The last naturally-occurring case of the deadly form of smallpox was recorded in 1975, when Rahima Banu was pictured with her mother.
Daniel Tarantola/WHOPeople are getting used to the idea that the virus won&t disappear. COVID will likely become endemic, a permanent part of our lives, that we will have to learn to live with and manage.
Only one human disease has ever been completely eradicated.
Daniel Tarantola, who was a medical officer with the World Health Organization in the 1970s, says that Smallpox was one of the most devastating diseases ever.
A Bangladesh district map in 1975 shows the locations of cases of the disease.
CDC/WHO/Stanley FosterPeople with the disease would have a rash on their bodies. The most deadly strain of the virus, calledVariola Major, killed almost a third of its victims. Those who recovered were scarred and blinded for the rest of their lives.
Alan Schnur, who was an epidemiologist with WHO's smallpox program, says that when they started eradication, people said that they couldn't eradicate the disease.
Bangladesh was the last country in the world to have cases ofVariola Major. In 1975, they traveled to a remote village on an island in the Bay of Bengal to meet a toddler who had recently fallen ill.
Rahima Banu was the last known person in the world to have been exposed to deadly smallpox, and she was a toddler at the time.
Smallpox was circulating for over 3000 years. The mummified bodies of several ancient Egyptian pharaohs have bumps on their skin. The virus is thought to have killed hundreds of millions of people in the 20th century.
The world's first vaccine was developed in 1796 by an English physician. The disease remained endemic in many parts of the world despite the eradication of it from the West by the early 1950s.
In the 1970s, the World Health Organization used an image of a smallpox recognition card to show people what the disease looked like.
WHOIn 1967, the World Health Organization set out to eradicate the virus.
Doctors and epidemiologists traveled from country to country to work with local health workers. They went to the markets and showed people pictures of the disease. Everyone in the surrounding households would be vaccined if they found a smallpox patient.
Bangladesh was the last country to have cases of variola major, the deadly form of smallpox. How do you know when you are done trying to eliminate a disease?
In Bengali, the season when the highest transmission of the disease occurred was known as the spring rash.
The WHO recruited a French doctor, Daniel Tarantola, to work in Bangladesh in the early 1970s. The United States and the Soviet Union were included in a team of health workers.
In November of 1975, Tarantola and a few colleagues gathered in Bangladesh to celebrate a milestone: their team had not received a single report of the disease in two months.
The end of the campaign for eradication of the disease was celebrated by Tarantola.
The world was told at a press conference that they had seen the last case of Variola Major. Tarantola received three telexes the next day. The first two were happy.
They received a third message from their colleagues on Bhola Island.
There was one active case of smallpox that was detected in Village Kuralia.
This was a pretty dramatic blow.
A special place would be held by Rahima Banu.
Daniel Tarantola/WHOThe toddler from the remote village of Kuralia was the subject of a telex. The house her family lived in was built from cattail leaves. Her parents were day laborers who fished and felled trees. She was the first child.
Banu was part of a chain of transmission that went undetected by health workers. Banu's uncle got sick first.
Banu told Radio Diaries that he jumped on him and started playing with the marks on his body.
Alan Schnur, the American epidemiologist, traveled to Banu's home with Stanley Foster, the head of WHO's smallpox program in Bangladesh, to confirm that she had been exposed to the disease.
In 1975, Alan Schnur spoke with Bangladeshi epidemiologists.
CDC/WHO/Stanley FosterThere was some civil unrest at the time, so they announced that all WHO international staff are restricted to Dhaka. I put some sort of cloth over my head so that they wouldn't see that the international WHO staff was breaking the rules.
The journey began with an overnight launch, a speedboat, a drive, and a walk to Banu's house.
Banu's mother sat on a bamboo bed, holding her child, whose face, arms, and legs were covered with white spots. Banu began to cry. Banu was crying in her mother's arms.
Banu says his mother was shocked.
The health workers explained to the family what they would do to stop the illness from spreading. Banu's father was paid so that he wouldn't have to leave for work, because the family was isolated in their home.
Banu's neighbors were hired to guard her family's home, limit the number of visitors, and make sure visitors were shot before entering.
The house where Rahima Banu grew up is pictured.
Daniel Tarantola/WHOBanu says that everyone in the area made money off of it.
Locals were hired as volunteer vaccinators. They were trained to use a bifurcated needle, an innovation in the eradication program that allowed a person to be successfully vaccineed using just a small drop of vaccine.
More than 18,000 people werevaccinated within a 1.5 mile circle of the house after training.
Health workers used to vaccine themselves in front of locals to make sure they were safe.
During my time in Bangladesh, I must have shot myself 10,000 times. The extra vaccinations had no effect on him.
The invention of a bifurcated needle helped end the disease.
WHOTeams of vaccinators would go from house to house in the middle of the night to make sure people were back from work.
Schnur remembers one house where a guy opened the window and asked if he was crazy. It is two o'clock in the morning. What are you doing? Schnur continued to knock, explaining that they could not leave until everyone in the house was vaccine free. The man let them in.
The area around Banu's home was searched and found to be free of active smallpox cases.
After looking for cases for two more years, health workers in Bangladesh were finally able to eradicate the disease in 1977. The milder form of the disease, calledVariola Minor, was stamped out in Ethiopia and then in Somalia.
Smallpox was declared eradicated in 1980.
WHOIn May 1980, the World Health Organization declared that all forms of the disease were gone. There are only two labs that have the virus, one in Russia and the other in the United States.
The eradication program for smallpox is the only one to have succeeded worldwide despite efforts to eradicate other human diseases. Both Schnur and Tarantola attribute this to the fact that there were no inapparent cases of the disease.
Schnur says that the disease is difficult to control because people are walking around with no symptoms.
The Banu family was photographed this year.
Dil Afrose JahanWhen she was a teenager, Rahima Banu learned she was famous for having the last known naturally-occuring case ofVariola Major.
Banu had no long-term health problems after recovering from the disease. She says she has been discriminated against because of her scars.
Banu says that she doesn't look beautiful with the scars.
Banu married. She says her husband accepted her despite not seeing her before the wedding.
Banu's husband is a day laborer who drives a van and does farm work, while her mother is a housewife. The youngest of their four children is in eighth grade. She grew up in the village where the family lives. Many geese provide eggs for the family and she owns a number of animals.
A woman is outside her home with her family.
Dil Afrose JahanThe family does not have a lot of money. Banu couldn't afford to take one of her daughters to the doctor because of an illness that causes swelling in her hands, and she was sometimes without food.
Banu talks about her life. She says her husband takes good care of her. Over the years she has received visits from public health workers and journalists who are curious to meet the person who survived the last known case of deadly smallpox.
I'm healthy. I have a family of my own. I have children of my own. She says her parents are alive.
The story was produced by Radio Diaries, with reporting and translation by Dil Afrose Jahan. It was edited by a few people. Additional translation help by Kasara Hassan. Thanks to Mycah Hazel.
Thanks to Leigh Henderson for the archival recordings of the WHO press conference. Thanks to the GBH archive, we were able to see a scene in the 1985 documentary The Last Wild Virus, which featured Daniel Tarantola reenacting his work in Bangladesh.
There is a longer version of this story on the Radio Diaries.
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