The root of Public health
John snow’s study about the Cholera and his investigation proving the connection between the occurrence of cholera and consumption of water from selected sources helped to establish public health and epidemiology domain as useful as any medical science and helped to establish principles and scope of Public Health. Just in the same way, the eradication of small pox in 1980 due to smallpox vaccination exemplifies how the diseases can be prevented, eradicated and health of the people can be protected.
Among all the stories behind the public health, the story behind the discovery of SmallPox always fascinated since the day I learnt about Smallpox vaccine. This is discovered or at least credited to be discovered by Edward Jenner, physician of England, born in 1749. If we unfold history of vaccination preceding Edward Jenner, there was scant practice of small pox inoculation but wasn’t established firmly. Edward Jenner successfully trialed the vaccine and founded a base for further discovery. However, the inspiration for this quest is quite interesting.
Loathsome Disease
Smallpox, a viral disease, which claimed many people usually due to compromised immunity, high grade fever, excessive oozing of blood and body fluids as the wound all over the body sloughed off and extreme pain, and left lifelong pock marks to the survivors. We can still find some aging survivors with small pox scars. I still remember recently deceased Indian actor Mr. Om Puri, who was able to survive small pox but left with scars.
William Foege, a physician from USA, a pioneer in small pox eradication, who worked relentlessly day and night in developing countries including Africa, Asia to eradicate Smallpox from the population, in his book “House on Fire, The Fight to eradicate smallpox” describes this disease as loathsome disease and he recollects how he was able to identify the cases just by smelling the putrid smell coming from the patients. He recalls how he spotted one of the cases of smallpox in his book,
“On at least two occasions, smell alone alerted me to the presence of smallpox. As I walked down a hospital hallway in India, the dead-animal odor stopped me in my tracks; following the smell, I located a smallpox patient.”
And he further describes its severity as
“ In another house a young man might be wearing only a loincloth, because he didn't want anything touching his face or limbs, which were covered with lesions. His legs were bloody. He was trying not to move, grimacing in pain when he did. Any touch caused the lesion to bleed. His face was contorted with pain; he wanted only to die.”
The Inspiration of Vaccine discovery
Edward Jenner in his early phase of career, he observed that many of the villagers were infected with smallpox and had pockmarked faces but the milkmaids. He observed that many milkmaids were fairer though people contracted diseases and left some survivors with the lifelong pockmarked scars and of course, immunized. He overheard milkmaid saying she would never get such pockmarked face, and she won’t contract small pox as she already got cowpox, which makes her invulnerable to smallpox. Influenced by those experiences and evidences, after 12 years of continuous observation and record keeping, Edward Jenner implemented the inoculation with cowpox for the first time in a child named James Phipps, and as his expectation, the child developed immunity against smallpox when later exposed to smallpox virus.
This first experiment engenders the principle of vaccination and beginning of smallpox eradication and maybe a root of public health.
Though there were many people before him, who practiced the inoculation or many just like William Foegoe who continued his endeavor as a physician, public health actor or care giver after him but he is definitely a pioneer who sow the seed to reap the fruits that swept away existence of nasty small pox virus. His scientific experiment, anecdotes founded the base of greatest invention of all the time.
Inspiring Attributes to adopt
We are faced with many diseases or challenges, or everyday situations that pose constant threat to our health and we might be neglecting the remedies that exist around us. The observation skill and bringing the observation into thinking is important first step. Edward Jenner's keen observation and conviction about relation of immunity of milkmaid with cowpox infection resulted in this greatest boon to mankind. Aside from the scientific knowledge, perseverance, and risk taking to give one's thought a chance routed to the discovery of the principles of vaccination and essential action of public health.
Every time I read this history I find its message more meaningful!
By Pramila Rai
-Inspired by the speech and the book “House on Fire, The Fight to eradicate smallpox” by William Foege