Vaccine

Introduction

The nature of cultural contact implies an exchange, in many cases this exchange was biological. The development and use of vaccines world wide reflects the nature of disease proliferation and the global need for vaccines. After exploration, migration and trade brought people together, diseases no longer stayed in their places of origin where the population has immunity or at the very least have resistance to their 'native' illnesses. Cultural Contact spread these diseases to populations with no prior exposure which caused epidemics and millions of deaths, creating the need for a vaccine. This report will cover the the specifics of cultural contact and disease and the development of vaccines to cure afflicted populations. This report will also broadly survey disease prevention methods used before vaccines were introduced by the scientific community as well as the complications that arise from their use.

Disease, Cultural Contact and the Need for Vaccines

Although cultural contact had occurred for centuries among Europeans, Asians, and Africans the age of exploration proliferated ‘old world’ diseases to populations never before exposed and thus with no immunological tools in which to fight them off. As Anne Ramenofsky et al explains people whom repeatedly come in contact with the same diseases develop a degree of resistance to said sickness. However the cultures that exploration accessed had been previously isolated and thus were completely decimated by diseases such as small pox, measles, and influenza [18]. Europeans also aided the transfer of contagious diseases by collecting indigenous persons together thus providing an environment that allowed illnesses to easily transfer from person to person. The mobile and communal nature of native bands also facilitated disease from community to community [19].

In fact the introduction of ‘old world’ infectious diseases, sparked by the voyages of Columbus in 1492 (also known as the Columbian Exchange), led to the death of 100 million indigenous people in the Americas and Pacific islands over two-hundred years [20]. The communities victimized by sickness did not forget these outbreaks and their source, for example native myths of the Pacific Northwest refer to European ships as “Disease Boats” [21]. Perhaps Europeans did not understand the full extent of their disease foot print, not realizing that these contact zones involved unexposed, virgin lands and thus were vulnerable [22].

In the ‘old world’ different cultures were continually connected via migration and trade. Many of Europe’s epidemics were caused by foreign diseases introduced through contact, for example it is theorized that the bubonic plague that historically ravaged Europe was introduced by Asiatic rat fleas. It is important to note that constant exposure to a disease does not make one completely immune as the make up of each sickness is constantly changing [23]. The age of exploration meant the end of geographical restrictions on disease. People from all areas, both the old world and the new, were coming into contact with diseases for which they possessed no immunological proficiencies. Vaccines were needed to protect persons against the biological byproducts of globalization and cultural contact for which they had no defenses.

History of vaccines

Vaccination began at a time when very little was known about germs, microbes or even our own immune system. The world was grappling with one of the oldest diseases ever recorded, smallpox. Smallpox is a devastating disease which produces lesions on victims’ face before spreading throughout the body[1]. Of those who survived the disease, all were left with disfiguring scars and one third became permanently blind[1]. Smallpox is believed to existed as early as 10,000 BC in Africa and spread throughout the world by trade routes[2]. By the 18th century, smallpox had become the leading cause of death of Europeans and killing 400,000 Europeans . The fatality rate for adults ranged from 20-60% while for infants that number was as high as 80%[1]. Today, we may be suffering the same fate if not for a simple observation from an English doctor.

Edward Jenner was born in Gloucestershire England in 1746[2]. In 1764, he became an apprentice of Dr. George Harwicke where his interest in cowpox, a similar disease to smallpox, blossomed[3]. At the time it was known that dairymaids who often contracted cowpox had immunity from smallpox yet nobody knew why. In 1796, Jenner performed an experiment where he inoculated a healthy eight year old boy with pus from cowpox lesions of a woman[1]. After the boy returned to full health ten days later, Jenner inoculated him with material collected from a smallpox lesion. The boy never became sick even after subsequent exposures to the smallpox disease[2].

The smallpox vaccine spread rapidly throughout Europe and by 1800, had reached most of Europe[4]. Despite setbacks including new epidemics in the 1900s and the revelation that revaccination was required to confer lifelong immunity, on May 8th 1980 the World Health Assembly declared the world free of smallpox[4]. Only 184 years after the first successful vaccination, Jenner’s vision of a world free of smallpox became reality.

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Medicinal Attempts Before The Development of Vaccines

The creation of vaccines originated from the result of numerous attempts through the centuries to gain immunity to diseases that were known to be fatal. Many of these attempts were seen during major epidemics such as the infamous plagues that have devastated the world’s population by the millions, and included the “Venice Treacle”, promoted by a surgeon-general called John Woodall in the 17th century during the London breakout of the plague which he claimed to cure the plague, or medicine made from the “flesh of a rattle-snake” and the “powder of toads” by Nathaniel Hodges, a doctor who also lived through the epidemic in London during the same time[5].

Beginnings of actual effective medicinal attempts to protect humans against diseases was said to be originated during the 17th century in India in the form of inoculation, a practice which involved the introduction of a mild form of a virus from a certain disease into a living being to create future immunity to deadlier forms of the disease[6]. The form of inoculation used there was variolation, or the act of inoculating one against smallpox[7]. It often involved dipping the pus from eruptions formed by the smallpox and dipping a needle in it before making punctures with the needle in the area of a patient’s deltoid muscle to infect them with the virus. Minor symptoms of smallpox would appear, such as fever and pustules, but they would eventually go away, leaving the patient immune to smallpox[8]. Inoculation was later shown to have spread from India to China, where medical practitioners used a variety of methods such as blowing powdered scabs from an infected person into the nostril of the patient or swearing a piece cotton with the “contents of a vesicle” and stuffing it into a patient’s nose[9].

Inoculation eventually reached Europe in the 18th century when it introduced to England by a woman called Lady Wortley Montagu who had seen inoculation being carried out while she was visiting Constantinople. As a survivor of smallpox herself, Lady Montagu had the procedure carried out on her children. During around the same time, inoculation also begun in America, started by Cotton Mather who was told of the practice by his African slave[9]. Inoculation had gradually spread from India to other parts of the world, where vaccines would eventually be developed.

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Responses and Restrictions

Each year, over seventeen million people die, world-wide, as a result of infectious disease. Pandemics - defined by the World Health Organization (WHO) as a new sustainable virus found in humans which spreads easily and causes serious illness[10]- are represented in this number. Historically, pandemics, such as smallpox, tuberculosis, and Acquired Immune Deficiency (AIDS), have caused a devastating loss of human life.[11] It is yet to be seen if the more recent 2009 H1N1 Type A virus will cause similar destruction.

Similar to personal illness, global epidemics elicit widespread fear. The term ‘pandemic’ evokes images of debilitating illness and mass death. This fear manifests itself in the hoarding and stockpiling of masks and anti-flu medications, such as Tamiflu, during epidemics. It also is exhibited by the drastic decrease in pork sales, during the H1N1 outbreaks[12]. Pharmaceutical corporations capitalize on this fear, often using media to promote ‘scare stories’, further instilling a sense of panic. Government and WHO recommendations and precautions also exacerbate public concern. The installation of temperature-checking devices in airports, mandatory health checks in schools and pamphlets filled with prevention recommendations, all result in increased fear[13].

As previously mentioned, global travel has facilitated the spread of disease. In response to this, world leaders and health organizations often discourage travel to those countries affected by diseases, which have the potential to become pandemics.[14,15] This limits interaction between countries, curtailing cultural contact. The development of vaccines alleviates both the sense of fear, and the resulting travel restrictions, brought about by pandemics.

It is important to note that while vaccines can have a positive impact upon cultural contact and exchanges, global accessibility limits their effectiveness. Although the global population is nearing seven billion, pharmaceutical companies have the capacity to generate only one or two billion doses a year. Ninety percent of companies able to produce flu vaccines are located in developed nations,[16] and as a result of both limited access and prohibitive costs, people in developing countries rarely receive these vaccines. According to health officials, unless everyone is vaccinated, the disease will continue to spread among those not protected, increasing the likelihood it will mutate[17] and place those already vaccinated in danger, once again.

References

[1] Barquet N, Domingo P. Smallpox: the triumph over the most terrible of the ministers of death. Ann Intern Med. 1997;127(8 Pt 1):635–642.

[2] Parish HJ. Victory with Vaccines: The Story of Immunization. Edinburgh: E & S Livingstone; 1968.

[3] Willis NJ. Edward Jenner and the eradication of smallpox. Scott Med J. 1997;42:118–121.

[4] World Health Organization. The Global Eradication of Smallpox: Final Report of the Global Commission for the Certification of Smallpox

[5] Holland, Bart K. "Treatment." Journal of the Royal Society of Medicine, June 2000: 322-324.

[6] Oxford English Dictionary. 2. Oxford University Press, 1989.

[7] Datta, SK. "Women and vaccinations From smallpox to the future, a tribute to a partnership benefiting humanity for over 200 years." Human Vaccines. July 2009. 450-456.

[8] Agrawal, D.P., and Lalit Tiwari. Did You Know? http://www.indianscience.org/dyk/t_dy_Q14.shtml (accessed November 13, 2009).

[9] Plotkin, Stanley A., Walter A. Orenstein, and Paul A. Offit. Vaccines. 5. Elsevier Health Sciences, 2008.

[10] Avian Influenza Frequently asked Questions. World Health Organization. 5 Dec. 2009. 15 Nov. 2009. <http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/>

[11] Moore, Pete. Killer Germs: Rogue Diseases of the Twenty-First Century. London: Carlton Books Ltd, 2001. 29 – 45.

[12] Engdahl, William. Flying Pigs, Tamiflu and Factory Farms. Centre for Research on Globalization. 29 April 2009. 16 Nov. 2009. <http://www.globalresearch.ca/index.phpcontext=va&aid=13408>

[13] Moore, Pete. Pandemic: The Terrifying Threat of the New Killer Plagues. New York: Citadel Press Books, 2001. 135

[14] Moore, Pete. Pandemic: The Terrifying Threat of the New Killer Plagues. New York: Citadel Press Books, 2001. 134 - 136

[15] Europeans Urged to avoid Mexico and US as swine flu death toll rises. Nasaw, D., McGreal, C., Tuckman, J. and Williams. R. 27 April 2009. 16 Nov. 2009. <http://www.guardian.co.uk/world/2009/apr/27/swine-flu-mexico>

[16] MacDonald, Noni. “H1N1 influenza vaccine: Global access for a global problem.” Canadian Medical Association Journal 181 (2009): 123.

[17] Moore, Pete. Pandemic: The Terrifying Threat of the New Killer Plagues. New York: Citadel Press Books, 2001. 235 – 236.

[18] Ramenofsky,Ann F et al. “Native American Disease History: Past, Present and Future Directions.” World Archaeology 35, no.2 (October 2003): 242. http://www.jstor.org/stable/3560225.

[19] Boyd, Robert. “Commentary on Early Contact-Era Smallpox in the Pacific Northwest Small pox came about in late 1700s, disastrous effects.” Ethnohistory 43, no. 2 (Spring 1996): 313. http://www.jstor.org/stable/483399.

[20] "Topics in World History” extracts from Bentley, Ziegler, and Streets. Traditions and Encounters: A Brief Global History (McGraw-Hill Primis Online): 372.

[21] Boyd, Robert . “Commentary on Early Contact-Era Smallpox in the Pacific Northwest Small pox came about in late 1700s, disastrous effects.” Ethnohistory 43, no. 2 (Spring 1996): 311. http://www.jstor.org/stable/483399.

[22] Ramenofsky,Ann F et al. “Native American Disease History: Past, Present and Future Directions.” World Archaeology 35, no.2 (October 2003): 242. http://www.jstor.org/stable/3560225.

[23] Appleby, Andrew. “The Disappearance of Plague: A Continuing Puzzle” The Economic History Review 33, no. 2 (May 1980):172. http://www.jstor.org/stable/2595837.