1974 smallpox epidemic in India

Map of India with states.

The 1974 smallpox epidemic in India infected 188,000 people, leading to the deaths of 31,000 Indians.[1]

The media reported the smallpox epidemic as the most severe.[2] However, the claim is debatable due to improvements in reporting since the epidemics of 1875 and 1967.[3] The 1974 epidemic occurred during the country’s intensified campaign against the virus, which saw a shift in strategy from mass vaccinations to search and containment.[4] The year prior, vaccination programs and improved vaccination techniques, along with surveillance and investigation strategies, reduced smallpox transmission in most of the country except for a few states, including Bihar, Uttar Pradesh, and West Bengal.[1]

The epidemic persisted in these regions in January and lasted until summer for several reasons. Smallpox was difficult to eradicate in rural, poor areas with inferior transportation and communications.[5] During the Indian smallpox eradication campaign, over 80% of the population lived in remote areas, creating logistical issues for vaccine delivery.[6]

Bihar and Uttar Pradesh accounted for approximately three-quarters of global smallpox cases in 1974.[3] The World Health Organization (WHO) reported 103,830 infections throughout India in January 1974, which was 20% higher than the total number of cases the year before.[7] In March, new cases were discovered in Madhya Pradesh, an area previously cleared of smallpox imported from Bihar.[3] By May, cases reached a record of 48,833.[3] Within one week in May, 11,000 new cases and 8600 imminent outbreaks were discovered in Bihar, resulting in one case each minute.[4]

An outbreak in southern Bihar in May traced back to Tata Group labourers, instigated vaccinations of railway workers and road closures to prevent further spread.[8] Nevertheless, 300 more outbreaks and 2,000 cases swept into 11 states.[8] A month later, the WHO estimated 75,000 infections in Bihar.[9]

The monsoon season stifled human interactions and, combined with increased containment activities, caused smallpox cases to decrease.[4]

  1. ^ a b Lahariya, Chandrakant (2014). "A brief history of vaccines & vaccination in India". The Indian Journal of Medical Research. 139 (4): 491–511. ISSN 0975-9174. PMC 4078488. PMID 24927336.
  2. ^ "India Rushes Health Teams Into Smallpox Epidemic Zone". The New York Times. 7 June 1974. p. 9. Retrieved 7 November 2022.
  3. ^ a b c d Brilliant, Lawrence B. (1985). The management of smallpox eradication in India. Ann Arbor: University of Michigan Press. ISBN 0-472-10059-9. OCLC 11599679.
  4. ^ a b c Dutta, Mahendra; Basu, R.N. (2011). "Lessons from smallpox eradication campaign in Bihar state and in India". Vaccine. 29: D19–D21. doi:10.1016/j.vaccine.2011.12.001. PMID 22486977.
  5. ^ "Global Effort Pays Off... Smallpox at Target "Zero"" (PDF). Dateline: Center for Disease Control. October 1979. Retrieved 7 November 2022.
  6. ^ Verma, A 2022, How India overcame smallpox, GAVI: The Vaccine Alliance, viewed 17 November 2022, Available at https://www.gavi.org/vaccineswork/how-india-overcame-smallpox
  7. ^ "30,000 Killed in India in Smallpox Epidemic". Los Angeles Times. 6 October 1974. pp. A4.
  8. ^ a b Henderson, Donald A. (2009). Smallpox : the death of a disease : the inside story of eradicating a worldwide killer. Amherst, N.Y.: Prometheus Books. ISBN 978-1-59102-722-5. OCLC 314597839.
  9. ^ "10,000 Die in India Smallpox Epidemic". The Atlanta Constitution. 5 June 1974. pp. 1C. Retrieved 7 November 2022.