Department of Health Sciences, University of Genoa, Italy.
UNESCO Chair "Anthropology of Health - Biosphere and Healing System", University of Genoa, Italy.
J Prev Med Hyg. 2024 Aug 31;65(2):E296-E302. doi: 10.15167/2421-4248/jpmh2024.65.2.3335. eCollection 2024 Jun.
The article aims to outline the features of the efforts for smallpox eradication within the pre-unitary context of the Kingdom of Sardinia, characterized by a long tradition in medical-health prevention. This tradition is partly inherited from the health magistracies of the Italian states during the ancient regime and partly adopted from policies initially outlined by Napoleon and later by other European states. In addition to prevention activities, authorities also engage in a vigorous information and awareness campaign aimed at eliminating common prejudices and doubts about vaccination among the population.
In analyzing the authorities' achievements in combating smallpox, this study examines the two epidemic waves (1829-30 and 1852-54), along with the legislative developments before, during, and after these periods. It also compares these regulatory changes with those in other European contexts.
The epidemiological situation turned out to be more complex to manage than the authorities had anticipated, as evidenced by the increasing controls imposed. Scientific and political communities, both in the Kingdom of Sardinia and in other European nations, found themselves divided on the legitimacy of proposing restrictive measures by the state. Some advocated for restricted access to public places and imposed mandatory vaccination for vulnerable individuals.
The comparison with smallpox resulted in a gradual improvement in of health security levels, although vaccination coverage did not reach the desired targets. Several factors contributed to this failure, including the limited expertise and reluctance of medical personnel, who were burdened with much of the operation's costs. Additionally, particularly in rural areas, there was widespread mistrust among the population towards doctors. Despite these challenges, the fight against smallpox enabled authorities to develop population control tools in the name of public health protection. However, it was not until 1888 that mandatory vaccination was introduced.
本文旨在概述在撒丁王国统一前的背景下，针对天花所进行的根除工作的特点。该王国在医学卫生预防方面有着悠久的传统。这一传统部分源自于旧政权时期意大利各城邦的卫生司法管辖区，部分则源自于拿破仑最初提出的政策，后来也被其他欧洲国家所采纳。除了预防活动外，当局还开展了一项积极的信息和宣传活动，旨在消除民众中对疫苗接种的普遍偏见和疑虑。
在分析当局在抗击天花方面的成就时，本研究考察了两次疫情浪潮（1829-30 年和 1852-54 年），以及这些时期前后的立法发展。它还将这些监管变化与其他欧洲背景下的变化进行了比较。
疫情情况比当局预期的要复杂得多，这反映在不断增加的控制措施上。在撒丁王国和其他欧洲国家，科学界和政治界在国家提出限制措施的合法性问题上存在分歧。一些人主张限制进入公共场所，并对弱势群体实施强制接种。
与天花的比较导致了健康安全水平的逐步提高，尽管疫苗接种覆盖率并未达到预期目标。造成这种失败的原因有很多，包括医务人员的专业知识有限和不情愿，他们承担了这项行动的大部分费用。此外，特别是在农村地区，民众对医生普遍存在不信任。尽管存在这些挑战，但抗击天花使当局能够以保护公共卫生为名义开发人口控制工具。然而，直到 1888 年才强制接种疫苗。
