Serious, contagious and deadly: What happened to smallpox in Chile?

During the last days, the presence of a rare and emerging zoonotic infectionpotentially deadly, called monkey pox. This immediately set off the alarms of the health authorities.

The disease, which can spread to humans with serious physical consequencesis already present in Europe, where the UK Health Security Agency (UKHSA, its acronym in English) confirmed a series of cases in England. It was also registered in the United States, Spain and Portugal, among other countries.

In Chile there is still no evidence of this new virus, as indicated by the Ministry of Health, ruling out that suspicious cases have been detected or confirmed cases of monkeypox in the national territory.

However, human smallpox, a “relative” of the one causing the current global outbreak, has a long and tragic history in our country. It was a serious infectious disease, contagious and with a high risk of death, caused by the virus Smallpox virus.

Although the first records worldwide were found in Egyptian mummies from the 3rd century BC. C., the first appearance of smallpox in Chile dates back to 1554, which occurred numerous times in the country in an epidemic form, causing high mortality rates in the population.

Finally the disease was declared eradicated in 1959 Throughout the national territory. Seven years later, in 1966, the World Health Organization it was proposed to definitively eradicate smallpox from the planet, which would be the first infectious disease to do so. This goal was achieved in 1980 (the last person died in 1978 in England).

Jose Pedro Hernandez, historian and academic of University of the Americas, points out that Chile had many epidemic processes regarding smallpox, “which unfortunately caused a high percentage of deaths in the population. It must be understood that this disease in the past, before the vaccine, it was very deadly.”

In Chile during the 19th century, it was endemic, this means that it occurred from time to time, regularly every four years. “Although the vaccine existed, the first to arrive in Chile were not very effective, some were, others were not, which caused a lot of damage,” explains the historian.

The saltpeter fields were one of the points affected by smallpox.

“There were problems, regardless of whether they existed the vaccine. The outbreaks occurred in different places, affecting the large cities, as well as the production centers, that is, the nitrate and coal mining companies, which brought economic problems,” adds Hernández.

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The academic from the University of the Americas clarifies that everything was solved during the 20th century with the vaccine policies implemented by the country, “especially since the 1950s, when the Chilean State proposes to eradicate it, which it finally achieves”.

Carlos Pérez, clinic infectologist University of the Andes and dean Faculty of Medicine and Science San Sebastian Universitypoints out that it is important to specify that the cases that we are seeing in several places in Europe and also in North America of the so-called monkeypox, “correspond to a viral infection by an agent that is from the same family as human smallpox, but that does not correspond to it, but is an agent that mainly affects wild animals”.

Roberto Olivares, head of Infectology at Davila Clinic, establishes that this disease, known as monkeypox, “is a pathological entity or a disease different from classic smallpox that plagued people for hundreds of years, and that thanks to the vaccine was declared eradicated by the World Health Organization . This disease was highly contagious and produced high mortality, while monkeypox, a zoonotic disease, is transmitted from animals, especially rodents, to people. Clinically it resembles, but it does not have the severity and contagiousness that classic smallpox had.”

Hands of a person in Congo infected with monkeypox. Brian WJ Mahy/CDC/Handout via REUTERS.

It can eventually be transmitted to man, but It is not easily transmitted between humans. It is transmitted mainly between animals and between animals and man. “Naturally if this continues to grow, and infections increase, especially between people, it could be a cause for concern. But I insist that it is a virus that primarily produces infection in animals more than in men, it is a virus that was already known, and to date there has never been an epidemic, “explains Pérez.

There is no possibility that the “classic” smallpox that affected people will appear again in the world, “because it is formally eradicated. It is necessary to see how this new outbreak behaves, it is a disease that has been going on for many decades, and it is necessary to evaluate how the virus is going to behave, if it is going to change, if it is going to generate a degree of contagiousness from person to older person, see the evolution you have. But it is a different disease, which generates milder conditions, with less mortality”, argues Olivares.

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The origin of inoculation against smallpox dates back to the 10th century AD. C, in China. A Taoist monk from Emeishan (Sichuan province) brought the method to the empire’s capital at the request of Prime Minister Wang Dan. Much later, the British lady Montagu (1689-1762) on a trip to Turkey observed how the Circassians did it with viruses from cows, and they did not get sick.

Finally, the scientist Edward Jenner (1749-1823), almost ninety years later, developed the vaccine.

In the origin of this, Chile also had participation. Peter Manuel Chaparro, a Juandedian friar born in what is now Chile, in 1765 began systematic vaccinations with pus from pustules to prevent smallpox. This action was so successful that of five thousand people inoculated, none died.

Edward Jenner advising a farmer about vaccinating his family (circa 1810). Wikipedia.

Currently not specific vaccines are available against infection for the public, since its production was suspended after the global Smallpox Eradication, after a worldwide campaign worth US$300 million. However, it could happen again.

Pérez explains that since monkeypox has similarities to human smallpox, “and the human smallpox vaccine has a protection of more than 85% against this virusif this were to continue to increase, its use could be considered again to protect against this agent”.

Despite the suspension of its production, the virus it is still stored in certain laboratories. “For example, after the attacks on the Twin Towers in the United States or bioterrorist attacks with anthrax spores, it was reactivated and, in fact, US troops received the vaccine, for fear that the virus would be used as a biological weapon,” explains Pérez.

In short, “the vaccine is available if necessary, but obviously it would have to be mass-produced. Also, at this point, we have some antivirals that could be used in more serious cases, although most resolve spontaneously, “explains the infectologist at Clínica Uandes.

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