream would provide relief for the sores, and the like. It was 2018 before there was an FDA-approved anti-viral that might be effective in treating smallpox.
  • Larry Brilliant was involved from 1973 to 1976 in the effort to eradicate smallpox through an enormous, worldwide vaccination effort. That effort started in 1959, when Brilliant was 15 years old, and lasted until 1979. The last naturally occurring case of the illness was in 1977, and in 1980 the World Health Organization (WHO) declared the disease effectively extinct. (Small stocks remain at the CDC and somewhere in Russia, I believe.) You can read about the WHO effort at the CDC web site. (Which should have mentioned that there was inoculation in China long before Edward Jenner, sigh, probably starting in the 16th c.)
So, Brilliant was active for several years only of a concerted 20-year effort to finally stamp out smallpox. 
Americans really want to have a hero to look up to, but in this case, it's a mistake. All credit to Brilliant for his years of service, but eradicating smallpox was a group effort that thousands of people participated in. From the CDC web site, a note about the last case of smallpox in the wild:
Three-year-old Rahima Banu, who is the last known person to have had naturally acquired smallpox, or variola major, in the world, with her mother in Bangladesh. Her case was reported to the local Smallpox Eradication Program team by an 8-year-old girl named Bilkisunnessa, who was paid 250 Taka reward for her diligence.
That exemplifies what went into the eradication of smallpox. Local teams and ordinary people and epidemiologists all played their part. No single individual should get more credit than they deserve.

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