ArticleSocial science & medicine (1982)2018
The geography of smallpox in England before vaccination: A conundrum resolved.
Article in Social science & medicine (1982), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 29 citations in OpenAlex.
- Canine Vaccination-A Survey of Owner Attitudes and Adherence to Vaccination Protocols.Pathogens (Basel, Switzerland) · 2026Article
- The spatial distribution of pertussis, but not measles or smallpox, in pre-industrial Finland matches dialects.iScience · 2025Article
- Identifying signature features of epidemic diseases from 19th century all-cause mortality data.American journal of epidemiology · 2025Article
- Geographical characteristics and formation mechanisms of smallpox epidemics in Hubei Province, China, 1488-1949.PloS one · 2025Article
- Local infectious disease experience influences vaccine refusal rates: a natural experiment.Proceedings. Biological sciences · 2023Article
- Mortality, migration and epidemiological change in English cities, 1600-1870.International journal of paleopathology · 2021Article
- A guide to vaccinology: from basic principles to new developments.Nature reviews. Immunology · 2021Review
- Patterns of smallpox mortality in London, England, over three centuries.PLoS biology · 2020Article
- Variola virus genome sequenced from an eighteenth-century museum specimen supports the recent origin of smallpox.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2020Article
- Dangerous Pathogens as a Potential Problem for Public Health.Medicina (Kaunas, Lithuania) · 2020Review
- An introduction to the history of infectious diseases, epidemics and the early phases of the long-run decline in mortality.The Economic history review · 2020Article
- Urbanization and mortality in Britain, c. 1800-50.The Economic history review · 2020Article
- Design of inhibitors of thymidylate kinase fromJournal of biomolecular structure & dynamics · 2019Article
- Infant-feeding practices and infant survival by familial wealth in London, 1752-1812.The history of the family : an international quarterly · 2019Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Smallpox is regarded as an ancient and lethal disease of humans, however very little is known about the prevalence and impact of smallpox before the advent of vaccination (c.1800). Here we use evidence from English burial records covering the period 1650-1799 to confirm a striking geography to smallpox patterns. Smallpox apparently circulated as a childhood disease in northern England and Sweden, even where population densities were low and settlement patterns dispersed. However, smallpox was a relatively rare epidemic disease in southern England outside the largest cities, despite its commercialised economy and the growing spatial interconnectedness of its settlements. We investigated a number of factors hypothesised to influence the regional circulation of smallpox, including exposure to naturally occurring orthopox viruses, settlement patterns, and deliberate preventative measures. We concluded that transmission was controlled in southern England by local practices of avoidance and mass inoculation that arose in the seventeenth and eighteenth centuries. Avoidance measures included isolation of victims in pest houses and private homes, as well as cancellation of markets and other public gatherings, and pre-dated the widespread use of inoculation. The historical pattern of smallpox in England supports phylogenetic evidence for a relatively recent origin of the variola strains that circulated in the twentieth century, and provides evidence for the efficacy of preventative strategies complementary to immunisation.
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