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• 1 2020-01-23T16:40:37+00:00 Smallpox and Inoculation: An Early Debate in Public Health 9 plain 2020-04-30T14:13:02+00:00 Smallpox is a disease caused by the variola virus, which has existed for 3000 years. Spread through person-to-person contact, it produced a high fever and rash and was fatal in up to 30% of cases (World Health Organization, 2016).  If we want to understand smallpox today, we have to go to an archive. Declared eradicated by the World Health Organization in 1979, it is hard to capture the panic and destruction that impacted communities affected by smallpox except as a historical exercise.
  
  Fortunately, we have many kinds of media available to us to recover a sense of the panic smallpox caused in the lives of sufferers and the communities affected by the disease. Photographs of the sick captured by researchers show us bodies covered in painful sores, and accounts by both survivors and caretakers tell us about the agony of high fevers and fatigue. Physicians’ case histories record deaths and recoveries, at times lacking any explanation of why some lived and others died. Sermons offer explanations of the reckoning affecting cities; and newspapers showcased debates over how best to treat smallpox and prevent further epidemics. While we can’t recover the lived experience of facing a smallpox epidemic, we can appreciate the ways illness poses a source of “dis-ease” to communities.  For example, recent anxieties over the spread of COVID-19 represent similar strains of “dis-ease.” Users attempt to make sense of its cause and prevention, often without fear or research, and post their findings in the cultural petri-dish that is the internet. While the internet is not known for its objectivity or fact-checking, its ability to spread false information is not unique.
  
  When the smallpox vaccine was first developed in the eighteenth century, for example, newspapers and other publications helped share information its authors believed to be true but was not (misinformation) and information its authors knew to be false and hoped to spread to support their beliefs (disinformation).
  
  One early example of misinformation was some of Ben Franklin’s earliest writing in a colonial newspaper on how best to prevent a smallpox epidemic.  Variolation (using live variola virus) developed as an early form of addressing the threat of epidemic. This early form of inoculation developed in China, India, and Africa, and by the eighteenth century, it reached Europe and England. Not everyone believed treating healthy people with disease was a good idea, however. Pushback against inoculation demonstrated tensions against this kind of preventative medicine and reflected broader issues in communities themselves. (Willrich, 35)  During a 1720-21 epidemic in Boston, a young Ben Franklin publicly criticized Reverend Cotton Mather, best known for his role in the Salem witch trials, for promoting inoculation. Writing under a pseudonym in the New England Courant, he attacked inoculation as an ineffective public health measure that could cause smallpox, not prevent it.
  
  Why promote a health measure that might prevent smallpox in one person but infect an entire neighborhood? How did that serve the public good?