Lorrine11I at 10:29, 21 October 2025

2025-10-21T10:29:25Z

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{{Short description|Disease outbreak in India}}
[[File:Map-of-India-States.gif|thumb|Map of India with states.]]
{{Use Indian English|date=January 2023}}
{{Use dmy dates|date=July 2019}}

The '''1974 smallpox epidemic in India''' infected 188,000 people, leading to the deaths of 31,000 Indians.<ref name=":0">{{Cite journal |last=Lahariya |first=Chandrakant |date=2014 |title=A brief history of vaccines & vaccination in India |journal=The Indian Journal of Medical Research |volume=139 |issue=4 |pages=491–511 |issn=0975-9174 |pmc=4078488 |pmid=24927336}}</ref>

The media reported the smallpox '''[[epidemic]]''' as the most severe of its kind.<ref>{{Cite news |date=7 June 1974 |title=India Rushes Health Teams Into Smallpox Epidemic Zone |pages=9 |work=The New York Times |url=https://www.nytimes.com/1974/06/07/archives/india-rushes-health-teams-into-smallpox-epidemic-zone.html |access-date=7 November 2022}}</ref> However, the claim is debatable due to improvements in reporting since the epidemics of 1875 and 1967.<ref name=":1">{{Cite book |last=Brilliant |first=Lawrence B. |title=The management of smallpox eradication in India |date=1985 |publisher=University of Michigan Press |isbn=0-472-10059-9 |location=Ann Arbor |oclc=11599679}}</ref> The 1974 epidemic occurred during the country’s intensified campaign against the virus, which saw a shift in strategy from [[mass vaccinations]] to search and containment.<ref name=":2">{{Cite journal |last1=Dutta |first1=Mahendra |last2=Basu |first2=R.N. |date=2011 |title=Lessons from smallpox eradication campaign in Bihar state and in India |url=https://linkinghub.elsevier.com/retrieve/pii/S0264410X11019128 |journal=Vaccine |language=en |volume=29 |pages=D19–D21 |doi=10.1016/j.vaccine.2011.12.001|pmid=22486977 |url-access=subscription }}</ref> The year prior, vaccination programs and improved vaccination techniques, along with surveillance and investigation strategies, reduced smallpox transmission in most of the country except for a few states, including [[Bihar]], [[Uttar Pradesh]], and [[West Bengal]].<ref name=":0" />

The epidemic persisted in these regions in January and lasted until summer for several reasons. Smallpox was difficult to eradicate in rural, poor areas with inferior transportation and communications.<ref>{{Cite web |date=October 1979 |title=Global Effort Pays Off... Smallpox at Target "Zero" |url=https://stacks.cdc.gov/view/cdc/29542/cdc_29542_DS1.pdf |access-date=7 November 2022 |website=Dateline: Center for Disease Control}}</ref> During the Indian smallpox eradication campaign, over 80% of the population lived in remote areas, creating logistical issues for vaccine delivery.<ref>{{Cite web |title=How India overcame smallpox |url=https://www.gavi.org/vaccineswork/how-india-overcame-smallpox |access-date=2024-12-05 |website=www.gavi.org |language=en}}</ref>

Bihar and Uttar Pradesh accounted for approximately three-quarters of global smallpox cases in 1974.<ref name=":1" /> The [[World Health Organization]] (WHO) reported 103,830 infections throughout India in January 1974, which was 20% higher than the total number of cases the year before.<ref>{{Cite news |date=6 October 1974 |title=30,000 Killed in India in Smallpox Epidemic |pages=A4 |work=Los Angeles Times |url=https://www.latimes.com/archives |access-date=}}</ref> In March, new cases were discovered in [[Madhya Pradesh]], an area previously cleared of smallpox imported from Bihar.<ref name=":1" /> By May, cases reached a record of 48,833.<ref name=":1" /> Within one week in May, 11,000 new cases and 8600 imminent outbreaks were discovered in Bihar, resulting in one case each minute.<ref name=":2" />

An outbreak in southern Bihar in May traced back to [[Tata Group]] labourers, instigated vaccinations of railway workers and road closures to prevent further spread.<ref name=":3">{{Cite book |last=Henderson |first=Donald A. |title=Smallpox : the death of a disease : the inside story of eradicating a worldwide killer |date=2009 |publisher=Prometheus Books |isbn=978-1-59102-722-5 |location=Amherst, N.Y. |oclc=314597839}}</ref> Nevertheless, 300 more outbreaks and 2,000 cases swept into 11 states.<ref name=":3" /> A month later, the WHO estimated 75,000 infections in Bihar.<ref>{{Cite news |date=5 June 1974 |title=10,000 Die in India Smallpox Epidemic |url=https://ajc.newspapers.com/article/the-atlanta-constitution-10000-die-in-i/183389625/ |access-date=7 November 2022 |work=The Atlanta Constitution |pages=1C}}</ref>

The [[Monsoon of South Asia|monsoon]] season stifled human interactions and, combined with increased containment activities, caused smallpox cases to decrease.<ref name=":2" />
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== Local and international response ==
[[File:Man with smallpox (MAMAS CA44-271-4), National Museum of Health and Medicine (5477391432).jpg|thumb|left|Example of smallpox infection on patient's feet.]]
[[File:Smallpox eradication team.jpg|thumb|Key members of the WHO smallpox eradication team.]]
[[File:Ministry of Health India.svg|thumb|Logo of the Indian Ministry of Health.]]
Collaboration between national and international governments, non-governmental agencies, and the private sector was a critical factor in the success of the response to the epidemic in India.<ref name=":2" />

In 1973, the national smallpox eradication program entered an intensified phase.<ref>{{Cite journal |last=Brimnes |first=Niels |date=2010 |title=Review of Expunging Variola: The Control and Eradication of Smallpox in India 1 947-77 New Perspectives in South Asian History, vol. 14 |url=https://www.jstor.org/stable/40664928 |journal=Modern Asian Studies |volume=44 |issue=3 |pages=663–666 |jstor=40664928 |issn=0026-749X}}</ref> In January 1974, the Indian campaign’s funds were dwindling.<ref name=":3" /> Financial support was acquired when the WHO re-directed funds China rejected to the Indian smallpox program.<ref name=":3" /> The [[Swedish International Development Cooperation Agency]] (SIDA) provided more aid ($14 million).<ref name=":3" /> The US [[Centers for Disease Control and Prevention]] (CDC) contributed trained administrators to help manage the increasing number of project staff and the complicated system of daily expenditures and infrastructure requirements.<ref name=":3" />

The efforts to tackle the epidemic included private-public partnerships. The [[Tata Group]] ran a steel plant in Bihar, responsible for spreading smallpox to other states.<ref name=":2" /> They provided medical workers, administrative support, and transportation and communications infrastructure.<ref name=":2" />

In June, the WHO's India smallpox staff, with the secretary of health and the director-general, created an emergency strategy for the nation: an increase in international epidemiologists, training of Indian junior medical officers, creation of central surveillance units, shifting resources from malaria projects to smallpox eradication, drastically increasing the number of containment teams, use of helicopters, vaccination checkpoints, and the acquisition of 375 vehicles and gasoline, finances for travelling healthcare workers, and funds for field equipment and supplies.<ref name=":1" />

The successful eradication of smallpox in India was an exceptional public health achievement.<ref name=":2" /> However, the WHO's Smallpox Eradication Programme (SEP) has been accused of violating individual civil rights through forced vaccinations and quarantine policies, particularly among [[Adivasi]] tribal groups.<ref>{{Cite journal |last1=Juran |first1=Luke |last2=Trivedi |first2=Jennifer |last3=N Kolivras |first3=Korine |date=2017 |title=Considering the "public" in public health: popular resistance to the Smallpox Eradication Programme in India |url=http://ijme.in/articles/considering-the-public-in-public-health-popular-resistance-to-the-smallpox-eradication-programme-in-india/?galley=html |journal=Indian Journal of Medical Ethics |volume=2 |issue=2 |pages=104–111 |doi=10.20529/IJME.2017.025|pmid=28512076 |url-access=subscription |doi-access=free }}</ref>

Ultimately, the response that led to smallpox eradication in India was a significant accomplishment for the scientific and humanitarian fields.<ref>{{Cite journal |last=Horton |first=Richard |date=2021-12-19 |title=Offline: The lessons of smallpox eradication for COVID-19 |journal=Lancet |volume=396 |issue=10267 |pages=1951 |doi=10.1016/S0140-6736(20)32713-6 |issn=1474-547X |pmc=7832049 |pmid=33341128}}</ref> Importantly, it also resulted in a strengthened healthcare system, trained healthcare workers, infrastructure for vaccine delivery, and an effective disease surveillance network.<ref name=":0" />

In 2008, [[William Foege]], a former US CDC director, and [[Mahendra Dutta]], a former Health Commissioner of [[New Delhi]], recalled response efforts facing heightened scrutiny because of India's first successful nuclear bomb detonation in May 1974, as part of [[Smiling Buddha|Operation Smiling Buddha]].<ref>{{Cite AV media |url=https://www.youtube.com/watch?v=pc6RzIlxjKg |title=2017.300.15 Dutta & Foege |date=16 March 2017 |last=Global Health Chronicles |type=Videotape |publisher=[[David J. Sencer CDC Museum]]}}</ref> Foreign press argued that if India was incapable of eradicating smallpox, its government could not be trusted to responsibly develop nuclear weapons.<ref>{{Cite journal |last=Naraindas |first=Harish |date=December 2003 |title=Crisis, Charisma and Triage: Extirpating the Pox |url=http://journals.sagepub.com/doi/10.1177/001946460304000403 |journal=[[Indian Economic and Social History Review]] |language=en |volume=40 |issue=4 |pages=425–457 |doi=10.1177/001946460304000403 |s2cid=145416917 |issn=0019-4646 |via=[[Sage Publishing|Sage Journals]]|url-access=subscription }}</ref>

== References ==
{{Reflist}}
{{Epidemics}}

{{DEFAULTSORT:1974 Smallpox Epidemic In India}}
[[Category:1974 in India|Smallpox Epidemic In India, 1974]]
[[Category:1974 disease outbreaks]]
[[Category:1970s epidemics]]
[[Category:1970s in Bihar]]
[[Category:1970s in Uttar Pradesh]]
[[Category:Epidemics in India]]
[[Category:Disasters in Bihar]]
[[Category:Smallpox eradication]]
[[Category:Smallpox epidemics]]

1974 smallpox epidemic in India - Revision history

Lorrine11I at 10:29, 21 October 2025