Pox_ An American History - Michael Willrich [12]
Epidemiological uncertainty made moral certainty easier. A common, cautionary theme pervades this accumulating archive of smallpox narratives: “The pestilence that walketh in darkness” travels unseen in the bodies of the strangers and outliers who move among us. And it is fearful indeed.17
At the end of the nineteenth century, smallpox still reigned as the most infamous and loathsome of infectious diseases. Since the 1870s, serious epidemics of smallpox had grown relatively uncommon in the United States, but that did not lessen the fears attached to the disease. Nor did the fact that Americans of the period were far more likely to fall ill or die from diphtheria, influenza, scarlet fever, typhoid fever, or consumption. Smallpox occupied a special place in the hall of human horrors. As J. N. McCormack, secretary of the Kentucky Board of Health, put it, “One case of smallpox in a tramp will create far more alarm in any community in Kentucky than a hundred cases of typhoid fever and a dozen deaths in the leading families.”18
The 1898 outbreaks coincided with the centennial commemorations of the invention of vaccination. In 1798, the English physician Edward Jenner had published his first paper on his experiments with smallpox vaccination (which he had conducted in 1796). Newspaper articles, magazine stories, and public speeches across the United States regaled Americans about the horrors of smallpox and the scientific triumph of Jennerian vaccination. In a speech to the “plain people” of Winston, North Carolina, “Colonel” A. W. Shaffer of the state board of health proclaimed that smallpox had been a “vile destroyer” since before “the first century of the Christian era.” “Great kings and royal princes, stately women of high degree and matchless beauty, and babes at the mother’s breast fell alike before its destroying blast and were disfigured and deformed for life, or thrust into the same hole with the filthy carcasses of their meanest subjects.”19
Shaffer did not exaggerate. The variola virus had been entangled with human history, to devastating effect, for millennia. No one knows when or how the virus first infected human beings. The earliest unequivocal descriptions of smallpox date to the fourth century A.D. in China, but scientists have long believed that the pustules found on the cheeks of Egyptian mummies from the twelfth century B.C. were caused by smallpox. Smallpox may have emerged as early as six thousand years ago—when the introduction of irrigated agriculture enabled human civilizations to grow large and dense enough to sustain the disease. By the time of Christ, smallpox was probably commonplace in the thickly populated valleys of the Nile and Ganges rivers, spreading from there across southwestern Asia. An inveterate camp follower, variola hitchhiked in the bodies of traders, soldiers, and other migrants. It spread east along the Burma and Silk roads and into China. In the eighth century, Islamic armies carried it through North Africa into the Iberian Peninsula. By the end of the tenth century, its expanding territory included much of southwestern Asia and the Mediterranean littoral of Africa and Europe. Many places had yet to be touched by the disease. But during the next six hundred years, smallpox became endemic in much of Europe, from whence it spread to most inhabited regions of the world. By the end of the eighteenth century, when Jenner first introduced vaccination in England, 400,000 Europeans were dying each year from smallpox.20
If the early history of smallpox remains mysterious, the origin of the variola virus itself is murkier still. The most plausible theory holds that the virus originated in a rodent, made the species leap to humans, adapted to its new host, and never went back. This much is certain: