28 April 2008

The Smallpox


The third in the ongoing series of plagues is this illustration of the smallpox. Ever since I was in elementary school and first saw the illustrations of the Aztec smallpox victims in the sixteenth century (taken from Historia De Las Cosas de Nueva Espana, Peabody Museum of Archaeology and Ethnology, Harvard University), I was fascinated by the beauty/awesomeness of that which one cannot see. I became aware of closed spaces, the increased temperature of crowded spaces, and the simplicity of a sneeze and it's future effects on each individual. I guess it would have been easy to become a hypochondriac at that moment, thankfully... I did not develop in that direction. Smallpox is a disease that spread exactly in this fashion.

Transmission of smallpox occurs through inhalation of airborne variola virus, usually droplets expressed from the oral, nasal, or pharyngeal mucosa of an infected person. It is transmitted from one person to another primarily through prolonged face-to-face contact with an infected person, usually within a distance of 6 feet, but can also be spread through direct contact with infected bodily fluids or contaminated objects (fomites) such as bedding or clothing. The incubation period between contraction and the first obvious symptoms of the disease is around 12 days. Once inhaled, variola virus invades the oropharyngeal (mouth and throat) or the respiratory mucosa, migrates to regional lymph nodes, and begins to multiply. The initial symptoms are similar to other viral diseases such as influenza and the common cold: fever (at least 38.5 °C (101 °F)), muscle pain, malaise, headache, and as the digestive tract is commonly involved (good times), nausea and vomiting and backache often occur. The preeruptive stage, usually lasts 2–4 days. By days 12–15 the first visible lesions—small reddish spots called enanthem—appear on mucous membranes of the mouth, tongue, palate, and throat, and temperature falls to near normal. These lesions rapidly enlarge and rupture, releasing large amounts of virus into the saliva.

Smallpox is believed to have emerged in human populations about 10,000 BC. The disease killed an estimated 400,000 Europeans each year during the 18th century (including five reigning monarchs), and was responsible for a third of all blindness. Between 20 and 60% of all those infected, and over 80% of infected children, died from the disease.

The Europeans brought to the "New World" smallpox, measles, diphtheria, trachoma, whooping cough, chicken pox, bubonic plague (carried by fleas, which were carried by European rats), malaria, typhoid fever, cholera, yellow fever, dengue fever, scarlet fever, amebic dysentery, influenza, and a number of worm infections. Native Americans had absolutely no antibodies to these diseases. To say that the effect of these illnesses on the population of the Americas was devastating would be an understatement. It has been estimated that by the end of the seventeenth century, between seventy and ninety percent of the population of the Americas had died of European-imported diseases. Unintentionally introduced at Veracruz with the arrival of Panfilo de Narvaez on April 23, 1520 Smallpox was credited with the victory of Cortes over the Aztec empire at Tenochtitlan (present-day Mexico City) in 1521. I've got one word for that; SCARY.

After successful vaccination campaigns throughout the 19th and 20th centuries, the World Health Organization certified the eradication of smallpox in 1979.To this day, smallpox is the only human infectious disease to have been completely eradicated from nature. BUT! (We all have big buts) In March 2003 smallpox scabs were found tucked inside an envelope in a book on Civil War medicine in Santa Fe, New Mexico. The envelope was labeled as containing the scabs and listed the names of the patients they came from. Assuming the contents could be dangerous, the librarian who found them did not open the envelope. The scabs ended up with employees from the CDC who responded quickly once informed of the discovery. The discovery raised concerns that smallpox DNA could be extracted from these and other scabs and used for a biological attack. All of my siblings except myself and the second youngest have the obvious arm scar that is the smallpox vaccination. I'm slightly nervous that I don't have one if anything ever were to resurface!

1 comment:

Bonnie said...

Love the illustration. Have you read 1491 by Charles. C Mann? Sounds like your cup of tea, there are many pages dedicated to trying to determine the Native population at contact and just how much an effect disease made an impact.