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Foreword | |
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Preface | |
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The Disease, The Virus, and its History | |
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The Oldest of Scourges and the Most Devastating | |
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A Case of Smallpox | |
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The Virus | |
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How long can the smallpox virus survive? | |
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Smallpox in Ancient Times | |
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Smallpox Becomes Endemic | |
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Smallpox and the Settlement of the New World | |
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Early Protection against Smallpox | |
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Variolation | |
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Jenner's Vaccine | |
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Needed-A Better Vaccine | |
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Calves become vaccinia factories | |
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Better distribution-door-to-door cows | |
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A heat-stable vaccine | |
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A Second Form of Smallpox | |
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Smallpox Begins to Lose Ground | |
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The World Decides to Eradicate Smallpox | |
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The Beginning of the Eradication Saga | |
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1953: A Global Eradication Program Is Proposed-and Rejected | |
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1958: The Soviet Union Makes a New Proposal to Eradicate Smallpox | |
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Mission Impossible? | |
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The US Communicable Disease Center Becomes Engaged with Smallpox | |
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Concerns about vaccine complications | |
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The United States Offers to Support a West Africa Program- A Startling Development | |
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The Director-General Challenges the 1966 Assembly | |
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Creating A Global Program | |
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A Program in Its Infancy | |
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Countries, Fiefdoms, and Short-Circuiting the Bureaucracy | |
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The Creation of the Program Budget | |
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How Many Smallpox Cases? | |
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The Realities of Executing a Simple, Two-Part Strategy | |
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Mass-vaccination strategy | |
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Surveillance and containment-a new component | |
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Availability of Vaccine-An Apparently Soluble Problem Is Anything But | |
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Vaccination Techniques-There Have to Be Better Ways | |
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Communication-Conflict and Controversy | |
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Off and on the World Health Assembly agendas | |
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Three reporting systems become one | |
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A surveillance report threatens the whole program | |
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Diplomatic Challenges-The Cold War and Other Problems | |
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Yet Another Problem-Obtaining a Competent Staff | |
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Results a Transformation | |
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Where to Begin? A Tale of Two Countries-Brazil and Indonesia | |
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Stonewalling | |
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The Brazilian Program-A Regrettable Saga | |
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Vaccine problems | |
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Surveillance-containment saves the day | |
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The program staggers to a finish | |
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A last regrettable chapter-certifying eradication in South America | |
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Indonesia-A Remarkable Achievement with Few Resources | |
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Certification of Eradication-A Serious Effort Is Made | |
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Africa-A Formidable and Complicated Challenge | |
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An Early Start in West Africa | |
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Surveillance-containment is renamed "Eradication-Escalation" | |
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Smallpox Is Eradicated from Africa's Two Largest Countries | |
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Zaire-major epidemic center at the heart of Africa | |
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Sudan-a smallpox-free country becomes infected | |
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Eastern Africa-A Mass-Vaccination Achievement | |
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Southern Africa | |
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The Botswana debacle | |
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The Lessons of Africa | |
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India and Nepal-A Natural Home of Endemic Smallpox | |
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An Ambitious National Program Is Created-1962 | |
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The Program Nearly Collapses-1967-1969 | |
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A Resurrection of the Program-1970 | |
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An Unexpected Catastrophe in West Bengal-Refugees from East Pakistan-1971 | |
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The "Final Phase"-Target Zero-Delusional Optimism-1972 | |
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The Ultimate Strategy-1973 | |
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The Darkest Days of All-January to June 1974 | |
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Yet another catastrophe | |
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A Summer Program-1974 | |
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Afghanistan, Pakistan, and Bangladesh-The last stronghold of Variola Major | |
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Afghanistan | |
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Pakistan (West Pakistan Province before December 1971) | |
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Bangladesh: The End of Variola Major | |
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A renewed eradication program begins-1968 | |
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Civil war-March 1971 | |
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Reinfection-December 1971 | |
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The epidemic spreads-1972 | |
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The disaster of November 1973 and recovery | |
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Bulldozers, floods, and famine trigger yet another disaster-1974 | |
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One Last Disaster-1975 | |
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Ethiopia and Somalia-The Last Countries with Smallpox | |
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Ethiopia | |
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Troubles in beginning the program | |
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The tip of the iceberg-1971-1972 | |
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Disaster: drought, famine, hordes of refugees-1974 | |
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Floods, fighting, and unexpected news-1975 | |
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Somalia: An Epidemic That Should Never Have Happened | |
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Smallpox before 1975 | |
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Growing suspicions | |
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Smallpox uncovered in Mogadishu-September 1976 | |
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Lies, cover-ups, and secret records | |
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The Last Case | |
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Smallpox-Post-Eradication | |
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Eradication-What Does It Mean and How Do We Define It? | |
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Surveillance and Search | |
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A routine reporting system | |
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Special searches | |
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Rumor registries | |
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International Commissions | |
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Global Certification of Smallpox Eradication | |
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The World Health Assembly-1980 | |
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Post-Eradication | |
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The book and the archives | |
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Monkeypox-a potential threat? | |
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Reserve stocks of vaccine | |
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Laboratories retaining stocks of smallpox virus | |
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To Destroy or To Retain the Remaining Stocks of Smallpox Virus | |
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The initial steps toward smallpox virus destruction | |
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Objections to virus destruction | |
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The January 1995 executive board is blocked from taking action | |
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Attempts to reconcile an impasse | |
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The executive board and the World Health Assembly-1996 and onward | |
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Smallpox as a Biological Weapon | |
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Biological Warfare-The Emerging Threat | |
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The Soviet Union's secret-a massive bioweapons program | |
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The Soviet bioweapons legacy-who else might have the smallpox virus? | |
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An Ill-Prepared United States Awakens to a Threat | |
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A symposium changes minds | |
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An expert "working group" | |
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From working group to a center | |
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The Center for Civilian Biodefense Studies | |
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The "Dark Winter" Exercise | |
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New Challenges-Post-September 11 | |
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How to Deal with a Smallpox Epidemic | |
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The vaccine production miracle | |
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The Office of Public Health Emergency Preparedness | |
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Let's Vaccinate Everyone! | |
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A national vaccination program starts and collapses | |
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Smallpox on the International Scene | |
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Atlantic Storm-a reminder that smallpox is not to be forgotten | |
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Lessons and Legacies of Smallpox Eradication | |
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The Siren Song of Eradication | |
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The Legacy of the Smallpox Eradication Program | |
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An Expanded Program on Immunization Begins | |
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A paradigm for EPI-the program in Latin America | |
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New Horizons in Public Health | |
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Acknowledgments | |
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Sources | |
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Index | |