Century Snapshots 8212; 1977

This milestone in public health history was achieved on April 23, 1977, after a sustained effort to eradicate the debilitating disease. Characterised by pustules, fever and high morbidity and mortality, smallpox epidemics occurred regularly despite the existence of a vaccination programme since 1827.

A more comprehensive vaccination programme covering the whole of the country was constituted after Independence in 1947.

By 1960, India had started a plan for the eradication of the disease in place through mass vaccination and further strengthening its vaccination programme. But so endemic was the disease that despite these efforts, the largestnumber of cases were reported in India, reaching 93,423 in 1963.

In 1967, the incidence became so high that a Government of India/WHO assessment team was set up to recommend suitable action.

This is were the highly successful Tamil Nadu study came in. Says Dr Lalit Kant, deputy director-general, Indian Council of Medical Research. 8220;To evaluate the success of surveillance-containment strategy, a programme to contain smallpox in Madras was launched headed by the city8217;s municipal health officer. So effective was the strategy that within six months, there was no indigenous transmission of the disease.8221;

Between 1967-70, the number of cases fell dramatically, especially in the south. But major setbacks were the epidemics in Gujarat in 1968-8217;69 and in Rajasthan and Haryana in 1970.

When refugees from what was then East Pakistan started pouring into West Bengal in the wake of the war for the liberation of Bangladesh, there was once again the fear of the smallpox infection. Cases surfaced in Orissa andBihar. Intensive search and containment ensured that by the end of 1974, smallpox was detected in just 285 of India8217;s 575,000 villages.

In December 1974, Operation Smallpox Zero was set in motion, which stated 8220;each outbreak must now be dealt as an absolute emergency with maximum mobilisation of staff and volunteers.8221; The target: stopping smallpox transmission completely within six to eighth weeks.

The Operation began in January 1975 and by April, one lakh fifteen thousand health workers had undertaken a house-to-house check through the entire country. The few cases found were all a result of importations. Saiban Bibi, a 30-year-old homeless Bangladeshi refugee in Karimganj, Assam, was the last person recorded to have the disease.

The International Commission visited India from April 6-20, 1977 and certified the country free of smallpox on April 23 the same year.

8212; SANCHITA SHARMA