How we conquered the deadly smallpox virus

10,000 years ago, a lethal virus emerged in northeastern Africa. This airborne virus targeted the skin cells, bone marrow, spleen, and lymph nodes of those infected. Symptoms included high fevers, vomiting, and rashes, with a mortality rate of 30% among sufferers during the second week. Survivors were marked by lifelong scars and scabs. This was the advent of smallpox.

By 1350 B.C., smallpox outbreaks first struck during the Egypt-Hittite conflict. Egyptian captives introduced smallpox to the Hittites, leading to the death of their king and severe repercussions for their civilization. The virus stealthily spread globally through Egyptian merchants, then with Crusaders across the Arab world, and later to the Americas via Spanish and Portuguese conquests. Over time, smallpox claimed the lives of billions, with an estimated 300 to 500 million deaths in the 20th century alone.

Yet, the defeat of smallpox began centuries earlier, around 1022 A.D. A Buddhist nun residing on O Mei Shan mountain in Sichuan province observed that survivors of smallpox did not contract the disease again. She ground smallpox scabs into powder and administered it nasally to healthy individuals, a practice known as variolation. By the 1700s, this technique evolved, with doctors transferring material from smallpox sores into healthy individuals through arm scratches. Although effective in preventing re-infection, variolation still carried risks, with up to three percent mortality.

The breakthrough came in 1796 when Edward Jenner, inspired by a dairy maid's remark, explored cowpox as a potential safeguard against smallpox. Jenner, a physician and apprentice to a surgeon near Bristol, discovered that individuals who contracted cowpox did not develop smallpox. Realizing the similarity between the viruses, Jenner inoculated eight-year-old James Phipps with cowpox matter taken from Sarah Nelmes, a dairy maid infected by her cow, Blossom. Following mild fever and discomfort, Phipps recovered, and subsequent exposure to smallpox showed no signs of disease, proving immunity.

Jenner's method, termed vaccination, differed from variolation by employing the less virulent cowpox virus instead of smallpox itself. Despite initial skepticism, the medical community eventually embraced vaccination, leading to the prohibition of variolation in England by 1840. Following widespread vaccination campaigns in the 19th and 20th centuries, the World Health Organization declared smallpox eradicated in 1979.

Edward Jenner is celebrated as the pioneer of immunology, yet the contributions of the Buddhist nun, Sarah Nelmes, and James Phipps were also pivotal in the journey to eradicate smallpox through vaccination.

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