91 YEARS AGO IN GROCOTT’S MAIL: 10 November 2017

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Smallpox in Natal

Tucked away at the bottom of the second page of the Grocott’s Mail of 10 November 1926 was the following small paragraph: “The smallpox menace, which, it was thought, had been more or less definitely banished, has been brought nearer the European population by a case of an Indian in Mayville, a suburb of Durban, which is on the fringe of the Berea, Durban’s most aristocratic residential district.”

There had been 11 deaths so far, but the article doesn’t note how many people were affected overall. The phrasing of the article is typical for that era’s newspaper reports about epidemics: to be blunt, most newspapers didn’t really care about epidemics – of smallpox, rabies or anything else – as long as they didn’t affect white people. This was characteristic of many South African newspapers well into the 1980s. What is unusual about this article is that the epidemic in question was one of smallpox, a disease nobody worries about anymore.

But it was once the scourge of the earth. The variola viruses jumped to humans from rodents about 10 000 years ago. Egyptian mummies show signs of smallpox infection, and the Pharaoh Ramses may have died of it. The earliest record of smallpox in Africa is from 568, when Ethiopian troops brought it back from a military campaign in what is now Saudi Arabia. Later, the Arab slave trade brought the disease to coastal settlements in East Africa. On the West African coast, the disease was spread by European slave traders. In North Africa, the disease spread down from the Mediterranean coast, probably carried by traders and travellers.

Death rates were astronomically high because African populations had never encountered the disease before, and thus had no natural immunity. In an Angolan epidemic of 1864, for example, 25 000 people died. In some parts of Central Africa, entire regions were depopulated. In the Americas and Australia, where indigenous people also had no natural immunity, death rates were exponentially high after European invaders and settlers introduced the disease.

Indeed, Southern Africa,managed to avoid smallpox until European settlements sprung up along the coast. Harbours were the prime points of entry for new diseases of all kind, and so it was with smallpox: in 1713, 1755, 1831 and 1840, ships from India brought infected laundry ashore, and the resulting epidemics killed thousands, affecting Khoi populations as far inland as the Kalahari.

The severity of these epidemics made the Cape Colony’s government declare vaccination compulsory in 1881, and the Union of South Africa made it compulsory in 1919. Epidemics in 1920 and 1921 were triggered by troop ships docking in Durban, causing over 2 000 deaths. The 1926 Durban outbreak, however, was unusual: there were low rates of smallpox in South Africa in the late 1920s.

Between 300 and 500 million people worldwide caught smallpox in the first half of the 20th century, 50 million in 1950s alone. In the 1970s, the World Health Organisation started a huge public vaccination campaign, and by December 1979, there were no more smallpox infections. At all. Anywhere. The last case in South Africa was reported in 1971.

The disease is one of only two that have been completely eradicated (the other is rinderpest), but in the 18th, 19th and early 20th centuries it was a serious and often deadly disease. Fatality rates for smallpox, caused by variola major or variola minor viruses, ranged between 10% and 60%; some forms of the disease could kill up to 80% of its victims. Fatality rates were particularly high among children, and survivors were often left scarred, blinded and beset with arthritis and osteomyelitis.

Today, the smallpox viruses survive only in laboratories: it is no longer a “wild” disease, and the debate about whether humanity has the right to exterminate it completely – to deliberately cause the extinction of an organism – is ongoing.

Queries, suggestions, tips and corrections to nervousflamingo@gmail.com.

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