Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Vaccine. 2011 Dec 30;29 Suppl 4(Suppl 4):D22-9. doi: 10.1016/j.vaccine.2011.06.081. Epub 2011 Dec 19.
Rahima Banu, the world's last endemic case of severe smallpox, Variola Major, developed rash on October 16, 1975 on Bhola Island, Bangladesh. Achieving eradication in a country destroyed by war challenged the achievement of smallpox eradication. Between January 1, 1972 and December 31, 1975, 225,000 smallpox cases and 45,000 smallpox deaths occurred. Adapting the global smallpox eradication strategies of surveillance, the detection of smallpox cases, and containment, the interruption of smallpox transmission, utilized progress toward three objectives to monitor performance: (1) surveillance - the percent of smallpox infected villages detected within 14 days of the first case of rash, (2) knowledge of the reward - public knowledge of the current amount of the reward for reporting smallpox, and (3) containment - the percent of infected villages interrupting smallpox transmission within 14 days of detection. Failures to achieve these objectives led to the identification and implementation of improved strategies that eventually achieved eradication. Essential to this success was a tripartite partnership of the citizens of Bangladesh, the Bangladesh Ministry of Health, its field staff, and staff and resources mobilized by the World Health Organization.
拉希玛·巴努是世界上最后一例天花地方性病例，她于 1975 年 10 月 16 日在孟加拉国的博拉岛出现皮疹。在一个饱受战争破坏的国家实现天花根除，这对实现这一目标构成了挑战。1972 年 1 月 1 日至 1975 年 12 月 31 日期间，该国共发生 22.5 万例天花病例和 4.5 万例天花死亡病例。为了适应全球根除天花的监测、发现天花病例和遏制措施，中断天花传播的战略，利用实现三个目标的进展来监测绩效：（1）监测——在首例皮疹出现后 14 天内发现感染村庄的百分比；（2）知识奖励——公众对当前报告天花奖励金额的了解程度；（3）遏制——在发现后 14 天内受感染村庄中断天花传播的百分比。未能实现这些目标导致了改进战略的确定和实施，最终实现了根除。孟加拉国公民、孟加拉国卫生部及其现场工作人员以及世界卫生组织动员的工作人员和资源之间的三方伙伴关系是这一成功的关键。
