Las epidemias de viruela y la introducción de la vacuna en el Virreinato del Río de la Plata / Smallpox epidemics and vaccine introduction in the Viceroyalty of the Río de la Plata

La viruela fue una de las enfermedades epidémicas más temidas desde la antigüedad debido a su alta mortalidad y a las secuelas que dejaba en aquellos que lograban sobrevivir. En el presente trabajo se abordará el ingreso de esta enfermedad en nuestro continente, así como su manifestación a través de epidemias, brotes y focos endémicos. Al mismo tiempo se verá qué reacciones provocó dentro del ámbito médico durante los años del Virreinato del Río de la Plata. Se analizarán los problemas que surgieron con el uso de la vacuna importada, así como el hallazgo de nuestra vacuna local, finalizando con los comienzos de la organización de los servicios de vacunación obligatoria. (AU)

Smallpox was one of the most feared epidemic diseases since ancient times due to its high mortality and the sequelae caused in those that managed to survive. In the present work, the introduction of this disease into our continent will be addressed as well as its manifestation through epidemics, outbreaks, and endemic foci. At the same time, the reactions this disease caused inside the medical field during the years of the Viceroyalty of the Río de la Plata will be observed. The problems that arose from the usage of the imported vaccine and the discovery of our local vaccine will be analyzed, and it will finish with the beginnings of the organization of the mandatory vaccination services. (AU)

[Viruses to rescue health: Vaccination]. / Les virus au service de la santé : la vaccination.

Viruses have been used as tools to prevent viral infections themselves for more than two centuries with impressive success. After the empirical discoveries of the first vaccines, today the development of genetic engineering, molecular virology, reverse genetics, the manipulation of viral genomes, their high-throughput sequencing and their chemical synthesis, the mastery of cell culture and purification methods have greatly benefited the development of viral vaccines. Since smallpox and rabies, the history of vaccinology has followed in the footsteps of the history of virology. New mRNA or viral vector vaccines have emerged in recent years. They were developed and distributed to the population in record time in the face of the Covid pandemic. Viruses in the service of health have a bright future ahead of them, whether to prevent other pandemics, to treat cancer, or to finally control HIV and malaria.

Title: Les virus au service de la santé : la vaccination. Abstract: Depuis plus de deux siècles, les virus sont utilisés, avec un succès impressionnant, comme outils de prévention des infections virales. Depuis la variole et la rage, l'histoire de la vaccinologie a suivi les pas de l'histoire de la virologie. Après les découvertes empiriques des premiers vaccins, le développement du génie génétique, de la virologie moléculaire, de la génétique inverse, la manipulation des génomes viraux, leur séquençage à haut débit et leur synthèse chimique, la maîtrise de la culture cellulaire et des méthodes de purification, ont considérablement contribué au développement de nouveaux vaccins viraux. Des vaccins à ARN messager ou à vecteur viral ont ainsi vu le jour ces dernières années et, face à la pandémie de Covid-19, ont été développés et distribués à la population en un temps record. Les virus au service de la santé ont un bel avenir devant eux, que cela soit pour prévenir d'autres pandémies, pour traiter le cancer, ou contrôler, enfin, le VIH ou le Plasmodium, l'agent du paludisme.

Las epidemias en La Pampa (Argentina), en perspectiva histórica* / The epidemics in La Pampa (Argentina), from a historical perspective

Resumen Este artículo describe el inicio de las preocupaciones sanitarias vinculadas a las epidemias ocurridas durante el siglo XX en La Pampa, provincia argentina. Las epidemias, como las de la viruela, fueron un estímulo para estas políticas que frecuentemente tuvieron origen en Buenos Aires, la capital del país. El contagio de muchas epidemias dependía de carencias de infraestructura: agua, desagüe y desecho adecuado de basuras, de la ausencia de un número suficiente de trabajadores de salud, de la presencia de vectores transmisores de enfermedades como los mosquitos y, en última instancia, de la pobreza. La experiencia histórica descrita en este texto resalta la importancia de analizar el impacto del SARS-CoV-2 más allá de las grandes ciudades.

Abstract This article describes the emergence of health concerns relating to the epidemics that occurred during the twentieth century in La Pampa, a province in Argentina. Epidemics such as smallpox drove such policies, which frequently originated in Buenos Aires, the country's capital. The spread of many epidemics was due to shortages: water, sewage and adequate refuse disposal, an insufficient number of health care workers, the presence of disease transmission vectors such as mosquitos, and, ultimately, poverty. The historical experience described in this text highlights the importance of analyzing the impact of SARS-CoV-2 beyond the big cities.

Antigen-Specific Treatment Modalities in MS: The Past, the Present, and the Future.

Antigen-specific therapy for multiple sclerosis may lead to a more effective therapy by induction of tolerance to a wide range of myelin-derived antigens without hampering the normal surveillance and effector function of the immune system. Numerous attempts to restore tolerance toward myelin-derived antigens have been made over the past decades, both in animal models of multiple sclerosis and in clinical trials for multiple sclerosis patients. In this review, we will give an overview of the current approaches for antigen-specific therapy that are in clinical development for multiple sclerosis as well provide an insight into the challenges for future antigen-specific treatment strategies for multiple sclerosis.

Los orígenes de la vacuna / The origins of the vaccine

La medicina china y su cultura ancestral parecen tener los antecedentes más remotos de los intentos por prevenir o curar el azote epidemiológico de esa época: la viruela. Estos conocimientos empíricos llegaron al Asia Central y Europa, y algunos granjeros hicieron observaciones de la utilidad de la inoculación o variolización sin llegar a documentar sus ensayos en la comunidad científica. El mérito de Edward Jenner reconocido como el descubridor de la vacuna antivariólica, radica en haber demostrado con evidencia práctica la protección conferida frente a la enfermedad por la administración en un niño sano de un material proveniente de una persona con lesiones causadas por el cowpox, virus de la viruela vacuna. Desde Europa en el siglo XVIII y comienzos del siglo XIX, la inoculación primero y luego la vacunación llegan a Hispanoamérica por vías informales o por determinación de la corona como un servicio a las colonias. La vacunación antivariólica tuvo el valor agregado de motivar y convencer a las autoridades gubernamentales sobre la necesidad de implementar políticas de salud pública para responder a las necesidades sanitarias de la población. En Chile, Fray Pedro Manuel Chaparro fue el pionero en la aplicación y difusión de la vacuna, realizó la primera campaña nacional y se cuenta entre los padres de la salud pública nacional.

Chinese medicine and its ancestral culture seem to have the most remote history of attempts to prevent or cure the epidemiological scourge of that era: smallpox. This empirical knowledge reached Central Asia and Europe, and some farmers made observations of the usefulness of inoculation or variolization without documenting their trials to the scientific community. The merit of Edward Jenner, recognized as the discoverer of the smallpox vaccine, lies in having demonstrated with practical evidence the protection conferred against the disease by the administration in a healthy child of a material from a person with cowpox lesions. From Europe in the eighteenth and early nineteenth centuries, first inoculation and then vaccination arrive in Latin America by informal means or by determination of the crown as a service to the colonies. Smallpox vaccination had the added value of motivating and convincing government authorities about the need to implement public health policies to respond to the health needs of the population. In Chile, Fray Pedro Manuel Chaparro was the pioneer in the application and diffusion of the vaccine, conducted the first national campaign and is counted among the parents of national public health.

An Analysis of the United States and United Kingdom Smallpox Epidemics (1901-5) - The Special Relationship that Tested Public Health Strategies for Disease Control.

At the end of the nineteenth century, the northern port of Liverpool had become the second largest in the United Kingdom. Fast transatlantic steamers to Boston and other American ports exploited this route, increasing the risk of maritime disease epidemics. The 1901-3 epidemic in Liverpool was the last serious smallpox outbreak in Liverpool and was probably seeded from these maritime contacts, which introduced a milder form of the disease that was more difficult to trace because of its long incubation period and occurrence of undiagnosed cases. The characteristics of these epidemics in Boston and Liverpool are described and compared with outbreaks in New York, Glasgow and London between 1900 and 1903. Public health control strategies, notably medical inspection, quarantine and vaccination, differed between the two countries and in both settings were inconsistently applied, often for commercial reasons or due to public unpopularity. As a result, smaller smallpox epidemics spread out from Liverpool until 1905. This paper analyses factors that contributed to this last serious epidemic using the historical epidemiological data available at that time. Though imperfect, these early public health strategies paved the way for better prevention of imported maritime diseases.

El niño con enfermedades infecciosas en las artes visuales: pintura / The child with infectious diseases in the visual arts: painting

Resumen: El impacto catastrófico de las enfermedades infecciosas sobre la salud infantil, como también el rol trascendental y benéfico aportado por la instauración y ejecución de medidas sanitarias y de inmuno- prevención ha sido un tema recurrente en la historia de la medicina, aunque una vez logrado el con trol de la enfermedad, estas pasan fácilmente al olvido. Ante esto, parece necesario rememorar aquel escenario social mediante un acercamiento a través de la pintura. Las obras pictóricas son testigo de aquello, pues las enfermedades son objeto de representación y a su vez se han convertido en un in valuable documento en la historia de la medicina. Patologías pediátricas como tuberculosis, difteria, poliomielitis, sarampión, viruela y sífilis como también el inicio de la vacunación, son analizadas en diversas pinturas con el objetivo de profundizar el conocimiento de la época histórica, el autor y su vínculo con dicha enfermedad.

Abstract: The catastrophic impact of infectious diseases on children's health, as well the transcendental and be neficial role played by the establishment and execution of health measures and immunoprevention, has been a recurrent subject in the history of medicine, although once the disease has been controlled, they are easily forgotten. In view of this, it seems necessary to recall that social scenario through an approach through painting. The pictorial works are witnesses of that since diseases are subject of representation, and at the same time, they have become an invaluable document in the history of me dicine. Pediatric pathologies such as tuberculosis, diphtheria, polio, measles, smallpox, and syphilis, as well as the initiation of vaccination, are analyzed in various paintings with the aim of deepening knowledge of the historical era, the author and his or her link to this disease.

Entre vacinas, doenças e resistências: os impactos de uma epidemia de varíola em Porto Alegre no século XIX / Between vaccines, diseases, and resistances: the impacts of a smallpox epidemic in nineteenth-century Porto Alegre

Resumo Uma epidemia de varíola que vitimou fatalmente 1% da população de Porto Alegre em 1874 é o tema deste artigo. Com base em ampla pesquisa documental e no cruzamento de informações produzidas por ocasião da morte dos indivíduos atingidos durante o evento, buscamos problematizar as razões pelas quais a varíola apresentou-se em formato epidêmico na cidade. De posse dos mapas de vacinados nos anos anteriores à eclosão da epidemia, pudemos constatar a baixa adesão da população de Porto Alegre ao preventivo, cujo benefício poderia ser ignorado pelos distintos grupos sociais que teciam relações dentro da cidade. Com a chegada de soldados doentes, oriundos de outras localidades, a moléstia se espalhou rapidamente pela cidade, causando a morte de centenas de pessoas.

Abstract This article examines a smallpox epidemic which killed 1% of the population of Porto Alegre in 1874. Through extensive documentary research and comparison with data from those who died, we problematize why smallpox manifested as an epidemic in the city. Maps showing vaccination in the years preceding the outbreak reveal that only low levels of the population of Porto Alegre participated in prevention efforts, and the benefits of these efforts were ignored by the different social groups which were interconnected within the city. As sick soldiers arrived from other places, the disease spread rapidly through the city and caused the death of hundreds of people.

Vaccination coverage among foreign-born and U.S.-born adolescents in the United States: Successes and gaps - National Immunization Survey-Teen, 2012-2014.

BACKGROUND: An overall increase has been reported in vaccination rates among adolescents during the past decade. Studies of vaccination coverage have shown disparities when comparing foreign-born and U.S.-born populations among children and adults; however, limited information is available concerning potential disparities in adolescents. METHODS: The National Immunization Survey-Teen is a random-digit-dialed telephone survey of caregivers of adolescents aged 13-17 years, followed by a mail survey to vaccination providers that is used to estimate vaccination coverage among the U.S. population of adolescents. Using the National Immunization Survey-Teen data, we assessed vaccination coverage during 2012-2014 among adolescents for routinely recommended vaccines for this age group (≥1 dose tetanus and diphtheria toxoids and acellular pertussis [Tdap] vaccine, ≥1 dose quadrivalent meningococcal conjugate [MenACWY] vaccine, ≥3 doses human papillomavirus [HPV] vaccine) and for routine childhood vaccination catch-up doses (≥2 doses measles, mumps, and rubella [MMR] vaccine, ≥2 doses varicella vaccine, and ≥3 doses hepatitis B [HepB] vaccine). Vaccination coverage prevalence and vaccination prevalence ratios were estimated. RESULTS: Of the 58,090 respondents included, 3.3% were foreign-born adolescents. Significant differences were observed between foreign-born and U.S.-born adolescents for insurance status, income-to-poverty ratio, education, interview language, and household size. Foreign-born adolescents had significantly lower unadjusted vaccination coverage for HepB (89% vs. 93%), and higher coverage for the recommended ≥3 doses of HPV vaccine among males, compared with U.S.-born adolescents (22% vs. 14%). Adjustment for demographic and socioeconomic factors accounted for the disparity in HPV but not HepB vaccination coverage. CONCLUSIONS: We report comparable unadjusted vaccination coverage among foreign-born and U.S.-born adolescents for Tdap, MenACWY, MMR, ≥2 varicella. Although coverage was high for HepB vaccine, it was significantly lower among foreign-born adolescents, compared with U.S.-born adolescents. HPV and ≥2-dose varicella vaccination coverage were low among both groups.

[The advent of a newborn specialty: 19th century pediatrics]. / Naissance de la pédiatrie au 19e siècle.

Pediatrics began under the most unfavorable conditions that are difficult to imagine nowadays. Children at the start of the 19th century were considered as negligible. The death rate was tremendous, increased by the work of children in factories as soon as 6 years of age in textile industries. In upper classes, infants were fed by a wet nurse, far from their parents and death rate was high as well. The emergence of pediatrics was the result of work carried out in adult medicine in the first half of the 19th century: clinical anatomic method, knowledge of contagious diseases even before the discovery of bacteria, birth of bacteriology. During the whole century, infectious diseases contributed in a large part to children mortality, as that of adults, by cholera, typhus, variola, diphtheria, measles and tuberculosis. Progresses noted during the 2nd part of the century resulted from beginning of hygiene, antisepsis, nutrition improvement, taking consideration of children as human being asking for protection. In contrast, therapeutics as serotherapy, vaccinations at the break of the 20th century played a secondary role.

Immunisation coverage annual report, 2014.

This 8th annual immunisation coverage report shows data for 2014 derived from the Australian Childhood Immunisation Register and the National Human Papillomavirus Vaccination Program Register. This report includes coverage data for 'fully immunised' and by individual vaccines at standard age milestones and timeliness of receipt at earlier ages according to Indigenous status. Overall, 'fully immunised' coverage has been mostly stable at the 12- and 24-month age milestones since late 2003, but at 60 months of age, it has increased by more than 10 percentage points since 2009. As in previous years, coverage for 'fully immunised' at 12 months of age among Indigenous children was 3.7% lower than for non-Indigenous children overall, varying from 6.9 percentage points in Western Australia to 0.3 of a percentage point in the Australian Capital Territory. In 2014, 73.4% of Australian females aged 15 years had 3 documented doses of human papillomavirus vaccine (jurisdictional range 67.7% to 77.4%), and 82.7% had at least 1 dose, compared with 71.4% and 81.5%, respectively, in 2013. The disparity in on-time vaccination between Indigenous and non-Indigenous children in 2014 diminished progressively from 20.2% for vaccines due by 12 months to 11.5% for those due by 24 months and 3.0% at 60 months of age.

Changing the Face of Veterinary Medicine: Research and Clinical Developments at AAVMC Institutions.

This paper provides a 50-year overview of research and clinical advances in AAVMC member colleges in four representative fields of veterinary medicine: oncology, vaccine development, production medicine, and public health. Though emphasis is on the progress since the mid-1960s, the salient background and associated personnel in each field are also identified to the extent that their description informs more recent events. Advances in board certification and post-graduate clinical and research educational opportunities are also described.

Control, contención y educación higiénica en las campañas de vacunación contra la viruela en México durante la década de 1940 / Control, containment and health education in the smallpox-vaccination campaigns in Mexico in the 1940s

El artículo examina algunas transformaciones por las que atravesaron los programas mexicanos de vacunación, a partir de 1943, al establecerse la Campaña Nacional contra la Viruela. Se analiza por qué se procuró implementar un método uniforme y coordinado de vacunación para terminar con los brotes epidémicos de esa enfermedad endémica, sobre todo en la región central del país; se estudian las acciones de su amplio y heterogéneo personal y los argumentos por los que se consideró que la vacunación antivariolosa era central para consolidar una cultura de prevención. En suma, se estudia por qué se favoreció la vacunación selectiva, la persuasión y la extensión de los programas de educación higiénica, temáticas que han sido escasamente abordadas en la historiografía.

This article examines some of the changes that the Mexican vaccination programs underwent starting in 1943, the year when the National Smallpox Campaign (Campaña Nacional contra la Viruela) was established. It analyzes why a uniform and coordinated vaccination method was adopted to counter the outbreaks of this endemic disease, especially in central Mexico; the actions of its numerous and heterogeneous staff; and the reasons why smallpox vaccination was considered critical to establish a culture of prevention. In summary, the article examines why selective vaccination was chosen and the expansion of the health-education programs, topics that have been seldom addressed in historical research.

The biography of the immune system and the control of cancer: from St Peregrine to contemporary vaccination strategies.

BACKGROUND: The historical basis and contemporary evidence for the use of immune strategies for prevention of malignancies are reviewed. Emphasis is focussed on the Febrile Infections and Melanoma (FEBIM) study on melanoma and on malignancies that seem to be related to an overexpression of human endogenous retrovirus K (HERV-K). DISCUSSION: It is claimed that, as a result of recent observational studies, measures for prevention of some malignancies such as melanoma and certain forms of leukaemia are already at hand: vaccination with Bacille Calmette-Guérin (BCG) of new-borns and vaccination with the yellow fever 17D (YFV) vaccine of adults. While the evidence of their benefit for prevention of malignancies requires substantiation, the observations that vaccinations with BCG and/or vaccinia early in life improved the outcome of patients after surgical therapy of melanoma are of practical relevance as the survival advantage conferred by prior vaccination is greater than any contemporary adjuvant therapy. SUMMARY: The reviewed findings open a debate as to whether controlled vaccination studies should be conducted in patients and/or regions for whom/where they are needed most urgently. A study proposal is made and discussed. If protection is confirmed, the development of novel recombinant vaccines with wider ranges of protection based, most likely, on BCG, YFV or vaccinia, could be attempted.

Between East and West: polio vaccination across the Iron Curtain in Cold War Hungary.

In 1950s Hungary, with an economy and infrastructure still devastated from World War II and facing further hardships, thousands of children became permanently disabled and many died in the severe polio epidemic that shook the globe. The relatively new communist regime invested significantly in solving the public health crisis, initially importing a vaccine from the West and later turning to the East for a new solution. Through the history of polio vaccination in Hungary, this article shows how Cold War politics shaped vaccine evaluation and implementation in the 1950s. On the one hand, the threat of polio created a safe place for hitherto unprecedented, open cooperation among governments and scientific communities on the two sides of the Iron Curtain. On the other hand, Cold War rhetoric influenced scientific evaluation of vaccines, choices of disease prevention, and ultimately the eradication of polio.

Immunisation coverage annual report, 2011.

This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of standard measures derived from Australian Childhood Immunisation Register data, and National Human Papillomavirus (HPV) Vaccination Program Register data. The proportion of children 'fully vaccinated' at 12, 24 and 60 months of age was 91.4%, 92.2% and 89.5% respectively. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.8%) and varicella at 24 months (83.9%). By late 2011, the percentage of children who received the 1st dose of DTPa vaccine dose at less than 8 weeks of age was greater than 50% in 3 jurisdictions, the Australian Capital Territory, Victoria, and Queensland and at 70% for New South Wales and Tasmania. Although coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied. Overall, coverage at 24 months of age exceeded that at 12 months of age nationally. At 60 months of age, there was dramatic variation between individual jurisdictions, ranging from coverage 8% lower in Indigenous children in South Australia to 6% higher in the Northern Territory. As previously documented, vaccines recommended for Indigenous children only (hepatitis A and pneumococcal polysaccharide vaccine) had suboptimal coverage at 60% and 68%, respectively. On-time receipt (before 49 months of age) of vaccines by Indigenous children at the 60-month milestone age improved between 2010 (18%) and 2011 (19%) but the disparity in on-time vaccination between Indigenous and non-Indigenous children increased at all 3 age milestones. The percentage of vaccine objectors in 2011 (1.7%) has increased from 2007 when it was 1.1%. Coverage data for the 3rd dose of HPV from the national HPV register in the school catch up program was 71% but was substantially lower for the catch-up program for women outside school (39%-67%), although this was an improvement from 2010.