Balmis Expedition

Royal Philanthropic Vaccine Expedition

Balmis balcony in theDomus museuminLa Coruña(Spain), a tribute to the people of the expedition
Date	November 30, 1803 – 1806
Location	Spanish Empire
Type	Scientific expedition
Cause	High mortality rate in the viceroyalties of theSpanish Empiredue tosmallpox
Motive	Vaccinate the inhabitants of the viceroyalties of theSpanish Empireagainst smallpox

Expedition by Balmis and his collaborators to America

Detail of expedition's routes in the Philippines

TheRoyal Philanthropic Vaccine Expedition(Spanish:Real Expedición Filantrópica de la Vacuna), commonly referred to as theBalmis Expedition,was a Spanish healthcare mission that lasted from 1803 to 1806, led by DrFrancisco Javier de Balmis,which vaccinated millionsof inhabitants ofSpanish Americaand Asia againstsmallpox.The vaccine was transported through children: orphaned boys who sailed with the expedition.

Background

Smallpox, a devastating disease that was endemic throughout much of theOld World,decimated the populations of the Americas after it was introduced by the Spanish conquistadors in the 1500s.By the late 16th century, smallpox had become endemic throughout Spain's holdings in the Americas and epidemics occurred periodically over the next 300 years.

In the 18th century there were scattered attempts in the colonies to usevariolation,an older, less-effective method ofinoculationusing smallpox material. These efforts did little to mitigate the epidemics and sometimes actually increased the spread of the contagion.

In 1798, English physicianEdward Jennerpioneered the use of avaccineto immunize persons with an inoculation ofcowpoxmaterial. The new vaccine was a much safer and more effective way to prevent smallpox. At the time, about 400,000 Europeans died each year from the disease which was also responsible for one-third of all cases of blindness in Europe. The use of Jenner's new vaccine spread rapidly through Europe and had a significant positive impact on the severity and frequency of smallpox epidemics.

The vaccine first reached Spain in late 1800 and by the end of 1801, several thousand persons had been vaccinated across the country. The efforts were well publicised in Spain and by 1804, dozens of papers, treatises, newspaper articles, and editorials had been published on the smallpox vaccine.

Francisco Javier de Balmiswas a military physician.

Expedition

Monument inA Coruñain honor of the orphan children who took part of the expedition

Historical marker installed in the Philippines to commemorate the arrival of the expedition in the Philippine Islands

In November 1794 the daughter of KingCharles IV of Spain,InfantaMaria Teresa, had died from smallpox. He had heard of the vaccine discovery. Colombia and Ecuador experienced a smallpox epidemic and called on the king for supplies.

On 30 November 1803, the expedition set off fromA Coruñain northwest Spain sailing onMaria Pita.It carried 22 orphan boys (aged 3 to 10) to act as carriers of the cowpox virus. The boys were necessary because the vaccine consisted of infecting patients with cowpox, which is a virus closely related to smallpox but produces a much milder disease that confers immunity to both. However, only an active infection could be transferred to successive patients, so two boys were infected with cowpox at the beginning of the voyage, with two more infected at a time as it progressed across the Atlantic and beyond.The medical staff and caretakers for the boys consisted of Balmis, a deputy surgeon, two assistants, two first-aid practitioners, three nurses, andIsabel Zendal Gómez,therectoressofCasa de Expósitos,an A Coruña orphanage.

The mission took the vaccine to theCanary Islands,Puerto Rico,Venezuela,Colombia,Ecuador,Peru,Mexico,thePhilippinesandChina.The ship carried also scientific instruments and translations of theHistorical and Practical Treatise on the Vaccineby Moreau de Sarthe to be distributed to the local vaccine commissions to be founded.

InPuerto Rico,the local population had already been inoculated from the Danish colony ofSaint Thomas.InVenezuela,the expedition divided atLa Guaira.Balmis went toCaracasand later toHavana.

At Balmis' request Cuba sent three enslaved girls toCampeche,Mexico, as additional carriers of the vaccine; following Mexican independence and emancipation, Mexico continued to bring in slaves from Cuba as vaccine carriers.

The Venezuelan poetAndrés Bellowrote an ode to Balmis. José Salvany, the deputy surgeon, went toward today's Colombia and the Viceroyalty of Peru (Ecuador, Peru, Chile, and Bolivia). The voyage took seven years and cost Salvany his life, as he died in 1810 inCochabamba.In New Spain, Balmis took on 25 more orphans to maintain the infection during the crossing of the Pacific. In the Philippines, they received help from the Catholic church, which was initially reluctant untilGovernor-GeneralRafael Aguilarmade an example by vaccinating his five children. Balmis sent most of the expedition back to New Spain while he went on to China, where he visitedMacauandCanton.On his way back to Spain in 1806, Balmis offered the vaccine to the British authorities inSaint Helena,despite theAnglo-Spanish War (1796–1808).

Legacy

Balmis expedition may be considered the first international healthcare expedition in history.Jenner himself wrote, "I don't imagine the annals of history furnish an example ofphilanthropyso noble, so extensive as this. "

In 2006,Julia AlvarezwroteSaving the World,a fictional account of the expedition from the perspective of its only female member.

Further reading

• Fenner, Frank (1988)."Smallpox and Its Eradication".History of International Public Health.World Health Organization.hdl:10665/39485.ISBN978-92-4-156110-5.
• Mark, Catherine; Rigau-Perez, Jose G. (2009)."The World's First Immunization Campaign: The Spanish Smallpox Vaccine Expedition, 1803–1813".Bulletin of the History of Medicine.83(1): 63–94.ISSN0007-5140.JSTOR44448715.

External links

• En el nombre de los Niños. Real expedición Filantrópica de la Vacuna 1803-1806.Spanish languagePDFbook by the Spanish Pediatry Association.