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Africa — Western & Central

Summary and Regional Information


The US Communicable Disease Center (CDC, now the Centers for Disease Control and Prevention) conducted a smallpox eradication/measles control program in Western and Central Africa. It began late in 1966, concluding in 1972, and was funded by the US Agency for International Development. The program was coordinated with WHO’s eradication programme through its Regional Office for Africa (AFRO).
For more information, see: Ghana. Healing smallpox lesions Nigedria. Simultaneous smallpox and measles vaccinations Mali. Vaccination team Nigeria. District Medical Officer Dr Osiu-Kamana demonstrates a jet injector in a staff training session. More photos...

Summary of Smallpox Status

Country Last endemic case Importations during SEP Country Last endemic case Importations during SEP
Benin (Dahomey)1 1969 None post-1969 Guinea 1968 None post-1968
Burkina Faso (Upper Volta)2 1968 None post-1958 Guinea-Bissau3 1957 None
Cameroon 1968 1969 Ivory Coast (Côte d'Ivoire) 1966 1967
Central African Republic 1963 None Liberia 1968 None post-1968
Chad 1965 1967,1968 Mali 1968 1969
Congo 1965 None Mauritania 1962 None
Equatorial Guinea 1960 None Niger 1968 1969
Gabon 1965 None Nigeria 1970 None post-1970
Gambia 1966 None Senegal 1963 None
Sierra Leone 1969 None Togo 1969 None post-1969
Ghana 1967 1968

Benin (Dahomey), Burkina Faso (Upper Volta), Ivory Coast (Côte d'Ivoire), Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo were certified as smallpox-free by an International Commission on 15 Apr 1976 (AFR/Smallpox/80).

Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea, and Gabon were certified as smallpox-free by an International Commission on 30 Jun 1977 (AFR/Smallpox/86).

  1. Dahomey was renamed Benin in 1975.
  2. Upper Volta was renamed Burkina Faso in 1984.
  3. Guinea-Bissau was a colony of Portugal until 1974. It did not receive assistance from the CDC/USAID regional program.

Historical Smallpox & Its Control

Year Title Authors Source URL
1967 The origins of smallpox in Central Africa. I. Roberts CJ Cent Afr J Med 1967 13(2): 31-3 contd
1973 Smallpox and traditional medicine in the developing countries of Africa and Asia Sery V Z Tropenmed Parasitol 1973 24(1): 105-18
*1975 Smallpox inoculation in Africa Herbert EW J Afr Hist 1975 16(4): 539-59 DOI: 10.1017/S0021853700014547
1981 Traditional African medicine and eradication of smallpox Singer P, Vann CR N Engl J Med 1981 304(15): 914-5 DOI: 10.1056/nejm198104093041520
1982 [Sakpata, a contribution of the African medicine man to smallpox eradication] German Stocklin WH Gesnerus 1982 39(3-4): 405-15 URL: brill.com/view/journals/ges/39/3-4/ges.39.issue-3-4.xml
1947 Yellow fever vaccination, simple or associated with vaccination against smallpox, of the populations of French West Africa by the method of the Pasteur Institute of Dakar Peltier MG Am J Public Health 1947 37(8): 1026-32 DOI: 10.2105/AJPH.37.8.1026
PMC: PMC1623887
*1948 [Mixed vaccination against yellow fever and smallpox according to the method of the Pasteur Institute in Dakar] French Peltier M Abstr Int Congr Trop Med Malar 1948 56(4th Congr): 37
*1949 [Dessicated vaccine and the campaign against smallpox in tropical countries] Spanish; Engl summary Fasquelle R, Fasquelle J Bol Oficina Sanit Panam 1949 28(11): 1118-25 PAHO: 10665.2/13311
2009 Smallpox in Africa during colonial rule Schneider WH Med Hist 2009 53(2): 193-227 DOI: 10.1017/s002572730000363x
PMC: PMC2668906
*1965 [The history and the performance of the O.C.C.G.E. in French-speaking West Africa] French Richet P Trans R Soc Trop Med Hyg 1965 59: 234-54 DOI: 10.1016/0035-9203(65)90002-7
*1971 [History of smallpox control in French speaking African countries] French Fasquelle R, Fasquelle A Bull Soc Pathol Exot Filiales 1971 64(5): 734-56
*1965 [Measles mortality and morbidity in French-speaking countries of West Africa (survey methods and results)] French Cantrelle P Arch Gesamte Virusforsch 1965 16: 35-45
1965 Field experience with combined live measles, smallpox and yellow fever vaccines. Meyer HM Jr Arch Gesamte Virusforsch 1965 16: 365-6 DOI: 10.1007/BF01253840
1966 Measles and smallpox eradication in West Africa West Afr Med J 1966 15(5): 167
*1967 Smallpox-eradication and measles-control programs in West and Central Africa: Theoretical and practical approaches and problems
Industry Council for Tropical Health, Boston, Oct 1966
Henderson DA In: Industry and tropical health VI, Boston, Harvard School of Public Health, 1967, pp 112-20 URL: wellcomecollection.org/works/yd92v4km
DAH: Chesney Med Arch
1968 WHO Smallpox Surveillance Report #7, Aug
Western and Central Africa
Smallpox unit, WHO Wkly Epidemol Rec 1968 43(35):444-7 WHO: 10665/216769
1968 WHO Smallpox Surveillance Report #12, Nov
Africa
Smallpox unit, WHO Wkly Epidemol Rec 1968 43(45):574-9 WHO: 10665/216887
1968 Cultural resistance to smallpox vaccination in West Africa Challenor BD WHO/SE/68.4 and
J Trop Med Hyg 1971 74(3): 57-9
WHO: 10665/67464
1969 WHO Smallpox Surveillance Report #17, 7 Feb 1969
Western and Central Africa. Outbreak: Sierra Leone
Smallpox unit, WHO Wkly Epidemol Rec 1969 44(6):113-6 WHO: 10665/217035
1969 WHO Smallpox Surveillance Report #23, 2 May 1969
Strategy of the smallpox surveillance and containment programme, Western and Central Africa
Smallpox unit, WHO Wkly Epidemol Rec 1969 44(18):297-303 WHO: 10665/217190
1971 Selective epidemiologic control in smallpox eradication Foege WH, Millar JD, Lane JM Am J Epidemiol 1971 94(4): 311-315 DOI: 10.1093/oxfordjournals.aje.a121325
*1971 Mass measles control in West and Central Africa Foster SO, Pifer JM Afr J Med Sci 1971 2(2): 151-8
1972 Potency and stability characteristics of smallpox vaccine used in the smallpox eradication programme in Western and West-central Africa
International Symposium on Smallpox Vaccine, Bilthoven, The Netherlands, 11-13 Oct 1972
Bernstein A, Bierly MZ Jr WHO/SE/72.49 and
Symp Series Immunobiol Stand 1973 19:157-65
WHO: 10665/67517
1972 Persistence of facial scars of smallpox in West African populations Foster SO WHO/SE/72.34 WHO: 10665/67492
*1974 Isolation of viruses from wild mammals in West Africa, 1966-1970 Kemp GE, Causey OR, Setzer HW, Moore DL J Wildl Dis 1974 10(3): 279-93 DOI: 10.7589/0090-3558-10.3.279
*1975 Smallpox eradication in West and Central Africa Foege WH, Millar JD, Henderson DA Bull WHO 1975 52(2):209-22 PMC: PMC2366358
1979 Smallpox Zero in Africa Bland J, Viedma C, Davies P, Thapalyal L, (eds.) World Health 1979 Oct: 114-19 WHO: 10665/368355
1980 [Eradication of variola in Africa (author's transl)] Czech Zikmund V, Slonim D, Prikazsky V Cesk Epidemiol Mikrobiol Imunol 1980 29(5): 309-18
1992 [Homage of the "Centers for Disease Control" of Atlanta (United States of America) to the French military physicians who participated in the Tropical African world program to eradicate smallpox: the Pharo, October 22, 1991] French Picq JJ Med Trop (Mars) 1992 52(4): 451-7
*1980 The last 50 years of smallpox in Africa Tulloch JL WHO Chron 1980 34(11): 407-12

1998 Commentary: Smallpox eradication in west and central Africa revisited Foege WH Bull WHO 1998 76(3):233-5 PMC: PMC2305707
2003 Smallpox eradication in West and Central Africa: surveillance-containment or herd immunity? Kaplan EH, Wein LM Epidemiology 2003 14(1): 90-2 DOI: 10.1097/00001648-200301000-00021
2011 Lessons and innovations from the West and Central African Smallpox Eradication Program
Smallpox Eradication after 30 Years: Lessons, Legacies and Innovations. Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, 24-27 Aug 2010
Foege WH Vaccine 2011 29(Suppl 4):D10-D12 DOI:10.1016/j.vaccine.2011.04.008
2021 Smallpox eradication: African origin, African solutions, and relevance for COVID-19 Breman JG Am J Trop Med Hyg 2021 104(2): 416-21 DOI: 10.4269/ajtmh.20-1557
PMC: PMC7866312

Program Implementation

Year Title Authors Source URL
*1969 Joint WHO/USAID/CDC Seminar on Smallpox Eradication and Measles Control in Western and Central Africa. Lagos, Nigeria, 13-20 May 1969
Selected references are listed below. See Meetings & Seminars for a complete listing of the 60+ presentations.
PROCEEDINGS - Part I [10.5 MB] CDC, SEP Report 1970 IV(1):1-66 DAH: Chesney Med Arch
— Development and status of the smallpox eradication and measles control programme in west Africa Millar JD CDC, SEP Report 1970 IV(1):21-7a DAH: Chesney Med Arch
— Epidemiology of smallpox in west and central Africa Foege WH CDC, SEP Report 1970 IV(1):29-35a DAH: Chesney Med Arch
— Summary: Smallpox Millar JD CDC, SEP Report 1970 IV(1):65-6 DAH: Chesney Med Arch
PROCEEDINGS - Part 2 [19.4 MB] CDC, SEP Report 1970 IV(2):1-225 DAH: Chesney Med Arch
— Assessment of surveillance systems in West Africa Henderson RH CDC, SEP Report 1970 IV(2):69-72 DAH: Chesney Med Arch
— Intercountry cooperation and coordination: An overview Lythcott GI CDC, SEP Report 1970 IV(2):76-7 DAH: Chesney Med Arch
— Smallpox eradication in Africa: Principles for action in the maintenance phase Binson B CDC, SEP Report 1970 IV(2):177-80 DAH: Chesney Med Arch
— A review of West African operations: Methods and tactics Hicks JW CDC, SEP Report 1970 IV(2):192-8 DAH: Chesney Med Arch
— Associated vaccine campaigns: Organization and logistics Labusquiere R CDC, SEP Report 1970 IV(2):216-20 DAH: Chesney Med Arch
— Summary: Programme operations Henderson DA CDC, SEP Report 1970 IV(2):224-5 DAH: Chesney Med Arch

Human Monkeypox

Year Title Authors Source URL
*1972 Human monkeypox Foster SO, Brink EW, Hutchins DL, Pifer JM,Lourie B, Moser CR, Cummings EC, Kuteyi OEK, Eke REA, Titus JB, Ademola Smith E, Hicks JW, Foege WH Bull WHO 1972 46(5): 569–576 PMC: PMC2480784
*1972 Human infection with monkeypox virus: Laboratory investigation of six cases in West Africa Lourie B, Bingham PG, Evans HH, Foster SO, Nakano JH, Herrmann KL Bull WHO 1972 46(5):633–639 PMC: PMC2480791
*1972 Isolation and properties of the causal agent of a new variola-like disease (monkeypox) in man Marennikova SS, Seluhina EM, Mal'ceva NN, Cimiskjan KL, Macevic GR Bull WHO 1972 46(5): 599-611 PMC: PMC2480798
1975 Relevance of some poxvirus infections in monkeys to smallpox eradication Gispen R Trans R Soc Trop Med Hyg 1975 69(3): 299-302 DOI: 10.1016/0035-9203(75)90122-4
*1976 Monkeypox-specific antibodies in human and simian sera from the Ivory Coast and Nigeria Gispen R, Brand-Saathof BB, Hekker AC Bull WHO 1976 53(4): 355-60 PMC: PMC2366533
*1976 Monkeypox and whitepox viruses in West and Central Africa. Arita I, Henderson DA WHO/SE/76.78 and
Bull WHO 1976 53(4): 347-353
WHO: 10665/68182
PMC: PMC2366520
*1977 Poxvirus in West African nonhuman primates: Serological survey results Breman JG, Bernadou J, Nakano JH Bull WHO 1977 55(5): 605-12 PMC: PMC2366701
1977 Human poxvirus disease after smallpox eradication Breman JG, Nakano JH, Coffi E, Godfrey H, Gautun JC Am J Trop Med Hyg 1977 26(2): 273-81 DOI: 10.4269/ajtmh.1977.26.273
*1984 The current status of human monkeypox: memorandum from a WHO meeting Bull WHO 1984 62(5): 703-13 PMC: PMC2536211
*1985 Human monkeypox: a newly emerged orthopoxvirus zoonosis in the tropical rain forests of Africa Arita I, Jezek Z, Khodakevich L, Ruti K Am J Trop Med Hyg 1985 34(4): 781-9 DOI: 10.4269/ajtmh.1985.34.781
*1985 [Monkey pox virus infection in humans in the Central African Republic] French Khodakevich L, Widy-Wirski R, Arita I, Marennikova SS, Nakano J, Meunier D Bull Soc Pathol Exot Filiales 1985 78(3): 311-20
1986 [Isolation of the monkey pox virus from a wild African squirrel] Russian Marennikova SS, Shelukhina EM, Khodakevich LN, Ianova NN Vopr Virusol 1986 31(2): 238-41