Chapter 2 - Edward Jenner, Vaccination and Eradication of Smallpox

Abstract

In 1796, Edward Jenner (1749–1823), a country physician in Gloustershire, England, investigated local beliefs that milkmaids were immune to smallpox because of their exposure to cowpox. He took matter from a cowpox pustule of a milkmaid and applied it with scratches to the skin of a young boy named James Phipps, who was later inoculated with smallpox and did not develop the disease. Smallpox continued to be a periodic pandemic worldwide with millions of sufferers and deaths. In 1953 the World Health Assembly (WHA) the governing body of the World Health Organization (WHO) rejected the notion that smallpox should be selected for eradication. But gradual expansion of smallpox vaccination globally during the 20th century led WHO in 1966 to declare eradication of smallpox as a global health target. In 1967 a year with more than 10 million smallpox cases and 2 million deaths in 43 countries, implementation of the eradication campaign was launched. The campaign was conducted by the WHO in cooperation with many agencies and countries, with combined strategies of mass vaccination and focal eradication based on case reporting and localized vaccination to prevent spread of the disease. The campaign was assisted by many innovations and use of volunteer community health workers. The last known case was identified in Somalia in 1977, and the WHO declared that global eradication of smallpox was accomplished in 1980. This enormous achievement has set precedents for global eradication of other infectious diseases including poliomyelitis, measles, and many others.