Urban inoculation and the decline of smallpox mortality in eighteenth-century cities-a reply to Razzell.
Urban inoculation and the decline of smallpox mortality in eighteenth-century cities-a reply to Razzell.
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DOI：
10.1111/ehr.12112
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Schwarz L
中科院分区：
文献类型：
--
作者：
Davenport RJ;Boulton J;Schwarz L
天花可能是十八世纪英国最致命的疾病，但由于1798年后的疫苗接种计划，到十九世纪中叶，天花已降至次要死因。虽然接种疫苗的成功是毋庸置疑的，但在18世纪，接种疫苗的预防性先驱--接种在多大程度上降低了天花死亡率，这一点仍然存在争议。天花在城市人群中最致命，但大多数研究人员认为接种疫苗在大城镇不受欢迎。然而，最近拉泽尔认为，在世纪的最后三分之一，接种大大降低了伦敦成人和年龄较大儿童的天花死亡率。本文使用来自伦敦和曼彻斯特的人口统计学证据来证实以前的发现，即成人天花死亡率突然下降，天花在儿童早期的重要性上升。1770.这些变化的性质与1770年后伦敦和曼彻斯特天花传播的增加相一致，并表明天花接种不足以降低大城镇的天花死亡率。目前尚不清楚接种是否可以增强天花传播，或者天花病毒特性的变化是否导致了1770年后幼儿天花死亡率的加剧。
Smallpox was probably the single most lethal disease in eighteenth‐century Britain but was reduced to a minor cause of death by the mid‐nineteenth century due to vaccination programmes post‐1798. While the success of vaccination is unquestionable, it remains disputed to what extent the prophylactic precursor of vaccination, inoculation, reduced smallpox mortality in the eighteenth century. Smallpox was most lethal in urban populations, but most researchers have judged inoculation to have been unpopular in large towns. Recently, however, Razzell argued that inoculation significantly reduced smallpox mortality of adults and older children in London in the last third of the eighteenth century. This article uses demographic evidence from London and Manchester to confirm previous findings of a sudden fall in adult smallpox mortality and a rise in the importance of smallpox in early childhood c. 1770. The nature of these changes is consistent with an increase in smallpox transmission in London and Manchester after 1770 and indicates that smallpox inoculation was insufficient to reduce smallpox mortality in large towns. It remains unclear whether inoculation could have operated to enhance smallpox transmission or whether changes in the properties of the smallpox virus drove the intensification of smallpox mortality among young children post‐1770.