Smallpox in Europe, 1950-1971

The 49 importations of smallpox into western countries in the past 20 years are reviewed. Such importations have been caused, for the most part, by visiting foreigners or by returning nationals who had scars from childhood vaccination. When appreciable numbers of indigenous cases or deaths have resulted, spread in hospitals has been responsible. Most deaths have been among medical personnel or elderly patients. The reputation of smallpox as a catastrophic, unpredictable, and uncontrollable disease seems unwarranted under modern conditions. Fear of incidents such as these should not be used to justify a policy of universal vaccination of children.