3 1570-1085 1085 BC 5 1157 BC

569 (A.D.) Marium Varius Variola 910 (A.D.) Al-Razi Razi * Pediatr Inf Dis J 1999; 18:85-93

400 (A.D.)

568 Elephant 1507 1520 1524 1555 1713 1738 1776

18

Marcus Aurelius 180 2 1650 1654 2 1730 15 1774 Pediatr Inf Dis J 1999; 18:85-93

Variolation (Variolation)

10 * 15 20 40 50 8 Uvularia grandiflora 2 6 1 * Fenner et al. Smallpox and its Eradication. p252

1798, (Cowpox) Cowpox) Variolae Vaccinae Variolae Vaccinae * Pediatr Inf Dis J 1999; 18:85-93

1796

Sarah Nelmes Sarah Nelmes 16 1796

982 Variolation 10 1650 1667 Inoculation Haygarth 1793

Variolation Variolation 1721 1721-1792 1792 97 97 2.0 2.0 9152 9152 30 30 132 132 1792 1792 95 95 0.9 0.9 4121 4121 33 33 122 122 1778 1778 90 90 0.6 0.6 4988 4988 10 10 304 304 1776 1776 87 87 0.9 0.9 4977 4977 18 18 699 699 1764 1764 28 28 1.4 1.4 2124 2124 10 10 5545 5545 1752 1752 10 10 3.0 3.0 400 400 14 14 3600 3600 1730 1730 5 2.1 2.1 287 287 15 15 5759 5759 1721 1721 Variolation Variolation % CFR CFR Variolation Variolation CFR CFR

1805 1864 Vaccination 1940 Collier * Henderson DA, Moss M, Smallpox and Vaccinia in Vaccines, 3 rd edition, 1999

1945

98%

* Dowdle WR, Hopkins DR, The Eradication of Infectious Diseases, John Wiley & Sons, Chichester 1998. pp47-59

1950 1959 1966 Pan American Sanitary Organization Henderson DA, Moss B, Smallpox and Vaccinia in Vaccines, 3 rd edition, 1999

1967 Henderson DA, Moss B, Smallpox and Vaccinia in Vaccines, 3 rd edition, 1999

1967 Endemic

Henderson DA, Moss B, Smallpox and Vaccinia in Vaccines, 3 rd edition, 1999

(Mass Vaccination)

*4 Modified from Epid Rev 1993;15: 265-302, Am J Prev Med 2001; 20 (4S): 88-153, MMWR 2000; 49 (SS-9); 27-38 R o 6-7 12-18 18 4-7 12-17 17 5-7 6-7 5-7 1999 19-35 35 85%* 83-94% 75-86% 92-94% 94% 80-86% 86% 83-85% 85% 80-85% 85% 83%* 92% 92% 83%* 90% 92% 1997-1998 1998 9% 96% 97% 97% 97% 97%

6 7 N-95

36-47 5 73-88 3 58% in Fenner F et al. Smallpox and its Eradication, pp200

Bull WHO 1975; 52: 209-222 26.2 26.2 12 12 45 45 Gerere Gerere 40.0 40.0 4 10 10 N Game Game 44.4 44.4 12 12 27 27 100 100

75 3 4 5 6 7 60 28 8 96 62.5 29.2 8.3 100.0 Am J Epidemiology 1974; 99: 291-302

26/27 10 5/115 10 8/65 96% 4% 12% From Mack et al, Summarized in Fenner et al. Smallpox and its eradication, pg 688

- 0 4 5-14 15-29 30-49 >50 50 0% 45% 0% 10.5% 0.7% 13.9% 3.7% 54.2% 5.5% 50.0% From Outbreak in Liverpool, England, 1902-1903 In Fenner F et al. Smallpox and its Eradication, pp53

1950-1971 1971 0 10 11 20 >20 52% 29% 1.4% 7% 11% In Fenner F et al. Smallpox and its Eradication, pp53

29.5% 47.6% 10 75.0 96.3 7 1.9 21.8 in Fenner F et al. Smallpox and its Eradication, pp 591

3, 1,000 1,000 2.4 1st and 2nd visit, 1-2 days apart Am J Epidemiolgy 1974; 99: 303-313 24.2 24.4 8.5 13.2 92.6 28.2 32.5

7 7 1968-1970 1970 Heiner et al Amer J Epidemiol 1971; 91:316-326 (N) 258 206 302 160 449 15 (N) 45 45 81 10 91 0 AR (%) 17.4 22.3 26.8 6.3 20.3 0

400,000

1972 5 1 1973 64 1 1974 416

Kuralia, Bhola

** Rahima Banu 1975 10 16 Ali Maow Maalin 1977 10 26 - - ** 1978 2

1980

Ken Alibek 1980 JAMA 1999; 281: 2127-2137