October 23, 2024

The Spread and Eradication of Smallpox: An Overview

Smallpox began causing illness and death more than a thousand years ago.
Follow its spread and eventual eradication in the timeline below.

Smallpox timeline

3rd century BC

Smallpox is present in the Egyptian Empire

A mummy's head — Traces of smallpox pustules found on the head of a 3,000-year-old mummy of the Pharaoh Ramses V.

4th century

A written description of a disease that clearly resembles smallpox appears in China

A colorful Chinese image — In China, people appealed to the god Yo Hoa Long for protection from smallpox.

6th century

Increased trade with China and Korea introduces smallpox into Japan.

A colorful drawing of a woman in red fighting a demon. — Drawing of a woman defeating the “smallpox demon” by wearing red. A myth commonly believed around the world advocated that red light would cure smallpox. In Japan, families who fell sick with smallpox set up shrines to the “smallpox demon” in their homes with the hope they would appease the demon and be cured.

7th century

Smallpox is widespread in India. Arab expansion spreads smallpox into northern Africa, Spain, and Portugal.

An Indian figurine of a goddess believed to be the cause and cure of smallpox. — Figurine of Indian smallpox goddess Shitala Mata worshipped in northern India. She was considered both the cause and cure of smallpox disease. Symbolically, she represents the importance of good hygiene in people’s health and motivates worshipers to keep their surroundings clean.

10th century

Smallpox spreads to Asia Minor, the area of present-day Turkey.

A map showing the Ottoman Empire in 1801 — The map shows the Ottoman Empire in 1801, which then extended from Turkey (Anatolia) to Greece, Hungary, Bulgaria, Romania, as well as northern Africa and parts of Middle East. Smallpox is thought to arrive to the area from Asia through major trade routes, like the Silk Road.

11th century

Entrance into Europe

Crusades further contribute to the spread of smallpox in Europe with the European Christians moving to and from the Middle East during the next two centuries.

13th century

Smallpox moves north

Population expansion and more frequent travel renders smallpox endemic in previously unaffected Central and North Europe, with severe epidemics occurring as far as Iceland.

15th century

Smallpox is widespread in many European countries, and Portuguese expeditions to African west coast and new trade routes with eastern parts of Africa introduce the disease into West Africa.

A statue with blue and gold colors, representing the West African god of smallpox. — Statue of Shapona, the West African god of smallpox. Smallpox was thought to be a disease forced upon humans due to Shapona’s “divine displeasure,” and formal worship of the god of smallpox was highly controlled by specific priests in charge of shrines to the god. People believed that the priests themselves were capable of causing smallpox outbreaks. Even though the British colonial rulers banned the worship of Shapona in 1907, worship of the deity continued.

16th century

European colonization and the African slave trade import smallpox into the Caribbean and Central and South America.

A black and white illustration showing people sick with smallpox. — Illustration by the Franciscan missionary Bernardino de Sahagun who wrote detailed accounts of the Aztec history during his life there from 1545 until his death in 1590 into 12 books entitled “General History of the Things of New Spain.” Introduction of smallpox into Mexico by the Spanish around 1520 was one of the factors that led to the demise of Aztec Empire.

Variolation—a process of grinding up dried smallpox scabs from a smallpox patient and inhaling them or scratching them into an arm of an uninfected person—is being used in China (inhalation technique) and India (cutaneous technique) to control smallpox.

A small brown, cylindrical container — A container from Ethiopia used to store the powdery variolation material, which was produced by grinding up dried smallpox scabs taken from a smallpox patient.

17th century

Increased use of variolation

Variolation (cutaneous technique) is a widespread method for preventing smallpox in the Ottoman Empire (former Asia Minor, present-day Turkey) and North Africa.

Smallpox spreads into North America

European colonization imports smallpox into North America.

18th century

Variolation is introduced into England by Lady Mary Wortley Montagu, the wife of the British ambassador to Turkey.

In 1796, Edward Jenner, an English doctor, shows the effectiveness of previous cowpox infection in protecting people from smallpox, forming the basis for vaccination.

A black and grey image of an 18th century man — Edward Jenner (1749–1823).

20th century

Smallpox is widespread in Africa, Asia, and South America in the early 1900s, while Europe and North America have smallpox largely under control through the use of mass vaccination.