Smallpox- the Death of a Disease: The Inside Story of Eradicating a Worldwide Killer [Hardcover]

D. A. Henderson (Author), Richard Preston (Foreword)

Book Description

Release date: June 23, 2009 | ISBN-10: 1591027225 | ISBN-13: 978-1591027225 | Edition: 1

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.

Editorial Reviews

From Publishers Weekly

In his introduction, The Hot Zone author Preston points to the fact that "in smallpox's last hundred years," 1879-1979, it killed more people than "all the wars on the planet during that time." For more than 50 years, doctor and public health expert Henderson combated the disease, first as director of the Center for Disease Control's Epidemic Intelligence Service, then (from 1965 on) as director of the World Health Organization initiative which would later be known as The Eradication. Henderson provides an overview of the painful disease, "a monster" that killed roughly a third of the unimmunized it infected. Chillingly, "variolation," the direct subcutaneous injection of a patient's pus into a healthy person, was used to spur immunity from before the 10th century. The much safer cowpox vaccination was discovered in 1796 (mandated by Washington for the Continental army); meanwhile, smallpox had decimated the Native American population. Henderson's "surveillance and containment strategy" would indeed eradicate smallpox globally; India, the last holdout, was rid of it in 1974 by 115,000 health workers, dispatched to villages throughout the country to identify, quarantine, and vaccinate. This inspiring achievement makes a stirring read for medical history fans, though readers of Preston may find it a bit dry.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Review

"Outstanding! What a great read. D.A. Henderson pulls no punches as he tells the inside story of the global eradication of smallpox. He and his WHO team faced a formidable array of obstacles, frustrations, and outright disasters in their decade-long struggle; any one of a hundred of which could have doomed the effort to failure....The passion, commitment, and raw determination shine through. THIS is the heroic stuff of true public health leadership!" --Donald S. Burke, MD, University of Pittsburgh Medical Center-Jonas Salk Chair in Global Health, University of Pittsburgh

There has been no greater medical --or humanitarian--miracle in modern times than the eradication of smallpox, history's deadliest infectious disease. Now, for the first time, we learn the inside story from D. A. Henderson, the legendary public health official who led the global effort that brought this miracle about. Smallpox--The Death Of A Disease is more than a riveting account of the day-to-day struggle for international cooperation in a divided world; it also offers a winning blueprint for the great medical challenges to come." --David Oshinsky, winner of the 2006 Pulitzer Prize in History for Polio: An American Story



"Thorough, balanced and well-crafted, Smallpox--The Death of a Disease is the story of one of mankind's greatest achievements. The success of the eradication campaign is a testament to the difference the global public health community can make when it truly comes together for a common purpose. Whether one speaks of HIV/AIDS or Neglected Tropical Diseases, the solution lies in allies and adversaries working as one to alleviate suffering and save lives. This is the lesson to be drawn from Dr. Henderson's excellent book." --Tommy G. Thompson, Secretary of Health and Human Services (2001-2005); Governor of Wisconsin (1987-2001)

See all Editorial Reviews

Product Details

• Hardcover: 334 pages
• Publisher: Prometheus Books; 1 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)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (13 customer reviews)
• Amazon Best Sellers Rank: #99,776 in Books (See Top 100 in Books)
  • #77 in Books > Medical Books > Medicine > Internal Medicine > Infectious Disease > Communicable Diseases

More About the Author

D. A. Henderson, MD is currently professor of medicine and public health at the University of Pittsburgh and a distinguished scholar at the Center for Biosecurity in Baltimore. He is a professor and former dean of the Johns Hopkins School of Public Health. He served as Life Sciences Adviser to President G. H. W. Bush and was the first director of the newly created Office of Public Health Emergency Preparedness in the Department of Health and Human Services. He is the recipient of the Presidential Medal of Freedom and the National Medal of Science plus many other awards. He has received the Japan Prize and has been knighted by the King of Thailand.

Photo by Will Kirk, John Hopkins University.

Most Helpful Customer Reviews

9 of 11 people found the following review helpful

5.0 out of 5 stars HENDERSON'S VIEWS ON SMALLPOX ERADICATION June 24, 2009

By Robert J. Davis

Format:Hardcover

This book fills a gap on the smallpox eradication bookshelf.

D. A. Henderson, who was chief of smallpox eradication at WHO from 1966 to 1977, co-authored with Frank Fenner and colleagues the 1988 magnum opus, Smallpox and Eradication, an encyclopedic overview of the disease and its eradication. That WHO publication, now on the Internet, is as close to an official history of smallpox eradication as we are likely to see.

In this briefer, 300 page narrative, printed without the WHO imprimatur, Henderson looks at the people and institutions who, in his view, assisted or impeded the march towards smallpox eradication. He is not very kind to some people in some governments (he is especially hard on the Siyad Barre regime in Somalia, to some of the WHO regional offices, and to some people in the US Agency for International Development). He is unfailingly supportive of the compact teams in Geneva, CDC/Atlanta and the field who, with the governments of the endemic countries, gave us the world's first and last cheap disease eradication effort ($125 million in agency expenditure).

On the technical side, Henderson points to the innovations (vaccine quality control, the bifurcated needle, surveillance and containment, and smallpox identification cards) which moved the global program forward.

No book on smallpox can be exhaustive. [...]is a bit daunting at 1400 pages; some readers will prefer Donald Hopkins' briefer account of the historical consequences of smallpox, Horace Ogden's richly anecdotal CDC and the Smallpox Crusade, or Lawrence Brilliant's out of print book on the management of smallpox eradication in India. Henderson's brief bibliography is a good starting point for those who want to explore the subject more deeply.

If you can only read one book on the subject. this is the one.

4 of 4 people found the following review helpful

5.0 out of 5 stars An extinction to celebrate December 26, 2009

By wiredweird HALL OF FAMETOP 500 REVIEWER

Format:Hardcover

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. Then, the team faced challenges from the terrain they had to cover, often in remote and nearly inaccessible areas - or in areas of active war, where the medical team needed permission from both sides to vaccinate and monitor the population. Not just doctors, educators, and negotiators, Henderson's team had to be mechanics as well, to deal with the inevitable breakdowns days away from the nearest repair shop. Then, they had to change their way of working to accommodate the unique political environment of every country in which they worked.

But, in the end, Henderson and his team succeeded, except for samples in two laboratories. Henderson and his team previously documented their approach to the eradication in a World Health Organization document over a thousand pages in length. The story deserves a wider audience, however. This book presents a lively and very readable summary of that massive report. Today we face challenges of our own, from other pathogens. Techniques specific to smallpox eradication might not be appropriate to malaria, HIV, or other diseases. Any eradication effort, however, can learn from the creativity and heroic determination of the team that drove smallpox to extinction.

-- wiredweird

4 of 4 people found the following review helpful

5.0 out of 5 stars The Personal Account September 19, 2009

By Nina Calantone

Format:Hardcover

After reading several other books that explore smallpox eradication, Henderson's account appears more in-depth and personal. It places the reader in the situation, its stresses and successes. The reality of the narrative is supported by both strong personal biases and fast-paced anecdotes. The bias is shown in dark portrayals of bureaucratic figures that were shown to impede progress instead of assisting eradication. Henderson writes with strong, liberal voice that is true to life. He is blunt and decisive, and this is reflected in the text.

The anecdotal clippings that are boxed and scattered in the book depict unique struggles and solutions of the eradication campaign. Cultural and environmental barriers of the campaign are exposed in the brief accounts. "A novel way to detect hidden cases" is one example of an unusual solution; in order to reveal denied cases of smallpox, a vehicle was driven into deep mud to interest infected villagers, bringing them out of their homes.

Henderson also emphasizes the need for rule-breaking. He boldly suggests that certain conditions require radical action. His assertions are projected by scenarios and are proven valid by the ultimate success achieved by Henderson and other members of the campaign to bring the death of a disease.