Smallpox
Today it is known that smallpox is caused by the variola virus, but in the 18th century the root cause was not known. People during the period did understand something about how the disease spread, however, and were able to take preventative measures to protect public health.
Transmission & Vectors
Smallpox was spread by coughing or sneezing particles of the virus while in close contact with other people. It was also spread through contact with surfaces or materials contaminated by the fluid from the sores on the infected person's skin.
Causes
Smallpox is caused by the variola virus, though this was not known at the time of the Revolution.
Symptoms
Smallpox has been noted to have distinct stages of progression. The initial symptoms an infected person notices are a high fever, body aches, and sometimes vomiting. This stage usually lasts two to four days.
In the next stage, the infected person develops a rash, followed by sores, in the mouth and throat. After these sores subside, a rash begins to form all over the body, followed by sores. The fever may decline at during this time. These skin sores fill with fluid and form an indentation at their peak. The fever typically returns at this time. This stage usually lasts about four days.
The next stage lasts about ten days. During this time, the sores become round pustules that are firm to the touch. These scab over after about five days.
Over the next six days or so, the scabs will fall off, sometimes leaving marks on the skin called pockmarks.
Once all the scabs have fallen off, approximately four weeks after the rash begins, the patient is no longer contagious.
Treatment
Because the disease of smallpox was not completely understood, treatments often varied. A common one recommended was bleeding, a common treatment for nearly everything at the time.
Prognosis
While smallpox was a survivable disease even in the 18th century, the fatality rate was usually around 30%. Those who did survive often were left with scars from the sores that were a signature of the disease. These were known as pockmarks.
Affected Groups
Smallpox was especially dangerous because anyone could get it, especially those living in close quarters, such as in the military. However, once a person had it and survived, they did not get it again.
Prevention
Though vaccines did not exist in the 18th century, inoculation was common. The process of inoculation required taking the contents of an infected person's smallpox sores and transferring it to the wound of someone who was not infected. Using the "live" version of the virus in this way often caused the person being inoculated to also become sick, but the illness was often (but not always) less severe than if they had acquired it naturally. Inoculation was used to ensure the health of the army under General George Washington throughout the American Revolution.
In order to protect the health of the larger population, people who were ill with smallpox were sometimes quatenteened in their homes.
Epidemiology
Smallpox could travel rapidly in areas of dense population or close living conditions. This is why it was a serious issue for armies in the 18th century and why Washington wanted his soldiers all inoculated.
History
Smallpox has impacted human history since the 6th century. Europeans spread it throughout the world, including to North America where it decimated Native populations who had not been exposed to the virus before.
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