The Impact Of Infectious Disease In The

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1. The Impact Of Infectious Disease In The New World Essay, Research Paper

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The Impact Of Infectious Disease In The New World Essay, Research Paper

“It is often said that in the centuries after Columbus landed in the New World on 12 October, 1492, more native North Americans died each year from infectious diseases brought by the European settlers than were born.” (6) The decimation of people indigenous to the Americas by diseases introduced by European invaders is unprecedented. While it is difficult to accurately determine the population of the pre-Columbian Americas, scholars estimate the number to have been between 40 and 50 million people. The population in Mexico alone in 1519 is believed to have been approximately 30 million. By 1568, that number was down to 3 million inhabitants. Although there were other causes for the population reduction such as “alcoholism, warfare, genocide, cultural disruption, and declines in fertility”, it is now known that disease played a central role in the depopulation of the Americas. But how is it that these native peoples harbored virtually no immunity to the European diseases? What were these diseases and how did they come to be so feared? Who introduced them to this New World? How did this biological disaster affect the social structure of the Indians? This brief will attempt to answer the preceding questions.

How is the presence or absence of disease in the New World determined? Archeologists are able to determine if a society or individual fell prey to disease by examining teeth, bones, coprolites(feces), and artistic depictions. Through the excavations of burial mounds, scientists have discovered that certain afflictions existed even before the white man landed. “Missing limbs, skin diseases, blindness, cleft palate, clubfoot, “dental disease, parasites, arthritis, and tuberculosis are all thought to have existed in pre-Columbian America. However, tracing epidemiology in the 15th century is difficult because so little was done to identify and classify diseases and their symptoms during this time period.

One might say that the New World was “ripe” for the onslaught of hitherto unknown diseases due to several demographic shifts prior to 1492. These are parallel to shifts that occurred in Europe such as the creation of large urban areas. Since city planning wasn’t what it is today, cities were overcrowded, sewers were nonexistent or inefficient, and disease carrying vermin multiplied. This created a welcome mat for infectious disease in addition to the general uncleanliness of the population and the great number of transient people such as soldiers, students, thieves and the mentally ill.

Another factor leading to the assault of disease on medieval Europe was the domestication of large mammals. These animals were the origins of some of the most cursed afflictions of the time. Smallpox is a derivative of cowpox, measles of canine distemper, and influenza of hog diseases. “At first, neither young or old were spared. After generations, susceptible individuals were eliminated and resistant survivors dominated the gene pool. Diseases went from epidemics to childhood ills.” (6) It was in this form that diseases were carried to the New World by unsuspecting conquistadors, to a population that had experienced its’ own shifts to largely urban and sedentary lifestyles that become fertile ground for such an unseemly weapon of destruction.

“Smallpox made its American debut in 1519, when it struck the Caribbean island of Santo Domingo, killing up to half of the indigenous population. From there outbreaks spread across the Antilles islands, onto the Mexican mainland, through the Isthmus of Panama and into South America.” (2) Some of the other diseases that followed this path were measles, plagues(bubonic and pulmonary), gonorrhea(from soldiers raping native women), mumps, typhoid, and cholera. Two African diseases, malaria and yellow fever, also came to Central American probably because of the ideal weather conditions in this region.

Prior to 1492, the Americas harbored relatively few infectious diseases. It is believed that the New World lived in virtual biological isolation from the rest of the planet due to the absence of domesticated animals and because of the path in which the Indians predecessors traveled. We know from origins of disease in Europe, that domesticated animals were to blame for the start of many epidemics. The New World lacked domesticated animals due to the extinction of large mammals, with which to draw from in the last ice age. Also, the remaining large mammals were not suitable for domestication for one reason or another. At the time of migration across the North American land bridge, cattle and sheep were still not utilized by society and therefore were not a cause for the spread of disease.

It is also believed that the path of migration across Beringia created a type of “germ filter” thanks to the harsh Arctic climate that killed off any bacteria or disease carriers such as worms or mosquitoes. In addition, the remoteness of clusters of migrants created a natural quarantine. By the time one group fell prey to an infectious disease they were unable to travel the great distances to infect other groups thereby extinguishing the disease. “While the New World had its native infections, including Chagas and Carrion’s diseases, trichinosis, tapeworm, and perhaps syphilis, few were deadly, and none (with the possible exception of syphilis), seriously threatened whole communities of European colonists.”(6)

The impact that this biological isolation had on the conquest of the Americas is obvious. Along with the weapons and horses that the Europeans brought to conquer the New World came disease. This was by far the most horrific instrument of destruction. After returning to Tenochtitlan from defeated a Spanish mission sent to est him and bringing with him only 1250 Spaniards and 8000 allied Tlaxcallan warriors, Cortes attacked the Aztecs which had pinned down the itinerant lieutenant left to govern them. His forces outnumbered and overcome by the Aztecs, he retreated and hours later Tenochtitlan was being ravaged by the previously unknown smallpox. It is believed that one of the soldiers picked up on the way back to Tenochtitlan by Cortes was suffering from smallpox. This disease wiped out Aztec leaders and warriors and subsequently cleared the path for Cortes to retake the city of 1.5 million. This victory was clearly not attributable to advanced weaponry, horses, or military genius but rather disease. Upon returning to the city, Cortes chronicler Bernal Diaz wrote, “‘I solemnly swear that all the houses and stockades in the lake were full of heads and corpses. It was the same in the streets and courts…We could not walk without treading on the bodies and heads of dead Indians. Indeed, the stench was so bad that no one could endure it…and even Cortes was ill from the odors which assailed his nostrils.’” (2) Indeed it is from these first hand accounts, not skeletal remains, which provide us with the most evidence of destruction caused by disease. These authors include Las Casas, Father Acuna, and Diaz del Castillo.

Before long the smallpox epidemic spread all over Central and South America. Infected natives, yet to develop symptoms, would flee their villages and travel to other villages carrying the disease with them. “…that any Indian who received news of the Spaniards could also have easily received the infection.” (2) The reason that smallpox traveled so fast is because it could live in a dormant state on blankets and clothing or be transmitted by human breath. The incubation period was a long 10-14 days and because of this unsuspecting traders carried the virus all over the New World. “In general, the epidemics moved from east to west, loosely following the extent of European-American Indian contact:” (4) This was compounded by the high population densities of large Inca and Aztec cities and a more sedentary lifestyle for the Indians.

By the time Pizarro and his conquistadors reached Peru in the 1520’s, the Incas had already suffered from the ravages of smallpox. The epidemic left their leader dead with no clear successors which caused political unrest and the civilization was split into two easily defeated armies. One Spanish contemporary wrote at the time,”Had the land not been divided, we would not have been able to enter or win.”(1) Clearly, the reason the Europeans were so successful in their campaign against the native populations despite being outnumbered was because of disease. Not only did disease result in military defeat but also enabled the Europeans to usurp property left behind by dead Indians and consequently fill the empty space with their own colonists.

The spread of disease in the New World contributed to the decay of the culture there. Indians became too weak to harvest food or care for their young. It is believed that the Indians became depressed by the upheaval caused by recent events and became complacent and suicidal. There was a large scale abandonment of traditions such as marriage customs, which became difficult to observe because of the scarcity of marriage partners. Survivors of dying tribes banded together and formed new tribes. And the most lasting effect was the undermining of the Indian religions that caused the large-scale conversions for which the Spanish missionaries had hoped. “The defeats suffered by indigenous peoples always had a religious dimension-the traditional gods seemed to have lost their power to save their worshipers’ lives. The argument that these abandoned then accepted whatever awaited them at the hands of their conquerors is however, the subject of continuing debate.” (3) The Indians were devastated. Their devastation was evident by the writings of the time. “Great was the stench of death. After our fathers and grandfathers succumbed, half the people fled to the fields. The dogs and vultures devoured the bodies. The mortality was terrible. Your grandfathers died, and with them died the son of the king and his brothers and kinsmen. So it was that we became orphans, oh, my sons! So we became when we were young. All of us were thus. We were born to die!(1)

One disease that may have originated in the New World is syphilis. Syphilis is named after a character in a poem written by Giraolamo Fracastoro in 1530 about a Greek shepherd Syphilis, who offended the goddess Venus and was punished. The term venereal disease comes from the name Venus. There are three theories concerning the origin of syphilis: 1. Syphilis originated completely in the New World and was transmitted by Columbus’ men to the Old World in 1493.

2. That syphilis was documented in Europe only after the discovery of the New World and that it already existed in the Americas is a complete coincidence.

3. Syphilis existed in Europe prior to 1492 but was not the venereal strain but rather a milder strain. Most information about the origin of syphilis supports the first theory, that syphilis was a New World disease and was transmitted sexually to the invading Spanish by Indian women. For example, most knowledge about syphilis after 1492 was mostly contained to the Spanish ports of Seville and Lisbon which were gateways to and from the New World. This would implicate that sailors coming from the Americas were treated here. There was consequently a leadership of Spanish and Portuguese physicians in the area of knowledge and therapy for syphilis. Also, there was no concrete name for syphilis in Europe before 1493. Symptoms that are similar to this form of venereal disease were widely referred to as leprosy, which was used to identify any disfiguring disease.

In addition, there were no writings about syphilis. On the contrary hundreds of Indian tribes had names for syphilis and evidence of it’s pre-Columbian existence is found in skeletal remains.

In addition, several historical accounts support the New World origin theory. Gonzalo Fernandez de Oviedo and Bartolome de Las Casas claimed syphilis was in the New World for a long time before discovery and that few were spared from this cursed disease. Dr. Ruy Diaz de Isla claims he treated Columbus’ crew members upon returning from Hispaniola and that this disease was not known in Europe before then. Dr. Diaz de Isla should have known. He was the leading authority on syphilis in Europe, being a syphilis specialist in Lisbon from 1495-1521. He wrote, “‘there is not a village in all Europe with a hundred inhabitants in which ten persons have not died(of syphilis) and a third of the people have not been infected.’” (3) Venereal syphilis didn’t discriminate between its’ victims. Royalty, as well as children, and grandchildren were affected because of transmission from mother to child. It’s victims were crippled, disfigured, if not killed by it. “Next to tobacco, it was the most harmful gift of the New World to the Old.”(3)

The New World origin detractors claim that although this theory was circulated in 1539 there are some questions with this logic. The 1539 theory was that syphilis entered Mediterranean ports from ships returning from the Americas. From here it spread to Naples and was picked up by invading French forces under the command of Charles VIII in 1494. However, there were no reports of infection during Columbus’ first return voyage in 1493 but by the return of the second voyage in 1496, syphilis was already spreading through Europe. By 1498, syphilis had arrived in India with Vasco de Gama and in 1505 arrived in China and Japan.

However devastating syphilis was to Europe it cannot be compared to the effect that infectious diseases had on the New World. “Biologically, this was the most spectacular thing that has ever happened to humans.” (2) Infectious disease brought over by the Europeans decimated the indigenous populations and enabled the conquering of civilizations that greatly outnumbered the arriving forces. Nor was the impact of smallpox and other diseases short -lived. “After 1492, it would take nearly 500 years of exposure to repeated epidemics and the advent of modern medicine, before their populations would begin to rebound.(6) Epidemic Timetable 1518 – Smallpox hits Espaniola. 1520 – Mexico with Cortes 1525, 26 – Peru, Pizarro conquers Cuzco 1530,31 – Measles hits Mexico and Peru 1546 – Typhus arrives 1556-60 – Influenza hits Europe and Japan 1558,59 – Influenza hits the New World 16th and 17th c. – Diphtheria, mumps, smallpox(again), and Influenza(again)

1. McNeill, William. Plagues and Peoples. 2 .Cowley, Geoffrey. The Great Disease Migration. Newsweek, Fall-Winter 1991 vol. 118, pg.54 . 3. Lunenfeld, Marvin. 1492 Discovery, Invasion, Encounter. Lexington, Mass. and Toronto, D.C. Heath and Company, 1991. 4. Bedini, Silvio A., Editor. The Christopher Columbus Encyclopedia. Vol 1. New York, NY, Simon and Schuster, 1992 5. Sale, Kirkpatrick. The Conquest of Paradise, Christopher Columbus and the Columbian Legacy. New York, NY, Penguin Group, 1990 6. Meltzer, David J. How Columbus Sickened the New World. New Scientist, Oct. 10, 1992 v. 136 pg. 38

The history of smallpox extends into pre-history, with the disease probably emerging in human populations about 10,000 BC. The earliest credible evidence of smallpox is found in the Egyptian mummies of people who died some 3,000 years ago. Smallpox has had a major impact on world history, not least because indigenous populations of regions where smallpox was non-native, such as the Americas and Australia, were rapidly and greatly reduced by smallpox (along with other introduced diseases) during periods of initial foreign contact, which helped pave the way for conquest and colonization. During the 18th century the disease killed an estimated 400,000 Europeans each year, including five reigning monarchs, and was responsible for a third of all blindness. Between 20 and 60% of all those infected—and over 80% of infected children—died from the disease.

During the 20th century, it is estimated that smallpox was responsible for 300–500 million deaths. In the early 1950s an estimated 50 million cases of smallpox occurred in the world each year. As recently as 1967, the World Health Organization estimated that 15 million people contracted the disease and that two million died in that year. After successful vaccination campaigns throughout the 19th and 20th centuries, the WHO certified the global eradication of smallpox in December 1979. Smallpox is one of two infectious diseases to have been eradicated, the other being rinderpest, which was declared eradicated in 2011.

It has been suggested that smallpox was a major component of the Plague of Athens that occurred in 430 BCE, during the Peloponnesian Wars, and was described by Thucydides. Galen's description of the Antonine Plague, which swept through the Roman Empire in 165–180 CE, indicates that it was probably caused by smallpox. Returning soldiers brought the disease home with them to Syria and Italy, where it raged for fifteen years and greatly weakened the Roman empire, killing up to one-third of the population in some areas. Total deaths have been estimated at 5 million. A second major outbreak of disease in the Roman Empire, known as the Plague of Cyprian (251–266 CE), was also either smallpox or measles. The Roman empire stopped growing as a consequence on these two plagues, according to historians like Theodore Mommsen. Although some historians believe that many historical epidemics and pandemics were early outbreaks of smallpox, contemporary records are not detailed enough to make a definite diagnosis.

Around 400 CE, an Indian medical book recorded a disease marked by pustules and boils, saying "the pustules are red, yellow, and white and they are accompanied by burning pain … the skin seems studded with grains of rice." The Indian epidemic was thought to be punishment from a god, and the survivors created a goddess, Sitala, as the anthropomorphic personification of the disease. Smallpox was thus regarded as possession by Sitala. In Hinduism the goddess Sitala both causes and cures high fever, rashes, hot flashes and pustules. All of these are symptoms of smallpox.
Most of the details about the epidemics are lost, probably due to the scarcity of surviving written records from the Early Middle Ages. The first incontrovertible description of smallpox in Western Europe occurred in 581 CE, when Bishop Gregory of Tours provided an eyewitness account describing the characteristic symptoms of smallpox. Waves of epidemics wiped out large rural populations. The establishment of the disease in Europe was of special importance, for this served as the endemic reservoir from which smallpox spread to other parts of the world, as an accompaniment of successive waves of European exploration and colonization.
In 710 CE, smallpox was re-introduced into Europe via Iberia by the Umayyad conquest of Hispania.
The Japanese smallpox epidemic of 735–737 is believed to have killed as much as one-third of Japan's population.
The clearest description of smallpox from pre-modern times was given in the 9th century by the Persian physician, Muhammad ibn Zakariya ar-Razi, known in the West as "Rhazes", who was the first to differentiate smallpox from measles and chickenpox in his Kitab fi al-jadari wa-al-hasbah (The Book of Smallpox and Measles).
Smallpox was a leading cause of death in the 18th century. Every seventh child born in Russia died from smallpox. It killed an estimated 400,000 Europeans each year in the 18th century, including five reigning European monarchs. Most people became infected during their lifetimes, and about 30% of people infected with smallpox died from the disease, presenting a severe selection pressure on the resistant survivors.
In northern Japan, Ainu population decreased drastically in the 19th century, due in large part to infectious diseases like smallpox brought by Japanese settlers pouring into Hokkaido.
The Franco-Prussian War triggered a smallpox pandemic of 1870–1875 that claimed 500,000 lives; while vaccination was mandatory in the Prussian army, many French soldiers were not vaccinated. Smallpox outbreaks among French prisoners of war spread to the German civilian population and other parts of Europe. Ultimately, this public health disaster inspired stricter legislation in Germany and England, though not in France.
In 1849 nearly 13% of all Calcutta deaths were due to smallpox. Between 1868 and 1907, there were approximately 4.7 million deaths from smallpox in India. Between 1926 and 1930, there were 979,738 cases of smallpox with a mortality of 42.3%.

Smallpox is exogenous to Africa. One of the oldest records of what may have been an encounter with smallpox in Africa is associated with the elephant war circa AD 568 CE, when after fighting a siege in Mecca, Ethiopian troops contracted the disease which they carried with them back to Africa.

Arab ports in Coastal towns in Africa likely contributed to the importation of smallpox into Africa, as early as the 13th century, though no records exist until the 16th century. Upon invasion of these towns by tribes in the interior of Africa, a severe epidemic affected all African inhabitants while sparing the Portuguese. Densely populated areas of Africa connected to the Mediterranean, Nubia and Ethiopia by caravan route likely were affected by smallpox since the 11th century, though written records do not appear until the introduction of the slave trade in the 16th century.
The enslavement of Africans continued to spread smallpox to the entire continent, with raiders pushing farther inland along caravan routes in search of people to enslave. The effects of smallpox could be seen along caravan routes, and those who were not affected along the routes were still likely to become infected either waiting to be put onboard or on board ships.
Smallpox in Angola was likely introduced shortly after Portuguese settlement of the area in 1484. The 1864 epidemic killed 25,000 inhabitants, one third of the total population in that same area. In 1713, an outbreak occurred in South Africa after a ship from India docked at Cape Town, bringing infected laundry ashore. Many of the settler European population suffered, and whole clans of the Khoisan people were wiped out. A second outbreak occurred in 1755, again affecting both the white population and the Khoisan. The disease spread further, completely eradicating several Khosian clans, all the way to the Kalahari desert. A third outbreak in 1767 similarly affected the Khoisan and Bantu peoples. But the European colonial settlers were not affected nearly to the extent that they were in the first two outbreaks, it has been speculated this is because of variolation. Continued enslavement operations brought smallpox to Cape Town again in 1840, taking the lives of 2500 people, and then to Uganda in the 1840s. It is estimated that up to eighty percent of the Griqua tribe was exterminated by smallpox in 1831, and whole tribes were being wiped out in Kenya up until 1899. Along the Zaire river basin were areas where no one survived the epidemics, leaving the land devoid of human life. In Ethiopia and the Sudan, six epidemics are recorded for the 19th century: 1811–1813, 1838–1839, 1865–1866, 1878–1879, 1885–1887, and 1889–1890.

Documented smallpox epidemics in the New World[31]

Year Location Description

1520–1527 Mexico, Central America, South America Smallpox kills millions of native inhabitants of Mexico. Unintentionally introduced at Veracruz with the arrival of Panfilo de Narvaez on April 23, 1520 and was credited with the victory of Cortes over the Aztec empire at Tenochtitlan (present-day Mexico City) in 1521. Kills the Inca ruler, Huayna Capac, and 200,000 others and weakens the Incan Empire.

1561–1562 Chile No precise numbers on deaths exist in contemporary records but it is estimated that natives lost 20 to 25 percent of their population. According to Alonso de Góngora Marmolejo, so many Indian laborers died that the Spanish gold mines had to shut down.[32]

1588–1591 Central Chile A combined smallpox, measles and typhus plague strikes Central Chile contributing to a decline of indigenous populations.[33]

1617–1619 North America northern east coast Killed 90% of the Massachusetts Bay Indians

1655 Chillán, Central Chile An outbreak of smallpox occurred among refugees from Chillán as the city was evacuated amidst the Mapuche uprising of 1655. Spanish authorities put this group in effective quarantine decreeing death sentences for anyone crossing Maule River north.[34]

1674 Cherokee Tribe Death count unknown. Population in 1674 about 50,000. After 1729, 1738, and 1753 smallpox epidemics their population was only 25,000 when they were forced to Oklahoma on the Trail Of Tears.

1692 Boston, MA

1702–1703 St. Lawrence Valley, NY

1721 Boston, MA A British sailor disembarking the HMS Seahorse brought smallpox to Boston. 5759 people were infected and 844 died.

1736 Pennsylvania

1738 South Carolina

1770s West Coast of North America At least 30% (tens of thousands) of the Northwestern Native Americans die from smallpox[35][36]

1781–1783 Great Lakes

1830s Alaska Reduced Dena'ina Athabaskan population in Cook Inlet region of southcentral Alaska by half.[37] Smallpox also devastated Yup'ik Eskimo populations in western Alaska.

1836–1840 Great Plains 1837 Great Plains smallpox epidemic

1860–1861 Pennsylvania

1862 British Columbia, Washington state & Russian America Known as the Great Smallpox of 1862, an outbreak of smallpox in a large encampment of all indigenous peoples from around the colony on June 10, 1862, dispersed by order of the government to return to their homes, resulted in the deaths of 50-90% of the indigenous peoples in the region[38][39][40][41][42]

1865–1873 Philadelphia, PA, New York, Boston, MA and New Orleans, LA Same period of time, in Washington D.C., Baltimore, MD, Memphis, TN, Cholera and a series of recurring epidemics of Typhus, Scarlet Fever and Yellow Fever

1869 Araucanía, southern Chile A smallpox epidemic breaks out among native Mapuches, just some months after a destructive Chilean military campaign in Araucanía.[43]

1877 Los Angeles, CA

1880 Tacna, Peru Tacna hosted the combined armies of Peru and Bolivia before being defeated by Chile in the Battle of Tacna. Before it fell to Chileans in late May 1880 infectious diseases were widespread in the city with 461 deaths of smallpox in the 1879-1880 period, making up 11.3% of all registered deaths for the city in the same period.[44]

1902 Boston, Massachusetts Of the 1,596 cases reported in this epidemic, 270 died.

After first contacts with Europeans and Africans, some believe that the death of 90–95% of the native population of the New World was caused by Old World diseases.[45] It is suspected that smallpox was the chief culprit and responsible for killing nearly all of the native inhabitants of the Americas. For more than 200 years, this disease affected all new world populations, mostly without intentional European transmission, from contact in the early 16th century until possibly as late as the French and Indian Wars (1754–1767).[46]

In 1519 Hernán Cortés landed on the shores of what is now Mexico and what was then the Aztec Empire. In 1520 another group of Spanish arrived in Mexico from Hispaniola, bringing with them the smallpox which had already been ravaging that island for two years. When Cortés heard about the other group, he went and defeated them. In this contact, one of Cortés's men contracted the disease. When Cortés returned to Tenochtitlan, he brought the disease with him.
Soon, the Aztecs rose up in rebellion against Cortés and his men. Outnumbered, the Spanish were forced to flee. In the fighting, the Spanish soldier carrying smallpox died. Cortés would not return to the capital until August 1521. In the meantime smallpox devastated the Aztec population. It killed most of the Aztec army and 25% of the overall population.[47] The Spanish Franciscan Motolinia left this description: "As the Indians did not know the remedy of the disease…they died in heaps, like bedbugs. In many places it happened that everyone in a house died and, as it was impossible to bury the great number of dead, they pulled down the houses over them so that their homes become their tombs."[48] On Cortés's return, he found the Aztec army’s chain of command in ruins. The soldiers who still lived were weak from the disease. Cortés then easily defeated the Aztecs and entered Tenochtitlán.[49] The Spaniards said that they could not walk through the streets without stepping on the bodies of smallpox victims.[50]
The effects of smallpox on Tahuantinsuyu (or the Inca empire) were even more devastating. Beginning in Colombia, smallpox spread rapidly before the Spanish invaders first arrived in the empire. The spread was probably aided by the efficient Inca road system. Within months, the disease had killed the Incan Emperor Huayna Capac, his successor, and most of the other leaders. Two of his surviving sons warred for power and, after a bloody and costly war, Atahualpa become the new emperor. As Atahualpa was returning to the capital Cuzco, Francisco Pizarro arrived and through a series of deceits captured the young leader and his best general. Within a few years smallpox claimed between 60% and 90% of the Inca population,[51] with other waves of European disease weakening them further. A handful of historians argue that a disease called Bartonellosis might have been responsible for some outbreaks of illness, but this opinion is in the scholarly minority. The effects of Bartonellosis were depicted in the ceramics of the Moche people of ancient Peru.
Even after the two largest empires of the Americas were defeated by the virus and disease, smallpox continued its march of death. In 1561, smallpox reached Chile by sea, when a ship carrying the new governor Francisco de Villagra landed at La Serena. Chile had previously been isolated by the Atacama Desert and Andes Mountains from Peru, but at the end of 1561 and in early 1562, it ravaged the Chilean native population. Chronicles and records of the time left no accurate data on mortality but more recent estimates are that the natives lost 20 to 25 percent of their population. The Spanish historian Marmolejo said that gold mines had to shut down when all their Indian labor died.[54] Mapuche fighting Spain in Araucanía regarded the epidemic as a magical attempt by Francisco de Villagra to exterminate them because he could not defeat them in the Arauco War.
In 1633 in Plymouth, Massachusetts, the Native Americans were struck by the virus. As it had done elsewhere, the virus wiped out entire population groups of Native Americans. It reached Mohawks in 1634,[55] the Lake Ontario area in 1636, and the lands of the Iroquois by 1679.
A particularly virulent sequence of smallpox outbreaks took place in Boston, Massachusetts. From 1636 to 1698, Boston endured six epidemics. In 1721, the most severe epidemic occurred. The entire population fled the city, bringing the virus to the rest of the Thirteen Colonies.
During the siege of Fort Pitt, as recorded in his journal by sundries trader and militia Captain, William Trent, on June 24, 1763, dignitaries from the Delaware tribe met with Fort Pitt officials, warned them of "great numbers of Indians" coming to attack the fort, and pleaded with them to leave the fort while there was still time. The commander of the fort refused to abandon the fort. Instead, the British gave as gifts two blankets, one silk handkerchief and one linen from the smallpox hospital, to two Delaware Indian delegates. The dignitaries were met again later and they seemingly hadn't contracted smallpox. A relatively small outbreak of smallpox had begun spreading earlier that spring, with a hundred dying from it among Native American tribes in the Ohio Valley and Great Lakes area through 1763 and 1764. The effectiveness of the biological warfare itself remains unknown, and the method used is inefficient compared to respiratory transmission and these attempts to spread the disease are difficult to differentiate from epidemics occurring from previous contacts with colonists,[63] as smallpox outbreaks happened every dozen or so years.
In the late 1770s, during the American Revolutionary War, smallpox returned once more and killed thousands. Peter Kalm in his Travels in North America, described how in that period, the dying Indian villages became overrun with wolves feasting on the corpses and weakened survivors. During the 1770s, smallpox killed at least 30% of the Northwestern Native Americans, killing tens of thousands. The smallpox epidemic of 1780–1782 brought devastation and drastic depopulation among the Plains Indians.[69] This epidemic is a classic instance of European immunity and non-European vulnerability. It is probable that the Indians contracted the disease from the ‘Snake Indians’ on the Mississippi. From there it spread eastward and northward to the Saskatchewan River. According to David Thompson’s account, the first to hear of the disease were fur traders from the Hudson’s House on October 15, 1781.A week later, reports were made to William Walker and William Tomison, who were in charge of the Hudson and Cumberland Hudson’s Bay Company posts. By February, the disease spread as far as the Basquia Tribe. Smallpox attacked whole tribes and left few survivors. E. E. Rich described the epidemic by saying that “Families lay unburied in their tents while the few survivors fled, to spread the disease.”After reading Tomison’s journals, Houston and Houston calculated that, of the Indians who traded at the Hudson and Cumberland houses, 95% died of smallpox.[69] Paul Hackett adds to the mortality numbers suggesting that perhaps up to one half to three quarters of the Ojibway situated west of the Grand Portage died from the disease. The Cree also suffered a casualty rate of approximately 75% with similar effects found in the Lowland Cree.[72] By 1785 the Sioux Indians of the great plains had also been affected.[30] Not only did smallpox devastate the Indian population, it did so in an unforgiving way. William Walker described the epidemic stating that “the Indians [are] all Dying by this Distemper … lying Dead about the Barren Ground like a rotten sheep, their Tents left standing & the Wild beast Devouring them.”
In 1799, the physician Valentine Seaman administered the first smallpox vaccine in the United States. He gave his children a smallpox vaccination using a serum acquired from Edward Jenner, the British physician who invented the vaccine from fluid taken from cowpox lesions. Though vaccines were misunderstood and mistrusted at the time, Seaman advocated their use and, in 1802, coordinated a free vaccination program for the poor in New York City.
By 1832, the federal government of the United States established a smallpox vaccination program for Native Americans.
In 1900 starting in New York City, smallpox reared its head once again and started a sociopolitical battle with lines drawn between the rich and poor, white and black. In populations of railroad and migrant workers who traveled from city to city the disease had reached an endemic low boil. This fact did not bother the government at the time, nor did it spur them to action. Despite the general acceptance of the germ theory of disease, pioneered by John Snow in 1849, smallpox was still thought to be mostly a malady that followed the less-distinct guidelines of a "filth" disease, and therefore would only affect the "lower classes".
The last major smallpox epidemic in the United States occurred in Boston, Massachusetts throughout a three-year period, between 1901 and 1903. During this three-year period, 1596 cases of the disease occurred throughout the city. Of those cases, nearly 300 people died. As a whole, the epidemic had a 17% fatality rate.
Those who were infected with the disease were detained in quarantine facilities in the hopes of protecting others from getting sick. These quarantine facilities, or pesthouses, were mostly located on Southampton Street. As the outbreak worsened, men were also moved to hospitals on Gallop’s Island. Women and children were primarily sent to Southampton Street. Smallpox patients were not allowed in regular hospital facilities throughout the city, for fear the sickness would spread among the already sick.
A reflection of the previous outbreak that occurred in New York, the poor and homeless were blamed for the sickness's spread. In response to this belief, the city instructed teams of physicians to vaccinate anyone living in inexpensive housing.
In an effort to control the outbreak, the Boston Board of Health began voluntary vaccination programs. Individuals could receive free vaccines at their work places or at different stations set up throughout the city. By the end 1901, some 40,000 of the city’s residents had received a smallpox vaccine. However, despite the city's efforts, the epidemic continued to grow. In January 1902, a door-to-door vaccination program was initiated. Health officials were instructed to compel individuals to receive vaccination, pay a $5 fine, or be faced with 15 days in prison. This door-to-door program was met by some resistance as some individuals feared the vaccines to be unsafe and ineffective. Others felt compulsory vaccination in itself was a problem that violated an individual's civil liberties.
This program of compulsory vaccination eventually led to the famous Jacobson v. Massachusetts case. The case was the result of a Cambridge resident's refusal to be vaccinated. Henning Jacobsen, a Swedish immigrant, refused vaccination out of fear it would cause him illness. He claimed a previous smallpox vaccine had made him sick as a child. Rather than pay the five dollar fine, he challenged the state's authority on forcing people to receive vaccination. His case was lost at the state level, but Jacobson appealed the ruling, and so, the case was taken up by the Supreme Court. In 1905 the Supreme Court upheld the Massachusetts law: it was ruled Jacobson could not refuse the mandatory vaccination.
In Canada, between 1702 and 1703, nearly a quarter of the population of Quebec city died due to a smallpox epidemic.
Island South East Asia Edit

There is evidence that smallpox reached the Philippine islands from the 4th century onwards – linked possibly to contact between South East Asians and Indian traders.[79]

During the 18th century, there were many major outbreaks of smallpox, driven possibly by increasing contact with European colonists and traders. There were epidemics, for instance, in the Sultanate of Banjar (South Kalimantan), in 1734, 1750–51, 1764–65 and 1778–79; in the Sultanate of Tidore (Moluccas ) during the 1720s, and in southern Sumatra during the 1750s, the 1770s and in 1786.[79][80][81]
Australia Edit

Smallpox was externally brought to Australia. The first recorded outbreak, in 1789, devastated the Aboriginal population; while the extent of this outbreak is disputed, some sources claim that it killed about 50% of coastal Aboriginal populations on the east coast.[82] There is an ongoing historical debate concerning two rival and irreconcilable theories about how the disease first entered the continent. The central hypotheses of these theories suggest that smallpox was transmitted to indigenous Australians by either:

the First Fleet of British settlers to arrive in the Colony of New South Wales, or;

other visitors to Australia, such as Makassan mariners visiting Arnhem Land and the Kimberley.

In 1914, Dr J. H. L. Cumpston, director of the Australian Quarantine Service tentatively put forward the hypothesis that smallpox arrived with British settlers.[83] Cumpston's theory was most forcefully reiterated by the economic historian Noel Butlin, in his book Our Original Aggression (1983).[84] Likewise David Day, in Claiming a Continent: A New History of Australia (2001), suggested that members of Sydney's garrison of Royal Marines may have attempted to use smallpox as a biological weapon in 1789.[85] However, in 2002, historian John Connor stated that Day's theory was "unsustainable".[86] That same year, theories that smallpox was introduced with settlers, deliberately or otherwise, were contested in a full-length book by historian Judy Campbell: Invisible Invaders: Smallpox and Other Diseases in Aboriginal Australia 1780-1880 (2002).[87] Campbell consulted, during the writing of her book, Frank Fenner, who had overseen the final stages of a successful campaign by the World Health Organization (WHO) to eradicate smallpox. Campbell argued that scientific evidence concerning the viability of variolous matter (used for inoculation) did not support the possibility of the disease being brought to Australia on the long voyage from Europe. Campbell also noted that there was no evidence of Aborigines ever having been exposed to the variolous matter, merely speculation that they may have been. Later authors, such as Christopher Warren, and Craig Mear [89] continued to argue that smallpox emanated from the importation of variolous matter on the First Fleet. Warren (2007) suggested that Campbell had erred in assuming that high temperatures would have sterilised the British supply of smallpox.[88] H. A. Willis (2010), in a survey of the literature discussed above, endorsed Campbell's argument.[90] In response, Warren (2011) suggested that Willis had not taken into account research on how heat affects the smallpox virus, cited by the WHO. Willis (2011) replied that his position was supported by a closer reading of Frank Fenner’s report to the WHO (1988) and invited readers to consult that report online.
The rival hypothesis, that the 1789 outbreak was introduced to Australia by visitors from Makassar, came to prominence in 2002, with Judy Campbell's book Invisible Invaders. Campbell expanded upon the opinion of C. C. Macknight (1986), an authority on the interaction between indigenous Australians and Makassans. Citing the scientific opinion of Fenner (who wrote the foreword to her book) and historical documents, Campbell argued that the 1789 outbreak was introduced to Australia by Makassans, from where it spread overland.[87] Nevertheless, Michael Bennett in a 2009 article in Bulletin of the History of Medicine, argued that imported "variolous matter" may have been the source of the 1789 epidemic in Australia. In 2011, Macknight re-entered the debate, declaring: “The overwhelming probability must be that it was introduced, like the later epidemics, by [Makassan] trepangers on the north coast and spread across the continent to arrive in Sydney quite independently of the new settlement there.” Warren (2013) disputed this, on the grounds that: there was no suitable smallpox in Makassar before 1789; there were no trade routes suitable for transmission to Port Jackson; the theory of a Makassan source for smallpox in 1789 was contradicted by Aboriginal oral tradition, and; the earliest point at which there was evidence of smallpox entering Australia with Makassan visitors was around 1824.
A further complication is that epidemiologists have described the behavior of at least the first of these "smallpox" epidemics as far more typical of the closely related but (to Europeans though not to Aborigines) less deadly chickenpox, which was certainly present in the settlement. Thus Professor John Carmody, after pointing out that none of the European colonists were threatened by it, remarked on ABC Radio's Science Show: “If it had really been smallpox, I would have expected about 50 cases amongst the colonists.”
Another major outbreak was observed in 1828–30, near Bathurst, New South Wales. A third epidemic occurred in the Northern Territory and northern Western Australia from the mid-1860s,[90] until at least 1870.
Polynesia Edit

Elsewhere in the Pacific, smallpox killed many indigenous Polynesians. Nevertheless, Alfred Crosby, in his major work, Ecological Imperialism: The Biological Expansion of Europe, 900-1900 (1986) showed that in 1840 a ship with smallpox on it was successfully quarantined, preventing an epidemic amongst Māori of New Zealand. The only major outbreak in New Zealand was a 1913 epidemic, which affected Māori in northern New Zealand and nearly wiped out the Rapa Nui of Easter Island (Rapa Nui), was reported by Te Rangi Hiroa (Dr Peter Buck) to a medical congress in Melbourne in 1914.

Micronesia Edit

The whaler ship Delta brought smallpox to the Micronesian island of Pohnpei on 28 February 1854. The Pohnpeians reacted by first feasting their offended spirits and then resorted hiding. The disease eventually wiped out more than half the island's population. The deaths of chiefs threw Pohnpeian society into disarray, and the people started blaming the God of the Christian missionaries. The Christian missionaries themselves saw the epidemic as God's punishment for the people and offered the natives inoculations, though often withheld such treatment from the priests. The epidemic abated in October 1854.

One viewpoint is that smallpox emerged in AD 1588 and the earlier reported cases were incorrectly identified as smallpox.

Clendening, Logan (1960). "Chapter XXVII. Smallpox". Source Book of Medical History. Dover. pp. 291–305. ISBN 9780486206219; reprint of 1942 book.

Otto, Simon; Cappel, Constance (2007). The smallpox genocide of the Odawa tribe at L'Arbre Croche, 1763: the history of a Native American people. Lewiston, NY: Edwin Mellen Press. ISBN 978-0-7734-5220-6.
"Hugh Walker and North Carolina's 'Smallpox Currency' of 1779", R. Neil Fulghum. The Colonial Newsletter, a research journal of the American Numismatic Society, New York. December 2005, pp. 2895–2934.
Rich, E. E.; Johnson, A. M. (1952). Cumberland House Journals and Inland Journals 1775–82. London: The Hudson’s Bay Record Society.
Sheldon Watts (1997). Epidemics and History: Disease, Power and Imperialism. New Haven: Yale University Press.
Inoculation for the Small-Pox defended—1750 article from Gentleman's Magazine

"Why Blame Smallpox?: The Death of the Inca Huayna Capac and the Demographic Destruction of Tawantinsuyu (Ancient Peru)" Revisionist argument regarding smallpox in 16th-century Peru.

History of Smallpox in South Asia.