We are in the middle of yet another planetary extinction. I am old enough that I think I have seen the slow changes of a planet on the outs. The world is not the same as I remember.

The ocean is higher. I remember as a kid I could just reach the low tide line with a three wood. Now, low tide is where high tide used to be, and high tide has rendered some beaches unwalkable.

The beaches are barren. The birds, except for an occasional unkillable gull, are mostly gone. The rocks, especially since the blob and the heat dome of 2021, are mostly barren. The smell is different as well; the rot of seaweed is gone, the air oddly fresh.

The forests are quieter. The buzz of bugs are gone and, with less to eat, it is rare to see a bird flit through the trees. And it has been years since my windshield obscured by bug squish.

Yep. Eradication of any number of species is proceeding apace and if you are old enough you will notice. Unbearably sad and it is only going to get worse. But then, I have zero optimism about the future.

But not all eradication is bad. I don’t think I would cry over much if disease-bearing mosquitoes were to vanish, although I have no doubt it would a bad idea.

There are two eradications that have been deliberate: rinderpest and smallpox, both thanks to vaccines.

Rinderpest is the measles of animals and is likely the source of human disease, rinderpest having jumped into humans maybe around the 11th century. It has been a blasphemous rumor that god has a sick sense of humor, so, turn about being fair-play, I would not be surprised if, in the future, measles jumped back into cows from unvaccinated humans.

Smallpox was eradicated last century but still exists in two labs (one in Russia. Yippy.) and, given that the genome is published, the virus could be reconstructed. It would be easier to do than a woolly mammoth. So smallpox, or rinderpest, could come back. And never underestimate human stupidity:

Federal scientists last week discovered a half-dozen forgotten vials of smallpox virus while cleaning out a storage area on the campus of the National Institutes of Health (NIH) in Bethesda, Maryland.

Smallpox, due to the variola virus, was eradicated with the vaccine, which is the vaccinia virus. The vaccinia virus is an odd one. Where did it come from? Unknown.

The precise origin of vaccinia virus is unknown due to the lack of record-keeping, as the virus was repeatedly cultivated and passaged in research laboratories for many decades. The most common notion is that vaccinia virus, cowpox virus, and variola virus (the causative agent of smallpox) were all derived from a common ancestral virus. There is also speculation that vaccinia virus was originally isolated from horses, and analysis of DNA from an early (1902) sample of smallpox vaccine showed that it was 99.7% similar to horsepox virus.

But vaccinia disease continues to circulate in Brazil:

In recent decades, several strains of the orthopoxvirus vaccinia virus (VACV) have been isolated throughout Brazil, including many genetically distinct isolates within the same outbreak.

And with the vaccinia vaccine no longer being used, other pox viruses are making a resurgence, like monkey pox. Remembering that smallpox likely jumped into humans from rats:

Our results show two primary VARV clades, which likely diverged from an ancestral African rodent-borne variola-like virus either ≈16,000 or ≈68,000 years before present (YBP), depending on which historical records (East Asian or African) are used to calibrate the molecular clock.

And no reason a pox virus could not jump again. Murphy was, after all, an optimist.

So who knows. A lab leak, stupidity, reconstruction, another zoonotic jump? Smallpox may be eradicated but it isn’t extinct. Unfortunately.

Which brings us to the next virus to hopefully be eradicated, but not rendered extinct: polio. As a recent article in Science noted, Global polio eradication effort struggles with the end game. As an aside, I never did understand why Ralph Lauren decided to use polio as the name for his line of clothes, even if he does make really nice, albeit too expensive for me, clothes. And even allowing artistic interpretation, the logo looks nothing like an iron lung, more like a guy on a horse. More mysteries.

Polio is a tricky virus. Three strains (1,2 and 3), and two vaccines. The killed vaccine prevents disease but does not prevent transmission. The live attenuated virus prevents disease and transmission but has the unfortunate rare complication of reverting to wild type to cause disease.

There is more vaccine strain disease, mostly in Africa, than wild-type disease, mostly in Afghanistan and Pakistan and, earlier in the century, Nigeria, where the vaccination programs have had difficulties that were the same as it ever was. As an aside (squirrel), go see the remastered Stop Making Sense while you can. Tremendous.

Some of the issues for why eradication programs for polio had trouble in Nigeria and Pakistan were the usual suspects: poverty, poor infrastructure, corrupt governments. But there are some other causes as well. Let’s see if anything sounds familiar.

In Nigeria and Pakistan, it was believed that the polio vaccine was a plot to sterilize Muslim girls and to spread HIV. I feel silly mentioning that neither is true, and before we feel oh so superior, remember, as Art Linkletter noted, anti-vaccine folks say the darndest things.

Here’s Where That COVID-19 Vaccine Infertility Myth Came From—And Why It Is Not True


There is no evidence that any COVID-19 vaccine contains HIV

In Nigeria it was the combination of governors

the governor of Kano, is quoted as saying: “Since September 11, the Muslim world is beginning to be suspicious of any move from the Western world…Our people have become really concerned about polio vaccine


Kano state governor, Ibrahim Shekarau, reaffirmed that their decision was influenced by unsatisfactory test results by the federal government’s teams.

A well-regarded doctor

Datti Ahmed, a Kano-based physician who heads a prominent Muslim group, the Supreme Council for Sharia in Nigeria (SCSN), is quoted as saying that polio vaccines were “corrupted and tainted by evildoers from America and their Western allies.” Ahmed went on to say: “We believe that modern-day Hitlers have deliberately adulterated the oral polio vaccines with anti-fertility drugs and…viruses which are known to cause HIV and AIDS”

And some Imams who thought vaccination was going against Gods will. God evidently wants children to be paralyzed by polio.

Nah. Those reasons for refusing the polio vaccine do not sound familiar to me in the least.

In Pakistan they were a bit more aggressively anti-vaccine:

Vaccination efforts have been seriously stalled by the murder of at least 35 health workers who had been attempting to vaccinate children since 2012. Militants are suspicious of vaccinations, which radical clerics claim are part of a Western plot to sterilize Muslims.

I would be hesitant to vaccinate children if it meant my murder, but at least this doesn’t happen in the home of the free, land of the AR -15. Yet.

By the way, it isn’t just Muslim clerics who have these beliefs. In Kenya

It all started in 2014 when the Catholic bishops complained that tetanus vaccine administered to women of reproductive age during a campaign was laced with contraceptives in the form of Human Chorionic Gonadotrophin (HCG) …However, the Catholic bishops were not fully satisfied with the process (of demonstrating the vaccines were not contaminated) and hence called on all their faithful to boycott the August 2015 polio campaign.

One study noted that the boycott, fortunately, did little.

Compared to the November 2014 campaign, the proportion of children who were not vaccinated due to parent’s refusal significantly increased from 6% to 12% in August 2015.

But oddly concluded

The call for boycott did not affect the campaign significantly.

I guess a few paralyzed children is only significant to the child and their family,

Safe to say Catholic Bishops are often not a reliable source of health information. At least we don’t see that kind of nonsense from US pastors.

Pakistan was the likely source for subsequent cases in nearby Afghanistan. I always remember that the first word in my sub-specialty is infectious: spreading or capable of spreading rapidly to others.

Despite relatively superficial differences, humans are mostly the same everywhere. It is why the planet is doomed.

Is there good news? Yes.

Nigeria is getting polio under control and the Taliban has decided polio vaccination is not so bad after all:

Taliban launches annual polio vaccination drive in Afghanistan.
Health ministry says the four-day campaign will cover more than nine million children in 31 of the country’s 34 provinces.

So maybe we will get the number of eradicated viruses to three. 350,00 cases of paralysis a year that will never happen. Add it to the innumerable species we have wiped off the planet.

A good thing (the eradication of polio, not the innumerable species), even if it means I will have to wear Calvin Kline instead.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at edgydoc.com.