when did they stop giving the smallpox vaccine

The basis for vaccination began in 1796 when the English doctor Edward Jenner noticed that milkmaids who had gotten cowpox were protected from smallpox. Bensom of Los Angeles used his vacation to mush to native villages in Alaska. MVA-BN has been approved in the European Union,[7] Canada,[38][39][40] and the United States. On October 12, 1977, he rode with two smallpox patients in a vehicle from the hospital to the local smallpox office. When there is NO smallpox outbreak, you should get the smallpox vaccine if you: Are a lab worker who works with virus that causes smallpox or other viruses that are similar to it. [78] In 1768, Dr John Fewster reported that variolation induced no reaction in persons who had had cowpox. They make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nutshell full of the matter of the best sort of small-pox and asks what veins you please to have opened. British, Canadian, Cuban, French, Soviet, and US vaccines were given freely to WHO and distributed onwards, sometimes with the strategic financial support of Sweden. Crucially all of at least four whom Jenner deliberately inoculated with smallpox virus resisted it. Having heard of local beliefs and practices in rural communities that cowpox A house-to-house vaccination campaign within a 1.5-mile radius of her home began immediately. [14][15]:115, The vaccine is administered by multiple puncture of the skin (scarification) with a bifurcated needle that holds vaccine solution in the fork. Smallpox was eradicated in the 1970s; the vaccination program is predicated on the fear that terrorists could get their hands on smallpox virus stocks left over from the Soviet Union's biological weapons program or from other sources. More experiments followed, and, in 1801, Jenner published his treatise On the Origin of the Vaccine Inoculation. In this work, he summarized his discoveries and expressed hope that the annihilation of the smallpox, the most dreadful scourge of the human species, must be the final result of this practice.. An account from letter by Lady Mary Wortley Montagu to Sarah Chiswell, dated 1 April 1717, from the Turkish Embassy describes this treatment: The small-pox so fatal and so general amongst us is here entirely harmless by the invention of ingrafting (which is the term they give it). A survey of vaccines in 1900 found wide variations in bacterial contamination. "[35] A "take" or "major cutaneous reaction" is a pustular lesion or an area of definite induration or congestion surrounding a central lesion, which can be a scab or an ulcer. Source: CDC/World Health Organization; Stanley O. If you need long-term protection, you may need to get booster vaccinations regularly. In a 2006 predictive analysis of casualties if there were a mass vaccination of the populations of Germany and the Netherlands, it was estimated that a total of 9.8 people in the Netherlands and 46.2 people in Germany would die from uncontrolled vaccinia infection after being vaccinated with the New York City Board of Health strain. have questioned the possible effectiveness of such a vaccine. [82], Perhaps there was already an informal public understanding of some connection between disease resistance and working with cattle. After drying the ampoules were sealed under nitrogen. The earliest written description of a disease like smallpox appeared in China in the 4th century CE (Common Era). Anderson MG, Frenkel LD, Homann S, and Guffey J. An investigation suggested that Janet Parker had been infected either via an airborne route through the medical school buildings duct system or by direct contact while visiting the microbiology corridor. During variolation, people who had never had smallpox were exposed to material from smallpox sores (pustules) by scratching the material into their arm or inhaling it through the nose. With renewed political commitment and the contributions of hundreds of thousands of local surveillance officers and health workers, even regions with nascent health systems and tremendous logistical challenges made remarkable progress. They help us to know which pages are the most and least popular and see how visitors move around the site. [55], The mortality of the severe form of smallpox variola major was very high without vaccination, up to 35% in some outbreaks. First and second-generation vaccines contain live unattenuated vaccinia virus and can cause serious side effects in a small percentage of recipients, including death in 110 people per million vaccinations. [67] According to Voltaire (1742), the Turks derived their use of inoculation from neighbouring Circassia. Edward Jenner (17491823). Guidance for clinicians", "Frequency of adverse events after vaccination with different vaccinia strains", "Correction: Frequency of Adverse Events after Vaccination with Different Vaccinia Strains", "Vaccinal Infection of the Chorio-Allantoic Membrane of the Chick Embryo", "ACAM2000 clonal Vero cell culture vaccinia virus (New York City Board of Health strain)--a second-generation smallpox vaccine for biological defense", "ACAM2000: the new smallpox vaccine for United States Strategic National Stockpile", "Modified Vaccinia Virus Ankara: History, Value in Basic Research, and Current Perspectives for Vaccine Development", "There's a shortage of monkeypox vaccine. Her mother, who was providing care for her, developed smallpox on September 7, despite having been vaccinated two weeks earlier. Then in the late 18th century a vaccine was discovered. Many people consider smallpox eradication to be the biggest achievement in international public health. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Working at the Chiba Serum Institute in Japan, So Hashizume passaged the Lister strain 45 times in primary rabbit kidney cells, interrupting the process after passages 36, 42, and 45 to grow clones on chorioallantoic membrane and select for pock size. While vaccine research continued, new vaccines were not introduced during the 1970s. [15]:292[17] If alcohol is used, it must be allowed to evaporate completely before the vaccine is administered. [146] According to some sources the term was first introduced by Jenner's friend Richard Dunning in 1800.[147]. She returned to London and had her daughter variolated in 1721 by Charles Maitland, during an epidemic of smallpox. 1766", "An examination of John Fewster's role in the discovery of smallpox vaccination", "Who discovered smallpox vaccination? 3. Therefore, Jenner was not the first to try cowpox inoculation. There is no example of any one that has died in it, and you may believe I am very well satisfied of the safety of the experiment since I intend to try it on my dear little son. Publication of the Inquiry and the subsequent energetic promulgation by Jenner of the idea of vaccination with a virus other than variola virus constituted a watershed in the control of smallpox for which he, more than anyone else deserves the credit. [66] In China, powdered smallpox scabs were blown up the noses of the healthy. He may have done some cowpox inoculations in 1796 at about the same time that Jenner vaccinated Phipps. [118] The level of bacterial contamination remained unregulated until the Therapeutic Substances Act, 1925 set an upper limit of 5,000 per gram, and rejected any batch of vaccine found to contain the causative organisms of erysipelas or wound infections. However, private practitioners had to purchase vaccine from commercial producers. After 3000 years of suffering and death from the disease, there hasnt been a recorded case of smallpox in almost half a century. Modern research suggests Jenner was trying to distinguish between effects caused by what would now[when?] [129] On May 6, the contract was awarded to Bavarian Nordic for their Imvamune vaccine. [114] Smallpox vaccine was the only vaccine available during this period, and so the determined opposition to it initiated a number of vaccine controversies that spread to other vaccines and into the 21st century. identified as a contact of a recent case. [113] During this period there were no adequate methods for assessing the safety of the vaccine and there were instances of contaminated vaccine transmitting infections such as erysipelas, tetanus, septicaemia and tuberculosis. [126], In 2002, the United States government started a program to vaccinate 500,000 volunteer health care professionals throughout the country. From 1770 to 1772 Jenner received advanced training in London at St Georges Hospital and as the private pupil of John Hunter, then returned to set up practice in Berkeley. He attracted a certain amount of local criticism and ridicule at the time then interest waned. In the early part of the 18th century, Boston, a city of 10,000 people, suffered an epidemic of smallpox 5,000 people were infected and 800 died from the disease. . [22] The Texas Department of Health began producing egg-based vaccine in 1939 and started using it in vaccination campaigns in 1948. On 9 December, 1979, health officials declared smallpox as the first and only human disease to be eradicated in what is considered the greatest achievement of modern medicine. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox virus. After variolation, people usually developed the symptoms associated with smallpox, such as fever and a rash. By 1984, England and South Africa had either destroyed their stocks or transferred them to other approved labs. [107]:23338, In the United States vaccination was regulated by individual states, the first to impose compulsory vaccination being Massachusetts in 1809. With this strategy they were able to eliminate highly contagious smallpox from the district within weeks. Wellcome Library, London via Wikimedia Commons. LC16m8 was approved in Japan in 1975 after testing in over 50,000 children. Voltaire does not speculate on where the Circassians derived their technique from, though he reports that the Chinese have practiced it "these hundred years". By 1930 Arizona, Utah, North Dakota and Minnesota prohibited compulsory vaccination, 35 states allowed regulation by local authorities, or had no legislation affecting vaccination, whilst in ten states, including Washington, D.C. and Massachusetts, infant vaccination was compulsory. [13], Ernest William Goodpasture, Alice Miles Woodruff, and G. John Buddingh grew vaccinia virus on the chorioallantoic membrane of chicken embryos in 1932. First-generation vaccines grown on the skin of live animals were widely distributed in the 1950s-1970s to eradicate smallpox. [107]:20213 This intensified opposition, and the 1898 Vaccination Act introduced a conscience clause. In higher-risk countries, laboratories began to produce higher-quality freeze-dried vaccines, and mass production of the innovative and easy-to-use The World Health Organization (WHO) declared it globally eradicated in 1979 after a 10-year campaign in South America, Africa and Asia. However, due to the high rate of serious adverse effects, the vaccine will only be made available to the CDC for the Strategic National Stockpile. The physician Valentine Seaman gave his children a smallpox vaccination using a serum acquired from Jenner. Because of successful eradication efforts, the smallpox vaccine was no longer recommended for use after 1972. The procedure had been known in Boston since 1706, when preacher Cotton Mather learned it from Onesimus, a man he held as a slave, who like many of his peers had been inoculated in Africa before they were kidnapped. Perhaps if I live to return I may, however, have courage to war with them. Death would come suddenly, often within 2 weeks, and survivors could be left with permanent harms such as blindness and Vaccine research and studies in vaccine delivery were carried out around the world in the search for more resilient and effective vaccines. If you still get the disease, you might get much less sick than an unvaccinated person would. [133]:9 Edward Jenner had obtained his vaccine from a cow, so he named the virus vaccinia, after the Latin word for cow. After a successful Phase I trial of ACAM1000, the virus was passaged three times in Vero cells to develop ACAM2000, which entered mass production at Baxter. They have very rarely above twenty or thirty in their faces, which never mark, and in eight days time they are as well as before the illness. The chief reason for the end of smallpox vaccination was fairly obvious. In India, similar practices were carried out through inoculation, using a lancet or needle to transfer material from smallpox pustules to the skin of healthy children. Following the eradication of smallpox, scientists and public health officials determined there was still a need to perform researchusing the variola virus. [138] The development of whole genome sequencing in the 1990s made it possible to compare orthopoxvirus genomes and identify their relationships with each other. The last naturally occurring case of smallpox occurred in. The Intensified Eradication Program began in 1967 with a promise of renewed efforts. This protected the virus during the freeze drying process. Accounts from the 18th century suggest this technique dates back hundreds of years. The origins of the smallpox vaccine became murky over time,[10] especially after Louis Pasteur developed laboratory techniques for creating vaccines in the 19th century. This was criticised at the time but vaccines derived from horsepox were soon introduced and later contributed to the complicated problem of the origin of vaccinia virus, the virus in present-day vaccine. This was a sharpened two-prong fork designed to hold one dose of reconstituted freeze-dried vaccine by capillarity. When the virus was eradicated in the. A smallpox vaccine manufactured by Mulford in 1902 is 99.7% similar to horsepox, closer than any previously known strain of vaccinia. By 1871, parents could be fined for non-compliance, and then imprisoned for non-payment. However, it remained in use into the 1970s where a satisfactory cold chain was available. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. By 1984, the only known stocks were kept at the CDC in the U.S. and the State Research Center of Virology and Biotechnology (VECTOR) in Koltsovo, Russia. [92][93] By 1800, Jenner's work had been published in all the major European languages and had reached Benjamin Waterhouse in the United States an indication of rapid spread and deep interest. Two reports on the Chinese practice of inoculation were received by the Royal Society in London in 1700; one by Dr. Martin Lister who received a report by an employee of the East India Company stationed in China and another by Clopton Havers. To test his theory, Dr. Jenner took material from a cowpox sore on milkmaid Sarah Nelmes hand and inoculated it into the arm of James Phipps, the 9-year-old son of Jenners gardener. Not everyone was on board with Jenner and his vaccine. According to the US Centers for Disease Control and Prevention (CDC), "within 3 days of being exposed to the virus, the vaccine might protect you from getting the disease. which came from endemic countries for their own eradication efforts. [15]:588 Lederle Laboratories began selling its Avianized smallpox vaccine in the United States in 1959. WHO poster commemorating the eradication of smallpox in October 1979, which was officially endorsed by the 33rd World Health Assembly on May 8, 1980. Some of the earliest statistical and epidemiological studies were performed by James Jurin in 1727 and Daniel Bernoulli in 1766. [63] It may also have occurred in India, but this is disputed; other investigators contend the ancient Sanskrit medical texts of India do not describe these techniques. In the latest development to come shortly after Murdoch admitted he did nothing to stop his Fox News talent from "promoting" ex-President . [81] At the age of 13, he was apprenticed to apothecary Daniel Ludlow and later surgeon George Hardwick in nearby Sodbury. [112] In 1896, Copeman was asked to supply "extra good calf vaccine" to vaccinate the future Edward VIII. [20][21], The second-generation vaccines consist of live vaccinia virus grown in the chorioallantoic membrane or cell culture. Janet Parker was the last person to die of smallpox. [15]:126162 However, even as the disease was being eradicated there still remained stocks of smallpox virus in many laboratories. One of the first methods for controlling smallpox was variolation, a process named after the virus that causes smallpox (variola virus). Vaccination with LC16m8 results in a vaccine "take," but safety is similar to MVA. Smallpox was declared globally eradicated in 1980; however, there are concerns . [18][19] Many countries have stockpiled first generation smallpox vaccines. [127] Fewer than 40,000 actually received the vaccine. Smallpox vaccination ends. [46] A woman planning on conceiving should not receive smallpox immunization. [15]:47273,56872 Rubin estimated that it was used to do 200 million vaccinations per year during the last years of the campaign. All cases were in young, otherwise healthy adult white men and all survived. The second-generation vaccines are also administered through scarification with a bifurcated needle, and they carry the same side effects as the first-generation vaccinia strain that was cloned. Laboratories in many countries where smallpox occurred regularly were able to produce more, higher-quality freeze-dried vaccine. The cost of the Intensified Smallpox Eradication Programme was approximately US$300 million, two thirds of However, Copeman found that vaccine suspended in 50% chemically pure glycerine and stored under controlled conditions contained very few "extraneous" bacteria and produced satisfactory vaccinations. Charles Creighton believed that uncontaminated vaccine itself was a cause of syphilis. Key components of the worldwide smallpox eradication effort included universal childhood immunization programmes in some countries, mass vaccination in others, and targeted surveillance-containment strategies during the end-game. [12], Horsepox is extinct in the wild, and the only known sample was collected in 1976. [106] It seems clear that the idea of using cowpox instead of smallpox for inoculation was considered, and actually tried in the late 18th century, and not just by the medical profession. But by 1801, through extensive testing, it was shown to effectively protect against smallpox. Saving Lives, Protecting People, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP), Community-Based Planning for a Smallpox Emergency, Help People with Functional, Language, or Cognitive Needs, Sample Alert Messages for Healthcare Providers, Comparison of Reactions for First-Time Vaccinees and Revaccinees, Examples of Major or Take Reactions to Smallpox Vaccination, Administering ACAM2000 Smallpox Vaccine Videos, Specimen Collection and Transport Guidelines for Suspect Smallpox Cases, Specimen Collection and Transport Guidelines for Suspect Smallpox Vaccine Adverse Events, Negative Staining Electron Microscope Protocol for Rash Illness, Packaging and Transporting Infectious Substances, Chart 1: Acute, Generalized Vesicular or Pustular Rash Illness Protocol, Chart 2: Laboratory Testing for Acute, Generalized Vesicular or Pustular Rash Illness, Chart 3: Laboratory Testing for Suspect Smallpox Vaccine Adverse Event (Vaccinia), Chart 4: Laboratory Testing for Environmental Sample, U.S. Department of Health & Human Services. [99] On August 26, 1807, Bavaria introduced a similar measure. Vaccinia does not cause smallpox, but it is very. Thanks to the combined efforts of national health agencies, WHO and scientists around the world, smallpox was eliminated from South America in 1971, Asia in 1975 and Africa in 1977. Submission #144762", "FDA approves first live, non-replicating vaccine to prevent smallpox and monkeypox", "Phase II Trial to Assess Safety and Immunogenicity of Imvamune", "Phase 3 Efficacy Trial of Modified Vaccinia Ankara as a Vaccine against Smallpox", "Vaccinia (smallpox) vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2001", "Vaccines and Related Biological Products Advisory Committee Meeting", "Aventis to Donate Smallpox Vaccine To the U.S. Government's Stockpile", "Emergent BioSolutions Awarded 10-Year HHS Contract to Deliver ACAM2000, (Smallpox (Vaccinia) Vaccine, Live) Into the Strategic", "Bavarian Nordic Announces U.S. FDA Approval of Jynneos (Smallpox and Monkeypox Vaccine, Live, Non-Replicating) for Prevention of Smallpox and Monkeypox Disease in Adults", "HHS Orders 2.5 Million More Doses of JYNNEOS Vaccine For Monkeypox Preparedness", "Clinical guidance for smallpox vaccine use in a postevent vaccination program", "Smallpox eradication: destruction of variola virus stocks", "Plan national de rponse une menace de variole", "Vaiolo delle scimmie, 'abbiamo 5 milioni dosi di vaccino: pronti se servir', "Milestones in history of adult vaccination in Korea", "Edward Jenner and the history of smallpox and vaccination", "The smallpox story: life and death of an old disease", "Smallpox inoculation and the Ottoman contribution: A Brief Historiography", "Black History Month II: Why Wasn't I Taught That? [108] Those seeking to enforce compulsory vaccination argued that the public good overrode personal freedom, a view supported by the U.S. Supreme Court in Jacobson v. Massachusetts in 1905, a landmark ruling which set a precedent for cases dealing with personal freedom and the public good. Jenner had sent the paper informally to Sir Joseph Banks, the Society's president, who asked Everard Home for his views. It was an unprecedented demonstration of global unity in the face of a common threat. Almost two centuries after Jenner hoped that vaccination could annihilate smallpox, the 33rd World Health Assembly declared the world free of this disease on May 8, 1980. Smallpox was a highly infectious and deadly disease which killed around 300 million people in the 20th century alone. The patients would then develop a mild case of the disease and from then on were immune to it. [13] However, Sanofi dropped its own vaccine after it acquired Acambis in 2008. One of the deadliest diseases known to humans, smallpox remains the only human disease There then followed sequences of compulsion, opposition and repeal in various states. Maalin was a hospital cook in Merca, Somalia. Enslaved West Africans had long practised the technique, and after his slave Onesimus told him about how it worked in 1716, Cotton Mather publicized it and argued for its [136], In 1939, Allan Watt Downie showed that the vaccinia virus was serologically distinct from the "spontaneous" cowpox virus. [123] Easy to use with minimum training, cheap to produce ($5 per 1000), using one quarter as much vaccine as other methods, and repeatedly re-usable after flame sterilization, it was used globally in the WHO Smallpox Eradication Campaign from 1968. The Vaccination Act made it compulsory for all children born after August 1st 1853 to have a smallpox vaccine in the first three months of their life. [30], Vaccinia is infectious, which improves its effectiveness, but causes serious complications for people with impaired immune systems (for example chemotherapy and AIDS patients) or history of eczema, and is not considered safe for pregnant women. [139] In a phylogenetic tree of the orthopoxviruses, horsepox forms a clade with vaccinia strains, and cowpox strains form a different clade. [74] However, a limited trial showed six deaths occurred out of 244 who were variolated (2.5%), while 844 out of 5980 died of natural disease (14%), and the process was widely adopted throughout the colonies. [119][120] Collier added 0.5% phenol to the vaccine to reduce the number of bacterial contaminants but the key stage was to add 5% peptone to the liquid vaccine before it was dispensed into ampoules. They also offered a reward to anyone who reported a smallpox case. Other vaccine material was not reliably derived from cowpox, but from other skin eruptions of cattle. Over a five year period, you tested the effectiveness of the vaccine to monkeys and then challenging the monkeys with meningitis bacteria. ", "Open Collections Program: Contagion, The Boston Smallpox Epidemic, 1721", "Statue of Dr Edward Jenner near the Italian Fountains, Kensington Gardens", "An attempt at a new analysis of the mortality caused by smallpox and of the advantages of inoculation to prevent it. Smallpox can be prevented by smallpox vaccines, also called vaccinia virus vaccines. The vaccines are made from a virus called vaccinia, which is a poxvirus similar to smallpox, but less harmful. Find out who should get smallpox vaccine. The first-generation vaccines are manufactured by growing live vaccinia virus in the skin of live animals. However, fewer people died from variolation than if they had acquired smallpox naturally. [15]:54345 English vaccine was occasionally made in sheep during World War I but from 1946 only sheep were used. [100][101] In Lutheran Sweden, the Protestant clergy played a pioneering role in voluntary smallpox vaccination as early as 1800. These cookies may also be used for advertising purposes by these third parties. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. More deaths were predicted for vaccines based other strains: Lister (55.1 Netherlands, 268.5 Germany) and Bern (303.5 Netherlands, 1,381 Germany). The smallpox vaccine is the first vaccine to be developed against a contagious disease. All three generations of vaccine are available in stockpiles. The smallpox vaccine, introduced by Edward Jenner in 1796, was the first successful vaccine to be developed. The last case in the Americas occurred in 1971 (Brazil), south-east Asia (Indonesia) in 1972, and on the Indian subcontinent in 1975 (Bangladesh). The ancient practice of variolation (named for smallpox, also known as variola or la variole) was widely used in Asia and some parts of Africa. The United States stopped giving mandatory smallpox. [26][27], The third-generation vaccines are based on attenuated vaccinia viruses that are much less virulent and carry lesser side effects. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. [15]:588. Instead, following the discovery of Dr Jenners vaccine, eradication was achieved through prevention, as he himself predicted. The history of smallpox holds a unique place in medicine. An 8-year-old girl named Bilkisunnessa reported the case to the local Smallpox Eradication Program team and received a 250 Taka reward. The smallpox eradication staff then correctly diagnosed him with smallpox on October 30. As vaccination spread, some European countries made it compulsory. The aim of the current review was to synthesise all 27 studies conducted in . Scientists developed a smallpox vaccine using a live variation of a virus called vaccinia. Smallpox was highly infectious, with no known cure. Courtesy of WHO. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. [124], Smallpox was eradicated by a massive international search for outbreaks, backed up with a vaccination program, starting in 1967. Rahima was the last known person to have had naturally acquired smallpox in the world. early as 200 BCE. At the same time the 1898 Vaccination Act banned arm-to-arm vaccination, thus preventing transmission of syphilis by this vaccine. Third-generation vaccines are much safer due to the milder side effects of the attenuated vaccinia strains. However, the dried vaccine was 100% effective when reconstituted after 6 months storage at 37C (99F) allowing it to be transported to, and stored in, remote tropical areas. [144], The word "vaccine" is derived from Variolae vaccinae (i.e. Mandatory smallpox vaccination came into effect in Britain and parts of the United States of America in the 1840s and 1850s, as well as in other parts of the world, leading to the establishment of the smallpox vaccination certificates required for travel. [62] A method of inducing immunity known as inoculation, insufflation or "variolation" was practiced before the development of a modern vaccine and likely occurred in Africa and China well before the practice arrived in Europe. Although routine smallpox vaccination is no longer performed on the general public, the vaccine is still being produced to guard against bioterrorism, biological warfare, and monkeypox. government. After sampling 154 studies that met their inclusion criteria, the authors included 27 studies in their synthesis, of which 6 were from Africa. He concluded that cowpox inoculation was a safe alternative to smallpox inoculation, but rashly claimed that the protective effect was lifelong. The United States had received 269 million doses of ACAM2000 and 28 million doses of MVA-BN by 2019,[51][52] but only 100 million doses of ACAM2000 and 65,000 doses of MVA-BN were still available from the stockpile at the start of the 2022 monkeypox outbreak. . [30] In the 2000s, MVA was tested in animal models at much higher dosages. As the World Health Organization launched the Smallpox Eradication Programme in 1959, WHO Member States enhanced their support and cooperation. Rumours circulated at the time that it would turn people into cows. It was a disease that didnt discriminate, killing at least 1 in 3 people infected, often more in the most severe forms of disease.

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