Las epidemias de viruela y la introducción de la vacuna en el Virreinato del Río de la Plata / Smallpox epidemics and vaccine introduction in the Viceroyalty of the Río de la Plata

La viruela fue una de las enfermedades epidémicas más temidas desde la antigüedad debido a su alta mortalidad y a las secuelas que dejaba en aquellos que lograban sobrevivir. En el presente trabajo se abordará el ingreso de esta enfermedad en nuestro continente, así como su manifestación a través de epidemias, brotes y focos endémicos. Al mismo tiempo se verá qué reacciones provocó dentro del ámbito médico durante los años del Virreinato del Río de la Plata. Se analizarán los problemas que surgieron con el uso de la vacuna importada, así como el hallazgo de nuestra vacuna local, finalizando con los comienzos de la organización de los servicios de vacunación obligatoria. (AU)

Smallpox was one of the most feared epidemic diseases since ancient times due to its high mortality and the sequelae caused in those that managed to survive. In the present work, the introduction of this disease into our continent will be addressed as well as its manifestation through epidemics, outbreaks, and endemic foci. At the same time, the reactions this disease caused inside the medical field during the years of the Viceroyalty of the Río de la Plata will be observed. The problems that arose from the usage of the imported vaccine and the discovery of our local vaccine will be analyzed, and it will finish with the beginnings of the organization of the mandatory vaccination services. (AU)

Research progress on the effectiveness of smallpox vaccination against mpox virus infection / 中华流行病学杂志

With the expansion of mpox virus infection from endemic to a global epidemic in 2022, the WHO declared that the mpox event constituted a Public Health Emergency of International Concern. Due to the high degree of gene sequence similarity among orthopox viruses and cross-reactive antibodies induced by orthoviruses, smallpox vaccination may affect the immune response induced by mpox virus infection. The analysis of the protective effects of smallpox vaccination against mpox virus infection will help define the focus of prevention and control. In this review, we clarify the protection of the smallpox vaccine against mpox virus infection by analyzing the correlation between smallpox vaccination, immune response status, and clinical data and providing evidence for the prevention, control, and strategies of mpox epidemics.

Recomendaciones de organismos internacionales y agencias reguladoras de medicamentos acerca de la vacuna contra la viruela símica / Recommendations from international organizations and drug regulatory agencies regarding the monkeypox vaccine

La publicación describe las recomendaciones emitidas por las autoridades nacionales de los países de España, Estados Unidos, Canadá, Alemania, Francia, Reino Unido, OMS/OPS, CDCUSA, y la información de las vacunas autorizadas por la FDA (Food and Drug Administration), Agencia Europea de Medicamentos (EMA) y la agencia reguladora de medicamentos de Reino Unido. Ninguno de los organismos internacionales revisados recomienda una vacunación masiva contra la viruela símica en población general. La OMS, Reino Unido, España y Estados Unidos recomiendan la vacunación pre-exposición a personas con riesgo ocupacional alto para la exposición al virus de la viruela símica, que incluye a trabajadores de salud específicos. Únicamente España, Alemania y Reino Unido añaden la recomendación de vacunación pre-exposición a grupos que tienen prácticas sexuales de alto riesgo, incluyendo a hombres que tienen sexo con hombres, población gay y bisexual y el caso de España también a personas que viven con VIH

Viruela símica en países no endémicos - 20 de mayo de 2022 / Varíola do macaco em países não endêmicos - 20 de maio de 2022 / Monkeypox in non-endemic countries - 20 May 2022

Ante la ocurrencia de casos de viruela símica en algunos países dentro y fuera de la Región de las Américas, la Organización Panamericana de la Salud/ Organización Mundial de la Salud (OPS/OMS) comparte con sus Estados Miembros una serie de consideraciones en relación con la identificación de casos, el aislamiento, identificación y seguimiento de contactos, el manejo clínico y la prevención y el control de infecciones asociadas a la atención en salud. También se brinda orientaciones sobre tratamiento disponible y vacunas.

Diante da ocorrência de casos de varíola do macaco em alguns países dentro e fora da Região das Américas, a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) compartilha com seus Estados-Membros uma série de considerações em relação a identificação de casos, isolamento, identificação e acompanhamento de contatos, manejo clínico, e prevenção e controle de infecção relacionada à atenção a saúde. Também oferece orientações sobre tratamentos disponíveis e vacinas

Given the occurrence of cases of monkeypox in countries within and outside of the Region of the Americas, the Pan American Health Organization / World Health Organization (PAHO/WHO) shares with its Member States a series of considerations in relation to the identification of cases, the isolation, identification and follow-up of contacts, the clinical management, and the prevention and control of healthcare-associated infections. Guidance regarding available treatment and vaccines is also provided

Comentario en torno al artículo "A propósito del bicentenario de la independencia de Colombia: las prácticas de lectura de Antonio Nariño y el desarrollo de una vacuna presuntamente efectiva contra la viruela" / Comment on the article "With regard to the bicentennial of the independence of Colombia: Reading practices of Antonio Nariño and the development of a presumably effective vaccine against smallpox"

Resumen | La viruela significó para las colonias americanas un proceso que desestabilizaba de forma dramática las dinámicas sociodemográficas de las colonias, lo que incentivó el desarrollo de estudios científicos sobre el virus causante. Cada libro acerca de la viruela en la biblioteca de Nariño constituyó una herramienta en la lucha contra el virus emprendida por el prócer. Tras la revisión del artículo "A propósito del bicentenario de la independencia de Colombia: las prácticas de lectura de Antonio Nariño y el desarrollo de una vacuna presuntamente efectiva contra la viruela" quise comentar y profundizar en torno al saber médico de Nariño mediante el acercamiento a las obras a las que recurrió para instruirse sobre la enfermedad. A partir de la semblanza de cada una de ellas, analicé el proceso de variolización en el Reino de la Nueva Granada y la necesidad de fabricar una vacuna propia.

Abstract | For the American colonies, smallpox implied a process that dramatically destabilized their sociodemographic dynamics, which explains why scientific development took place around the causative virus. Each book about smallpox in Nariño's library was a tool in the fight against smallpox undertaken by the founding father. After reviewing the article "About the bicentennial of the independence of Colombia: The reading practices of Antonio Nariño and the development of a vaccine that is presumably effective against smallpox", I set myself to study Antonio Nariño's medical knowledge further. Through the approach to the works that Nariño used to educate himself on smallpox and the development of a biographical sketch of each of them, I analyzed the process of variolization in the Kingdom of Nueva Granada and the need to manufacture a vaccine locally.

La epidemia de viruela en la Alcaldía Mayor de Tegucigalpa año 1815 / The smallpox epidemic in the Mayoralty of Tegucigalpa year 1815

En 1815 una epidemia de viruela ingresó a la Alcaldía Mayor de Tegucigalpa que, a pesar de los esfuerzos de las autori-dades por esparcir la vacuna, causó estragos en la población indí-gena. Al mismo tiempo, en la época lluviosa de ese año, las lluvias fueron menores a lo acostumbrado, provocando el fracaso de las plantaciones, lo que llevó a una escasez de granos y a una hambru-na generalizada en el territorio. En este escenario, el Alcalde Mayor Simón Gutiérrez se vio obligado a cobrar el tributo de los pueblos indígenas, maniobrando políticamente la situación para evitar algu-na revuelta de la población. La epidemia de viruela y la hambruna ejemplifican la aplicación de política sanitaria en la Honduras colo-nial, destacando las maneras en que las acciones individuales de los funcionarios eran un ejercicio de administración de la vida de los habitantes de la provincia. De manera similar, en 2020 los intere-ses políticos y económicos han interferido en la prevención efectiva contra el COVID-19...(AU)

A propósito del bicentenario de la independencia de Colombia: las prácticas de lectura de Antonio Nariño y el desarrollo de una vacuna presuntamente efectiva contra la viruela / With regard to the bicentennial of the independence of Colombia: Reading practices of Antonio Nariño and the development of a presumably effective vaccine against smallpox

Introducción. La historia social de la cultura escrita reflexiona sobre los hábitos y prácticas que permiten apropiarse de los textos mediante la lectura y la escritura. De allí, que la biblioteca de un individuo permita comprender sus hábitos de lectura, su manera de imaginar la naturaleza, su relación con el poder político y religioso, y su vinculación con la sociedad. Objetivo. Interpretar las prácticas de lectura de Antonio Nariño a partir de los libros de Medicina de su biblioteca, para aproximarse a la manera en que desarrolló una vacuna presuntamente efectiva contra la viruela. Materiales y métodos. Se hizo una descripción bibliográfica de los documentos "Confiscación y embargo de bienes de Nariño" y "Papeles, libros y bienes de Sebastián López Ruiz en poder de Nariño" del Archivo Nariño de la Universidad Nacional de Colombia. Resultados. De los 39 libros sobre Medicina (siete tratados de Cirugía, 12 compendios del ejercicio práctico, 11 manuales de enfermedades, siete compendios de temáticas médicas y dos libros sobre partos), tres eran tratados sobre la viruela. Conclusión. El ejercicio médico-científico de Antonio Nariño refleja sus prácticas de lectura y de escritura, sus habilidades y sus competencias, y permite reconocer sus actitudes culturales y sociales ante la promoción de la noción de salud pública. El estudio de Nariño como médico autodidacta permitió relacionar las técnicas de producción científica (desarrollo de la vacuna) y la materialidad cultural (situación actual), a partir de los textos de Medicina de su biblioteca.

Introduction: The social history of written culture reflects the reading and writing habits and practices that allow us to appropriate the texts to build our sense of community. Hence, the library of individuals reflects their reading habits, their way of imagining nature, their relationship with political and religious power, and their involvement with society. Objective: To interpret Antonio Nariño's reading practices by means of the medical books in his library to approach the way he developed a presumably effective vaccine against smallpox. Materials and methods: We made a bibliographic description of the documents "Confiscación y embargo de bienes de Nariño" and "Papeles, libros y bienes de Sebastián López Ruiz en poder de Nariño" from the Nariño Archive of the Universidad Nacional de Colombia. Results: Out of the 39 books about Medicine (seven treatises on surgery, 12 compendia of practical exercise, 11 disease manuals, seven compendia of medical topics, and two books on childbirth) three were smallpox treatises. Conclusion: Antonio Nariño's medical and scientific practice reflects his reading and writing habits, his skills and competences, and his cultural attitudes, which promoted the notion of public health. The study of Nariño as a self-taught physician allowed for relating the scientific production techniques (development of the vaccine) and the cultural materiality (state of the art) based on the medical texts in his library.

Entre vacinas, doenças e resistências: os impactos de uma epidemia de varíola em Porto Alegre no século XIX / Between vaccines, diseases, and resistances: the impacts of a smallpox epidemic in nineteenth-century Porto Alegre

Resumo Uma epidemia de varíola que vitimou fatalmente 1% da população de Porto Alegre em 1874 é o tema deste artigo. Com base em ampla pesquisa documental e no cruzamento de informações produzidas por ocasião da morte dos indivíduos atingidos durante o evento, buscamos problematizar as razões pelas quais a varíola apresentou-se em formato epidêmico na cidade. De posse dos mapas de vacinados nos anos anteriores à eclosão da epidemia, pudemos constatar a baixa adesão da população de Porto Alegre ao preventivo, cujo benefício poderia ser ignorado pelos distintos grupos sociais que teciam relações dentro da cidade. Com a chegada de soldados doentes, oriundos de outras localidades, a moléstia se espalhou rapidamente pela cidade, causando a morte de centenas de pessoas.

Abstract This article examines a smallpox epidemic which killed 1% of the population of Porto Alegre in 1874. Through extensive documentary research and comparison with data from those who died, we problematize why smallpox manifested as an epidemic in the city. Maps showing vaccination in the years preceding the outbreak reveal that only low levels of the population of Porto Alegre participated in prevention efforts, and the benefits of these efforts were ignored by the different social groups which were interconnected within the city. As sick soldiers arrived from other places, the disease spread rapidly through the city and caused the death of hundreds of people.

Extermination of the Smallpox Virus – Light at the End of the Tunnel… or not – the Stalemate Continues.

The following is a commentary on the article “Arita I, Breman JG. Evaluation of smallpox vaccination policy. Bulletin of the World Health Organization. 1979;57(1):1-9.” Abstract (of the original article): During 1978 and 1979 the Global Commission for the Certification of Smallpox Eradication will proceed with verification of smallpox eradication in 31 countries. If current surveillance activities do not discover any further cases before the end of 1979, the world will be declared smallpox free. However, the recent occurrence of two laboratory associated smallpox cases in Birmingham, England, revealed that the stocks of variola virus held in at least 12 laboratories in the world pose a real danger to the achievement of smallpox eradication and efforts are being made to reduce the number of laboratories retaining the virus to not more than 4-all WHO collaborating centres-by 1980. Scientific data indicate the unlikelihood of smallpox recurring once it has been eradicated from the human population, although further confirmatory studies are continuing. If the Global Commission verifies the eradication of smallpox, continuation of smallpox vaccination will be unjus-tifiable in view of its severe complications, however infrequent, and the expected global savings that would result from the termination of vaccination programmes.

Immune control strategies for vaccinia virus-related laboratory-acquired infections / 生物医学与环境科学（英文）

While presenting biological characteristics of vaccinia virus and laboratory-acquired infections during related research processes, this paper focuses on benefits and risks of vaccinia virus immunization in relation to laboratory-acquired infections, describes characteristics and the adaptation of vaccinia virus vaccine, analyses the role vaccinia virus immunization plays in the prevention and control of laboratory-acquired infections, and finally proposes solutions and countermeasures to further promote and implement immune control strategies. The problem related to immune strategy and laboratory- acquired infections which is being raised, analyzed and explored plays an active and instructive role in vaccinia virus related researches and laboratory- acquired infections, and also helps to recommend and develop relevant immune strategy for future vaccine control of such infections.

A epidemia de variola e o medo da vacina em Goias / The smallpox epidemic and fear of the vaccine in Goias

Analisa dois aspectos referentes à varíola em Goiás. Um se refere à reconstituição histórica dos principais surtos no estado, nos séculos XIX e nas três primeiras décadas do XX, focalizando o aumento dos surtos epidêmicos da doença como consequência da modernização dos meios de transportes e do crescimento demográfico. O outro centra-se na resistência da população goiana do século XIX à vacina antivariólica, que pode ser compreendida num quadro mais amplo de resistência às medidas civilizadoras implantadas pelo Estado em Goiás. Em termos metodológicos, o artigo considera a varíola evento hermenêutico, procurando situá-la na proposta de normatização higiênica pretendida pelos administradores públicos, então em choque com os valores e atitudes da população local.

An analysis is made of two aspects of smallpox in the Brazilian state of Goiás. One is a historical reconstruction of the main outbreaks in the state in the nineteenth century and the first three decades of the twentieth century, focusing on the increased number of epidemics of the disease as transportation was modernized and the population grew. The other concerns the people's resistance in the nineteenth century to the smallpox vaccine, which may be understood in a broader context of resistance to the modernizations introduced by the State in Goiás. According to the methodology used, smallpox is regarded as a hermeneutic event within the broader efforts to standardize public health made by the public authorities, which ran counter to the local people's values and attitudes.

Vaccines today, vaccines tomorrow: a perspective

Vaccines are considered as one of the major contributions of the 20th century and one of the most cost effective public health interventions. The International Vaccine Institute has as a mission to discover, develop and deliver new and improved vaccines against infectious diseases that affects developing nations. If Louis Pasteur is known across the globe, vaccinologists like Maurice Hilleman, Jonas Salk and Charles Merieux are known among experts only despite their contribution to global health. Thanks to a vaccine, smallpox has been eradicated, polio has nearly disappeared, Haemophilus influenzae B, measles and more recently meningitis A are controlled in many countries. While a malaria vaccine is undergoing phase 3, International Vaccine Institute, in collaboration with an Indian manufacturer has brought an oral inactivated cholera vaccine to pre-qualification. The field of vaccinology has undergone major changes thanks to philanthropists such as Bill and Melinda Gates, initiatives like the Decade of Vaccines and public private partnerships. Current researches on vaccines have more challenging targets like the dengue viruses, malaria, human immunodeficiency virus, the respiratory syncytial virus and nosocomial diseases. Exciting research is taking place on new adjuvants, nanoparticles, virus like particles and new route of administration. An overcrowded infant immunization program, anti-vaccine groups, immunizing a growing number of elderlies and delivering vaccines to difficult places are among challenges faced by vaccinologists and global health experts.

A Study on the Anti-smallpox Policy of Joseon Government-General / 의사학

In the beginning of the colonial era, the Joseon Government-General's most important medical policy was related to the disease of smallpox. The Government-General reused some of policies established by the Great Han Empire. They also made an effort to improve the shortcomings in that anti-smallpox policy by phasing out technically insufficient vaccinators and by incubating female vaccinators. However, compulsory vaccination was the major component of the Government-General's anti-smallpox policy. The vaccination effort was lead by police officers and the frequency of vaccinations was increased two-fold. When the anti-smallpox policy became effective in 1910, the incidence of smallpox decreased. However, after 1919, the incidence of smallpox began to increase once more. According to the Government-General, this increase was the result of a decrease in the frequency of vaccinations. Therefore, in 1923, the Government-General increased the frequency of vaccinations from twice to three times by implementing the Joseon Cowpox Ordinance. Under this policy adults were also vaccinated. Interventions by local organizations were also expanded. However, through the end of the colonial era, smallpox never fully disappeared in Joseon. The lower-than-expected rate of vaccination has been identified as one of important reasons for the constant presence of this pathogenesis. Incomplete census registration was identified as the major reason for the decrease in the vaccination rate. Insufficient technologies for disseminating the smallpox vaccine and ambiguity with regard to the vaccine's effectiveness also prevented the people of Joseon from voluntarily obtaining their vaccinations. To increase the rate of vaccination, it was necessary to secure the cooperation of Koreans. However, that cooperation has never been harmonious. No records exist of any discussions related to the problem of smallpox or the effect of the anti-smallpox vaccination, which was a reasonable expectation for the citizens of Joseon. Moreover, the Government-General kept insisting that the Joseon citizens' ideas about the need for sanitary and effective vaccinations were insufficient. The sought-after cooperation was never easy, and this resulted in the extensive duration of outbreaks of smallpox.

Francisco Xavier Balmis y las Juntas de Vacuna, un ejemplo pionero para implementar la vacunación / Francisco Xavier Balmis and the vaccine network, a pioneering example of vaccination implementation

La primera campaña mundial de vacunación organizada fue efectuada en América y las Filipinas por la Real Expedición Filantrópica de la Vacuna (1803-1810). La labor de Balmis como director y de Salvany, subdirector, no se limitó al mero transporte del fluido vacunal a través de los niños vacuníferos sino también al sistema organizativo que aplicaron. Las Juntas de Vacuna fueron una red de centros creados para preservar y transportar el fluido vacuno en buenas condiciones hasta los lugares de vacunación. Disponían de un Reglamento con instrucciones sobre las características del puesto de vacunación o cómo efectuar el censo de vacunados. Para mejorar la aceptabilidad vacunal integraron a los sanitarios locales y utilizaron la prensa para difundir noticias. La estrategia desarrollada constituye un antecedente que, transcurridos doscientos años, guarda una indudable similitud con modelos de planificación sanitaria como el de Pineault y Daveluy utilizados en los modernos programas de inmunización.

The first organised global immunization campaign was undertaken in America and the Philippines by the 'Royal Philanthropic Expedition of the Vaccine' (1803-1810). The work of Balmis as director of the Expedition and Salvany, his Assistant Director, not only included vaccinating children but also the development of an organised model for its application. The model was based on a network of centres created to protect and transport the vaccine fluids in good condition until they reached their vaccination sites and how to conduct a census of vaccinated people. In order to improve vaccine acceptability, local health workers were incorporated and the press was used to disseminate news. The strategy developed served as an antecedent that, two hundred years later, is unquestionably similar to health planning models such as Pineault and Daveluy, used in modern vaccination campaigns.

Vacinação, varíola e uma cultura da imunização no Brasil / Vaccination, smallpox, and a culture of immunization in Brazil

O objetivo deste artigo é discutir a emergência e o estabelecimento de uma "cultura da imunização" no Brasil contemporâneo a partir da erradicação da varíola. Essa cultura está associada a um longo processo de introdução de vacinas, de campanhas de vacinação e de vacinação em massa empreendidas pelo Estado brasileiro desde o final do século XIX. Particular importância é atribuída à campanha de erradicação da varíola no Brasil (1966-1973). A experiência da vacinação em massa da população contra a varíola é contrastada com episódios de resistência como a "Revolta da Vacina", e considerada como crucial na configuração de novas políticas e novas compreensões sobre o papel da imunização na saúde pública e seu lugar na sociedade brasileira.

The aim of this paper is to discuss the emergence and establishment of a "culture of immunization" in the contemporary Brazil from the eradication of smallpox. This culture is associated with a long process of introduction of vaccines, vaccination campaigns and mass vaccination undertaken by the Brazilian government since the late nineteenth century. Particular importance is attributed to the campaign to eradicate smallpox in Brazil (1966-1973). The experience of mass vaccination of the population against smallpox is contrasted with episodes of resistance as the "revolt against the vaccine", and regarded as crucial in shaping new policies and new understandings about the role of immunization in public health and its place in society Brazil.

Sobre a varíola e as práticas da vacinação em Minas Gerais (Brasil) no século XIX / About smallpox and vaccination practices in Minas Gerais (Brazil) in the 19th century

Este artigo analisa o impacto da varíola e da prática da vacinação antivariólica em Minas Gerais durante o período imperial brasileiro (1822-1889). Apesar da presença de órgãos que visavam à organização e à propagação da vacina no país desde o início do século XIX, identifica-se, pela documentação relativa à saúde pública produzida pelas autoridades provinciais, uma série de fatores de natureza administrativa e cultural que influenciaram negativamente na plena implementação quer da vacina quer da estrutura organizada no período visando à sua difusão. Seguindo as proposições da historiografia dedicada ao tema, discute-se que, apesar da tendência à centralização observada em diferentes esferas da administração no processo de estruturação do Estado Imperial, no âmbito da saúde e, particularmente, no âmbito do serviço de vacinação antivariólica, prevaleceu uma desarticulação entre os diferentes agentes responsáveis pela implementação e o controle desse serviço. Outro aspecto que contribuiu para as dificuldades relativas à implementação desse serviço foi a grande resistência da população em submeter-se à vacina e que pode ser entendida pela análise das percepções sociais construídas sobre a doença e o método da vacinação.

This article discusses the impact of smallpox and vaccination practices used against the disease used in the province of Minas Gerais, in Brazil, during the Imperial Period (1822-1889). Despite the existence of services responsible for the organization and dissemination of the vaccine in the country since the early 19th century, some administrative and cultural factors, as identified in documents produced by the province's public health authorities at the time, had a negative impact upon the full implementation of both practice and organization of services aimed at the dissemination of smallpox vaccination. Based upon historiographic sources, it is argued that despite the trend towards centralization observed at different governmental spheres during the structuring of the Imperial State, in particular, in the provision of vaccination services, there was a prevailing disharmony between the different agencies responsible for the implementation and management of such services. A further contributor to the difficulties in the service implementation was the resistance of the population to submit to the vaccination, a phenomenon that can be best understood through examination of the social construction of perceptions about diseases and the vaccination method used against the smallpox.

Marcados en la piel: vacunación y viruela en Argentina (1870-1910) / Marked on the skin: vaccination and smallpox in Argentina (1870-1910)

Este artículo estudia la vacunación antivariólica en Argentina desde 1870, cuando se inician los debates al respecto, hasta la década de 1910, cuando se amplía al resto del país. Se analizan las prácticas de inmunización puestas en marcha con anterioridad a la Ley de vacunación obligatoria, aprobada en 1886 para la Capital y en 1904 para el resto del país. Tal medida fue resistida desde diferentes sectores. Su aprobación dependió de las consecuencias del proceso de modernización y urbanización acelerada, del peso de los higienistas en el escenario político y su extensión dependió de una concepción administrativa diferente, que incorporaba nuevas áreas y sectores al escenario nacional.

This paper studies the smallpox vaccination in Argentina since 1870, when these discussions were inittiaded until the 1910s, when they were extended to the rest of the country. We analyze immunization practices implemented prior to the compulsory vaccination law, passed in 1886 for the Capital and in 1904 for the rest of the country. Such a move found resistance from different sectors. Its approval depended on the consequences of modernization and urbanization, the weight of hygienists in the political arena, and its extension depended on a different administrative conception, incorporating new areas and sectors to the national scenario.