Register      Login
Microbiology Australia Microbiology Australia Society
Microbiology Australia, bringing Microbiologists together
RESEARCH ARTICLE

History and eradication of smallpox in Turkey

Osman Şadi Yenen
+ Author Affiliations
- Author Affiliations

İstanbul University
İstanbul Medical Faculty
Department of Medical Microbiology
Çapa, İstanbul, Turkey
Email: yenen@istanbul.edu.tr

Microbiology Australia 35(3) 156-164 https://doi.org/10.1071/MA14054
Published: 8 September 2014

Abstract

Turkey has played a prominent role for the Western World in the prevention of disease from two different angles. The first is the İstanbul connection from where the variolation originated. The Ankara connection, on the other hand, provided the source for the modified Vaccinia Virus Ankara (MVA) as both the third generation smallpox vaccine and the recombinant vector for modern day vaccine development. In this article, the history of disease and eradication efforts both in the Ottoman Empire and in the Republic era of Turkey will be discussed with an emphasis on the worldwide significance of İstanbul and Ankara connections in the history of smallpox.


References

[1]  Schepin, O.P. and Yermakov, W.V. (1991) International Quarantine. (Translated from Russian by B. Meerovich and V. Bobrov). Connecticut, International Universities Press, Inc., pp. 1–344.

[2]  Damon, I.K. (2013) Poxviruses. In: Knipe, D. M. and Howley, P. M. (eds), Fields Virology, 6th edn. Philadelphia, Lippincott Williams & Wilkins, pp. 2160–2184.

[3]  McClain, C.S. (1997) A new look at an old disease: smallpox and biotechnology. In: Inhorn M. C. and Brown, P. J. (eds): The Anthropology of Infectious Disease. International Health Perspectives. Australia, Gordon and Breach Publishers, pp. 97–117.

[4]  Biagini, P. et al. (2012) Variola virus in a 300-year-old Siberian mummy. N. Engl. J. Med. 367, 2057–2059.
Variola virus in a 300-year-old Siberian mummy.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhslOitrnM&md5=bbeb561bdec9fd7d2b0566979ff29920CAS | 23171117PubMed |

[5]  McNeill, W.H. (1998) Plagues and Peoples. (Third edn) New York, Anchor Books Doubleday, pp. 35–93.

[6]  Gubser, C. and Smith, G.L. (2002) The sequence of camelpox virus shows it is most closely related to variola virus, the cause of smallpox. J. Gen. Virol. 83, 855–872.
| 1:CAS:528:DC%2BD38XislGhsLo%3D&md5=197e828208a4b2d213dae0394ab0a872CAS | 11907336PubMed |

[7]  Babkin, I.V. and Babkina, I.N. (2012) A retrospective study of the orthopoxvirus molecular evolution. Infect. Genet. Evol. 12, 1597–1604.
A retrospective study of the orthopoxvirus molecular evolution.Crossref | GoogleScholarGoogle Scholar | 22878096PubMed |

[8]  Fenner, F. et al. (1998) Smallpox and its eradication. Geneva, World Health Organization, pp. 209–244.

[9]  Rhazes (Abu Becr Mohammed ibn Zacariya Ar-Razi) (1848) A Treatise on the Small-Pox and Measles. (Translated from the Original Arabic by William Alexander Greenhill). London, Printed for The Sydenham Society 1848 (reprinted in 2013), pp. 29, 94.

[10]  Oldstone, M.B.A. (1998) Viruses, Plagues, & History. Oxford, Oxford University Press, pp. 27–44.

[11]  Watts, S. (1997) Epidemics and History. Disease, Power and Imperialism. New Haven, Yale University Press, pp. 84–121.

[12]  Barquet, N. and Domingo, P. (1997) Smallpox: the triumph over the most terrible of the ministers of death. Ann. Intern. Med. 127, 635–642.
Smallpox: the triumph over the most terrible of the ministers of death.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svmtVentg%3D%3D&md5=c09d205058e6cb3425b1f0391710ae82CAS | 9341063PubMed |

[13]  Ligon, B.L. (2001) Smallpox: its history and re-emergence as a weapon of biological warfare. Semin. Pediatr. Infect. Dis. 12, 71–80.
Smallpox: its history and re-emergence as a weapon of biological warfare.Crossref | GoogleScholarGoogle Scholar |

[14]  Henderson, D.A. (2009) Smallpox The Death of A Disease. New York, Prometheus Books, pp. 1–334.

[15]  Institute of Medicine (2009) Live Variola Virus: Considerations for Continuing Research. Washington, DC, The National Academies Press, pp. 1–151.

[16]  Boylston, A.W. (2012) Defying Providence Smallpox and the Forgotten 18th Century Medical Revolution. North Charleston, SC, Create Space Independent Publishing Platform, pp. 1–282.

[17]  Bazin, H. (2000) The Eradication of Smallpox. Edward Jenner and The First and Only Eradication of a Human Infectious Disease. London, Academic Press, pp. 1–246.

[18]  Hopkins, D.R. (2002) The Greatest Killer: Smallpox in History. Chicago and London, The University of Chicago Press, pp. 1–380 (Originally published as Princes and Peasants: Smallpox in History by The University of Chicago Press in 1983)

[19]  Poulakou-Rebelakou, E. and Lascaratos, J. (2003) Emmanuel Timonis, Jacobus Pylarinus and inoculation. J. Med. Biogr. 11, 181–182.
| 12870046PubMed |

[20]  Timonius, E. and Woodward, J. (1714) An account, or history, of the procuring the smallpox by incision, or inoculation; as it has for some time been practised at Constantinople. Being the extract of a letter from Emanuel Timonius, Oxon. & Patav. M.D. S.R.S dated at Constantinople, December, 1713. Phil Trans 29, 72–82.
An account, or history, of the procuring the smallpox by incision, or inoculation; as it has for some time been practised at Constantinople. Being the extract of a letter from Emanuel Timonius, Oxon. & Patav. M.D. S.R.S dated at Constantinople, December, 1713.Crossref | GoogleScholarGoogle Scholar |

[21]  Pylarini, J. (1716) A new and safe method of communicating the small-pox by inoculation, lately invented and brought into use. Translated and abridged from the Latin. In: Phil. Trans. R. Soc. Lond. from their commencement, in 1665, to the year 1800, Abridged, Vol. VI from 1713 to 1723. London, L & R Baldwin, 1809: 207–210.

[22]  Russell, P. and Russell, A. (1768) An account of inoculation in Arabia, in a letter from Dr. Patrick Russell, physician, at Aleppo, to Alexander Russell, M.D., F.R.S. proceeded by a letter from Dr. Alexander Russell to the Earl of Morton. P.R.S. Phil. Trans. 58, 140–150.
An account of inoculation in Arabia, in a letter from Dr. Patrick Russell, physician, at Aleppo, to Alexander Russell, M.D., F.R.S. proceeded by a letter from Dr. Alexander Russell to the Earl of Morton. P.R.S.Crossref | GoogleScholarGoogle Scholar |

[23]  Yıldırım, N. (2010) A History of Healthcare in İstanbul. Düzey Matbaacılık, İstanbul, pp. 70–77.

[24]  Unat, E.K. (1970) Osmanlı İmparatorluğunda Bakteriyoloji ve Viroloji. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Yayınları İstanbul, pp. 17–30.

[25]  Ünver, A.S. (1948) An outlook on the history of smallpox vaccination during the last century and a half in Turkey and in the whole world. In: Ünver A. S. (Ed) Türkiye’de Çiçek Aşısı veTarihi [An outlook on the history of smallpox vaccination]. İstanbul Üniversitesi Tıp Tarihi Enstitüsü Yayını Yayın No: 38 İstanbul, pp. 279–288.

[26]  Baxby, D. (2002) Smallpox vaccination techniques; from knives and forks to needles and pins. Vaccine 20, 2140–2149.
Smallpox vaccination techniques; from knives and forks to needles and pins.Crossref | GoogleScholarGoogle Scholar | 11972983PubMed |

[27]  Montagu, M.W. (1717) The Turkish Embassy Letters. Introduction: Dessai A, and Text edited and annotated Jack M. Virago Press, London 2011 (13rd reprinted from 1994’s edition), pp. 1–190.

[28]  Behbehani, A.M. (1983) The smallpox story: life and death of an old disease. Microbiol. Rev. 47, 455–509.
| 1:STN:280:DyaL2c7hslWlsQ%3D%3D&md5=89ec1753a8aa71b7a319dcb466e6e528CAS | 6319980PubMed |

[29]  Huth, E. (2006) Quantitative evidence for judgments on the efficacy of inoculation for the prevention of smallpox: England and New England in the 1700s. J. R. Soc. Med. 99, 262–266.
Quantitative evidence for judgments on the efficacy of inoculation for the prevention of smallpox: England and New England in the 1700s.Crossref | GoogleScholarGoogle Scholar | 16672762PubMed |

[30]  Silverstein, A.M. (2009) A History of Immunology. (Second edn). London, Academic Press, pp. 291–303.

[31]  Sloane, H. and Birch, T. (1755–1756) An account of inoculation by Sir Hans Sloane, Bart. Given to Mr. Ranby, to be published, Anno 1736. Communicated by Thomas Birch, D. D. Secret. R. S. Phil Trans 49, 516–520.
An account of inoculation by Sir Hans Sloane, Bart. Given to Mr. Ranby, to be published, Anno 1736. Communicated by Thomas Birch, D. D. Secret. R. S.Crossref | GoogleScholarGoogle Scholar |

[32]  Jenner, E. (1996) An Inquiry into the Causes and Effects of the Variolae Vacciniae, or Cow-pox 1798. In: Jenner, E (Ed.) Vaccination against Smallpox. New York, Prometheus Books Great Minds Series, pp. 13–40.

[33]  Boylston, A. (2013) The origins of vaccination: no inoculation, no vaccination. J. R. Soc. Med. 106, 395–398.
The origins of vaccination: no inoculation, no vaccination.Crossref | GoogleScholarGoogle Scholar | 24097964PubMed |

[34]  Dinç, G. and Ulman, Y.I. (2007) The introduction of variolation ‘A La Turca’ to the West by Lady Mary Montagu and Turkey’s contribution to this. Vaccine 25, 4261–4265.
The introduction of variolation ‘A La Turca’ to the West by Lady Mary Montagu and Turkey’s contribution to this.Crossref | GoogleScholarGoogle Scholar | 17383778PubMed |

[35]  Walsh, R. (1836) A Residence at Constantinople. Vol II, Ch XI. London, Westley, F. and Davis, A. H., 300–302.

[36]  Baldwin, P. (1999) Contagion and the State in Europe 1830–1930. Cambridge, Cambridge University Press, pp. 244–354.

[37]  Stone, A.F.M. and Stone, W.D. (2002) Lady Mary Wortley Montagu: medical and religious controversy following her introduction of smallpox inoculation. J. Med. Biogr. 10, 232–236.
| 1:STN:280:DC%2BD38njtVGlsw%3D%3D&md5=02892a3b356fbb08c54d05204ba3ac7aCAS |

[38]  Özdemir, H. (2008) The Ottoman Army 1914–1918 Disease & Death on the Battlefield. Salt Lake City, The University of Utah Press, pp. 1–274.

[39]  Özlüarda, E. (1962) Çiçek aşısı istihsalinde kullanılan yeni metod ve aşı tatbikatında dikkat edilmesi gereken hususlar. Turk Hij. Tecr. Biyol. Derg. 22, 206–218.

[40]  Erzin, N. (1952) Türkiye’de çiçek. Turk Hij. Tecr. Biyol. Derg. 12, 138–142.

[41]  Özlüarda, E. et al. (1963) Memleketimizde 1962 yılında yapılan çiçeğe karşı kitle aşılaması ve elde edilen sonuçlar. Turk Hij. Tecr. Biyol. Derg. 23, 179–201.

[42]  Verardi, P.H. et al. (2012) A vaccinia virus renaissance: new vaccine and immunotherapeutic uses after smallpox eradication. Hum. Vaccin. Immunother. 8, 961–970.
A vaccinia virus renaissance: new vaccine and immunotherapeutic uses after smallpox eradication.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhsF2nsbjO&md5=51db5ceabf83f6678aca69458ca0f923CAS | 22777090PubMed |

[43]  Mayr, A. et al. (1975) Abstammung, Eigenschaften und Verwendung des attenuierten Vaccinia-Stammes MVA Infection 3, 6–14.
Abstammung, Eigenschaften und Verwendung des attenuierten Vaccinia-Stammes MVACrossref | GoogleScholarGoogle Scholar |

[44]  Mustafa, Ş. (1948) Müdürü bulunduğum zamanda İstanbul telkihhanesinin kapanışına kadar metod ve çalışmalarımıza ve müessesenin Ankara’ya nakline dair. In: Ünver, A. S. (Ed): Türkiye’de Çiçek Aşısı ve Tarihi [An outlook on the history of smallpox vaccination]”. İstanbul Üniversitesi Tıp Tarihi Enstitüsü Yayını, Yayın No: 38 İstanbul, pp. 190–205.

[45]  Mayr, A. (2003) Smallpox vaccination and bioterrorism with pox viruses. Comp. Immunol. Microbiol. Infect. Dis. 26, 423–430.
Smallpox vaccination and bioterrorism with pox viruses.Crossref | GoogleScholarGoogle Scholar | 12818626PubMed |

[46]  Meyer, H. et al. (1991) Mapping of deletions in the genome of the highly attenuated vaccinia virus MVA and their influence on virulence. J. Gen. Virol. 72, 1031–1038.
Mapping of deletions in the genome of the highly attenuated vaccinia virus MVA and their influence on virulence.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK3MXksVarur8%3D&md5=16815de0b453c7c6b4165cfc4db7d846CAS | 2033387PubMed |

[47]  Antoine, G. et al. (1998) The complete genomic sequence of the modified vaccinia Ankara strain: comparison with other orthopoxviruses. Virology 244, 365–396.
The complete genomic sequence of the modified vaccinia Ankara strain: comparison with other orthopoxviruses.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK1cXjtFahsLY%3D&md5=7515b783ddd5942fb9da64f15c92a5aeCAS | 9601507PubMed |

[48]  McCurdy, L.H. et al. (2004) Modified vaccinia Ankara: potential as an alternative smallpox vaccine. Clin. Infect. Dis. 38, 1749–1753.
Modified vaccinia Ankara: potential as an alternative smallpox vaccine.Crossref | GoogleScholarGoogle Scholar | 15227622PubMed |

[49]  Gómez, C.E. et al. (2013) Clinical applications of attenuated MVA poxvirus strain. Expert Rev. Vaccines 12, 1395–1416.
Clinical applications of attenuated MVA poxvirus strain.Crossref | GoogleScholarGoogle Scholar | 24168097PubMed |

[50]  Stickl, H. et al. (1974) MVA-Stufenimpfung gegen Pocken. Klinische Erprobung des attenuierten Pocken-Leben-dimpfstoffes, Stamm MVA Dtsch. Med. Wochenschr. 99, 2386–2392.
MVA-Stufenimpfung gegen Pocken. Klinische Erprobung des attenuierten Pocken-Leben-dimpfstoffes, Stamm MVACrossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE2M%2FjvVGktA%3D%3D&md5=e5d80ac528350a5d1eb0c8468b588656CAS | 4426258PubMed |

[51]  Blanchard, T.J. et al. (1998) Modified vaccinia virus Ankara undergoes limited replication in human cells and lacks several immunomodulatory proteins implications for use as a human vaccine. J. Gen. Virol. 79, 1159–1167.
| 1:CAS:528:DyaK1cXivFOltb4%3D&md5=dfb7eb79a53c6d109d25068991e76bc6CAS | 9603331PubMed |

[52]  Rosenthal, S.R. et al. (2001) Developing new smallpox vaccines. Emerg. Infect. Dis. 7, 920–926.
Developing new smallpox vaccines.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MnpvFWhtw%3D%3D&md5=9a9d0ec48758f5a4f7ebf6053e9f9505CAS | 11747717PubMed |

[53]  Whitley, R.J. (2003) Smallpox: a potential agent of bioterrorism. Antiviral Res. 57, 7–12.
Smallpox: a potential agent of bioterrorism.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXhs1Cnu7Y%3D&md5=49859a90c0638454cacf8cfbc912061eCAS | 12615298PubMed |

[54]  Onul, B. (1980) İnfeksiyon Hastalıkları. Ankara Üniversitesi Tıp Fakültesi Yayını, Sayı: 391 Ankara. 6. Basım, pp. 194–222.

[55]  Unat, E.K. (1982) Tıp Bakteriyolojisi ve Virolojisi. Dergâh Yayınları İstanbul, pp. 936–954.

[56]  Gerner, P. et al. (2003) Die Pocken. Prävention, Diagnose und Therapie einer ausgerotteten Erkrankung Monatsschr. Kinderheilkd. 151, 893–907.
Die Pocken. Prävention, Diagnose und Therapie einer ausgerotteten ErkrankungCrossref | GoogleScholarGoogle Scholar |

[57]  Sarı, N. (1999) Osmanlı hekimliği ve tıp bilimi (Ottoman Medical practice and Science). Yeni Tip Tarihi Arastirmalari 5, 11–68.