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Wednesday, December 18, 2002

Thanks to the work of Edward Jenner - the pioneer of scientific vaccination - the fatal and disfiguring disease smallpox has been eliminated worldwide and is officially only kept in existence by two labarotories, one in the USA and one in Siberia (although France, Iraq + North Korea are also suspected of having stockpiles).

Smallpox used to be a widespread disease responsible for millions of deaths each year. In the UK, smallpox was the most feared and greatest killer of 18th century, killing approximately 10% of the population and even well-known figures such as Elizabeth I, Mozart, George Washington + Abraham Lincoln experienced the terror of catching this dreadful disease.

In order to lessen the risk of dying of smallpox some communities tried scratching scab material from someone with a mild form of smallpox into their skin and Lady Mary Wortley Montagu introduced the practice of innoculating with smallpox into England from Turkey in 1721.

This practice of deliberately giving people smallpox was later called variolation... unfortunately, the identification of a suitable strain of the disease was not a precise science and deaths from variolation were not uncommon!

Although, Edward Jenner carried out variolation in order to protect his patients from smallpox he was intrigued by country-lore which said that people who caught cowpox from their cows could not catch smallpox. This and his own traumatic experience of variolation as a boy led him to investigate whether or not the country-lore had any basis in fact. Cowpox is a mild viral infection of cows that causes a few weeping spots (pocks) on their udders, but little discomfort. Milkmaids occasionally caught cowpox from the cows and although they felt rather off-colour for a few days and developed a small number of pocks, usually on the hand, the disease did not trouble them.

In 1796 a dairymaid, Sarah Nelmes, consulted Jenner about a rash on her hand. He diagnosed cowpox rather than smallpox and Sarah confirmed that one of her cows, a Gloucester cow called Blossom, had recently had cowpox. Edward Jenner realised that this was his opportunity to test the protective properties of cowpox by giving it to someone who had not yet suffered smallpox...

Jenner chose James Phipps, the eight-year old son of his gardener and on 14th May he made a few scratches on one of James' arms and rubbed into them some material from one of the pocks on Sarah's hand. A few days later James became mildly ill with cowpox but was well again a week later. This meant Jenner knew that cowpox could pass from person to person as well as from cow to person.

The next step was to test whether the cowpox would now protect James from smallpox. So on 1st July 1796 Jenner variolated the boy. As Jenner anticipated James did not develop smallpox, either on this occasion or on subsequent ones when his immunity was tested again.

Jenner subsequently developed techniques for taking matter from human cowpox pocks and drying it onto threads of glass so that it could be widely transported and, in Jenner's honour, the technique of introducing material under the skin to produce protection against disease became universally known as vaccination, a word derived from the Latin name for the cow (vacca).

In 1967 the World Health Organization (WHO) launched its campaign to eradicate smallpox worldwide. They estimated at that time that there were still up to 15 million cases of smallpox each year with the biggest problem areas being South America, Africa and the Indian subcontinent. Thanks to a massive international vaccination effort and extensive "mopping-up" operations by 1977 a hospital worker who became ill in Somalia, and survived, was the last person on Earth to catch smallpox by natural transmission.

In 1980 the WHO formally declared that smallpox had successfully been eradicated. It has thus been estimated that the task Jenner started has led to the saving of more human lives than the work of any other person.

Today, the use of the smallpox vaccine continues to be refined in order to tackle the risk posed by stored samples of smallpox should they are ever be obtained by terrorists. President Bush is even due to be vaccinated and millions of smallpox vaccine doses have been bought by the US and UK in case there is ever a terror attack.

The Global Alliance for Vaccine and Immunization (GAVI) are also working to fight preventable diseases such as Yellow Fever, Measles, Polio, Meningococcal Meningitis, Hepatitis B, Diphtheria + Tetanus which are still big killers. In due course it may even be possible to vaccinate against a range of cancers, HIV/AIDS, Malaria and Tuberculosis.

We obviously owe Edward Jenner, Blossom + James Phipps a great deal!

Please see the Edward Jenner Museum's site for more details about Jenner's life, work and impact... amongst other things he was interested in migration (they used to think birds hibernated in river mud), hibernation, balloon flight + fossils!