Speaker 1: The red areas spread into blotches across the face and arms,
Speaker 1: and within hours the blotches broke out into seas of
Speaker 1: tiny pimples. They were sharp, feeling not itchy, and by
Speaker 1: nightfall they covered the face, arms, hands, and feet. Pimples
Speaker 1: were rising out of the soles of the feet and
Speaker 1: on the palms of the hands too. During the night,
Speaker 1: the pimples developed tiny blistered heads, and the heads continued
Speaker 1: to grow larger, rising all over the body at the
Speaker 1: same speed, like a field of barley sprouting after the rain.
Speaker 1: They hurt dreadfully, and they were enlarging into boils. They
Speaker 1: had a waxy, hard look, and they seemed unripe. Fevers
Speaker 1: soared abruptly and began to rage. The rubbing of pajamas
Speaker 1: on the skin felt like a roasting fire. By dawn,
Speaker 1: the body had become a mass of knob like blisters.
Speaker 1: They were everywhere all over, but clustered, most thickly on
Speaker 1: the face and extreme. The inside of the mouth and ear,
Speaker 1: canals and sinuses had pustulated. It felt as if the
Speaker 1: skin was pulling off of the body, that it would
Speaker 1: split and rupture. The blisters were hard and dry, and
Speaker 1: they didn't leak. They were like ball bearings embedded in
Speaker 1: the skin, with a soft, velvety feel on the surface.
Speaker 1: Each pustule had a dimple in the center. They were
Speaker 1: pressurized with an opalescent puss. The pustules began to touch
Speaker 1: one another, and finally they merged into confluent sheets that
Speaker 1: covered the body like a cobblestone street. The skin was
Speaker 1: torn away across the body, and the pustules on the
Speaker 1: face combined into a bubbled mass filled with fluid, until
Speaker 1: the skin of the face essentially detached from its underlayers
Speaker 1: and became a bag surrounding the tissues of the head. Tongue, gums,
Speaker 1: and hard palate were studded with pustules, the mouth dry.
Speaker 1: The virus had stripped the skin off the body, both
Speaker 1: inside and out, and the pain seemed almost beyond the
Speaker 1: capacity of human nature to endure.
Speaker 2: Hi, Hi, Welcome to episode three of this podcast Will
Speaker 2: Kill You.
Speaker 1: This week we're talking about smallpox.
Speaker 2: Clearly that was smallpox.
Speaker 1: Yeah, it's horrifying, Oh my god. And that quote was
Speaker 1: from The Demon in the Freezer by Richard Preston.
Speaker 2: Wow.
Speaker 1: So how about a little something to take the edge off.
Speaker 2: Yeah, let's take that edge off.
Speaker 1: What are we drinking this week today?
Speaker 2: We're drinking smallpox on the rocks. That's gross.
Speaker 1: Yeah, I don't know if I want to drink that anymore.
Speaker 2: It's you know, it takes the edge off.
Speaker 1: Yeah, sure, sure. What's in smallpox on the rocks?
Speaker 2: Basically, it's a whiskey sour.
Speaker 1: Sign me up. That's pretty signed up.
Speaker 2: It's if you'd like to drink along at home, you
Speaker 2: can make your own smallpox on the rocks by mixing
Speaker 2: two ounces of.
Speaker 1: Your favorite whiskey wood.
Speaker 2: That's the Kentuckians.
Speaker 1: That's my plug.
Speaker 2: She's she would know, you know, like she does know.
Speaker 1: But you know, let's go with bourbon and the juice of.
Speaker 2: Half a lemon, which is literally every recipe and I
Speaker 2: looked it up. It's about three tablespoons of lemon juice.
Speaker 2: That's the juice of.
Speaker 1: No, that's that's a juice of a whole lemon.
Speaker 2: You're right, So it's one and a half tablespoons of lemon.
Speaker 1: I maybe more is better. We did it one and
Speaker 1: a half tablespoons per two ounces of bourbon and about.
Speaker 2: A half a teaspoon of sugar. Shake it up over ice,
Speaker 2: drink it on the rocks.
Speaker 1: Cheers, cheers.
Speaker 2: I wonder what that sounded like. I don't know. It
Speaker 2: was good better clinking glasses. Yeah, let's define a few
Speaker 2: words for this week. What are the words that we're
Speaker 2: gonna be defining this week.
Speaker 1: Let's start with endemic.
Speaker 2: So, in terms of disease, endemic is a disease that
Speaker 2: is regularly found among a particular people or in a
Speaker 2: certain area. So, for example, there are certain areas of
Speaker 2: the world where malaria is considered endemic, and if you
Speaker 2: see malaria in those areas, that's sort of normal. Whereas
Speaker 2: if you were to see malaria outside of those areas,
Speaker 2: that would be considered an epidemic or an outbreak.
Speaker 1: Gotcha, all right. Next one is bio terrorism.
Speaker 2: Bioterrorism is pretty straightforward. It's essentially just terrorism that includes
Speaker 2: the release of a biological toxic agent. That's it, clear
Speaker 2: clear to me, clear as day.
Speaker 1: Clear as day. Let's talk about what a reservoir is.
Speaker 2: So a reservoir for disease is a long term host
Speaker 2: of a pathogen that often do not show symptoms or
Speaker 2: have sort of subclinical infections. So in leprosy, we talked
Speaker 2: about armadillos armadillos are reservoirs for the leprosy bacteria.
Speaker 1: Eradication.
Speaker 2: Eradication is a fun one, a happy one. It's a
Speaker 2: happy one. So eradication of a disease, according to the CDC,
Speaker 2: is the permanent reduction to zero of worldwide incidents of
Speaker 2: infection caused by a specific agent that is the result
Speaker 2: of deliberate efforts in order to eradicate that disease to
Speaker 2: the point where intervention measures are no longer needed to
Speaker 2: control that disease. There are two diseases in the world
Speaker 2: that have been eradicated, Aaron, What are those diseases?
Speaker 1: Oh, smallpox, that's the topic of today. And actually the
Speaker 1: other one, which you may not have heard of, it's
Speaker 1: called render pest and it is a disease of cattle yep,
Speaker 1: both domestic and wild, so ungillates, ungillates, and they're both gone.
Speaker 1: So cool, awesome, go, and hopefully hopefully soon polio, guinea worm,
Speaker 1: some of the other diseases will be also on that
Speaker 1: list thanks to the Carter Foundation. Right, it's the Carter Foundation,
Speaker 1: is it? I don't know, it's Jimmy Carter. Cool. Jimmy
Speaker 1: Carter's doing a lot of work for eradication.
Speaker 2: That's awesome for.
Speaker 1: Those Yeah, he's awesome. Now that we've defined those terms,
Speaker 1: let's jump into the biology. Aaron, tell me all about smallpox.
Speaker 2: I'd love to Aaron. Okay, so smallpox, this one is
Speaker 2: a doozy, no lie, this is I know.
Speaker 1: I mean we were already hit pretty hard at the
Speaker 1: beginning of this episode.
Speaker 2: Just starting us off with a bang. So here are
Speaker 2: the basics. Smallpox is a virus. Uh, it's a DNA virus.
Speaker 2: So if you remember influenza was an RNA virus, right,
Speaker 2: this is a little bit different. It is in a
Speaker 2: family of viruses known as the pox viruses. And I
Speaker 2: feel the need to tell you that chicken pox is
Speaker 2: not a pox virus.
Speaker 1: That's an important clarification.
Speaker 2: It really is. Chicken pox is caused by a herpes virus.
Speaker 2: So it's a totally different family of viruses. But there
Speaker 2: are a ton of other pox viruses besides smallpox. There
Speaker 2: are pox viruses that infect basically every vertebrate that you
Speaker 2: can think of. There is monkey pox, turkey pox, gerbil pox,
Speaker 2: camel pox, dolphin pox, snake, there's crocodile pox, kangaroo.
Speaker 1: I think I think we get the point.
Speaker 2: Yeah, literally that that wasn't even the whole list. What
Speaker 2: about fish, Well, there's dolphin pox. Dolphins aren't fish.
Speaker 1: My gosh, are you serious? There actually is, actually is
Speaker 1: dolphin pox.
Speaker 2: That's not a lie. And then yeah, I mean reptiles
Speaker 2: can get various poxes snake pox, so I think there
Speaker 2: could be.
Speaker 1: Fish pox is probably a really old family of virus.
Speaker 2: Yes, there are also insect pox viruses, and those are
Speaker 2: gnarly because insects don't have skin, so they basically turn
Speaker 2: into a giant ball of pox jelly. It's gnarly.
Speaker 1: I want to I want to google that. You should.
Speaker 1: Let's let's post a picture of insect infected by some
Speaker 1: sort of POxy.
Speaker 2: It's just gonna be go, just do so. Small Pox
Speaker 2: itself has two major forms, Variola major and Variola minor,
Speaker 2: that are basically named because major is a major problem.
Speaker 2: Minor was a minor problem. We're not really going to
Speaker 2: get into the distinction for this episode. Most of what
Speaker 2: you hear about in terms of the statistics about this
Speaker 2: disease have to do with Veryola major. Okay, even though
Speaker 2: there are pox viruses that can infect tons of other vertebrates,
Speaker 2: smallpox itself is an exclusively human specific virus. It likely
Speaker 2: jumped into humans from some type of rodent we don't
Speaker 2: know exactly what kind really. Yeah, it's most closely related
Speaker 2: to a rodent pox virus, and this likely happened around
Speaker 2: the time of the agricultural Revolution about ten thousand years ago,
Speaker 2: but estimates really vary on that. It's not exactly clear
Speaker 2: when this first happened. But the reason that we think
Speaker 2: it likely was around the agricultural Revolution is because math
Speaker 2: models have shown that this virus needs a really large
Speaker 2: human population size in order to sustain itself.
Speaker 1: So, but not just human population size, but human population density.
Speaker 2: Exactly, exactly, Yes.
Speaker 1: Okay, that's right.
Speaker 2: Okay, So let's get into the disease itself. Yes, we've
Speaker 2: already heard a little bit. It's just gonna get worse better,
Speaker 2: I don't know, probably worse, yeah, and also better. I
Speaker 2: mean it'll get worse and then it will get better.
Speaker 1: We're not sure where we're gonna end up.
Speaker 2: Well, we'll find out. So smallpox has an incubation period, which,
Speaker 2: if you remember from the last episode, is the time
Speaker 2: from when you're exposed to when you show symptoms is
Speaker 2: about twelve days ten to fourteen days, but twelve days on.
Speaker 1: Average, that's a long time.
Speaker 2: It's a pretty long time. The one good thing, and
Speaker 2: I really think this is the only good thing about
Speaker 2: the smallpox virus no joke, is that it does not
Speaker 2: tend to be infectious until you start showing symptoms, and
Speaker 2: you are the most infectious. That is, you're shedding the
Speaker 2: most virus when you have some of the more severe symptoms,
Speaker 2: which are well, let's get into it, the progression of
Speaker 2: the disease. So it starts off with fever and body
Speaker 2: aches and sometimes vomiting. And this is not just a
Speaker 2: typical fever in body aches. This is you are too
Speaker 2: sick to continue on with your daily activities, and this
Speaker 2: generally lasts for about two to four days. After that,
Speaker 2: you'll get a rash and redness that generally starts on
Speaker 2: the face, especially in your mouth and on your tongue.
Speaker 2: Oh no, yeah, so inside your mouth you'll get that
Speaker 2: may break open and these sores are literally filled with
Speaker 2: viral particles.
Speaker 1: Oh yeah. So then when somebody is nursing you and
Speaker 1: being like, oh, let me make you feel better, right,
Speaker 1: and you turn to them and cough a little bit.
Speaker 2: Yeah, So it's important. This is a respiratory virus. So
Speaker 2: this is shed by breathing, coughing, et cetera. So, yeah,
Speaker 2: if you're infected all up in your mouth and then
Speaker 2: you're coughing on the people trying to help you, Bobo's Harley,
Speaker 2: my gosh. So then the rash will spread to your body,
Speaker 2: to your arms, to your legs. Unlike leprosy, this starts
Speaker 2: sort of in the middle of your body and then
Speaker 2: spreads outwards.
Speaker 1: Right, Okay.
Speaker 2: This stage generally lasts around four days, and it is
Speaker 2: the most contagious part of this infection. Then you start
Speaker 2: to get these lesions, these sores that are filled with fluid.
Speaker 2: They can become really firm, and like you described earlier,
Speaker 2: they get this characteristic dimple in the center. Then you'll
Speaker 2: move on to the pustular rash and scab. Oh stage
Speaker 2: stop please, I can't stop. I just can't. This is
Speaker 2: described as peas under the skin, right, it's so disgusting.
Speaker 2: They're sharply raised, they're firm to the touch. This lasts
Speaker 2: for about ten days.
Speaker 1: This is a long days.
Speaker 2: This is a long infection.
Speaker 1: Ten days of pea pimples.
Speaker 2: Yes, And after about five days they'll start to crust over.
Speaker 2: And I also want to point out that these sores
Speaker 2: are literally covering your entire body, your entire body, confluent, yeah,
Speaker 2: all over, confluent whatever, all over your body, these scabs,
Speaker 2: and then eventually they'll begin to scab, and then they'll
Speaker 2: fall off, and you continue to be infectious until the
Speaker 2: last scab has fallen off your body. That's if you
Speaker 2: survive that.
Speaker 1: Long, and not only are you infectious, but your scabs
Speaker 1: are too.
Speaker 2: Exactly, so, if you imagine, like I mean today we
Speaker 2: have when when was the vacuum invented?
Speaker 1: The vacuum? Yeah, oh gosh, like the early nineteen hundred.
Speaker 2: There you go. So imagine that you're cleaning up after
Speaker 2: your you know, family member who is sick, and they're
Speaker 2: dropping scabs all over the place, and then you go
Speaker 2: to vacuum them up, and now you're spewing scab dust
Speaker 2: into the air and then you breathe it in. That's real.
Speaker 1: Or for instance, I just made that up. Blankets. Yeah,
Speaker 1: you'll talk a lot about that. Yeah, I'll get into that.
Speaker 2: So, yeah, that's if the person survives all this, they're
Speaker 2: contagious for that entire time.
Speaker 1: It's and how many people did survive this.
Speaker 2: In general, the mortality rate is about twenty to forty percent,
Speaker 2: usually considered about thirty percent, so on average, about one
Speaker 2: in three people infected with smallpox will die.
Speaker 1: Oh my god.
Speaker 2: Now it gets a little bit worse.
Speaker 1: No, what I just.
Speaker 2: Described was the progression of what is called ordinary smallpox.
Speaker 1: Ordinary, that's the ordinary version. So that's if you were lucky.
Speaker 1: This is the most this is the baseline.
Speaker 2: This is the baseline exactly. So some people who were
Speaker 2: vaccinated this is the good version, would end up with
Speaker 2: what's called modified smallpox, which is basically a less severe form.
Speaker 2: But a large number of people, not a large number,
Speaker 2: about five to ten percent of cases would be what's
Speaker 2: called malignant. These have a longer prodrome period, which is
Speaker 2: the period at the beginning when you just have like
Speaker 2: a fever and a mild rash. So they'd have a
Speaker 2: longer period of that.
Speaker 1: So it's not like they would be infectious longer.
Speaker 2: Not necessarily no, But then when they started to get
Speaker 2: a rash, the pustules that they would get were slower growing,
Speaker 2: and they would stay flat rather than being raised, and
Speaker 2: their skin would stay This is a quote from the
Speaker 2: CDC Soft and velvety ew is that yucky?
Speaker 1: What do you what does a velve What does velvet
Speaker 1: skin feel like?
Speaker 2: I don't know, but it doesn't sound good.
Speaker 1: I don't think it's touching our faces.
Speaker 2: I need to put lotion on. Yeah, but this form
Speaker 2: of the disease is almost always fatal. And what's really
Speaker 2: sad is about seventy two percent of the malignant cases
Speaker 2: we're in children. Oh yeah, there's a worse one too.
Speaker 2: The even worse one, how yeah, is called hemorrhagic small pots.
Speaker 1: Oh okay, that's how yeah.
Speaker 2: So hemorrhagic meaning bleeding out essentially, so instead of just
Speaker 2: forming these pustubles under the skin, you would literally just
Speaker 2: bleed underneath your skin. You'd bleed into your eyes.
Speaker 1: And your skin would slough off.
Speaker 2: Your skin would just be like puddles of blood like
Speaker 2: your whole skin. You bleed into your eyes to the
Speaker 2: point where the whites of your eyes would turn black
Speaker 2: because they're just full of dried blood. You could even
Speaker 2: get this might be getting too gnarly, but you could
Speaker 2: even get your bleeding so much that in your capillaries
Speaker 2: blood is clotting as it's leaking out, so you have
Speaker 2: just blood clots and blood everywhere in your body, and
Speaker 2: it's described as very thick and very dark. You would
Speaker 2: bleed out of all of your mucous membranes, out of
Speaker 2: every orifice.
Speaker 1: People would turn purple yes exactly because there would be
Speaker 1: so much skin exactly.
Speaker 2: This is about two percent of cases overall, but somewhere
Speaker 2: between three and twenty five percent of all fatal cases.
Speaker 2: So this, as you can imagine, was almost always fatal.
Speaker 1: Was do you know anything about why a case would
Speaker 1: become hemorrhagic versus.
Speaker 2: You know, I tried to find information about that, and
Speaker 2: I really couldn't find good explanation.
Speaker 1: Makes sense that there weren't. Yeah, I don't know.
Speaker 2: If it's just immune related, that's what I would guess,
Speaker 2: but I don't really know. Another thing to make all
Speaker 2: of this that much worse is that people infected with smallpox.
Speaker 2: You can imagine that if you're infected with a disease
Speaker 2: that makes you this sick, you're probably not aware of
Speaker 2: what's going on because your body is just in overload.
Speaker 2: But with smallpox, you stay weirdly, very conscious and aware
Speaker 2: of everything that's happening to you.
Speaker 1: That would be horrible, I think.
Speaker 2: Isn't that your actual worst nightmare.
Speaker 1: It's one of them. Personally, I have a lot of
Speaker 1: worst nightmare.
Speaker 2: It's gnarley. Gnarley is the word of my read Yeah,
Speaker 2: the most in my notes.
Speaker 1: Yeah.
Speaker 2: So that's smallpox in a nutshell.
Speaker 1: Okay, So now that we have a let's call it
Speaker 1: baseline understanding of just how awful this disease can be.
Speaker 2: I really, I have to be honest, I did not
Speaker 2: know just how horrible this disease was until I really
Speaker 2: started reading about it. It is beyond anything that I
Speaker 2: could have imagined.
Speaker 1: It's really scary.
Speaker 2: It's terrifying.
Speaker 1: Let's hear more more, Let's hear about how terrifying it
Speaker 1: was for people throughout history.
Speaker 2: Let's learn. I want to learn it all.
Speaker 1: So, like you said, the smallpox's iris probably made the
Speaker 1: leap from domesticated animals or rodents. As it turns out,
Speaker 1: about ten thousand years ago estimates.
Speaker 2: Rodents were like when we domesticated animals, It's like we
Speaker 2: practically domesticated rodents by accident because they were living in
Speaker 2: all of like the grains and things that we started storing.
Speaker 2: So we had huge booms in rodent populations.
Speaker 1: Ex the same time, scientists aren't exactly sure which animal
Speaker 1: it came from, but it probably originated in the same
Speaker 1: place geographically that agriculture and livestock domestication took off, which
Speaker 1: is the river valleys of Africa and India. And we
Speaker 1: actually see our first physical evidence of smallpox from around
Speaker 1: fifteen hundred to one thousand BC, what in Egyptian mummies
Speaker 1: whose preserved skin shows telltale pock marks from the disease.
Speaker 2: Oh my god, you can see the pock marks on
Speaker 2: mummies actual, like on actual mummies.
Speaker 1: Yeah, we're gonna post a picture.
Speaker 2: Oh my god, that's so cool.
Speaker 1: It's really cool. Smallpox is what we refer to as
Speaker 1: a crowd disease. In order for the virus to successfully
Speaker 1: establish in a population, there needs to be enough people
Speaker 1: in close contact with one another so that it can
Speaker 1: be transmitted and maintained. Otherwise it'll just blow through population
Speaker 1: or village and.
Speaker 2: Die out right because it just kills people like yeah, ooh,
Speaker 2: I hope that snap got sounded.
Speaker 1: Yeah. Yeah. So it's no coincidence that smallpox started spreading
Speaker 1: globally just as human population size took off thanks to
Speaker 1: farming from India and northern Africa. It spread east and
Speaker 1: west to China, Greece, Rome, et cetera. Around one hundred AD,
Speaker 1: smallpox caused a devastating epidemic in the Roman Empire, and
Speaker 1: this epidemic was called the plague of Antonius. Ooh yeah,
Speaker 1: Like with the nineteen eighteen pan flu pandemic, soldiers returning
Speaker 1: home were probably responsible for facilitating the spread of the
Speaker 1: smallpox virus, always them soldiers. And at the height of
Speaker 1: this particular epidemic, two thousand people died daily in Rome.
Speaker 1: Oh my wow. Yeah, this is really bad. I feel
Speaker 1: like there wasn't that many people in Rome.
Speaker 2: Well that's the thing.
Speaker 1: Some historians actually suggest that smallpox, along with malaria, contributed
Speaker 1: to the fall of the Roman Empire. I love information
Speaker 1: like that, I know, because no one really talks about
Speaker 1: the role of infectious disease in history, or they do,
Speaker 1: but it's not I feel like it's not.
Speaker 2: As it's not as big of a deal as like
Speaker 2: and then the three hundred people came and they the
Speaker 2: people now or whatever.
Speaker 1: Yeah, yeah, it's all about to talk about it.
Speaker 2: It all comes back to infectious disease people. That's the
Speaker 2: point of what we're trying to teach you here.
Speaker 1: Yeah, it is after wreaking havoc in Rome, smallpox made
Speaker 1: its way to the rest of Europe, probably through the
Speaker 1: Huns or returning crusaders around like the twelfth and thirteenth century.
Speaker 1: Were the crusaders?
Speaker 2: Okay, I was going to say, like, I don't know, Yeah,
Speaker 2: I know, I know.
Speaker 1: I had to look it up. The Crusaders. Yeah, that's
Speaker 1: sure a time that happened well in either case. As
Speaker 1: global population continued to grow, smallpox epidemics grew more frequent
Speaker 1: and more intense, and in many areas it became endemic.
Speaker 1: There's a word callback more of a childhood illness. Okay,
Speaker 1: let's talk about Yeah, and he serious, because here comes
Speaker 1: one of the most for me, classic small pox periods
Speaker 1: of history. One of the things that history teachers in
Speaker 1: high school at least tend to gloss over here in
Speaker 1: the US is the devastating impact that small packs and
Speaker 1: other Old World diseases had on the native North and
Speaker 1: South American populations.
Speaker 2: This is where it gets really depressing.
Speaker 1: Yeah, it's gonna be that way for a while. Yeah yeah,
Speaker 1: buckle up.
Speaker 2: Buckled your history teacher, have another have just drink.
Speaker 1: Drink up. Here's the time bottoms up. It's not yet.
Speaker 1: It's just gonna get worse. Your history teacher may have
Speaker 1: forgotten to tell you how smallpox blankets were given to
Speaker 1: Native Americans intentionally by invading Europeans in an often successful
Speaker 1: attempt to deliberately infect them with this devastating disease.
Speaker 2: Like smallpox blankets, as in some white dude was like, hey, yo,
Speaker 2: I got a blanket. I'm gonna rub it all around
Speaker 2: a person with smallpox and then I'm going to give it.
Speaker 2: That means that they knew enough to know that this
Speaker 2: disease was transmitted.
Speaker 1: Ugh, you sound like you want a direct quote.
Speaker 2: I do, thank you.
Speaker 1: I'm happy to provide. In the War of seventeen sixty
Speaker 1: three between England and France for control of North America,
Speaker 1: the British troops were asked, could it not be contrived
Speaker 1: to send the smallpox among those disaffected tribes of Indians.
Speaker 1: We must, on this occasion used every stratagem in our
Speaker 1: power to reduce them. That's a direct quote. And wait
Speaker 1: a second, it's not done yet, because there was a
Speaker 1: return letter from the ranking British officer who said, quote,
Speaker 1: I will try to inoculate the Indians with some blankets
Speaker 1: that fall into their hands and take care not to
Speaker 1: get the disease myself. What that really happened? Even in
Speaker 1: the instances when it's not entirely clear how deliberately smallpox
Speaker 1: is spread, like whether it was deliberate.
Speaker 2: Or not, sounds pretty deliberate.
Speaker 1: Oh yeah, I mean yeah, for instance, in that case
Speaker 1: is certainly deliberate. But still Europeans definitely use smallpox to
Speaker 1: their advantage. Yeah. Take for instance, Spanish conquistador Hernando Cortes.
Speaker 1: He along with around six hundred men or so, landed
Speaker 1: in the Yucatan Peninsula around fifteen twenty one and headed
Speaker 1: to the Aztec capital city of tanoche Tutlan which is
Speaker 1: now Mexico City, to try to take over the Aztec Empire.
Speaker 1: He and his fellow conquistadors were soundly defeated in their
Speaker 1: first fight with the Aztecs, and they expected to lose
Speaker 1: again when the inevitable second blow would come, but it
Speaker 1: never came. A little confused and apprehensive, yeah that's what
Speaker 1: I wrote, and tired of waiting, the Spanish stormed the city.
Speaker 1: Once inside, they found that smallpox had devastated the city.
Speaker 1: Oh my god, Cortes and his men had probably all
Speaker 1: been exposed to smallpox's children, and so the disease didn't
Speaker 1: affect them. Seeing this furthered the belief among the Aztecs
Speaker 1: that the invading Spanish were gods, a belief that the
Speaker 1: Spanish did nothing to discourage.
Speaker 2: And wow, that's so sad.
Speaker 1: It is it is? And that is how Cortes and
Speaker 1: his band of around five hundred, six hundred concuistadors toppled
Speaker 1: the twenty five million people strong as Tech Empire. That
Speaker 1: was it. That was the end of the Aztec Empire
Speaker 1: for all intents and purposes. Oh my god, this is
Speaker 1: mirrored I I just in the fall oh of the
Speaker 1: Inca Empire.
Speaker 2: This is a really depressing episode.
Speaker 1: Yep, the Inca Empire, which was mainly in Peru and
Speaker 1: Ecuador in South America. This time when Pizarro, so this
Speaker 1: is another Spanish conquistador and his one hundred and twenty
Speaker 1: eight are you really men? When they arrived, they found
Speaker 1: an already decimated empire, as smallpox had preceded their arrival.
Speaker 1: And they found these huge structures, these huge towns, these
Speaker 1: huge buildings, and they looked around and thought, there's there's
Speaker 1: no way that these few people could have actually done
Speaker 1: this what has happened? Right, because the people were starving
Speaker 1: because they were dying of smallpox, and then they had
Speaker 1: no one to take care of them. It was I mean,
Speaker 1: no one to take care of the field, no one
Speaker 1: at farm. So even if you survived smallpox, you had
Speaker 1: no food.
Speaker 2: Right.
Speaker 1: It was absolutely terrible, terrible, terrible.
Speaker 2: I think I'm going to cry.
Speaker 1: Well, we're not done.
Speaker 2: You're gonna get more depressing, Okay.
Speaker 1: I mean because we have to talk about North America.
Speaker 2: Oh yeah.
Speaker 1: Historian Elizabeth Fenn tracks a massive smallpox epidemic in North
Speaker 1: America in the late seventeen hundreds, coinciding with the time
Speaker 1: of the American Revolution. In her book Po's Americana, she
Speaker 1: describes British soldiers who were more protected from smallpox infection
Speaker 1: because inoculation was more popular in England than it was
Speaker 1: in the US at the time anyway, so she describes
Speaker 1: British soldiers and officers deliberately trying to infect American soldiers
Speaker 1: where inoculation wasn't as widely accepted.
Speaker 2: So is this where they were started to decide that
Speaker 2: all is fair in love and war. Theyre like, we're
Speaker 2: just gonna I mean, it's always been fair, all fair
Speaker 2: in war. But also you're like, I'm not going to
Speaker 2: try and actually fight you. I'm just gonna get you sick,
Speaker 2: Like get come on, man, that's.
Speaker 1: Not that's not cool. Bioterrorism.
Speaker 2: It's not bioterrorism. That's what it is.
Speaker 1: You're right by bio warfare at the very least. Yep yep,
Speaker 1: she described. And so this, this smallpox epidemic that she
Speaker 1: describes around the late seventeen hundreds, was not isolated to
Speaker 1: the colonial states at the time, so the areas of
Speaker 1: New England and the Eastern seaboard. It spread across the country.
Speaker 2: And this, as you said, American Revolution, right.
Speaker 1: So seventeen seventy in the years she describes her seventeen
Speaker 1: seventy seven to seventeen eighty five. Okay. The reason, or
Speaker 1: one of the reasons is that smallpox was so devastating
Speaker 1: for native North and South American populations is because these
Speaker 1: were completely naive. They had never been exposed to smallpox before.
Speaker 1: And so for instance, the Spanish conquistadors had been probably
Speaker 1: exposed as children, or the English they over across the
Speaker 1: board had lower mortality rates ranging around thirty whereas some
Speaker 1: to read about it, some Native American groups had mortality
Speaker 1: rates upwards of ninety percent, one hundred percent. I mean,
Speaker 1: it was unbelievable.
Speaker 2: But like, one of the ways that they figured out
Speaker 2: how to end up with the vaccines is that if
Speaker 2: people were exposed to other forms of pox viruses by
Speaker 2: living with other animals, then they could even if they
Speaker 2: never got smallpox, if they were exposed to another form
Speaker 2: of pox virus might have had some sort of immunity,
Speaker 2: which is why you saw lower mortality rates in the
Speaker 2: European population.
Speaker 1: This is a nice little segue, yeah, into talking about
Speaker 1: inoculation and vaccination ooh, and their relevance to the fight
Speaker 1: against smallpox.
Speaker 2: Yeah.
Speaker 1: Inoculation as a practice had been around for hundreds of
Speaker 1: years in certain cultures and regions, such as among groups
Speaker 1: in Western Africa and Turkey. Okay, but Western medicine had
Speaker 1: ignored the practice, chalking it up to old wives tales
Speaker 1: and uneducated nonsense.
Speaker 2: So can you explain what inoculation is?
Speaker 1: Sure? Inoculation is the practice of taking material, so usually
Speaker 1: like pus or skin from a person who had active
Speaker 1: smallpox infection. Yeah, taking that and then injecting it or
Speaker 1: inserting it in some way into an individual who had
Speaker 1: never been exposed to smallpox.
Speaker 2: Basically like exposing them directly exposed to them infectious gunk.
Speaker 1: But through a non but through a root, which was
Speaker 1: not as common.
Speaker 2: Right, because it's a respiratory virus. Right.
Speaker 1: And so what was the usual outcome of inoculation was
Speaker 1: a mild smallpox infection. The majority, the vast majority of
Speaker 1: patients who were inoculated survived.
Speaker 2: Okay, So the.
Speaker 1: Mortality rate for innoculation was two point five percent.
Speaker 2: Wow, that's a lot lower than twenty to forty percent, right.
Speaker 1: So you were way better off becoming inoculated lower. Yeah,
Speaker 1: And so you you had a mild infection and you
Speaker 1: generally recovered without any scars or pock marks. However, during
Speaker 1: the time that you did show symptoms of your mild
Speaker 1: smallpox infection, you were infectious to others, and so it
Speaker 1: was still really a dangerous practice in some ways.
Speaker 2: Okay, that makes sense.
Speaker 1: Inoculation was not very popular then in Western cultures, so
Speaker 1: in Europe, in parts of Europe, and in North America. Okay.
Speaker 1: But then around the same time in the early eighteenth century,
Speaker 1: which is the early seventeen hundred, I.
Speaker 2: Was gonna ask, because I'm the worst at those okay numbers.
Speaker 1: Two people on two different continents, one a high born
Speaker 1: woman in England whose name was Lady Mary Montague, and
Speaker 1: the other a reverend in colonial Boston named Cotton Mather. Yeah, Cotton,
Speaker 1: good old Cotton Mather. Where did you say he was Boston?
Speaker 2: Oh? That wasn't of a good Boston accent.
Speaker 1: I just I wonder how that name fell out of style. Anyway,
Speaker 1: these two took note of these practices and tried to
Speaker 1: bring them to the places they lived. The story goes
Speaker 1: that lady was a beautiful, popular.
Speaker 2: Woman, aren't they all?
Speaker 1: And then she got smallpox at twenty six, oh, baby,
Speaker 1: which left her pock marked eyelash lists.
Speaker 2: That's if you are a woman, especially at that time.
Speaker 1: I mean, I forget about it. Thank god. She's already married, Oh,
Speaker 1: thank god, and horribly fearful of the disease, which had
Speaker 1: killed her favorite brother in the same epidemic. Wait, her favorite, Yeah,
Speaker 1: that's from the book.
Speaker 2: She had like an outward You can't have an outward favorite.
Speaker 1: That's not I mean, okay, whichever brother is listening to this,
Speaker 1: you're my favorite.
Speaker 2: That's rude.
Speaker 1: She moved with her husband to Turkey, where she saw
Speaker 1: that smallpox wasn't viewed with the same terror as it
Speaker 1: was in England. There she first encountered innoculation, the practice,
Speaker 1: like we said, of grafting a bit of small pox
Speaker 1: after active smallpox into an unexposed person.
Speaker 2: Okay, so she got smallpox before she learned what inoculation was. Yes, okay,
Speaker 2: got it late.
Speaker 1: Mary immediately saw the enormous potential of inoculation and ordered
Speaker 1: her children to be inoculated.
Speaker 2: Yeah me too. Oh yeah.
Speaker 1: Upon her return to England, she tried to popularize it,
Speaker 1: but most doctors and the general public were horrified. Yeah.
Speaker 1: One they figured that actively giving yourself a disease was
Speaker 1: basically suicide, I mean and crazy.
Speaker 2: It sounds pretty crazy, sounds pretty crazy crazy.
Speaker 1: And two that this was going against the will of God.
Speaker 2: Oh gotta bring God into it at some point.
Speaker 1: Because if God wanted you or your kids to die
Speaker 1: of smallpox.
Speaker 2: Then so she had wow yep.
Speaker 1: To combat some of this incredibly stupid nonsense, Lady Mary
Speaker 1: and a few pro inoculation doctors designed an experiment in
Speaker 1: which they would inoculate a bunch of people who had
Speaker 1: never had smallpox to show to the public and also themselves,
Speaker 1: because they weren't entirely sure that inoculation was safe practice.
Speaker 2: I hope that they got perm who they chose, Oh,
Speaker 2: let me guess prisoners U huh and uh children maybe
Speaker 2: not kind of children, foster children, orphans, orphans, orphans, Ye,
Speaker 2: prisoners and orphans, prisoners and orphans. Always at the end
Speaker 2: of the short.
Speaker 1: Stan medical ethics was not a practice at this No. Well, regardless,
Speaker 1: the experiment worked, which is good. At least. A somewhat
Speaker 1: similar sequence of events occurred in Boston, except that there
Speaker 1: was no formalized experiment on repressed populations, just people going
Speaker 1: up to this doctor named you ready for this doctor
Speaker 1: zab deal? Oh geez Boylston, Boyleston.
Speaker 2: Yeah, it was a terrible but also very appropriate.
Speaker 1: Occasion, the early seventeen hundred.
Speaker 2: Boyleston studying smallpox.
Speaker 1: And and asking and asking him to inoculate them.
Speaker 2: Okay, so, at least in this case it was willing volunteer.
Speaker 1: For the most part.
Speaker 2: It's gotta be the first time that the US has
Speaker 2: done it, right A just kidding, I don't know.
Speaker 1: I mean, who knows. He did catch a lot of flak, though,
Speaker 1: for inoculating people because it was also hugely unpopular and
Speaker 1: actually survived several assassination attempts.
Speaker 2: Oh wow. Interesting.
Speaker 1: Eventually the numbers couldn't be ignored. Inoculation carried a mortality
Speaker 1: rate of two point five, while, like you said, natural
Speaker 1: infection was upwards of thirty yep. Inoculation became pactchually popular
Speaker 1: throughout the eighteenth century, but was dethroned by vaccination in
Speaker 1: seventeen ninety three. Ooh, you're probably somewhat familiar with this story,
Speaker 1: or at least the name of its star. Edward Jenner
Speaker 1: Eddie was just going about his life as a country
Speaker 1: doctor Eddie when he noticed that milk maids who had
Speaker 1: once been infected with cowpox never got smallpox. So cowpox
Speaker 1: is a much milder infection in humans with basically no
Speaker 1: chance of mortality.
Speaker 2: Because I'm guessing that it is a virus that general
Speaker 2: infects cows.
Speaker 1: You're right about that.
Speaker 2: Oh, I'm so good at the guessing.
Speaker 1: He decided to try to take some of the puss
Speaker 1: of an active infection of cow pox and then put
Speaker 1: it into the skin of a completely unexposed person to
Speaker 1: cow or smallpox.
Speaker 2: Interesting. So it's kind of like an inoculation, but with
Speaker 2: a different virus, a more mild virus, more mild form.
Speaker 1: Okay, cool, and Jenner tried this out on eight year
Speaker 1: old farm hand James Phipps. Hello, medical ethics board, where
Speaker 1: are you still? No?
Speaker 2: James was like, he's choice.
Speaker 1: You Uh, but was Jenner supposed to just sit around
Speaker 1: and wait for smallpox to come to James Phipps. Nope,
Speaker 1: smallpox would come to James via Jenner, who directly exposed him. Luckily,
Speaker 1: for James and the rest of the world, his previous
Speaker 1: exposure to cow pox fully protected him.
Speaker 2: Awesome.
Speaker 1: Yeah, it's really I mean it's actually a huge step.
Speaker 2: Hold on, wait he so he gave James Phipps, poor
Speaker 2: little kid, cow hand, stuck him with cowpox, and then
Speaker 2: he exposed him his smallpox.
Speaker 1: Yeah. Wow, that's awful. I'm so glad it worked. Yeah,
Speaker 1: I also so is James. Jenner decided to call this
Speaker 1: practice vaccination vacca, meaning cow in Latin. Yeah, so that's
Speaker 1: where vaccination comes from. It's pretty cool.
Speaker 2: That is awesome. So literally the word vaccination that we
Speaker 2: use now for all vaccines, all vaccines is because of smallpox.
Speaker 1: Yes, vacca that is so cool. Yeah, Like inoculation vaccination
Speaker 1: took a little bit to catch on, but once it did,
Speaker 1: it spread faster than the smallpox virus around the world.
Speaker 2: That was a really good one.
Speaker 1: Thanks, and enabled doctors to eradicate this disease which had
Speaker 1: plagued humanity for millennia, which brings us to yeah, eradication, eradication.
Speaker 1: The gold stuff are on the story, the bright shining
Speaker 1: moment to lift you up. I think for most of us,
Speaker 1: smallpox feels ancient, like a thing of I don't know, history,
Speaker 1: like the sixteen hundreds, I mean when when Columbus came over. Like,
Speaker 1: it feels so far removed from where I am in
Speaker 1: terms of thinking about people who are actually infected by it.
Speaker 1: But did you know that in the twentieth century smallpox
Speaker 1: killed over three hundred million people? Oh my god, that's more, yeah,
Speaker 1: than all twentieth century wars combined World War One, World
Speaker 1: War two, Vietnam War, so many wars, and also more
Speaker 1: than the nineteen eighteen flu.
Speaker 2: It's also the population of the United States of America. Yeah, Like,
Speaker 2: there's what three hundred and fifty something, three hundred million
Speaker 2: people that was in the twentieth century alone. Huh, oh
Speaker 2: my god.
Speaker 1: Now thankfully though, it is a thing of the past. Yeah,
Speaker 1: smallpox death toll in the twenty first century zero so far,
Speaker 1: But I'm getting ahead of myself. In nineteen sixty six,
Speaker 1: the World Health organization the WHO proposed a plan to
Speaker 1: eradicate smallpox and put D. A. Henderson in charge of
Speaker 1: carrying it out. Over the next twelve years, thousands of
Speaker 1: people traveled to some of the world's most remote corners,
Speaker 1: living in extremely challenging conditions and working in conflict ridden
Speaker 1: countries to administer smallpox vaccine in an attempt to eliminate
Speaker 1: it completely. And it worked. The last natural case of
Speaker 1: smallpox infection occurred in Somalia on October thirty first, nineteen
Speaker 1: seventy seven, over forty years ago this month. This wow, well, next.
Speaker 2: Time, not anymore.
Speaker 1: Yeah, And it happened in a twenty three year old
Speaker 1: cook named ali Mao Mahlen who had actually once worked
Speaker 1: as a smallpox vaccinator despite never having been vaccinated himself.
Speaker 2: Wait, so he worked administering the smallpox vaccine to people
Speaker 2: never vaccinated, and then was the last natural.
Speaker 1: Case of That's isn't that funny?
Speaker 2: That is really funny, I did not know that.
Speaker 1: Yeah. Once news of his infection reached the WHO, a
Speaker 1: team was sent to vaccinate the around ninety people who
Speaker 1: had come into contact with him.
Speaker 2: Isn't that crazy?
Speaker 1: Ninety people that he came.
Speaker 2: In contact with before they were able to be like,
Speaker 2: oh man, we need to stop isolate this person.
Speaker 1: Luckily, he survived the infection and no more cases emerged.
Speaker 1: The world was declared smallpox free on May eighth, nineteen eighty.
Speaker 1: And this guy, actually Ellie, went on to work very
Speaker 1: hard for the Carter Foundation to eliminate polio. Oh wow,
Speaker 1: but he died last year of malaria.
Speaker 2: Oh that's sad.
Speaker 1: Sorry, he was sixty three, he was Oh that's so young.
Speaker 2: Oh God.
Speaker 1: I wish the story of smallpox could end here, But
Speaker 1: I have a sad story to share. Oh remember how
Speaker 1: I said Molin was the last natural case of smallpox.
Speaker 2: Yeah?
Speaker 1: I used that qualifier because there was another case after his.
Speaker 1: What in England? Come On August eleventh, nineteen seventy eight,
Speaker 1: a medical photographer, Janet Parker became ill and started showing
Speaker 1: signs of smallpox.
Speaker 2: It turns out in England.
Speaker 1: In England, what, Yeah, that's ridiculous oh, did just listen
Speaker 1: on It turns out she had used a phone booth
Speaker 1: in a building which shared an air duct with a
Speaker 1: smallpox research lab, and some of the virus must have
Speaker 1: escaped threw the duck into the booth where she inhaled it. Yeah,
Speaker 1: she and her mother both came down with smallpox, and
Speaker 1: possibly her father, but he died of a heart attack
Speaker 1: before symptoms appeared. Oh my god, her mother made it,
Speaker 1: Janet did not. The scientist whose lab it was, doctor
Speaker 1: Henry Bedson, committed suicide. Oh, this whole ordeal.
Speaker 2: Oh my. The person who was the one in the
Speaker 2: building studying smallpox when he heard he felt responsible.
Speaker 1: Oh I'm sorry to end on a side note.
Speaker 2: Yeah, what the heck? He could have stopped it. Eradicated?
Speaker 2: But smallpox is.
Speaker 1: Gone mostly Yeah, at least it remains the only human
Speaker 1: infectious disease to have been eliminated.
Speaker 2: Wow.
Speaker 1: Though I'm hopeful that those words will be wrong within
Speaker 1: a few years when polio and guinea worm are gone.
Speaker 2: Wouldn't that be great?
Speaker 1: Yeah? So aaron smallpox is eradicated. Does that mean we
Speaker 1: don't have to worry about it?
Speaker 2: Oh?
Speaker 1: Hell no? Oh no, no, I'm also really worried about it.
Speaker 2: No, yeah, uh no, lie me too. Basically, we're all forked.
Speaker 1: I read something in one of the books about how
Speaker 1: a Russian scientist defected to the US after he had
Speaker 1: been working in a lab whose goal it was to
Speaker 1: make a more virulent vaccine resistance strain smallpox. Yeah. This
Speaker 1: was in the eighties. Yeah, and this it turns out
Speaker 1: that this lab had not been listed on any register
Speaker 1: as to the remaining places that smallpox was supposed to
Speaker 1: be held. So, in case you don't know, smallpox is
Speaker 1: officially on paper at least exists in two labs, one
Speaker 1: in the US.
Speaker 2: Right, two specific buildings. One the building is called Corpus six.
Speaker 2: It's at Vector, which is a research institution in Russia.
Speaker 2: The other place that it exists on paper is in
Speaker 2: the Maximum Containment Laboratory at the Center for Disease Control
Speaker 2: in Atlanta in the United States. Those are the only
Speaker 2: two places in the world on paper that smallpox virus exists.
Speaker 1: But you're a fool if you believe that that's the
Speaker 1: only that those are the only places it is because
Speaker 1: North Korea, right definitely has smallpox.
Speaker 2: I have a whole list of a bunch of.
Speaker 1: Reantries, not where that worried about France.
Speaker 2: But you know, I'm worried about France. I don't know
Speaker 2: why I'm said, people, I'm just worried about every Let's
Speaker 2: see India, Pakistan, China, Israel, Iraq, North Korea, Iran, possibly China,
Speaker 2: possibly Taiwan, possibly France. Yeah, dude, that's a whole lot
Speaker 2: of countries.
Speaker 1: I mean, who's gonna go, Oh, yeah, here's all the smallpox,
Speaker 1: right wink.
Speaker 2: So everyone the World Health Organization, back when they were
Speaker 2: sort of trailblazing on this eradication effort, they were getting
Speaker 2: really close to eradicating the disease, they started sort of
Speaker 2: strongly suggesting that everyone who was doing research on smallpox
Speaker 2: either destroy their stores of the vaccine or send them
Speaker 2: to the US and Russia.
Speaker 1: There was a date around nineteen ninety five when everyone
Speaker 1: was supposed to have just either actually, okay, sorry, So
Speaker 1: prior to nineteen ninety five, all all these countries were
Speaker 1: supposed to have sent their samples to Russia or the
Speaker 1: US exactly, and then in nineteen ninety five there were
Speaker 1: Russia and the US were supposed to destroy samples.
Speaker 2: And so basically what has happened is every few years
Speaker 2: since then there is a convention and people decide should
Speaker 2: we destroy everything or should we wait a few years
Speaker 2: for research purposes? And that has literally been what has
Speaker 2: happened every few years until this day. Those stores still exist,
Speaker 2: people maybe are still doing research. It's really hard to
Speaker 2: find any information about what type of research might be happening.
Speaker 1: Well, they certainly were following nine to eleven. Yeah, well,
Speaker 1: but actually during yeah, for and during so but since
Speaker 1: since nine to eleven, since the anthrax scare, smallpox has
Speaker 1: been considered to be one of the more viable threats
Speaker 1: for in terms of bioterrorism. Yep, because it is so fatal,
Speaker 1: it is so infectious, or at least infectious enough, and
Speaker 1: it can be dispersed very easily. Right, it's airborne, airborne,
Speaker 1: it's airborne, and so it's it's a really interesting ethical issue.
Speaker 1: It is because because there's no more smallpox in the world, right,
Speaker 1: do we continue how do we justify the continued research funds,
Speaker 1: research animals?
Speaker 2: Yeah, And at this point, really the only reason that
Speaker 2: it is quote unquote justified to keep these stores of
Speaker 2: smallpox virus is because of the threat of bioterrorism, and
Speaker 2: so we need to be able to develop vaccines, we
Speaker 2: need to be able to do research. But then that
Speaker 2: is only because we think that there are other people
Speaker 2: out there doing research to potentially make this a weapon.
Speaker 1: And well so, but there are like that has been verifle.
Speaker 2: Well yeah, but that's the thing is I mean, it's
Speaker 2: it's not like it's just one person or one entity
Speaker 2: that's doing that and then everyone else is just trying
Speaker 2: to defend against it, right, It's it's likely everyone who
Speaker 2: is doing research on how to weaponize it. I mean,
Speaker 2: we uh, this is just us talking, but I mean
Speaker 2: this is also logic.
Speaker 1: I think it's I think it's a very real fear
Speaker 1: that this could be weaponized because there was research done
Speaker 1: on mousepox to have and so a group of researchers
Speaker 1: in Australia manipulated the mousepox virus to defeat the vaccine
Speaker 1: so that vaccinated mice died or were susceptible to mousepox virus.
Speaker 1: And that is very easy. That could be very easily
Speaker 1: done with smallpox as well.
Speaker 2: And the other thing is that the smallpox vaccine is
Speaker 2: extraordinarily imperfect. Imperfect is sort of a nice word to
Speaker 2: use for it. Currently today, about twenty percent of people
Speaker 2: would not be eligible to be vaccinated for the smallpox vaccine.
Speaker 1: Right, So before you go jumping to your doctor and
Speaker 1: trying to get a hold of smallpox vaccine, first of all,
Speaker 1: it's not gonna happen.
Speaker 2: They're never.
Speaker 1: Second of all, you may not be eligible.
Speaker 2: So anyone with exzema or who lives in a householder
Speaker 2: who has family members with egzma is not eligible to
Speaker 2: get the vaccine. Pregnant or if you live in a
Speaker 2: house with babies, you cannot give it. What else, if
Speaker 2: you're a moutocompromised, Yeah, if you have any sort of
Speaker 2: autoimmune disease, or are on chemotherapy, or have HIV, or honestly,
Speaker 2: if you probably live in a household with an immunal
Speaker 2: compromise person. Because the thing is that the current vaccination
Speaker 2: for smallpox is another virus. It is not a modified,
Speaker 2: killed form of the smallpox virus. It is a live, active,
Speaker 2: different virus that they inject you with under your skin
Speaker 2: that actually causes a viral infection. It's just very localized
Speaker 2: to one pak essentially.
Speaker 1: Right. So you've probably seen the scars.
Speaker 2: Yes, and that I used to actually think that that
Speaker 2: scar was because the way that they injected the vaccine
Speaker 2: was like a big idea too, That's what I thought.
Speaker 1: So there are things that are vaccine guns they use,
Speaker 1: So did you.
Speaker 2: See that, Well, but that's what I used to think
Speaker 2: that the scar is from.
Speaker 1: Well, but it's it's because it's because that's the way
Speaker 1: the pope.
Speaker 2: There was an actual poc there.
Speaker 1: And actually this reminds me one of the things that
Speaker 1: makes smallpox such a good candidate for eradication. There are
Speaker 1: multiple reasons. One, you can easily tell who has been
Speaker 1: vaccinated or not judging from the smallpox scar that they
Speaker 1: have or the vaccination scar. The second is that the
Speaker 1: vaccine itself, when freeze dried, has really long or has
Speaker 1: really high longevity, and it's really stable, and so you
Speaker 1: can transport it to these tropic countries where there tend
Speaker 1: to be a lot of more cases of smallpox. And
Speaker 1: the third is that there is no known animal host reservoir.
Speaker 1: You reservoir, and so even so, for instance, if you
Speaker 1: eliminated it entirely from here humans, if it still could
Speaker 1: infect animals or was or animals were a reservoir for it, right,
Speaker 1: it means that you could still potentially humans could still
Speaker 1: potentially be exposed. Right.
Speaker 2: That's why there are so many diseases that, as much
Speaker 2: as we would like to eliminate them, it's nearly impossible
Speaker 2: because there are animal reservoirs for so many diseases. The
Speaker 2: other thing about the smallpox vaccine, besides the fact that
Speaker 2: about twenty percent of the population could not be vaccinated
Speaker 2: in case of an outbreak, is that, though there are
Speaker 2: probably swaths of the population that were vaccinated either as
Speaker 2: children or I double checked with my brother in law,
Speaker 2: some active duty military people also get vaccinated, depending on
Speaker 2: where they I don't know if it's what branch of
Speaker 2: the military they're in, or if it's where they're going
Speaker 2: to be sent to, but they are also given the vaccine.
Speaker 2: But immunity tends to only last about four to five years,
Speaker 2: so if you were vaccinated a few years ago or
Speaker 2: when you were a child, you're no longer immune essentially,
Speaker 2: So if there were any sort of outbreak that happened today, sorry,
Speaker 2: yeah it is you no good.
Speaker 1: I mean, it could be the case that you have
Speaker 1: a lesser infection, like a lesser.
Speaker 2: Possible you might end up with this sort of mixed
Speaker 2: form or whatever. Is that what it's called modified modified.
Speaker 2: You might end up with the modified form, but still
Speaker 2: pretty gnarly.
Speaker 1: I think our point is, how scared should you be
Speaker 1: of smallpox? Pretty scared?
Speaker 2: Really really forkin scared. Seriously, I didn't even.
Speaker 1: I mean, I mean, I think I think it's smallpox,
Speaker 1: despite having been completely eradicated, is so important and so
Speaker 1: relevant for today for a number of reasons, one of
Speaker 1: which is bioterrorism right, the other which is the vaccine scare,
Speaker 1: which I don't want to get into the whole nitty
Speaker 1: gritty on oh, vaccines are bad for you.
Speaker 2: We're gonna get too angry at this time of night.
Speaker 2: I think, if yeah, yeah, get into that.
Speaker 1: But I think it is really fascinating to see these
Speaker 1: parallels between yeah, vaccination when it was first introduced and nowadays,
Speaker 1: and the pushback against that and the reasons why. And
Speaker 1: I think that the absence of diseases, such a visible
Speaker 1: diseases such a smallpox, ye, really lead people to forget
Speaker 1: how important vaccination actually is.
Speaker 2: That's the thing is it's really easy when you're so
Speaker 2: far removed. The thing that I think is so crazy
Speaker 2: is that not a single physician in the world who
Speaker 2: has been trained since the late nineteen seventies, has ever
Speaker 2: seen a case of smallpox ever? And hopefully they never
Speaker 2: ever ever.
Speaker 1: Will hopefully, But oh, I think it's incredible.
Speaker 2: It is absolutely incredible because the thing is, like I mean,
Speaker 2: I'm in medical school right now, we have never talked
Speaker 2: about smallpox. Besides to say that this is a disease
Speaker 2: that has been eradicated, we never talked about the symptoms
Speaker 2: in depth.
Speaker 1: Don't worry, it's eradicated. The gotcha, right?
Speaker 2: And so to think that if there were to be
Speaker 2: even if you don't think about it from a sort
Speaker 2: of large scale bio terrorism aspect, if you just think
Speaker 2: of what if a few particles somehow got out.
Speaker 1: In a lab accident, such as happened to Janet Parker exactly.
Speaker 2: And so I mean, if something like that were to happen,
Speaker 2: could we even diagnose it in order to contain it?
Speaker 1: Oh?
Speaker 2: Isn't that scary? I thought of that while doing all
Speaker 2: this research.
Speaker 1: Is there a movie that is smallpox?
Speaker 2: Not that I know of.
Speaker 1: There should be screenwriters, get on this.
Speaker 2: Yeah, are you hearing this? Guys? This is a great
Speaker 2: This is scarier than the movie Contagion, Oh way scarier. Yeah,
Speaker 2: So if we were at one point, we talked about
Speaker 2: doing a sort of threat level on all of these episodes,
Speaker 2: like terror threat level orange or whatever.
Speaker 1: This threat level. Wear a diaper because you're about to
Speaker 1: pee your parts. Yeah we have no scale.
Speaker 2: No scale. Yeah we don't have a scale.
Speaker 1: But in reality, yeah, be really scared. Smallpox is awful.
Speaker 2: It's really terrifying.
Speaker 1: But wait, we've been using the wrong verb tense. Smallpox
Speaker 1: was awful.
Speaker 2: It was thank goodness, thank goodness, thank you World Health Organization.
Speaker 1: It's actually amazing what they accomplished.
Speaker 2: It really is. We should let people know if they'd
Speaker 2: like to read more, because some of these books are
Speaker 2: really amazing. Got a list, I've got a hit me
Speaker 2: with them.
Speaker 1: If you want to know more about inoculation and the
Speaker 1: development of inoculation as a practice in England and the US,
Speaker 1: you should read The Speckled Monster by Jennifer Lee Carroll.
Speaker 1: If you are interested in the nitty gritty of the
Speaker 1: epidemic that happened in North America from seventeen seventy seven
Speaker 1: to seventeen eighty five, you should check out Pox Americana
Speaker 1: by Elizabeth Fenn. Smallpox The Death of a Disease by D. A. Henderson,
Speaker 1: is a book penned by the leader of the eradication
Speaker 1: effort himself, and it is an amazing book. It is
Speaker 1: really great.
Speaker 2: Also, don't you have a signed copy of that?
Speaker 1: I do, I know, I got it all got it
Speaker 1: like a books Amazon, and it's sign so thrilled.
Speaker 2: By literally the person who was the reason that we
Speaker 2: were able to eradicate this disease, Da Henderson props.
Speaker 1: The other book that I think you should read is
Speaker 1: called The Demon in the Freezer and it's by Richard Preston.
Speaker 1: It reads like a movie script. It is really exciting.
Speaker 1: It's more about the eradication effort of smallpox and then
Speaker 1: anthrax in terms of bioterrorism. It's a little dated, but
Speaker 1: it's really still really good. The Power of Plagues by
Speaker 1: Irwin Sherman. It's a compilation book with chapters on different
Speaker 1: diseases or on different topics in terms of plagues and
Speaker 1: epidemics throughout history, and all of those are great. We
Speaker 1: recommend them, so if you're interested read more. Yeah, check
Speaker 1: it out, check it out, fact check us.
Speaker 2: That'd be fun. If we're wrong, let us know, man.
Speaker 1: Yeah, we would love to hear yeah, because we're just
Speaker 1: doing this for fun.
Speaker 2: Yeah, it's very fun, it is.
Speaker 1: And so what's happening next week? Speaking of more fun, I.
Speaker 2: Don't know what is happening next week. Colra Coolera, Yeah,
Speaker 2: oh man, that's gonna be fun.
Speaker 1: Colra is gonna be good. Get ready for some good
Speaker 1: John snow Puns, The.
Speaker 2: King of the North. That was my first attempt.
Speaker 1: The King of Coolera.
Speaker 2: We'll work on it.
Speaker 1: Yeah, we've got a long way to go.
Speaker 2: Please please, please, please please rate and review us on
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Speaker 2: So if you like us, then you think other people
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Speaker 1: if you want to see some really cool pictures of disease,
Speaker 1: or see some cool facts, or get our recipe for
Speaker 1: whatever quarantine or we're.
Speaker 2: Drinking yep, we post that every week this podcast will
Speaker 2: kill you. Our Twitter is our acronym. I can't spell it.
Speaker 1: PWK. Why that's it? All right?
Speaker 2: I think that's it.
Speaker 1: Yeah, all right, everyone wash your hands.
Speaker 2: Yeah. Fealthy animals