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Only 1 human disease has ever been completely eradicated: Smallpox

MARY LOUISE KELLY, HOST:

COVID-19 is unlikely just to disappear one day. In fact, only one human disease has ever been completely eradicated, and that is smallpox. The deadliest strain of smallpox killed almost a third of its victims. Thanks to the world's very first vaccine, smallpox was eliminated in the West by the mid-20th century. Soon after, World Health Organization workers started tracking down cases around the globe. The last country to have the deadly form of smallpox was Bangladesh.

And by the fall of 1975, public health workers there thought they were done. But off in remote village, a toddler was developing telltale white spots. From Radio Diaries, here's the story of that one last case.

(SOUNDBITE OF KNOCKING ON DOOR)

UNIDENTIFIED PERSON #1: (Non-English language spoken).

UNIDENTIFIED PERSON #2: What is your name?

RAHIMA BANU: My name is Rahima Banu.

(Through interpreter) My name is Rahima Banu. Growing up, my village was close to the river. My house was made of cattail leaves, and it had a mud floor. My father was a laborer. My mother was a housewife. I was their first child, and I was adored. When I was 1 1/2 years old, I had smallpox.

DANIEL TARANTOLA: My name is Daniel Tarantola, and back in 1975, I was a medical officer with WHO assigned to Bangladesh for the eradication of smallpox.

ALAN SCHNUR: My name is Alan Schnur, and I was the WHO epidemiologist in Bangladesh.

TARANTOLA: The smallpox eradication campaign had been an exhausting exercise, and so we were celebrating the end of a very difficult road.

SCHNUR: We were at a meeting in Dhaka at that time. They had a zero up on the wall saying these are the - currently the number of active smallpox cases in Bangladesh.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED REPORTER #1: Good morning.

TARANTOLA: And we had informed the press.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED REPORTER #1: I understand that you have an official statement today with regard to Bangladesh.

UNIDENTIFIED PERSON #3: Yes, indeed. As far as can be determined, we believe we have seen the last case of the deadliest form of smallpox - variola major.

TARANTOLA: Then we decided to celebrate, and we organized a party. And as we were having the party, we received three telexes - two of them saying wonderful achievements, congratulations, and then a third message came from our team based in Bhola Island in the Bay of Bengal. It had one active smallpox case, date of detection 14 November '75, details follow. So this was a pretty dramatic setback.

BANU: (Through interpreter) My uncle got sick, and I went up to him and jumped on him. And I started playing with these marks he had on his body. On that very night, my mother saw three pimples break out in my forehead. And by the morning, I had it all over my body.

TARANTOLA: Our goal was to go to the home where the case had been found.

SCHNUR: The next day, we arrived and took this very flimsy boat with no life rafts across this huge river. And then we had to walk up to the household where the smallpox case was.

BANU: (Through interpreter) My mother saw a lot of people coming towards us. It looked like a wedding celebration. It was so many people.

TARANTOLA: It was the end of the day, so it was fairly dark outside. And there was a kerosene lantern inside the house giving a little light. We found a woman sitting there on a bed, bamboo bed, holding a child. The child, she had white spots on the face, on the palms, on the soles, on the legs and arms. And she began to cry. And I took a picture of her then, crying, and the mother holding her in her arms.

BANU: (Through interpreter) They have that photo of us. I was little, and I was afraid of all the people.

TARANTOLA: We explained to her that we would have to isolate the child in her home, that there would be guards around, that visitors would be limited but would have to be vaccinated.

BANU: (Through interpreter) They set up three camps around our house, and they paid our neighbors to watch us so that we wouldn't try to run away. Everyone in that area made money from it.

(SOUNDBITE OF ARCHIVED RECORDING)

TARANTOLA: And the best way to stop smallpox is to vaccinate.

We then hired volunteers from the neighborhood to vaccinate everyone within a 1.5-mile radius of the house. People would train over a couple of hours.

(SOUNDBITE OF ARCHIVED RECORDING)

TARANTOLA: And here is a needle.

BANU: (Through interpreter) People in the village were afraid that they would die from the vaccine. Some didn't want to take it out of fear.

TARANTOLA: For them to be confident that there was no risk, we used to vaccinate ourselves. I must have vaccinated myself 10,000 times in Bangladesh during the time I was there, and usually the acceptance of vaccination is very high.

(SOUNDBITE OF ARCHIVED RECORDING)

TARANTOLA: OK? Is it clear now? All right. We go vaccinate.

SCHNUR: Off we went, house by house in the middle of the night to knock on doors.

TARANTOLA: We realized over the following three weeks that there was no other active case - that is infectious case - on the island.

SCHNUR: When we started smallpox eradication, people said, you're crazy. You can never eradicate smallpox. We, of course, achieved smallpox eradication. And then people said, what took you so long?

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED REPORTER #2: Today, a substantial milestone in human history - the World Health Organization says smallpox has now been wiped off the face of the Earth and will never return. It says it will never return because smallpox can only be caught from another person. And if no other person has it, there is no other way to catch it.

SCHNUR: I haven't seen Rahima Banu since the time I was in Kuralia Village (ph), but she has some fame as being the last variola major smallpox case in the world.

BANU: (Through interpreter) Allah kept me alive, but I still have scars from my disease. It's a dot, dot, dot, dark spot all over my body. I don't look beautiful with these scars. Sometimes, people discriminate against me. If I wouldn't have had this disease, honestly, I could have married off to a wealthy family. But I have a husband. He's a day laborer. He didn't see me before we married, but he accepted me. He likes me as I am. I'm healthy. I have a family. I have children. My parents are alive. I have everything.

(SOUNDBITE OF MUSIC)

KELLY: The World Health Organization declared that smallpox had been eradicated in May of 1980.

This story was produced by Alissa Escarce of Radio Diaries, with reporting by Dil Afrose Jahan. It was edited by Joe Richman, Deborah George and Ben Shapiro. To hear a longer version, visit the Radio Diaries podcast. Transcript provided by NPR, Copyright NPR.