People are starting to accept that COVID-19 isn’t going away after more than two years. Scientists predict that COVID may become an endemic disease, and that it will be a part of our daily lives for the rest of our lives.
Only smallpox, the only human disease that has been eradicated completely, is in fact the most successful.
“Smallpox” was one of the most deadly diseases since the beginning of human history,” said Daniel Tarantola who was a medical officer in the World Health Organization’s smallpox program. He died in 1973.
Smallpox patients will develop painful, reddened rash all over their body. Variola Major, the most fatal strain of the virus killed nearly a third. The majority of those who survived were left scarred and blinded for the rest of their lives.
“When we started smallpox elimination, people said, ‘You’re crazy, you can’t eradicate smallpox.’” Alan Schnur, an epidemiologist for WHO’s smallpox programme, says.
Tarantola was based in Bangladesh in 1975. Bangladesh was the last country to be affected by Variola Major in 1975. In 1975, the couple traveled to Bangladesh to visit a village on an island in the Bay of Bengal to see a child who had just fallen ill.
Rahima Banu was that toddler. She would go on to become a legend as the last person to have been infected naturally with deadly smallpox.
The smallpox virus circulated for over 3,000 years. The first evidence of smallpox is found in the mummified bodies and skin of several ancient Egyptian pharaohs. Their skin has the distinctive bumps. It is believed that the virus killed more than 300 million people in 20th-century America.
Dr. Edward Jenner, an English physician developed the first vaccine against smallpox in 1796. Although smallpox was eradicated in the West by the 1950s, the disease remained widespread in many parts.
In 1967, the World Health Organization began to eradicate the virus completely.
World-renowned epidemiologists and doctors traveled to different countries in order to collaborate with local health workers. They visited local markets and went house to house, taking photographs of smallpox cases and asking questions about the outbreaks. They would seek out smallpox patients and then isolate them, in order to vaccinate all the residents.
In 1975, Bangladesh was still the only country that had Variola Major, a deadly form of smallpox. How do you know when it’s done?
Smallpox in Bengali was called guti boshonto (or “spring rash”), a reference to the time when transmission was most severe.
French doctor Daniel Tarantola was recruited by WHO to work in Bangladesh’s smallpox program. This was in the early 1970s. He was part of a group of health workers representing more than 20 countries including the United States and Soviet Union.
Tarantola and some colleagues met in Dhaka in November 1975 to celebrate a significant milestone: the team had not received any smallpox reports in two months.
Tarantola stated that the smallpox campaign was exhausting. “And so, we celebrated the end of a very difficult journey.”
WHO headquarters held a press conference in order to announce that they believed they had seen Variola Major’s last case. Tarantola was presented with three telexes the next day. The first two were congratulatory.
A third message was then sent by their colleagues, who were based at Bhola Island in the Bay of Bengal.
It read, “One active smallpox patient detected in Village Kuralia.” Details follow.
Tarantola says, “This was a very dramatic setback.”
Tarantola received a telex about Rahima Banu. She was a child from Kuralia. Her family lived in an earthen floor and a house made from cattail leaves. Her father was a day laborer, who fished and felled trees. Her mother was a housewife. She was their first child.
Banu was one of several smallpox cases that went undiagnosed by health workers for many weeks. Banu’s 10-year-old uncle, who lived in Banu’s home, became ill first.
Banu said that he jumped up on Banu and began playing with the marks he left on his body. Banu spoke through a translator. “My mother noticed three pimples on my forehead that night and it was all over my body by morning.”
American epidemiologist Alan Schnur traveled to Banu’s house with Stanley Foster, who is the head of WHO’s smallpox programme in Bangladesh to confirm that she had smallpox.
Schnur recalls that there was civil unrest at that time and they announced that all WHO international staff were restricted to Dhaka. “We got in the Jeep and slouched on the ground. To hide the fact that this international WHO staff was breaking regulations, I covered my head with a cloth.
The trip involved an overnight launch, speedboat, driving, and finally a walk to Banu’s house.
Tarantola arrived shortly after, finding Banu’s mother on a bamboo mattress, with her child. Banu began to weep, afraid of the visitors. Tarantola snapped a few black and white photos of Banu in her mother’s arms crying.
Banu said that “my mother was shocked.” “She couldn’t speak a word.”
The family was explained by the health workers what the process would be to prevent the disease from spreading to their neighbours. Banu’s father was paid to stay at home with the family so he didn’t have leave for work.
Banu’s neighbours were hired to protect her home and limit visitors. They also made sure that any visitors were immunized before they entered.
Banu says, “They set up three camps surrounding our house.” “Everyone in this area made money from it.”
Local health workers also employed volunteers to vaccinate their neighbors. They were given instruction on how to properly inoculate neighbors with what was known as a bifurcated needle. This innovative eradication method allowed for a person to successfully be vaccinated with a very small amount of vaccine in just a few hours.
After being trained, teams went out to vacinate all residents within a 1.5-mile radius. This included over 18,000 people.
Health workers used to immunize themselves in front of locals to assure them that vaccines were safe.
Tarantola claims that he must have been vaccinated 10,000 times in Bangladesh while he was there. He was already immunized so the extra vaccines did not have any effect.
To ensure that people returned from the fields, teams of vaccinators would travel from one house to another in the middle of the night.
Schnur said, “I only remember one house.” Schnur says that it was a two-story house and that a man opened the window to ask Schnur if he was crazy. It’s 2 o’clock in morning. What are you doing? Go .”” Schnur kept knocking and explained that they couldn’t leave until everyone was vaccinated. They were eventually allowed in by the man.
After searching for smallpox cases in the vicinity of Banu’s house for several weeks, health professionals concluded there was no active case.
For two more years health workers searched for smallpox cases in Bangladesh. It wasn’t until December 1977, however, that the disease was officially declared extinct in Bangladesh. In Ethiopia and Somalia, smallpox was eradicated in a milder form called Variola Minor.
In May 1980, the World Health Organization declared smallpox eliminated in all forms. Two laboratories now have the virus, one in Russia and one in the United States.
Even though there have been efforts to eradicate other diseases such as polio or malaria, the smallpox program is still the only one that has succeeded in eliminating the disease. Both Schnur and Tarantola both credit this to the fact smallpox was an easily visible disease with few cases.
Schnur said, “You could see it.” “That’s why COVID-19 can be so hard to control. There are people who walk around without symptoms spreading the disease.
Rahima Banu was just a teenager when she discovered that Variola Major was the last naturally occurring case in the world.
Banu was able to recover from smallpox and has no long-term problems. She also had dotted scars on her body. She claims she was discriminated against because of these scars.
Banu said, “I don’t look beautiful with these marks.” “It would have been easy to marry a wealthy family if I hadn’t had this disease.”
Banu was married. It was an arrangement marriage. Her husband had never seen her before the wedding but accepted her. She says, “He likes my as I am.”
Banu’s husband, a day laborer, drives a van and does farmwork; Banu, just like her mother is a housewife. The couple has four children. The youngest is in the eighth grade. The family lives in the same village as her childhood. She has a variety of animals, including geese that produce eggs for her family.
The family has very little financial resources. Banu was often without food during the COVID-19 lockdown and couldn’t afford to transport one of her daughters to the doctor, as she has a condition that causes swelling in her hands.
Banu still speaks with gratitude about her life. She says her husband is devoted to her and takes great care of her. She’s also enjoyed the visits and attention she’s received from journalists and public health workers over the years, who were curious to see the person who was able to survive deadly smallpox.
“I’m healthy. I have a family. I have children. She says that her parents are still alive. “I have everything.”
Alissa Escarce, Radio Diaries’ producer, produced this story. Dil Afrose Jahan translated and reported the report. Ben Shapiro, Deborah George, Joe Richman edited it. Kasara Hassan provided additional translation assistance. Nellie Gilles and Mycah Hazel are gratefully acknowledged.
Leigh Henderson is also grateful for the archival recordings from the WHO press conference of November 1975. Thanks to the GBH archive, we have access to The Last Wild Virus 1985 documentary. This story featured Daniel Tarantola reenacting his work from Bangladesh.
Radio Diaries Podcast has a longer version of the story and many other stories similar to it.