Washington’s Victory over Smallpox

Extract

INTRODUCTION

Throughout the eighteenth century, smallpox was a dreaded disease in the colonies, often appearing in epidemics that ravaged entire communities, with mortalities ranging from 15 to 50%.¹ There were only two ways to prevent an outbreak of the extremely contagious Variola virus—either through isolation via quarantine or inoculation.¹

In inoculation, the patient was deliberately exposed to the virus, becoming contagious after approximately 12 days and remaining so for another 2 weeks. Although the procedure had a milder infection,¹ it still had an approximate 2% mortality risk.² Inoculation was also an expensive, grueling, and time-consuming process that was too impractical for the poor.² Many colonists refused the procedure, and it was outright banned in a number of states.¹ With the outbreak of the American Revolution, General George Washington was highly restricted in dealing with smallpox—he had to request the permission of local authorities to inoculate his troops, and even setting up hospitals to quarantine infected soldiers required local permission.¹ Washington was intimately familiar with the disease, having personally contracted smallpox at the age of 19 years.³ On a strategic level, effective management of infectious disease also played a major role in contemporary warfare—approximately 90% of the Continental Army’s 70,000 fatalities from 1775 to1781 were because of the disease.⁴ Despite his concerns about the health of his soldiers, Washington was forced to acquiesce in the early stages of the war, and in 1776 ordered, “No person whatever, belonging to the Army, is to be inoculated for the smallpox.”⁵