Former Pitt professor reflects on eradicating smallpox

In October 1966, Pitt professor of medicine and public health D.A. Henderson arrived in Geneva as a general ready for battle against one of the deadliest foes of the 20th century.

Smallpox had killed an estimated 300 million people worldwide since 1900, compared to the 120 million people who died because of armed conflict. The World Health Organization had picked Henderson to achieve “target zero” — the complete eradication of smallpox from the human population — in 10 years.

At the time, WHO officials were trying, and failing, to eliminate malaria. So few people, including many WHO officials, thought the smallpox eradication program would work.

But Henderson, with a budget of $2.4 million per year from the WHO, proved his superiors wrong. On Oct. 26, 1977, the last case of smallpox occurred in Somalia, nine months after Henderson’s target goal.

Henderson spoke last Thursday in Alumni Hall to launch the release of his new book, “Smallpox: The Death of a Disease.” The date also marked the 30th anniversary of the declaration that smallpox had been eradicated.

Former U.S. Secretary of Health and Human Services Tommy Thompson, who has worked closely in Washington with Henderson since Sept. 11 to buffet the nation’s biosecurity, introduced Henderson as a friend and dedicated servant of public health.

Richard Preston, the author of a nonfiction book about smallpox and bioterrorism, wrote on the jacket for Henderson’s book that his discovery was “one of the noblest and best things that we have ever done as a species.”

Henderson worked for the Centers for Disease Control before he was chosen to lead the WHO program, helping to compile statistics about the feasibility of a global effort to eliminate smallpox, which killed Egyptian pharaohs 3,000 years ago.

Former U.S. Assistant Surgeon General James Watt called Henderson to Washington and ordered him to assume the directorship of the program.

On a budget that allotted less than $50,000 per year for each endemic country, Henderson had to cut a lot of costs. The international staff working out of Geneva never amounted to more than 150 people.

Most of the vaccinations were injected by health officials working in their own countries. Henderson and his team coordinated the effort to send them the vaccine and supplies needed to deliver it.

In the first chapter of his book, Henderson describes his most lasting memory of the horror of smallpox. He remembered Dhaka, Bangladesh, in particular.

“Neither water nor food offered comfort. Pus-filled lesions covered the insides of their mouths, making it painful for them to even swallow or chew,” he writes. “Flies were everywhere, thickly clustered over eyes half- closed by pastules.”

At the book launch, Henderson showed a series of graphic photos of a small boy infected with smallpox, which is transferrable between humans only when rashes form on the body.

The boy’s face was first covered with small pastules, which look similar to chicken pox. The pastules grew larger with each photo, eventually forming legions that engulfed the boy’s face.

Henderson developed a strategy to quarantine smallpox and developed a highly organized system to deliver vast quantities of the smallpox vaccine swiftly and cheaply.

At the outset of each new smallpox case in the endemic countries, Henderson and his team moved in with the vaccine to form a ring of vaccinated people around the outbreak so it couldn’t spread to the rest of the population.

The vaccine was administered cheaply using an innovative tool called the bifurcated needle, pictured on the front of Henderson’s new book.

Aid workers injected the vaccine eight times into the skin of each patient. This technique provided a cheap and efficient way to vaccinate large populations of people.

In 1973, smallpox was dying fast, but remained strong in India, where Henderson had struggled to vaccinate such a dense population. He organized an effort to search every village in India in 10 days for cases of the virus, using more than 100,000 health staff members in the country.

After the disease was officially declared dead, Henderson was awarded the Presidential Medal of Freedom and became dean of the Johns Hopkins Bloomberg School of Public Health.

He has worked closely with past presidential administrations, especially the Bush administration, to prepare the world for a biomedical attack, which could involve using an infectious disease as a weapon.

Since 2003, Henderson has worked as a resident scholar at Pitt’s Center for Biosecurity — as part of a collaboration between Johns Hopkins University and Pitt — to prepare the nation for a potential biological attack.

While introducing Henderson, Thompson told the audience he’s seen few men who garnered the respect Henderson did.

“When he went before the U.S. Senate, every member gave him a standing ovation,” Thompson said. “In all my years in Washington, I had never seen that.”