In Indian Country, it is an accepted fact that white settlers distributed items, such as blankets contaminated with smallpox and other infectious diseases, aiming to reduce the population of Native people resisting their Manifest Destiny. These accounts have left a legacy of trauma and distrust in Native communities that persist to this day. It comes as quite a surprise to Indigenous people to learn that a controversy exists regarding the veracity of these events. This article aims to answer some of the lingering questions while shedding light on the controversy.
What Made Smallpox So Infamous?
Smallpox is a highly contagious disease caused by the variola virus in the Orthopoxvirus family. It is widely considered one of the deadliest viruses in human history. Smallpox-like rashes on Egyptian mummies suggest that it existed with humans for at least 3,000 years. In the 20th century alone, smallpox is estimated to have killed 300 million people.
Smallpox Symptoms
The first symptoms of smallpox disease are fever, headache and fatigue lasting 2-4 days. After the onset of symptoms, a characteristic rash appears and develops in stages, beginning in the mouth and expanding to cover the whole body. Eventually, the bumps scab over and fall off, leaving very visible scarring. Victims remain contagious until the last scab falls off (~3-4 weeks after onset).
Types of Smallpox
There are 2 recognized forms of smallpox, variola minor and variola major, which carry mortality rates of 1% and 30%, respectively. In addition, there are 4 clinical presentations of the disease: ordinary, modified, flat and hemorrhagic. Historically speaking, ordinary (variola major) and modified-type smallpox were the most frequent infections and had the lowest mortality rates. Modified-type smallpox occurred in previously vaccinated people and produced a less severe rash than ordinary smallpox. For reasons that are not completely understood, children and pregnant people were most likely to be afflicted with the variations. Flat-type (malignant) smallpox occurred more often in children and was nearly always fatal. In this form, the bumps from the rash merged and never filled with fluid. Hemorrhagic smallpox mainly occurred during pregnancy and was almost always fatal. The rash did not harden, but the skin underneath bled, causing it to look burnt. This was accompanied by internal bleeding and organ failure.
Identification of Smallpox
The unique and easily recognizable rash caused by smallpox makes it easy to identify. Approximately 65-80% of survivors are afflicted with lifelong severe pockmark scarring. Other complications include miscarriage, blindness, opportunistic infection, arthritis and encephalitis. These created lifelong physical and psychological suffering for survivors.
Smallpox Eradication
The first ever vaccine was created to prevent smallpox when Edward Jenner noted that milkmaids did not develop the disease after exposure to cows infected with the
