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&lt;p&gt;Use of this information is free, but please see &lt;strong&gt;“About this Site”&lt;/strong&gt; for guidance on how to acknowledge the sources of the information used&lt;/p&gt;
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&lt;p&gt;Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  &lt;/p&gt;
&lt;p&gt;The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.&lt;/p&gt;
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              <text>&lt;pre&gt;&lt;strong&gt;
 Interview Transcript
&lt;/strong&gt;
Interview

Dr. Dan Blumenthal with Dr. David Sencer
Transcribed: January 23, 2009


Dr. Sencer: This is the 1st day of April at CDC. I'm David  Sencer  and  I'm
           interviewing  Dr.  Dan  Blumenthal,  a  Professor  at  Morehouse
           University School of Medicine on his experiences in the Smallpox
           Program. He knows he is being taped and he has signed a release.


           Good morning, Dr..

Dr. Blumenthal:  Good morning.

Dr. Sencer: Do you want to tell me a little about  who  Dan  Blumenthal  is?
           How he got to be Dan Blumenthal?

Dr. Blumenthal:  Well sure. I started out, I think - picking up  maybe  when
           I was in high school really intending to be a research  type  of
           person, pursuing a PhD in the biological science and -

Dr. Sencer:      Where did you go to high school?

Dr.  Blumenthal:    In  the  suburb  of  St.  Louis,  Missouri,  my  college
           experience in  particular;  a  summer  research  experience  had
           convinced me that I really needed to pursue an MD rather than  a
           PhD, or perhaps both. My original  intention  was  to  go  after
           both, but I put myself in a position to do  Biomedical  Research
           as something that would be more immediately relevant to  humans.
           By the time I did  some  more  research  in  medical  school,  I
           decided I really didn't want to pursue a  research  career,  but
           rather, more of a medical practice career. So I kind of  changed
           my career direction again. I was  then,  I  think  -  eventually
           headed for some kind of pediatric practice, but -

Dr. Sencer:      Where did you go to medical school?

Dr. Blumenthal:   I went to the University  of  Chicago.  Actually,  I  went
           there because they had a good combined MD/PhD Program  and  that
           was what I thought I wanted to do at that time, but as  I  said,
           after a few more  laboratory  experiences,  I  decided  that  it
           really wasn't for me. I wasn't a laboratorian. I thought I was a
           clinician and maybe I still am to some extent. I got into public
           health as a result of the war in Vietnam and I had actually -  I
           was so opposed to the war that I just knew that I  wasn't  going
           to serve in the military. I was prepared to move  to  Canada  if
           that was what was required, but I was looking for an alternative
           in the U.S. instead and I applied to the Indian Health  Service.
           I think today, admission to the Indian Health Service would  not
           be a problem, but in those days it was, so I didn't get into the
           Indian Health Service. I  talked  to  my  father  who's  also  a
           physician and he said, "Well, why don't you try applying to  the
           NCDC?" As it was known at that time, the  National  Communicable
           Disease Center, and I said, "What's that?" and he  explained  to
           me that it was a  Public  Health  Service  facility  located  in
           Atlanta, and I did apply to the EIS; and I was admitted  to  the
           EIS. At the time, I really knew very little about public health.
           I had learned almost nothing  about  public  health  in  medical
           school and very little more during my residency,  but  this  was
           certainly an attractive alternative, so I learned  about  public
           health here at CDC and it clearly made an incredible  difference
           in my career. I  still  do  practice  clinical  pediatrics,  but
           public health is a major part of my life, and it is probably the
           biggest part of my career now.

Dr. Sencer:      Who was in charge of the EIS program when you were there?

Dr. Blumenthal:   Phil Brachman was the Director of the  EIS  at  that  time
           and provided great leadership. I still talk to Phil from time to
           time. He's teaching at Emory and we keep in touch.

Dr. Sencer:      What did you do in the EIS?

Dr. Blumenthal:  I spent a year  in  the  Nutrition  Program  and  then  the
           Nutrition Program went out of business, and so I spent a  second
           year and then a third year in the Parasitic Diseases Branch, and
           did some work with Ascaris and other intestinal  parasites  here
           in the U.S.

Dr. Sencer:      How did you end up in India?

Dr. Blumenthal:  When I was in  the  Parasitic  Disease  Branch  a  call,  I
           guess, went  out  for  epidemiologists  to  participate  in  the
           Smallpox Eradication Program in India and I wanted to do  it,  I
           guess, for two reasons. One was because it was a noble cause. It
           was  something  that  really  sounded  like  it  could  make  an
           incredible difference in health for people in India  and  around
           the world, and second because it sounded like a great adventure.
           It was really working on the frontlines of  something  important
           and the frontlines in this case were far away from places  where
           American physicians usually work. Far away from all  the  things
           that we know and it sounded exciting and different and  unusual,
           and that was very appealing to me at that time.

Dr. Sencer:      When did you go to India?

Dr. Blumenthal:  1974. I was assigned to Bihar which was  in  the  Northeast
           part of India, just  South  of  Nepal  and  I  was  assigned  to
           Samastipur District which is - Patna is  the  capital  of  Bihar
           State, and from Patna you cross the Ganges River and go  a  ways
           further on, and eventually arrive in Samastipur. We flew  in  to
           New Delhi originally and had some orientation there and then -

Dr. Sencer:      Who did the orientation?

Dr. Blumenthal:  Well, Bill Foege  was  there  but  I  actually  don't  -  I
           remember the hotel, I remember the swimming pool,  but  I  don't
           remember too much about what we did in New Delhi. I remember the
           train ride then from New Delhi to Patna in a train  drawn  by  a
           coal-burning engine and cinders and smoke flying in through  the
           windows, and it was done that way  because  Bill  Foege  thought
           that he shouldn't send everybody  by  airplane  because  he  was
           afraid the plane might crash. So some people went by plane but I
           was with the group that went by train.

Dr. Sencer:      Who were some of your colleagues?

Dr. Blumenthal:   Steve  Jones  was  in  the  next  district  over,  it  was
           Jafarpur, and when I got lonely for  the  company  of  a  fellow
           American, I would get in my jeep and drive over to Jafarpur. I'd
           probably do that two or three times  during  that  time  that  I
           spent in India and spent a couple of  days  with  Steve  sitting
           around and speaking American to each other, and then I  was  re-
           energized and could go back to work in Samastipur. There were  a
           number of others in the surrounding districts and I'm  afraid  I
           can't remember everybody's name, but I know that we did a couple
           of R &amp;amp; R to Katmandu which was a fairly easy hop from  Patna  to
           Katmandu by airplane. So I had some good  friends  at  the  time
           whose names I can't remember now.

Dr. Sencer: Where you working - did you have an Indian counterpart  or  were
           you just sort of off on your own?

Dr. Blumenthal:   Well, I had a driver, I had a paramedical  assistant,  and
           for part of the time when I was there,  I  had  a  young  Indian
           physician colleague who  traveled  around  with  me  and  shared
           responsibilities. I think that was maybe only for a month or  so
           though.

Dr. Sencer:      What sort of duties did you have?

Dr.  Blumenthal:   The  basic  program  was  to  follow  behind  my   Indian
           colleagues who were permanent workers in the  healthcare  system
           to ensure that  the  search  for  smallpox  cases  and  smallpox
           outbreaks was being appropriately carried out. So on  a  typical
           day I would visit the health office, the  local  health  office,
           where, posted on the wall was a list of all the  outbreaks  that
           were being worked; and I would say, "Let's go to that one," just
           kind of picking one  at  random.  Typically,  the  local  health
           officer would say, "No. You wouldn't want to  go  to  that  one.
           That one is far off of the paved road. You'll get stuck  in  the
           mud. It's very difficult. You'll have to walk. I suggest  we  go
           to this one which is right on the paved road." And I'd say, "No.
           Since you've told me that now I know that I want to  go  to  the
           first one that I picked." So we'd get in the  jeep  and  he  was
           right, we got stuck in the mud, and so we had  to  get  out  and
           walk, and we'd eventually get to the outbreak; and of course few
           people there had been vaccinated, and it was  typical  the  work
           that was supposed to have been done hadn't  been  done,  so  his
           interest in having me not go  there  was  both  related  to  the
           difficulty in getting there and the fact that he knew what  we'd
           find when we did get there. So that was the biggest part of  it,
           and there were periodic meetings that I would have to go back to
           Patna to participate in, and reporting, and we filled out a  lot
           of forms, but it was  mostly  that  kind  of  spot-checking  and
           supervision and traveling from one health office to  another  in
           the district.


           I'll tell you a story about getting stuck in the  mud.  We  were
           traveling to one of those outbreaks and the jeep  got  stuck  in
           the mud and it was clear that we couldn't  get  any  further  on
           that road in a motorized vehicle, and it was still quite a  ways
           to the village we were traveling to. But just down the road  was
           the estate of a very wealthy landowner who kept an elephant as a
           pet. This was the sort of beast of burden that in past times  in
           India was used for actually doing work. The elephants,  I  guess
           are no longer used for work in India, or very little,  but  they
           were still, at least at that time, kept by some of  the  wealthy
           Indians as a kind of status symbols. So we walked down the road.
           My paramedical assistant was not very enthusiastic  about  this,
           but I insisted that this would work. We walked  down  the  road,
           knocked on the door, introduced ourselves, we  were  invited  in
           for tea, and I asked the gentleman if we could please borrow his
           elephant; and he agreed and we all climb  on  the  elephant  and
           there was an elephant driver who urged the  elephant  along.  It
           was sort of worrisome because he had a metal rod and  every  now
           and then, he would whack the elephant on the side  of  the  head
           with the metal rod and I was just seriously concerned  that  the
           elephant was going to react to this in some way, but  it  didn't
           seem to bother him. We eventually got to the  outbreak  and  all
           the kids were excited to see us coming and they all  ran  around
           yelling "Hati! Hati!" Which means elephant; so we did  our  work
           there, rode the elephant back, and four years later when  I  was
           in  Somalia,  somebody  in  the  smallpox  program  that  I  was
           introduced to said, "Blumenthal, you are the guy  who  rode  the
           elephant to the outbreak. Aren't you?" So  that  little  episode
           gave me a certain amount of fame in  the  smallpox  program.  So
           that was not a typical day but it represented the kind  of  work
           that I was doing in India.

Dr. Sencer:      The word is improvisation.

Dr. Blumenthal:   The word is improvisation. Right.

Dr. Sencer:      Do you have any other tales of your time in India?

Dr. Sencer: Well, I guess there are many. One  that  I  enjoy  telling  from
           time to time involves a visit I was to make the next  day  to  a
           village that was located on a river, and  I  was  having  dinner
           with a number of Indian colleagues and I asked them, "Are  there
           crocodiles in that river?"  and  one  of  them  said,  "Oh  yes.
           Crocodiles are available." Another one said,  "He  doesn't  want
           crocodiles. You goof." So, we got a chuckle out of that one.

Dr. Sencer:      But you lived to tell the tale?

Dr. Blumenthal:   Yeah,  I  lived  to  tell  -  I  actually  never  saw  any
           crocodiles. I suppose they were available, but I didn't see any.
           So I would have to say that that period of time I spent in India
           was one of the most rewarding of my professional career; and the
           reason is this, that when I got there and began  visiting  these
           outbreaks and visiting villages, there were  so  many  outbreaks
           and so many cases of  smallpox,  and  it  was  such  a  terrible
           disease that I said to myself and to others,  "This  is  absurd.
           This is never going to be  eradicated.  There  is  no  hope  for
           success here. This is an  interesting  experience  and  a  great
           adventure for me, but I can't imagine  that  this  is  going  to
           succeed;" and yet, by the time I left only a few months later, I
           couldn't find a case. It virtually disappeared  before  my  eyes
           during just three months while I was there, and I would have  to
           say that that's the part that I remember most. That was the most
           satisfying part of that experience.

Dr. Sencer:      It was an achievement. You mentioned you were in Somalia.

Dr. Blumenthal:  I was, four years later - Honestly, what happened was  four
           years later, I just decided I needed to  go  to  Africa.  I  had
           never been to Africa and it was a place I wanted -

Dr. Sencer:      Are you still part of CDC?

Dr. Blumenthal:   No. At that time I was no longer working for  CDC.  I  was
           working for Emory University. But nonetheless, word  reached  me
           that CDC was looking for people to go to Somalia. This was  what
           appeared to be the last outbreak of  smallpox,  smallpox's  last
           stand, and I really not only wanted to go to Africa, but when  I
           heard about that, I wanted to be part of that. I was  hoping  to
           get there in time to see  the  last  case.  So  I  succeeded  in
           getting a period of leave from my position at Emory  and  signed
           up and went to Somalia a bit too late. The last case had already
           taken place, so I missed that. I spent three months in  Somalia,
           conducting a search, really knowing that I wasn't going to  find
           any smallpox. So we did other things. One of - somebody back  at
           CDC I guess was interested in studying other pox -

Dr. Sencer:      [crosstalk/inaudible 0:15:43]

Dr. Blumenthal:  Well, other pox viruses, so they had me looking  for  camel
           pox which is a pox disease with camels; and I actually  found  a
           camel that had camel pox and gathered some material from some of
           the lesions and send it back to CDC. I don't know what  happened
           with that study, but I'm sure we know a little  bit  more  about
           camel pox now than we did before because of that.


           A story from Somalia: The work in Somalia was fairly similar  to
           the work in India in the sense of going around and  checking  to
           make sure that the - in this case, that the search had been done
           properly because there wasn't any smallpox to be  found.  So  in
           one  local  health  office,  I  went  through  my   routine   of
           identifying a place that I wanted to visit and having the health
           officer there explain that this was a very  difficult  place  to
           reach and so I probably shouldn't go there, and having  me  say,
           "Well, in that case, that's definitely the place I want to  go."
           So my job was to go to the place and take  the  little  smallpox
           picture that we used and go from one dwelling to another, asking
           if somebody had been there and showing this picture, and  asking
           about any cases of rash. Now this  was  in  a  part  of  Somalia
           that's called Gedo. Now I digress at this point to say  that  on
           my way to Somalia I had stopped in Geneva for a couple  of  days
           to, I don't know, fill out some forms or something at  WHO,  and
           one of the people who was returning from Somalia said,  "Listen.
           When you get there, you can  go  to  any  part  of  Somalia.  It
           doesn't matter where they assign you, as long as it's not  Gedo.
           You don't want to go to Gedo." So, of course when I  got  there,
           that was where they sent me. This was fairly a remote part of  a
           remote country located where Somalia,  Ethiopia  and  Kenya  all
           meet. It was a little risky because there was a  bit  of  a  war
           going on at that time between  Somalia  and  Ethiopia  over  the
           Ogaden Desert. I'm not sure why anybody would  want  the  Ogaden
           Desert, but both of these countries did, so they  were  fighting
           it out.

Dr. Sencer:      Still do.

Dr. Blumenthal:  Yeah. So we had to stop from time to time because  we  were
           told there were land mines in the road  up  ahead  and  so  we'd
           spend the night by the side of the road and the next day we were
           assured the land mines had all been cleared away and we would go
           on. I'm off of my story. The  story  is  -  I  need  to  further
           explain that the populace in this area was mostly  Nomadic;  and
           they would herd camels and some goats and some  sheep  from  one
           place to another, looking for food for the livestock;  and  they
           would set up their huts and stay in one place for a few days and
           then move on to another place. This was the dry season and there
           were some places that were - where food for the livestock  could
           be found and there were other  places  where  no  food  for  the
           livestock could be found. There were some settled villages along
           a river that flowed through the area, but mostly, the population
           was Nomadic.

           So this is a backdrop. I will return to the story  where  I  had
           identified the place that I wanted to visit and so myself and my
           driver, and my interpreter, and the local health officer all set
           out in our land rover to visit this site; and we traveled for  a
           long way in the land rover and then we got to a place where  the
           health officer said, "You know, I really don't know  this  area.
           We'll have to find somebody here, a local guide who can take  us
           to the place where we want to go." So we hunted  around  and  we
           found somebody who said he knew where that place was, and so  we
           put him in the jeep - in the land rover and we  drove  until  we
           came to a dry wadi, which is a dry riverbed, a gulch. In the dry
           season there's no water in it, but we couldn't drive  across  so
           we had to leave the land rover there and  we  got  down  and  we
           walked. We probably walked five miles and it was hot and it  was
           dry, but we finally got to a place where our guide  said,  "Here
           we are." And I said, "Where are we?"  He  said,  "We're  at  the
           place you said you wanted to  go."  And  I  said,  "But  there's
           nobody here." And he said, "Well, of course not.  There's  never
           anybody here this time of the year." So, all I  could  say  was,
           "Well, I guess there's no smallpox here." Then we turned  around
           and walked back. So that  was  Somalia  -  I  met  bed  bugs  in
           Somalia. I had never seen bed bugs before, but traveling  around
           from one place to another in some of the little towns there  are
           little hotels. We stayed in a little  hotel,  and  some  of  the
           little hotels had bed bugs so that was -

Dr. Sencer:      And you had bed bugs?

Dr. Blumenthal:   I had bed bugs. The bed had bed bugs  and  they  came  out
           and fed on me. My experience with bed bugs was I woke up in  the
           middle of the night - my first experience with bed bugs, I  woke
           up in the middle of night and I was being bitten  by  an  insect
           which I thought must be mosquitoes  so  I  pulled  my  cover  up
           around my head and the more I pulled  the  cover  up  around  my
           head, the more I got bitten by the bugs. So I finally got out of
           bed, got out my flashlight and shown it around,  and  found  bed
           bugs. I've never seen them before, but I figured out  what  they
           were. So I found ways to deal with the bed bugs, but basically I
           just sort of coated myself with insect repellent and  that  kept
           the bed bugs away.

Dr. Sencer:      Was that your only health problem overseas?

Dr. Blumenthal:   Well, occasional diarrhea but I never  got  seriously  ill
           during the time I was overseas, took malaria prophylaxis  and  I
           was reasonably careful about what I ate and drank.

Dr. Sencer: To what extent do you think your experience  with  the  smallpox
           influenced the rest of your career?

Dr. Blumenthal:   I've maintained an interest in international health and  I
           feel like I have had more of an international health  experience
           than many of my colleagues who also do international health. But
           their international health work may involve going to the capital
           city and giving some lecture at the medical school and  it  sort
           of entitles me to scoff and say, "You  call  that  international
           health? That's not really international health." I've maintained
           that it has stimulated an interest  in  infectious  disease,  so
           although  I  would  not  attempt  to  pass  myself  off  as   an
           Infectious Disease Specialist, it does help me keep current  and
           I know a lot more about infectious disease than many of my other
           non-infectious disease specialist colleagues,  because  I  think
           more than anything, it  has  given  me  a  lifelong  feeling  of
           satisfaction that I was part of this program that  achieved  one
           of the greatest public health  accomplishments  ever,  and  I've
           always been glad to have that on my curriculum vitae.

Dr. Sencer:      Well, good. Anything else you want to say?

Dr. Blumenthal:  Seems like enough.

Dr. Sencer:      It's good. Thank you.

Dr. Blumenthal:   Thank you for the opportunity.


[End of audio 0:23:30]
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