1775–1782 North American smallpox epidemic

However, there is a period of time in which individuals are contagious but have only begun to experience minor symptoms such as fever, headaches, body aches, and sometimes vomiting.

During this time, there was no medical technology widely available to protect soldiers from outbreaks in crowded and unhygienic troop camps.

[citation needed] It is not known where the outbreak began, but the epidemic was not limited to the colonies on the Eastern seaboard, nor to the areas ravaged by hostilities.

Many escaped slaves who had fled to the British lines in the South likewise contracted smallpox and died.

In the South, it reached Texas, and from 1778 to 1779, New Orleans was especially hard hit due to its densely populated urban area.

At its end, the epidemic had crossed the Great Plains, reaching as far west as the Pacific coast, as far north as Alaska, and as far south as Mexico, infecting virtually every part of the continent.

It is estimated to have killed nearly 11,000 Native Americans in the Western area of present-day Washington, reducing the population from 37,000 to 26,000 in just seven years.

[citation needed] Though there was not too much known about viruses and their transitions, English colonists in North America recognized the effectiveness of isolating individuals infected with smallpox.

One of the earliest recorded examples of this was a quarantine established in 1647 by Puritans in order to prevent the spread of disease from ships coming from the Caribbean.

[6] Upon taking charge of the Continental Army, Washington recognized the severe danger that smallpox posed to his men and the outcome of the war.

Further, Washington was prepared to quarantine any member of his troops showing symptoms according to previously discovered methods and guidelines, including through the use of a special hospital.

Additionally, certain retreats of the Continental Army can be linked to Washington's wish to avoid smallpox and his intense caution when it came to his troops.

[8] The practice was widely publicized over a century later by Lady Mary Wortley Montagu, who inoculated her own children against smallpox, despite widespread concern and controversy.

[citation needed] George Washington contributed greatly to the progression of public health systems in America.

Having himself suffered from many illnesses and observing those of his family, George Washington was an integral part of the establishment of American public health programs.

With this, he was able to both protect his soldiers and take advantage of the vulnerability of Boston and its British inhabitants during the smallpox outbreak of March 1776.

But as he watched many of his men fall victim to smallpox, Washington believed that he would be able to keep his troops healthy through sanitary and quarantine methods.

First, Washington recognized that quarantine and attempted cleanliness were not enough to keep his vital troops healthy and in fighting form.

This was due to the more accepted practice of inoculation in Europe and the high rate of childhood cases, resulting in immunity.

The Adams both understood the toll that smallpox could take and therefore feared the disease and its potentially devastating lasting effects.

Adams was able to spread his progressive beliefs about public health programs such as inoculation by taking advantage of his status during this time.

Prior to the steps made by these parties, public health policies in the colonies were not well established; they were limited to emergency situations.

[9] However, the scourge of smallpox prompted changes to be made that would impact the public health of America for years to come.

The smallpox inoculation program paved the way for the global public health system that is responsible for the control and eradication of many deadly diseases, including but not limited to polio, measles, and diphtheria.