Saturday, February 12, 2011

Smallpox: The Death of a Disease - The Inside Story of Eradicating a Worldwide Killer PDF

Rating: (13 reviews) Author: ISBN : 9781591027225 New from $13.75 Format: PDF
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For more than 3000 years, hundreds of millions of people have died or been left permanently scarred or blind by the relentless, incurable disease called smallpox. In 1967, Dr. D.A. Henderson became director of a worldwide campaign to eliminate this disease from the face of the earth.

This spellbinding book is Dr. Henderson’s personal story of how he led the World Health Organization’s campaign to eradicate smallpox—the only disease in history to have been deliberately eliminated. Some have called this feat "the greatest scientific and humanitarian achievement of the past century."

In a lively, engrossing narrative, Dr. Henderson makes it clear that the gargantuan international effort involved more than straightforward mass vaccination. He and his staff had to cope with civil wars, floods, impassable roads, and refugees as well as formidable bureaucratic and cultural obstacles, shortages of local health personnel and meager budgets. Countries across the world joined in the effort; the United States and the Soviet Union worked together through the darkest cold war days; and professionals from more than 70 nations served as WHO field staff. On October 26, 1976, the last case of smallpox occurred. The disease that annually had killed two million people or more had been vanquished–and in just over ten years.

The story did not end there. Dr. Henderson recounts in vivid detail the continuing struggle over whether to destroy the remaining virus in the two laboratories still that held it. Then came the startling discovery that the Soviet Union had been experimenting with smallpox virus as a biological weapon and producing it in large quantities. The threat of its possible use by a rogue nation or a terrorist has had to be taken seriously and Dr. Henderson has been a central figure in plans for coping with it.

New methods for mass smallpox vaccination were so successful that he sought to expand the program of smallpox immunization to include polio, measles, whooping cough, diphtheria, and tetanus vaccines. That program now reaches more than four out of five children in the world and is eradicating poliomyelitis.

This unique book is to be treasured—a personal and true story that proves that through cooperation and perseverance the most daunting of obstacles can be overcome.
Direct download links available for PRETITLE Smallpox: The Death of a Disease - The Inside Story of Eradicating a Worldwide Killer [Hardcover] POSTTITLE
  • Hardcover: 334 pages
  • Publisher: Prometheus Books; 1st edition (June 23, 2009)
  • Language: English
  • ISBN-10: 1591027225
  • ISBN-13: 978-1591027225
  • Product Dimensions: 6.1 x 1.1 x 9.1 inches
  • Shipping Weight: 1.4 pounds (View shipping rates and policies)

Smallpox: The Death of a Disease - The Inside Story of Eradicating a Worldwide Killer PDF

Smallpox reigned through history as one of the most destructive diseases the human species ever suffered. Hundreds of millions of people are estimated to have died from it in the twentieth century alone. Its eradication, twenty years ago this year, remains unique: no other disease has been eliminated, once and and for all.

To some extent, smallpox almost aided in its own demise. Unlike life-long HIV infections, smallpox runs its course, to survival or death, within a few weeks. Unlike bubonic plague, there is no animal reservoir for the pathogen - when no more people have the disease, it can't come back. Unlike influenza, for which new vaccines are needed every year, only one vaccine was needed during the decades of intensive eradication effort. The disease's deadliness was only one reason it was such an attractive target for elimination.

This book tells the story of that elimination effort, written by the man who led that effort. Not just a medical miracle, it required cooperation from every nation on earth plus the warring factions that controlled areas where smallpox was endemic. That feat of cooperation very nearly counts as a miracle in itself and represents, to my mind, Dr. Henderson's most stunning achievement.

That cooperation faced continuous threats through the decades of the eradication program. As in any field, funding was always uncertain - especially when so many 'experts' said the goal was impossible, and that the funds should be directed to other diseases. The funding agencies quarreled amongst themselves, too. In one case Henderson describes, a funding group refused to pay for fuel for the team's trucks, on the grounds that a different agency had provided the trucks.
The eradication of smallpox relieved cataclysmic amounts of human suffering.

Henderson organized this book chronologically with plenty of illustrative, entertaining vignettes. I found it more useful to organize the things I learned categorically rather than chronologically.underplayed

Scientific: smallpox has several attributes that made it specially vulnerable to eradication. There is only one infected species. There are no asymptomatic carriers. Smallpox symptoms are easy to recognize.

Technological: from antiquity, variolation provided protection at the expense of infecting others during the variolation time. Jenner developed the first effective vaccine by working from a folk medicine story. Later vaccines were not heat-stable (decayed at room temperature). The most modern vaccine, freeze-dried, was heat-stable (I would have called it "room-temperature-stable"). That enabled the creation and distribution of enough doses for the whole world.

Technology 2: several generations of vaccination equipment culminating in the bifurcated needle which reduced the vaccine dose needed by 4x compared to previous needles.

Politics: initial funding and resource allocation. Working around reporting systems that lied, national health systems that hid patients (!), bureaucrats who know how to say "no" but don't know how to say "yes", people who want to do things differently or not at all. Working with both sides in countries embroiled in civil war.

Strategy: mass vaccinations vs surveillance and quick-response teams. Responding to waves of refugee migration and nomadic people.

Logistics: a great challenge. The programs in many countries took longer, cost more. Transportation broke down. Communication was difficult.

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