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Donald Ainslie Henderson

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Smallpox: The Death of a Disease - The Inside Story of Eradicating a Worldwide Killer Hardcover – June 23, 2009

by D. A. Henderson (Author), Richard Preston (Foreword)

4.4 70 ratings

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For more than 3000 years, hundreds of millions of people have died or been left permanently scarred or blind by the relentless, incurable disease called smallpox. In 1967, Dr. D.A. Henderson became director of a worldwide campaign to eliminate this disease from the face of the earth.

This spellbinding book is Dr. Henderson’s personal story of how he led the World Health Organization’s campaign to eradicate smallpox—the only disease in history to have been deliberately eliminated. Some have called this feat "the greatest scientific and humanitarian achievement of the past century."

In a lively, engrossing narrative, Dr. Henderson makes it clear that the gargantuan international effort involved more than straightforward mass vaccination. He and his staff had to cope with civil wars, floods, impassable roads, and refugees as well as formidable bureaucratic and cultural obstacles, shortages of local health personnel and meager budgets. Countries across the world joined in the effort; the United States and the Soviet Union worked together through the darkest cold war days; and professionals from more than 70 nations served as WHO field staff. On October 26, 1976, the last case of smallpox occurred. The disease that annually had killed two million people or more had been vanquished–and in just over ten years.

The story did not end there. Dr. Henderson recounts in vivid detail the continuing struggle over whether to destroy the remaining virus in the two laboratories still that held it. Then came the startling discovery that the Soviet Union had been experimenting with smallpox virus as a biological weapon and producing it in large quantities. The threat of its possible use by a rogue nation or a terrorist has had to be taken seriously and Dr. Henderson has been a central figure in plans for coping with it.

New methods for mass smallpox vaccination were so successful that he sought to expand the program of smallpox immunization to include polio, measles, whooping cough, diphtheria, and tetanus vaccines. That program now reaches more than four out of five children in the world and is eradicating poliomyelitis.

This unique book is to be treasured—a personal and true story that proves that through cooperation and perseverance the most daunting of obstacles can be overcome.

Print length

334 pages
Language

English
Publisher

Prometheus Books
Publication date

June 23, 2009
Dimensions

5.6 x 0.94 x 8.4 inches
ISBN-10

1591027225
ISBN-13

978-1591027225
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David M. Oshinsky
1,101
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Editorial Reviews

From Publishers Weekly

In his introduction, The Hot Zone author Preston points to the fact that "in smallpox's last hundred years," 1879-1979, it killed more people than "all the wars on the planet during that time." For more than 50 years, doctor and public health expert Henderson combated the disease, first as director of the Center for Disease Control's Epidemic Intelligence Service, then (from 1965 on) as director of the World Health Organization initiative which would later be known as The Eradication. Henderson provides an overview of the painful disease, "a monster" that killed roughly a third of the unimmunized it infected. Chillingly, "variolation," the direct subcutaneous injection of a patient's pus into a healthy person, was used to spur immunity from before the 10th century. The much safer cowpox vaccination was discovered in 1796 (mandated by Washington for the Continental army); meanwhile, smallpox had decimated the Native American population. Henderson's "surveillance and containment strategy" would indeed eradicate smallpox globally; India, the last holdout, was rid of it in 1974 by 115,000 health workers, dispatched to villages throughout the country to identify, quarantine, and vaccinate. This inspiring achievement makes a stirring read for medical history fans, though readers of Preston may find it a bit dry.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Review

"Outstanding! What a great read. D.A. Henderson pulls no punches as he tells the inside story of the global eradication of smallpox. He and his WHO team faced a formidable array of obstacles, frustrations, and outright disasters in their decade-long struggle; any one of a hundred of which could have doomed the effort to failure....The passion, commitment, and raw determination shine through. THIS is the heroic stuff of true public health leadership!" --Donald S. Burke, MD, University of Pittsburgh Medical Center-Jonas Salk Chair in Global Health, University of Pittsburgh

There has been no greater medical --or humanitarian--miracle in modern times than the eradication of smallpox, history's deadliest infectious disease. Now, for the first time, we learn the inside story from D. A. Henderson, the legendary public health official who led the global effort that brought this miracle about. Smallpox--The Death Of A Disease is more than a riveting account of the day-to-day struggle for international cooperation in a divided world; it also offers a winning blueprint for the great medical challenges to come." --David Oshinsky, winner of the 2006 Pulitzer Prize in History for Polio: An American Story

"Thorough, balanced and well-crafted, Smallpox--The Death of a Disease is the story of one of mankind's greatest achievements. The success of the eradication campaign is a testament to the difference the global public health community can make when it truly comes together for a common purpose. Whether one speaks of HIV/AIDS or Neglected Tropical Diseases, the solution lies in allies and adversaries working as one to alleviate suffering and save lives. This is the lesson to be drawn from Dr. Henderson's excellent book." --Tommy G. Thompson, Secretary of Health and Human Services (2001-2005); Governor of Wisconsin (1987-2001)

Product details

Publisher ‏ : ‎ Prometheus Books; First Edition (June 23, 2009)
Language ‏ : ‎ English
Hardcover ‏ : ‎ 334 pages
ISBN-10 ‏ : ‎ 1591027225
ISBN-13 ‏ : ‎ 978-1591027225
Item Weight ‏ : ‎ 1.36 pounds
Dimensions ‏ : ‎ 5.6 x 0.94 x 8.4 inches

Best Sellers Rank: #1,977,120 in Books (See Top 100 in Books)
- #838 in Viral Diseases (Books)
- #1,020 in Communicable Diseases (Books)
- #2,121 in History of Medicine (Books)

Customer Reviews:
4.4 70 ratings

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Donald Ainslie Henderson

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D. A. Henderson, MD is currently professor of medicine and public health at the University of Pittsburgh and a distinguished scholar at the Center for Biosecurity in Baltimore. He is a professor and former dean of the Johns Hopkins School of Public Health. He served as Life Sciences Adviser to President G. H. W. Bush and was the first director of the newly created Office of Public Health Emergency Preparedness in the Department of Health and Human Services. He is the recipient of the Presidential Medal of Freedom and the National Medal of Science plus many other awards. He has received the Japan Prize and has been knighted by the King of Thailand.

Photo by Will Kirk, John Hopkins University.

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4.4 out of 5

70 global ratings

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Mec

Exalted work, accessible book

Reviewed in the United States on March 20, 2012

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The eradication of smallpox relieved cataclysmic amounts of human suffering.

Henderson organized this book chronologically with plenty of illustrative, entertaining vignettes. I found it more useful to organize the things I learned categorically rather than chronologically.underplayed

Scientific: smallpox has several attributes that made it specially vulnerable to eradication. There is only one infected species. There are no asymptomatic carriers. Smallpox symptoms are easy to recognize.

Technological: from antiquity, variolation provided protection at the expense of infecting others during the variolation time. Jenner developed the first effective vaccine by working from a folk medicine story. Later vaccines were not heat-stable (decayed at room temperature). The most modern vaccine, freeze-dried, was heat-stable (I would have called it "room-temperature-stable"). That enabled the creation and distribution of enough doses for the whole world.

Technology 2: several generations of vaccination equipment culminating in the bifurcated needle which reduced the vaccine dose needed by 4x compared to previous needles.

Politics: initial funding and resource allocation. Working around reporting systems that lied, national health systems that hid patients (!), bureaucrats who know how to say "no" but don't know how to say "yes", people who want to do things differently or not at all. Working with both sides in countries embroiled in civil war.

Strategy: mass vaccinations vs surveillance and quick-response teams. Responding to waves of refugee migration and nomadic people.

Logistics: a great challenge. The programs in many countries took longer, cost more. Transportation broke down. Communication was difficult. Perpetual scrounging for resources. Lots of surprises.

Recruiting: finding people who can do the job and will work hard and cheerfully -- even when the job is dirtier, harder, and longer than everybody signed up for. Some field agents were enormously more effective than average. How do you find and keep people like that?

Resolution: many of the people in the smallpox program went on to other work after the eradication of smallpox. Henderson thought he would. But even though people don't get infected anymore, someone still has to work on smallpox.

===

Two parts of the book bothered me. First, I think Henderson gave too little consideration to the valid points made by anti-eradication doctors. It was not at all certain that eradication would work. Second, in several parts of the book, Henderson laments that other humanitarian programs wouldn't share resources with his program -- but he gives no instance of any other program asking his smallpox teams for resources and his teams' response. In countries suffering from droughts, famines, civil wars, and mass migrations, surely some other groups asked his teams for transportation and other resources? How did the smallpox teams reply?

Overall, though, this book was excellent. Thank you, D. A. Henderson, for your work. And thank you for setting down hundreds of pages of information accessible to a layman.

7 people found this helpful

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J. Murszewski

Eloquent, Thrilling, Informative, and Astounding

Reviewed in the United States on August 25, 2012

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This book is unequivocally one of the most well written and informative works I have ever read. Henderson gives an endearing and witty account of himself through the turmoils of battling one of the world's greatest scourges on mankind. His writing is extremely real but yet with a touch of eloquence. Reading the book you can feel yourself become one of his disciples against the complete eradication of smallpox. The best part is you also are being imbibed with something so important- knowledge. You are introduced to a full timeline of smallpox: from the invention of the bifurcated needle to the declaration by the WHO of eradication. You are also given cultural perspectives as well and shown how many places worshiped smallpox as deities. Henderson also goes into great depth reflecting upon the future implications of keeping variola major stores in US and Russia. That it is undoubtedly the one fact that pulls the entire triumphant story of global eradication down. The book's forward is written by Richard Preston, author of The Hot Zone. He states that "... [Henderson] feels that the official destruction of smallpox would set a moral and ethical standard for the international community. Any person, group, or nation that continued to hold smallpox after the point [of complete reserve destruction] would be committing a crime against humanity." With that, it is almost a cruel and sick slap in the face to the hundreds of thousands of people who worked to eradicate the disease as the DNA for smallpox has been decoded. That is the one true life caveat that I wish could change to make Henderson's work complete. Thrilling book that you will relish cover to cover. Not enough praise can be heaped upon this book for its quality.

3 people found this helpful

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Adentate

Read It.

Reviewed in the United States on December 15, 2016

The thing I love about history, particularly disease history, is that it is absolutely packed with incredible stories of men and women who were completely undaunted by the most fearsome plagues and insurmountable obstacles.

This story is no different. The Eradicators did a service to humanity that unfortunately, many today take for granted. They prevented the deaths of hundreds of millions. They prevented the pain and suffering of untold spouses, families, and friends who had to watch a victim die. They prevented the pain and suffering of untold millions who would have lived on after infection with permanent disfigurement, blindness, and more. What they did was thought impossible, yet it did not stop them.

This book chronicles the story of The Eradicators, and what they did for us. Though slightly dry in the middle of the book, when the author is describing eradication country by country, I found the rest of the book fantastic.

Reviewed in the United States on January 9, 2020

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I got a this have not finished it yet. But I was beyond excited that used copy I got was actually signed by D.A. Henderson himself. Like the way the book is written. I am a fan of Richard Preston's books and way of writing.

2 people found this helpful

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anna

a good book for those interested in public health

Reviewed in the United States on March 24, 2016

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a bit more about the reporting and containment strategy than anything. a good book for those interested in public health. I was looking for more anecdotes and details about work arounds for the problems that exist dealing with people.

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Wilbur D McFadden

the victims dying a horrible death or else leaving them scarred for life

Reviewed in the United States on June 19, 2015

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A very well written story about the WHO program to eradicate that killed more people in our world's history than any other disease. Smallpox is still a disease without treatment, a contagious disease with a high mortality rate, the victims dying a horrible death or else leaving them scarred for life. This book has another huge plus-----it is written by D.L. Henderson, the leader of the very successful program. Truly one of the really remarkable medical stories of the 20th century!

2 people found this helpful

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Amazon Customer

Very informative and interesting

Reviewed in the United States on April 4, 2018

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Excellent overview of how DA Henderson and his small group of epidemiologists and young field workers eradicated smallpox. I use this book to teach graduate and undergraduate Public Health students about this topic. This book is very well written and interesting.

One person found this helpful

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Top reviews from other countries

Julie Burns

Wonderful

Reviewed in the United Kingdom on June 16, 2014

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Fantastic book. Dr Henderson is a real modern hero. Anyone who reads this will be convinced of the wonderful power of vaccination.

3 people found this helpful

C. Meadows

Paperback version missing photos and inaccurate introduction

Reviewed in the United Kingdom on June 18, 2022

Verified Purchase

A good book and well worth a read, despite giving the impression through lack of personal detail that the author was never really on the frontline (unlike other accounts from the period).
However, two major gripes: the text refers to ‘plates’ as in (see Plate 7) indicating there should be colour photographs somewhere in the book. There are none in the paperback version, this is highly irritating. And the new Introduction by Phillip K Peterson, MD, contains the ridiculously silly error of getting the name of both the ‘father of vaccinology’ and the boy he immunised with cowpox incorrect! It was Edward Jenner and James Phipps, correctly stated in the Foreward by Richard Preston which follows directly afterwards. Nice work editor. 🙄

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