1972 outbreak of smallpox in Yugoslavia
Encyclopedia
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...
in Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
. It was centred in Kosovo
Kosovo
Kosovo is a region in southeastern Europe. Part of the Ottoman Empire for more than five centuries, later the Autonomous Province of Kosovo and Metohija within Serbia...
and Belgrade
Belgrade
Belgrade is the capital and largest city of Serbia. It is located at the confluence of the Sava and Danube rivers, where the Pannonian Plain meets the Balkans. According to official results of Census 2011, the city has a population of 1,639,121. It is one of the 15 largest cities in Europe...
, Serbia
Serbia
Serbia , officially the Republic of Serbia , is a landlocked country located at the crossroads of Central and Southeast Europe, covering the southern part of the Carpathian basin and the central part of the Balkans...
(both then part of Socialist Federal Republic of Yugoslavia
Socialist Federal Republic of Yugoslavia
The Socialist Federal Republic of Yugoslavia was the Yugoslav state that existed from the abolition of the Yugoslav monarchy until it was dissolved in 1992 amid the Yugoslav Wars. It was a socialist state and a federation made up of six socialist republics: Bosnia and Herzegovina, Croatia,...
). A Muslim pilgrim had contracted the smallpox virus
Virus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
in the Middle East. Upon returning to his home in Kosovo, he started the epidemic in which 175 people were infected, 35 of whom died. The epidemic was efficiently contained by enforced quarantine
Quarantine
Quarantine is compulsory isolation, typically to contain the spread of something considered dangerous, often but not always disease. The word comes from the Italian quarantena, meaning forty-day period....
and mass vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...
. The 1982 film Variola Vera
Variola Vera
Variola Vera is a 1982 Serbian film directed by Goran Marković. The subject of the film is the 1972 outbreak of smallpox in Yugoslavia, more specifically the events related to the epidemic and the subsequent quarantine at Belgrade's General Hospital...
is based on the event.
Background
By 1972, vaccination for smallpox had long been widely available and the disease was considered to be eradicated in Europe. The population of Yugoslavia had been regularly vaccinated against smallpox for 50 years, and the last case was reported in 1930. This was the major cause for the initial slow reaction by doctors, who did not promptly recognize the symptoms of the disease.In October 1970, an Afghan family went on pilgrimage from Afghanistan, where smallpox was endemic, to Mashhad
Mashhad
Mashhad , is the second largest city in Iran and one of the holiest cities in the Shia Muslim world. It is also the only major Iranian city with an Arabic name. It is located east of Tehran, at the center of the Razavi Khorasan Province close to the borders of Afghanistan and Turkmenistan. Its...
in Iran, triggering a massive epidemic of smallpox in Iran that would last until September 1972. By late 1971, smallpox-infected devotees on pilgrimage had carried the smallpox from Iran into Syria and Iraq.
The outbreak
In early 1972, a 38-year-old Kosovo Albanian MuslimMuslim
A Muslim, also spelled Moslem, is an adherent of Islam, a monotheistic, Abrahamic religion based on the Quran, which Muslims consider the verbatim word of God as revealed to prophet Muhammad. "Muslim" is the Arabic term for "submitter" .Muslims believe that God is one and incomparable...
clergyman named Ibrahim Hoti, from Damnjane near Đakovica, Kosovo, Serbia, undertook the pilgrimage to Mecca
Hajj
The Hajj is the pilgrimage to Mecca, Saudi Arabia. It is one of the largest pilgrimages in the world, and is the fifth pillar of Islam, a religious duty that must be carried out at least once in their lifetime by every able-bodied Muslim who can afford to do so...
. He also visited holy sites in Iraq
Iraq
Iraq ; officially the Republic of Iraq is a country in Western Asia spanning most of the northwestern end of the Zagros mountain range, the eastern part of the Syrian Desert and the northern part of the Arabian Desert....
, where there were known cases of smallpox. He returned home on February 15. The following morning he felt achy and tired, but attributed this to the long bus journey. Hoti soon realised that he had some kind of infection, but, after feeling feverish for a couple of days and developing a rash, he recovered - probably because he had been vaccinated two months earlier.
On March 3, Latif Musa, a thirty-year-old schoolteacher, who had just arrived in Đakovica to enroll at the local higher institute of education, fell ill. He had no known direct contacts with the clergyman, so he might have been infected by one of the clergyman's friends or relatives who visited him during his illness, or by passing the clergyman in the street.
When Musa visited the local medical center two days later, the doctors tried to treat his fever with penicillin
Penicillin
Penicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
(smallpox is a virus, so this was ineffective). His condition didn't improve, and after a couple of days his brother took him to the hospital in Čačak
Cacak
Čačak is a city in central Serbia. It is the administrative center of the Moravica District of Serbia. Čačak is also the main industrial, cultural and sport center of the district...
, 150 km to the north in Serbia. The doctors there could not help him, so he was transferred by ambulance to the central hospital in Belgrade
Belgrade
Belgrade is the capital and largest city of Serbia. It is located at the confluence of the Sava and Danube rivers, where the Pannonian Plain meets the Balkans. According to official results of Census 2011, the city has a population of 1,639,121. It is one of the 15 largest cities in Europe...
.
On March 9, Musa was shown to medical students and staff as a case of an atypical reaction to penicillin, which was a plausible explanation for his condition. On the following day, Musa suffered massive internal bleeding and, despite efforts to save his life, died in the evening.
The cause of death was listed as "reaction to penicillin". In fact he had contracted black pox
Black Pox
Black pox is a symptom of smallpox that is caused by bleeding under the skin which makes the skin look charred or black. It was more common in teenagers. This symptom usually indicates that a patient with smallpox is going to die....
, a highly contagious form of smallpox. Before his death, Musa directly infected 38 people (including nine doctors and nurses), eight of whom would consequently die.
A few days after Musa's death, a wave of 140 smallpox cases erupted across Kosovo province.
Reaction
The government's reaction was swift. Martial lawMartial law
Martial law is the imposition of military rule by military authorities over designated regions on an emergency basis— only temporary—when the civilian government or civilian authorities fail to function effectively , when there are extensive riots and protests, or when the disobedience of the law...
was declared on March 16. Measures included blockades of villages and neighbourhoods, roadblocks, prohibition of public meetings, closure of borders and prohibition of all non-essential travel. Hotels were requisitioned for quarantines in which 10,000 people who may have been in contact with the virus were held under guard by the army.
Musa's brother developed a smallpox rash on March 20, resulting in medical authorities realising that Musa had died of smallpox. The authorities undertook a massive revaccination of the population, helped by the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
, '...almost the entire Yugoslavian population of 18 million people was vaccinated.'. Leading experts on smallpox were flown in to help, including Donald Henderson
Donald Henderson
Donald Ainslie Henderson, known as D.A. Henderson, is an American physician and epidemiologist, who headed the international effort during the 1960s to eradicate smallpox. , he is a Distinguished Scholar at the University of Pittsburgh Medical Center's Center for Biosecurity and a professor of...
and Don Francis
Don Francis
Donald Pinkston Francis is an American epidemiologist who worked on the Ebola outbreak in Africa in the late 1970s, and researched on HIV and AIDS. He retired from the U.S. Public Health Service in 1992, after 21 years of service. According to him, the White House wanted him fired, but in order to...
.
Within two weeks, almost the entire population had been re-vaccinated. By mid-May the spread of the disease was stopped and the country returned to normal life. During the epidemic, 175 people contracted smallpox and 35 of them died.
Legacy
The Yugoslav government received international praise for the successful containment of the epidemic, which was also one of the finest hours for Donald HendersonDonald Henderson
Donald Ainslie Henderson, known as D.A. Henderson, is an American physician and epidemiologist, who headed the international effort during the 1960s to eradicate smallpox. , he is a Distinguished Scholar at the University of Pittsburgh Medical Center's Center for Biosecurity and a professor of...
and the WHO, as well as one of crucial steps in the eradication of smallpox.
In 1982, Serbian director Goran Marković made the film Variola Vera about a hospital under quarantine during the epidemic. In 2002, the BBC
BBC
The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...
screened a television drama called Smallpox 2002, which was partly inspired by the events.
Timeline
- February 15, 1972 - Ibrahim Hoti, a clergyman, returns from pilgrimage to Mecca infected with the smallpox virus.
- February 16 - Hoti feels unwell.
- February 21 - Latif Musa, a thirty-year old school teacher, arrives in Đakovica to continue his studies.
- March 3 - Musa falls ill with a highly contagious form of smallpox.
- Between March 3 and March 9 Musa is misdiagnosed and moved to hospitals in Čačak and then Belgrade. During this time, he directly infects 38 people.
- March 9 - Musa is shown to medical students in the Belgrade hospital as a case of reaction to penicillin.
- March 10 - Musa develops massive internal bleeding and dies.
- March 22 - Doctors correctly diagnose the cause of Musa's death and government begins measures to contain the epidemic.
- Early April - Mass revaccination begins. Donald Henderson arrives.
- Late May - The epidemic is over. 175 people were infected; 35 died.
External links
- Variola vera. Internet Movie DatabaseInternet Movie DatabaseInternet Movie Database is an online database of information related to movies, television shows, actors, production crew personnel, video games and fictional characters featured in visual entertainment media. It is one of the most popular online entertainment destinations, with over 100 million...
entry for a film based on the 1972 smallpox outbreak in Yugoslavia. Verified availability 2005-03-12. - Smallpox 2002: Silent Weapon hosted by Drama. Drama-documentary about a hypothetical bioterrorismBioterrorismBioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents are bacteria, viruses, or toxins, and may be in a naturally occurring or a human-modified form. For the use of this method in warfare, see biological warfare.-Definition:According to the...
attack involving smallpox. Verified availability 2005-03-12.