A Planet of Viruses - Carl Zimmer [30]
But what a virus to wipe out. Over the past three thousand years, smallpox may have killed more people than any other disease on Earth. Ancient physicians were well aware of smallpox, because its symptoms were so clear and distinct. A victim became infected when the virus slipped into the airway. After a week or so, the infection brought chills, a blazing fever, and agonizing aches. The fever ebbed after a few days, but the virus was far from done. Red spots developed inside the mouth, then the face, and then over the rest of the body. The spots filled with pus and caused stabbing pain. About a third of people who got smallpox eventually died. In the survivors, scabs covered over the pustules, which left behind deep, permanent scars.
Some thirty-five hundred years ago, smallpox left its first recorded trace on humanity: three mummies from ancient Egypt, studded with pustules. Many of the oldest centers of civilization in the Old World, from China to India to ancient Greece, felt the wrath of the virus. In 430 BC, an epidemic of smallpox swept through Athens, killing a quarter of the Athenian army and a large percentage of the city’s population. In the Middle Ages, crusaders returning from the Middle East brought smallpox to Europe. Each time the virus arrived in a new defenseless population, the effects were devastating. In 1241 smallpox first came to Iceland, where it promptly killed twenty thousand of the island’s seventy thousand inhabitants. Smallpox became well established in the Old World as cities grew, providing a high density of potential hosts. Between 1400 and 1800, smallpox killed an estimated five hundred million people every century in Europe alone. Its victims included sovereigns such as Czar Peter II of Russia, Queen Mary II of England, and Emperor Joseph I of Austria.
It was not until Columbus’s arrival in the New World that Native Americans got their first exposure to the virus. The Europeans unwittingly brought a biological weapon with them that gave the invaders a brutal advantage over their opponents. With no immunity whatsoever to smallpox, Native Americans died in droves when they were exposed to the virus. In Central America, over 90 percent of the native population is believed to have died of smallpox in the decades following the arrival of the Spanish conquistadores in the early 1500s.
The first effective way to prevent the spread of smallpox probably arose in China around AD 900. A physician would rub a scab from a smallpox victim into a scratch in the skin of a healthy person. (Sometimes they administered it as an inhaled powder instead.) Variolation, as this process came to be called, typically caused just a single pustule to form on the inoculated arm. Once the pustule scabbed over, a variolated person became immune to smallpox.
At least, that was the idea. Fairly often, variolation would trigger more pustules, and in 2 percent of cases, people died. Still, a 2 percent risk was more attractive than the 30 percent risk of dying from a full-blown case of smallpox. Variolation spread across Asia, moving west along trade routes until the practice came to Constantinople in the 1600s. As news of its success traveled into Europe, physicians there began to practice variolation as well. The practice triggered religious objections that only God should decide who survived the dreaded smallpox. To counteract these suspicions, doctors organized public experiments. Zabdiel Boylston, a Boston doctor, publicly variolated hundreds of people in 1721 during a smallpox epidemic; those who had been variolated survived the epidemic in greater numbers than those who had not been part of the trial.
No one at the time knew why variolation worked, because nobody knew what viruses were or how our immune systems fought them. The treatment of smallpox moved forward mainly by trial