smallpox

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1. outline2. origin3. Phase4. Symptom5. prevention6. damage case7. The first disease eradicated by humans8. eradication, after
8.1. Current state of smallpox vaccine stockpiling in each country
9. biological weapon10. creations11. related document

1. outline

(Secondly) Deadly Virus[1]
/ / smallpox

Smallpox , or smallpox , is an infectious disease caused by infection with two types of smallpox viruses , Variola major and Variola minor, also called smallpox , pox , dysentery , pestilence , or red death .

As can be seen from the fact that it is described in the past tense, smallpox, which was a disease that had caused numerous victims , has no more cases of natural outbreaks since the last outbreak in 1977 , that is, it is the first disease eradicated by mankind . There are only two infectious diseases that humanity has completely eradicated and permanently erased from the world. One is this natural disease, and the other is rinderpest, which was eradicated in 2001 and officially declared eradicated in 2011 .

At the time it existed, the overall fatality rate was as high as 30%, and in certain circumstances[2] It was a dangerous disease where the risk rose to almost 100% .[3] Even if he survived, he could not avoid having severe scars on his face and body. For this reason, the medical community researched artificially manipulating the virus to enable preemptive response, and the Soviet Union also initially considered developing it as a biological weapon , but it was virtually impossible to control due to its extreme contagiousness, so it was discarded. The good news is that once cured, immunity develops and the disease never occurs again, and the only hosts were humans. If the smallpox virus had been a virus that does not easily produce immunity, like influenza, or had multiple host species, it would have been killing many people by now.

It is sometimes misunderstood as an infectious disease transmitted from cattle due to the cowpox method, but according to modern research, it appears to have originated from the rodent taterapox virus (TATV) and is a very close relative of Camelpox virus (CMPV). TATV's original host is believed to be Kemp's gerbil ( Gerbilliscus kempi ), a type of rodent native to central Africa . It is presumed that CMPV originated from TATV when Kemp's gerbil came into contact with dromedary camels introduced to the Ethiopia - Somalia region about 3,500 to 4,500 years ago, and that the smallpox virus was passed from camels to humans.[4]

Meanwhile, the name 'smallpox' is relatively new. The name was given after the artificial pharynx and cowpox were created, meaning that it was a disease that occurred naturally. In the past, this disease was usually called smallpox or pox.[5]

2. origin

Smallpox has been plaguing humans since about 10,000 BC. Egypt Pharaoh The discovery of a pustular rash on the mummy of Ramses V is thought to be the oldest physical evidence of smallpox.

Smallpox killed 400,000 people every year in Europe alone before the 18th century , and one-third of the blind people lost their eyesight due to smallpox. 20-60% of those infected died, and 80% of children died when infected.

The barrier mayor virus is much worse than the barrier -minor virus, and the mortality rate is 30-35%. The barola Minor has a less severe symptom than the Bariola Mallor, and it is also referred to as a separate cotton or small mama (CottonPox, Milkpox). The representative one of the long -term complications of the barrier mayor virus is the so -called Gombo , and 65-85%of the survivors became Gombo. In addition to Gombo, it was a complication of 2-5% of the blindness due to the cornea ulcer , the complications of smallpox , and the limbs variants caused by boneitis .

In English , it was originally just called pox, but the word smallpox was first used in England in the 15th century to distinguish syphilis from great pox . Another expression was called red plague.

3. Phase

Until it was eradicated, smallpox was treated as the worst disaster along with war and war, and was called the deadliest disease in human history . Its destructive power can be compared to the epidemic diseases in the plague apocalypse disaster.

In human history, the cumulative deaths of black deaths are estimated at about 300 million and influenza cumulative deaths are estimated at approximately 350 million, with smallpox cumulative deaths .[6] As a disease caused by only one kind of pathogen,[7] Instead of killing and hitting in a short period of time, such as the Black Death , the Spanish flu , or the covid-19 , it has been popular in humanity for more than a thousand years.

The reasons why smallpox was such a devastating disease are as follows.
  • Silent spread due to incubation period
    Smallpox has an incubation period of approximately 10 to 14 days before symptoms appear after infection. During this period, infected people traveled long distances or came in contact with family members and neighbors without knowing that they were sick, and in a time when there was no epidemiological investigation like in modern times, the disease spread throughout the village without knowing who transmitted it to whom.
  • Widespread indirect infection due to strong survivability
    Normally, a virus dies quickly once it leaves the host's body, but the smallpox virus is persistent enough to survive for several months in a scab that falls from a patient's body. Therefore, the room the patient stayed in, the clothes they touched, and the blanket they covered showed tremendous indirect infectious power, turning into biological weapons in themselves.
  • Infects only humans
    Smallpox only infects humans and is a disease specialized for attacking humans. Unlike zoonotic infectious diseases, it has evolved only against humans, so it has the optimal balance of 'spreading best between people and maximizing spread by keeping them alive'.[8][9] As humans live more and more densely together, their destructive power has become stronger. If there is an animal that acts as an intermediary, the transmission would be reduced without that animal, but since the transmission route for smallpox is humans themselves, the virus spread through the 'human network' itself, in such a way that if one person caught it, the entire family was wiped out, and if a family caught it, the entire village was wiped out. Paradoxically, since smallpox only infected humans, immunizing all humans through a vaccine gave the virus nowhere to go, allowing humanity to completely eradicate the disease.
  • Spread to the Americas where there was no herd immunity
    Smallpox killed an unprecedented 90% of Native Americans. Unlike Europeans who had been fighting smallpox for thousands of years and had some degree of resistance, when Native Americans, who had no resistance at all, came into contact with the smallpox virus, the infection rate reached 100% and the mortality rate reached 80-90%. Among the diseases brought in by Europeans, there were many to which the natives had no resistance, but smallpox swept through the native society with its unique ability to spread, as it could be transmitted just by breathing and could cause illness even by touching an object that the carrier had touched. Not only did people die from the virus itself, but indirect deaths were also serious. With common diseases, when someone is sick, a healthy person can give them water and light a fire to maintain their body temperature, but in an indigenous village, more than 90% of the entire population was infected at the same time, and while they were unable to move their bodies due to high fever, dehydration caused by not being able to drink water, vertigo due to failure to regulate body temperature, and starvation caused by not being able to hunt and farm caused a disaster that killed more people than the actual virus.

In Korea, it is traditionally called (big) mama (媽媽), a big guest, and the five generals (general, lieutenant general, major general, brigadier general, sergeant) of the Korean Armed Forces were so feared that they were included among the six great mamas of Joseon (Sanggam mama, Jungjeon mama, Daebi mama, Donggung mama, Binggung mama, Big mama). The title of 'Mama' could not be received even by a grand general or a prince , let alone a first rank , and although it was a title reserved for the direct line of the king, which could easily be accused of treason if used carelessly, it was acceptable to call Smallpox 'Mama', which shows his status.

Similarly, relatively mild diseases such as measles and chickenpox are called little mamas or little guests. Titles such as mama or guest were originally terms used in shamanism , which referred to the ghost that caused the disease as a precious guest. This is because in the past, smallpox was a very scary disease that killed both royalty and commoners and was highly contagious . In shamanism and folk tales, smallpox was considered a terrible plague god called ‘Mamasin’ . Therefore, once Mama God came in (=if she contracted smallpox), she literally had no choice but to entertain her as if she were the 'Mama' of the Jungjeon or the 'Mama' of the Donggung Palace and pray for her to leave gracefully.

The superstition that arose here is that 'the demon god is very jealous and does not like other ghosts coming in, so ancestral rites should not be held in a house where there is a demon patient.' Even if this is a superstitious explanation , it is an appropriate quarantine measure. As Korea's traditional ancestral rites are large events where the entire family gathers, if a ancestral rite is held in a house with an infectious disease patient, everyone can become infected and the family may be ruined. Even smallpox was an airborne disease, so its contagiousness was extremely high. Basic infection reproduction index (R0R_0) ranks highest at 5 to 7. It is highly likely that this custom arose because the people of the time knew from experience under what circumstances smallpox was contagious, even if they did not know the scientific cause. The educated class of the Joseon Dynasty, who made Confucianism the national policy, deplored this trend, and in Yulgok Yi-i's 'Haeju Hyangyak' and Choryeo Yu-tae's 'Jeonghun (庭訓)', when there was a person in a village who abolished ancestral rites due to smallpox, noblemen and commoners were Regardless, it is said to be punished with severe punishment.[10] It appears that it was of no use because even the royal family was afraid of smallpox and suffered from it.

4. Symptom

The most common symptom is a rash that appears all over the body , starting with red dots and then developing into severe pustules on the face and other areas. In severe cases, the rash is so numerous that it is repulsive to others, and it is not just a matter of it appearing in large quantities, but the damage is so severe that the skin becomes almost like a rag, so even if you survive, you will have scars (called pockmarks) that will never go away. These marks are also considered unsightly and have been the subject of discrimination and ridicule.

So, in addition to the pain of the symptoms, the social isolation caused by this terrible and shocking condition, which is clearly visible at a glance, really caused great suffering to the patients. However, it does not end there. In most cases, severe high fever develops and death occurs during the illness, and the aftereffects due to the fever cannot be ignored. It is a quite vicious disease. Because nerve cells are weak to heat, there were numerous cases of brain damage or loss of vision .

A smallpox survivor described the scars on his face as 'scratched', and such people were called pimples and blackheads. Adults say he has a dirty face .

In fact, there are four main types of smallpox symptoms. The commonly known type of symptom accounts for 90% and is commonly referred to as smallpox. There is also a slow-progressing, non-fatal, modified type of smallpox that mainly affects vaccinated patients. In comparison, malignant and hemorrhagic smallpox, which occur at a rate of about 5 to 10%, are[11] shows fatal symptoms with a fatality rate approaching 100%. It is not known why virulent smallpox and hemorrhagic smallpox types occur when people are infected with the same type of virus.

In addition, it was highly contagious as it could be transmitted through the air, so if even one patient contracted smallpox, the entire country would turn upside down and epidemics would occur periodically, causing many deaths.

5. prevention

File:Vaccine Fac...
Korean Empire in 1909 Internal hygiene and sanitary workroom. A calf used to produce a smallpox vaccine is shown.

Source: Seoul History Archive, 「Resident General of Chosen, The Second Annual Report on Reforms and Progress in Korea (1908-1909)」
File:Treatment o...
File:Selection o...
In 1915, head to head[12] Calves being slaughtered for production . The location is Beonsachang in Samcheong -dong , which was used as a bacteriological examination room under the Inspector-General of Police under the Japanese Government-General of Korea .

Source: 『ANNUAL REPORT』 (GOVERNMENT-GENERAL OF CHOSEN, 1915) owned by Seoul History Archive
Calves are being selected for smallpox vaccine production in front of the farm in 1915 .

Source: 『ANNUAL REPORT』 (GOVERNMENT-GENERAL OF CHOSEN, 1915) owned by Seoul History Archive

After 1798, the number of cases decreased sharply after the method developed by British physician Edward Jenner became popular.

Jenner developed a vaccine based on the fact that people who had contracted 'cowpox' while milking cows did not get smallpox . Cowpox is a disease that occurs in cows and was found to be genetically similar to smallpox. In other words, cowpox is a zoonotic disease . Mild ulcers develop on the udders of cows, and infected cows show abnormal symptoms such as a runny nose, but the fatality rate is close to 0%, and it usually recovers naturally after a few weeks. It can also be infected in humans and temporarily cause boils, but the symptoms themselves are not as severe as smallpox, and it also recovers naturally. Recently, it has also been studied as an anticancer treatment through genetic manipulation.

The early cowpox vaccine was a primitive one that used the pus of cows infected with cowpox to infect the human body with the cowpox virus and induce immunity, but later vaccines were made based on a different virus (vaccinia). According to recent research, the vaccinia virus is an 'accidental crossbreeding' of the cowpox and smallpox viruses.[13] It is believed to be a virus created by . However, if an unhealthy person is hit, there are rare side effects that cause symptoms such as encephalitis .

Even modern smallpox vaccines are not made from smallpox virus. Instead, the vaccine contains live cowpox viruses.[14] , which is related to the viruses that cause ampox and smallpox. There are two smallpox vaccines licensed in the United States.
  • ACAM2000 is a live vaccinia virus that reproduces in the person receiving it. Vaccination with the vaccinia virus causes a mild infection and protects against smallpox.
  • JYNNEOS is a live but weakened (attenuated) vaccinia virus that does not reproduce in people who receive it. It is approved for the prevention of smallpox and amphox.

The ACAM2000 vaccine is not an injection like the flu or COVID-19 vaccines. Culture the virus and mix the solution with the dried powder. One vial can hit 100 people. Usually, the vaccination site is disinfected with an alcohol swab before injection, but this is different in that it does not use an alcohol swab to promote vaccine activation. The tip of a special needle called a branch needle is dipped in a solution and the needle is rapidly pierced 15 times with sufficient force in an area about 5 mm in diameter to collect a small amount of blood. If the vaccine is administered successfully, blisters will appear at the site of vaccine administration within approximately 7 days. Cover the vaccine area with a dressing to prevent the vaccine virus from spreading to other parts of the body or close contacts. If you go through the process of pus coming out and a scab forming and falling off, you have been properly vaccinated. During the blister and pus process, the gauze should be changed once every 1 to 3 days. Also, since it can be transmitted to other people through blisters and pus, you should never use a bathhouse or swimming pool, and you must be very careful, such as using separate towels with your family.

Fever, muscle aches, and a general feeling of illness are common in the week after vaccination. General adverse reactions such as fever and rash may occur after vaccination. Rarely, there are cases where the virus is infected by scratching the vaccination site with your hand and then touching your eyes without washing your hands. Administration of the ACAM2000 vaccine may help up to 7 days after exposure to smallpox, but the sooner the vaccine is given, the more effective it is.

Because ACAM2000 is a live virus, it is dangerous for some people, especially those with weakened immune systems. Therefore, vaccination is prohibited for the following people: △ patients with congenital or acquired immunodeficiency, △ patients taking immunosuppressants, △ patients with heart disease or a history of heart disease, △ patients with eye disease receiving topical steroid treatment, △ patients with or a history of eczema, △ infants under 12 months of age, and △ pregnant or lactating women. Rarely, even some healthy people may have adverse reactions to this smallpox vaccine. Adverse reactions are less common in people who have been previously vaccinated than in people who have never been vaccinated.

About 1 in 10,000 healthy people who had not previously been vaccinated developed serious complications, and about 1 in a million died. If you have a very severe reaction to the vaccine, your doctor may try antiviral medications such as tecovirimat, cidofovir, or brincidofovir.

JYNNEOS is administered as two injections four weeks apart. It is approved for those 18 years of age and older, and may play a role in vaccination of people at risk for ACAM2000, such as people with weakened immune systems or atopic dermatitis.

Administration of smallpox vaccine is recommended only for those at high risk of exposure, primarily certain military personnel, laboratory workers administering or handling vaccines and related materials, and health care workers.

People with symptoms suggestive of smallpox should be isolated to prevent spreading the infection. Because smallpox does not spread if infected people start to feel sick and have not started developing a rash, it is not necessary to quarantine anyone who has been in contact with people with suspected symptoms of smallpox at this time. However, close contacts should be closely monitored and quarantined at the first sign of infection.

6. damage case

  • It already existed in Korea during the Three Kingdoms period and was called 'Mama' in the old days. There is also a theory that the 'Yeokshin' in Silla's Cheoyongga is related to smallpox. Its power was so great that, as described in the document above, the people called smallpox with honorifics such as 'Sonnim' and held 'Baesong Gut ' to pray for the smallpox ghost 'nim' to quickly go away.
  • Princess Jeongso , the first child of King Sejong of the Joseon Dynasty , contracted smallpox on February 25, 1424 (6th year of King Sejong's reign) and died young at the young age of 13. There is even a legend that King Sejong, who was heartbroken over the death of Princess Jeongso, who had received special affection from all the adults in the royal family at the time, held on to Princess Jeongso's body and would not let her go, delaying the princess' funeral. It is said that King Sejong was very sad even afterward, looking at the swing that Princess Jeongso used to play on when she was alive.
  • Queen Ingyeong, the wife of King Sukjong of the Joseon Dynasty , also passed away at the age of 19. And Sukjong also suffered from smallpox, and his mother, Queen Myeongseong, who was looking for a way to treat Sukjong's smallpox, believed that if she sprinkled cold water on Queen Myeongseong's body in the middle of winter and prayed, Sukjong's illness would be cured and she did so. In the end, Sukjong's smallpox was cured, but Queen Myeongseong contracted influenza as an aftereffect and passed away.
  • It is said that Queen Hyoeui , the wife of King Jeongjo of the Joseon Dynasty , also suffered from smallpox when she was young and had scars. She contracted smallpox when she entered the palace for a state wedding after completing the three selections . There is also a theory that she became an ugly woman and thus had a bad relationship with King Jeongjo, but both Queen Hyoeui and King Jeongjo suffered from smallpox to a mild degree and their relationship got better as time went on. They just had no children.
  • 1790s Taxidermy and Jeong Yak-yong[15] It appears that the existence of the cowpox method itself was known in the late Joseon Dynasty, as it appears that the Jenner-style cowpox method was included in the 'Jongdu Bangseo' written in collaboration with others, but unfortunately, this knowledge was not properly mobilized to save lives due to the bizarre rumor that "if you are hit by cowpox, you will turn into a cow."
  • An epidemic occurred in 1946, killing 4,234 people, and in 1951, during the Korean War, it became so violent that 40,000 people were infected and 11,530 people died. I think it was because I was exposed to UN troops in an area where smallpox was prevalent during the Korean War .
    • However, since 1954, the number has decreased significantly to about 10, and since 3 smallpox patients occurred in 1960, smallpox has completely disappeared from Korea. According to statistics from the Korea Disease Control and Prevention Agency in 2022, a total of 152,314 smallpox patients occurred in Korea from 1910 to the end of 1960 (about 3,000 on average per year), but there have been no cases since 1961.
  • Meanwhile, because the Manchu people originally had no resistance to smallpox, there were many deaths in the early Qing period. Even after Emperor Sungdeok won the Manchu War , he did not annex Joseon or set up a puppet government, but only arrested people because he was afraid that smallpox would spread to the army.[16] , Emperor Shunzhi , Emperor Shunzhi's uncle King Yetong Qin Tao, and several cousins ​​of Emperor Shunzhi also died of smallpox while attacking the Ming Dynasty . Among Emperor Shunzhi's several sons, Fujeon and Hyeonyeop were considered successors, and the Jesuits who were staying in China at the time After asking missionary Father Adam Schall for his opinion on whether he was resistant to smallpox, he decided on Hyeon-yeop, who had already been recorded as being favored and was resistant to smallpox after saving his life, as his successor. This person was Emperor Kangxi , the Gombo emperor .

    Emperor Kangxi, who became emperor because he survived smallpox, established a specialized institution to prevent smallpox and had it conduct various studies. At this time, he developed the 'poisoning method' in the style of the Qing Dynasty. The pharynx method, first created in India and introduced to China, literally involves mildly infecting humans with smallpox bacteria to develop immunity. It mainly involves wearing the clothes of a person who had smallpox or collecting the pus, drying it, grinding it, and applying it to parts of the body. In other words, the basic principle is the same as the attenuated vaccine, which induces immunity by damaging and weakening the virus. However, under the pre-modern medical standards of the time, the procedures were difficult, and if you were not careful, you could not only infect an otherwise healthy person with smallpox, but in severe cases, there was a serious side effect of spreading the disease further.

    The pharyngeal method and smallpox test method were introduced to England through Russia and Turkiye, and became the main preventive methods until doctor Edward Jenner invented the smallpox method 120 years later. If this procedure was performed, the survival rate was 90% and the fatality rate was about 10%. The fatality rate for smallpox was previously 30%, so although pharyngeal treatment is a better option, it is not completely safe. Allen's record also contains a description of the pharyngeal method being used in Joseon at the time, so it is assumed that the pharyngeal method was widespread among the civilian population at the time. According to Allen's records, in the 1880s, 60 to 70 out of 100 people underwent pharyngeal treatment.
  • Queen Elizabeth I of England also contracted smallpox early in her reign and suffered death. Fortunately, he recovered completely, but he was left with some marks on his face and hair loss that he had to cover up with heavy makeup and a wig. There is a story that a maid who assisted Queen Elizabeth I suffered from smallpox around the same time, but her face was so badly scarred that she had to leave the palace. King Willem II in 1650 , Princess Royal Mary in 1660 , and Mary II in 1694 also died young from this disease. In this way, William III lost both his parents and wife at a young age.
  • King Louis XV of France also died of smallpox. There is a theory that he contracted the disease after passing by the funeral of a woman who died of smallpox, became curious, and opened the coffin lid. This is a very gentle theory, and an even worse theory is that he contracted the disease after seeing a pretty young woman while passing by on a country road and having sexual intercourse with her openly. It was May 10, 1774. This issue was also addressed in the cartoon The Rose of Versailles .

    For reference, Maria Josepha, the older sister of Marie Antoinette , the grandson and daughter-in-law of Louis Because of this, Marie Antoinette's older sister, Maria Carolina , married the King of Naples instead, and Marie Antoinette married Louis XVI instead of Maria Carolina, who was originally scheduled to marry Louis XVI . In addition, Marie Antoinette's other older sister, Maria Elisabeth, who was said to be the most beautiful of her sisters, contracted smallpox when she was single. Although she survived after fighting the disease, she was left with marks all over her face. It's like losing your beauty in an instant.

    Maria Theresa , who took advantage of her children's arranged marriages for political reasons, was criticized as a heartless mother as she mercilessly put Maria Elisabeth in a convent because her face became like that and she could not be marketed for arranged marriages. Afterwards, Maria Elisabeth could not have an arranged marriage due to health reasons, so she became the head of a convent like her older sister, Maria Anna, who had entered a convent first , and she remained close to Maria Anna throughout her life.
  • If you look at the portrait of Oh Myeong- hang, a figure of King Yeongjo of Joseon Dynasty , a central figure of the Soron faction , and a meritorious subject who suppressed the rebellion of Yi In-jwa, you can see the scars from smallpox clearly on his face. In addition, Oh Myeong-hang's liver health deteriorated later, and the portrait he left behind shows his condition getting worse. This is often cited as an example when praising the realism of Joseon Dynasty portraits.
  • Ashikaga Yoshiteru, the shogun of the Muromachi shogunate , is also believed to have suffered from a natural disease. A portrait of Yoshiteru made in 1577 shows a bear mark on his cheek. It is said that he was sick and prayed.
  • It is said that Yamamoto Haruyuki, a general of daimyo Takeda Shingen during the Warring States period , lost one eye from smallpox as a child and became ugly, and that Date Masamune, a daimyo during the Warring States period, lost one eye from smallpox when he was five years old. Ashina Kamewakamaru, the son of daimyo Ashina Moritaka during the Warring States period, became the head of the clan at a young age, but died at the age of three from smallpox.
  • Kasugano Tsubone of the Edo Shogunate suffered from smallpox and was immune to smallpox, so in 1604 Tokugawa Ieyasu recruited a nanny for Tokugawa Iemitsu and was hired as a nanny .
  • Japan's Komei Tenno also died young from this disease, and his son Meiji Tenno also suffered from smallpox as a child and survived, but had to live with pockmarks for the rest of his life, and it is said that he developed a complex about it and was reluctant to take pictures. So the subjects sent Eo Jin-yeong to the German Empire. He was portrayed as agile and charismatic like the Kaiser .
  • Baekbeom Kim Gu also suffered from severe smallpox as a child and barely survived, but the scars from the aftereffects remained here and there on his face even into his old age.
  • Joseph Stalin, the first general secretary of the former Soviet Union , also suffered from smallpox, so many pockmarks remain in the unedited photo. When I was young, even if I had pockmarks, they weren't noticeable, but as I got older and had wrinkles and age spots on my face, the pockmarks were also noticeable and made me look disfigured. Of course, most of the photos were edited because the Soviet authorities would never have allowed such photos to be released to the public.
  • The fear of smallpox is also evident during the Old World's exploration of the New World. An incomparable number of New World natives were annihilated by Old World epidemics, which was incomparable to wars of aggression or massacres using weapons, civilization collapsed, and more than half of the population disappeared. Of course, it was infected by Europeans who visited the New World, so a native who met a Dutchman said that before you white people came, our tribe's population was ten times larger.
  • Internationally, there have been no more smallpox victims since the laboratory accident in Birmingham , England in August 1978. The last person to be naturally infected was a cook at a hospital in Mercasi, Somalia, where smallpox was prevalent in October 1977. He is said to have recovered and lived until 2013 .

7. The first disease eradicated by humans

The first infectious disease eradicated by humans on Earth[17]

Smallpox is the first to be completely eradicated by mankind since the beginning of human history . In particular, the prevention was found in a very early period of fatal infectious diseases, which is a great merit to remain in Edward Jenner 's human history .

After World War II, the World Health Organization (WHO), with support from the United States, led the malaria eradication campaign until the 1950s , but it was recognized that malaria eradication was close to impossible despite massive investment of funds.[18] Next, following the Soviet Union’s opinion,[19] The direction changed with the eradication of smallpox. At the time, the Soviet Union was desperate to eradicate smallpox because smallpox was prevalent in the border area due to immigrants. Ultimately, the Soviet Union developed and distributed on a large scale a groundbreaking freeze-dried smallpox vaccine that showed excellent efficacy in any region, regardless of terrain or climate. At this time, the Soviet Union donated a whopping 1.5 billion doses of vaccine to WHO free of charge .[20] And when these two superpowers, the United States and the Soviet Union, joined forces, smallpox began to disappear from the face of the earth at an alarming rate. At first, the Soviet Union attempted mass vaccination by simply pushing the quantity and succeeded in greatly increasing the number of people vaccinated, but there were limits to complete eradication. Therefore, from the mid-1960s, the encirclement vaccination method proposed by Dr. Donald Henderson of the United States was adopted, and from this point on, smallpox began to be 'eradicated' in earnest. Along with the smallpox eradication movement, the newly introduced strategies at WHO are currently acting as a core mechanism representing the ideology of the WHO's vertical faction, and these strategies remain as important historical materials that show how humanity survived against an incurable disease.
  • 1 week reporting system
    A strategy that has made the World Health Organization the best defender of humanity from pandemic situations. A system established to control the global medical system so that the World Health Organization can be notified within a week of any infectious disease that occurs in a specific region. Even now, this system is the core operating mechanism of the World Health Organization. When a suspected infectious disease occurs in a local clinic around the world, it is reported to WHO within one week through the higher-level medical system. WHO prepares a report every week to monitor the situation of the infectious disease. And if there are concerns about the spread of infection, a preemptive response strategy will be established. The world's population has reached 7 billion since the 2010s, and the fact that several people in a small African village are infected with Ebola can be reported across the globe through news agencies. This is due to the medical support from local medical centers to higher-level hospitals and each country. It is thanks to this system that has been created to systematically report to WHO within one week via the administrative department.
  • Mass Vaccination
    This is an early inoculation method attempted by the Soviet Union immediately after smallpox eradication was adopted as the official goal of WHO. To put it simply, it can be seen as a volume offensive. This method aims to vaccinate more than 80% of the world's population, and although it has been effective in developed countries and areas under administrative power, it has the limitation that complete eradication and complete vaccination are impossible in civil war countries, underdeveloped countries, and remote areas where administrative power is not properly reached, as it is impossible to properly identify vaccinators. So in reality, smallpox still persisted until the mid-1960s.
  • Ring Vaccination
    This is a vaccination method proposed by American Dr. Donald Henderson (1928 ~ 2016) in the mid-1960s. If there is an area where smallpox is especially prevalent, smallpox is first eradicated from the areas surrounding that area where smallpox is relatively less prevalent. Then, since the surrounding area surrounding the area can be considered to be free of smallpox patients, it becomes easier to focus on exterminating the last remaining and most dangerous smallpox epidemic area, and it becomes easier to identify infected people. To put it simply, it can be said to be a military strategy of encirclement and annihilation.
  • containment strategy
    It is a strategy to vaccinate all residents of the area when a smallpox patient occurs in a specific area, regardless of the reason and whether or not they have been previously vaccinated. It does not matter if you have already received the smallpox vaccine. If there is a smallpox patient in a village, all members of the village are obliged to be vaccinated regardless of whether they have been vaccinated or immunized, regardless of their individual will. Still, smallpox patients occur again? Then everyone should get the vaccine again. This is because someone has not yet developed immunity with just a few doses of vaccination, so it is possible that others have not developed immunity as well.

8. eradication, after

Smallpox was an infectious disease caused by variola virus (often called smallpox virus), which belongs to the genus Orthopoxvirus.
Smallpox was an infectious disease caused by the variola virus (commonly called smallpox virus), a member of the orthopoxvirus family .

The back of English Wikipedia and smallpox items. You can see what you wrote as a brother.[21]
Even in the 1950s and 1960s, smallpox was a terrible infectious disease that killed millions of people mainly in India , Southeast Asia , Africa , and South America .[22] Meanwhile , as a result of the smallpox eradication plan led by the World Health Organization since 1967 , in 1980 On May 8, smallpox was officially declared eradicated. Since the smallpox virus does not infect animals other than humans , the eradication of the virus was possible as vaccinations were widely spread and the virus had no host to live on. After the declaration of smallpox eradication, smallpox vaccination was no longer recommended in Korea .[23] According to WHO statistics, in 1977 The last natural infection was from a 23-year-old hospital medical worker named Ali Maow Maalin in Somalia.[24] , the last official death was in 1978 uk He was a photographer in Birmingham . After that, the World Health Organization declared the eradication of smallpox worldwide, and smallpox vaccination disappeared from 1998 .

At this time, the strategy used to eradicate smallpox remains as a legend in medical history, and if you listen to the contents, it is said that the strategy was similar to the siege eradication in the army . Content English However, concerns are being raised about it because the generation after vaccination has disappeared and there is no cure for it.

Laboratory accident in Birmingham, England , 1978[25] Afterwards, smallpox virus control became more stringent, and the U.S. All smallpox viruses from laboratories except those of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta and Koltsovo, Russia , were destroyed. In 1999 , the World Health Organization recommended the United States and Russia to destroy the smallpox virus, but they persisted and did not do so. And while this is only official, there is evidence that some countries, including North Korea , have unofficial possession of it for use as biological weapons . The debate over the disposal of the smallpox virus continues in modern times, with those who want to keep it for research purposes and those who want to scrap it because it could be leaked and misused.

In 2014, six vials of smallpox samples were discovered during a freezer inventory search at a disease research center in the United States. News The sample is believed to have been made in the 1950s, and the freezer was located at a National Institutes of Health (NIH) laboratory before being transferred to the FDA in the early 1970s. The vial was labeled as containing smallpox virus and was in a box with 10 other unlabeled vials. NIH and CDC plan to immediately store the smallpox sample in a level 4 isolation laboratory and begin disposal procedures through WHO after confirming that it contains the smallpox virus. This is not the first incident that occurred after the order to completely recover the smallpox virus was issued, and the same thing has already happened several times. Experts believe that there is a possibility that the lost smallpox virus, which has not yet been recovered, may fall into the hands of terrorists.

After the eradication of smallpox, vertical medical practitioners selected measles and polio as the next diseases to be eradicated. Polio was selected as the next target, but thanks to enormous capital investment, all but 10 countries around the world have succeeded in eradicating polio, but in the remaining 10 or so countries, eradication continues to fail. There is no vaccine with insanely high efficacy like the smallpox vaccine, and depending on the climate, there are even reports that 10 doses of the polio vaccine are required to develop immunity, making eradication difficult.[26] The effectiveness of the measles vaccine is just as good as that of the smallpox vaccine, and once you catch it, you won't get it again, but it is very difficult to catch it because its spread is so powerful that it far exceeds that of smallpox. As a result, it is still designated as a national mandatory vaccination and vaccination is mandatory.

Rather strangely, as people's sanitary conditions improve, it seems that the next disease scheduled for extinction will be the parasite Medina . However , some say that this disease has become impossible to extinct as investigations have revealed that this parasite began to use dogs as hosts, as well as humans in order to survive .

However, in 2022 , 42 years after smallpox disappeared, Empox, a disease similar to smallpox , began to spread around the world . Experts have different opinions on whether the situation will worsen. Fortunately, the terrible nightmare of smallpox did not repeat itself, and the WHO declared the pandemic to be under control as of May 2023.

8.1. Current state of smallpox vaccine stockpiling in each country

Currently, there are only eight countries and international organizations that have officially confirmed and announced their stockpiles of smallpox vaccine. In addition, most first- and second-generation vaccines are stockpiled because they can be stored almost permanently in a dry environment at -20℃ and their efficacy is still maintained even if stored for decades. In addition, the first and second generation vaccines are effective even when diluted and administered, so they can be administered to a larger population in an emergency.
State/International organization
base year
1st generation
2nd generation
3rd generation
total
source
korea
2022
Ransivacina
35 million doses
35 million doses
Korea Centers for Disease Control and Prevention
france
2006
Purquier
55 million doses
55 million doses
French Ministry of Health
japan
2006
LC16m8
56 million doses
56 million doses
germany
2022
Other first-generation vaccines
24 million doses
Lister/Elstree-BN
Over 30 million doses
MVA-BN
stockpile unknown
100 million doses
Italy
2022
5 million doses
Netherlands
2017
Lister/Elstree-RVIM
stockpile unknown
USA
2022
WetVax
85 million doses
ACAM2000
100 million doses
MVA-BN
65,000 doses
185 million doses
world health organization
2013
Other first-generation vaccines
2.4 million doses
ACAM2000
300,000 doses
2.7 million doses

9. biological weapon

Smallpox, for which vaccination was discontinued after the anthrax terrorist attacks, is receiving renewed attention as a biological weapon, and as a result, countries around the world are making efforts to prevent a resurgence of smallpox, such as by reproducing smallpox vaccines. Korea also designated smallpox as a statutory infectious disease in 2001. However, the important thing is securing the vaccine, but the quantity is too short.[27] In addition, there is no means of preventing smallpox other than the smallpox method, and there is no cure even in modern medicine, so it is designated as biosafety level 4.[28] Not only is there no cure or vaccination, but future generations do not even have immunity, so once it spreads, it could literally cause a global catastrophe like it did in the past.[29]

In July 2018, an article was published saying that the FDA had officially approved a new smallpox treatment. It was said to be part of a response to the possibility that it could be used in chemical warfare, such as terrorism. #

10. creations

  • Smallpox is also mentioned in the Warhammer universe, and Nurgle , the god of plague , hates anything related to smallpox, to the point of disgust. The extent to which he hates it is that he usually laughs it off even when the demons under his command make mistakes, even when Kugas ruins his greatest masterpiece, but when his subordinates bring up the topic of smallpox, he immediately gets angry to the core. It is said that even the most courageous of the Great Unclean Ones, the Greater Daemons of Nurgle, cannot bring up the topic of smallpox in front of Nurgle.[30]
  • As it is a disease that terrified the entire world and is the first to successfully eradicate humankind, it is a subject that occasionally appears in light novels set in the Middle Ages. However, compared to the Black Death, it appears less frequently. Smallpox leaves behind unsightly scars even if one survives, so it would be difficult to deal with in a light novel where the appearance of the characters is important.

10.1. Cards from Magic the Gathering

File:details ico...  more detailsSmallpox (Magic: The Gathering) documentcastPlease note.

10.2. Virus in Tom Clancy's The Division

The in -game name is green flu , which is literally a biological weapon that Gordon Amarst has added six deadly pathogenic genes to the natural beans . The spread through Black Friday is virtually anarchy , and players who play the game will be put into New York as a division secondary agent in the name of correcting the order of New York, which has collapsed with the virus. The game is reproduced as the game. See the document for details.

Tom Clancy's The Division is the only game series that bears the name of famous novelist Tom Clancy and has a pandemic apocalypse worldview.

11. related document

[1] For reference, the most deadly virus is a rabies virus with a 99.9 percent mortality rate .[2] hemorrhagic smallpox[3] Lane JM (April 2011). "Remaining questions about clinical variola major". Emerging Infectious Diseases.[4] IV Babkin and IN Babkina (2015) - The Origin of the Variola Virus, Viruses , 7(3), 1100-1112 doi:10.3390/v7031100[5] Jeong Yeon-sik (2001), 『Stories of the Joseon Dynasty seen through daily life 1』, Seoul: Youth History, 124.[6] In the 20th century alone, 300 million people died from smallpox, and between 1877 and 1977 alone, 500 million people died of smallpox.[7] Malaria is the most common, including cases in which several types of pathogens cause a single disease . A whopping 5 billion people. Even this side is in an endemic state like influenza , so it is expected that there will be more in the future.[8] Ebola has a fatality rate of 50-100%, but it kills the host too quickly, making it difficult to cause a pandemic. Influenza, such as the Spanish flu , has a low fatality rate but kills many people with its enormous spread. The fatality rate of 30% for smallpox is an efficient figure that 'kills a moderate number of people, but can spread throughout the world through the remaining 70%', and unlike the Black Death , which showed unprecedented destructive power in a short period of time, it was difficult to block the transmission route because there were no animal vectors ( rats and fleas in the case of the Black Death ).[9] Of course, if you exclude some strains of influenza , the mortality rate is in the several percent range, even the virulent Spanish influenza is up to 10%, and while AIDS is becoming less toxic by the day, smallpox has a mortality rate of at least 30-maximum 100%, comparable to Ebola even after thousands of years have passed . You can see how crazy this disease is. Moreover, unlike Ebola, this disease is extremely contagious.[10] Ibid., 132.[11] This is the type that is mainly experimented with biological weapons.[12] Raw material for cowpox medicine, a smallpox vaccine[13] In pre-modern times, in order to preserve the vaccinia virus for a long period of time, an attempt was made to propagate and preserve vaccinia by inoculating cows with vaccinia bacteria or bodily fluids from people who had received vaccinia. This vaccinia virus was transmitted to cowpox while already carrying smallpox. It is believed to have originated from 'reverse vaccination' of cattle with the bodily fluids of an inoculated person.[14] That is, it is an attenuated vaccine .[15] Dasan Jeong Yak-yong suffered from smallpox when he was young and survived.[16] However, the reason why the Qing did not annex Joseon was not only because of the smallpox epidemic. One point that is overlooked because Joseon was defeated so quickly during the Byeongjahoran invasion is that this was a time when the Ming Dynasty was still holding on. At that time, the Qing Dynasty was blocked from the Yeongseong Province and could not even cross the Liaoxi Corridor. After trade with the Ming was cut off, there was chronic food shortage due to the nature of the nomadic people, and the explosive population increase due to people defecting from the Ming and other countries led to famine. In other words, the Manchu War at the time was truly an adventure even for the Qing Dynasty. The purpose of Emperor Sungdeok was not to annex Joseon, but to stabilize the rear by neutralizing Joseon.[17] A video of ' subtle miscellaneous knowledge '.[18] It is possible to eradicate only the mosquito , which is a mosquito , but the number of mosquitoes is estimated to be more than 110 trillion (as of 2023), so it is impossible to eradicate the extinction of the vampire and the malaria .[19] In 1958, the WHO General Assembly passed a proposal by Dr. Viktor Zhdanov, Deputy Minister of Health of the Soviet Union, and the full-scale smallpox eradication operation began.[20] Of course, the Soviet Union did not make donations solely for pure purposes; the purpose was to incorporate the Third World, which was growing independent, into the communist bloc, and at the same time, it also had the purpose of promoting the system, saying, "While Western countries are just tapping away at calculators, the Soviet Union saves humanity for free."[21] The rules that scientific facts in English grammar are used as a simple current tense in the past , and the two rules of self -evident historical facts collide, the only case where the past form of scientific facts is allowed.[22] In 1967, when the worldwide eradication of smallpox began, the number of infected people was said to have reached 1 billion.[23] Compulsory vaccination was discontinued in 1979 .[24] The young man was cured. Ali later became active in the fight against malaria , but eventually died of malaria in Somalia in 2013 .[25] A photographer living upstairs from the laboratory where the smallpox virus was stored at the time became infected and died. This is the last death that came out earlier. As a result of checking immediately after the incident, it was discovered that the mother was also infected, which caused shock and fear, but due to the quick follow-up response, there were no more victims.[26] Here the United States As the CIA 's search for the DNA of polio vaccines during the CIA's search for a polio , the spread of phobia and conspiracy theories of vaccines through various causes.[27] Fortunately, due to the nature of South Korea over North Korea, which is certain to have the smallpox virus, it has already secured a lot of vaccines in preparation for emergencies, so it is said that it is possible to vaccinate more than 30 million people.[28] Since this virus is extremely viable, hand washing is of course ineffective.[29] In modern times, antiviral drugs that may be effective against smallpox have been discovered, but clinical trials cannot be conducted because there are no more patients. In addition, if a clinical experiment were conducted with smallpox, which has the power of a biological weapon, and it spreads incorrectly, there is a very high risk of a biological disaster similar to COVID-19 due to the three-stage combo of lack of treatment, extremely high contagiousness, and high fatality rate.[30] The reason why Nurgle hates hearing about smallpox so much is because although smallpox is a very deadly plague, it was completely eradicated in just 200 years by the work started by a single mortal doctor who was neither a hero nor a wizard like the Emperor of Mankind . Even considering that the method of cowpox was developed through a disease called cowpox, it is as if the plague was eradicated as a plague in front of the god of plague . It is truly an indelible dishonor and complex to have the god of plague bow down to a single doctor.

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