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Dev Biol Stand 1999;100:31-7 |
Books
Standardization of smallpox vaccines and the
eradication programme--a WHO perspective.
Arita I.
Agency for Cooperation in International Health (ACIH), Kumamoto-city, Kumamoto,
Japan.
Smallpox vaccine was born in 1796 and the need for it ended in 1980 with the eradication of
smallpox. What was remarkable was that in its 200 years history, when
the global smallpox eradication programme really needed the vaccine in 1967, it
was found that, on the whole, quality was unsatisfactory and supply was short.
Unconventional counter measures were taken by WHO, including an international
independent testing system, provision of reference preparations in large
quantity etc. They effectively solved the problems meeting the target
eradication schedule of 10 years. The lessons learned would be of some value to
the future eradication or effective control programme of vaccine preventable
diseases.
Publication Types:
·
Historical Article
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Review
·
Review, Tutorial
PMID: 10616173 [PubMed - indexed for MEDLINE]
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Bull World Health Organ 1998;76(3):233-5 |
Commentary: smallpox eradication in west and
central Africa revisited.
Foege WH.
Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
In May 1980, the
Thirty-third World Health Assembly adopted a resolution accepting the report of
the Global Commission for the Certification of Smallpox Eradication and
affirming its belief that this once-universal disease had been eradicated
worldwide, 21 years after the global eradication programme had begun in
1959. A key element in the eradication effort was the surveillance-containment
strategy, which was first tested in Nigeria in 1966, and which led to its
adoption throughout the world. West and Central Africa became the first region
of the world to be smallpox free and one by one other regions followed. One of
the major lessons to be learned from the smallpox eradication programme is that
interdependence is required if global results are to be achieved.
Unfortunately, however, humanity has failed to learn this lesson in the
long-term, and although global health has improved dramatically the gaps
between the rich and poor remain vast.
Publication Types:
·
Historical Article
PMID: 9744242 [PubMed - indexed for MEDLINE]
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Rev Med Chil 1998 Jul;126(7 Suppl):19-25 |
[World-wide eradication of smallpox]
[Article in Spanish]
Rodriguez H.
Departamento de Sanidad, Fuerza Aerea de Chile, Santiago, Chile.
A short history of the disease and its vaccination is described. The role of
WHO and its country members is underlined, in this unique triumph of the
history of medicine. The success of the implementation of the programme and its
monitoring of the epidemiological situation of the disease to the final declaration of the WHO
1980, of smallpox eradication, are analyzed.
Publication Types:
·
Historical Article
PMID: 9838277 [PubMed - indexed for MEDLINE]
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Bull World Health Organ 1998;76 Suppl 2:17-21 |
Eradication: lessons from the past.
Henderson DA.
Johns Hopkins University, Baltimore, MD, USA.
The declaration in 1980
that smallpox had been eradicated reawakened interest in disease
eradication as a public health strategy. The smallpox programme's success
derived, in part, from lessons learned from the preceding costly failure of the
malaria eradication campaign. In turn, the smallpox programme offered important
lessons with respect to other prospective disease control programmes, and these
have been effectively applied in the two current global eradication
initiatives, those against poliomyelitis and dracunculiasis. Taking this theme
a step further, there are those who would now focus on the development of an
inventory of diseases which might, one by one, be targeted either for
eradication or elimination. This approach, while interesting, fails to
recognize many of the important lessons learned and their broad implications
for contemporary disease control programmes worldwide.
PMID: 10063668 [PubMed - indexed for MEDLINE]
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Pubbl Stn Zool Napoli II 1993;15(3):397-420 |
Smallpox: emergence, global spread, and
eradication.
Fenner F.
John Curtin School of Medical Research, Australian National University,
Canberra.
Speculatively, it is suggested that variola virus, the cause of smallpox,
evolved from an orthopoxvirus of animals of the central African rain forests
(possibly now represented by Tatera poxvirus), some thousands of years ago, and
first became established as a virus specific for human beings in the dense
populations of the Nile valley perhaps five thousand years ago. By the end of
the first millennium of the Christian era, it had spread to all the densely
populated parts of the Eurasian continent and along the Mediterranean fringe of
north Africa. It became established in Europe during the times of the Crusades.
The great voyages of European colonization carried smallpox to the Americas and
to Africa south of the Sahara. Transported across the Atlantic by Europeans and
their African slaves, it played a major role in the conquest of Mexico and Peru
and the European settlement of north America. Variolation, an effective
preventive inoculation, was devised as early as the tenth century. In 1798 this
practice was supplanted by Jenner's cowpox vaccine. In 1967, when the disease
was still endemic in 31 countries and caused ten to fifteen million cases and
about two million deaths annually, the World Health Organization embarked on a
programme that was to see the disease eradicated globally just over ten years
later, and the world was
formally declared to be free of smallpox in May 1980. Smallpox is
unique--a specifically human disease that emerged from some animal reservoir,
spread to become a worldwide, severe and almost universal affliction, and
finally underwent the reverse process to emergence, namely global eradication.
Publication Types:
·
Historical Article
PMID: 7529932 [PubMed - indexed for MEDLINE]
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J Hyg Epidemiol Microbiol Immunol 1983;27(1):1-12 |
Five years of freedom from smallpox.
Ladnyi ID, Jezek Z, Gromyko A.
In 1967, when the intensified global eradication programme was launched,
smallpox was still endemic in 35 countries with a total population of 1200
million and caused an estimated 10-15 million cases, resulting in 2 million
deaths. Ten years and ten months later, on 26 October 1977 through intensified
public health activities, the chain of smallpox transmission was finally broken
in Merka, south Somalia; the World Health Organization missed its ten-year
target line by ten months. In December 1979, the Global Commission concluded
that the global eradication of smallpox had been achieved and the Organization
formulated its policy for the post-eradication era. In May 1980, the 33rd World Health Assembly endorsed
the Commission's conclusion and officially confirmed the international
acceptance of smallpox eradication as the most outstanding achievement in
international public health. This achievement has unmistakably
demonstrated that the concept of disease eradication is correct and feasible.
WHO encouraged countries to discontinue smallpox vaccination and/or the need
for a smallpox vaccination certificate from international travellers. However,
WHO is continuing its vigilance over the disease and promoting further research
on orthopox viruses. Globally, US$ 313 million were spent on the eradication of
smallpox from the world. However, conservative calculations indicate that in
the post-eradication era, concrete economic returns resulting from the
eradication of smallpox throughout the world, are estimated at US$ 1000 to 2000
million, annually. For the last five years of smallpox-free status, savings of
about US$ 5000-10 000 million could be diverted for other health projects,
which has had a major impact on international public health. However, there are
other dividends similarly worthy as those of economic value. The most important
of these are the hundreds of thousands of experienced and dedicated health
workers who remain now in the countries as a solid base for implementing other
important public health programmes.
PMID: 6854010 [PubMed - indexed for MEDLINE]
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Am J Infect Control 1982 May;10(2):53-9 |
The global eradication of smallpox.
Strassburg MA.
On May 8, 1980, the 33rd
World Health Assembly declared the world free of smallpox. This followed
approximately 2 1/2 years after the last documented naturally occurring case of
smallpox was diagnosed in a hospital worker in Merca, Somalia. A major
breakthrough for the eventual control of this disease was the discovery of an
effective vaccine by Edward Jenner in 1796. In 1966 the World Health Assembly
voted a special budget to eliminate smallpox from the world. At that time,
smallpox was endemic in more than 30 countries. Mass vaccination programs were
successful in many Western countries; however, a different approach was taken
in developing countries. This approach was known as surveillance and containment.
Surveillance was aided by extensive house-to-house searches and rewards offered
for persons reporting smallpox cases. Containment measures included ring
vaccination and isolation of cases and contacts. Hospitals played a major role
in transmission in a number of smallpox outbreaks. The World Health
Organization is currently supporting several control programs and has not
singled out another disease for eradication. The lessons learned from the
smallpox campaign can be readily applied to other public health programs.
Publication Types:
·
Historical Article
PMID: 7044193 [PubMed - indexed for MEDLINE]
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N Engl J Med 1980 Nov 27;303(22):1263-73 |
The confirmation and maintenance of smallpox
eradication.
Breman JG, Arita I.
In December 1979, an
independent scientific commission certified global eradication of smallpox.
This conclusion was accepted at the 33d World Health Assembly of the World Health
Organization (WHO) in May 1980. After WHO's intensified eradication
program began in 1967, special certification procedures were used in 35
countries where the disease had been endemic and in 44 others at special risk.
Six laboratories are known to retain variola virus; efforts have been made to
ensure strict containment of these strains. There is no evidence that smallpox
will recur as an endemic disease. Nevertheless, WHO will promote surveillance
of smallpox-like disease and selected laboratory research on certain
orthopoxviruses. These efforts will maintain confidence that smallpox has been
eradicated and confirm that there are no animal reservoirs of variola virus. A
more complete understanding of the orthopoxviruses, including monkeypox virus,
should also be obtained.
PMID: 6252467 [PubMed - indexed for MEDLINE]
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: Z Gesamte Inn Med 1980 Dec 15;35(24):858-63 |
[The world is free of pox - Implementation
and success of a grandiose program]
[Article in German]
Dittmann S.
At the beginning of this century the compulsory vaccination and revaccination
which was legally founded after the introduction of the vaccination by Jenner
(1796) led to the removal of the smallpox in Europe and Northern America.
However, up to the sixties in the developing countries of Asia, Africa as well
as of Southern America and Middle America still fell ill and died of small-pox
millions of people. Between 1953 and 1973 importations into countries of Europe
and Northern America took place in 51 cases. In 1959 on the motion of the USSR
the WHO decided performance of a world-wide eradication programme of small-pox
which could be led to success with comprehensive personal, material and
financial support of many countries. Flanking scientific, technological and
methodical measures were of essential importance. In May 1980 the World Health Assembly in Geneva announced
in solemn form the world-wide eradication of the small-pox and gave
recommendations to the member countries for concluding measures concerning the
small-pox vaccination, the foundation of vaccine reserves and the control of
the epidemiological situation in the world. Also in the GDR the small-pox
vaccination in childhood could be abolished.
Publication Types:
·
Historical Article
PMID: 7013291 [PubMed - indexed for MEDLINE]