Smallpox epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
==Epidemiology | ==Epidemiology== | ||
==Demographics== | |||
Smallpox killed an estimated 60 million europeans, including five reigning European monarchs, in the 18th century alone. Up to 30% of those infected, including 80% of the children under 5 years of age, died from the disease, and one third of the survivors became blind.<ref>{{cite journal |author=Barquet N, Domingo P |title=Smallpox: the triumph over the most terrible of the ministers of death |journal=Ann. Intern. Med. |volume=127 |issue=8 Pt 1 |pages=635-42 |year=1997 |pmid=9341063 |doi=}}</ref><ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1200696 Edward Jenner and the history of smallpox and vaccination]</ref> | Smallpox killed an estimated 60 million europeans, including five reigning European monarchs, in the 18th century alone. Up to 30% of those infected, including 80% of the children under 5 years of age, died from the disease, and one third of the survivors became blind.<ref>{{cite journal |author=Barquet N, Domingo P |title=Smallpox: the triumph over the most terrible of the ministers of death |journal=Ann. Intern. Med. |volume=127 |issue=8 Pt 1 |pages=635-42 |year=1997 |pmid=9341063 |doi=}}</ref><ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1200696 Edward Jenner and the history of smallpox and vaccination]</ref> | ||
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===The Americas=== | ===The Americas=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [3]
Overview
Epidemiology
Demographics
Smallpox killed an estimated 60 million europeans, including five reigning European monarchs, in the 18th century alone. Up to 30% of those infected, including 80% of the children under 5 years of age, died from the disease, and one third of the survivors became blind.[1][2]
Smallpox was responsible for an estimated 300–500 million deaths in the 20th century. As recently as 1967, the World Health Organization (WHO) estimated that 15 million people contracted the disease and that two million died in that year.[3] After first contacts with Europeans and Africans, some believe that the death of 90 to 95 percent of the native population of the New World was caused by Old World diseases.[4] It is suspected that smallpox was the chief culprit and responsible for killing nearly all of the native inhabitants of the Americas. For more than two hundred years, this disease affected all new world populations, mostly without intentional European transmission (Excluding the British Settlements), from contact in the early 1500s to until possibly as early as the French and Indian Wars (1754-1767).[5]
The eradication of smallpox required a global effort. Every country was susceptible to the devastating disease. Eradicating this infection would take many years a significant sum of money, but with a worldwide commitment, it would be possible. Success was achieved in the 1970s and smallpox was officially eradicated.
The Americas
| Documented Smallpox Epidemics in the New World[6] | ||
|---|---|---|
| Year | Location | Description |
| 1520-1527 | Mexico, Central America, South America | Smallpox kills millions of native inhabitants of Mexico. Unintentionally introduced at Veracruz with the arrival of Panfilo de Narvaez on April 23, 1520[7] and was credited with the victory of Cortes over the Aztec empire at Tenochtitlan (present-day Mexico City) in 1521. Kills the Inca ruler, Huayna Capac, and 200,000 others and destroys the Incan Empire. |
| 1617-1619 | North America northern east coast | Killed 90% of the Massachusetts Bay Indians |
| 1674 | Cherokee Tribe | Death count unknown. Population in 1674 about 50,000. After 1729, 1738, and 1753 smallpox epidemics their population was only 25,000 when they were forced to Oklahoma on the Trail Of Tears |
| 1692 | Boston, MA | |
| 1702-1703 | St. Lawrence Valley, NY | |
| 1721 | Boston, MA | |
| 1736 | Pennsylvania | |
| 1738 | South Carolina | |
| 1754-1767 | North East U.S. and South East Canada | "Smallpox was probably first used as a biological weapon during the French and Indian Wars of 1754-1767 when British forces in North America distributed blankets that had been used by smallpox patients among them to Native Americans collaborating with the French."[5] |
| 1770s | West Coast of North America | Kills out 30% of the West Coast Native Americans |
| 1781-1783 | Great Lakes | |
| 1830s | Alaska | Reduced Dena'ina Athabaskan population in Cook Inlet region of southcentral Alaska by half.[8] Smallpox also devastated Yup'ik Eskimo populations in western Alaska. |
| 1860-1861 | Pennsylvania | |
| 1865-1873 | Philadelphia, PA, New York, Boston, MA and New Orleans, LA | Same period of time, in Washington DC, Baltimore, MD, Memphis, TN Cholera and a series of recurring epidemics of Typhus, Scarlet Fever and Yellow Fever |
| 1877 | Los Angeles, CA | |
After first contacts with Europeans and Africans, some believe that the death of 90 to 95 percent of the native population of the New World was caused by Old World diseases.[9] It is suspected that smallpox was the chief culprit and responsible for killing nearly all of the native inhabitants of the Americas. For more than two hundred years, this disease affected all new world populations, mostly without intentional European transmission (Excluding the British Settlements), from contact in the early 1500s to until possibly as early as the French and Indian Wars (1754-1767).[5]
In 1519 Hernán Cortés landed on the shores of what is now Mexico and was then the Aztec empire. In 1520 another group of Spanish came from Cuba and landed in Mexico. Among them was an African slave who had smallpox. When Cortés heard about the other group, he went and defeated them. In this contact, one of Cortés's men contracted the disease. When Cortés returned to Tenochtitlan, he brought the disease with him.
Soon, the Aztecs rose up in rebellion against Cortés. Outnumbered, the Spanish were forced to flee. In the fighting, the Spanish soldier carrying smallpox died. After the battle, the Aztecs contracted the virus from the invaders' bodies. Cortes would not return to the capital until August 1521. In the meantime smallpox devastated the Aztec population. It killed most of the Aztec army, the emperor, and 25% of the overall population. A Spanish priest left this description: "As the Indians did not know the remedy of the disease…they died in heaps, like bedbugs. In many places it happened that everyone in a house died and, as it was impossible to bury the great number of dead, they pulled down the houses over them so that their homes become their tombs." On Cortés's return, he found the Aztec army’s chain of command in ruins. The soldiers who lived were still weak from the disease. Cortés then easily defeated the Aztecs and entered Tenochtitlán, where he found that smallpox had killed more Aztecs than had the cannons. The Spaniards said that they could not walk through the streets without stepping on the bodies of smallpox victims.
The effects of smallpox on Tahuantinsuyu (or the Inca empire) were even more devastating. Beginning in Colombia, smallpox spread rapidly before the Spanish invaders first arrived in the empire. The spread was probably aided by the efficient Inca road system. Within months, the disease had killed the Sapa Inca Huayna Capac, his successor, and most of the other leaders. Two of his surviving sons warred for power and, after a bloody and costly war, Atahualpa become the new Sapa Inca. As Atahualpa was returning to the capital Cuzco, Francisco Pizarro arrived and through a series of deceits captured the young leader and his best general. Within a few years smallpox claimed between 60% and 90% of the Inca population[10], with other waves of European disease weakening them further. However, some historians think a serious native disease called Bartonellosis may have been responsible for some outbreaks of illness. The effects of smallpox were dipicted in the ceramics of the Moche people of ancient Peru. [11]
Even after the two mighty empires of the Americas were defeated by the virus, smallpox continued its march of death. In 1633 in Plymouth, Massachusetts, the Native Americans were struck by the virus. As it had done elsewhere, the virus wiped out entire population groups of Native Americans. It reached Lake Ontario in 1636, and the lands of the Iroquois by 1679, killing millions. The worst sequence of smallpox attacks took place in Boston, Massachusetts. From 1636 to 1698, Boston endured six epidemics. In 1721, the most severe epidemic occurred. The entire population fled the city, bringing the virus to the rest of the Thirteen Colonies. In the late 1770s, during the American Revolutionary War, smallpox returned once more and killed an estimated 125,000 people.[12] Peter Kalm in his “Travels in North America”, described how in that period, the dying Indian villages became overrun with wolves feasting on the corpses and weakened survivors.[13]
Eurasia
It is important to note that, while historical epidemics and pandemics are believed by some historians to have been early outbreaks of smallpox, contemporary records are not detailed enough to make a definite diagnosis at this distance.[14]
The Plague of Athens devastated the city of Athens in 430 BC, killing around a third of the population, according to Thucydides. Historians have long considered this an example of bubonic plague, but more recent examination of the reported symptoms led some scholars to believe the cause may have been measles, smallpox, typhus, or a viral hemorrhagic fever (like Ebola).
The Antonine Plague that swept through the Roman Empire and Italy in 165–180 is also thought to be either smallpox or measles.[15] [14] A second major outbreak of disease in the Empire, known as the Plague of Cyprian (251–266), was also either smallpox or measles.
The next major epidemic believed to be smallpox occurred in India]. The exact date is unknown. Around A.D. 400, an Indian medical book recorded a disease marked by pustules, saying "the pustules are red, yellow, and white and they are accompanied by burning pain … the skin seems studded with grains of rice." The Indian epidemic was thought to be punishment from a god, and the survivors created a goddess, Sitala, as the anthropomorphic personification of the disease.[16][17][18] Smallpox was thus regarded as possession by Sitala. In Hinduism the goddess Sitala both causes and cures high fever, rashes, hot flashes and pustules. All of these are symptoms of smallpox.
Smallpox did not definitively enter Western Europe until about 581 when Bishop Gregory of Tours provided an eyewitness account that describes the characteristic findings of smallpox.[14] Most of the details about the epidemic that followed are lost, probably due to the scarcity of surviving written records of early medieval society.
References
- ↑ Barquet N, Domingo P (1997). "Smallpox: the triumph over the most terrible of the ministers of death". Ann. Intern. Med. 127 (8 Pt 1): 635–42. PMID 9341063.
- ↑ Edward Jenner and the history of smallpox and vaccination
- ↑ "Smallpox". WHO Factsheet. Retrieved 2007-09-22.
- ↑ The Story Of... Smallpox
- ↑ 5.0 5.1 5.2 Henderson DA, Inglesby TV, Bartlett JG; et al. (1999). "Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense" (PDF). JAMA. 281 (22): 2127–37. PMID 10367824.
- ↑ [1] Worldwide Epidemics 1999 Genealogy Inc
- ↑ The Demon in the Freezer
- ↑ Boraas AS (1991). Peter Kalifornsky: A Biography. In: A Dena’ina Legacy — K’tl’egh’i Sukdu: The Collected Writings of Peter Kalifornsky (Kari J, Boraas AS, eds). Fairbanks, AK: Alaska Native Language Center, University of Alaska Fairbanks. p. 475.
- ↑ The Story Of... Smallpox
- ↑ Silent Killers of the New World
- ↑ Berrin, Katherine & Larco Museum. The Spirit of Ancient Peru:Treasures from the Museo Arqueológico Rafael Larco Herrera. New York: Thames and Hudson, 1997.
- ↑ Fenn EA (2001). Pox Americana: The Great Smallpox Epidemic of 1775-82 (1st ed. ed.). Hill and Wang. ISBN 0-8090-7820-1.
- ↑ "Groundhog day at the wolf wars". Retrieved 2007-06-18.
- ↑ 14.0 14.1 14.2 Hopkins DR (2002). The Greatest Killer: Smallpox in history. University of Chicago Press. ISBN 0-226-35168-8. Originally published as Princes and Peasants: Smallpox in History (1983), ISBN 0-226-35177-7
- ↑ Annals of Internal Medicine
- ↑ Nicholas R (1981). "The goddess Sitala and epidemic smallpox in Bengal". J Asian Stud. 41 (1): 21–45. PMID 11614704.
- ↑ "Sitala and Smallpox". The thermal qualities of substance: Hot and Cold in South Asia. Retrieved 2006-09-23.
- ↑ http://reli350.vassar.edu/kissane/sitala.html Vassar: Points out that variolation was regarded as a means of invoking the goddess whereas vaccination was opposition to her. Gives duration of belief as until 50 years ago.