Storesund A
Institutt for allmenn- og samfunnsmedisin, Universitetet i Oslo, Postboks 1130 Blindern, 0317 Oslo.
Tidsskr Nor Laegeforen. 2000 Dec 10;120(30):3694-8.
Was vaccination the only cause of the decline of smallpox in Norway during the 19th century? This regional study focuses on the history of the disease in Telemark county with special emphasis on the last, extensive epidemic in 1868. In addition to vaccination, other possible causal relations are discussed. In Telemark, smallpox seems to have been relatively mild in the 19th century with the exception of the epidemics at the end of the 1830s and in 1868. In 1868 the disease spread along the main transportation routes northward through the western part and eastward through the more densely populated districts along the coast. The importance of vaccination is apparent from the fact that the municipalities with the lowest annual percentage of newborns vaccinated were most heavily struck by the epidemic. Despite vaccination procedures, both adults and unvaccinated children were groups at risk. Local initiatives--especially isolation and revaccination--largely prevented or restricted outbreaks of smallpox. It seems that the efforts of the district medical officers and local health administrators after 1860 were of decisive importance for the decline in smallpox cases in the period in question.
接种疫苗是19世纪挪威天花发病率下降的唯一原因吗？这项区域研究聚焦于泰勒马克郡的疾病史，特别着重于1868年最后一次大规模流行疫情。除了接种疫苗，还讨论了其他可能的因果关系。在泰勒马克郡，19世纪的天花似乎相对温和，19世纪30年代末和1868年的疫情除外。1868年，这种疾病沿着主要交通路线向北蔓延至西部，向东蔓延至沿海人口更密集的地区。接种疫苗的重要性从以下事实中可见一斑：新生儿年接种率最低的自治市受疫情影响最为严重。尽管有接种程序，但成年人和未接种疫苗的儿童仍是高危群体。地方举措——尤其是隔离和再次接种——在很大程度上预防或限制了天花的爆发。1860年之后地区医务人员和地方卫生管理人员的努力似乎对该时期天花病例的减少起到了决定性作用。
