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Epidemics

Smallpox, steamships, and two port cities

Brabin B · Medical history · 2020

Open access · cc by · source: Europe PMC

Brabin compares Boston and Liverpool's 1901–5 smallpox epidemics, arguing steamship traffic linked peak US incidence to Liverpool while Hope and Durgin used surveillance, isolation and ring vaccination later reused in global eradication.

Key findings

After 1860, rapid steamers guaranteed transatlantic smallpox passage. Incubating travellers delayed recognition. Despite 1901 contact between Liverpool Port Authority and the USPHS, maritime surveillance was not heightened. Both cities used screening, isolation, quarantine, contact tracing and ring vaccination; Boston's anti-vaccinationists were especially vehement. Liverpool's post-exposure vaccination helps explain a rapid 1903 fall.

Methodology

A comparative historical analysis of the US and UK smallpox epidemics of 1901–5, especially Boston and Liverpool, using public-health reports, port records, and accounts of Medical Officers Hope and Durgin, including anti-vaccination politics.

Limitations

This is not a modern vaccine RCT. Historical protective-effect inferences from Liverpool data are not a new serological survey of 1901 populations.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsEpidemicsconcept

    Boston and Liverpool’s 1901–5 smallpox epidemics were linked by steamship traffic, with uneven inspection, quarantine and vaccination.

    Evidence for the claim as stated.

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