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The geography of smallpox in England before vaccination: A conundrum resolved

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  • Davenport, Romola Jane
  • Satchell, Max
  • Shaw-Taylor, Leigh Matthew William

Abstract

Smallpox is regarded as an ancient and lethal disease of humans, however very little is known about the prevalence and impact of smallpox before the advent of vaccination (c.1800). Here we use evidence from English burial records covering the period 1650–1799 to confirm a striking geography to smallpox patterns. Smallpox apparently circulated as a childhood disease in northern England and Sweden, even where population densities were low and settlement patterns dispersed. However, smallpox was a relatively rare epidemic disease in southern England outside the largest cities, despite its commercialised economy and the growing spatial interconnectedness of its settlements. We investigated a number of factors hypothesised to influence the regional circulation of smallpox, including exposure to naturally occurring orthopox viruses, settlement patterns, and deliberate preventative measures. We concluded that transmission was controlled in southern England by local practices of avoidance and mass inoculation that arose in the seventeenth and eighteenth centuries. Avoidance measures included isolation of victims in pest houses and private homes, as well as cancellation of markets and other public gatherings, and pre-dated the widespread use of inoculation. The historical pattern of smallpox in England supports phylogenetic evidence for a relatively recent origin of the variola strains that circulated in the twentieth century, and provides evidence for the efficacy of preventative strategies complementary to immunisation.

Suggested Citation

  • Davenport, Romola Jane & Satchell, Max & Shaw-Taylor, Leigh Matthew William, 2018. "The geography of smallpox in England before vaccination: A conundrum resolved," Social Science & Medicine, Elsevier, vol. 206(C), pages 75-85.
  • Handle: RePEc:eee:socmed:v:206:y:2018:i:c:p:75-85
    DOI: 10.1016/j.socscimed.2018.04.019
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    References listed on IDEAS

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    1. Romola Davenport & Leonard Schwarz & Jeremy Boulton, 2011. "The decline of adult smallpox in eighteenth‐century London," Economic History Review, Economic History Society, vol. 64(4), pages 1289-1314, November.
    2. Raymond Gani & Steve Leach, 2001. "Transmission potential of smallpox in contemporary populations," Nature, Nature, vol. 414(6865), pages 748-751, December.
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    Cited by:

    1. David Kaniewski & Nick Marriner, 2020. "Conflicts and the spread of plagues in pre-industrial Europe," Palgrave Communications, Palgrave Macmillan, vol. 7(1), pages 1-10, December.
    2. Tim Riswick & Sanne Muurling & Katalin Buzasi, 2022. "Exploring the mortality advantage of Jewish neighbourhoods in mid-19th century Amsterdam," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 46(25), pages 723-736.
    3. Leigh Shaw‐Taylor, 2020. "An introduction to the history of infectious diseases, epidemics and the early phases of the long‐run decline in mortality," Economic History Review, Economic History Society, vol. 73(3), pages 1-19, August.

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