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Containing smallpox in Victorian London

'This loathsome disease'
Smallpox in Victorian London
The smallpox ships
The River Ambulance Service
Patients and staff
The end of the hospital ships
The return of smallpox?
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The return of smallpox?

Fears of terrorism

Smallpox is currently in the news once more. This is because of fears that the Variola major virus could be used in a biological weapon.

Quantities of the virus are still stored in several laboratories around the world. Any terrorist group that could obtain the virus might try to create a smallpox epidemic. Although this would be difficult, the possibility cannot be ignored.

An unprepared world

A box containing Vaccinia vaccine.
View full size imageA box containing Vaccinia vaccine. © Centers for Disease Control, Public Health Images Library
Much of the world would be poorly prepared, as more people are susceptible now than at any time in the past. Smallpox still has the power to kill many millions of people, as only those old enough to have had the disease are immune.

For most people, protection would depend on vaccination. Those vaccinated several decades ago will have little immunity left.

The production and rapid distribution of enough vaccine to protect large numbers of people would require an enormous effort. In poorer countries, where most people in the world live, few would get any protection.

Responding to a future crisis

Women shopping at a flower stall.
View full size imageA scene from everyday life.  © NMM
If smallpox returned, governments worldwide would find themselves in exactly the same position as the Metropolitan Asylums Board a century ago.

This would require the immediate removal of the sick to isolation centres and the widest possible use of vaccination.

The speed, efficiency and dedication of the Metropolitan Asylums Board saved thousands of lives. Many millions of lives could depend on a similar rapid response to any future crisis.

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