Dr. Donald A. Henderson, Who Helped End Smallpox, Dies at 87

An article by The New York Times
August 21, 2016

Dr. Donald A. Henderson, a leader of one of mankind’s greatest public health triumphs, the eradication of smallpox, died on Friday in Towson, Md. He was 87.

Dr. Henderson, who lived in Baltimore, died in a hospice of complications of a hip fracture, including infection with antibiotic-resistant staphylococcus, a dangerous pathogen he had himself researched and raised alarms about, said his daughter, Leigh Henderson.

Starting in 1966, Dr. Henderson, known as D. A., led the World Health Organization’s war on the smallpox virus. He achieved success astonishingly quickly. The last known case was found in a hospital cook in Somalia in 1977.

Long after the disease was officially declared eradicated in 1980, he remained in the field as a dean of what is now the Johns Hopkins Bloomberg School of Public Health and as an adviser on bioterrorism to several presidents.

Euphoria over the smallpox victory led to calls for the elimination of measles, polio, Guinea worm and other diseases, and Dr. Henderson was a sometimes irascible but often prescient critic of flaws in those campaigns. None have yet been successful.

The only other disease to have been banished from the earth is rinderpest, a little-known relative of measles that kills hoofed animals and once caused widespread starvation in Africa; it was eradicated in 2011.

Like any war, the one against smallpox involved thousands of foot soldiers — notably outbreak tracers and vaccinators — and more than a few generals. They came from both the United States and the Soviet Union, which first called for the disease’s elimination, as well as from other nations.

But, along with Dr. William H. Foege, now an adviser to the Bill and Melinda Gates Foundation, Dr. Henderson was considered a field marshal whose combination of vision, bluntness, tenacity and political acumen carried the campaign to victory.

Smallpox, caused by the variola virus, was long one of mankind’s most terrifying scourges. Called the “red plague” or the “speckled monster,” it killed almost a third of its victims, often through pneumonia or brain inflammation. Many others were left blind from corneal ulcerations or severely disfigured by pockmarks.

It is thought to have emerged from a rodent virus more than 10,000 years ago, and signs of it are found in the mummy of Pharaoh Ramses V of Egypt. Some terrified ancient civilizations worshiped it as a deity.

It carried off many European monarchs and buried the lines of succession to thrones from England to China. Because it killed 80 percent of the American Indians who caught it, it was a major factor in the European conquest of the New World.

Three American presidents survived it: George Washington, Andrew Jackson and Abraham Lincoln. In the 20th century, before it was extinguished, it was blamed for at least 300 million deaths.

The victory over smallpox proved the power of vaccine. Before the 18th century, some peoples, especially in Asia Minor and West Africa, inoculated themselves by piercing their skin with pus from victims or inhaling dried pox scabs. Although that sometimes produced a full-blown lethal infection, it killed much less often than epidemics did.

In 1796, Dr. Edward Jenner, an English physician, infected a young boy with cowpox taken from a blister on a milkmaid’s hand. Cowpox, a mild disease, protected those who had it from smallpox, and the modern vaccine era began. The word “vaccine” come from the Latin for “cow.”

Donald Ainslee Henderson was born on Sept. 7, 1928, in Lakewood, Ohio, the son of a Union Carbide engineer and a nurse. He graduated from Oberlin College, got his medical degree from the University of Rochester and did his residency at a hospital in Cooperstown, N.Y.

In 1955, he joined the Epidemic Intelligence Service, the elite disease-detective branch of the Centers for Disease Control and Prevention, and in 1960, as the chief of viral disease surveillance, he devised a campaign to eliminate smallpox and control measles in Africa. Smallpox had been eliminated in much of the West shortly after World War II, but it persisted in Brazil, Africa and South Asia.

In 1966, he was sent to Geneva to run the World Health Organization’s global campaign.

“The sense at the W.H.O. was that this was an impossible mission, so they chose a young man who didn’t have a reputation to tarnish,” said Dr. Thomas V. Inglesby, the director of the U.P.M.C. Center for Health Security, where Dr. Henderson was a resident scholar at his death. “I don’t want to say as cannon fodder, but something like that.”

World Health Organization campaigns to end yellow fever and malaria had both petered out, and the organization adopted the smallpox goal only after the Soviets and the Americans insisted, Dr. Foege said. “D. A. always said they wanted an American to blame,” he added.

He was given little staff or support, but remaining on the C.D.C. payroll gave him independence.

“Although outspoken, he understood the absolute importance of diplomacy, and he had the ability to recognize who could go out in the field and get things done with a minimum of supervision,” said Dr. J. Michael Lane, another leader of the fight, now affiliated with Emory University Medical School.


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