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Pox Americana

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Pox Americana: The Great Smallpox Epidemic of 1775-82. By Elizabeth Anne Fenn. (Hill & Wang - A Division of Farrar, Straus and Giroux, New York: 2002. Pg. 384.) ISBN: 080907821X.

Reviewed by Rochelle Caviness - March 11, 2004

Smallpox! Almost thirty years after it was officially eradicated, the word still has the power to send shivers down your spine. Smallpox (variola virus) has killed and maimed millions during its ghastly association with mankind. After it was officially eradicated from the wild in 1979, the use of the smallpox vaccine gradually ended. That is, until recent events hinted of the possible release, by terrorist, of smallpox back into a population that has little, if any, immunity to the killer disease.

What would happen if smallpox was to reemerge, either purposely or naturally? What would the death rate be? Would entire cities be evacuated by people attempting to flee the infection? What would happen to the economy? Would a massive infection rate alter the balance of world power? The questions are numerous, and hopefully we will never have to find out what the answers would be. Yet to get an idea of what might happen, it is useful to take a look back to see what happened the last time that smallpox was introduced into a population that had little immunity to the disease. Juxtaposed about a population with some immunity, yet in which the disease still took a devastating toll would help to give a modern audience a taste of what might happen if smallpox where to break out today.

In Pox Americana - The Great Smallpox Epidemic of 1775-82, Elizabeth Anne Fenn takes a comprehensive look at the effect that this epidemic had on both native American, and American colonists, who had little immunity to the disease. For the native Americans, the disease spread like wildfire. With no immunity, entire communities came down with the disease at once, leaving no one to care for the ill. Lack of care killed just as effectively as did the virus itself. The American colonist also had little immunity to the disease, despite hailing from Europe, where the disease was endemic. The Americas where relatively free of the disease until the 1770's, and most people, especially the young, lacked immunity because they had never been exposed to the disease. This lack of immunity was to play an important role in the American War of Independence, because most of the British troops where immune to the disease, either due to prior exposure or due to vaccination against it.

In the pages of this book, Fenn tracks the history of the disease in America, as well as the attitudes and legalities surrounding vaccination. She examines, in detail, the impact that the disease had on Washington's Army, and various battles in which it played a major role. Most interestingly, she tracks the spread of the disease through the various Indian tribes, trying to discern how it was transmitted and the long term effects that it had, both on tribal relations and on the relations between the various tribes and the colonist. Trade, politics, marriage, food, the movement of people - almost every aspect of life was impacted by this epidemic. By the time the epidemic subsided, it had spread across the continent, and as far north as Alaska, and as far south as Mexico.

Pox Americana is a fascinating book. She illustrates, with dramatic clarity, the role that vaccination had in helping the American's win their war against the British, and the devastating impact that it had on the native peoples. Throughout, Fenn quotes from diaries, letters, church records, notes made by explorers, and other primary documents. These excerpts make the epidemic more comprehensible to a modern audience, allowing those who never witnessed the horrors of a smallpox outbreak get a realistic glimpse of how the epidemic affected people on a personal level.

Pox Americana is a must read for anyone interested in smallpox, Colonial American history, the history of infectious disease, or Native American history.


Related Reviews:

Scourge: The Once and Future Threat of Smallpox, by Jonathan B. Tucker.
A history Smallpox: how it spread around the globe, how it affected civilization, and how Smallpox was eradicated. Plus a look at what might happen if smallpox were ever used as a bioweapon.

Timebomb: The Global Epidemic of Multi-Drug-Resistant Tuberculosis, by Lee B. Reichman and Janice Hopkins Tanne.
An riveting account of the rise in Tuberculosis cases around the globe, and the increased threat posed by multi-drug-resistant strains of TB.

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