November 14, 2017 • 57 mins
This week we pay tribute to one of the gnarliest diseases of all time, and the only human disease that's ever been eradicated (thus far). That's right, people- we're talking smallpox! It's gonna get grody. Smallpox has a depressing history, a fascinating biology, a moderately uplifting present, and a precarious future. We'll cover it all.
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Speaker 1 (00:04):
The red areas spread into blotches across the face and arms,
and within hours the blotches broke out into seas of
tiny pimples. They were sharp, feeling not itchy, and by
nightfall they covered the face, arms, hands, and feet. Pimples
were rising out of the soles of the feet and
on the palms of the hands too. During the night,
(00:24):
the pimples developed tiny blistered heads, and the heads continued
to grow larger, rising all over the body at the
same speed, like a field of barley sprouting after the rain.
They hurt dreadfully, and they were enlarging into boils. They
had a waxy, hard look, and they seemed unripe. Fevers
soared abruptly and began to rage. The rubbing of pajamas
(00:48):
on the skin felt like a roasting fire. By dawn,
the body had become a mass of knob like blisters.
They were everywhere all over, but clustered, most thickly on
the face and extreme. The inside of the mouth and ear,
canals and sinuses had pustulated. It felt as if the
skin was pulling off of the body, that it would
(01:08):
split and rupture. The blisters were hard and dry, and
they didn't leak. They were like ball bearings embedded in
the skin, with a soft, velvety feel on the surface.
Each pustule had a dimple in the center. They were
pressurized with an opalescent puss. The pustules began to touch
one another, and finally they merged into confluent sheets that
(01:30):
covered the body like a cobblestone street. The skin was
torn away across the body, and the pustules on the
face combined into a bubbled mass filled with fluid, until
the skin of the face essentially detached from its underlayers
and became a bag surrounding the tissues of the head. Tongue, gums,
and hard palate were studded with pustules, the mouth dry.
(01:53):
The virus had stripped the skin off the body, both
inside and out, and the pain seemed almost beyond the
capacity of human nature to endure.
Speaker 2 (02:15):
Hi, Hi, Welcome to episode three of this podcast Will
Kill You.
Speaker 1 (02:21):
This week we're talking about smallpox.
Speaker 2 (02:24):
Clearly that was smallpox.
Speaker 1 (02:27):
Yeah, it's horrifying, Oh my god. And that quote was
from The Demon in the Freezer by Richard Preston.
Speaker 2 (02:35):
Wow.
Speaker 1 (02:36):
So how about a little something to take the edge off.
Speaker 2 (02:39):
Yeah, let's take that edge off.
Speaker 1 (02:41):
What are we drinking this week today?
Speaker 2 (02:42):
We're drinking smallpox on the rocks. That's gross.
Speaker 1 (02:48):
Yeah, I don't know if I want to drink that anymore.
Speaker 2 (02:51):
It's you know, it takes the edge off.
Speaker 1 (02:53):
Yeah, sure, sure. What's in smallpox on the rocks?
Speaker 2 (02:57):
Basically, it's a whiskey sour.
Speaker 1 (03:00):
Sign me up. That's pretty signed up.
Speaker 2 (03:04):
It's if you'd like to drink along at home, you
can make your own smallpox on the rocks by mixing
two ounces of.
Speaker 1 (03:12):
Your favorite whiskey wood.
Speaker 2 (03:15):
That's the Kentuckians.
Speaker 1 (03:16):
That's my plug.
Speaker 2 (03:17):
She's she would know, you know, like she does know.
Speaker 1 (03:22):
But you know, let's go with bourbon and the juice of.
Speaker 2 (03:25):
Half a lemon, which is literally every recipe and I
looked it up. It's about three tablespoons of lemon juice.
That's the juice of.
Speaker 1 (03:33):
No, that's that's a juice of a whole lemon.
Speaker 2 (03:35):
You're right, So it's one and a half tablespoons of lemon.
Speaker 1 (03:38):
I maybe more is better. We did it one and
a half tablespoons per two ounces of bourbon and about.
Speaker 2 (03:48):
A half a teaspoon of sugar. Shake it up over ice,
drink it on the rocks.
Speaker 1 (03:53):
Cheers, cheers.
Speaker 2 (03:56):
I wonder what that sounded like. I don't know. It
was good better clinking glasses. Yeah, let's define a few
words for this week. What are the words that we're
gonna be defining this week.
Speaker 1 (04:11):
Let's start with endemic.
Speaker 2 (04:14):
So, in terms of disease, endemic is a disease that
is regularly found among a particular people or in a
certain area. So, for example, there are certain areas of
the world where malaria is considered endemic, and if you
see malaria in those areas, that's sort of normal. Whereas
if you were to see malaria outside of those areas,
(04:35):
that would be considered an epidemic or an outbreak.
Speaker 1 (04:37):
Gotcha, all right. Next one is bio terrorism.
Speaker 2 (04:42):
Bioterrorism is pretty straightforward. It's essentially just terrorism that includes
the release of a biological toxic agent. That's it, clear
clear to me, clear as day.
Speaker 1 (04:53):
Clear as day. Let's talk about what a reservoir is.
Speaker 2 (04:58):
So a reservoir for disease is a long term host
of a pathogen that often do not show symptoms or
have sort of subclinical infections. So in leprosy, we talked
about armadillos armadillos are reservoirs for the leprosy bacteria.
Speaker 1 (05:15):
Eradication.
Speaker 2 (05:17):
Eradication is a fun one, a happy one. It's a
happy one. So eradication of a disease, according to the CDC,
is the permanent reduction to zero of worldwide incidents of
infection caused by a specific agent that is the result
of deliberate efforts in order to eradicate that disease to
(05:39):
the point where intervention measures are no longer needed to
control that disease. There are two diseases in the world
that have been eradicated, Aaron, What are those diseases?
Speaker 1 (05:50):
Oh, smallpox, that's the topic of today. And actually the
other one, which you may not have heard of, it's
called render pest and it is a disease of cattle yep,
both domestic and wild, so ungillates, ungillates, and they're both gone.
So cool, awesome, go, and hopefully hopefully soon polio, guinea worm,
(06:13):
some of the other diseases will be also on that
list thanks to the Carter Foundation. Right, it's the Carter Foundation,
is it? I don't know, it's Jimmy Carter. Cool. Jimmy
Carter's doing a lot of work for eradication.
Speaker 2 (06:24):
That's awesome for.
Speaker 1 (06:25):
Those Yeah, he's awesome. Now that we've defined those terms,
let's jump into the biology. Aaron, tell me all about smallpox.
Speaker 2 (06:33):
I'd love to Aaron. Okay, so smallpox, this one is
a doozy, no lie, this is I know.
Speaker 1 (06:41):
I mean we were already hit pretty hard at the
beginning of this episode.
Speaker 2 (06:44):
Just starting us off with a bang. So here are
the basics. Smallpox is a virus. Uh, it's a DNA virus.
So if you remember influenza was an RNA virus, right,
this is a little bit different. It is in a
family of viruses known as the pox viruses. And I
feel the need to tell you that chicken pox is
not a pox virus.
Speaker 1 (07:05):
That's an important clarification.
Speaker 2 (07:07):
It really is. Chicken pox is caused by a herpes virus.
So it's a totally different family of viruses. But there
are a ton of other pox viruses besides smallpox. There
are pox viruses that infect basically every vertebrate that you
can think of. There is monkey pox, turkey pox, gerbil pox,
(07:28):
camel pox, dolphin pox, snake, there's crocodile pox, kangaroo.
Speaker 1 (07:37):
I think I think we get the point.
Speaker 2 (07:39):
Yeah, literally that that wasn't even the whole list. What
about fish, Well, there's dolphin pox. Dolphins aren't fish.
Speaker 1 (07:46):
My gosh, are you serious? There actually is, actually is
dolphin pox.
Speaker 2 (07:50):
That's not a lie. And then yeah, I mean reptiles
can get various poxes snake pox, so I think there
could be.
Speaker 1 (07:56):
Fish pox is probably a really old family of virus.
Speaker 2 (08:00):
Yes, there are also insect pox viruses, and those are
gnarly because insects don't have skin, so they basically turn
into a giant ball of pox jelly. It's gnarly.
Speaker 1 (08:14):
I want to I want to google that. You should.
Let's let's post a picture of insect infected by some
sort of POxy.
Speaker 2 (08:22):
It's just gonna be go, just do so. Small Pox
itself has two major forms, Variola major and Variola minor,
that are basically named because major is a major problem.
Minor was a minor problem. We're not really going to
get into the distinction for this episode. Most of what
(08:43):
you hear about in terms of the statistics about this
disease have to do with Veryola major. Okay, even though
there are pox viruses that can infect tons of other vertebrates,
smallpox itself is an exclusively human specific virus. It likely
jumped into humans from some type of rodent we don't
(09:04):
know exactly what kind really. Yeah, it's most closely related
to a rodent pox virus, and this likely happened around
the time of the agricultural Revolution about ten thousand years ago,
but estimates really vary on that. It's not exactly clear
when this first happened. But the reason that we think
it likely was around the agricultural Revolution is because math
(09:26):
models have shown that this virus needs a really large
human population size in order to sustain itself.
Speaker 1 (09:33):
So, but not just human population size, but human population density.
Speaker 2 (09:37):
Exactly, exactly, Yes.
Speaker 1 (09:39):
Okay, that's right.
Speaker 2 (09:39):
Okay, So let's get into the disease itself. Yes, we've
already heard a little bit. It's just gonna get worse better,
I don't know, probably worse, yeah, and also better. I
mean it'll get worse and then it will get better.
Speaker 1 (09:50):
We're not sure where we're gonna end up.
Speaker 2 (09:52):
Well, we'll find out. So smallpox has an incubation period, which,
if you remember from the last episode, is the time
from when you're exposed to when you show symptoms is
about twelve days ten to fourteen days, but twelve days on.
Speaker 1 (10:04):
Average, that's a long time.
Speaker 2 (10:06):
It's a pretty long time. The one good thing, and
I really think this is the only good thing about
the smallpox virus no joke, is that it does not
tend to be infectious until you start showing symptoms, and
you are the most infectious. That is, you're shedding the
most virus when you have some of the more severe symptoms,
(10:27):
which are well, let's get into it, the progression of
the disease. So it starts off with fever and body
aches and sometimes vomiting. And this is not just a
typical fever in body aches. This is you are too
sick to continue on with your daily activities, and this
generally lasts for about two to four days. After that,
(10:48):
you'll get a rash and redness that generally starts on
the face, especially in your mouth and on your tongue.
Oh no, yeah, so inside your mouth you'll get that
may break open and these sores are literally filled with
viral particles.
Speaker 1 (11:08):
Oh yeah. So then when somebody is nursing you and
being like, oh, let me make you feel better, right,
and you turn to them and cough a little bit.
Speaker 2 (11:20):
Yeah, So it's important. This is a respiratory virus. So
this is shed by breathing, coughing, et cetera. So, yeah,
if you're infected all up in your mouth and then
you're coughing on the people trying to help you, Bobo's Harley,
my gosh. So then the rash will spread to your body,
to your arms, to your legs. Unlike leprosy, this starts
(11:43):
sort of in the middle of your body and then
spreads outwards.
Speaker 1 (11:46):
Right, Okay.
Speaker 2 (11:47):
This stage generally lasts around four days, and it is
the most contagious part of this infection. Then you start
to get these lesions, these sores that are filled with fluid.
They can become really firm, and like you described earlier,
they get this characteristic dimple in the center. Then you'll
move on to the pustular rash and scab. Oh stage
(12:11):
stop please, I can't stop. I just can't. This is
described as peas under the skin, right, it's so disgusting.
They're sharply raised, they're firm to the touch. This lasts
for about ten days.
Speaker 1 (12:26):
This is a long days.
Speaker 2 (12:28):
This is a long infection.
Speaker 1 (12:29):
Ten days of pea pimples.
Speaker 2 (12:31):
Yes, And after about five days they'll start to crust over.
And I also want to point out that these sores
are literally covering your entire body, your entire body, confluent, yeah,
all over, confluent whatever, all over your body, these scabs,
and then eventually they'll begin to scab, and then they'll
(12:54):
fall off, and you continue to be infectious until the
last scab has fallen off your body. That's if you
survive that.
Speaker 1 (13:01):
Long, and not only are you infectious, but your scabs
are too.
Speaker 2 (13:06):
Exactly, so, if you imagine, like I mean today we
have when when was the vacuum invented?
Speaker 1 (13:12):
The vacuum? Yeah, oh gosh, like the early nineteen hundred.
Speaker 2 (13:16):
There you go. So imagine that you're cleaning up after
your you know, family member who is sick, and they're
dropping scabs all over the place, and then you go
to vacuum them up, and now you're spewing scab dust
into the air and then you breathe it in. That's real.
Speaker 1 (13:30):
Or for instance, I just made that up. Blankets. Yeah,
you'll talk a lot about that. Yeah, I'll get into that.
Speaker 2 (13:37):
So, yeah, that's if the person survives all this, they're
contagious for that entire time.
Speaker 1 (13:42):
It's and how many people did survive this.
Speaker 2 (13:46):
In general, the mortality rate is about twenty to forty percent,
usually considered about thirty percent, so on average, about one
in three people infected with smallpox will die.
Speaker 1 (13:57):
Oh my god.
Speaker 2 (13:59):
Now it gets a little bit worse.
Speaker 1 (14:01):
No, what I just.
Speaker 2 (14:03):
Described was the progression of what is called ordinary smallpox.
Speaker 1 (14:08):
Ordinary, that's the ordinary version. So that's if you were lucky.
This is the most this is the baseline.
Speaker 2 (14:15):
This is the baseline exactly. So some people who were
vaccinated this is the good version, would end up with
what's called modified smallpox, which is basically a less severe form.
But a large number of people, not a large number,
about five to ten percent of cases would be what's
called malignant. These have a longer prodrome period, which is
(14:36):
the period at the beginning when you just have like
a fever and a mild rash. So they'd have a
longer period of that.
Speaker 1 (14:43):
So it's not like they would be infectious longer.
Speaker 2 (14:46):
Not necessarily no, But then when they started to get
a rash, the pustules that they would get were slower growing,
and they would stay flat rather than being raised, and
their skin would stay This is a quote from the
CDC Soft and velvety ew is that yucky?
Speaker 1 (15:05):
What do you what does a velve What does velvet
skin feel like?
Speaker 2 (15:08):
I don't know, but it doesn't sound good.
Speaker 1 (15:10):
I don't think it's touching our faces.
Speaker 2 (15:14):
I need to put lotion on. Yeah, but this form
of the disease is almost always fatal. And what's really
sad is about seventy two percent of the malignant cases
we're in children. Oh yeah, there's a worse one too.
The even worse one, how yeah, is called hemorrhagic small pots.
Speaker 1 (15:36):
Oh okay, that's how yeah.
Speaker 2 (15:37):
So hemorrhagic meaning bleeding out essentially, so instead of just
forming these pustubles under the skin, you would literally just
bleed underneath your skin. You'd bleed into your eyes.
Speaker 1 (15:50):
And your skin would slough off.
Speaker 2 (15:52):
Your skin would just be like puddles of blood like
your whole skin. You bleed into your eyes to the
point where the whites of your eyes would turn black
because they're just full of dried blood. You could even
get this might be getting too gnarly, but you could
even get your bleeding so much that in your capillaries
(16:15):
blood is clotting as it's leaking out, so you have
just blood clots and blood everywhere in your body, and
it's described as very thick and very dark. You would
bleed out of all of your mucous membranes, out of
every orifice.
Speaker 1 (16:30):
People would turn purple yes exactly because there would be
so much skin exactly.
Speaker 2 (16:36):
This is about two percent of cases overall, but somewhere
between three and twenty five percent of all fatal cases.
So this, as you can imagine, was almost always fatal.
Speaker 1 (16:48):
Was do you know anything about why a case would
become hemorrhagic versus.
Speaker 2 (16:53):
You know, I tried to find information about that, and
I really couldn't find good explanation.
Speaker 1 (16:58):
Makes sense that there weren't. Yeah, I don't know.
Speaker 2 (17:00):
If it's just immune related, that's what I would guess,
but I don't really know. Another thing to make all
of this that much worse is that people infected with smallpox.
You can imagine that if you're infected with a disease
that makes you this sick, you're probably not aware of
what's going on because your body is just in overload.
(17:22):
But with smallpox, you stay weirdly, very conscious and aware
of everything that's happening to you.
Speaker 1 (17:30):
That would be horrible, I think.
Speaker 2 (17:33):
Isn't that your actual worst nightmare.
Speaker 1 (17:35):
It's one of them. Personally, I have a lot of
worst nightmare.
Speaker 2 (17:39):
It's gnarley. Gnarley is the word of my read Yeah,
the most in my notes.
Speaker 1 (17:47):
Yeah.
Speaker 2 (17:48):
So that's smallpox in a nutshell.
Speaker 1 (17:58):
Okay, So now that we have a let's call it
baseline understanding of just how awful this disease can be.
Speaker 2 (18:06):
I really, I have to be honest, I did not
know just how horrible this disease was until I really
started reading about it. It is beyond anything that I
could have imagined.
Speaker 1 (18:21):
It's really scary.
Speaker 2 (18:23):
It's terrifying.
Speaker 1 (18:24):
Let's hear more more, Let's hear about how terrifying it
was for people throughout history.
Speaker 2 (18:32):
Let's learn. I want to learn it all.
Speaker 1 (18:34):
So, like you said, the smallpox's iris probably made the
leap from domesticated animals or rodents. As it turns out,
about ten thousand years ago estimates.
Speaker 2 (18:44):
Rodents were like when we domesticated animals, It's like we
practically domesticated rodents by accident because they were living in
all of like the grains and things that we started storing.
So we had huge booms in rodent populations.
Speaker 1 (18:55):
Ex the same time, scientists aren't exactly sure which animal
it came from, but it probably originated in the same
place geographically that agriculture and livestock domestication took off, which
is the river valleys of Africa and India. And we
actually see our first physical evidence of smallpox from around
(19:15):
fifteen hundred to one thousand BC, what in Egyptian mummies
whose preserved skin shows telltale pock marks from the disease.
Speaker 2 (19:25):
Oh my god, you can see the pock marks on
mummies actual, like on actual mummies.
Speaker 1 (19:31):
Yeah, we're gonna post a picture.
Speaker 2 (19:33):
Oh my god, that's so cool.
Speaker 1 (19:34):
It's really cool. Smallpox is what we refer to as
a crowd disease. In order for the virus to successfully
establish in a population, there needs to be enough people
in close contact with one another so that it can
be transmitted and maintained. Otherwise it'll just blow through population
or village and.
Speaker 2 (19:53):
Die out right because it just kills people like yeah, ooh,
I hope that snap got sounded.
Speaker 1 (19:59):
Yeah. Yeah. So it's no coincidence that smallpox started spreading
globally just as human population size took off thanks to
farming from India and northern Africa. It spread east and
west to China, Greece, Rome, et cetera. Around one hundred AD,
smallpox caused a devastating epidemic in the Roman Empire, and
(20:23):
this epidemic was called the plague of Antonius. Ooh yeah,
Like with the nineteen eighteen pan flu pandemic, soldiers returning
home were probably responsible for facilitating the spread of the
smallpox virus, always them soldiers. And at the height of
this particular epidemic, two thousand people died daily in Rome.
(20:46):
Oh my wow. Yeah, this is really bad. I feel
like there wasn't that many people in Rome.
Speaker 2 (20:53):
Well that's the thing.
Speaker 1 (20:54):
Some historians actually suggest that smallpox, along with malaria, contributed
to the fall of the Roman Empire. I love information
like that, I know, because no one really talks about
the role of infectious disease in history, or they do,
but it's not I feel like it's not.
Speaker 2 (21:08):
As it's not as big of a deal as like
and then the three hundred people came and they the
people now or whatever.
Speaker 1 (21:14):
Yeah, yeah, it's all about to talk about it.
Speaker 2 (21:17):
It all comes back to infectious disease people. That's the
point of what we're trying to teach you here.
Speaker 1 (21:21):
Yeah, it is after wreaking havoc in Rome, smallpox made
its way to the rest of Europe, probably through the
Huns or returning crusaders around like the twelfth and thirteenth century.
Were the crusaders?
Speaker 2 (21:34):
Okay, I was going to say, like, I don't know, Yeah,
I know, I know.
Speaker 1 (21:37):
I had to look it up. The Crusaders. Yeah, that's
sure a time that happened well in either case. As
global population continued to grow, smallpox epidemics grew more frequent
and more intense, and in many areas it became endemic.
There's a word callback more of a childhood illness. Okay,
(22:00):
let's talk about Yeah, and he serious, because here comes
one of the most for me, classic small pox periods
of history. One of the things that history teachers in
high school at least tend to gloss over here in
the US is the devastating impact that small packs and
(22:23):
other Old World diseases had on the native North and
South American populations.
Speaker 2 (22:28):
This is where it gets really depressing.
Speaker 1 (22:30):
Yeah, it's gonna be that way for a while. Yeah yeah,
buckle up.
Speaker 2 (22:34):
Buckled your history teacher, have another have just drink.
Speaker 1 (22:38):
Drink up. Here's the time bottoms up. It's not yet.
It's just gonna get worse. Your history teacher may have
forgotten to tell you how smallpox blankets were given to
Native Americans intentionally by invading Europeans in an often successful
attempt to deliberately infect them with this devastating disease.
Speaker 2 (23:02):
Like smallpox blankets, as in some white dude was like, hey, yo,
I got a blanket. I'm gonna rub it all around
a person with smallpox and then I'm going to give it.
That means that they knew enough to know that this
disease was transmitted.
Speaker 1 (23:19):
Ugh, you sound like you want a direct quote.
Speaker 2 (23:21):
I do, thank you.
Speaker 1 (23:22):
I'm happy to provide. In the War of seventeen sixty
three between England and France for control of North America,
the British troops were asked, could it not be contrived
to send the smallpox among those disaffected tribes of Indians.
We must, on this occasion used every stratagem in our
(23:45):
power to reduce them. That's a direct quote. And wait
a second, it's not done yet, because there was a
return letter from the ranking British officer who said, quote,
I will try to inoculate the Indians with some blankets
that fall into their hands and take care not to
get the disease myself. What that really happened? Even in
(24:09):
the instances when it's not entirely clear how deliberately smallpox
is spread, like whether it was deliberate.
Speaker 2 (24:15):
Or not, sounds pretty deliberate.
Speaker 1 (24:17):
Oh yeah, I mean yeah, for instance, in that case
is certainly deliberate. But still Europeans definitely use smallpox to
their advantage. Yeah. Take for instance, Spanish conquistador Hernando Cortes.
He along with around six hundred men or so, landed
in the Yucatan Peninsula around fifteen twenty one and headed
(24:38):
to the Aztec capital city of tanoche Tutlan which is
now Mexico City, to try to take over the Aztec Empire.
He and his fellow conquistadors were soundly defeated in their
first fight with the Aztecs, and they expected to lose
again when the inevitable second blow would come, but it
never came. A little confused and apprehensive, yeah that's what
(25:03):
I wrote, and tired of waiting, the Spanish stormed the city.
Once inside, they found that smallpox had devastated the city.
Oh my god, Cortes and his men had probably all
been exposed to smallpox's children, and so the disease didn't
affect them. Seeing this furthered the belief among the Aztecs
that the invading Spanish were gods, a belief that the
(25:26):
Spanish did nothing to discourage.
Speaker 2 (25:29):
And wow, that's so sad.
Speaker 1 (25:32):
It is it is? And that is how Cortes and
his band of around five hundred, six hundred concuistadors toppled
the twenty five million people strong as Tech Empire. That
was it. That was the end of the Aztec Empire
for all intents and purposes. Oh my god, this is
mirrored I I just in the fall oh of the
(25:55):
Inca Empire.
Speaker 2 (25:56):
This is a really depressing episode.
Speaker 1 (25:59):
Yep, the Inca Empire, which was mainly in Peru and
Ecuador in South America. This time when Pizarro, so this
is another Spanish conquistador and his one hundred and twenty
eight are you really men? When they arrived, they found
an already decimated empire, as smallpox had preceded their arrival.
(26:20):
And they found these huge structures, these huge towns, these
huge buildings, and they looked around and thought, there's there's
no way that these few people could have actually done
this what has happened? Right, because the people were starving
because they were dying of smallpox, and then they had
no one to take care of them. It was I mean,
(26:41):
no one to take care of the field, no one
at farm. So even if you survived smallpox, you had
no food.
Speaker 2 (26:45):
Right.
Speaker 1 (26:45):
It was absolutely terrible, terrible, terrible.
Speaker 2 (26:49):
I think I'm going to cry.
Speaker 1 (26:52):
Well, we're not done.
Speaker 2 (26:53):
You're gonna get more depressing, Okay.
Speaker 1 (26:56):
I mean because we have to talk about North America.
Speaker 2 (26:58):
Oh yeah.
Speaker 1 (26:59):
Historian Elizabeth Fenn tracks a massive smallpox epidemic in North
America in the late seventeen hundreds, coinciding with the time
of the American Revolution. In her book Po's Americana, she
describes British soldiers who were more protected from smallpox infection
because inoculation was more popular in England than it was
(27:20):
in the US at the time anyway, so she describes
British soldiers and officers deliberately trying to infect American soldiers
where inoculation wasn't as widely accepted.
Speaker 2 (27:33):
So is this where they were started to decide that
all is fair in love and war. Theyre like, we're
just gonna I mean, it's always been fair, all fair
in war. But also you're like, I'm not going to
try and actually fight you. I'm just gonna get you sick,
Like get come on, man, that's.
Speaker 1 (27:50):
Not that's not cool. Bioterrorism.
Speaker 2 (27:53):
It's not bioterrorism. That's what it is.
Speaker 1 (27:55):
You're right by bio warfare at the very least. Yep yep,
she described. And so this, this smallpox epidemic that she
describes around the late seventeen hundreds, was not isolated to
the colonial states at the time, so the areas of
New England and the Eastern seaboard. It spread across the country.
Speaker 2 (28:15):
And this, as you said, American Revolution, right.
Speaker 1 (28:18):
So seventeen seventy in the years she describes her seventeen
seventy seven to seventeen eighty five. Okay. The reason, or
one of the reasons is that smallpox was so devastating
for native North and South American populations is because these
were completely naive. They had never been exposed to smallpox before.
And so for instance, the Spanish conquistadors had been probably
(28:41):
exposed as children, or the English they over across the
board had lower mortality rates ranging around thirty whereas some
to read about it, some Native American groups had mortality
rates upwards of ninety percent, one hundred percent. I mean,
it was unbelievable.
Speaker 2 (28:59):
But like, one of the ways that they figured out
how to end up with the vaccines is that if
people were exposed to other forms of pox viruses by
living with other animals, then they could even if they
never got smallpox, if they were exposed to another form
of pox virus might have had some sort of immunity,
which is why you saw lower mortality rates in the
(29:19):
European population.
Speaker 1 (29:21):
This is a nice little segue, yeah, into talking about
inoculation and vaccination ooh, and their relevance to the fight
against smallpox.
Speaker 2 (29:29):
Yeah.
Speaker 1 (29:30):
Inoculation as a practice had been around for hundreds of
years in certain cultures and regions, such as among groups
in Western Africa and Turkey. Okay, but Western medicine had
ignored the practice, chalking it up to old wives tales
and uneducated nonsense.
Speaker 2 (29:46):
So can you explain what inoculation is?
Speaker 1 (29:49):
Sure? Inoculation is the practice of taking material, so usually
like pus or skin from a person who had active
smallpox infection. Yeah, taking that and then injecting it or
inserting it in some way into an individual who had
never been exposed to smallpox.
Speaker 2 (30:11):
Basically like exposing them directly exposed to them infectious gunk.
Speaker 1 (30:16):
But through a non but through a root, which was
not as common.
Speaker 2 (30:20):
Right, because it's a respiratory virus. Right.
Speaker 1 (30:23):
And so what was the usual outcome of inoculation was
a mild smallpox infection. The majority, the vast majority of
patients who were inoculated survived.
Speaker 2 (30:34):
Okay, So the.
Speaker 1 (30:35):
Mortality rate for innoculation was two point five percent.
Speaker 2 (30:38):
Wow, that's a lot lower than twenty to forty percent, right.
Speaker 1 (30:41):
So you were way better off becoming inoculated lower. Yeah,
And so you you had a mild infection and you
generally recovered without any scars or pock marks. However, during
the time that you did show symptoms of your mild
smallpox infection, you were infectious to others, and so it
(31:01):
was still really a dangerous practice in some ways.
Speaker 2 (31:04):
Okay, that makes sense.
Speaker 1 (31:05):
Inoculation was not very popular then in Western cultures, so
in Europe, in parts of Europe, and in North America. Okay.
But then around the same time in the early eighteenth century,
which is the early seventeen hundred, I.
Speaker 2 (31:21):
Was gonna ask, because I'm the worst at those okay numbers.
Speaker 1 (31:25):
Two people on two different continents, one a high born
woman in England whose name was Lady Mary Montague, and
the other a reverend in colonial Boston named Cotton Mather. Yeah, Cotton,
good old Cotton Mather. Where did you say he was Boston?
Speaker 2 (31:45):
Oh? That wasn't of a good Boston accent.
Speaker 1 (31:47):
I just I wonder how that name fell out of style. Anyway,
these two took note of these practices and tried to
bring them to the places they lived. The story goes
that lady was a beautiful, popular.
Speaker 2 (32:02):
Woman, aren't they all?
Speaker 1 (32:03):
And then she got smallpox at twenty six, oh, baby,
which left her pock marked eyelash lists.
Speaker 2 (32:11):
That's if you are a woman, especially at that time.
Speaker 1 (32:14):
I mean, I forget about it. Thank god. She's already married, Oh,
thank god, and horribly fearful of the disease, which had
killed her favorite brother in the same epidemic. Wait, her favorite, Yeah,
that's from the book.
Speaker 2 (32:28):
She had like an outward You can't have an outward favorite.
Speaker 1 (32:31):
That's not I mean, okay, whichever brother is listening to this,
you're my favorite.
Speaker 2 (32:35):
That's rude.
Speaker 1 (32:36):
She moved with her husband to Turkey, where she saw
that smallpox wasn't viewed with the same terror as it
was in England. There she first encountered innoculation, the practice,
like we said, of grafting a bit of small pox
after active smallpox into an unexposed person.
Speaker 2 (32:54):
Okay, so she got smallpox before she learned what inoculation was. Yes, okay,
got it late.
Speaker 1 (33:00):
Mary immediately saw the enormous potential of inoculation and ordered
her children to be inoculated.
Speaker 2 (33:06):
Yeah me too. Oh yeah.
Speaker 1 (33:08):
Upon her return to England, she tried to popularize it,
but most doctors and the general public were horrified. Yeah.
One they figured that actively giving yourself a disease was
basically suicide, I mean and crazy.
Speaker 2 (33:23):
It sounds pretty crazy, sounds pretty crazy crazy.
Speaker 1 (33:25):
And two that this was going against the will of God.
Speaker 2 (33:29):
Oh gotta bring God into it at some point.
Speaker 1 (33:32):
Because if God wanted you or your kids to die
of smallpox.
Speaker 2 (33:36):
Then so she had wow yep.
Speaker 1 (33:39):
To combat some of this incredibly stupid nonsense, Lady Mary
and a few pro inoculation doctors designed an experiment in
which they would inoculate a bunch of people who had
never had smallpox to show to the public and also themselves,
because they weren't entirely sure that inoculation was safe practice.
Speaker 2 (34:00):
I hope that they got perm who they chose, Oh,
let me guess prisoners U huh and uh children maybe
not kind of children, foster children, orphans, orphans, orphans, Ye,
prisoners and orphans, prisoners and orphans. Always at the end
of the short.
Speaker 1 (34:18):
Stan medical ethics was not a practice at this No. Well, regardless,
the experiment worked, which is good. At least. A somewhat
similar sequence of events occurred in Boston, except that there
was no formalized experiment on repressed populations, just people going
up to this doctor named you ready for this doctor
(34:41):
zab deal? Oh geez Boylston, Boyleston.
Speaker 2 (34:45):
Yeah, it was a terrible but also very appropriate.
Speaker 1 (34:50):
Occasion, the early seventeen hundred.
Speaker 2 (34:52):
Boyleston studying smallpox.
Speaker 1 (34:54):
And and asking and asking him to inoculate them.
Speaker 2 (34:57):
Okay, so, at least in this case it was willing volunteer.
Speaker 1 (35:00):
For the most part.
Speaker 2 (35:01):
It's gotta be the first time that the US has
done it, right A just kidding, I don't know.
Speaker 1 (35:07):
I mean, who knows. He did catch a lot of flak, though,
for inoculating people because it was also hugely unpopular and
actually survived several assassination attempts.
Speaker 2 (35:16):
Oh wow. Interesting.
Speaker 1 (35:18):
Eventually the numbers couldn't be ignored. Inoculation carried a mortality
rate of two point five, while, like you said, natural
infection was upwards of thirty yep. Inoculation became pactchually popular
throughout the eighteenth century, but was dethroned by vaccination in
seventeen ninety three. Ooh, you're probably somewhat familiar with this story,
(35:40):
or at least the name of its star. Edward Jenner
Eddie was just going about his life as a country
doctor Eddie when he noticed that milk maids who had
once been infected with cowpox never got smallpox. So cowpox
is a much milder infection in humans with basically no
chance of mortality.
Speaker 2 (35:57):
Because I'm guessing that it is a virus that general
infects cows.
Speaker 1 (36:01):
You're right about that.
Speaker 2 (36:02):
Oh, I'm so good at the guessing.
Speaker 1 (36:05):
He decided to try to take some of the puss
of an active infection of cow pox and then put
it into the skin of a completely unexposed person to
cow or smallpox.
Speaker 2 (36:15):
Interesting. So it's kind of like an inoculation, but with
a different virus, a more mild virus, more mild form.
Speaker 1 (36:21):
Okay, cool, and Jenner tried this out on eight year
old farm hand James Phipps. Hello, medical ethics board, where
are you still? No?
Speaker 2 (36:31):
James was like, he's choice.
Speaker 1 (36:35):
You Uh, but was Jenner supposed to just sit around
and wait for smallpox to come to James Phipps. Nope,
smallpox would come to James via Jenner, who directly exposed him. Luckily,
for James and the rest of the world, his previous
exposure to cow pox fully protected him.
Speaker 2 (36:54):
Awesome.
Speaker 1 (36:55):
Yeah, it's really I mean it's actually a huge step.
Speaker 2 (36:57):
Hold on, wait he so he gave James Phipps, poor
little kid, cow hand, stuck him with cowpox, and then
he exposed him his smallpox.
Speaker 1 (37:09):
Yeah. Wow, that's awful. I'm so glad it worked. Yeah,
I also so is James. Jenner decided to call this
practice vaccination vacca, meaning cow in Latin. Yeah, so that's
where vaccination comes from. It's pretty cool.
Speaker 2 (37:26):
That is awesome. So literally the word vaccination that we
use now for all vaccines, all vaccines is because of smallpox.
Speaker 1 (37:34):
Yes, vacca that is so cool. Yeah, Like inoculation vaccination
took a little bit to catch on, but once it did,
it spread faster than the smallpox virus around the world.
Speaker 2 (37:46):
That was a really good one.
Speaker 1 (37:47):
Thanks, and enabled doctors to eradicate this disease which had
plagued humanity for millennia, which brings us to yeah, eradication, eradication.
The gold stuff are on the story, the bright shining
moment to lift you up. I think for most of us,
smallpox feels ancient, like a thing of I don't know, history,
(38:11):
like the sixteen hundreds, I mean when when Columbus came over. Like,
it feels so far removed from where I am in
terms of thinking about people who are actually infected by it.
But did you know that in the twentieth century smallpox
killed over three hundred million people? Oh my god, that's more, yeah,
than all twentieth century wars combined World War One, World
(38:35):
War two, Vietnam War, so many wars, and also more
than the nineteen eighteen flu.
Speaker 2 (38:40):
It's also the population of the United States of America. Yeah, Like,
there's what three hundred and fifty something, three hundred million
people that was in the twentieth century alone. Huh, oh
my god.
Speaker 1 (38:54):
Now thankfully though, it is a thing of the past. Yeah,
smallpox death toll in the twenty first century zero so far,
But I'm getting ahead of myself. In nineteen sixty six,
the World Health organization the WHO proposed a plan to
eradicate smallpox and put D. A. Henderson in charge of
carrying it out. Over the next twelve years, thousands of
(39:17):
people traveled to some of the world's most remote corners,
living in extremely challenging conditions and working in conflict ridden
countries to administer smallpox vaccine in an attempt to eliminate
it completely. And it worked. The last natural case of
smallpox infection occurred in Somalia on October thirty first, nineteen
seventy seven, over forty years ago this month. This wow, well, next.
Speaker 2 (39:41):
Time, not anymore.
Speaker 1 (39:42):
Yeah, And it happened in a twenty three year old
cook named ali Mao Mahlen who had actually once worked
as a smallpox vaccinator despite never having been vaccinated himself.
Speaker 2 (39:55):
Wait, so he worked administering the smallpox vaccine to people
never vaccinated, and then was the last natural.
Speaker 1 (40:02):
Case of That's isn't that funny?
Speaker 2 (40:04):
That is really funny, I did not know that.
Speaker 1 (40:06):
Yeah. Once news of his infection reached the WHO, a
team was sent to vaccinate the around ninety people who
had come into contact with him.
Speaker 2 (40:14):
Isn't that crazy?
Speaker 1 (40:16):
Ninety people that he came.
Speaker 2 (40:18):
In contact with before they were able to be like,
oh man, we need to stop isolate this person.
Speaker 1 (40:23):
Luckily, he survived the infection and no more cases emerged.
The world was declared smallpox free on May eighth, nineteen eighty.
And this guy, actually Ellie, went on to work very
hard for the Carter Foundation to eliminate polio. Oh wow,
but he died last year of malaria.
Speaker 2 (40:41):
Oh that's sad.
Speaker 1 (40:42):
Sorry, he was sixty three, he was Oh that's so young.
Speaker 2 (40:46):
Oh God.
Speaker 1 (40:47):
I wish the story of smallpox could end here, But
I have a sad story to share. Oh remember how
I said Molin was the last natural case of smallpox.
Speaker 2 (40:58):
Yeah?
Speaker 1 (40:58):
I used that qualifier because there was another case after his.
What in England? Come On August eleventh, nineteen seventy eight,
a medical photographer, Janet Parker became ill and started showing
signs of smallpox.
Speaker 2 (41:13):
It turns out in England.
Speaker 1 (41:14):
In England, what, Yeah, that's ridiculous oh, did just listen
on It turns out she had used a phone booth
in a building which shared an air duct with a
smallpox research lab, and some of the virus must have
escaped threw the duck into the booth where she inhaled it. Yeah,
she and her mother both came down with smallpox, and
(41:35):
possibly her father, but he died of a heart attack
before symptoms appeared. Oh my god, her mother made it,
Janet did not. The scientist whose lab it was, doctor
Henry Bedson, committed suicide. Oh, this whole ordeal.
Speaker 2 (41:48):
Oh my. The person who was the one in the
building studying smallpox when he heard he felt responsible.
Speaker 1 (41:55):
Oh I'm sorry to end on a side note.
Speaker 2 (41:58):
Yeah, what the heck? He could have stopped it. Eradicated?
But smallpox is.
Speaker 1 (42:03):
Gone mostly Yeah, at least it remains the only human
infectious disease to have been eliminated.
Speaker 2 (42:09):
Wow.
Speaker 1 (42:10):
Though I'm hopeful that those words will be wrong within
a few years when polio and guinea worm are gone.
Speaker 2 (42:17):
Wouldn't that be great?
Speaker 1 (42:18):
Yeah? So aaron smallpox is eradicated. Does that mean we
don't have to worry about it?
Speaker 2 (42:23):
Oh?
Speaker 1 (42:23):
Hell no? Oh no, no, I'm also really worried about it.
Speaker 2 (42:29):
No, yeah, uh no, lie me too. Basically, we're all forked.
Speaker 1 (42:44):
I read something in one of the books about how
a Russian scientist defected to the US after he had
been working in a lab whose goal it was to
make a more virulent vaccine resistance strain smallpox. Yeah. This
was in the eighties. Yeah, and this it turns out
(43:04):
that this lab had not been listed on any register
as to the remaining places that smallpox was supposed to
be held. So, in case you don't know, smallpox is
officially on paper at least exists in two labs, one
in the US.
Speaker 2 (43:22):
Right, two specific buildings. One the building is called Corpus six.
It's at Vector, which is a research institution in Russia.
The other place that it exists on paper is in
the Maximum Containment Laboratory at the Center for Disease Control
in Atlanta in the United States. Those are the only
two places in the world on paper that smallpox virus exists.
Speaker 1 (43:48):
But you're a fool if you believe that that's the
only that those are the only places it is because
North Korea, right definitely has smallpox.
Speaker 2 (43:55):
I have a whole list of a bunch of.
Speaker 1 (43:57):
Reantries, not where that worried about France.
Speaker 2 (43:59):
But you know, I'm worried about France. I don't know
why I'm said, people, I'm just worried about every Let's
see India, Pakistan, China, Israel, Iraq, North Korea, Iran, possibly China,
possibly Taiwan, possibly France. Yeah, dude, that's a whole lot
of countries.
Speaker 1 (44:18):
I mean, who's gonna go, Oh, yeah, here's all the smallpox,
right wink.
Speaker 2 (44:23):
So everyone the World Health Organization, back when they were
sort of trailblazing on this eradication effort, they were getting
really close to eradicating the disease, they started sort of
strongly suggesting that everyone who was doing research on smallpox
either destroy their stores of the vaccine or send them
(44:46):
to the US and Russia.
Speaker 1 (44:48):
There was a date around nineteen ninety five when everyone
was supposed to have just either actually, okay, sorry, So
prior to nineteen ninety five, all all these countries were
supposed to have sent their samples to Russia or the
US exactly, and then in nineteen ninety five there were
Russia and the US were supposed to destroy samples.
Speaker 2 (45:11):
And so basically what has happened is every few years
since then there is a convention and people decide should
we destroy everything or should we wait a few years
for research purposes? And that has literally been what has
happened every few years until this day. Those stores still exist,
people maybe are still doing research. It's really hard to
(45:33):
find any information about what type of research might be happening.
Speaker 1 (45:36):
Well, they certainly were following nine to eleven. Yeah, well,
but actually during yeah, for and during so but since
since nine to eleven, since the anthrax scare, smallpox has
been considered to be one of the more viable threats
for in terms of bioterrorism. Yep, because it is so fatal,
(45:56):
it is so infectious, or at least infectious enough, and
it can be dispersed very easily. Right, it's airborne, airborne,
it's airborne, and so it's it's a really interesting ethical issue.
It is because because there's no more smallpox in the world, right,
do we continue how do we justify the continued research funds,
(46:21):
research animals?
Speaker 2 (46:22):
Yeah, And at this point, really the only reason that
it is quote unquote justified to keep these stores of
smallpox virus is because of the threat of bioterrorism, and
so we need to be able to develop vaccines, we
need to be able to do research. But then that
(46:43):
is only because we think that there are other people
out there doing research to potentially make this a weapon.
Speaker 1 (46:50):
And well so, but there are like that has been verifle.
Speaker 2 (46:52):
Well yeah, but that's the thing is I mean, it's
it's not like it's just one person or one entity
that's doing that and then everyone else is just trying
to defend against it, right, It's it's likely everyone who
is doing research on how to weaponize it. I mean,
we uh, this is just us talking, but I mean
this is also logic.
Speaker 1 (47:12):
I think it's I think it's a very real fear
that this could be weaponized because there was research done
on mousepox to have and so a group of researchers
in Australia manipulated the mousepox virus to defeat the vaccine
so that vaccinated mice died or were susceptible to mousepox virus.
(47:34):
And that is very easy. That could be very easily
done with smallpox as well.
Speaker 2 (47:38):
And the other thing is that the smallpox vaccine is
extraordinarily imperfect. Imperfect is sort of a nice word to
use for it. Currently today, about twenty percent of people
would not be eligible to be vaccinated for the smallpox vaccine.
Speaker 1 (47:54):
Right, So before you go jumping to your doctor and
trying to get a hold of smallpox vaccine, first of all,
it's not gonna happen.
Speaker 2 (47:59):
They're never.
Speaker 1 (48:00):
Second of all, you may not be eligible.
Speaker 2 (48:03):
So anyone with exzema or who lives in a householder
who has family members with egzma is not eligible to
get the vaccine. Pregnant or if you live in a
house with babies, you cannot give it. What else, if
you're a moutocompromised, Yeah, if you have any sort of
autoimmune disease, or are on chemotherapy, or have HIV, or honestly,
if you probably live in a household with an immunal
(48:25):
compromise person. Because the thing is that the current vaccination
for smallpox is another virus. It is not a modified,
killed form of the smallpox virus. It is a live, active,
different virus that they inject you with under your skin
(48:46):
that actually causes a viral infection. It's just very localized
to one pak essentially.
Speaker 1 (48:53):
Right. So you've probably seen the scars.
Speaker 2 (48:55):
Yes, and that I used to actually think that that
scar was because the way that they injected the vaccine
was like a big idea too, That's what I thought.
Speaker 1 (49:03):
So there are things that are vaccine guns they use,
So did you.
Speaker 2 (49:08):
See that, Well, but that's what I used to think
that the scar is from.
Speaker 1 (49:10):
Well, but it's it's because it's because that's the way
the pope.
Speaker 2 (49:15):
There was an actual poc there.
Speaker 1 (49:16):
And actually this reminds me one of the things that
makes smallpox such a good candidate for eradication. There are
multiple reasons. One, you can easily tell who has been
vaccinated or not judging from the smallpox scar that they
have or the vaccination scar. The second is that the
vaccine itself, when freeze dried, has really long or has
(49:38):
really high longevity, and it's really stable, and so you
can transport it to these tropic countries where there tend
to be a lot of more cases of smallpox. And
the third is that there is no known animal host reservoir.
You reservoir, and so even so, for instance, if you
eliminated it entirely from here humans, if it still could
(50:02):
infect animals or was or animals were a reservoir for it, right,
it means that you could still potentially humans could still
potentially be exposed. Right.
Speaker 2 (50:10):
That's why there are so many diseases that, as much
as we would like to eliminate them, it's nearly impossible
because there are animal reservoirs for so many diseases. The
other thing about the smallpox vaccine, besides the fact that
about twenty percent of the population could not be vaccinated
in case of an outbreak, is that, though there are
(50:31):
probably swaths of the population that were vaccinated either as
children or I double checked with my brother in law,
some active duty military people also get vaccinated, depending on
where they I don't know if it's what branch of
the military they're in, or if it's where they're going
to be sent to, but they are also given the vaccine.
But immunity tends to only last about four to five years,
(50:54):
so if you were vaccinated a few years ago or
when you were a child, you're no longer immune essentially,
So if there were any sort of outbreak that happened today, sorry,
yeah it is you no good.
Speaker 1 (51:09):
I mean, it could be the case that you have
a lesser infection, like a lesser.
Speaker 2 (51:14):
Possible you might end up with this sort of mixed
form or whatever. Is that what it's called modified modified.
You might end up with the modified form, but still
pretty gnarly.
Speaker 1 (51:25):
I think our point is, how scared should you be
of smallpox? Pretty scared?
Speaker 2 (51:31):
Really really forkin scared. Seriously, I didn't even.
Speaker 1 (51:36):
I mean, I mean, I think I think it's smallpox,
despite having been completely eradicated, is so important and so
relevant for today for a number of reasons, one of
which is bioterrorism right, the other which is the vaccine scare,
which I don't want to get into the whole nitty
gritty on oh, vaccines are bad for you.
Speaker 2 (51:56):
We're gonna get too angry at this time of night.
I think, if yeah, yeah, get into that.
Speaker 1 (52:01):
But I think it is really fascinating to see these
parallels between yeah, vaccination when it was first introduced and nowadays,
and the pushback against that and the reasons why. And
I think that the absence of diseases, such a visible
diseases such a smallpox, ye, really lead people to forget
how important vaccination actually is.
Speaker 2 (52:22):
That's the thing is it's really easy when you're so
far removed. The thing that I think is so crazy
is that not a single physician in the world who
has been trained since the late nineteen seventies, has ever
seen a case of smallpox ever? And hopefully they never
(52:43):
ever ever.
Speaker 1 (52:43):
Will hopefully, But oh, I think it's incredible.
Speaker 2 (52:47):
It is absolutely incredible because the thing is, like I mean,
I'm in medical school right now, we have never talked
about smallpox. Besides to say that this is a disease
that has been eradicated, we never talked about the symptoms
in depth.
Speaker 1 (53:01):
Don't worry, it's eradicated. The gotcha, right?
Speaker 2 (53:05):
And so to think that if there were to be
even if you don't think about it from a sort
of large scale bio terrorism aspect, if you just think
of what if a few particles somehow got out.
Speaker 1 (53:19):
In a lab accident, such as happened to Janet Parker exactly.
Speaker 2 (53:23):
And so I mean, if something like that were to happen,
could we even diagnose it in order to contain it?
Speaker 1 (53:31):
Oh?
Speaker 2 (53:31):
Isn't that scary? I thought of that while doing all
this research.
Speaker 1 (53:35):
Is there a movie that is smallpox?
Speaker 2 (53:38):
Not that I know of.
Speaker 1 (53:39):
There should be screenwriters, get on this.
Speaker 2 (53:41):
Yeah, are you hearing this? Guys? This is a great
This is scarier than the movie Contagion, Oh way scarier. Yeah,
So if we were at one point, we talked about
doing a sort of threat level on all of these episodes,
like terror threat level orange or whatever.
Speaker 1 (53:59):
This threat level. Wear a diaper because you're about to
pee your parts. Yeah we have no scale.
Speaker 2 (54:08):
No scale. Yeah we don't have a scale.
Speaker 1 (54:10):
But in reality, yeah, be really scared. Smallpox is awful.
Speaker 2 (54:16):
It's really terrifying.
Speaker 1 (54:18):
But wait, we've been using the wrong verb tense. Smallpox
was awful.
Speaker 2 (54:23):
It was thank goodness, thank goodness, thank you World Health Organization.
Speaker 1 (54:28):
It's actually amazing what they accomplished.
Speaker 2 (54:31):
It really is. We should let people know if they'd
like to read more, because some of these books are
really amazing. Got a list, I've got a hit me
with them.
Speaker 1 (54:41):
If you want to know more about inoculation and the
development of inoculation as a practice in England and the US,
you should read The Speckled Monster by Jennifer Lee Carroll.
If you are interested in the nitty gritty of the
epidemic that happened in North America from seventeen seventy seven
(55:02):
to seventeen eighty five, you should check out Pox Americana
by Elizabeth Fenn. Smallpox The Death of a Disease by D. A. Henderson,
is a book penned by the leader of the eradication
effort himself, and it is an amazing book. It is
really great.
Speaker 2 (55:21):
Also, don't you have a signed copy of that?
Speaker 1 (55:24):
I do, I know, I got it all got it
like a books Amazon, and it's sign so thrilled.
Speaker 2 (55:31):
By literally the person who was the reason that we
were able to eradicate this disease, Da Henderson props.
Speaker 1 (55:39):
The other book that I think you should read is
called The Demon in the Freezer and it's by Richard Preston.
It reads like a movie script. It is really exciting.
It's more about the eradication effort of smallpox and then
anthrax in terms of bioterrorism. It's a little dated, but
(55:59):
it's really still really good. The Power of Plagues by
Irwin Sherman. It's a compilation book with chapters on different
diseases or on different topics in terms of plagues and
epidemics throughout history, and all of those are great. We
recommend them, so if you're interested read more. Yeah, check
(56:19):
it out, check it out, fact check us.
Speaker 2 (56:22):
That'd be fun. If we're wrong, let us know, man.
Speaker 1 (56:25):
Yeah, we would love to hear yeah, because we're just
doing this for fun.
Speaker 2 (56:28):
Yeah, it's very fun, it is.
Speaker 1 (56:30):
And so what's happening next week? Speaking of more fun, I.
Speaker 2 (56:33):
Don't know what is happening next week. Colra Coolera, Yeah,
oh man, that's gonna be fun.
Speaker 1 (56:38):
Colra is gonna be good. Get ready for some good
John snow Puns, The.
Speaker 2 (56:43):
King of the North. That was my first attempt.
Speaker 1 (56:45):
The King of Coolera.
Speaker 2 (56:47):
We'll work on it.
Speaker 1 (56:49):
Yeah, we've got a long way to go.
Speaker 2 (56:51):
Please please, please, please please rate and review us on
iTunes or wherever you get your podcasts and subscribe, and
that is how people are able to find this podcast.
So if you like us, then you think other people
will like us, then you should definitely rate and review
us so that other people can find us in the
first place.
Speaker 1 (57:09):
We are also on all these other podcast hosting websites.
We're on Podbean, you can find us on Stitcher, on
Google Play, anywhere else to get your podcast. And we
also have a Facebook page, an Instagram page, and a
Twitter page, so please follow us on each of those
if you want to see some really cool pictures of disease,
(57:29):
or see some cool facts, or get our recipe for
whatever quarantine or we're.
Speaker 2 (57:34):
Drinking yep, we post that every week this podcast will
kill you. Our Twitter is our acronym. I can't spell it.
Speaker 1 (57:41):
PWK. Why that's it? All right?
Speaker 2 (57:44):
I think that's it.
Speaker 1 (57:45):
Yeah, all right, everyone wash your hands.
Speaker 2 (57:49):
Yeah. Fealthy animals
The red areas spread into blotches across the face and arms,
and within hours the blotches broke out into seas of
tiny pimples. They were sharp, feeling not itchy, and by
nightfall they covered the face, arms, hands, and feet. Pimples
were rising out of the soles of the feet and
on the palms of the hands too. During the night,
(00:24):
the pimples developed tiny blistered heads, and the heads continued
to grow larger, rising all over the body at the
same speed, like a field of barley sprouting after the rain.
They hurt dreadfully, and they were enlarging into boils. They
had a waxy, hard look, and they seemed unripe. Fevers
soared abruptly and began to rage. The rubbing of pajamas
(00:48):
on the skin felt like a roasting fire. By dawn,
the body had become a mass of knob like blisters.
They were everywhere all over, but clustered, most thickly on
the face and extreme. The inside of the mouth and ear,
canals and sinuses had pustulated. It felt as if the
skin was pulling off of the body, that it would
(01:08):
split and rupture. The blisters were hard and dry, and
they didn't leak. They were like ball bearings embedded in
the skin, with a soft, velvety feel on the surface.
Each pustule had a dimple in the center. They were
pressurized with an opalescent puss. The pustules began to touch
one another, and finally they merged into confluent sheets that
(01:30):
covered the body like a cobblestone street. The skin was
torn away across the body, and the pustules on the
face combined into a bubbled mass filled with fluid, until
the skin of the face essentially detached from its underlayers
and became a bag surrounding the tissues of the head. Tongue, gums,
and hard palate were studded with pustules, the mouth dry.
(01:53):
The virus had stripped the skin off the body, both
inside and out, and the pain seemed almost beyond the
capacity of human nature to endure.
Speaker 2 (02:15):
Hi, Hi, Welcome to episode three of this podcast Will
Kill You.
Speaker 1 (02:21):
This week we're talking about smallpox.
Speaker 2 (02:24):
Clearly that was smallpox.
Speaker 1 (02:27):
Yeah, it's horrifying, Oh my god. And that quote was
from The Demon in the Freezer by Richard Preston.
Speaker 2 (02:35):
Wow.
Speaker 1 (02:36):
So how about a little something to take the edge off.
Speaker 2 (02:39):
Yeah, let's take that edge off.
Speaker 1 (02:41):
What are we drinking this week today?
Speaker 2 (02:42):
We're drinking smallpox on the rocks. That's gross.
Speaker 1 (02:48):
Yeah, I don't know if I want to drink that anymore.
Speaker 2 (02:51):
It's you know, it takes the edge off.
Speaker 1 (02:53):
Yeah, sure, sure. What's in smallpox on the rocks?
Speaker 2 (02:57):
Basically, it's a whiskey sour.
Speaker 1 (03:00):
Sign me up. That's pretty signed up.
Speaker 2 (03:04):
It's if you'd like to drink along at home, you
can make your own smallpox on the rocks by mixing
two ounces of.
Speaker 1 (03:12):
Your favorite whiskey wood.
Speaker 2 (03:15):
That's the Kentuckians.
Speaker 1 (03:16):
That's my plug.
Speaker 2 (03:17):
She's she would know, you know, like she does know.
Speaker 1 (03:22):
But you know, let's go with bourbon and the juice of.
Speaker 2 (03:25):
Half a lemon, which is literally every recipe and I
looked it up. It's about three tablespoons of lemon juice.
That's the juice of.
Speaker 1 (03:33):
No, that's that's a juice of a whole lemon.
Speaker 2 (03:35):
You're right, So it's one and a half tablespoons of lemon.
Speaker 1 (03:38):
I maybe more is better. We did it one and
a half tablespoons per two ounces of bourbon and about.
Speaker 2 (03:48):
A half a teaspoon of sugar. Shake it up over ice,
drink it on the rocks.
Speaker 1 (03:53):
Cheers, cheers.
Speaker 2 (03:56):
I wonder what that sounded like. I don't know. It
was good better clinking glasses. Yeah, let's define a few
words for this week. What are the words that we're
gonna be defining this week.
Speaker 1 (04:11):
Let's start with endemic.
Speaker 2 (04:14):
So, in terms of disease, endemic is a disease that
is regularly found among a particular people or in a
certain area. So, for example, there are certain areas of
the world where malaria is considered endemic, and if you
see malaria in those areas, that's sort of normal. Whereas
if you were to see malaria outside of those areas,
(04:35):
that would be considered an epidemic or an outbreak.
Speaker 1 (04:37):
Gotcha, all right. Next one is bio terrorism.
Speaker 2 (04:42):
Bioterrorism is pretty straightforward. It's essentially just terrorism that includes
the release of a biological toxic agent. That's it, clear
clear to me, clear as day.
Speaker 1 (04:53):
Clear as day. Let's talk about what a reservoir is.
Speaker 2 (04:58):
So a reservoir for disease is a long term host
of a pathogen that often do not show symptoms or
have sort of subclinical infections. So in leprosy, we talked
about armadillos armadillos are reservoirs for the leprosy bacteria.
Speaker 1 (05:15):
Eradication.
Speaker 2 (05:17):
Eradication is a fun one, a happy one. It's a
happy one. So eradication of a disease, according to the CDC,
is the permanent reduction to zero of worldwide incidents of
infection caused by a specific agent that is the result
of deliberate efforts in order to eradicate that disease to
(05:39):
the point where intervention measures are no longer needed to
control that disease. There are two diseases in the world
that have been eradicated, Aaron, What are those diseases?
Speaker 1 (05:50):
Oh, smallpox, that's the topic of today. And actually the
other one, which you may not have heard of, it's
called render pest and it is a disease of cattle yep,
both domestic and wild, so ungillates, ungillates, and they're both gone.
So cool, awesome, go, and hopefully hopefully soon polio, guinea worm,
(06:13):
some of the other diseases will be also on that
list thanks to the Carter Foundation. Right, it's the Carter Foundation,
is it? I don't know, it's Jimmy Carter. Cool. Jimmy
Carter's doing a lot of work for eradication.
Speaker 2 (06:24):
That's awesome for.
Speaker 1 (06:25):
Those Yeah, he's awesome. Now that we've defined those terms,
let's jump into the biology. Aaron, tell me all about smallpox.
Speaker 2 (06:33):
I'd love to Aaron. Okay, so smallpox, this one is
a doozy, no lie, this is I know.
Speaker 1 (06:41):
I mean we were already hit pretty hard at the
beginning of this episode.
Speaker 2 (06:44):
Just starting us off with a bang. So here are
the basics. Smallpox is a virus. Uh, it's a DNA virus.
So if you remember influenza was an RNA virus, right,
this is a little bit different. It is in a
family of viruses known as the pox viruses. And I
feel the need to tell you that chicken pox is
not a pox virus.
Speaker 1 (07:05):
That's an important clarification.
Speaker 2 (07:07):
It really is. Chicken pox is caused by a herpes virus.
So it's a totally different family of viruses. But there
are a ton of other pox viruses besides smallpox. There
are pox viruses that infect basically every vertebrate that you
can think of. There is monkey pox, turkey pox, gerbil pox,
(07:28):
camel pox, dolphin pox, snake, there's crocodile pox, kangaroo.
Speaker 1 (07:37):
I think I think we get the point.
Speaker 2 (07:39):
Yeah, literally that that wasn't even the whole list. What
about fish, Well, there's dolphin pox. Dolphins aren't fish.
Speaker 1 (07:46):
My gosh, are you serious? There actually is, actually is
dolphin pox.
Speaker 2 (07:50):
That's not a lie. And then yeah, I mean reptiles
can get various poxes snake pox, so I think there
could be.
Speaker 1 (07:56):
Fish pox is probably a really old family of virus.
Speaker 2 (08:00):
Yes, there are also insect pox viruses, and those are
gnarly because insects don't have skin, so they basically turn
into a giant ball of pox jelly. It's gnarly.
Speaker 1 (08:14):
I want to I want to google that. You should.
Let's let's post a picture of insect infected by some
sort of POxy.
Speaker 2 (08:22):
It's just gonna be go, just do so. Small Pox
itself has two major forms, Variola major and Variola minor,
that are basically named because major is a major problem.
Minor was a minor problem. We're not really going to
get into the distinction for this episode. Most of what
(08:43):
you hear about in terms of the statistics about this
disease have to do with Veryola major. Okay, even though
there are pox viruses that can infect tons of other vertebrates,
smallpox itself is an exclusively human specific virus. It likely
jumped into humans from some type of rodent we don't
(09:04):
know exactly what kind really. Yeah, it's most closely related
to a rodent pox virus, and this likely happened around
the time of the agricultural Revolution about ten thousand years ago,
but estimates really vary on that. It's not exactly clear
when this first happened. But the reason that we think
it likely was around the agricultural Revolution is because math
(09:26):
models have shown that this virus needs a really large
human population size in order to sustain itself.
Speaker 1 (09:33):
So, but not just human population size, but human population density.
Speaker 2 (09:37):
Exactly, exactly, Yes.
Speaker 1 (09:39):
Okay, that's right.
Speaker 2 (09:39):
Okay, So let's get into the disease itself. Yes, we've
already heard a little bit. It's just gonna get worse better,
I don't know, probably worse, yeah, and also better. I
mean it'll get worse and then it will get better.
Speaker 1 (09:50):
We're not sure where we're gonna end up.
Speaker 2 (09:52):
Well, we'll find out. So smallpox has an incubation period, which,
if you remember from the last episode, is the time
from when you're exposed to when you show symptoms is
about twelve days ten to fourteen days, but twelve days on.
Speaker 1 (10:04):
Average, that's a long time.
Speaker 2 (10:06):
It's a pretty long time. The one good thing, and
I really think this is the only good thing about
the smallpox virus no joke, is that it does not
tend to be infectious until you start showing symptoms, and
you are the most infectious. That is, you're shedding the
most virus when you have some of the more severe symptoms,
(10:27):
which are well, let's get into it, the progression of
the disease. So it starts off with fever and body
aches and sometimes vomiting. And this is not just a
typical fever in body aches. This is you are too
sick to continue on with your daily activities, and this
generally lasts for about two to four days. After that,
(10:48):
you'll get a rash and redness that generally starts on
the face, especially in your mouth and on your tongue.
Oh no, yeah, so inside your mouth you'll get that
may break open and these sores are literally filled with
viral particles.
Speaker 1 (11:08):
Oh yeah. So then when somebody is nursing you and
being like, oh, let me make you feel better, right,
and you turn to them and cough a little bit.
Speaker 2 (11:20):
Yeah, So it's important. This is a respiratory virus. So
this is shed by breathing, coughing, et cetera. So, yeah,
if you're infected all up in your mouth and then
you're coughing on the people trying to help you, Bobo's Harley,
my gosh. So then the rash will spread to your body,
to your arms, to your legs. Unlike leprosy, this starts
(11:43):
sort of in the middle of your body and then
spreads outwards.
Speaker 1 (11:46):
Right, Okay.
Speaker 2 (11:47):
This stage generally lasts around four days, and it is
the most contagious part of this infection. Then you start
to get these lesions, these sores that are filled with fluid.
They can become really firm, and like you described earlier,
they get this characteristic dimple in the center. Then you'll
move on to the pustular rash and scab. Oh stage
(12:11):
stop please, I can't stop. I just can't. This is
described as peas under the skin, right, it's so disgusting.
They're sharply raised, they're firm to the touch. This lasts
for about ten days.
Speaker 1 (12:26):
This is a long days.
Speaker 2 (12:28):
This is a long infection.
Speaker 1 (12:29):
Ten days of pea pimples.
Speaker 2 (12:31):
Yes, And after about five days they'll start to crust over.
And I also want to point out that these sores
are literally covering your entire body, your entire body, confluent, yeah,
all over, confluent whatever, all over your body, these scabs,
and then eventually they'll begin to scab, and then they'll
(12:54):
fall off, and you continue to be infectious until the
last scab has fallen off your body. That's if you
survive that.
Speaker 1 (13:01):
Long, and not only are you infectious, but your scabs
are too.
Speaker 2 (13:06):
Exactly, so, if you imagine, like I mean today we
have when when was the vacuum invented?
Speaker 1 (13:12):
The vacuum? Yeah, oh gosh, like the early nineteen hundred.
Speaker 2 (13:16):
There you go. So imagine that you're cleaning up after
your you know, family member who is sick, and they're
dropping scabs all over the place, and then you go
to vacuum them up, and now you're spewing scab dust
into the air and then you breathe it in. That's real.
Speaker 1 (13:30):
Or for instance, I just made that up. Blankets. Yeah,
you'll talk a lot about that. Yeah, I'll get into that.
Speaker 2 (13:37):
So, yeah, that's if the person survives all this, they're
contagious for that entire time.
Speaker 1 (13:42):
It's and how many people did survive this.
Speaker 2 (13:46):
In general, the mortality rate is about twenty to forty percent,
usually considered about thirty percent, so on average, about one
in three people infected with smallpox will die.
Speaker 1 (13:57):
Oh my god.
Speaker 2 (13:59):
Now it gets a little bit worse.
Speaker 1 (14:01):
No, what I just.
Speaker 2 (14:03):
Described was the progression of what is called ordinary smallpox.
Speaker 1 (14:08):
Ordinary, that's the ordinary version. So that's if you were lucky.
This is the most this is the baseline.
Speaker 2 (14:15):
This is the baseline exactly. So some people who were
vaccinated this is the good version, would end up with
what's called modified smallpox, which is basically a less severe form.
But a large number of people, not a large number,
about five to ten percent of cases would be what's
called malignant. These have a longer prodrome period, which is
(14:36):
the period at the beginning when you just have like
a fever and a mild rash. So they'd have a
longer period of that.
Speaker 1 (14:43):
So it's not like they would be infectious longer.
Speaker 2 (14:46):
Not necessarily no, But then when they started to get
a rash, the pustules that they would get were slower growing,
and they would stay flat rather than being raised, and
their skin would stay This is a quote from the
CDC Soft and velvety ew is that yucky?
Speaker 1 (15:05):
What do you what does a velve What does velvet
skin feel like?
Speaker 2 (15:08):
I don't know, but it doesn't sound good.
Speaker 1 (15:10):
I don't think it's touching our faces.
Speaker 2 (15:14):
I need to put lotion on. Yeah, but this form
of the disease is almost always fatal. And what's really
sad is about seventy two percent of the malignant cases
we're in children. Oh yeah, there's a worse one too.
The even worse one, how yeah, is called hemorrhagic small pots.
Speaker 1 (15:36):
Oh okay, that's how yeah.
Speaker 2 (15:37):
So hemorrhagic meaning bleeding out essentially, so instead of just
forming these pustubles under the skin, you would literally just
bleed underneath your skin. You'd bleed into your eyes.
Speaker 1 (15:50):
And your skin would slough off.
Speaker 2 (15:52):
Your skin would just be like puddles of blood like
your whole skin. You bleed into your eyes to the
point where the whites of your eyes would turn black
because they're just full of dried blood. You could even
get this might be getting too gnarly, but you could
even get your bleeding so much that in your capillaries
(16:15):
blood is clotting as it's leaking out, so you have
just blood clots and blood everywhere in your body, and
it's described as very thick and very dark. You would
bleed out of all of your mucous membranes, out of
every orifice.
Speaker 1 (16:30):
People would turn purple yes exactly because there would be
so much skin exactly.
Speaker 2 (16:36):
This is about two percent of cases overall, but somewhere
between three and twenty five percent of all fatal cases.
So this, as you can imagine, was almost always fatal.
Speaker 1 (16:48):
Was do you know anything about why a case would
become hemorrhagic versus.
Speaker 2 (16:53):
You know, I tried to find information about that, and
I really couldn't find good explanation.
Speaker 1 (16:58):
Makes sense that there weren't. Yeah, I don't know.
Speaker 2 (17:00):
If it's just immune related, that's what I would guess,
but I don't really know. Another thing to make all
of this that much worse is that people infected with smallpox.
You can imagine that if you're infected with a disease
that makes you this sick, you're probably not aware of
what's going on because your body is just in overload.
(17:22):
But with smallpox, you stay weirdly, very conscious and aware
of everything that's happening to you.
Speaker 1 (17:30):
That would be horrible, I think.
Speaker 2 (17:33):
Isn't that your actual worst nightmare.
Speaker 1 (17:35):
It's one of them. Personally, I have a lot of
worst nightmare.
Speaker 2 (17:39):
It's gnarley. Gnarley is the word of my read Yeah,
the most in my notes.
Speaker 1 (17:47):
Yeah.
Speaker 2 (17:48):
So that's smallpox in a nutshell.
Speaker 1 (17:58):
Okay, So now that we have a let's call it
baseline understanding of just how awful this disease can be.
Speaker 2 (18:06):
I really, I have to be honest, I did not
know just how horrible this disease was until I really
started reading about it. It is beyond anything that I
could have imagined.
Speaker 1 (18:21):
It's really scary.
Speaker 2 (18:23):
It's terrifying.
Speaker 1 (18:24):
Let's hear more more, Let's hear about how terrifying it
was for people throughout history.
Speaker 2 (18:32):
Let's learn. I want to learn it all.
Speaker 1 (18:34):
So, like you said, the smallpox's iris probably made the
leap from domesticated animals or rodents. As it turns out,
about ten thousand years ago estimates.
Speaker 2 (18:44):
Rodents were like when we domesticated animals, It's like we
practically domesticated rodents by accident because they were living in
all of like the grains and things that we started storing.
So we had huge booms in rodent populations.
Speaker 1 (18:55):
Ex the same time, scientists aren't exactly sure which animal
it came from, but it probably originated in the same
place geographically that agriculture and livestock domestication took off, which
is the river valleys of Africa and India. And we
actually see our first physical evidence of smallpox from around
(19:15):
fifteen hundred to one thousand BC, what in Egyptian mummies
whose preserved skin shows telltale pock marks from the disease.
Speaker 2 (19:25):
Oh my god, you can see the pock marks on
mummies actual, like on actual mummies.
Speaker 1 (19:31):
Yeah, we're gonna post a picture.
Speaker 2 (19:33):
Oh my god, that's so cool.
Speaker 1 (19:34):
It's really cool. Smallpox is what we refer to as
a crowd disease. In order for the virus to successfully
establish in a population, there needs to be enough people
in close contact with one another so that it can
be transmitted and maintained. Otherwise it'll just blow through population
or village and.
Speaker 2 (19:53):
Die out right because it just kills people like yeah, ooh,
I hope that snap got sounded.
Speaker 1 (19:59):
Yeah. Yeah. So it's no coincidence that smallpox started spreading
globally just as human population size took off thanks to
farming from India and northern Africa. It spread east and
west to China, Greece, Rome, et cetera. Around one hundred AD,
smallpox caused a devastating epidemic in the Roman Empire, and
(20:23):
this epidemic was called the plague of Antonius. Ooh yeah,
Like with the nineteen eighteen pan flu pandemic, soldiers returning
home were probably responsible for facilitating the spread of the
smallpox virus, always them soldiers. And at the height of
this particular epidemic, two thousand people died daily in Rome.
(20:46):
Oh my wow. Yeah, this is really bad. I feel
like there wasn't that many people in Rome.
Speaker 2 (20:53):
Well that's the thing.
Speaker 1 (20:54):
Some historians actually suggest that smallpox, along with malaria, contributed
to the fall of the Roman Empire. I love information
like that, I know, because no one really talks about
the role of infectious disease in history, or they do,
but it's not I feel like it's not.
Speaker 2 (21:08):
As it's not as big of a deal as like
and then the three hundred people came and they the
people now or whatever.
Speaker 1 (21:14):
Yeah, yeah, it's all about to talk about it.
Speaker 2 (21:17):
It all comes back to infectious disease people. That's the
point of what we're trying to teach you here.
Speaker 1 (21:21):
Yeah, it is after wreaking havoc in Rome, smallpox made
its way to the rest of Europe, probably through the
Huns or returning crusaders around like the twelfth and thirteenth century.
Were the crusaders?
Speaker 2 (21:34):
Okay, I was going to say, like, I don't know, Yeah,
I know, I know.
Speaker 1 (21:37):
I had to look it up. The Crusaders. Yeah, that's
sure a time that happened well in either case. As
global population continued to grow, smallpox epidemics grew more frequent
and more intense, and in many areas it became endemic.
There's a word callback more of a childhood illness. Okay,
(22:00):
let's talk about Yeah, and he serious, because here comes
one of the most for me, classic small pox periods
of history. One of the things that history teachers in
high school at least tend to gloss over here in
the US is the devastating impact that small packs and
(22:23):
other Old World diseases had on the native North and
South American populations.
Speaker 2 (22:28):
This is where it gets really depressing.
Speaker 1 (22:30):
Yeah, it's gonna be that way for a while. Yeah yeah,
buckle up.
Speaker 2 (22:34):
Buckled your history teacher, have another have just drink.
Speaker 1 (22:38):
Drink up. Here's the time bottoms up. It's not yet.
It's just gonna get worse. Your history teacher may have
forgotten to tell you how smallpox blankets were given to
Native Americans intentionally by invading Europeans in an often successful
attempt to deliberately infect them with this devastating disease.
Speaker 2 (23:02):
Like smallpox blankets, as in some white dude was like, hey, yo,
I got a blanket. I'm gonna rub it all around
a person with smallpox and then I'm going to give it.
That means that they knew enough to know that this
disease was transmitted.
Speaker 1 (23:19):
Ugh, you sound like you want a direct quote.
Speaker 2 (23:21):
I do, thank you.
Speaker 1 (23:22):
I'm happy to provide. In the War of seventeen sixty
three between England and France for control of North America,
the British troops were asked, could it not be contrived
to send the smallpox among those disaffected tribes of Indians.
We must, on this occasion used every stratagem in our
(23:45):
power to reduce them. That's a direct quote. And wait
a second, it's not done yet, because there was a
return letter from the ranking British officer who said, quote,
I will try to inoculate the Indians with some blankets
that fall into their hands and take care not to
get the disease myself. What that really happened? Even in
(24:09):
the instances when it's not entirely clear how deliberately smallpox
is spread, like whether it was deliberate.
Speaker 2 (24:15):
Or not, sounds pretty deliberate.
Speaker 1 (24:17):
Oh yeah, I mean yeah, for instance, in that case
is certainly deliberate. But still Europeans definitely use smallpox to
their advantage. Yeah. Take for instance, Spanish conquistador Hernando Cortes.
He along with around six hundred men or so, landed
in the Yucatan Peninsula around fifteen twenty one and headed
(24:38):
to the Aztec capital city of tanoche Tutlan which is
now Mexico City, to try to take over the Aztec Empire.
He and his fellow conquistadors were soundly defeated in their
first fight with the Aztecs, and they expected to lose
again when the inevitable second blow would come, but it
never came. A little confused and apprehensive, yeah that's what
(25:03):
I wrote, and tired of waiting, the Spanish stormed the city.
Once inside, they found that smallpox had devastated the city.
Oh my god, Cortes and his men had probably all
been exposed to smallpox's children, and so the disease didn't
affect them. Seeing this furthered the belief among the Aztecs
that the invading Spanish were gods, a belief that the
(25:26):
Spanish did nothing to discourage.
Speaker 2 (25:29):
And wow, that's so sad.
Speaker 1 (25:32):
It is it is? And that is how Cortes and
his band of around five hundred, six hundred concuistadors toppled
the twenty five million people strong as Tech Empire. That
was it. That was the end of the Aztec Empire
for all intents and purposes. Oh my god, this is
mirrored I I just in the fall oh of the
(25:55):
Inca Empire.
Speaker 2 (25:56):
This is a really depressing episode.
Speaker 1 (25:59):
Yep, the Inca Empire, which was mainly in Peru and
Ecuador in South America. This time when Pizarro, so this
is another Spanish conquistador and his one hundred and twenty
eight are you really men? When they arrived, they found
an already decimated empire, as smallpox had preceded their arrival.
(26:20):
And they found these huge structures, these huge towns, these
huge buildings, and they looked around and thought, there's there's
no way that these few people could have actually done
this what has happened? Right, because the people were starving
because they were dying of smallpox, and then they had
no one to take care of them. It was I mean,
(26:41):
no one to take care of the field, no one
at farm. So even if you survived smallpox, you had
no food.
Speaker 2 (26:45):
Right.
Speaker 1 (26:45):
It was absolutely terrible, terrible, terrible.
Speaker 2 (26:49):
I think I'm going to cry.
Speaker 1 (26:52):
Well, we're not done.
Speaker 2 (26:53):
You're gonna get more depressing, Okay.
Speaker 1 (26:56):
I mean because we have to talk about North America.
Speaker 2 (26:58):
Oh yeah.
Speaker 1 (26:59):
Historian Elizabeth Fenn tracks a massive smallpox epidemic in North
America in the late seventeen hundreds, coinciding with the time
of the American Revolution. In her book Po's Americana, she
describes British soldiers who were more protected from smallpox infection
because inoculation was more popular in England than it was
(27:20):
in the US at the time anyway, so she describes
British soldiers and officers deliberately trying to infect American soldiers
where inoculation wasn't as widely accepted.
Speaker 2 (27:33):
So is this where they were started to decide that
all is fair in love and war. Theyre like, we're
just gonna I mean, it's always been fair, all fair
in war. But also you're like, I'm not going to
try and actually fight you. I'm just gonna get you sick,
Like get come on, man, that's.
Speaker 1 (27:50):
Not that's not cool. Bioterrorism.
Speaker 2 (27:53):
It's not bioterrorism. That's what it is.
Speaker 1 (27:55):
You're right by bio warfare at the very least. Yep yep,
she described. And so this, this smallpox epidemic that she
describes around the late seventeen hundreds, was not isolated to
the colonial states at the time, so the areas of
New England and the Eastern seaboard. It spread across the country.
Speaker 2 (28:15):
And this, as you said, American Revolution, right.
Speaker 1 (28:18):
So seventeen seventy in the years she describes her seventeen
seventy seven to seventeen eighty five. Okay. The reason, or
one of the reasons is that smallpox was so devastating
for native North and South American populations is because these
were completely naive. They had never been exposed to smallpox before.
And so for instance, the Spanish conquistadors had been probably
(28:41):
exposed as children, or the English they over across the
board had lower mortality rates ranging around thirty whereas some
to read about it, some Native American groups had mortality
rates upwards of ninety percent, one hundred percent. I mean,
it was unbelievable.
Speaker 2 (28:59):
But like, one of the ways that they figured out
how to end up with the vaccines is that if
people were exposed to other forms of pox viruses by
living with other animals, then they could even if they
never got smallpox, if they were exposed to another form
of pox virus might have had some sort of immunity,
which is why you saw lower mortality rates in the
(29:19):
European population.
Speaker 1 (29:21):
This is a nice little segue, yeah, into talking about
inoculation and vaccination ooh, and their relevance to the fight
against smallpox.
Speaker 2 (29:29):
Yeah.
Speaker 1 (29:30):
Inoculation as a practice had been around for hundreds of
years in certain cultures and regions, such as among groups
in Western Africa and Turkey. Okay, but Western medicine had
ignored the practice, chalking it up to old wives tales
and uneducated nonsense.
Speaker 2 (29:46):
So can you explain what inoculation is?
Speaker 1 (29:49):
Sure? Inoculation is the practice of taking material, so usually
like pus or skin from a person who had active
smallpox infection. Yeah, taking that and then injecting it or
inserting it in some way into an individual who had
never been exposed to smallpox.
Speaker 2 (30:11):
Basically like exposing them directly exposed to them infectious gunk.
Speaker 1 (30:16):
But through a non but through a root, which was
not as common.
Speaker 2 (30:20):
Right, because it's a respiratory virus. Right.
Speaker 1 (30:23):
And so what was the usual outcome of inoculation was
a mild smallpox infection. The majority, the vast majority of
patients who were inoculated survived.
Speaker 2 (30:34):
Okay, So the.
Speaker 1 (30:35):
Mortality rate for innoculation was two point five percent.
Speaker 2 (30:38):
Wow, that's a lot lower than twenty to forty percent, right.
Speaker 1 (30:41):
So you were way better off becoming inoculated lower. Yeah,
And so you you had a mild infection and you
generally recovered without any scars or pock marks. However, during
the time that you did show symptoms of your mild
smallpox infection, you were infectious to others, and so it
(31:01):
was still really a dangerous practice in some ways.
Speaker 2 (31:04):
Okay, that makes sense.
Speaker 1 (31:05):
Inoculation was not very popular then in Western cultures, so
in Europe, in parts of Europe, and in North America. Okay.
But then around the same time in the early eighteenth century,
which is the early seventeen hundred, I.
Speaker 2 (31:21):
Was gonna ask, because I'm the worst at those okay numbers.
Speaker 1 (31:25):
Two people on two different continents, one a high born
woman in England whose name was Lady Mary Montague, and
the other a reverend in colonial Boston named Cotton Mather. Yeah, Cotton,
good old Cotton Mather. Where did you say he was Boston?
Speaker 2 (31:45):
Oh? That wasn't of a good Boston accent.
Speaker 1 (31:47):
I just I wonder how that name fell out of style. Anyway,
these two took note of these practices and tried to
bring them to the places they lived. The story goes
that lady was a beautiful, popular.
Speaker 2 (32:02):
Woman, aren't they all?
Speaker 1 (32:03):
And then she got smallpox at twenty six, oh, baby,
which left her pock marked eyelash lists.
Speaker 2 (32:11):
That's if you are a woman, especially at that time.
Speaker 1 (32:14):
I mean, I forget about it. Thank god. She's already married, Oh,
thank god, and horribly fearful of the disease, which had
killed her favorite brother in the same epidemic. Wait, her favorite, Yeah,
that's from the book.
Speaker 2 (32:28):
She had like an outward You can't have an outward favorite.
Speaker 1 (32:31):
That's not I mean, okay, whichever brother is listening to this,
you're my favorite.
Speaker 2 (32:35):
That's rude.
Speaker 1 (32:36):
She moved with her husband to Turkey, where she saw
that smallpox wasn't viewed with the same terror as it
was in England. There she first encountered innoculation, the practice,
like we said, of grafting a bit of small pox
after active smallpox into an unexposed person.
Speaker 2 (32:54):
Okay, so she got smallpox before she learned what inoculation was. Yes, okay,
got it late.
Speaker 1 (33:00):
Mary immediately saw the enormous potential of inoculation and ordered
her children to be inoculated.
Speaker 2 (33:06):
Yeah me too. Oh yeah.
Speaker 1 (33:08):
Upon her return to England, she tried to popularize it,
but most doctors and the general public were horrified. Yeah.
One they figured that actively giving yourself a disease was
basically suicide, I mean and crazy.
Speaker 2 (33:23):
It sounds pretty crazy, sounds pretty crazy crazy.
Speaker 1 (33:25):
And two that this was going against the will of God.
Speaker 2 (33:29):
Oh gotta bring God into it at some point.
Speaker 1 (33:32):
Because if God wanted you or your kids to die
of smallpox.
Speaker 2 (33:36):
Then so she had wow yep.
Speaker 1 (33:39):
To combat some of this incredibly stupid nonsense, Lady Mary
and a few pro inoculation doctors designed an experiment in
which they would inoculate a bunch of people who had
never had smallpox to show to the public and also themselves,
because they weren't entirely sure that inoculation was safe practice.
Speaker 2 (34:00):
I hope that they got perm who they chose, Oh,
let me guess prisoners U huh and uh children maybe
not kind of children, foster children, orphans, orphans, orphans, Ye,
prisoners and orphans, prisoners and orphans. Always at the end
of the short.
Speaker 1 (34:18):
Stan medical ethics was not a practice at this No. Well, regardless,
the experiment worked, which is good. At least. A somewhat
similar sequence of events occurred in Boston, except that there
was no formalized experiment on repressed populations, just people going
up to this doctor named you ready for this doctor
(34:41):
zab deal? Oh geez Boylston, Boyleston.
Speaker 2 (34:45):
Yeah, it was a terrible but also very appropriate.
Speaker 1 (34:50):
Occasion, the early seventeen hundred.
Speaker 2 (34:52):
Boyleston studying smallpox.
Speaker 1 (34:54):
And and asking and asking him to inoculate them.
Speaker 2 (34:57):
Okay, so, at least in this case it was willing volunteer.
Speaker 1 (35:00):
For the most part.
Speaker 2 (35:01):
It's gotta be the first time that the US has
done it, right A just kidding, I don't know.
Speaker 1 (35:07):
I mean, who knows. He did catch a lot of flak, though,
for inoculating people because it was also hugely unpopular and
actually survived several assassination attempts.
Speaker 2 (35:16):
Oh wow. Interesting.
Speaker 1 (35:18):
Eventually the numbers couldn't be ignored. Inoculation carried a mortality
rate of two point five, while, like you said, natural
infection was upwards of thirty yep. Inoculation became pactchually popular
throughout the eighteenth century, but was dethroned by vaccination in
seventeen ninety three. Ooh, you're probably somewhat familiar with this story,
(35:40):
or at least the name of its star. Edward Jenner
Eddie was just going about his life as a country
doctor Eddie when he noticed that milk maids who had
once been infected with cowpox never got smallpox. So cowpox
is a much milder infection in humans with basically no
chance of mortality.
Speaker 2 (35:57):
Because I'm guessing that it is a virus that general
infects cows.
Speaker 1 (36:01):
You're right about that.
Speaker 2 (36:02):
Oh, I'm so good at the guessing.
Speaker 1 (36:05):
He decided to try to take some of the puss
of an active infection of cow pox and then put
it into the skin of a completely unexposed person to
cow or smallpox.
Speaker 2 (36:15):
Interesting. So it's kind of like an inoculation, but with
a different virus, a more mild virus, more mild form.
Speaker 1 (36:21):
Okay, cool, and Jenner tried this out on eight year
old farm hand James Phipps. Hello, medical ethics board, where
are you still? No?
Speaker 2 (36:31):
James was like, he's choice.
Speaker 1 (36:35):
You Uh, but was Jenner supposed to just sit around
and wait for smallpox to come to James Phipps. Nope,
smallpox would come to James via Jenner, who directly exposed him. Luckily,
for James and the rest of the world, his previous
exposure to cow pox fully protected him.
Speaker 2 (36:54):
Awesome.
Speaker 1 (36:55):
Yeah, it's really I mean it's actually a huge step.
Speaker 2 (36:57):
Hold on, wait he so he gave James Phipps, poor
little kid, cow hand, stuck him with cowpox, and then
he exposed him his smallpox.
Speaker 1 (37:09):
Yeah. Wow, that's awful. I'm so glad it worked. Yeah,
I also so is James. Jenner decided to call this
practice vaccination vacca, meaning cow in Latin. Yeah, so that's
where vaccination comes from. It's pretty cool.
Speaker 2 (37:26):
That is awesome. So literally the word vaccination that we
use now for all vaccines, all vaccines is because of smallpox.
Speaker 1 (37:34):
Yes, vacca that is so cool. Yeah, Like inoculation vaccination
took a little bit to catch on, but once it did,
it spread faster than the smallpox virus around the world.
Speaker 2 (37:46):
That was a really good one.
Speaker 1 (37:47):
Thanks, and enabled doctors to eradicate this disease which had
plagued humanity for millennia, which brings us to yeah, eradication, eradication.
The gold stuff are on the story, the bright shining
moment to lift you up. I think for most of us,
smallpox feels ancient, like a thing of I don't know, history,
(38:11):
like the sixteen hundreds, I mean when when Columbus came over. Like,
it feels so far removed from where I am in
terms of thinking about people who are actually infected by it.
But did you know that in the twentieth century smallpox
killed over three hundred million people? Oh my god, that's more, yeah,
than all twentieth century wars combined World War One, World
(38:35):
War two, Vietnam War, so many wars, and also more
than the nineteen eighteen flu.
Speaker 2 (38:40):
It's also the population of the United States of America. Yeah, Like,
there's what three hundred and fifty something, three hundred million
people that was in the twentieth century alone. Huh, oh
my god.
Speaker 1 (38:54):
Now thankfully though, it is a thing of the past. Yeah,
smallpox death toll in the twenty first century zero so far,
But I'm getting ahead of myself. In nineteen sixty six,
the World Health organization the WHO proposed a plan to
eradicate smallpox and put D. A. Henderson in charge of
carrying it out. Over the next twelve years, thousands of
(39:17):
people traveled to some of the world's most remote corners,
living in extremely challenging conditions and working in conflict ridden
countries to administer smallpox vaccine in an attempt to eliminate
it completely. And it worked. The last natural case of
smallpox infection occurred in Somalia on October thirty first, nineteen
seventy seven, over forty years ago this month. This wow, well, next.
Speaker 2 (39:41):
Time, not anymore.
Speaker 1 (39:42):
Yeah, And it happened in a twenty three year old
cook named ali Mao Mahlen who had actually once worked
as a smallpox vaccinator despite never having been vaccinated himself.
Speaker 2 (39:55):
Wait, so he worked administering the smallpox vaccine to people
never vaccinated, and then was the last natural.
Speaker 1 (40:02):
Case of That's isn't that funny?
Speaker 2 (40:04):
That is really funny, I did not know that.
Speaker 1 (40:06):
Yeah. Once news of his infection reached the WHO, a
team was sent to vaccinate the around ninety people who
had come into contact with him.
Speaker 2 (40:14):
Isn't that crazy?
Speaker 1 (40:16):
Ninety people that he came.
Speaker 2 (40:18):
In contact with before they were able to be like,
oh man, we need to stop isolate this person.
Speaker 1 (40:23):
Luckily, he survived the infection and no more cases emerged.
The world was declared smallpox free on May eighth, nineteen eighty.
And this guy, actually Ellie, went on to work very
hard for the Carter Foundation to eliminate polio. Oh wow,
but he died last year of malaria.
Speaker 2 (40:41):
Oh that's sad.
Speaker 1 (40:42):
Sorry, he was sixty three, he was Oh that's so young.
Speaker 2 (40:46):
Oh God.
Speaker 1 (40:47):
I wish the story of smallpox could end here, But
I have a sad story to share. Oh remember how
I said Molin was the last natural case of smallpox.
Speaker 2 (40:58):
Yeah?
Speaker 1 (40:58):
I used that qualifier because there was another case after his.
What in England? Come On August eleventh, nineteen seventy eight,
a medical photographer, Janet Parker became ill and started showing
signs of smallpox.
Speaker 2 (41:13):
It turns out in England.
Speaker 1 (41:14):
In England, what, Yeah, that's ridiculous oh, did just listen
on It turns out she had used a phone booth
in a building which shared an air duct with a
smallpox research lab, and some of the virus must have
escaped threw the duck into the booth where she inhaled it. Yeah,
she and her mother both came down with smallpox, and
(41:35):
possibly her father, but he died of a heart attack
before symptoms appeared. Oh my god, her mother made it,
Janet did not. The scientist whose lab it was, doctor
Henry Bedson, committed suicide. Oh, this whole ordeal.
Speaker 2 (41:48):
Oh my. The person who was the one in the
building studying smallpox when he heard he felt responsible.
Speaker 1 (41:55):
Oh I'm sorry to end on a side note.
Speaker 2 (41:58):
Yeah, what the heck? He could have stopped it. Eradicated?
But smallpox is.
Speaker 1 (42:03):
Gone mostly Yeah, at least it remains the only human
infectious disease to have been eliminated.
Speaker 2 (42:09):
Wow.
Speaker 1 (42:10):
Though I'm hopeful that those words will be wrong within
a few years when polio and guinea worm are gone.
Speaker 2 (42:17):
Wouldn't that be great?
Speaker 1 (42:18):
Yeah? So aaron smallpox is eradicated. Does that mean we
don't have to worry about it?
Speaker 2 (42:23):
Oh?
Speaker 1 (42:23):
Hell no? Oh no, no, I'm also really worried about it.
Speaker 2 (42:29):
No, yeah, uh no, lie me too. Basically, we're all forked.
Speaker 1 (42:44):
I read something in one of the books about how
a Russian scientist defected to the US after he had
been working in a lab whose goal it was to
make a more virulent vaccine resistance strain smallpox. Yeah. This
was in the eighties. Yeah, and this it turns out
(43:04):
that this lab had not been listed on any register
as to the remaining places that smallpox was supposed to
be held. So, in case you don't know, smallpox is
officially on paper at least exists in two labs, one
in the US.
Speaker 2 (43:22):
Right, two specific buildings. One the building is called Corpus six.
It's at Vector, which is a research institution in Russia.
The other place that it exists on paper is in
the Maximum Containment Laboratory at the Center for Disease Control
in Atlanta in the United States. Those are the only
two places in the world on paper that smallpox virus exists.
Speaker 1 (43:48):
But you're a fool if you believe that that's the
only that those are the only places it is because
North Korea, right definitely has smallpox.
Speaker 2 (43:55):
I have a whole list of a bunch of.
Speaker 1 (43:57):
Reantries, not where that worried about France.
Speaker 2 (43:59):
But you know, I'm worried about France. I don't know
why I'm said, people, I'm just worried about every Let's
see India, Pakistan, China, Israel, Iraq, North Korea, Iran, possibly China,
possibly Taiwan, possibly France. Yeah, dude, that's a whole lot
of countries.
Speaker 1 (44:18):
I mean, who's gonna go, Oh, yeah, here's all the smallpox,
right wink.
Speaker 2 (44:23):
So everyone the World Health Organization, back when they were
sort of trailblazing on this eradication effort, they were getting
really close to eradicating the disease, they started sort of
strongly suggesting that everyone who was doing research on smallpox
either destroy their stores of the vaccine or send them
(44:46):
to the US and Russia.
Speaker 1 (44:48):
There was a date around nineteen ninety five when everyone
was supposed to have just either actually, okay, sorry, So
prior to nineteen ninety five, all all these countries were
supposed to have sent their samples to Russia or the
US exactly, and then in nineteen ninety five there were
Russia and the US were supposed to destroy samples.
Speaker 2 (45:11):
And so basically what has happened is every few years
since then there is a convention and people decide should
we destroy everything or should we wait a few years
for research purposes? And that has literally been what has
happened every few years until this day. Those stores still exist,
people maybe are still doing research. It's really hard to
(45:33):
find any information about what type of research might be happening.
Speaker 1 (45:36):
Well, they certainly were following nine to eleven. Yeah, well,
but actually during yeah, for and during so but since
since nine to eleven, since the anthrax scare, smallpox has
been considered to be one of the more viable threats
for in terms of bioterrorism. Yep, because it is so fatal,
(45:56):
it is so infectious, or at least infectious enough, and
it can be dispersed very easily. Right, it's airborne, airborne,
it's airborne, and so it's it's a really interesting ethical issue.
It is because because there's no more smallpox in the world, right,
do we continue how do we justify the continued research funds,
(46:21):
research animals?
Speaker 2 (46:22):
Yeah, And at this point, really the only reason that
it is quote unquote justified to keep these stores of
smallpox virus is because of the threat of bioterrorism, and
so we need to be able to develop vaccines, we
need to be able to do research. But then that
(46:43):
is only because we think that there are other people
out there doing research to potentially make this a weapon.
Speaker 1 (46:50):
And well so, but there are like that has been verifle.
Speaker 2 (46:52):
Well yeah, but that's the thing is I mean, it's
it's not like it's just one person or one entity
that's doing that and then everyone else is just trying
to defend against it, right, It's it's likely everyone who
is doing research on how to weaponize it. I mean,
we uh, this is just us talking, but I mean
this is also logic.
Speaker 1 (47:12):
I think it's I think it's a very real fear
that this could be weaponized because there was research done
on mousepox to have and so a group of researchers
in Australia manipulated the mousepox virus to defeat the vaccine
so that vaccinated mice died or were susceptible to mousepox virus.
(47:34):
And that is very easy. That could be very easily
done with smallpox as well.
Speaker 2 (47:38):
And the other thing is that the smallpox vaccine is
extraordinarily imperfect. Imperfect is sort of a nice word to
use for it. Currently today, about twenty percent of people
would not be eligible to be vaccinated for the smallpox vaccine.
Speaker 1 (47:54):
Right, So before you go jumping to your doctor and
trying to get a hold of smallpox vaccine, first of all,
it's not gonna happen.
Speaker 2 (47:59):
They're never.
Speaker 1 (48:00):
Second of all, you may not be eligible.
Speaker 2 (48:03):
So anyone with exzema or who lives in a householder
who has family members with egzma is not eligible to
get the vaccine. Pregnant or if you live in a
house with babies, you cannot give it. What else, if
you're a moutocompromised, Yeah, if you have any sort of
autoimmune disease, or are on chemotherapy, or have HIV, or honestly,
if you probably live in a household with an immunal
(48:25):
compromise person. Because the thing is that the current vaccination
for smallpox is another virus. It is not a modified,
killed form of the smallpox virus. It is a live, active,
different virus that they inject you with under your skin
(48:46):
that actually causes a viral infection. It's just very localized
to one pak essentially.
Speaker 1 (48:53):
Right. So you've probably seen the scars.
Speaker 2 (48:55):
Yes, and that I used to actually think that that
scar was because the way that they injected the vaccine
was like a big idea too, That's what I thought.
Speaker 1 (49:03):
So there are things that are vaccine guns they use,
So did you.
Speaker 2 (49:08):
See that, Well, but that's what I used to think
that the scar is from.
Speaker 1 (49:10):
Well, but it's it's because it's because that's the way
the pope.
Speaker 2 (49:15):
There was an actual poc there.
Speaker 1 (49:16):
And actually this reminds me one of the things that
makes smallpox such a good candidate for eradication. There are
multiple reasons. One, you can easily tell who has been
vaccinated or not judging from the smallpox scar that they
have or the vaccination scar. The second is that the
vaccine itself, when freeze dried, has really long or has
(49:38):
really high longevity, and it's really stable, and so you
can transport it to these tropic countries where there tend
to be a lot of more cases of smallpox. And
the third is that there is no known animal host reservoir.
You reservoir, and so even so, for instance, if you
eliminated it entirely from here humans, if it still could
(50:02):
infect animals or was or animals were a reservoir for it, right,
it means that you could still potentially humans could still
potentially be exposed. Right.
Speaker 2 (50:10):
That's why there are so many diseases that, as much
as we would like to eliminate them, it's nearly impossible
because there are animal reservoirs for so many diseases. The
other thing about the smallpox vaccine, besides the fact that
about twenty percent of the population could not be vaccinated
in case of an outbreak, is that, though there are
(50:31):
probably swaths of the population that were vaccinated either as
children or I double checked with my brother in law,
some active duty military people also get vaccinated, depending on
where they I don't know if it's what branch of
the military they're in, or if it's where they're going
to be sent to, but they are also given the vaccine.
But immunity tends to only last about four to five years,
(50:54):
so if you were vaccinated a few years ago or
when you were a child, you're no longer immune essentially,
So if there were any sort of outbreak that happened today, sorry,
yeah it is you no good.
Speaker 1 (51:09):
I mean, it could be the case that you have
a lesser infection, like a lesser.
Speaker 2 (51:14):
Possible you might end up with this sort of mixed
form or whatever. Is that what it's called modified modified.
You might end up with the modified form, but still
pretty gnarly.
Speaker 1 (51:25):
I think our point is, how scared should you be
of smallpox? Pretty scared?
Speaker 2 (51:31):
Really really forkin scared. Seriously, I didn't even.
Speaker 1 (51:36):
I mean, I mean, I think I think it's smallpox,
despite having been completely eradicated, is so important and so
relevant for today for a number of reasons, one of
which is bioterrorism right, the other which is the vaccine scare,
which I don't want to get into the whole nitty
gritty on oh, vaccines are bad for you.
Speaker 2 (51:56):
We're gonna get too angry at this time of night.
I think, if yeah, yeah, get into that.
Speaker 1 (52:01):
But I think it is really fascinating to see these
parallels between yeah, vaccination when it was first introduced and nowadays,
and the pushback against that and the reasons why. And
I think that the absence of diseases, such a visible
diseases such a smallpox, ye, really lead people to forget
how important vaccination actually is.
Speaker 2 (52:22):
That's the thing is it's really easy when you're so
far removed. The thing that I think is so crazy
is that not a single physician in the world who
has been trained since the late nineteen seventies, has ever
seen a case of smallpox ever? And hopefully they never
(52:43):
ever ever.
Speaker 1 (52:43):
Will hopefully, But oh, I think it's incredible.
Speaker 2 (52:47):
It is absolutely incredible because the thing is, like I mean,
I'm in medical school right now, we have never talked
about smallpox. Besides to say that this is a disease
that has been eradicated, we never talked about the symptoms
in depth.
Speaker 1 (53:01):
Don't worry, it's eradicated. The gotcha, right?
Speaker 2 (53:05):
And so to think that if there were to be
even if you don't think about it from a sort
of large scale bio terrorism aspect, if you just think
of what if a few particles somehow got out.
Speaker 1 (53:19):
In a lab accident, such as happened to Janet Parker exactly.
Speaker 2 (53:23):
And so I mean, if something like that were to happen,
could we even diagnose it in order to contain it?
Speaker 1 (53:31):
Oh?
Speaker 2 (53:31):
Isn't that scary? I thought of that while doing all
this research.
Speaker 1 (53:35):
Is there a movie that is smallpox?
Speaker 2 (53:38):
Not that I know of.
Speaker 1 (53:39):
There should be screenwriters, get on this.
Speaker 2 (53:41):
Yeah, are you hearing this? Guys? This is a great
This is scarier than the movie Contagion, Oh way scarier. Yeah,
So if we were at one point, we talked about
doing a sort of threat level on all of these episodes,
like terror threat level orange or whatever.
Speaker 1 (53:59):
This threat level. Wear a diaper because you're about to
pee your parts. Yeah we have no scale.
Speaker 2 (54:08):
No scale. Yeah we don't have a scale.
Speaker 1 (54:10):
But in reality, yeah, be really scared. Smallpox is awful.
Speaker 2 (54:16):
It's really terrifying.
Speaker 1 (54:18):
But wait, we've been using the wrong verb tense. Smallpox
was awful.
Speaker 2 (54:23):
It was thank goodness, thank goodness, thank you World Health Organization.
Speaker 1 (54:28):
It's actually amazing what they accomplished.
Speaker 2 (54:31):
It really is. We should let people know if they'd
like to read more, because some of these books are
really amazing. Got a list, I've got a hit me
with them.
Speaker 1 (54:41):
If you want to know more about inoculation and the
development of inoculation as a practice in England and the US,
you should read The Speckled Monster by Jennifer Lee Carroll.
If you are interested in the nitty gritty of the
epidemic that happened in North America from seventeen seventy seven
(55:02):
to seventeen eighty five, you should check out Pox Americana
by Elizabeth Fenn. Smallpox The Death of a Disease by D. A. Henderson,
is a book penned by the leader of the eradication
effort himself, and it is an amazing book. It is
really great.
Speaker 2 (55:21):
Also, don't you have a signed copy of that?
Speaker 1 (55:24):
I do, I know, I got it all got it
like a books Amazon, and it's sign so thrilled.
Speaker 2 (55:31):
By literally the person who was the reason that we
were able to eradicate this disease, Da Henderson props.
Speaker 1 (55:39):
The other book that I think you should read is
called The Demon in the Freezer and it's by Richard Preston.
It reads like a movie script. It is really exciting.
It's more about the eradication effort of smallpox and then
anthrax in terms of bioterrorism. It's a little dated, but
(55:59):
it's really still really good. The Power of Plagues by
Irwin Sherman. It's a compilation book with chapters on different
diseases or on different topics in terms of plagues and
epidemics throughout history, and all of those are great. We
recommend them, so if you're interested read more. Yeah, check
(56:19):
it out, check it out, fact check us.
Speaker 2 (56:22):
That'd be fun. If we're wrong, let us know, man.
Speaker 1 (56:25):
Yeah, we would love to hear yeah, because we're just
doing this for fun.
Speaker 2 (56:28):
Yeah, it's very fun, it is.
Speaker 1 (56:30):
And so what's happening next week? Speaking of more fun, I.
Speaker 2 (56:33):
Don't know what is happening next week. Colra Coolera, Yeah,
oh man, that's gonna be fun.
Speaker 1 (56:38):
Colra is gonna be good. Get ready for some good
John snow Puns, The.
Speaker 2 (56:43):
King of the North. That was my first attempt.
Speaker 1 (56:45):
The King of Coolera.
Speaker 2 (56:47):
We'll work on it.
Speaker 1 (56:49):
Yeah, we've got a long way to go.
Speaker 2 (56:51):
Please please, please, please please rate and review us on
iTunes or wherever you get your podcasts and subscribe, and
that is how people are able to find this podcast.
So if you like us, then you think other people
will like us, then you should definitely rate and review
us so that other people can find us in the
first place.
Speaker 1 (57:09):
We are also on all these other podcast hosting websites.
We're on Podbean, you can find us on Stitcher, on
Google Play, anywhere else to get your podcast. And we
also have a Facebook page, an Instagram page, and a
Twitter page, so please follow us on each of those
if you want to see some really cool pictures of disease,
(57:29):
or see some cool facts, or get our recipe for
whatever quarantine or we're.
Speaker 2 (57:34):
Drinking yep, we post that every week this podcast will
kill you. Our Twitter is our acronym. I can't spell it.
Speaker 1 (57:41):
PWK. Why that's it? All right?
Speaker 2 (57:44):
I think that's it.
Speaker 1 (57:45):
Yeah, all right, everyone wash your hands.
Speaker 2 (57:49):
Yeah. Fealthy animals
Hosts And Creators
Erin Welsh
Erin Allmann Updyke
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