Smallpox Eraducation Programme Archive

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"The Big Red Book"

The Big Red Book

Big Red Book

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Smallpox and Its Eradication

Fenner, Frank; Henderson, Donald A; Arita, Isao; Ježek, Zdenek; Ladnyi, Ivan Danilovich

World Health Organization, Geneva: 1988

1460 pages; references: pp. 1371-1409

480 tables; 268 figures; 375 plates (84 color)

In May 1980, WHO's Thirty-third World Health Assembly accepted the report and recommendations of the Global Commission for the Certification of Smallpox Eradication. One of these recommendations was that "the Director-General ... ensure the production ... of appropriate publications describing smallpox and its eradication, in order to preserve the unique historical experience of eradication and thereby contribute to the development of other health programmes".

This book, published by WHO, is the result. Each of the authors was deeply involved in the execution of the Intensified Smallpox Eradication programme (SEP). Each reviewed and commented on multiple drafts of all chapters. In addition, 78 other persons, each an expert in an appropriate scientific field or who had personal knowledge of a national eradication or certification programme, commented on chapter drafts.

The successful execution of the SEP depended on activities ranging from field work to administration through laboratory studies and fund-raising. The authors believed that the book would be most instructive if it incorporated the whole spectrum of activities.

[The complete volume (83.9 MB) may be slow to open or download; individual chapters are available below.]

Chapters 1-4 are concerned with the basic sciences required in the SEP.

Chapter 1 (4.5 MB) is a well-illustrated clinical description of smallpox so that readers can understand the nature of what was one of man's most serious diseases.

Chapter 2 (3.1 MB) describe the virology of variola and other orthopoxviruses.

Chapter 3 (2.8 MB) describes the pathogenesis, pathology, and immunology of variola virus (the cause of smallpox) and vaccinia virus (used to produce the smallpox vaccine).

Chapter 4 (2.2 MB) describes the epidemiology of smallpox—eradication could not have been achieved without understanding how the disease was transmitted or if an animal reservoir were present.

Chapters 5-8 establish smallpox and its control in historical perspective.

Chapter 5 (2.3 MB) addresses the history of smallpox from ancient times until the end of the 19th century.

Chapter 6 (2.1 MB) describes early efforts at smallpox control: variolation, vaccination, and isolation and quarantine.

Chapter 7 (2.2 MB) traces developments in smallpox vaccine production and vaccination techniques from 1900-66; complications of vaccination; and and an overview of vaccination programs from 1900-66.

Chapter 8 (2.1 MB) is concerned with the extent, incidence, and control of smallpox from 1900-58, when global eradication was first proposed in WHO's World Health Assembly.

Chapters 9-11 describe various aspects of the global eradication campaign.

Chapter 9 (3.1 MB) explores the development and application of the concept of eradication; the events leading to the World Health Assembly's 1959 resolution that global smallpox eradication be undertaken; progress from 1959-66; and the circumstances leading to the decision in 1966 to begin the SEP.

Chapter 10 (8.1 MB) summarizes major events and developments in the SEP from 1967-80, providing a perspective for subsequent chapters. A year-by-year series of world maps, graphs, and text summarizes the accomplishments of this period.

Chapter 11 (2.9 MB) is devoted to two topics of central importance to the SEP: the provision of adequate amounts of a potent and stable vaccine and the development of better methods of vaccination.

Chapters 12-22 describe the operations of the SEP in different countries or parts of the world

The order of the chapters corresponds, in large part, to the temporal sequence in which they were begun or strengthened.

Chapter 12 (1.7 MB) South America

Chapter 13 (1.6 MB) Indonesia

Chapter 14 (2.8 MB) Afghanistan and Pakistan

Chapter 15 (5.2 MB) India and the Himalayan Area

Chapter 16 (2.3 MB) Bangladesh

Chapter 17 (3.6 MB) Western and Central Africa

Chapter 18 (2.0 MB) Zaire and Sudan

Chapter 19 (1.4 MB) Eastern Africa: Kenya, Uganda, United Republic of Tanzania, Rwanda and Burundi

Chapter 20 (1.6 MB) South Africa

Chapter 21 (2.5 MB) Ethiopia, Yemen and Democratic Yemen

Chapter 22 (1.9 MB) Somalia and Djibouti

Chapter 23 (1.8 MB) is devoted to the many importations, some with serious consequences, that occurred because of travel between countries; and to infections which occurred in laboratories.

Chapters 24-27 review the process of certification that smallpox had been eradicated

Chapter 24 (2.4 MB) details the concepts, strategy and tactics used in certification.

Chapter 25 (2.3 MB) describes certification by International Commissions from 1973-77.

Chapter 26 (1.7 MB) describes the certification of 29 countries in Africa and Asia from 1978-79.

Chapter 27 (2.1 MB) describes the completion of global certification in the Horn of Africa and China.

Chapter 28 (1.3 MB) describes the implementation, from 1980-88 of 19 recommendations made by the Global Commission and adopted by Thirty-third World Health Assembly for activities to be conducted in the post-eradication era.

Chapter 29 (2.0 MB) details investigations into the nature and public health importance of human monkeypox, the smallpox-like disease discovered during the eradication campaign in Africa.

Chapter 30 (1.3 MB) reviews the virology and epidemiology of smallpox to answer questions about its possible return.

Chapter 31 (2.2 MB) responds to the request of the World Health Assembly that the book should discuss "the principles and methods that are applicable to other programmes", and assesses the costs and benefits of the SEP.

Title Pages, Table of Contents, Foreword, Preface, Acknowledgments, Reviewers (0.5 MB)
References (2.8 MB)
Index of Names (0.4 MB)
Subject Index (1.7 MB)