Vaccine eradication of disease - Page 2

[pers]

Originally Posted by Bokonon 

Smallpox and polio were "around and killing long before anybody was vaccinating either people or cows" too, but that doesn't mean that the vaccines never caused the disease.  And yes, the TB vaccine has caused TB.

"In the summer of 1930, in Lubeck, Germany, 240 infants were vaccinated with BCG; 72 of the vaccinated infants developed tuberculosis and died…."

http://insidevaccines.com/wordpress/2010/11/08/tuberculosis-vaccine-use-based-on-blind-faith/

Yes, the contaminated vaccine in that case was a horrible tragedy that never should have happened with more careful handling.   And yes, there are other problems with the vaccine, including that it is not very effective at all.  TB is not nearly as contagious as disease such as measles, flu, chickenpox - rather than being passed easily by brief exposure, TB is generally only transmitted to people who have frequent and prolonged contact with the sick person, though that can end up being quite a few people if TB is left untreated as an active case of TB can last months or even years.  But because it is not so contagious, it is easier to track down people who need testing, and with treatment a person is advised to stay fairly isolated for a couple weeks and then they are no longer contagious.  So TB is fairly easy to keep in check in the US through screening of at risk populations, tracking down likely contacts, and prompt treatment of all discovered cases.  This coupled with the problems with the TB vaccine are why it is currently not used here.  Because when a vaccine is neither needed nor effective, it isn't used here. 

But that's not what we were talking about before.  In the measles thread that this on spun off from, there was a link to a paper on smallpox which, among other things, brought forth the idea that the smallpox vaccine may cause TB.  The only evidence presented to support this notion was that Jenner's son, vaccinated for smallpox, died of TB at age 21 and that the first boy he tested the vaccine on also may have died of TB at age 21.... or he may have live past the age of sixty (other sources support the long life) and a rather odd quote from the editor of a shortly lived medical journal in the mid-19th century that "consumptions follows vaccination as surely as effect follows cause."  I personally found it rather bizarre that she would even bother to bring it up when that is the best she can do for supporting it.  And that is what the discussion of vaccine causing TB was about.  

Originally Posted by miriam 

[QUOTE]
VACCINIA VACCINE

Dryvax,® the vaccinia (smallpox) vaccine currently licensed in the United States, is a lyophilized, live-virus preparation of infectious vaccinia virus (Wyeth Laboratories, Inc., Marietta, Pennsylvania). Vaccinia vaccine does not contain smallpox (variola) virus. Previously, the vaccine had been prepared from calf lymph with a seed virus derived from the New York City Board of Health (NYCBOH) strain of vaccinia virus and has a minimum concentration of 108 pock-forming units (PFU)/ml. Vaccine was administered by using the multiple-puncture technique with a bifurcated needle. A reformulated vaccine, produced by using cell-culture techniques, is now being developed. [/UNQUOTE]

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htm

If smallpox is eradicated, why are we reformulating the vaccine against it?  

If smallpox was eradicated by the vaccine, obviously the old vaccine worked well enough.  

Why re-invent the vaccine that did the job?

...And why are we reformulating a vaccine for a disease that has supposedly been eradicated?  :scratch

As someone else said, again, fear of biological warfare as a result of virus deliberately kept alive in labs, and also because  while at the time that was written, they had not re-started vaccinating military personal, they still were vaccinating anyone working with the virus.  While a safer vaccine would be great, the main reason for a new one was that the vaccine had not been produced since 1983 so old stocks were diminished and expiring, and the facilities and infrastructure for the old process of making the vaccine were no longer available, so they needed to develop one that could be produced with modern technology. 

This link should give a better answer to your questions: http://www.cdc.gov/ncidod/eid/vol7no6/rosenthal.htm

[Calm]

Originally Posted by JMJ 

Do you think it is possible to use vaccines to eradicate diseases?  Do you think it has been done in the case of small pox worldwide and other diseases in certain regions?  If it might be possible, then what makes a disease worth eradicating or a vaccine worth using to eradicate it?

I think the pure idea of vaccination is valid, and therefore its potential to eradicate disease.  Since I first started my degree in health science 17 years ago, if not before that, I was very inspired by vaccination... at least, by the idea of it.  I nearly wrote my thesis on vaccination.  Added to my interest is my personal experience of never having been sick with any of the diseases (nor was I vaxed).  I often wondered if I was immune because I tried so hard to get sick from my friends to get days off school with everyone else but never got so much as a spot (goddammit).  Turns out I am immune according to blood tests, I just became that way the "vaccine" way - exposure stimulating my immune system but not enough to get symptoms.  My immune system is fort knox, I just don't get bugs (I do get hangovers however ).  That's the ideal situation, and the theory behind vaccination.. to stimulate the body to produce antibodies without the body getting symptoms.

The problem is, scientific theory doesn't often become scientific law.  

In studying disease eradication, we need to look at other aspects.  Diseases naturally eradicate themselves.  Belief in this idea is crucial to even have a chance of being open to ideas apart from vax for health advances.  We can look back at how ridiculous it was to suffer scurvy when the cure was so simple... but science simply could not figure it out.  In fact, we always look back and scoff at how infantile science was "back then", and to think in future our children won't look back on us as total idiots is arrogant and not learning from history.  Right now, there are tons of things, perhaps all things, we do medically that will seem completely ridiculous, and bluntly: incompetent and dangerous.  Chemotherapy, for starters.  That's akin to blood letting but if you even mention that, even with its sorry 5% "success" rate, people invariably get their panties in a wad about how brilliant it is and how modernity has saved us.  Um. Yeah.  Whatever.  Chemo is the best we have right now.  To put it on a higher pedestal than that is at the very least pessimistic.  

Aside from medical arrogance which is littered all through civilised history and the cause of more loss of life than any disease known to humanity, we do have modern evidence of natural eradication of disease, but logic also leads us to that conclusion.  History has a timeline of each disease, so we can see when they first appeared and all of them had a start point.  Even if records cannot show or prove the start point of one of them, there is one.  I very much doubt that previous to that time there were no diseases.  These are just the diseases of "our time".  

That means that there have been other diseases in human culture that have come and gone, all of their own accord, even before the sanitation and clean water factor of the 20th century.  People existed before all of that, therefore, it is safe to say so did diseases.  

In fact, the poor hygiene era was a mere blip on the radar of human existence, caused by our initial grouping together in civilisation to share agriculture, moving from wild foragers to static crop planters who imprisoned animals for our designs (meat, labour, etc).  This culminated in the era when people pooped into buckets and then threw it into the street each morning.  Before plumbing, piping and sanitised water, things were dire in the civilised age.  Anyone who has done a modicum of vax research has come across that ... what is less discussed is the fact that humans existed before that period in time.   It is possible we didn't have diseases before that shift, which is estimated at 5000BC... although even I doubt that and I am a big proponent of wild living and blame most of our woes on civilisation.  Everywhere "white man" went, we spread our religion, ridiculously uptight morality and our diseases, literally like the plague.  We have systematically destroyed many healthy, well functioning cultures... who ironically now rely on our modern medicine.  Interesting details to be found in the book Guns, Germs and Steel or the documentary based on same.

Smallpox is seen as a vaccination success, but not by all.  A medical professor was the first person to teach me that it was not due to vaccines, and was by no means the last "lettered" person to talk to me directly about this, or indirectly.  This doctor's letter that I have linked before is the kind of plea I am seeing more and more often these days:

"Smallpox was not eradicated by vaccines as many doctors readily say it was. They say this out of conditioning rather than out of understanding the history or science."

 

One of the problems with the correlation of smallpox with vaccines is that so few were vaccinated for smallpox.  All other diseases, (as contagious as smallpox or not), need an extremely high rate of coverage before it is eradicated in any one area.  For examples, measles.  In the US, measles is officially recognised as an imported disease (this may or may not be true, as not all measles cases are reported because many parents still deal with these diseases without much fuss).  We'll assume it is eradicated except for imports.... yet, measles is still a massive problem in parts of the world that have the sanitation, water and nutrition issues our culture had when measles was as great a threat to life here.  

If you look at the figures, some can be found on the link Pers has upthread, scroll down... or google some further, you'll see that a very small amount of people were vaccinated, and overall, a rate of 10% or less was vaccinated for smallpox.  Yet, you don't see smallpox even in Africa or Asia today.  When someone tries to tell you it was simply "well contained" and those other arguments... they dunno much about Africa or Asia.  Even now, it is absolute chaos over there, and they have much more aid now than they ever did in the smallpox era.  

We have a correlation, and that's it.  Correlation is not evidence of cause.  That is a glaring cum hoc ergo propter hoc - a logical fallacy.  This diagram is a funny example of this particular logical fallacy.

However, what is even more interesting is that with smallpox vaccination, the less vaccinated a particular area, the less deaths from smallpox.  Scroll down until you get to the charts again.

So there isn't even a correlation.  It is patently absurd to attribute the eradication of smallpox to the vaccine when so few were vaccinated ... this is a common quote for a reason.  When challenged with this inconvenient fact, to then hold that disease up as the only one that was able to be eradicated by low vaccine coverage, ever, with absolutely no evidence to support that position is grasping, at best.  It is an argument, that when pushed, cannot be upheld.  

Smallpox Eradication Success Reconsidered

I have to run, out of time now.  

Edited - I said vaccine eradication when I meant disease eradication.  

Edited by Calm - 4/18/11 at 7:31pm

[PlayaMama]

Originally Posted by Calm 

The problem is, scientific theory doesn't often become scientific law.  

sorry to nitpick, but scientific theories never become scientific laws.

they are two distinct ideas in science that are often confused by those not familiar with scientific vocabulary. (i had to refresh my own memory when i started teaching science four years ago after seven years away from it).

a theory is an overarching idea that connects a group of hypotheses that has been supported by a large amount of evidence and is generally thought to be true, though if enough evidence were found to the contrary, it would be disproved.

a law is a statement of an observable event, usually physical in nature, that is thought to be universal because it has always been observed to be true.

[Calm]

Scientific fact, scientific rule.  

I figure 10 poor word choices or less is pretty good for 6am.  

[PlayaMama]

to be honest, i didn't read the rest of your post after that jumped out at me.

i just hate to see scientific terms misused because i think it dilutes the scientific meaning of the words.

the idea that theories gestate into laws is a common misconception and it confuses the meaning of a "scientific" theory as opposed to any other sort of theory.

also, a "scientific rule" doesn't exist and a "scientific fact" is something that is universally accepted by scientists, so something along the lines of a law, i guess, i don't think it's used very commonly though. neither of which morph into anything else with more evidence.

[JMJ]

I'm glad to see you finally made it into the conversation, Calm.  Can you tell me more about the idea that "diseases eradicate themselves?"  How would this work?  Besides smallpox, do you know of any diseases that have been eradicated?  You make a good point about the infrastructure in Africa not being there well enough to chase down diseases.  Can you explain more about how you think the eradication of smallpox happened?

[Bokonon]

Originally Posted by JMJ 

I'm glad to see you finally made it into the conversation, Calm.  Can you tell me more about the idea that "diseases eradicate themselves?"  How would this work?  Besides smallpox, do you know of any diseases that have been eradicated?  You make a good point about the infrastructure in Africa not being there well enough to chase down diseases.  Can you explain more about how you think the eradication of smallpox happened?

Didn't the Black Plague eradicate itself pretty well?  Or at least limit itself significantly?  

[member234098]

?  

Edited by member234098 - 6/8/12 at 8:51am

[member234098]

D

Edited by member234098 - 6/8/12 at 8:47am

[stik]

Originally Posted by Bokonon 

Didn't the Black Plague eradicate itself pretty well?  Or at least limit itself significantly?  

The Black Plague is still around, and you can still catch it.  The CDC and the WHO maintain statistics on plague cases in various parts of the world.  It is much less common than it used to be in the human population.  In the US, it's endemic in prairie dogs.  A typical year in the US has a small handful of human cases usually occurring as a result of encounters with dead or dying wildlife.  As in the middle ages, y. pestis (the Plague bacteria) continues to be spread by fleas.  The Plague is a great example of a disease whose spread was dramatically limited by sanitation and hygiene.  This is because most (not all, but most) plague variants were spread by fleas, not by coughing or sneezing.  We've gotten much better at controlling rats and fleas since the 14th century.  There has not been a case of human-to-human transmission of the plague in the US since the 1920s.  There was a vaccine, but manufacturers stopped making it because of a complete and total lack of demand.  

[Chamomile Girl]

Originally Posted by stik 

The Black Plague is still around, and you can still catch it.  The CDC and the WHO maintain statistics on plague cases in various parts of the world.  It is much less common than it used to be in the human population.  In the US, it's endemic in prairie dogs.  A typical year in the US has a small handful of human cases usually occurring as a result of encounters with dead or dying wildlife.  As in the middle ages, y. pestis (the Plague bacteria) continues to be spread by fleas.  The Plague is a great example of a disease whose spread was dramatically limited by sanitation and hygiene.  This is because most (not all, but most) plague variants were spread by fleas, not by coughing or sneezing.  We've gotten much better at controlling rats and fleas since the 14th century.  There has not been a case of human-to-human transmission of the plague in the US since the 1920s.  There was a vaccine, but manufacturers stopped making it because of a complete and total lack of demand.  

Weeeeelllll......yes and no. Hygene may have been part of it but so was built genetic natural immunity as evidenced by what happened to the native populations of N. America when introduced to what at the time was seen as a rarely lethal disease. Also evidenced by the declining death rates in Europe with each wave of epidemic after 1348.

Plus nobody really knows why England never had another plague epidemic after 1665. Sure the next year most of London burned down, but it rose from the ashes in much the same squalor so better sanitation was probably not the reason. Probably had more to do with the interruption of the rat population. Some epidemiologists theorise that it was because the brown or Norwegian rat replaced the black rat (rattus rattus) as the dominant rat of Europe (r. rattus being a more aggressive, people-tolerant rat). There are lots of factors that contribute to the spread of disease.

Smallpox is another interesting disease that seems to have become more virulent around the 17th century. In the medieval period a disease with the same ability to disfigure and kill as smallpox does not seem to have existed (there were pox-type illnesses but not serious ones). The transformation of smallpox into the awful thing it became was a real hallmark of the early-modern period, and obviously had a huge impact on how the medical professsion was formed. But again, nobody knows why smallpox changed, just that it did.

On a side note in California plague is actually endemic in ground squirrels...you know, those cutie little chipmunk guys all the tourists feed at Yosemite.

[Chamomile Girl]

Originally Posted by miriam 

Why wasn't smallpox eradicated by the Chinese thousands of years ago when they used the "dried pus sniffed into the nose" method?  That method was used all over China and the Middle East for a very long time by very many people. It is described in the Mothering Book, Vaccines: Issue For Our Times, the first issue. That method was used for thousands of years and smallpox was NOT eradicated in all of that time anywhere. 

What do you know about smallpox as a disease? What organs does it affect?  How does it kill the afflicted person?  Describe the course of the disease. What exactly are we talking about?  

Smallpox attacks the body in a way similar to chickenpox just way nastier. You start with a two-week incubation period, then a high feaver/headache followed by a rash. The rash would then form pustules, which would eventually burst and scab over causing pock marks (if you were lucky...otherwise by then you were dead). People with the worst cases would have blisters everywhere and it was this inflammatory response (often coupled with infection from the less than sanitary conditions they convalesced in) that would kill then. It was a nasty, nasty disease and I have seen way to many pictures of smallpox victims to ever think about it lightly.

And as I mentioned above smallpox did not become the virulent disease we are familiar with until around the 17th century. In the late 18th century people used inoculation to ensure they got a mild case of the disease. This was later discontinued when vaccination became more popular, but there was a bit of a propaganda war waged between the two methods for awhile.

[Calm]

Originally Posted by PlayaMama 

to be honest, i didn't read the rest of your post after that jumped out at me.

i just hate to see scientific terms misused because i think it dilutes the scientific meaning of the words.

the idea that theories gestate into laws is a common misconception and it confuses the meaning of a "scientific" theory as opposed to any other sort of theory.

also, a "scientific rule" doesn't exist and a "scientific fact" is something that is universally accepted by scientists, so something along the lines of a law, i guess, i don't think it's used very commonly though. neither of which morph into anything else with more evidence.

I certainly hope you don't hold all MDC members up to this kind of scrutiny and judgment and only read posts that are accurate to the nth degree.  Who is going to learn under those conditions?  I've had debates online with scholars (religious debates mostly) and scientists and now and again, they make mistakes.  In fact, there are one or two who are so accurate, if you can pick a mistake in their information, you get an "I corrected Blair" icon - so even the most pedantic do such things and to disregard their information based on what is rather an inconsequential piece of the point is only shooting yourself in the foot.  I personally don't like language mistakes... grammar, spelling, etc... but the thing is, most people aren't good at language so I have to deal with that.  I don't skip over posts that don't satisfy my personal grievances.  

Because I write with a pedantic style, I do tend to draw "corrections", I've had to learn to live with that.  As some have said to me:  consider yourself with a strong case if all the other side can do is correct your spelling or inconsequential mistakes to discredit all your info based on that.  I've actually seen people discredit others based on spelling mistakes... I know, that's funny, but it happens in attempts to discredit the writer.  It is basically an ad hominem logical fallacy.  

ETA don't confuse what I've said here with an objection to corrections.  I appreciate corrections, I give them myself.  It was skipping the rest of my post based on that that I am addressing.  And as an aside, are you aware how common it is to mix theory and law, let alone law and fact?  It is taught in science class for a reason, and then refreshed in university for a reason.  

[Calm]

Originally Posted by JMJ 

I'm glad to see you finally made it into the conversation, Calm.  Can you tell me more about the idea that "diseases eradicate themselves?"  How would this work?  Besides smallpox, do you know of any diseases that have been eradicated?  You make a good point about the infrastructure in Africa not being there well enough to chase down diseases.  Can you explain more about how you think the eradication of smallpox happened?

When you see someone dying painfully from scurvy, it seems unfathomable that a few oranges could save them.  But if you don't have fresh fruit, or if you cook it... you have no vitamin C, you will get very sick, and then you will die.  

Can scurvy be eradicated?  In my opinion, the answer to that question is the same as the answer to the question of communicable diseases.  

It is only a belief that we are powerless to bugs that allows a person to think things like, "no matter how healthy you are, if a bug hits you, you can get sick... there is little you can do to prevent bugs from making you sick or even killing you... it is random... there is little I can do to protect my child from bugs..." and so on.  We're just not there yet, in the majority, where we connect cancer to our general health, bugs to general health, and so on.  

We're very much a blaming society, with a mass victim mentality; we still sit low on the emotional intelligence scale and that's no revelation to hear.  "It's not my fault" would be our collective mantra.  But we are getting there, because it wasn't that long ago that diet was laughed out of every room in relation to health (and boy, do I know THAT feeling)... doctors prescribe vitamins now... this is a huge leap forward.  I argued with a doctor once about cranberry helping cystitis symptoms, and this was only 15 years ago... 10 years later this same doctor was prescribing cranberry.  We also, on the large, connect many non communicable disease to lifestyle now, most of us do connect cancer to our general health and no longer see it as a random strike upon the powerless and helpless.  And really, most people do accept that how healthy they are is directly related to how well they fight off bugs each year, or big bugs like salmonella.  It's just much harder for them, at this stage, to accept that it is just the same for ALL disease.  They still feel most comfortable in the powerless meme, and that's ok.  But it's not the truth, it's just their truth.  

What does it take to eradicate a disease?  I personally think it takes high immune function which is stimulated by a biologically appropriate lifestyle.    When we look at a time line though, what it shows is that it takes time.  But that is usually time to spread the information to the people.  And even then, what we had last century was an accidental decrease in mortality... all we have are guesses as to why the death rates plummeted to virtually all diseases, communicable or not, before vaccines and antibiotics.  

Imagine what would happen if our nutrition wasn't just "better" than medieval, but was "optimal"?  Look what happened with the subtle changes in our environments and access to foods.  I know we're talking about eradication which is cases, not mortality, but what mortality rates show us is our strength against diseases.  Our defenses against acute disease such as viral and bacterial in the west had gained magnificent strength last century in the west.  When we follow the pattern of diseases, we see that those that are proven directly related to diet had the exact same decrease in mortality as the communicable ones, as this chart shows, comparing measles and scurvy.  Yet oh how strongly science had refused to acknowledge this connection when it comes to communicable disease!  In fact, all the clinical trials on vitamin A for measles is dated 1989 or later.  Time.  It seems to take a lot of frustrating time.

Shoot.  Must run again.  *tips hat*  I'll try to find info to get to the point a little better... I know I'm not very concise, it's one of my many flaws.

[JMJ]

Very good food for thought, ladies!  I'd love to talk more about what happened in the specific cases of Black Plague, scarlet fever, and smallpox that caused them to be major killers at points in history and much less of a problem or no problem at all now.  In reference to the diseases brought to the Americas by European settlers, I was always taught that the Europeans had been exposed to the diseases and developed a communal "herd" immunity, not such that they didn't get the diseases at all, but so that the diseases were no longer killers while the immune systems of the locals had never had any exposure to these diseases, and entire communities were wiped out by diseases that were not much of a problem for the Europeans.  This theory seems to me to be pretty well backed up by history and could also explain some of why when a disease first appears or mutates, it is a huge problem, but over time, it becomes less of one.

Still, the Black Plague wiped out over half of Europe and other diseases have been similarly lethal in smaller communities.  That seems like a pretty high price to pay as we wait for a disease to run its course.  Is it possible, ethical, wise to help along the process by supplying artificial, often incomplete immunity to people through vaccines?  If herd immunity can be obtained by allowing a disease to ravage a culture for decades, can a less effective but less destructive herd immunity be obtained by vaccinating a culture before the disease claims so many lives?  I realize that vaccination does not have the same effect as having the disease.  Each new generation becomes like the Native Americans, completely vulnerable, should we be exposed to the disease.  Each new generation requires vaccination to continue to be protected from death until the disease is eradicated.  Is this a good way to attack some of the diseases we have with us?

Calm, in a previous post, it sounded like you were saying that there have always been diseases that have come and go, and there will continue to be new diseases that will come and go, but in this last post, it sounds like you believe that with optimum nutrition, we could wipe out all disease, infectious and not.  Could you clarify.

I agree that we could do a lot with the diseases that we have with us to make them much less of a problem with optimum nutrition, but I still think there will always be diseases of our time and of the time of future generations.  To a large extent, I think diseases have to be seen as individuals.  Scurvy can be wiped out by adequate vitamin C, but Vitamin C alone can't do everything.  Black Plague can be controlled by controlling the rodent and flea population, but not all diseases are spread by rodents and fleas.  Then, along comes something like HIV, and we realize that nothing we have tried yet works on it.  Actually, we're making good progress when it comes to treating people who have just been exposed to keep them from getting infected, but the methods we are using are anything but nutrition.  Even if we find nutritional answers to everything we have now, there will always be more.  Is there no optimum nutrition?  Just incremental progress to treat whatever comes up?

I would love to hear more alternative theories to why smallpox was wiped out.  True that Africa isn't the best place to be chasing communities down with vaccines, but it's not really a place of great cleanliness and optimum nutrition either.

[member234098]

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Edited by member234098 - 6/8/12 at 8:48am

[Chamomile Girl]

Originally Posted by miriam 

So smallpox was a skin disease that killed people?

"Coupled with the less than sanitary conditions", your words, - might that have been the real reason smallpox was eradicated - better sanitation?  That is my point.  Better nutrition, better sanitation leads to better health, less mortality, and less disease, but the vaccine got the accolades.  WHO and CDC do not draw a line here, they just point to vaccines.

I have seen the pictures, thanks, I have seen scars on my older relatives and I have seen the smallpox vaccination scar on the arms of my contemporaries.  

Hmmm...why the hostility? Yes, smallpox was a skin disease that killed people. Yes I am aware of the sanitation vs vaccination debate.

In regards to smallpox and hygiene I think there is certainly a link but I don't think better sanitation can possibly be the entire story, simply because sanitation did not improve worldwide (nor did nutrition) but smallpox did. Now if you only look at western countries than the link is stronger, and smallpox mortality rates were already dropping among the "better (cleaner, less-crowded) sort" when the vaccine became popular. For awhile, at least in England, smallpox was seen as a disease of the poor for this reason. It was this same time period that isolation of people ill with smallpox became mandatory which was very sucessfull in mitigating the spread. When the WHO administered the worldwide vaccine they too relied on isolation, so I think that is another overlooked part of the story.

Plus the sanitation argument can actually go the other way too...as we have found too much sanitation actually can lead to stronger, resistant bugs. Our bodies are an ecosystem, and disease is part of the tricky balance.

[member234098]

N

Edited by member234098 - 6/8/12 at 8:45am

[member234098]

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Edited by member234098 - 6/8/12 at 8:44am

[stik]

Smallpox caused fever, vomiting, diarrhea, and in some cases could lead to pneumonia, encephalitis, damage to connective tissue, and uncontrollable bleeding.  Some smallpox deaths also may have been a result of immune over-response or a wave of infection that resulted from a breakdown in the body's first line of defense against disease - the skin.  This is why skin diseases kill - your skin is a crucial piece of your immune system.  People die from skin diseases all the time.  Necrotizing fasciitis, for example, kills up to 70% of victims if left untreated.  

Because of concerns that smallpox could reappear as a result of biological terrorism, the CDC maintains a diagnostic protocol for smallpox. I haven't seen it today, but I imagine the WHO has one too.  Few doctors alive today have encountered a clinical case of smallpox, but it is an extremely contagious disease associated with a quite striking presentation and a 30% fatality rate.  It would be difficult for a competent physician to misdiagnose it for more than the first few cases of an outbreak.  

There are, as you note, remote populations that haven't seen doctors in ages.  Remote populations with little contact with outsiders are generally thought to have lower rates of infectious disease because they aren't constantly exposed to other people's germs.  Also, if they were still having ongoing smallpox outbreaks, that would mean that someone in the community would have to have been ill with smallpox almost continuously since their last contact with the outside world.  Which would probably mean they were basically all dead by now (resistant wouldn't be an option in your scenario - if they were resistant, they wouldn't be sick with smallpox).  They don't have smallpox because they haven't been exposed to it, partly because they are remote, and partly because the disease has been eradicated in the wild.

I think the way that vaccination campaigns were conducted in the French and British empires probably goes a long way towards explaining on-going resistance to vaccination among a number of populations.  I don't think that resistance has anything to do with the effectiveness of the vaccines (I think people's perceptions of the effectiveness of the vaccines plays a role - but even educated people can be misled.  It happens all the time.) 

Of all the arguments ever made against vaccination, the idea that smallpox isn't a big deal is honestly one of the more ludicrous.