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Smallpox: Gone but Not Forgotten from Incubation · What's Your Problem?

0:01
Speaker 1: Hey, it's Jacob and I've been working on another podcast
0:05
Speaker 1: that's just coming out. It's called Incubation, and it's about viruses.
0:09
Speaker 1: It's about how viruses attack us, how we fight back,
0:13
Speaker 1: and what humanity has learned in the course of fighting
0:16
Speaker 1: with viruses for hundreds of years. In each episode, we'll
0:19
Speaker 1: tell you the story of one virus. The first episode
0:23
Speaker 1: starts with a particularly nasty virus, smallpox. You can listen
0:27
Speaker 1: to Incubation wherever you get your podcasts. Here's the show.
0:31
Speaker 2: I hope you like it.
0:36
Speaker 1: We heard a lot about coronaviruses over the past few years,
0:40
Speaker 1: really a lot, maybe too much, definitely more than we
0:44
Speaker 1: ever expected to hear, but we heard a lot less
0:47
Speaker 1: about other viruses, and viruses are amazing. Viruses are older
0:55
Speaker 1: than animals, they're older than plants. Some scientists thinkviruses may
1:00
Speaker 1: be the origin of all life on Earth. Viruses have
1:04
Speaker 1: been infecting humans, sometimes invisibly, sometimes with terrible consequences, for
1:09
Speaker 1: as long as there have been humans. The story of
1:13
Speaker 1: viruses is the story of humanity's survival as a species,
1:17
Speaker 1: and we're going to tell some of those viral stories
1:19
Speaker 1: on this podcast. I'm Jacob Goldstein and This is Incubation,
1:24
Speaker 1: a show about the other viruses. It's about science and
1:27
Speaker 1: about culture. It's about how viruses attack people and how
1:31
Speaker 1: people fight back. On each episode of Incubation, we're going
1:36
Speaker 1: to tell the story of one virus, and we're starting
1:39
Speaker 1: off with one of the deadliest viruses in history, smallpox.
1:44
Speaker 1: Smallpox stalked humanity for thousands of years. It gave people
1:48
Speaker 1: rashes and blisters all over their bodies, and often it
1:52
Speaker 1: killed them. Smallpox killed hundreds of millions of people, but
1:58
Speaker 1: we humans fought back in profound and brilliant ways. Our
2:04
Speaker 1: episode today starts with the story of Edward Jenner, a
2:08
Speaker 1: doctor in the British countryside, and it ends centuries later
2:11
Speaker 1: with thousands of people working together to wipe smallpox from
2:15
Speaker 1: the face of the earth. My first guest today is
2:20
Speaker 1: Gareth Williams. He's the author of Angel of Death, The
2:23
Speaker 1: Story of Smallpox, and Gareth he knows a lot about
2:27
Speaker 1: Edward Jenner.
2:28
Speaker 3: He was a great fields naturalist, and he also worked
2:33
Speaker 3: at something about the migration of birds, which was completely
2:37
Speaker 3: unknown before that. People thought that swallows went off and
2:40
Speaker 3: hid in mud under riverbanks and things like this.
2:43
Speaker 1: I read that he built a hydrogen balloon that flew
2:46
Speaker 1: twelve miles. That he played the violin, that he wrote poetry.
2:50
Speaker 3: He did only above. He played the flute. I think
2:52
Speaker 3: rather beten. He played the fiddle. He sang, He had
2:54
Speaker 3: a good singing voice. I can recite one of his
2:57
Speaker 3: poems if you'd like it.
2:58
Speaker 1: Of course, give it to my mony.
3:01
Speaker 3: That he wrote it when a man called doctor Weight
3:05
Speaker 3: died and doctor Weight had made medicinal gingerbread biscuits gingerbread nuts,
3:10
Speaker 3: which not only tasted good, but actually killed intestinal worms.
3:14
Speaker 3: Talking about tapeworms and things that round to twenty feet
3:17
Speaker 3: or more. So, here's a put on the death of
3:18
Speaker 3: doctor Weight. It begins with the Latin names of the
3:21
Speaker 3: worms ascarides, tearies, Lumbricki, and all the kyle sucking insects
3:27
Speaker 3: that tremblingly crawl. No more, be afraid you're quite safe
3:31
Speaker 3: in our guts, for Dr Weight has finished making his
3:34
Speaker 3: gingerbread nuts.
3:37
Speaker 1: So in addition to writing poems about nuts, non trivially,
3:42
Speaker 1: Jenner also invented the first vaccine in human history. Let's
3:47
Speaker 1: talk about that. That's really what we're here to talk
3:48
Speaker 1: about today. He's born in seventeen forty nine. He's growing
3:53
Speaker 1: up in England in the you know, second half of
3:55
Speaker 1: the seventeen hundreds. What would his experience of small parks.
3:58
Speaker 3: Have been in Jenna's day? If you got smallpox and
4:02
Speaker 3: you had roughly a one in three chance of getting
4:04
Speaker 3: it during your lifetime, then you had about a one
4:07
Speaker 3: in four chance of being killed by it. He went
4:10
Speaker 3: to boarding school when he was eight. Both his parents
4:12
Speaker 3: had died by then, and he had to be protected
4:16
Speaker 3: against smallpox which had broken out nearby.
4:19
Speaker 1: And this thing happens to him where somebody, if I
4:21
Speaker 1: understand right, cuts open his arm and puts dried out
4:26
Speaker 1: pus from a smallpox patient into the cut on Jenner's arm.
4:31
Speaker 1: What's going on here?
4:32
Speaker 3: This was what was called variolation. And variola is the
4:37
Speaker 3: Latin word for speckled or spotted. It's the old name
4:40
Speaker 3: for smallpox, and it's the name of the virus that
4:43
Speaker 3: causes small pox, of Variola virus. And in brief, variolation
4:47
Speaker 3: was giving healthy people, usually children, the real thing, in
4:51
Speaker 3: the hope that the artificial infection wouldn't kill them, and
4:55
Speaker 3: that it would somehow leave them protected against future attacks
4:59
Speaker 3: of nature re acquired smallpox. It was about a one
5:03
Speaker 3: in fifty mortality, so very very much lower. You got
5:07
Speaker 3: a little bit of small pox puss from one of
5:09
Speaker 3: those revolting blisters that covered people in the tens and thousands,
5:13
Speaker 3: and you would scratch a little bit of that revolting
5:17
Speaker 3: fluid into the skin on the arm of a healthy child.
5:20
Speaker 1: Does it work?
5:21
Speaker 3: It's mad, bad, crazy, dangerous, sounds completely counterintuitive. The amazing
5:27
Speaker 3: thing is it did work, very much so. And the
5:29
Speaker 3: other thing is that if you were vari related, even
5:32
Speaker 3: if you survived while you had your artificial dose of smallpox,
5:37
Speaker 3: you had the real thing. So even though you might
5:39
Speaker 3: get over it in two or three weeks, you could
5:42
Speaker 3: spread it to other non immune people. You had people
5:46
Speaker 3: going back into the community causing little mini outbreaks of
5:49
Speaker 3: small pox and killing lots of other people bi collateral damage.
5:53
Speaker 2: Wow.
5:54
Speaker 1: So okay, So this is the world Jenner is born
5:58
Speaker 1: into the world where you can either get smallpox and
6:02
Speaker 1: a good chance of dying from it if you get it,
6:05
Speaker 1: or if you're sort of lucky in a weird way,
6:08
Speaker 1: you can get violated and have a non trivial chance
6:12
Speaker 1: of getting and dying of small pox and maybe spreading
6:15
Speaker 1: it to other people.
6:16
Speaker 2: That was it.
6:16
Speaker 1: Those were the options. Absolutely, How does he go from
6:20
Speaker 1: being an eight year old boy getting very related to
6:22
Speaker 1: inventing the first vaccine in the world.
6:24
Speaker 3: Okay, if you want the conventional story, yeah.
6:28
Speaker 1: I feel like you're going to give me two stories.
6:29
Speaker 2: What is it?
6:30
Speaker 1: Jenner classic, So give me gener classic.
6:32
Speaker 3: The gender classic is he is a medical apprentice in
6:35
Speaker 3: his early teens and he meets a milkmaid smallpox has
6:40
Speaker 3: reappeared nearby, and she allegedly says to him, look, Gov,
6:44
Speaker 3: you don't need to worry about me having that, because
6:47
Speaker 3: I've had cowpox and that means that I can never
6:49
Speaker 3: ever catch smallpox. And this was complete news to January'd
6:54
Speaker 3: never come across it. But it was also complete news
6:56
Speaker 3: to all his teachers. It simply wasn't part of conventional
7:00
Speaker 3: medical knowledge. It was common knowledge in the farming community.
7:03
Speaker 1: It was folk knowledge that had not sort of crossed
7:06
Speaker 1: over to kind of high brow medical knowledge.
7:09
Speaker 3: A lot of people didn't want to believe it because
7:11
Speaker 3: it had come up from the peasantry.
7:13
Speaker 1: Interesting, so you're saying that's kind of the classic tale.
7:16
Speaker 1: Do you think it's true.
7:18
Speaker 3: I'd like to believe it's true. The alternative story is
7:22
Speaker 3: that one of Jenna's medical colleagues in Thornbury was actually
7:25
Speaker 3: a varulator, very successful one, and he noted, apparently independently,
7:31
Speaker 3: that some people that evarulated the e varulation didn't take.
7:36
Speaker 3: In otherwords, there was no sign that they'd caught this
7:38
Speaker 3: artificial dose of smallpox. And this man was called John Fuster.
7:43
Speaker 3: And story B if you like, is that it was
7:45
Speaker 3: actually Feuster who made the original observation. Jenna was a
7:49
Speaker 3: close friend of his, and Jenna may have decided to
7:52
Speaker 3: pick up on it. Feusa didn't want to pursue it
7:55
Speaker 3: because he was making so much money as a valulator.
7:57
Speaker 3: He didn't see the need for any particular improved.
8:01
Speaker 1: Okay, so Jenner has this idea, whether it's from the
8:05
Speaker 1: milkmaid or from his colleague, this idea that cowpox, which
8:11
Speaker 1: we should say is not a deadly disease in humans, right,
8:15
Speaker 1: can protect humans against a small pox. What does he
8:20
Speaker 1: do with this idea.
8:22
Speaker 3: Well, he doesn't do anything with it for over thirty years.
8:25
Speaker 3: He goes off he finishes his medical studies in London.
8:28
Speaker 3: In seventeen ninety six, he gets the idea of collecting
8:33
Speaker 3: cases of people who've had cowpox and look to see
8:37
Speaker 3: if they appear to be protected against smallpox. And he
8:41
Speaker 3: collects a number of cases and the story appears to
8:44
Speaker 3: be true. And then he moves beyond that to actually
8:46
Speaker 3: test the hypothesis that giving somebody an artificial dose of
8:50
Speaker 3: cowpox will protect them against smallpox. The killer and his
8:55
Speaker 3: first guinea pig is his gardener's son, James Phipps. And
9:00
Speaker 3: the ethics might be regarded as a bit dodgy, because
9:04
Speaker 3: back then, if you were the gardener's son, then you
9:07
Speaker 3: were effectively the property of the lord of the manor.
9:10
Speaker 3: II Jenna, and he introduced cowpox into the arm of
9:15
Speaker 3: James Phipps, who was eight years old. And what Jenna
9:18
Speaker 3: did was to find a case of cowpox with a
9:21
Speaker 3: lovely juicy cowpox bister on the back of her hand.
9:24
Speaker 3: He stuck a lancid in that collected the juice and
9:26
Speaker 3: scratched the cowpox juice into the arm of James Phipps,
9:30
Speaker 3: and that all went well. The lad got a bit
9:33
Speaker 3: of a local reaction, he's got a bit of a fever.
9:36
Speaker 3: Two weeks later he was back to normal. So Jenna
9:39
Speaker 3: now has to test his hypothesis to see if the
9:42
Speaker 3: lad is protected against smallpox. The killer gave him a
9:46
Speaker 3: small dose of smallpox and it didn't take. So that,
9:49
Speaker 3: if you like, was the Eureka moment.
9:52
Speaker 1: So he just invented the first vaccine in the history
9:54
Speaker 1: of the world, a vaccine against maybe the most deadly
9:58
Speaker 1: infectious disease. Truly one of the great discoveries in the
10:01
Speaker 1: history of medicine and the history of public health. What's
10:03
Speaker 1: the first thing he does to try and tell.
10:05
Speaker 3: The world, Well, he writes it all up as a paper,
10:09
Speaker 3: and he sends it off to the Royal Society, and amazingly,
10:13
Speaker 3: the Royal Society reject the paper.
10:17
Speaker 1: They reject his paper, They reject the guy just invented vaccines.
10:21
Speaker 3: Well, they probably wouldn't have appreciated the full significance, but
10:24
Speaker 3: you're right. It is one of the great pinnacle publications
10:27
Speaker 3: in the history of medicine science.
10:29
Speaker 1: But he doesn't give up. What's he doing next?
10:31
Speaker 3: So he writes it up as a pamphlet. It's always
10:34
Speaker 3: known as the Inquiry, okay, and it was published by
10:38
Speaker 3: private printer in Soho came out in September seventeen ninety eight.
10:42
Speaker 3: Jenna did not attempt to hide or make secret his invention.
10:46
Speaker 3: He wanted everybody to know. He wanted everybody to do
10:49
Speaker 3: it because he wanted to conquer smallpox.
10:52
Speaker 1: But you're saying he could also have not published it
10:55
Speaker 1: and just tried to sell vaccination himself and be the
10:59
Speaker 1: sort of soul purveyor of it.
11:01
Speaker 3: That's exactly it. His aim was to spread the words
11:04
Speaker 3: as widely and as quickly as possible. It really takes
11:07
Speaker 3: off and people recognize the value of vaccination immediately, and
11:12
Speaker 3: within a few months, it's on the continent of Europe,
11:15
Speaker 3: it's widespread across England, it's making its appearance in North America.
11:19
Speaker 3: You said within months, within months and months within.
11:22
Speaker 1: This is an era when there's obviously no electronic communication.
11:25
Speaker 1: They're going to have to put the inquiry on a
11:27
Speaker 1: ship and sail it across the ocean. But you're saying
11:30
Speaker 1: it spreads basically immediately.
11:32
Speaker 3: In the absolute absolutely, What do we.
11:35
Speaker 1: Know about, how how many people are being vaccinated, how
11:38
Speaker 1: widespread it is? Like, tell me more about that.
11:42
Speaker 3: Well, it's still the preserve of the rich and wealthy
11:46
Speaker 3: who could afford to pay for medical services, so it's
11:49
Speaker 3: not widespread and philanthropic. But in terms of geographical reach,
11:54
Speaker 3: it is very impressive. It reaches Switzerland very quickly, the Inquiry,
12:00
Speaker 3: which is the King of Spain, and he arranges for
12:03
Speaker 3: the divine gift of vaccination to be sent out to
12:06
Speaker 3: all the Spanish colonies and the Caribbean, South America around
12:10
Speaker 3: the back of the world.
12:11
Speaker 1: So this is all happening in his lifetime, right, He's
12:13
Speaker 1: seeing this happen well.
12:16
Speaker 3: Jenna works very hard actually trying to spread the word.
12:20
Speaker 3: He is always one of the great saints of medicine.
12:23
Speaker 3: But he wasn't a perfect man in any sense, and
12:25
Speaker 3: one of the things that he got wrong quite early
12:27
Speaker 3: was to be able to con himself into thinking that
12:30
Speaker 3: vaccination was absolutely perfect, whereas in fact it did have
12:35
Speaker 3: side effects. For example, you could get a farmyard infection
12:38
Speaker 3: from kylepox having get scratched into your arm. And the
12:41
Speaker 3: other thing was that it needed to be topped.
12:43
Speaker 1: Up, meaning like a booster, you needed what.
12:46
Speaker 3: To absolutely so other countries were giving boosters in the
12:51
Speaker 3: early teenage years, and again if smallpox broke out again,
12:54
Speaker 3: say in Germany, then people nearby would be revaccinated again.
12:58
Speaker 3: So that was one of the things that he got
13:00
Speaker 3: tragically wrong.
13:02
Speaker 1: What's the end of his story?
13:04
Speaker 3: He gets gifts and accolades from all over the world.
13:08
Speaker 3: He gets diamond ring from the Empress of Russia. He
13:12
Speaker 3: spent his declining years, if you like, after his wife died,
13:16
Speaker 3: being the vaccine clerk to the world. That's the way
13:19
Speaker 3: he described himself. He was sitting in his office writing
13:23
Speaker 3: letters back to all the fan mail that poured in
13:25
Speaker 3: from across the world. He was able to look around
13:29
Speaker 3: the world and see a world that was already changing.
13:34
Speaker 1: By the way, how does he come up with the
13:35
Speaker 1: name vaccine?
13:36
Speaker 3: Well, the name was actually coined by somebody else. It's
13:39
Speaker 3: from the Latin vacca meaning cow, and Louis pasteur. When
13:44
Speaker 3: he invented his rabies vaccine and various other vaccines, he
13:49
Speaker 3: suggested that all such immanising or protective preparations should be
13:54
Speaker 3: called vaccines in honor of Jena. So that's why we
13:57
Speaker 3: call them all vaccines today.
14:01
Speaker 1: Thank you for your time. Was a delight to talk
14:03
Speaker 1: with you.
14:04
Speaker 3: Pleasure, Thank you for yours.
14:06
Speaker 1: Edward Jenner died in eighteen twenty three. In the twentieth century,
14:11
Speaker 1: his vaccine would serve as the inspiration for one of
14:13
Speaker 1: the most ambitious public health projects in the history of
14:16
Speaker 1: the world to wipe out every single case of smallpox forever,
14:22
Speaker 1: We'll be right back. In the first half of the
14:31
Speaker 1: twentieth century, Edward Jenner's vaccine continued to spread, but huge
14:35
Speaker 1: swaths of the population remained unvaccinated, and hundreds of millions
14:40
Speaker 1: of people continued to die of smallpox. The world had
14:43
Speaker 1: become smaller and more connected. Air travel was taking off,
14:46
Speaker 1: and smallpox was happy to hitch a ride. Even countries
14:49
Speaker 1: that thought they'd eliminated smallpox found out that they could
14:52
Speaker 1: only keep it at bay for so long.
14:57
Speaker 2: A smallpox scare grips Great Britain, and.
15:00
Speaker 1: Weight of five deaths attributed to the disease that was
15:02
Speaker 1: all but wiped out in Western nations.
15:04
Speaker 2: Tens of thousands throughout the nation line up at health
15:07
Speaker 2: centers to be inoculated. The outbreak of a red.
15:10
Speaker 4: Disease is checked by modern medical science.
15:17
Speaker 1: In the middle of the twentieth century, leaders around the
15:20
Speaker 1: world cooked up an audacious plan to drive the smallpox
15:24
Speaker 1: virus to extinction, to eradicate it from the face of
15:27
Speaker 1: the earth. Donald Hopkins directed the smallpox eradication campaign in
15:32
Speaker 1: Sierra Leone in the late nineteen sixties, just as the
15:35
Speaker 1: global eradication project was getting started. When he arrived in
15:38
Speaker 1: Sierra Leone, the West African nation had the highest smallpox
15:41
Speaker 1: rate in the world. You get to this country, what
15:46
Speaker 1: do you see on the ground?
15:48
Speaker 2: Well, I see, first of all, a beautiful country, and
15:52
Speaker 2: then I'm introduced to the health workers that I'm going
15:56
Speaker 2: to be working with and find that they are very capable,
16:00
Speaker 2: very enthusiastic. I'm young, and very optimistic as well. Yes,
16:05
Speaker 2: people were dying, but the upshot of that was that
16:09
Speaker 2: people were eager. Most people were eager to get vaccinated,
16:12
Speaker 2: and so we did not have a problem of trying
16:16
Speaker 2: to persuade people to cooperate with the program, and that
16:21
Speaker 2: made things a lot easier.
16:24
Speaker 1: Yeah, easier, but this is still a country where there
16:27
Speaker 1: are a lot of places that are just hard to
16:29
Speaker 1: get to, right, I mean, are there any particular instances
16:32
Speaker 1: you remember that were especially challenging.
16:35
Speaker 2: So in the summer of nineteen sixty eight, it's the
16:38
Speaker 2: rainy season in sily Young, we get a message that
16:41
Speaker 2: there is an outbreak in this area southeast of the capital,
16:46
Speaker 2: the area called Moyamba. So I went there with a
16:51
Speaker 2: driver and a couple of the Siri lell and public
16:54
Speaker 2: health workers and the village that we were were summoned
17:01
Speaker 2: to visit, in fact, was about a forty five minute
17:06
Speaker 2: trek from the nearest road. I'm afraid of snakes, and
17:11
Speaker 2: this was a this was a trek through the forest.
17:14
Speaker 1: You're like Indiana Jones. You're wearing a hot.
17:20
Speaker 2: No hat I had. I had a full head of
17:22
Speaker 2: hair then, so I didn't I didn't have to wear
17:25
Speaker 2: a hat. But to beget into this get into this village,
17:29
Speaker 2: and there are lots of people with smallpox, including most
17:32
Speaker 2: notably a newborn infant only a few days old, that
17:38
Speaker 2: was lying on a mat between its mother and the
17:42
Speaker 2: mother's co wife.
17:44
Speaker 1: When you say co wife, what does that mean?
17:47
Speaker 2: That means that they were both married to the same man. Okay,
17:50
Speaker 2: and uh. The child had not been vaccinated, but both
17:54
Speaker 2: of these two women were in the full throws of
17:58
Speaker 2: smallpox infections, and so that infant had been exposed. Fortunately,
18:04
Speaker 2: I had vaccine with me. I was able to vaccinate
18:07
Speaker 2: the infant, and later about ten days later, when I
18:11
Speaker 2: came back, I saw that the vaccination was taking and
18:15
Speaker 2: that baby was saved.
18:16
Speaker 1: And just to just because you know, I've never seen smallpox. Thankfully,
18:21
Speaker 1: when you say that two women were in the throes
18:25
Speaker 1: of infection. What did they look like?
18:27
Speaker 2: Well, it's hard to see people suffering so much, because
18:30
Speaker 2: it's not only that people their bodies are swollen. They're
18:34
Speaker 2: covered in all of these pustules. But it's very painful.
18:38
Speaker 2: People described it as feeling as if your skin was
18:42
Speaker 2: on fire. Smallpox caused a generalized rash over most of
18:46
Speaker 2: the body. It was most intense over the face, the hands,
18:52
Speaker 2: and the feet. But in this instance you could see
18:56
Speaker 2: these raised pimples. First you get little bumps that turn
19:03
Speaker 2: into blisters that then fill with puffs, which then these
19:10
Speaker 2: blisters break, and if you're lucky and survive the broken
19:16
Speaker 2: blisters and puffs, that all drives up and gradually, over
19:20
Speaker 2: the course of two three weeks the scabs drop off.
19:24
Speaker 2: But all of that is infectious, and people when they're
19:27
Speaker 2: just even before the rash starts, when they start feeling
19:31
Speaker 2: headache fever, they're already breathing out smallpox virus onto other people.
19:37
Speaker 2: And so the challenge is the situation like that, to
19:42
Speaker 2: vaccinate as many people who do not yet have smallpox
19:45
Speaker 2: as quickly as you can.
19:48
Speaker 1: So, okay, so you get to this village, you see
19:50
Speaker 1: these two women and the baby. The women are clearly sick.
19:53
Speaker 1: You vaccinate the baby because the smallpox vaccine can actually
19:57
Speaker 1: help people who are in the early stages of an infection.
20:00
Speaker 1: What do you do next? What else is happening in
20:02
Speaker 1: this village?
20:04
Speaker 2: In this census, we learned very quickly that two weeks before,
20:10
Speaker 2: a very prominent man in that village who was head
20:13
Speaker 2: of a secret society, had gotten smallpox and had died.
20:18
Speaker 2: Because he was so prominent, people came from other villages
20:23
Speaker 2: to visit him when he was ill, and people came
20:27
Speaker 2: for his funeral.
20:29
Speaker 1: This is a giant alarm bell. This is very bad
20:32
Speaker 1: news for you in nineteen.
20:34
Speaker 2: Sixty eight, very very bad news, because we also began
20:38
Speaker 2: learning when I was there. What we were seeing was
20:40
Speaker 2: that many people had come from other villages as well
20:45
Speaker 2: surrounding this village, and so this was a much bigger
20:50
Speaker 2: outbreak than what we were expecting.
20:52
Speaker 1: So tell me about what containment meant at this time
20:55
Speaker 1: in this context.
20:56
Speaker 2: Yes, when we first began working in the smallpox program,
21:00
Speaker 2: the strategy was to mass vaccinate eighty percent or more
21:04
Speaker 2: of the population. The containment surveillance strategy was developed where
21:10
Speaker 2: the strategy became find out where the current cases of
21:15
Speaker 2: smallpox are go there, give priority to vaccinating people in
21:22
Speaker 2: those households and that village and nearby villages. So called
21:29
Speaker 2: ring vaccination, because if you could do that, you could
21:32
Speaker 2: stop the virus from spreading to other people. That was
21:36
Speaker 2: a much more efficient way of getting after the virus
21:40
Speaker 2: to stop transmission, because now you're looking to vaccinate three
21:45
Speaker 2: four five percent of the population rather than eighty percent
21:48
Speaker 2: of the population.
21:49
Speaker 1: It's like you draw a circle, a big circle around
21:52
Speaker 1: the village where the infection is, and you vaccinate everybody
21:55
Speaker 1: inside that circle. So it's like you're surrounding the virus
21:59
Speaker 1: with immune people.
22:01
Speaker 2: That's exactly what you're doing. And the radius of that
22:04
Speaker 2: circle was at least five miles.
22:07
Speaker 1: Okay, so you have your information right, you have your
22:11
Speaker 1: epidemiological surveillance, you have your your ring on a map.
22:15
Speaker 1: What do you do?
22:16
Speaker 2: We then come back with several other vaccinators and have
22:21
Speaker 2: a plan to assign different groups to go to each
22:25
Speaker 2: of these villages and make sure that everyone there is vaccinated.
22:30
Speaker 1: And you just show up in a village with your
22:32
Speaker 1: briefcase full of a vaccine and say here we are
22:37
Speaker 1: come line up.
22:38
Speaker 2: The villagers had had warning, and in fact, we discussed
22:43
Speaker 2: with the village chief and the senior people in the
22:45
Speaker 2: village to agree on a mutual time when was most
22:50
Speaker 2: convenient for them for us to come back and make
22:53
Speaker 2: sure everybody was vaccinated. You had to give them notice
22:56
Speaker 2: in advance, because otherwise, if you just show up, people
22:59
Speaker 2: are out on the farms, which could be two or
23:01
Speaker 2: three miles away in many different directions, et cetera.
23:05
Speaker 1: So how long does it take you to with your
23:08
Speaker 1: team go to all of the villages inside this ring
23:11
Speaker 1: and vaccinate everybody.
23:13
Speaker 2: That took a matter of a few days fast. So
23:17
Speaker 2: each team only had to go to one or two villages,
23:20
Speaker 2: and so we were able to get there in a
23:22
Speaker 2: few days and get them vaccinated, and we were able
23:25
Speaker 2: to stop that particular outbreak in only three or four
23:29
Speaker 2: weeks max.
23:30
Speaker 4: Wow.
23:30
Speaker 1: So it worked.
23:31
Speaker 2: It worked. It not only worked in Sierra Leone, but
23:33
Speaker 2: when we sent a telegram back to CDC headquarters to
23:38
Speaker 2: let them know what had happened, they were ecstatic. And
23:42
Speaker 2: of course, this was one of the first big demonstrations
23:46
Speaker 2: of the power of this new ring vaccination strategy, and
23:52
Speaker 2: so it electrified the entire global smallpox eradication program to
23:58
Speaker 2: see that this worked so well in Sierra Leone, which
24:02
Speaker 2: had so much smallpox.
24:06
Speaker 1: So we have the good news. What did you do next?
24:09
Speaker 1: How long were you in Ciri Leone? What happened next?
24:11
Speaker 2: I was in Siri Leone for a total of two years,
24:13
Speaker 2: that was. I left Sierra Leone in August of nineteen
24:16
Speaker 2: sixty nine. Smallpox was gone from Sierra Leone by April
24:21
Speaker 2: May of nineteen sixty nine.
24:24
Speaker 1: So by the time you left, you and your team
24:26
Speaker 1: had eradicated smallpox from one of the worst affected countries
24:30
Speaker 1: in the world.
24:31
Speaker 2: Exactly, And that was a big exclamation point. I was
24:35
Speaker 2: then forever optimistic that smallpox was gonna go. It was
24:42
Speaker 2: then to me just a matter of time.
24:46
Speaker 1: It's really striking to me that we, or you, you
24:50
Speaker 1: and your colleagues eradicated smallpox more than forty years ago now,
24:57
Speaker 1: and we humanity, I haven't succeeded in eradicating anything else yet.
25:02
Speaker 1: I know we're getting close on polio, but we've been
25:05
Speaker 1: close on polio for a while, and yes, it's not
25:08
Speaker 1: gone yet. Was smallpox unanomaly.
25:13
Speaker 2: Yes, smallpox is anomaly. Unfortunately, nothing else is like smallpox
25:18
Speaker 2: eradication means you have to get to whatever disease you're
25:24
Speaker 2: targeting everywhere wherever it exists, and it's going to exist
25:31
Speaker 2: in some places where it's a big problem, people care
25:33
Speaker 2: about it, they're motivated to work against it. But it's
25:36
Speaker 2: also going to exist in some areas where it's a
25:39
Speaker 2: trivial problem, where people have much bigger things to worry
25:43
Speaker 2: about than that targeted disease. But you're going to have
25:48
Speaker 2: to get them on board as well, because as long
25:50
Speaker 2: as it exists anywhere, it's unsafe for people everywhere.
25:55
Speaker 1: Doctor, it was a real delight to talk to you.
25:58
Speaker 1: Let me say thank thank you for your work. I'm
26:01
Speaker 1: very grateful to live in a world with no smallpox.
26:04
Speaker 2: Well, thank you, I'm i am too.
26:07
Speaker 1: Donald Hopkins is currently the Special Advisor for guinea worm
26:11
Speaker 1: eradication at the Carter Center. Thanks to my guest today
26:14
Speaker 1: Gareth Williams and Donald Hopkins. Next week we'll tell the
26:18
Speaker 1: story of the race for the polio vaccine, and we'll
26:21
Speaker 1: try to figure out why polio and other viruses have
26:24
Speaker 1: turned out to be so much harder to eradicate than smallpox.
26:28
Speaker 4: We need to ensure that we have full momentum for
26:34
Speaker 4: this last push, the final push to reach that last
26:38
Speaker 4: child in that last village of these areas.
26:43
Speaker 1: Incubation is a co production of Pushkin Industries and Ruby
26:46
Speaker 1: Studio at iHeartMedia. It's produced by Gabriel Hunter Chang, Ariela Markowitz,
26:51
Speaker 1: and Amy Gaines McQuaid. Our editors are Julia Barton and
26:54
Speaker 1: Karen SCHAKERJI mastering by Anne Pope, fact checking by Joseph Fridman,
26:59
Speaker 1: our executive. Our producers are Katherine Girardeau and Matt Romano.
27:02
Speaker 1: I'm Jacob Goldstein. Thanks for listening.