When Edward Jenner invented the smallpox vaccination, it was said that those who were vaccinated would grow horns [BOOK EXTRACT]

– Jenner, who was a very good observer, noticed at one point that the milking machines working in the barns – apart from having ugly-looking, but still harmless changes on the skin of their hands, which is characteristic of cowpox – do not suffer from the real one. So he came to the conclusion that getting sick with vaccinia somehow protects them from the terrible disease that was smallpox. That is why he decided to conduct – as we would say today – a medical experiment – explains Dr. n. med. Aneta Nitsch-Osuch, epidemiologist and pediatrician from the Department of Family Medicine at the Medical University of Warsaw.

1. in 1796, Edward Jenner invented the first vaccine in history – against smallpox
2. Before vaccination was invented, the death rate from smallpox could exceed 80%.
3. Shortly after the announcement of Jenner’s discovery, there were voices talking about cow horns growing out of the vaccinated. This was probably related to vaccinia pox, a much less dangerous variety of animal pox, the passage of which made it resistant to this real
4. The last case of smallpox was in 1978. In 1980, the disease was considered eradicated, i.e. not present in the natural environment
5. The interview is an excerpt from the book “Virologists talk about the fight against the plague” in which Mira Suchodolska talks with Polish scientists and doctors professionally dealing with the COVID-19 pandemic. The book was published by the Czerwone i Czarne publishing house

The COVID-19 pandemic meant that anti-vaccines once again had the opportunity to speak up in a public forum and spew their theories. And this is in a situation where people all over the world are folding their hands to heaven, asking good God to help scientists come up with a vaccine for this coronavirus. But the truth is, the anti-vaccine movement is not a recent invention. It is as old as the vaccines themselves.

True, the history of anti-vaccination resistance is as long as the history of vaccinology, the science of vaccination. The beginnings of vaccinology date back to the end of the 1796th century, when in XNUMX British physician Edward Jenner (later knighted for his services) performed the first vaccination against smallpox on an eight-year-old boy, James Phipps. At that time, this disease decimated the European population, but not only it. It caused entire cities, towns and villages to disappear from the map because the death rate of smallpox was very high, reaching eighty percent. Vaccination in this child was successful, so it began to be vaccinated in other children. However, Jenner’s contemporaries, instead of being afraid of the disease, which they knew very well and saw its tragic effects every day, began to fear this new medical procedure. And they started spreading the theory that people grow horns when vaccinated.

Where did this horn idea come from?

I think it was about stigmatizing the people who get vaccinated. The horns are something very visible, animal, hence the message that inoculation causes some kind of bad transformation and humans become animals, losing all of their humanity. Figures showing people after vaccination as other animals, for example pigs with snouts, have also been preserved.

Wasn’t it because the viruses used in the Jenner vaccine were animal pathogens that cause cow pox, called vaccinia?

In fact, the story behind the invention of the vaccine has influenced how the side effects of vaccines have been imagined. Jenner, who was a very good observer, noticed at one point that the milking machines working in the barns – apart from having ugly-looking, but still harmless changes on the skin of their hands, which is characteristic of cowpox – do not suffer from the real one. So he came to the conclusion that getting sick with vaccinia somehow protects them from the terrible disease that was smallpox. That is why he decided to conduct – as we would say today – a medical experiment. It consisted in taking biological material, i.e. the secretion from skin lesions on the hands of the milking machines, and administered a two-piece needle through the process of scarification, i.e. puncturing the skin several times, to this young boy. He waited a few weeks and, to prove the validity of his assumption, gave the boy the same method of biological material that came from a person who had died from smallpox. The boy did not get sick, he got immunized.

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Very risky to say myself diplomatically.

In today’s standards for performing a medical experiment, this would be absolutely unacceptable. Jenner made this child contract a terminal disease. Fortunately, the vaccine has proved to be effective. Anyway, later, according to historical sources, Jenner also vaccinated his children, which may indicate how confident he was in the rightness of his actions. He was not the only scientist to conduct medical experiments on his own family. But in the end, this little boy was lucky Jenner chose him: he was successfully vaccinated and he didn’t get sick. So are any subsequent children to be vaccinated. Therefore, these first reluctant attitudes towards vaccination are all the more surprising as they emerged in a community that saw the tragic effects of smallpox with its own eyes.

Today we have a slightly different situation: people downplay infectious diseases because no one has seen their victims for many years. For example, people who had childhood poliomyelitis (aka polio, viral anterior horn inflammation of the spinal cord or Heine-Medin disease – editor’s note). Such people have difficulty moving and have to use various types of orthopedic equipment. Almost no one living in the XNUMXst century, including doctors, has seen a child die of this disease despite being placed in an “iron lung,” as some type of respirator is called. Fortunately, he did not have to see, because polio vaccinations have been obligatory since the beginning of the XNUMXs and are carried out on a mass scale, therefore the disease does not occur. As a community, we have already forgotten about it, we are not afraid of it. Mass vaccinations make the disease disappear, but this does not mean that the disease agent has been eradicated from all over the world.

So far, only the smallpox virus has been eradicated. And it happened quite recently, at the end of the XNUMXth century.

Yes, this is the only one hundred percent success of epidemiologists, to which Poles also contributed, including the founder of Polish epidemiology, Professor Jan Kostrzewski. A victory over smallpox was announced by the World Health Organization in 1980, but the last natural disease occurred in Somalia in 1977. The second disease, not of humans anymore, but of animals, which has also been eradicated, is rinderpest, or cattle plague. In this case, the victory was celebrated in 2010. But that’s the end of the good news. And we do not count on the fact that there will be more successes in the field of infectious diseases, because in order to completely eradicate an infectious disease, certain criteria must be met.

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What?

There must be an effective preventive measure that is readily available. So a vaccine, because the drug will not work prophylactically. There is also a second condition: the pathogen, the virus, should not be present outside the natural environment of humans.

What does it mean?

For example, polio is not a disease that we can completely eradicate because polio viruses can be found in sewage, in an inanimate environment, and can survive outside the human body. And smallpox viruses don’t. You can make polio free in some area, Europe has been free from this disease since 2002, which is very soon. But this only means that the continent has had no native illnesses for eighteen years, not that it will never come back.

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The smallpox virus exists in only two laboratories – in Our Country and the United States. Dread to think he can get out of these labs.

There are such fears. These laboratories are heavily guarded, but there is no guarantee that under some unfavorable circumstances the virus cannot get out of hand. In addition, there is another danger: a pathogen stored for scientific purposes may be tempted to use as a biological weapon. This was especially emphasized after the 2001 attacks on the World Trade Center, when the threat of terrorism and biological weapons emerged. Indeed, the smallpox virus is number one for a potentially dangerous disease agent that could be used in attacks.

Why would he be the best weapon?

Because the infection is transmitted by droplets, i.e. quickly and effectively, this virus causes a disease with high mortality, and moreover, the modern population is not immune to it, because vaccination against smallpox, for example in Poland, was completed in the early XNUMXs. Although there is a vaccine for this disease, it is currently only available in the United States and intended for the military.

So someone who would like to use the smallpox virus as a weapon has such an easy situation that he can vaccinate his own, and the enemies will fall? Which, for example, is impossible in the case of SARS-CoV-2, because no one has a vaccine for it.

True, at the moment we cannot protect ourselves against this coronavirus, except for the use of social distancing and personal protective equipment. Therefore, we can put theories that it was bred in a laboratory as a weapon between fairy tales.

Because it would be a weapon that bioterrorists alone could not control … Are there any other viruses besides smallpox that could be used as biological weapons?

Absolutely, for example, the influenza virus that has been known to us for millennia. In his case, there is a concern that some madman may think of developing an influenza virus mutant that would be highly infectious, which is typical of the seasonal flu virus, and on the other hand, the tremendous mortality that occurs and is described in the course of infections caused by the avian influenza virus. at people. As a reminder, seasonal flu, like COVID-19, spreads very easily, as described by the so-called basic reproduction number, which indicates how much one sick person is able to infect those around him. For the flu, this figure is around two and for COVID it is three. But the mortality rate from seasonal flu is 0,2-0,3 percent. A higher COVID-19 mortality rate of three percent was observed during the 1918 Spanish flu pandemic. But those were different times, the end of World War I, people were exhausted, malnourished, and there was no vaccine or effective medicine at their disposal. In contrast, the mortality rate of avian influenza in humans is up to fifty percent. So every second infected person dies. Therefore, please imagine a mutant, created somewhere in the laboratory, that will spread easily, like the seasonal flu by droplets, when coughing or sneezing, but will cause death in every second person.

Disaster.

There are still some factors that can be used as a biological weapon, one of the more often mentioned that we actually fear is botulinum toxin, or botulism. This bacterium can also be used for intentional infections.

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And in 2001, after the attack on the World Trade Center, there was anthrax.

Anthrax bacilli were sent in letters to important institutions in the USA. The pulmonary form of anthrax, which is also characterized by a very high mortality of over XNUMX%, is also one of the main pathogens on list A.

What is A List?

Scientists from the Center for Disease Control have divided dangerous biological agents that can be used as weapons into three categories. Category A includes the highest priority pathogens, characterized by ease of transmission and high mortality, causing diseases such as anthrax, botulism, tularemia, plague, Lassa fever, hemorrhagic fever, and smallpox. Category B includes the second-order highest priority pathogens with moderately easy transmission, moderate mortality, causing diseases such as, for example, Bang’s disease, glanders, melioidosis, spotted fever, spotted typhus, Western equine encephalomyelitis. In contrast, Category C includes the highest priority third-order pathogens, which include emerging pathogens that may be genetically engineered for mass dissemination.

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It’s often the case that when someone starts talking about bioterrorism, others look at him doubtfully, nodding their heads as if to say, okay, okay, man, you’ve watched bad movies.

But these are real threats. After all, letters with anthrax sticks were sent out quite recently. From somewhere, this anthrax-causing bacterium made it on these lists. It was then that, at various levels – global, regional – rapid alert systems were established in the event of bioterrorist events of great importance for public health. Such a system also exists and works in Poland. We can console ourselves that this is fortunately only a hypothetical risk, but unfortunately such a situation can happen at any time. Instead, I want to reiterate clearly: in the case of SARS-CoV-2, there is absolutely no scientific evidence to presume that it was created artificially, in a laboratory, for use as a biological weapon.

But bioterrorism is one thing, and so far nature has the power to surprise us with new infectious diseases. In which we help her a lot by changing our ecosystem. Many of the new infectious diseases of increasing importance are zoonoses, diseases that originally only occurred in animals. However, the pathogen broke the interspecies barrier and now humans are becoming infected.

Where is our fault here?

Of course, this breaking of the barrier is controlled by the forces of nature, but it is man who contributes to it. I will give examples. Well, in the eighties of the twentieth century in the United States, i.e. in a country where sanitary and epidemiological supervision works well, there were severe cases of respiratory infections in which there was bleeding from the respiratory system. Epidemiologists and virologists were very surprised when hantaviruses were grown from biological material collected from patients. They were well known before, but they were found only in small field animals, such as mice and voles. The investigation began and it turned out that the infection occurs in a limited area of ​​the United States called the Four Corners Area (Utah, Colorado, New Mexico and Arizona – editor’s note). There, a moment earlier, there had been massive deforestation and the destruction of farmland in order to build houses in their place. Rodents had nowhere to live, because they had been deprived of their natural ecosystem, and therefore they moved to these newly built houses and lived close to people.

Have they started eating their food and leaving poop?

Just like that. People had contact with the excreta of these rodents much more often than before and unknowingly inhaled the viruses that were in them. Previously, there were no opportunities for such close meetings. Therefore, it was not long before these hantaviruses crossed the interspecies barrier, found a way to replicate in the human body, causing hemorrhagic fever, also known as hantavirus pulmonary syndrome in humans. This jump over the interspecies barrier is always a bit like a plane crash: several factors contribute to the misfortune. In this case, the disturbance in the ecosystem and the moving of voles under the roofs was also followed by an extremely hot summer, which favored the multiplication of rodents. And more pets mean more excrement, and therefore more hantavirus for humans to inhale.

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I’m glad I have two cats …

There is another interesting example. This is the appearance of Nipah virus encephalitis. This time it is working in Malaysia, where in the late XNUMXs it was observed that people started getting encephalitis. The mortality rate was very high, between forty and fifty percent. It turned out that there was also a massive felling there, this time of rainforests inhabited by bats. Pig farms were built in place of forests. The homeless bats moved to the pigsties and “sold” the Nipah virus to pigs. And from the pigs, this paramyxovirus jumped to humans. That’s how it works. Right now, sixty percent of new infectious diseases are zoonoses.

***

Dr hab. n. med. Aneta Nitsch-Osuch – epidemiologist and pediatrician, assistant professor at the Chair and Department of Family Medicine at the Medical University of Warsaw. He is a member of the Committee on Epidemiology and Bioterrorism at the Sanitary and Epidemiological Council, which is part of the early warning system in the event of bioterrorist events of great importance to public health. Educator and promoter of vaccinations.

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