1 00:00:01,280 --> 00:00:04,320 Speaker 1: Welcome to Stuff You Missed in History Class, a production 2 00:00:04,360 --> 00:00:13,880 Speaker 1: of I Heart Radio. Hello, and welcome to the podcast. 3 00:00:14,000 --> 00:00:18,080 Speaker 1: I'm Tracy V. Wilson and I'm Holly Fry. Late March 4 00:00:18,120 --> 00:00:21,639 Speaker 1: of last year, I researched and wrote our episode on 5 00:00:21,760 --> 00:00:25,400 Speaker 1: the eradication of render pest because in that moment, it 6 00:00:25,480 --> 00:00:27,960 Speaker 1: just felt really weird to me to work on episodes 7 00:00:28,400 --> 00:00:32,519 Speaker 1: that were not about the pandemic somehow, because that was 8 00:00:32,600 --> 00:00:36,920 Speaker 1: dominating everything in our lives. But at the same time, 9 00:00:36,960 --> 00:00:38,879 Speaker 1: I wanted to work on something that felt kind of 10 00:00:38,920 --> 00:00:44,200 Speaker 1: optimistic because the pandemic was dominating our lives. Uh So, 11 00:00:44,280 --> 00:00:47,680 Speaker 1: now it's almost a year and a half later here 12 00:00:47,720 --> 00:00:51,800 Speaker 1: in the US, we had a pretty hopeful springtime regarding 13 00:00:51,920 --> 00:00:55,400 Speaker 1: the progress of the pandemic. I know that was not 14 00:00:55,480 --> 00:00:58,680 Speaker 1: the case in the whole world, but we had what 15 00:00:58,840 --> 00:01:04,679 Speaker 1: was looking like improved situations that obviously has taken a 16 00:01:04,760 --> 00:01:08,560 Speaker 1: turn once again for the worst, or at least the worst, 17 00:01:09,200 --> 00:01:12,920 Speaker 1: maybe not the worst of ever, but definitely worse. I 18 00:01:12,959 --> 00:01:15,320 Speaker 1: wanted to kind of return to the idea of wiping 19 00:01:15,600 --> 00:01:19,080 Speaker 1: a disease off the face of the earth. So render 20 00:01:19,120 --> 00:01:21,840 Speaker 1: pest and smallpox are the only two diseases that have 21 00:01:21,959 --> 00:01:25,960 Speaker 1: been eradicated through human activity. Neither one of them is 22 00:01:26,000 --> 00:01:29,880 Speaker 1: technically extinct, because there are some samples of both viruses 23 00:01:29,959 --> 00:01:33,479 Speaker 1: that still exist in labs. They're no longer circulating out 24 00:01:33,480 --> 00:01:37,040 Speaker 1: in the wild, though. And we've talked about smallpox a 25 00:01:37,040 --> 00:01:39,080 Speaker 1: bit on the show before. We had our episode on 26 00:01:39,200 --> 00:01:42,600 Speaker 1: Edward Jenner and the smallpox vaccine and how the vaccine 27 00:01:42,640 --> 00:01:45,360 Speaker 1: was developed and then generous efforts to try to make 28 00:01:45,400 --> 00:01:49,960 Speaker 1: it more widely available. More recently, we did the episode 29 00:01:50,000 --> 00:01:53,480 Speaker 1: on the Royal Philanthropic Vaccine Expedition, and that was all 30 00:01:53,480 --> 00:01:57,080 Speaker 1: about Spain's efforts to transport the smallpox vaccine to the 31 00:01:57,080 --> 00:02:00,840 Speaker 1: America's which required a chain of living hum and hosts. 32 00:02:01,360 --> 00:02:05,960 Speaker 1: We mentioned pretty briefly the eradication of smallpox and both 33 00:02:05,960 --> 00:02:08,919 Speaker 1: of those episodes, but we have not gone into detail 34 00:02:09,480 --> 00:02:12,760 Speaker 1: about how that happened. That's what we're going to talk 35 00:02:12,800 --> 00:02:17,239 Speaker 1: about today. And when Tracy mentioned it to me, I said, 36 00:02:17,240 --> 00:02:20,080 Speaker 1: we've covered that. No, it just keeps coming up. It 37 00:02:20,160 --> 00:02:23,000 Speaker 1: just keeps coming up. We've said in like a sentence 38 00:02:23,040 --> 00:02:25,120 Speaker 1: how it was done, but it's a more than a 39 00:02:25,200 --> 00:02:29,760 Speaker 1: sentence worth of explanation. Yeah, it's just it's a it's 40 00:02:29,800 --> 00:02:33,119 Speaker 1: been just peppered in enough that my brain was like, yeah, 41 00:02:33,160 --> 00:02:37,320 Speaker 1: that that was an episode, right, No, Nope. So smallpox 42 00:02:37,520 --> 00:02:40,680 Speaker 1: is a viral disease that has existed for millennia when 43 00:02:40,680 --> 00:02:43,519 Speaker 1: it was circulating in the wild. It's spread from person 44 00:02:43,560 --> 00:02:47,400 Speaker 1: to person through the air, usually through face to face contact, 45 00:02:47,720 --> 00:02:50,519 Speaker 1: and it can also be spread through contact with contaminated 46 00:02:50,560 --> 00:02:55,800 Speaker 1: objects and surfaces. People who contracted smallpox typically developed a 47 00:02:55,880 --> 00:02:58,440 Speaker 1: high fever and body aches, and that was followed by 48 00:02:58,440 --> 00:03:02,360 Speaker 1: a distinctive rash. There are two different strains of the 49 00:03:02,440 --> 00:03:05,560 Speaker 1: very Ola virus that were causing smallpox, very il a 50 00:03:05,680 --> 00:03:09,399 Speaker 1: major and verial a minor. As that name suggests, very 51 00:03:09,400 --> 00:03:13,119 Speaker 1: el a major caused more serious illnesses. As many as 52 00:03:13,200 --> 00:03:16,040 Speaker 1: a third of people who were infected with very Ola 53 00:03:16,080 --> 00:03:20,920 Speaker 1: major died, as many as nine of babies died. It 54 00:03:21,040 --> 00:03:24,960 Speaker 1: was also particularly lethal any time it was introduced somewhere 55 00:03:24,960 --> 00:03:28,200 Speaker 1: that it hadn't existed before, such as when Europeans started 56 00:03:28,280 --> 00:03:32,200 Speaker 1: arriving in the Americas, and in those cases, smallpox usually 57 00:03:32,280 --> 00:03:35,920 Speaker 1: killed about half the people who contracted it Among the 58 00:03:35,960 --> 00:03:39,480 Speaker 1: people who survived the disease. Smallpox could also be both 59 00:03:39,560 --> 00:03:45,360 Speaker 1: disabling and disfiguring. There was and is no cure for smallpox, 60 00:03:45,440 --> 00:03:49,440 Speaker 1: so even as science and medicine progressed, it continued to 61 00:03:49,480 --> 00:03:52,400 Speaker 1: be deadly. But it also had some traits that made 62 00:03:52,400 --> 00:03:56,840 Speaker 1: it a good candidate for a worldwide eradication campaign. Smallpox 63 00:03:56,960 --> 00:04:00,800 Speaker 1: was easy to recognize and diagnose. Unlike say, the flu, 64 00:04:00,920 --> 00:04:05,119 Speaker 1: which can resemble a lot of other respiratory infections, smallpox 65 00:04:05,160 --> 00:04:08,880 Speaker 1: passed directly from person to person and only infected humans, 66 00:04:08,960 --> 00:04:11,960 Speaker 1: so there were no hidden reservoirs of the virus that 67 00:04:12,000 --> 00:04:15,920 Speaker 1: could potentially start a new outbreak. That's different from something 68 00:04:15,960 --> 00:04:19,560 Speaker 1: like yellow fever, which also infects other primates and is 69 00:04:19,600 --> 00:04:24,520 Speaker 1: transmitted by mosquitoes. Another plus, once a person had recovered 70 00:04:24,560 --> 00:04:28,479 Speaker 1: from smallpox, they were immune for life. For a number 71 00:04:28,520 --> 00:04:33,400 Speaker 1: of reasons, smallpox outbreaks also tended to develop relatively slowly. 72 00:04:34,040 --> 00:04:37,480 Speaker 1: Once people were contagious, they were usually also too sick 73 00:04:37,600 --> 00:04:41,400 Speaker 1: to really leave home, so outbreaks tended to cluster around 74 00:04:41,440 --> 00:04:45,200 Speaker 1: members of the same household and their immediate neighborhood. And 75 00:04:45,240 --> 00:04:49,039 Speaker 1: then once an outbreak was identified, swift action could keep 76 00:04:49,040 --> 00:04:52,800 Speaker 1: it from spreading very far. And most importantly, there was 77 00:04:52,800 --> 00:04:56,159 Speaker 1: a way to disrupt transmission of the disease in this 78 00:04:56,200 --> 00:05:00,680 Speaker 1: case of vaccine in terms of the smallpox vaccine. At first, 79 00:05:00,800 --> 00:05:05,360 Speaker 1: people prevented smallpox using a technique called variolation that involved 80 00:05:05,400 --> 00:05:10,239 Speaker 1: intentionally introducing material from one person's smallpox sore or scab 81 00:05:10,360 --> 00:05:14,200 Speaker 1: into another person. Practitioners in Asia were doing this as 82 00:05:14,200 --> 00:05:18,800 Speaker 1: early as the eleventh century, and the technique spread from there. Then, 83 00:05:18,960 --> 00:05:21,440 Speaker 1: in the late eighteenth century, people started to make a 84 00:05:21,440 --> 00:05:25,560 Speaker 1: connection between smallpox and another much milder disease that was 85 00:05:25,600 --> 00:05:29,400 Speaker 1: called cow pox. The smallpox and cow pox viruses are 86 00:05:29,480 --> 00:05:32,960 Speaker 1: both in the genus orthopox virus, and people who had 87 00:05:32,960 --> 00:05:38,240 Speaker 1: contracted cow pox seemed immune to smallpox. Several people, including 88 00:05:38,360 --> 00:05:42,520 Speaker 1: Edward Jenner, tried deliberately exposing people to cow pox as 89 00:05:42,520 --> 00:05:46,640 Speaker 1: a way to prevent smallpox. Jenner called this vaccination, after 90 00:05:46,680 --> 00:05:51,680 Speaker 1: the Latin word for cow. So both variolation and vaccination 91 00:05:51,760 --> 00:05:55,960 Speaker 1: could prevent smallpox, but since variolation could also cause full 92 00:05:56,000 --> 00:06:00,800 Speaker 1: blown smallpox, vaccination was a lot safer. At the same time, though, 93 00:06:01,120 --> 00:06:05,039 Speaker 1: vaccination in its earliest forms carried some of the same 94 00:06:05,160 --> 00:06:09,440 Speaker 1: risks that variolation did, including the potential for transmitting other 95 00:06:09,560 --> 00:06:13,880 Speaker 1: illnesses like syphilis and hepatitis from person to person. During 96 00:06:13,880 --> 00:06:18,359 Speaker 1: these person to person vaccination chains. Sometime in the nineteenth century, 97 00:06:18,520 --> 00:06:22,479 Speaker 1: people shifted from using cow pox to using vaccinia virus, 98 00:06:22,520 --> 00:06:27,280 Speaker 1: which is another orthopox virus, to make smallpox vaccine. The 99 00:06:27,360 --> 00:06:31,080 Speaker 1: origins of the vaccinia virus are unclear. It is possible 100 00:06:31,120 --> 00:06:33,680 Speaker 1: that it's actually some kind of hybrid of cow pox 101 00:06:33,960 --> 00:06:37,560 Speaker 1: and smallpox, or that it developed over time as cow 102 00:06:37,640 --> 00:06:41,159 Speaker 1: pox virus was passed through multiple hosts in the process 103 00:06:41,200 --> 00:06:46,760 Speaker 1: of making vaccines. Eventually, vaccinia virus replaced cow pox virus 104 00:06:46,839 --> 00:06:51,560 Speaker 1: for vaccination purposes, just as vaccination with cowpox had previously 105 00:06:51,600 --> 00:06:56,680 Speaker 1: replaced variolation with smallpox itself. At first, vaccines made with 106 00:06:56,760 --> 00:07:00,400 Speaker 1: vaccinia virus were grown in the skin of live animals 107 00:07:00,560 --> 00:07:05,080 Speaker 1: like calves, sheep, and rabbits. Eventually that shifted to growing 108 00:07:05,120 --> 00:07:09,000 Speaker 1: the virus in tissue cultures or in chicken eggs. These 109 00:07:09,000 --> 00:07:12,720 Speaker 1: methods replaced those arm to arm vaccination chains that we 110 00:07:12,760 --> 00:07:16,600 Speaker 1: talked about in our episode on the Royal Philanthropic Vaccine Expedition. 111 00:07:17,160 --> 00:07:20,880 Speaker 1: Countries actually started to outlaw arm to arm vaccinations in 112 00:07:20,880 --> 00:07:24,960 Speaker 1: the late nineteenth century. Many of the vaccinia strains used 113 00:07:25,000 --> 00:07:29,200 Speaker 1: to make vaccines were attenuated or weakened by repeatedly passing 114 00:07:29,240 --> 00:07:34,200 Speaker 1: them through a non human host, things like chick embryo cells, eggs, 115 00:07:34,400 --> 00:07:38,120 Speaker 1: or mice. This process resulted in a virus that produced 116 00:07:38,120 --> 00:07:40,720 Speaker 1: an immune response when a person was vaccinated with it, 117 00:07:41,040 --> 00:07:44,320 Speaker 1: but couldn't reproduce in that person's body and make them sick. 118 00:07:44,960 --> 00:07:48,640 Speaker 1: So while vaccination with cowpox virus was safer than variolation 119 00:07:48,680 --> 00:07:53,240 Speaker 1: with smallpox virus, vaccination with an attenuated version of vaccinia 120 00:07:53,320 --> 00:07:59,320 Speaker 1: virus was also safer than vaccination with live, unattenuated cow pox. Yeah, 121 00:07:59,320 --> 00:08:03,680 Speaker 1: there were still potentials for various complications, but this was 122 00:08:03,720 --> 00:08:08,120 Speaker 1: an improvement overall. It really didn't take long after the 123 00:08:08,160 --> 00:08:12,280 Speaker 1: development of vaccines for people to wonder whether vaccines could 124 00:08:12,280 --> 00:08:16,760 Speaker 1: be used to eliminate smallpox entirely, but early attempts to 125 00:08:16,800 --> 00:08:19,840 Speaker 1: do this faced a lot of obstacles. As we talked 126 00:08:19,880 --> 00:08:23,360 Speaker 1: about in our episode on the Royal Philanthropic Vaccine Expedition, 127 00:08:23,680 --> 00:08:28,120 Speaker 1: Early versions of smallpox vaccine lost their potency really quickly, 128 00:08:28,360 --> 00:08:31,800 Speaker 1: especially in hot weather, and that continued to be true 129 00:08:31,920 --> 00:08:35,560 Speaker 1: after vaccinia replaced cow pox as the preferred virus for 130 00:08:35,640 --> 00:08:40,240 Speaker 1: smallpox vaccines. But then in the nineteen forties people started 131 00:08:40,240 --> 00:08:43,800 Speaker 1: working on dehydrated and freeze dried versions of the vaccine. 132 00:08:44,520 --> 00:08:48,640 Speaker 1: The Vaccine Institute in Paris produced a freeze dride vacuum 133 00:08:48,679 --> 00:08:51,800 Speaker 1: packed vaccine that had a longer shelf life. In the 134 00:08:51,920 --> 00:08:56,080 Speaker 1: nineteen fifties, Leslie Harold Collier at the Lister Institute study 135 00:08:56,160 --> 00:08:58,960 Speaker 1: the preservation methods that were in use and how effective 136 00:08:58,960 --> 00:09:02,800 Speaker 1: they were. In he developed a process that didn't require refrigeration, 137 00:09:03,320 --> 00:09:07,760 Speaker 1: even in tropical temperatures. Once the vaccine was reconstituted, it 138 00:09:07,840 --> 00:09:10,800 Speaker 1: still had a short shelf life, but until that point 139 00:09:10,880 --> 00:09:13,959 Speaker 1: it could survive in the field for months. It also 140 00:09:14,000 --> 00:09:17,480 Speaker 1: protected people from smallpox infection for at least ten years, 141 00:09:17,880 --> 00:09:20,960 Speaker 1: and offered protection against dying of smallpox for some time 142 00:09:21,000 --> 00:09:25,359 Speaker 1: after that. Callier's method eventually became the World Health Organization 143 00:09:25,440 --> 00:09:30,560 Speaker 1: standard for vaccine used for the eradication campaign. Smallpox was 144 00:09:30,600 --> 00:09:34,120 Speaker 1: eliminated in North America in nineteen fifty two and in 145 00:09:34,160 --> 00:09:37,400 Speaker 1: Europe in nineteen fifty three, and that was done primarily 146 00:09:37,520 --> 00:09:40,920 Speaker 1: through mass vaccination campaigns, especially once that were done in 147 00:09:40,960 --> 00:09:44,840 Speaker 1: response to outbreaks. And this success came in spite of 148 00:09:44,960 --> 00:09:50,080 Speaker 1: increasing resistance to vaccines and to compulsory vaccine programs and 149 00:09:50,120 --> 00:09:54,040 Speaker 1: the United States. This resistance led to a Supreme Court 150 00:09:54,080 --> 00:09:58,200 Speaker 1: case in nineteen o five, the city of Cambridge, Massachusetts, 151 00:09:58,200 --> 00:10:01,000 Speaker 1: had been trying to stop a small pox outbreak and 152 00:10:01,040 --> 00:10:03,959 Speaker 1: had ordered all adults to be vaccinated or to pay 153 00:10:04,000 --> 00:10:08,600 Speaker 1: a five dollar fine. Henning Jakobsen refused to be vaccinated, 154 00:10:08,720 --> 00:10:11,280 Speaker 1: and then, after being fined, he took the matter to court. 155 00:10:11,760 --> 00:10:14,800 Speaker 1: In the words of the court's decision, quote, the liberty 156 00:10:14,920 --> 00:10:17,720 Speaker 1: secured by the Constitution of the United States does not 157 00:10:17,960 --> 00:10:21,520 Speaker 1: import an absolute right in each person to be at 158 00:10:21,520 --> 00:10:25,559 Speaker 1: all times and in all circumstances, wholly freed from restraint. 159 00:10:26,160 --> 00:10:28,760 Speaker 1: Nor is it an element in such liberty that one 160 00:10:28,800 --> 00:10:32,760 Speaker 1: person or a minority of persons residing in any community 161 00:10:32,840 --> 00:10:36,200 Speaker 1: and enjoying the benefits of local government, should have power 162 00:10:36,280 --> 00:10:39,640 Speaker 1: to dominate the majority, when supported in their action by 163 00:10:39,679 --> 00:10:42,720 Speaker 1: the authority of the state. It is within the police 164 00:10:42,720 --> 00:10:45,840 Speaker 1: power of a state to enact a compulsory vaccination law, 165 00:10:46,120 --> 00:10:48,600 Speaker 1: and it is for the legislature and not for the courts, 166 00:10:48,640 --> 00:10:52,280 Speaker 1: to determine in the first instance, whether vaccination is or 167 00:10:52,440 --> 00:10:54,960 Speaker 1: is not the best mode for the prevention of smallpox 168 00:10:55,360 --> 00:10:58,640 Speaker 1: and the protection of the public health. We'll get some 169 00:10:58,720 --> 00:11:02,079 Speaker 1: more on the campaign to eradicate smallpox and the rest 170 00:11:02,120 --> 00:11:14,520 Speaker 1: of the world after a sponsor break. The World Health 171 00:11:14,640 --> 00:11:18,679 Speaker 1: Organization's decision making body is called the World Health Assembly, 172 00:11:19,200 --> 00:11:22,240 Speaker 1: and in nineteen fifty three, the w h A didn't 173 00:11:22,280 --> 00:11:25,920 Speaker 1: consider smallpox to be a candidate for global eradication. It 174 00:11:26,040 --> 00:11:30,240 Speaker 1: just wasn't a priority. But five years later a delegate 175 00:11:30,280 --> 00:11:33,800 Speaker 1: to the w h A proposed a ten year eradication plan. 176 00:11:34,400 --> 00:11:38,400 Speaker 1: That delegate was Professor Viktor Jdanoff, who was Deputy Health 177 00:11:38,440 --> 00:11:42,840 Speaker 1: Minister of the Soviet Union, and this proposal included vaccine 178 00:11:42,840 --> 00:11:46,920 Speaker 1: donations that would be provided by the USSR. But even 179 00:11:46,960 --> 00:11:50,480 Speaker 1: with the promise of donated vaccines, this proposal still didn't pass. 180 00:11:51,000 --> 00:11:53,400 Speaker 1: At the time, the World Health Organization was working on 181 00:11:53,440 --> 00:11:57,000 Speaker 1: an anti malaria program and that was really just drawing 182 00:11:57,040 --> 00:12:00,600 Speaker 1: most of the focus. In nineteen fifty nine, the Soviet 183 00:12:00,679 --> 00:12:04,520 Speaker 1: Union's proposal was reintroduced, and this time it was passed 184 00:12:04,520 --> 00:12:09,960 Speaker 1: as a voluntary global vaccine campaign. Countries where smallpox was endemic, 185 00:12:10,120 --> 00:12:14,000 Speaker 1: that is, freely circulating, were asked to institute mass vaccine 186 00:12:14,000 --> 00:12:18,240 Speaker 1: programs with a goal of vaccinating eight of their populations, 187 00:12:18,840 --> 00:12:21,600 Speaker 1: and the countries where it wasn't, which were generally richer, 188 00:12:21,920 --> 00:12:25,440 Speaker 1: were asked to contribute funding or vaccines towards the effort. 189 00:12:26,160 --> 00:12:30,160 Speaker 1: At that point, smallpox was being reported in sixty three countries, 190 00:12:30,320 --> 00:12:34,680 Speaker 1: and together those countries reported seventy seven thousand, five hundred 191 00:12:34,760 --> 00:12:38,720 Speaker 1: fifty five cases of the disease. But it became obvious 192 00:12:38,800 --> 00:12:42,000 Speaker 1: really fast that that number was way, way too low. 193 00:12:42,600 --> 00:12:45,920 Speaker 1: For one thing, those sixty three countries only included the 194 00:12:45,920 --> 00:12:49,200 Speaker 1: ones that were members of the World Health Organization, and 195 00:12:49,440 --> 00:12:52,880 Speaker 1: some countries where smallpox was endemic were not members at 196 00:12:52,880 --> 00:12:55,719 Speaker 1: that point, and that included China, which had a population 197 00:12:55,760 --> 00:12:59,000 Speaker 1: of more than six hundred and sixty million people. But 198 00:12:59,080 --> 00:13:02,240 Speaker 1: even in those sixty three countries, reporting was all over 199 00:13:02,280 --> 00:13:06,000 Speaker 1: the place. In countries without a lot of public health infrastructure, 200 00:13:06,600 --> 00:13:10,080 Speaker 1: smallpox cases weren't really being tracked. But even in places 201 00:13:10,080 --> 00:13:13,960 Speaker 1: where that wasn't the case, sometimes the only smallpox infections 202 00:13:14,000 --> 00:13:16,880 Speaker 1: being reported were the ones that ended up in hospitals. 203 00:13:17,480 --> 00:13:20,360 Speaker 1: In reality, the countries or smallpox was still endemic in 204 00:13:20,480 --> 00:13:24,319 Speaker 1: ninety nine were home to more than half the world's population, 205 00:13:24,960 --> 00:13:28,000 Speaker 1: and that total number of annual cases was probably more 206 00:13:28,080 --> 00:13:33,800 Speaker 1: like fifty million, not seventy seven thousand. This voluntary program 207 00:13:33,840 --> 00:13:37,920 Speaker 1: was focused on national vaccine campaigns, and at least in theory, 208 00:13:38,160 --> 00:13:43,200 Speaker 1: each nation's campaign would be tailored for its own culture, needs, resources, 209 00:13:43,200 --> 00:13:46,880 Speaker 1: and infrastructure, but that also meant there was really no 210 00:13:47,040 --> 00:13:51,160 Speaker 1: central strategy at work. The World Health Organization's role was 211 00:13:51,240 --> 00:13:54,520 Speaker 1: mostly just making sure that there was enough vaccine available 212 00:13:54,920 --> 00:13:58,640 Speaker 1: and providing assistance if nations asked for it. It wasn't 213 00:13:58,679 --> 00:14:02,640 Speaker 1: really coordinating efforts. Are doing a lot of tracking and monitoring, 214 00:14:02,960 --> 00:14:06,360 Speaker 1: and because under reporting of cases continued to be a 215 00:14:06,440 --> 00:14:10,520 Speaker 1: huge problem, it was almost impossible to tell whether these 216 00:14:10,640 --> 00:14:14,600 Speaker 1: national programs were even working. That made it much harder 217 00:14:14,640 --> 00:14:17,960 Speaker 1: to secure funding or to rally support from nations that 218 00:14:18,000 --> 00:14:22,200 Speaker 1: had already eradicated smallpox within their own borders, and for 219 00:14:22,240 --> 00:14:25,640 Speaker 1: the most part, these early national campaigns were not working 220 00:14:25,760 --> 00:14:29,160 Speaker 1: at least not very well. In many places, success was 221 00:14:29,200 --> 00:14:33,440 Speaker 1: measured by how many vaccines were administered. Sometimes this led 222 00:14:33,520 --> 00:14:37,680 Speaker 1: vaccinators to go after the easiest targets first, like vaccinating 223 00:14:37,680 --> 00:14:40,320 Speaker 1: all the students at a school, but that meant that 224 00:14:40,400 --> 00:14:43,760 Speaker 1: children in more outlying areas who were not attending school 225 00:14:43,880 --> 00:14:48,320 Speaker 1: were not being vaccinated. Since there often weren't clear records, 226 00:14:48,400 --> 00:14:51,040 Speaker 1: it wasn't unheard of for vaccinators to go back to 227 00:14:51,080 --> 00:14:54,960 Speaker 1: the same school and vaccinate children again. Even though a 228 00:14:55,000 --> 00:15:00,240 Speaker 1: successful smallpox vaccine typically left a recognizable scar be because 229 00:15:00,240 --> 00:15:02,920 Speaker 1: of issues like this. At one point, India was reporting 230 00:15:02,920 --> 00:15:06,640 Speaker 1: a vaccination rate of a hundred and forty because so 231 00:15:06,720 --> 00:15:10,800 Speaker 1: many people were being vaccinated more than once. Things moved 232 00:15:10,920 --> 00:15:14,480 Speaker 1: pretty slowly with all this for about five years, but 233 00:15:14,520 --> 00:15:18,800 Speaker 1: then in nineteen sixty four, Dr Korrel Rashka of Czechoslovakia, 234 00:15:18,920 --> 00:15:23,400 Speaker 1: who was a huge advocate of smallpox eradication, became Director 235 00:15:23,520 --> 00:15:27,200 Speaker 1: of the Division of Communicable Diseases at the World Health Organization. 236 00:15:28,080 --> 00:15:31,760 Speaker 1: In nineteen sixty five, the World Health Organization established a 237 00:15:31,800 --> 00:15:36,960 Speaker 1: dedicated smallpox eradication unit, and that same year President Lyndon 238 00:15:37,080 --> 00:15:40,600 Speaker 1: Johnson announced that the United States would start supporting the 239 00:15:40,600 --> 00:15:45,040 Speaker 1: global smallpox eradication program. Soon, the US was supporting the 240 00:15:45,120 --> 00:15:48,560 Speaker 1: work of the Pan American Health Organization in South America 241 00:15:48,720 --> 00:15:53,840 Speaker 1: and also funding major vaccine efforts in Western and Central Africa. 242 00:15:54,080 --> 00:15:58,360 Speaker 1: These years also saw improvements in how smallpox vaccines were administered. 243 00:15:59,160 --> 00:16:02,720 Speaker 1: Most vaccines that people receive today are administered as shots. 244 00:16:02,760 --> 00:16:05,920 Speaker 1: They go into the muscle or the subcutaneous skin layer 245 00:16:06,080 --> 00:16:09,920 Speaker 1: using a needle, but smallpox vaccine goes into the skins 246 00:16:09,920 --> 00:16:13,400 Speaker 1: superficial layers by the mid nineteen sixties. There were a 247 00:16:13,440 --> 00:16:16,800 Speaker 1: few different methods for doing this. One was to scratch 248 00:16:16,800 --> 00:16:19,800 Speaker 1: a person's skin with a needle or lancet, and another 249 00:16:19,920 --> 00:16:22,440 Speaker 1: was to repeatedly press the tip of the needle into 250 00:16:22,440 --> 00:16:26,840 Speaker 1: a person's skin. Neither of these methods was very precise. 251 00:16:27,280 --> 00:16:30,440 Speaker 1: Depending on how skilled the vaccinator was, they might press 252 00:16:30,480 --> 00:16:33,200 Speaker 1: the needle too far into the skin or not far enough. 253 00:16:33,960 --> 00:16:37,160 Speaker 1: The amount of vaccine on the needle usually depended on 254 00:16:37,240 --> 00:16:40,280 Speaker 1: things like how deeply it had been inserted into the 255 00:16:40,360 --> 00:16:44,680 Speaker 1: vaccine bile. Excess vaccine was often left behind on a 256 00:16:44,760 --> 00:16:47,440 Speaker 1: person's skin and left to either dry there or be 257 00:16:47,520 --> 00:16:51,440 Speaker 1: wiped away. Kind of wasteful. It's so fascinating to me 258 00:16:51,560 --> 00:16:55,040 Speaker 1: to think about this when I think most of the 259 00:16:55,120 --> 00:16:58,560 Speaker 1: vaccines I've received are like those pre measured very carefully, 260 00:16:58,640 --> 00:17:03,240 Speaker 1: like you open the uh dose and that's it. Yeah. 261 00:17:03,360 --> 00:17:06,040 Speaker 1: So the margin for error of it is a little 262 00:17:06,040 --> 00:17:09,400 Speaker 1: bit mind boggling. Yeah. And there are for sure vaccines 263 00:17:09,440 --> 00:17:12,360 Speaker 1: that are not administered with shots at this point, but 264 00:17:12,480 --> 00:17:14,880 Speaker 1: the shots, at least here in the US, are the 265 00:17:14,920 --> 00:17:20,120 Speaker 1: majority of them. The standard Yeah, jet injector devices were 266 00:17:20,160 --> 00:17:22,199 Speaker 1: made to try to address some of this and to 267 00:17:22,240 --> 00:17:26,240 Speaker 1: make vaccinating more efficient. In theory, these could vaccinate one 268 00:17:26,280 --> 00:17:30,040 Speaker 1: thousand people an hour, but in practice they were limited. 269 00:17:30,400 --> 00:17:33,919 Speaker 1: Some required electricity to work, and others were operated with 270 00:17:33,960 --> 00:17:37,680 Speaker 1: a foot pedal that was clunky, so these were only 271 00:17:37,720 --> 00:17:40,480 Speaker 1: really practical in places where you could bring huge groups 272 00:17:40,520 --> 00:17:44,200 Speaker 1: of people to one location to be vaccinated. Plus, these 273 00:17:44,240 --> 00:17:46,879 Speaker 1: devices were expensive, and they were hard to clean, and 274 00:17:46,920 --> 00:17:51,480 Speaker 1: they were prone to breaking down. But then Dr Benjamin A. 275 00:17:51,640 --> 00:17:55,720 Speaker 1: Ruben developed the bifurcated needle, which was patented in July 276 00:17:55,800 --> 00:17:59,560 Speaker 1: of nine. This was a simple needle and when it 277 00:17:59,640 --> 00:18:03,080 Speaker 1: was started into a vaccine vial, it picked up one 278 00:18:03,400 --> 00:18:07,439 Speaker 1: measured dose of liquid in between the two prongs. The 279 00:18:07,480 --> 00:18:10,280 Speaker 1: prongs themselves were designed to keep the needle at the 280 00:18:10,320 --> 00:18:13,840 Speaker 1: correct angle and depth with a person's skin, and the 281 00:18:13,920 --> 00:18:17,440 Speaker 1: two pronged structure meant that it needed fewer presses into 282 00:18:17,440 --> 00:18:21,240 Speaker 1: the skin to administer each vaccine. This made everything way 283 00:18:21,280 --> 00:18:24,920 Speaker 1: more efficient. One vial of vaccine could be used to 284 00:18:25,000 --> 00:18:28,879 Speaker 1: vaccinate four times as many people, and people could be 285 00:18:28,920 --> 00:18:32,359 Speaker 1: trained to administer the vaccine with the bifurcated needle in 286 00:18:32,400 --> 00:18:37,720 Speaker 1: about fifteen minutes, even if they had no previous medical experience. Plus, 287 00:18:37,760 --> 00:18:41,400 Speaker 1: the bifurcated needles were cheap to produce, although they were 288 00:18:41,400 --> 00:18:45,920 Speaker 1: originally intended to be disposable at the World Health Organization's request, 289 00:18:46,040 --> 00:18:48,200 Speaker 1: they were made from a steel alloy, they could hold 290 00:18:48,280 --> 00:18:51,879 Speaker 1: up to boiling or flaming. They could be sterilized and 291 00:18:51,960 --> 00:18:56,119 Speaker 1: reused over and over before they started to dull. Boilable 292 00:18:56,160 --> 00:18:59,600 Speaker 1: containers were designed so that vaccinators could drop used needles 293 00:19:00,000 --> 00:19:02,680 Speaker 1: into the container as they went and boiled the whole 294 00:19:02,680 --> 00:19:06,240 Speaker 1: thing at the end of a shift. Also, it was 295 00:19:06,320 --> 00:19:10,080 Speaker 1: standard practice to clean a person's arm with paths that 296 00:19:10,080 --> 00:19:13,480 Speaker 1: were soaked in alcohol or soap before giving them the vaccine. 297 00:19:14,160 --> 00:19:17,160 Speaker 1: I know every time I've gotten a shot, there's been 298 00:19:17,160 --> 00:19:20,879 Speaker 1: a little alcohol wiped down on the injection site. But 299 00:19:21,040 --> 00:19:25,919 Speaker 1: studies had suggested that this wasn't actually removing bacteria or 300 00:19:25,960 --> 00:19:29,120 Speaker 1: other contaminants, it was just sort of moving things around. 301 00:19:29,880 --> 00:19:34,359 Speaker 1: Studies confirmed that the number of complications and secondary infections 302 00:19:34,400 --> 00:19:38,840 Speaker 1: after smallpox vaccination was the same regardless of whether the 303 00:19:38,960 --> 00:19:43,000 Speaker 1: vaccine site was wiped down beforehand or not, so most 304 00:19:43,080 --> 00:19:48,359 Speaker 1: vaccination programs, especially in like more impoverished areas, dropped this step, 305 00:19:48,440 --> 00:19:52,199 Speaker 1: and together all of this brought the cost for smallpox 306 00:19:52,280 --> 00:19:56,760 Speaker 1: vaccination down to about ten cents a person. By nineteen 307 00:19:56,880 --> 00:20:00,200 Speaker 1: sixty six, smallpox was endemic in thirty one country piece. 308 00:20:00,480 --> 00:20:02,840 Speaker 1: That was down from the sixty three or more reported 309 00:20:02,840 --> 00:20:06,840 Speaker 1: back in nineteen fifty nine. The number of estimated worldwide 310 00:20:06,840 --> 00:20:10,280 Speaker 1: cases had dropped from about fifty million to somewhere between 311 00:20:10,320 --> 00:20:14,359 Speaker 1: ten and fifteen million, although the officially reported tally was 312 00:20:14,440 --> 00:20:18,000 Speaker 1: still much lower. Somewhere between one point five and two 313 00:20:18,080 --> 00:20:21,840 Speaker 1: million people were still dying of smallpox per year. This 314 00:20:21,960 --> 00:20:25,080 Speaker 1: was better, obviously, but it was also clear that a 315 00:20:25,200 --> 00:20:30,160 Speaker 1: voluntary vaccination program wasn't going to be enough to eradicate smallpox. 316 00:20:30,760 --> 00:20:33,960 Speaker 1: So the World Health Assembly back to proposal for an 317 00:20:34,000 --> 00:20:38,880 Speaker 1: intensified smallpox eradication program, which would start on January first, 318 00:20:39,000 --> 00:20:44,640 Speaker 1: nineteen sixty seven. Its goal was to eradicate smallpox worldwide 319 00:20:44,680 --> 00:20:49,040 Speaker 1: within ten years, with the last naturally occurring case being 320 00:20:49,080 --> 00:20:53,119 Speaker 1: found in Isolated by December thirty feet, nineteen seventy six. 321 00:20:53,920 --> 00:20:57,360 Speaker 1: The intensified program was given an initial budget of two 322 00:20:57,359 --> 00:21:01,240 Speaker 1: point five million dollars, and this was our money than before. 323 00:21:01,920 --> 00:21:05,000 Speaker 1: But those thirty one countries where smallpox was still in 324 00:21:05,040 --> 00:21:08,640 Speaker 1: endemic also had neighbors that needed to be protected from 325 00:21:08,720 --> 00:21:12,000 Speaker 1: introduced cases, so this only worked out to about fifty 326 00:21:12,080 --> 00:21:16,439 Speaker 1: thousand dollars per country. Donald A. Henderson, who was Chief 327 00:21:16,480 --> 00:21:20,399 Speaker 1: of the Centers for Disease Control Smallpox Eradication Program, was 328 00:21:20,440 --> 00:21:24,679 Speaker 1: made Chief Medical Officer of the Intensified Eradication Program, and 329 00:21:24,760 --> 00:21:27,679 Speaker 1: in his account, this ten year goal was pretty arbitrary. 330 00:21:28,040 --> 00:21:31,280 Speaker 1: It had been inspired by John F. Kennedy's declaration that 331 00:21:31,359 --> 00:21:33,240 Speaker 1: the U. S Could land a man on the Moon 332 00:21:33,320 --> 00:21:37,119 Speaker 1: within ten years. He also described the World Health Organization 333 00:21:37,240 --> 00:21:41,320 Speaker 1: as pessimistic about the chances of success. W h O 334 00:21:41,440 --> 00:21:45,080 Speaker 1: Director General Dr Marcolina Kandao was from Brazil and thought 335 00:21:45,160 --> 00:21:49,479 Speaker 1: smallpox eradication would be impossible just in the Amazon Basin, 336 00:21:49,600 --> 00:21:53,280 Speaker 1: much less anywhere else. According to Henderson, the World Health 337 00:21:53,359 --> 00:21:56,719 Speaker 1: Organization wanted an American to head the program so that 338 00:21:56,800 --> 00:21:59,639 Speaker 1: if it failed, the US would shoulder some of the 339 00:21:59,640 --> 00:22:02,440 Speaker 1: blame rather than all of it falling on the w 340 00:22:02,680 --> 00:22:05,760 Speaker 1: h O. I read a right up that Henderson wrote 341 00:22:06,240 --> 00:22:10,520 Speaker 1: briefly about this uh, this campaign, and he had sort 342 00:22:10,560 --> 00:22:13,560 Speaker 1: of spelled out how it sort of seemed like things 343 00:22:13,560 --> 00:22:17,000 Speaker 1: were happening almost on a whim, and he was like, 344 00:22:17,080 --> 00:22:19,840 Speaker 1: I'm just I'm writing this too. Disabuse you of the 345 00:22:19,880 --> 00:22:23,879 Speaker 1: notion that there may have been extensive planning involved in 346 00:22:23,920 --> 00:22:27,760 Speaker 1: the outset of this. We will get to how this 347 00:22:27,880 --> 00:22:32,080 Speaker 1: intensified program, even though it still seemed a little haphazard, 348 00:22:32,119 --> 00:22:36,480 Speaker 1: how it successfully eradicated smallpox after another quick sponsor break. 349 00:22:45,920 --> 00:22:51,280 Speaker 1: When the World Health Organization established the Intensified Smallpox Eradication Program, 350 00:22:51,440 --> 00:22:56,159 Speaker 1: smallpox was still endemic and multiple countries in Asia, South America, 351 00:22:56,240 --> 00:22:59,920 Speaker 1: and Sub Saharan Africa, and especially at first, a lot 352 00:23:00,119 --> 00:23:02,960 Speaker 1: the financial support and a lot of the vaccines for 353 00:23:03,000 --> 00:23:06,840 Speaker 1: the program were coming from wealthier nations where smallpox had 354 00:23:06,880 --> 00:23:11,320 Speaker 1: already been eradicated, nations like the United States, and for 355 00:23:11,400 --> 00:23:15,280 Speaker 1: these countries, their motive was not just humanitarian. There was 356 00:23:15,359 --> 00:23:19,800 Speaker 1: also a lot of money and politics involved. For example, 357 00:23:19,920 --> 00:23:24,320 Speaker 1: if smallpox was eradicated worldwide, these nations would not need 358 00:23:24,359 --> 00:23:28,680 Speaker 1: to fund vaccination programs in other countries or spend money 359 00:23:28,760 --> 00:23:34,040 Speaker 1: vaccinating their own populations anymore. For wealthier countries, these smallpox 360 00:23:34,080 --> 00:23:38,480 Speaker 1: vaccination programs also served as opportunities to vaccinate people for 361 00:23:38,560 --> 00:23:42,959 Speaker 1: other diseases and to try to build political influence and 362 00:23:43,040 --> 00:23:46,879 Speaker 1: goodwill in the places where the programs were operating. Also, 363 00:23:47,080 --> 00:23:51,400 Speaker 1: countries where smallpox had been eradicated, still occasionally faced outbreaks 364 00:23:51,400 --> 00:23:55,480 Speaker 1: that were usually introduced through travel. Although these tended to 365 00:23:55,520 --> 00:23:58,720 Speaker 1: be very small and quickly contained, they were still disruptive 366 00:23:58,840 --> 00:24:03,920 Speaker 1: and expensive and sometimes sparked a public panic. Global smallpox 367 00:24:03,960 --> 00:24:06,639 Speaker 1: eradication would mean not having to deal with any of 368 00:24:06,680 --> 00:24:09,639 Speaker 1: that anymore. Yeah, there was a lot of self interest 369 00:24:09,720 --> 00:24:14,480 Speaker 1: involved in the wealthier nations who gave money and vaccine 370 00:24:14,520 --> 00:24:19,399 Speaker 1: and other support to this whole program. Although each nation 371 00:24:19,600 --> 00:24:23,400 Speaker 1: still needed a plan that was customized to its own needs. 372 00:24:23,680 --> 00:24:26,960 Speaker 1: There also needed to be a better unifying strategy behind 373 00:24:26,960 --> 00:24:31,399 Speaker 1: this whole program, something beyond a target of vaccinating of 374 00:24:31,440 --> 00:24:35,920 Speaker 1: the population. That number I feel like keeps getting repeated 375 00:24:35,960 --> 00:24:38,280 Speaker 1: today is like the standard for what is needed, but 376 00:24:38,359 --> 00:24:42,040 Speaker 1: it had not really been based on epidemiology or on 377 00:24:42,160 --> 00:24:46,680 Speaker 1: public health data. Had just seemed like a reasonable operational 378 00:24:46,720 --> 00:24:50,359 Speaker 1: goal for the voluntary program, And it had also become 379 00:24:50,400 --> 00:24:54,920 Speaker 1: clear that the number of vaccines administered did not really 380 00:24:54,960 --> 00:24:58,880 Speaker 1: work as the goal, since teams might wind up vaccinating 381 00:24:58,920 --> 00:25:03,080 Speaker 1: the same people more than once, driving up their vaccination 382 00:25:03,160 --> 00:25:07,400 Speaker 1: numbers without actually vaccinating more of the population. One big 383 00:25:07,440 --> 00:25:10,640 Speaker 1: gap that needed to be filled with this was surveillance 384 00:25:11,200 --> 00:25:14,400 Speaker 1: reporting methods were still all over the place, and eradication 385 00:25:14,480 --> 00:25:17,919 Speaker 1: was only possible if health officials actually knew when and 386 00:25:17,960 --> 00:25:21,560 Speaker 1: where outbreaks were happening. This was something that just required 387 00:25:21,600 --> 00:25:24,919 Speaker 1: a ton of communication from the World Health Organization and 388 00:25:25,000 --> 00:25:28,199 Speaker 1: all through every level of a nation's governments, all the 389 00:25:28,240 --> 00:25:32,400 Speaker 1: way down to individual doctors, hospitals, and community leaders who 390 00:25:32,520 --> 00:25:35,800 Speaker 1: needed to report any suspected cases in order for this 391 00:25:35,880 --> 00:25:40,960 Speaker 1: to work. Another gap was standards for the vaccine itself. 392 00:25:41,280 --> 00:25:44,120 Speaker 1: The Soviet Union and the United States were the two 393 00:25:44,160 --> 00:25:48,920 Speaker 1: biggest donors of vaccines, with the USSR donating a hundred 394 00:25:48,920 --> 00:25:52,200 Speaker 1: and forty million doses a year and the United States 395 00:25:52,240 --> 00:25:56,000 Speaker 1: donating forty million doses. Other countries donated as well, but 396 00:25:56,040 --> 00:25:59,960 Speaker 1: in smaller amounts. In nineteen sixty seven, the World Health 397 00:26:00,080 --> 00:26:05,480 Speaker 1: Organization asked vaccine manufacturers to submit samples of their smallpox vaccine, 398 00:26:06,040 --> 00:26:10,720 Speaker 1: and only thirty percent of them met WHO standards for 399 00:26:10,840 --> 00:26:15,400 Speaker 1: quality and potency. Some of us submitted vaccine samples did 400 00:26:15,440 --> 00:26:19,800 Speaker 1: not contain any vaccinia virus at all. Others were contaminated 401 00:26:19,840 --> 00:26:25,119 Speaker 1: with bacteria. Led to the WHO establishing more stringent standards 402 00:26:25,200 --> 00:26:28,440 Speaker 1: for the vaccines and then monitoring them to make sure 403 00:26:28,440 --> 00:26:31,879 Speaker 1: the vaccines actually met those standards. As all of this 404 00:26:32,080 --> 00:26:35,480 Speaker 1: was happening, Of course, wars and other unrest we're making 405 00:26:35,560 --> 00:26:40,080 Speaker 1: vaccination programs difficult. In some places where smallpox was still circulating, 406 00:26:40,720 --> 00:26:44,000 Speaker 1: The Nigerian Civil War began in ninety seven, which made 407 00:26:44,000 --> 00:26:47,480 Speaker 1: things more dangerous for health workers and their patients, and 408 00:26:47,520 --> 00:26:50,879 Speaker 1: it also led to a vaccine shortage. But this shortage 409 00:26:50,960 --> 00:26:54,760 Speaker 1: also led to a shift in how smallpox vaccinations were prioritized. 410 00:26:55,280 --> 00:26:58,600 Speaker 1: Since there wasn't enough vaccine available for the whole population, 411 00:26:59,080 --> 00:27:02,320 Speaker 1: health officials show used on vaccinating family members and other 412 00:27:02,359 --> 00:27:06,880 Speaker 1: close contacts of anyone who developed smallpox. This turned out 413 00:27:06,880 --> 00:27:08,639 Speaker 1: to be an effective way to stop the spread of 414 00:27:08,640 --> 00:27:12,639 Speaker 1: the disease, and Nigeria's last smallpox case was reported in 415 00:27:12,720 --> 00:27:17,679 Speaker 1: May of nineteen seventy. The focus on monitoring and reporting 416 00:27:17,720 --> 00:27:21,679 Speaker 1: cases that was so necessary for the program's success also 417 00:27:21,760 --> 00:27:24,879 Speaker 1: made it easier to see trends and how and where 418 00:27:25,040 --> 00:27:31,320 Speaker 1: smallpox outbreaks developed. Vaccinators started taking better advantage of seasonal variations. 419 00:27:31,680 --> 00:27:34,360 Speaker 1: They would use all that surveillance work to trace people's 420 00:27:34,440 --> 00:27:37,720 Speaker 1: contacts and to vaccinate more people at the start of 421 00:27:37,720 --> 00:27:41,399 Speaker 1: the season when the smallpox case numbers were lower to 422 00:27:41,520 --> 00:27:46,120 Speaker 1: contain those outbreaks. Before they spread. By nineteen seventy three, 423 00:27:46,119 --> 00:27:52,240 Speaker 1: smallpox existed in only five countries Bangladesh, India, Nepal, Pakistan, 424 00:27:52,359 --> 00:27:56,320 Speaker 1: and Ethiopia. Bangladesh had previously been free of the disease, 425 00:27:56,359 --> 00:27:59,040 Speaker 1: but it had been reintroduced there as refugees fled the 426 00:27:59,040 --> 00:28:02,800 Speaker 1: Indo Pakistani War, and by this point, about eight percent 427 00:28:02,840 --> 00:28:05,160 Speaker 1: of the vaccines being used for this effort were being 428 00:28:05,200 --> 00:28:07,919 Speaker 1: made in the countries where they were being administered, and 429 00:28:07,960 --> 00:28:11,040 Speaker 1: at least of the vaccines that the World Health Organization 430 00:28:11,119 --> 00:28:16,679 Speaker 1: tested met its standards. Having only five countries remaining was 431 00:28:16,800 --> 00:28:21,760 Speaker 1: obviously a huge accomplishment, But at the same time, more 432 00:28:21,840 --> 00:28:26,360 Speaker 1: than seven hundred million people lived in Bangladesh, India, Pakistan, 433 00:28:26,440 --> 00:28:29,760 Speaker 1: and Nepal. They were all neighboring countries, and it had 434 00:28:29,800 --> 00:28:34,119 Speaker 1: become really obvious that a mass vaccination program just wasn't 435 00:28:34,160 --> 00:28:37,400 Speaker 1: going to be able to eradicate the disease in this region. 436 00:28:38,040 --> 00:28:41,320 Speaker 1: These neighboring nations had been trying to vaccinate their whole 437 00:28:41,360 --> 00:28:45,800 Speaker 1: populations for years. There were a hundred and twenty thousand 438 00:28:45,960 --> 00:28:50,160 Speaker 1: health staff working on the program in India alone, So 439 00:28:50,440 --> 00:28:54,040 Speaker 1: the strategy shifted to mirror what had actually worked in 440 00:28:54,160 --> 00:28:58,760 Speaker 1: Nigeria in the late nineteen sixties, health officials quarantined anyone 441 00:28:58,840 --> 00:29:02,880 Speaker 1: who contracted small talks and used extensive contact tracing to 442 00:29:03,000 --> 00:29:06,760 Speaker 1: determine who else might have been exposed. They vaccinated their 443 00:29:06,800 --> 00:29:10,880 Speaker 1: immediate families and the surrounding communities. This became known as 444 00:29:10,920 --> 00:29:14,240 Speaker 1: the ring method, basically making a ring of vaccinated people 445 00:29:14,400 --> 00:29:17,840 Speaker 1: around each active smallpox case so that the disease just 446 00:29:17,920 --> 00:29:22,720 Speaker 1: could not spread. Monitoring and surveillance were critically important to 447 00:29:22,760 --> 00:29:26,280 Speaker 1: this process, since health workers could only make a vaccinated 448 00:29:26,360 --> 00:29:29,719 Speaker 1: ring around cases of smallpox that they knew about, so 449 00:29:29,840 --> 00:29:35,280 Speaker 1: health workers traveled from place to place, educating local doctors, healers, leaders, 450 00:29:35,280 --> 00:29:39,800 Speaker 1: and officials about smallpox, reporting and seeking out and isolating 451 00:29:40,160 --> 00:29:44,000 Speaker 1: active smallpox cases, and then vaccinating anyone who may have 452 00:29:44,080 --> 00:29:48,480 Speaker 1: come into contact with these patients. Using this method, Pakistan 453 00:29:48,560 --> 00:29:52,360 Speaker 1: saw its last reported case of smallpox in October of 454 00:29:52,440 --> 00:29:56,280 Speaker 1: nineteen seventy four, Nepal in April of nineteen seventy five, 455 00:29:56,800 --> 00:30:00,280 Speaker 1: India in May of nineteen seventy five, and bangal H 456 00:30:00,360 --> 00:30:05,720 Speaker 1: in October of nineteen seventy Unfortunately, although Ethiopia's last case 457 00:30:05,760 --> 00:30:09,040 Speaker 1: of smallpox was reported in August of nineteen seventy six. 458 00:30:09,640 --> 00:30:13,040 Speaker 1: By that point it had been reintroduced into neighboring Somalia, 459 00:30:13,200 --> 00:30:17,600 Speaker 1: which was still experiencing active cases. In nineteen seventy seven, 460 00:30:17,640 --> 00:30:23,040 Speaker 1: Donald Henderson resigned as the head of the intensified eradication program. 461 00:30:23,080 --> 00:30:26,040 Speaker 1: He was replaced by Asao Arita, who had been Medical 462 00:30:26,080 --> 00:30:29,440 Speaker 1: Officer of Infectious Disease Control in the Ministry of Health 463 00:30:29,480 --> 00:30:33,120 Speaker 1: and Welfare in Japan before joining the World Health Organization. 464 00:30:34,240 --> 00:30:38,160 Speaker 1: That same year, nineteen seventy seven, authorities started trying to 465 00:30:38,240 --> 00:30:42,160 Speaker 1: contain an outbreak a very elam minor among nomadic people's 466 00:30:42,200 --> 00:30:45,960 Speaker 1: in the desert region that spans parts of Ethiopia, Somalia, 467 00:30:46,040 --> 00:30:51,520 Speaker 1: and Kenya. Smallpox was reintroduced into Kenya, but that introduction 468 00:30:51,640 --> 00:30:55,800 Speaker 1: was quickly contained, and Kenya reported its last case in 469 00:30:55,920 --> 00:31:00,720 Speaker 1: February of nineteen seventy seven. In July of nineteen seventy seven, 470 00:31:01,000 --> 00:31:04,840 Speaker 1: Somalia and Ethiopia went to war over control of part 471 00:31:04,880 --> 00:31:07,959 Speaker 1: of this region, and then that hampered efforts to control 472 00:31:08,040 --> 00:31:12,600 Speaker 1: this ongoing outbreak in Somalia. Somalia actually reported three hundred 473 00:31:12,720 --> 00:31:16,680 Speaker 1: cases of smallpox in v seven. The last one was 474 00:31:16,760 --> 00:31:19,360 Speaker 1: the case of Ali Maomalin, who was a cook at 475 00:31:19,400 --> 00:31:24,600 Speaker 1: Merca Hospital. On October twelfth seven, a driver carrying two 476 00:31:24,640 --> 00:31:28,600 Speaker 1: smallpox patients to an isolation camp stopped at the hospital 477 00:31:28,680 --> 00:31:31,920 Speaker 1: to ask for directions. Malen got into the car and 478 00:31:32,000 --> 00:31:34,800 Speaker 1: rode with them for fifteen minutes or less. He did 479 00:31:34,840 --> 00:31:36,680 Speaker 1: that so he could guide them to where the leader 480 00:31:36,680 --> 00:31:40,440 Speaker 1: of the smallpox surveillance team lived. These two patients were 481 00:31:40,440 --> 00:31:43,520 Speaker 1: siblings six and one and a half years old, and 482 00:31:43,560 --> 00:31:48,160 Speaker 1: when authorities traced their contacts, Maleen was overlooked. Although Maleen 483 00:31:48,240 --> 00:31:52,240 Speaker 1: worked in a hospital, he wasn't vaccinated against smallpox. In 484 00:31:52,280 --> 00:31:54,560 Speaker 1: an interview later in his life, he said that he 485 00:31:54,600 --> 00:31:57,800 Speaker 1: had been afraid of the vaccine. There are a couple 486 00:31:57,800 --> 00:31:59,920 Speaker 1: of accounts that said that he had been back to 487 00:32:00,040 --> 00:32:03,320 Speaker 1: NATed but his vaccine hadn't taken, and that disagrees with 488 00:32:03,360 --> 00:32:06,760 Speaker 1: the interview that he gave later. He started feeling sick 489 00:32:06,840 --> 00:32:10,560 Speaker 1: on October nineteen seventy seven, and at first doctors thought 490 00:32:10,600 --> 00:32:14,880 Speaker 1: he had malaria. Then he developed a rash on October six, 491 00:32:15,080 --> 00:32:19,040 Speaker 1: and he was initially diagnosed with chicken pox. He started 492 00:32:19,080 --> 00:32:22,800 Speaker 1: to worry that he had smallpox on October, and on 493 00:32:22,840 --> 00:32:26,360 Speaker 1: October somebody reported to health officials that he had a 494 00:32:26,400 --> 00:32:30,880 Speaker 1: potential smallpox case. His diagnosis was confirmed through lab tests 495 00:32:30,920 --> 00:32:34,680 Speaker 1: that day. The effort to prevent Maulein's smallpox case from 496 00:32:34,680 --> 00:32:38,640 Speaker 1: sparking another outbreak really demonstrates what was involved in all 497 00:32:38,640 --> 00:32:44,280 Speaker 1: of this. Contact tracing identified one hundred sixty one possible exposures, 498 00:32:44,320 --> 00:32:46,360 Speaker 1: some of them as far as a hundred and twenty 499 00:32:46,440 --> 00:32:52,040 Speaker 1: kilometers away. This included hospital staff, family, and friends, many 500 00:32:52,080 --> 00:32:55,480 Speaker 1: of whom had visited him while he was ill. Authorities 501 00:32:55,520 --> 00:32:58,719 Speaker 1: identified thirty three face to face contacts who had no 502 00:32:58,800 --> 00:33:02,000 Speaker 1: evidence of prior small pox infection and had not been 503 00:33:02,080 --> 00:33:05,360 Speaker 1: vaccinated within the past three years, and twelve of those 504 00:33:05,400 --> 00:33:08,680 Speaker 1: had no prior evidence of a smallpox infection or vaccine 505 00:33:08,720 --> 00:33:13,600 Speaker 1: at all. All those people were vaccinated, along with all 506 00:33:13,640 --> 00:33:17,920 Speaker 1: known and possible contacts and their families. During an eighteen 507 00:33:18,000 --> 00:33:22,640 Speaker 1: day surveillance period. Health workers made multiple in person visits 508 00:33:22,680 --> 00:33:26,400 Speaker 1: to each person who had potentially been exposed. The number 509 00:33:26,480 --> 00:33:30,000 Speaker 1: and frequency of those visits depended on the person's relative 510 00:33:30,240 --> 00:33:32,840 Speaker 1: level of exposure and their risks. So if they had 511 00:33:32,880 --> 00:33:36,080 Speaker 1: been around him a long time and we're not vaccinated, 512 00:33:36,400 --> 00:33:39,920 Speaker 1: they got multiple different visits from from the health staff. 513 00:33:39,960 --> 00:33:41,960 Speaker 1: But if they had been vaccinated and it was a 514 00:33:41,960 --> 00:33:44,960 Speaker 1: shorter time they might get two check ins. In the end, 515 00:33:45,000 --> 00:33:48,800 Speaker 1: though none of those hundred and sixty one contacts developed smallpox, 516 00:33:49,480 --> 00:33:51,760 Speaker 1: but it did not stop with those hundred and sixty 517 00:33:51,760 --> 00:33:55,920 Speaker 1: one contacts. Warning signs were posted at Merca Hospital, which 518 00:33:55,960 --> 00:33:59,760 Speaker 1: was placed under twenty four hour guard. Vaccines were administered 519 00:33:59,800 --> 00:34:02,400 Speaker 1: to everyone who worked at the hospital and all of 520 00:34:02,400 --> 00:34:06,880 Speaker 1: the patients. Patients in the surgical ward were quarantined until November, 521 00:34:07,760 --> 00:34:10,800 Speaker 1: and in the medical ward they were quarantined until November seventeen. 522 00:34:11,560 --> 00:34:16,279 Speaker 1: The hospital also suspended all non emergency care, referred outpatient 523 00:34:16,360 --> 00:34:20,360 Speaker 1: procedures to other facilities, and required daily temperature checks for 524 00:34:20,440 --> 00:34:25,239 Speaker 1: patients and staff. There was also a mass vaccination campaign 525 00:34:25,239 --> 00:34:28,319 Speaker 1: and the ward of the city where Malin lived and 526 00:34:28,440 --> 00:34:32,279 Speaker 1: the hospital was This was a multi phase process, was 527 00:34:32,400 --> 00:34:36,160 Speaker 1: vaccinators going house to house to vaccinate everyone and to 528 00:34:36,280 --> 00:34:40,040 Speaker 1: look for any signs of smallpox cases, and then returning 529 00:34:40,080 --> 00:34:43,600 Speaker 1: to vaccinate anybody who had arrived since the last pass 530 00:34:43,719 --> 00:34:47,080 Speaker 1: or whose first vaccines showed no evidence of a vaccine scar. 531 00:34:47,880 --> 00:34:50,880 Speaker 1: Once that ward of the city was done, health workers 532 00:34:50,920 --> 00:34:54,319 Speaker 1: did the same for the rest of the city. Checkpoints 533 00:34:54,320 --> 00:34:58,080 Speaker 1: were established at all the roads and footpaths leading into market, 534 00:34:58,160 --> 00:35:01,520 Speaker 1: and anyone who was her going was advised to this 535 00:35:01,600 --> 00:35:05,640 Speaker 1: possible outbreak. They vaccinated everybody who was passing through, and 536 00:35:05,680 --> 00:35:07,400 Speaker 1: then on top of all of that, there was a 537 00:35:07,440 --> 00:35:12,520 Speaker 1: massive public information campaign with a reward for reporting smallpox cases. 538 00:35:13,080 --> 00:35:16,040 Speaker 1: In the end, Ali ma Omalin was the last person 539 00:35:16,080 --> 00:35:19,960 Speaker 1: to contract naturally occurring smallpox. That was ten years nine 540 00:35:20,000 --> 00:35:22,640 Speaker 1: months in twenty six days after the start of the 541 00:35:22,680 --> 00:35:26,960 Speaker 1: intensified eradication campaign, so it just barely missed that ten 542 00:35:27,040 --> 00:35:31,920 Speaker 1: year goal, even if it had been arbitrary. After recovering 543 00:35:32,000 --> 00:35:35,440 Speaker 1: from smallpox, Maline later became part of the effort to 544 00:35:35,480 --> 00:35:39,239 Speaker 1: eradicate polio, working as a vaccinator and organizing door to 545 00:35:39,320 --> 00:35:43,200 Speaker 1: door campaigns. He would share his own story about how 546 00:35:43,239 --> 00:35:46,000 Speaker 1: he had been afraid to be vaccinated for smallpox and 547 00:35:46,040 --> 00:35:50,680 Speaker 1: then had ultimately become the last smallpox patient. Somalia was 548 00:35:50,719 --> 00:35:54,000 Speaker 1: declared free of polio in two thousand seven, but it 549 00:35:54,120 --> 00:35:58,640 Speaker 1: re emerged there. When that happened, Malin went back to 550 00:35:58,680 --> 00:36:02,960 Speaker 1: his vaccinating work. He suddenly became ill not long afterward, 551 00:36:03,120 --> 00:36:08,680 Speaker 1: and he died on July of what was diagnosed as malaria. 552 00:36:08,920 --> 00:36:11,680 Speaker 1: But the last person to die of smallpox contracted it 553 00:36:11,800 --> 00:36:16,279 Speaker 1: after Malin did. That was Janet Parker, a medical photographer 554 00:36:16,320 --> 00:36:19,640 Speaker 1: who was infected on the job at England's Birmingham University 555 00:36:19,640 --> 00:36:24,720 Speaker 1: Medical School in night. The microbiology lab was one floor 556 00:36:24,719 --> 00:36:27,120 Speaker 1: below her dark room in the office that she used 557 00:36:27,160 --> 00:36:31,080 Speaker 1: to make phone calls. It is not clear exactly how 558 00:36:31,080 --> 00:36:33,880 Speaker 1: she came into contact with smallpox virus from the lab. 559 00:36:34,600 --> 00:36:37,520 Speaker 1: At the time, the prevailing theory was that it was 560 00:36:37,560 --> 00:36:41,000 Speaker 1: through a shared air event, but later studies suggested that 561 00:36:41,000 --> 00:36:45,399 Speaker 1: that was actually unlikely. Parker had been vaccinated for smallpox, 562 00:36:45,640 --> 00:36:49,120 Speaker 1: but as we mentioned earlier, the vaccines protection was expected 563 00:36:49,160 --> 00:36:51,719 Speaker 1: to last for about ten years, and she had been 564 00:36:51,800 --> 00:36:55,719 Speaker 1: vaccinated back in nineteen sixty six. The strain she was 565 00:36:55,760 --> 00:37:00,479 Speaker 1: exposed to was also a particularly deadly one. Her mother, 566 00:37:00,600 --> 00:37:04,759 Speaker 1: Hilda Whitcomb, contracted smallpox while caring for her, but she recovered, 567 00:37:05,320 --> 00:37:08,720 Speaker 1: but Janet's father, Frederick died of an apparent heart attack 568 00:37:08,800 --> 00:37:13,880 Speaker 1: while in quarantine. Helda missed both his and Janet's funerals 569 00:37:13,920 --> 00:37:18,440 Speaker 1: because of her own illness. Health workers quarantined hundreds of 570 00:37:18,480 --> 00:37:22,000 Speaker 1: people who had possibly been exposed, and at least five 571 00:37:22,080 --> 00:37:25,360 Speaker 1: hundred people were vaccinated to keep this outbreak from spreading 572 00:37:25,400 --> 00:37:29,279 Speaker 1: any further. This lab had been scheduled to close as 573 00:37:29,320 --> 00:37:32,000 Speaker 1: the World Health Organization tried to reduce the number of 574 00:37:32,000 --> 00:37:36,000 Speaker 1: facilities that had samples of the virus. Although the lab 575 00:37:36,040 --> 00:37:39,440 Speaker 1: had previously been inspected and was allowed to continue operation, 576 00:37:40,000 --> 00:37:42,480 Speaker 1: it didn't have a lot of basic safety measures in 577 00:37:42,520 --> 00:37:47,520 Speaker 1: place to contain deadly pathogens, things like changing facilities, dedicated showers, 578 00:37:47,560 --> 00:37:50,840 Speaker 1: and airlocks. It also had been the source of another 579 00:37:50,920 --> 00:37:55,080 Speaker 1: smallpox case, also involving a medical photographer, back in nineteen 580 00:37:55,120 --> 00:37:59,040 Speaker 1: sixty six. It really seems like when they inspected the 581 00:37:59,120 --> 00:38:01,239 Speaker 1: lab and they were like, it doesn't have all these 582 00:38:01,280 --> 00:38:05,239 Speaker 1: things that we recommend to control potential spread of pathogens, 583 00:38:05,320 --> 00:38:08,280 Speaker 1: but like, only three people work here, so it's probably fine. 584 00:38:09,320 --> 00:38:13,719 Speaker 1: This became a huge scandal later. The labs director, Dr 585 00:38:13,760 --> 00:38:16,080 Speaker 1: Henry Benson, had been trying to finish as much of 586 00:38:16,160 --> 00:38:19,640 Speaker 1: his work as possible before the lab was closed. He 587 00:38:19,800 --> 00:38:22,920 Speaker 1: blamed himself for Parker's illness and took his own life 588 00:38:22,960 --> 00:38:26,240 Speaker 1: a few days before her death, which was on September eleventh. 589 00:38:28,000 --> 00:38:31,719 Speaker 1: As this was happening, health officials were still closely monitoring 590 00:38:31,760 --> 00:38:35,959 Speaker 1: other countries to confirm that smallpox was no longer circulating. There. 591 00:38:36,640 --> 00:38:40,480 Speaker 1: On October nineteen seventy nine, a ceremony was held in 592 00:38:40,560 --> 00:38:43,920 Speaker 1: their Robi to announce that smallpox had been eradicated in 593 00:38:43,960 --> 00:38:47,000 Speaker 1: the Horn of Africa. That was two years after Ali 594 00:38:47,080 --> 00:38:51,359 Speaker 1: Mao Malin had first developed a smallpox rash. On December nine, 595 00:38:51,960 --> 00:38:55,560 Speaker 1: vy nine, the Global Commission for the Certification of Smallpox 596 00:38:55,560 --> 00:39:00,680 Speaker 1: Eradication declared smallpox eradicated, and on May eighth, venteen eighty, 597 00:39:00,760 --> 00:39:05,799 Speaker 1: the World Health Organization confirmed the disease eradication. There's been 598 00:39:05,840 --> 00:39:09,200 Speaker 1: some stuff floating around social media lately about how this 599 00:39:09,320 --> 00:39:13,520 Speaker 1: was only possible because everyone did their part, either implying 600 00:39:13,719 --> 00:39:17,799 Speaker 1: or just flat out saying that everybody accepted the vaccine 601 00:39:17,960 --> 00:39:21,399 Speaker 1: during this process, but that is just not true. There 602 00:39:21,480 --> 00:39:25,600 Speaker 1: was a lot of resistance and hesitancy, especially in campaigns 603 00:39:25,600 --> 00:39:28,879 Speaker 1: to vaccinate children. A lot of parents just didn't want 604 00:39:28,880 --> 00:39:31,480 Speaker 1: to do something that might hurt their child or make 605 00:39:31,520 --> 00:39:36,080 Speaker 1: them sick. The process of administering the vaccine also evolved 606 00:39:36,120 --> 00:39:38,760 Speaker 1: over the years, and some parents that had like pretty 607 00:39:38,800 --> 00:39:42,400 Speaker 1: traumatic vaccine experiences that they didn't want repeated with their child. 608 00:39:43,000 --> 00:39:46,480 Speaker 1: Anti vaccine activists such as Lily Loate, who worked for 609 00:39:46,480 --> 00:39:51,279 Speaker 1: the National Anti Vaccination League and edited its journal distributed 610 00:39:51,480 --> 00:39:56,239 Speaker 1: literature against vaccines in general and against the smallpox vaccine 611 00:39:56,360 --> 00:40:01,480 Speaker 1: specifically well into this eradication effort. Aside from that, because 612 00:40:01,520 --> 00:40:04,400 Speaker 1: earlier versions of the smallpox vaccine were grown in the 613 00:40:04,480 --> 00:40:09,000 Speaker 1: skin of live animals, animal rights activists and anti vivisectionists 614 00:40:09,000 --> 00:40:12,920 Speaker 1: objected to their use when methods progressed to using tissue. 615 00:40:12,960 --> 00:40:16,680 Speaker 1: Cultures mistrust of science lad people to object to this 616 00:40:16,800 --> 00:40:21,560 Speaker 1: method as well. In places like India, smallpox vaccination had 617 00:40:21,560 --> 00:40:24,279 Speaker 1: been a routine part of the public health service since 618 00:40:24,360 --> 00:40:28,240 Speaker 1: nineteen seven, and yet there were still outbreaks for decades 619 00:40:28,320 --> 00:40:32,080 Speaker 1: after that. This led people to claim that the vaccine 620 00:40:32,200 --> 00:40:35,120 Speaker 1: was worthless, or even that it was what had been 621 00:40:35,160 --> 00:40:39,719 Speaker 1: causing the smallpox. Nations stopped vaccinating people for smallpox once 622 00:40:39,760 --> 00:40:42,960 Speaker 1: the disease had been eradicated from within their borders, and 623 00:40:42,960 --> 00:40:47,160 Speaker 1: and some people this just reinforced that perception, like there 624 00:40:47,160 --> 00:40:50,239 Speaker 1: were no vaccines happening anymore. That must be why there's 625 00:40:50,280 --> 00:40:54,320 Speaker 1: no small box happening anymore. There were also religious objections 626 00:40:54,360 --> 00:40:59,759 Speaker 1: to smallpox vaccinations. Various peoples and cultures interpreted smallpox as 627 00:40:59,800 --> 00:41:03,799 Speaker 1: kind from divine will, or interpreted existing methods of smallpox 628 00:41:03,840 --> 00:41:08,200 Speaker 1: prevention or treatment as religiously significant, and most of the 629 00:41:08,280 --> 00:41:11,640 Speaker 1: last nations to eradicate smallpox were the same ones that 630 00:41:11,719 --> 00:41:14,839 Speaker 1: had a long history of being colonized and exploited by 631 00:41:14,880 --> 00:41:20,080 Speaker 1: European powers, so people were understandably suspicious of this largely 632 00:41:20,160 --> 00:41:23,799 Speaker 1: Western led public health effort. So the global eradication of 633 00:41:23,840 --> 00:41:28,040 Speaker 1: smallpox happened in spite of hesitancy and resistance, not in 634 00:41:28,120 --> 00:41:34,080 Speaker 1: the absence of it, so that that's how smallpox was 635 00:41:34,160 --> 00:41:36,840 Speaker 1: finally eradicated. It does still exist in a couple of labs. 636 00:41:36,840 --> 00:41:40,280 Speaker 1: There have been ongoing conversations about destroying those remaining stocks, 637 00:41:40,320 --> 00:41:44,560 Speaker 1: and that it keeps getting postponed. I would really like 638 00:41:44,640 --> 00:41:48,560 Speaker 1: it if we as a global society could get control 639 00:41:48,840 --> 00:41:54,200 Speaker 1: of the COVID nineteen pandemic, because unless the Carter Center 640 00:41:54,280 --> 00:42:00,239 Speaker 1: program successfully and eradicates guinea worm disease and the immediate few, sure, 641 00:42:00,360 --> 00:42:03,719 Speaker 1: we don't have any more eradications of diseases to cover 642 00:42:03,880 --> 00:42:08,080 Speaker 1: on the show when I need an optimistic story related 643 00:42:08,120 --> 00:42:12,560 Speaker 1: to all this, right, We're uh, that would be great 644 00:42:12,640 --> 00:42:18,080 Speaker 1: to report as a history in the making, But fingers crossed, 645 00:42:19,080 --> 00:42:21,799 Speaker 1: do you have some listener mail for us? I do 646 00:42:21,920 --> 00:42:25,200 Speaker 1: have listener mail This is from Alex and Alex wrote 647 00:42:25,239 --> 00:42:30,080 Speaker 1: after our Deportation of the Acadians episode and Alex route Hi, 648 00:42:30,200 --> 00:42:33,600 Speaker 1: Tracy and Hallie. How surprised I was when I opened 649 00:42:33,600 --> 00:42:36,640 Speaker 1: my podcast player yesterday and found finally an episode on 650 00:42:36,680 --> 00:42:40,680 Speaker 1: the Acadian deportation. I immediately broke my rule of listening 651 00:42:40,719 --> 00:42:43,680 Speaker 1: episodes in order because I was a few episodes behind. 652 00:42:43,800 --> 00:42:46,920 Speaker 1: I'm a longtime listener and have suggested myself an episode 653 00:42:46,960 --> 00:42:49,600 Speaker 1: on the subject a few years back. I do not 654 00:42:49,760 --> 00:42:52,640 Speaker 1: know if it was on purpose or a lucky coincidence, 655 00:42:52,760 --> 00:42:56,640 Speaker 1: but the release of the episode coincides with National Acadian Day, 656 00:42:56,680 --> 00:43:00,440 Speaker 1: which is August fifteen. On this day, Acadians from munities 657 00:43:00,440 --> 00:43:05,080 Speaker 1: and the maritime provinces in Quebec celebrate Acadian culture. This 658 00:43:05,160 --> 00:43:08,520 Speaker 1: event is usually marked by a tentamar where people walk 659 00:43:08,640 --> 00:43:12,360 Speaker 1: in the street at around six pm and start making 660 00:43:12,480 --> 00:43:15,279 Speaker 1: noise by banging on pots and hands in a way 661 00:43:15,320 --> 00:43:17,640 Speaker 1: to remind the rest of the world of our ongoing 662 00:43:17,719 --> 00:43:22,960 Speaker 1: presence and resilience. Today, New Brunswick is about forty Francophone, 663 00:43:23,120 --> 00:43:26,720 Speaker 1: mostly of Acadian heritage. New Brunswick is still the only 664 00:43:26,800 --> 00:43:31,440 Speaker 1: officially bilingual province in Canada. Both English and French speaking 665 00:43:31,480 --> 00:43:36,680 Speaker 1: communities coexist harmoniously, although some friction occasionally flares up, with 666 00:43:36,719 --> 00:43:39,880 Speaker 1: some in the political arena blaming the bilingual status of 667 00:43:39,920 --> 00:43:43,520 Speaker 1: the provinces a reason to explain the economic problems of 668 00:43:43,560 --> 00:43:47,600 Speaker 1: the province. Outside the Maritimes, Quebec is probably the region 669 00:43:47,640 --> 00:43:50,879 Speaker 1: with the most Acadian descent, with as researchers proved over 670 00:43:50,920 --> 00:43:54,600 Speaker 1: the year, over a million of the seven million inhabitants 671 00:43:54,680 --> 00:43:57,560 Speaker 1: are of Acadian descent. And the United States, many Acadians 672 00:43:57,560 --> 00:44:00,680 Speaker 1: would assimilate into American culture, with most of them anglicizing 673 00:44:00,719 --> 00:44:04,160 Speaker 1: their name. For example, some little blancs became white and 674 00:44:04,239 --> 00:44:09,000 Speaker 1: so on. Alex ends with a personal note about family 675 00:44:09,080 --> 00:44:14,200 Speaker 1: genealogy and uh in Acadian descent. So thank you so much, Alex. 676 00:44:14,239 --> 00:44:16,799 Speaker 1: A couple of people wrote in about two things, One 677 00:44:17,840 --> 00:44:21,920 Speaker 1: about New Brunswick being the only officially bilingual Canadian province, 678 00:44:22,040 --> 00:44:25,080 Speaker 1: and a couple of people wrote in about August fifteen 679 00:44:25,239 --> 00:44:29,879 Speaker 1: being National Acadian Day. Uh. That was a hundred percent coincidental, 680 00:44:29,960 --> 00:44:34,200 Speaker 1: not even coincidental. It's like there, it was accidental. This 681 00:44:34,320 --> 00:44:37,080 Speaker 1: episode was originally going to come out a little bit later, 682 00:44:37,160 --> 00:44:40,360 Speaker 1: but we had a very very last minute schedule Switchery 683 00:44:42,000 --> 00:44:44,640 Speaker 1: is the only reason the Acadian episode actually came out 684 00:44:44,680 --> 00:44:49,400 Speaker 1: before August fifties instead of afterwards. So happy coincidences happened 685 00:44:49,400 --> 00:44:52,320 Speaker 1: in our calendar sometimes, and that was one of them. 686 00:44:52,440 --> 00:44:56,160 Speaker 1: So thanks so much Alex for sending this email. If 687 00:44:56,200 --> 00:44:58,399 Speaker 1: you would like to email us about this or any 688 00:44:58,400 --> 00:45:01,520 Speaker 1: other podcast, where a history podcast at i heart radio 689 00:45:01,600 --> 00:45:04,960 Speaker 1: dot com. We're all over social media at miss in History. 690 00:45:05,000 --> 00:45:08,440 Speaker 1: That's where you'll find our Facebook, Twitter, Pinterest, and Instagram. 691 00:45:08,480 --> 00:45:10,680 Speaker 1: And you can subscribe to our show on the I 692 00:45:10,760 --> 00:45:13,080 Speaker 1: heart radio app and anywhere else you like to get 693 00:45:13,120 --> 00:45:21,080 Speaker 1: your podcasts. Stuff you Missed in History Class is a 694 00:45:21,120 --> 00:45:24,319 Speaker 1: production of I heart Radio. For more podcasts from I 695 00:45:24,400 --> 00:45:27,799 Speaker 1: heart Radio, visit the iHeart Radio app, Apple Podcasts, or 696 00:45:27,840 --> 00:45:29,760 Speaker 1: wherever you listen to your favorite shows.