Following the arrival of Spanish colonizers in 1519, namely Hernando Cortes and his 600 conquistadors, the indigenous population of the Mexican valley saw a dramatic decline. In the first two years of conquest, thousands of indigenous Americans perished while fighting the European invaders, including an estimated 100,000 who died of violence or starvation during Cortes' siege of the Aztec capital city, Tenochtitlan (present-day Mexico City), in 1520. However, the impact of European violence on population decline pales in comparison to the impact of Old World diseases, which saw the indigenous population of the region drop from roughly 22 million to less than two million within eight decades.. Virgin soil pandemics Almost immediately after the Spanish arrival, a wave of smallpox swept across the indigenous populations, with some estimates suggesting that five to eight million natives died in the subsequent pandemic between 1519 and 1520. This outbreak was not an isolated incident, with the entire indigenous population of the Americas dropping by roughly ninety percent in the next two centuries. The Mexican valley specifically, which was the most populous region of the pre-Columbian Americas, suffered greatly due to virgin soil pandemics (where new diseases are introduced to biologically defenseless populations). In the Middle Ages, the majority of Europeans contracted smallpox as children, which generally granted lifelong immunity. In contrast, indigenous Americans had never been exposed to these diseases, and their populations (of all ages) declined rapidly. Cocoliztli Roughly three decades after the smallpox pandemic, another pandemic swept across the valley, to a more devastating effect. This was an outbreak of cocoliztli, which almost wiped out the entire population, and was followed by a second pandemic three decades later. Until recently, historians were still unsure of the exact causes of cocoliztli, with most hypothesizing that it was a rodent-borne disease similar to plague or an extreme form of a haemorrhagic fever. In 2018, however, scientists in Jena, Germany, studied 29 sets of teeth from 16th century skeletons found in the Oaxaca region of Mexico (from a cemetery with known links to the 1545 pandemic); these tests concluded that cocoliztli was most likely an extreme and rare form of the salmonella bacterium, which caused paratyphoid fever. These pandemics coincided with some of the most extreme droughts ever recorded in North America, which exacerbates the spread and symptoms of this disease, and the symptoms described in historical texts give further credence to the claim that cocoliztli was caused by salmonella.

The World Health Organization (WHO) estimates that there were millions of smallpox cases every year until the 1970s, when the WHO's eradication program then successfully eliminated the disease in nature. Some academic estimates place smallpox's death toll at 300 million in the twentieth century, and 500 million in its final hundred years of existence. The development of the smallpox vaccination, which was the first successfully developed vaccine (the word vaccination comes from the Latin word for cow;"vacca", as cowpox was used to develop the smallpox vaccine), greatly contributed to the significant decline in infant and child mortality across the globe, and the boom in population growth during the twentieth century. Reported cases In spite of these large numbers, the figures for reported cases was only a tiny fraction of this; for example, the WHO estimates that there were fifty million cases in 1950, however less than one percent of these cases were recorded. In spite of this, the data is still useful for showing how smallpox developed and spread throughout the world; we know that the majority of these cases were recorded in the Indian sub-continent, and that epidemics across Asia drove the number of recorded cases up in the middle of the century. The final naturally-occurring cases were observed in 1977, while the two cases in 1978 were due to a lab accident in England, which resulted in one fatality.

Although vaccination was discovered in England in 1796, the practice was not made compulsory until 1853 in England and Wales, and 1864 in Scotland. For this reason, the number of smallpox deaths per million people fluctuated from year to year, often doubling or tripling from one year to the next, before the death rate for both countries settled in the late 1960s. The Great Pandemic of the 1870s, which was the last major smallpox pandemic in Europe, caused the number of smallpox deaths to soar once more, peaking at over 1,000 deaths per million people in England and Wales in 1871, and at over 820 deaths per million people in Scotland in 1872. During this pandemic, mandatory vaccination became enforced, where parents who did not vaccinate their children within the first three years of life were penalized with fines or imprisonment, and this helped the smallpox death rate to remain low and plateau in the final two decades of the nineteenth century; an estimated 11,000 of these penalties were handed out during the 1880s, which included 115 prison sentences for failure to vaccinate children. Smallpox cases in Britain were rare throughout the early twentieth century; not counting a lab accident in 1978 that infected two people (one of whom died), natural smallpox cases were eradicated in Britain in 1934.

The Great Smallpox Pandemic of 1870 to 1875 was the last major smallpox epidemic to reach pandemic level across Europe. The outbreak has its origins in the Franco-Prussian War of 1870 to 1871, where unvaccinated French prisoners of war infected the German civilian population, before the virus then spread to all corners of Europe. The death rates peaked in different years for individual countries; with the highest numbers recorded in 1871 for the German states, Belgium and the Netherlands, while death rates peaked in Austria, Scotland and Sweden in later years (the states that peaked in 1871 were closer in proximity to the frontlines of the Franco-Prussian War). Impact of compulsory vaccination The average number of deaths per million people was much higher in countries without compulsory vaccination, ranging from 953 to 1,360 in the samples given here. In comparison to this, the countries with compulsory vaccination barely reached these numbers in the years when the epidemic was at its worst, and their annual averages ranged between 314 and 361 deaths per million people during the six years shown here. Impact of the Great Pandemic Following the surge in smallpox deaths caused by the pandemic, many of the countries listed here introduced mandatory vaccination, or introduced penalties for parents who did not vaccinate their children. Germany and the Netherlands** did this in 1874, while Britain and Sweden enforced their vaccination laws with stricter penalties in 1871 and 1880 respectively. Perhaps surprisingly, Austria and Belgium, the two countries with the highest average death rate shown here, never introduced mandatory smallpox vaccination.

In Britain in the early 1890s, a smallpox epidemic spread across the country and infected thousands. While the death rate was just a fraction of the level observed during the Great Pandemic of the 1870s, the overall death rate increased from 16 deaths in 1890 to 1,456 deaths in 1893. Among all outbreaks shown here, there were more cases among those who were vaccinated and over the age of ten than in any other group, however the death rate of the infected ranged from just one to ten percent. To put this into context, the death rates among the unvaccinated over the age of ten reached as high as forty percent in Gloucester. Unvaccinated children below ten years of age had the highest death rate among infected cases, and in the second outbreak in London, there were 148 deaths in 205 cases among unvaccinated children, whereas there were no deaths in 72 cases among vaccinated children. Another development in this pandemic was that the number of cases in children below the age of ten years was much lower than those above the age of ten; this trend that did not exist in previous centuries. A century of change In the pre-vaccination era, smallpox cases among adults were rare, as the majority of adults had contracted smallpox as children and had therefore built up a tolerance to the disease. In the early nineteenth century, the number of cases among children decreased, thanks to the protection granted to them through vaccination; however vaccination did not guarantee lifelong protection, which meant that the share of smallpox cases in young adults rose until revaccination then brought this trend back down. As we can see during these epidemics in England in the 1890s, the distribution of smallpox cases was much more representative of the population's age distribution, showing the impact and development of vaccination in its first century.

Following Edward Jenner's development of the smallpox vaccine in 1796, the death rate due to smallpox in England and Wales dropped significantly. Although Jenner's work was published in 1797, it would take over half a century for the British government to make vaccination compulsory for all infants. Between 1847 and 1853, when vaccination was optional, children under the age of five years had, by far, the largest number of deaths; the total death rate was 1.6 thousand deaths per million people, which was more than five times the overall death rate due to smallpox. When compulsory vaccination was introduced, this helped bring the smallpox death rate in this age group down by over fifty percent between 1854 and 1871. When compulsory vaccination was enforced with penalties in the wake of the Great Pandemic of the 1870s, the smallpox death rate among children under the age of five dropped to approximately fifteen percent of its optional vaccination level. Increase among adults Along with the youngest age group, children aged five to ten years also saw their death rates decrease by roughly two thirds, and the death rate among those aged ten to 15 declined by just under one third during this time. It was among adults, aged above 15 years, where the introduction of mandatory vaccination had an adverse effect on their death rates; increasing by fifty percent among young adults, and almost doubling among those aged 25 to 45. The reason for this was because, contrary to Jenner's theory, vaccination did not guarantee lifelong protection, and immunization gradually wore off making vaccinated people susceptible to the virus again in adulthood. There was some decline in the smallpox death rates among adults throughout the 1870s and 1880s, as revaccination became more common, and the enforced vaccination of children prevented smallpox from spreading as rapidly as in the pre-vaccination era. Overall trends While the introduction of mandatory vaccination saw the number of smallpox deaths increase for age groups above 15 years, the overall rate among all ages decreased, due to the huge drop in deaths among infants and children. The smallpox death rate dropped by over one quarter when compulsory vaccination was introduced, and it then fell to just over one third of it's optional-vaccination level when these measures were enforced. The development of the smallpox vaccine and the implementation of mandatory vaccination led to the eradication of the disease in Britain by 1934, and contributed greatly to the demographic developments of the twentieth century, such as the declines in fertility rate and birth rate, and the increase in life expectancy.

Towards the end of the 1880s, a localized smallpox epidemic had broken out in the North of England, and had infected thousands in the region; with one news report claiming that Sheffield was responsible for three quarters of all smallpox cases in England at this time; just under 500 people died from smallpox in this pandemic. Of the entire population of Sheffield, 98 percent claimed to have been vaccinated, and (assuming these figures are correct) the death rate among cases of vaccinated people was below five percent. In stark contrast to this, cases among unvaccinated patients resulted in fatalities almost fifty percent of the time, meaning that infected persons who were not vaccinated were ten times more likely to succumb to the disease than those who had been. This ratio is similar among the infected aged above ten years, however vaccinated patients below the age of ten were 25 times more likely to survive.

In the history of the United States, smallpox played a pivotal role in shaping the direction of the country's development. When Europeans first arrived in the Americas, they unintentionally introduced smallpox to the continent and the disease helped to wipe out as much as 95 percent of indigenous Americans. This was one factor that allowed European settlers to colonize the continent with relative ease, although the disease remained active in the Americas until the second half of the twentieth century. The number of smallpox cases in the United States fluctuated between 1900 and 1930, with as many as 110,000 reported cases in 1920, however the number of cases fell sharply in the 1930s, and there were no cases at all in the United States from 1950 onwards. In 1980, the World Health Organization declared the disease to be successfully eradicated on a global scale, making it the first infectious disease to be wiped out by intentional human activity.

A simple susceptible–infectious–removed epidemic model for smallpox, with birth and death rates based on historical data, produces oscillatory dynamics with remarkably accurate periodicity. Stochastic population data cause oscillations to be sustained rather than damped, and data analysis regarding the oscillations provides insights into the same set of population data. Notably, oscillations arise naturally from the model, instead of from a periodic forcing term or other exogenous mechanism that guarantees oscillation: the model has no such mechanism. These emergent natural oscillations display appropriate periodicity for smallpox, even when the model is applied to different locations and populations. The model and datasets, in turn, offer new observations about disease dynamics and solution trajectories. These results call for renewed attention to relatively simple models, in combination with datasets from real outbreaks.

Statistical table of the number of cases by region, age group, and gender since 2003 (disease name: smallpox, date type: onset date, case type: confirmed case, source of infection: domestic, imported)

From the 1630s to the 1830s, the annual number of smallpox deaths in each decade fluctuated greatly in London. The population of London in 1650 is estimated to have stood at 350,000 inhabitants, with an average annual death toll of roughly 680 people during this time. As London's population grew over the next hundred years, the number of smallpox deaths also increased at varying rates in each decade. Scientific advancements flatten the curve The average number of annual smallpox deaths was between 1.7 and 2.5 thousand in each decade between 1710 and 1799, as the introduction of inoculation (i.e. using a mild dose of smallpox to develop some immunity to the virus) helped to lower the smallpox death rate to some extent. Following Jenner's discovery of vaccination in 1796 (which provided a much safer and more reliable method of protection), the death rate decreases further. London's population at this time was just under one million people, and the average number of deaths in the first decade of the 1800s was 1.4 thousand per year (or 1.4 deaths per thousand inhabitants). Vaccination brought this number down even further in the next quarter century, despite the fact that mandatory vaccination was not implemented by the British government until 1853. Smallpox death rate in other capitals While there is little reliable data for other major cities in the seventeenth or early-eighteenth century, London's death rate can be compared with that of Berlin or Copenhagen at the turn of the nineteenth century, during a time of increased urbanization and industrialization. In 1800, Berlin was estimated to have a population of roughly 170,000 people, and Copenhagen's was 100,000. This gave Berlin a smallpox of death rate of roughly 2.7 deaths per thousand in the first decade of the 1800s, and Copenhagen's was 0.67 deaths per thousand. Berlin's smallpox death rate was consistent between 1770 and 1809, while Copenhagen and London's both decrease after vaccination was introduced (Denmark made it mandatory in 1810). Unfortunately, a lack of information from this time makes it difficult to draw further conclusions about the spread of smallpox in urban centers in these years.

A simple susceptible–infectious–removed epidemic model for smallpox, with birth and death rates based on historical data, produces oscillatory dynamics with remarkably accurate periodicity. Stochastic population data cause oscillations to be sustained rather than damped, and data analysis regarding the oscillations provides insights into the same set of population data. Notably, oscillations arise naturally from the model, instead of from a periodic forcing term or other exogenous mechanism that guarantees oscillation: the model has no such mechanism. These emergent natural oscillations display appropriate periodicity for smallpox, even when the model is applied to different locations and populations. The model and datasets, in turn, offer new observations about disease dynamics and solution trajectories. These results call for renewed attention to relatively simple models, in combination with datasets from real outbreaks.

Depending on the reach and level of vaccination within Europe's various states in the 1870s, smallpox had a varied impact on various age groups. For infants below the age of one year, smallpox was responsible for between 15 and 30 percent of all deaths in the given regions, as many of these babies had not yet been vaccinated and were at a high risk of succumbing to the virus. In states where the vaccination of infants was not compulsory, such as the Netherlands, Berlin (Prussia) and Leipzig (Saxony), the share of deaths due to smallpox among young children remained high, while it was relatively low in Hesse and Scotland, who had introduced mandatory vaccination in 1815 and 1864 respectively. Great Pandemic highlights the need for revaccination As Hesse had been vaccinating on a large scale for generations, the share of smallpox deaths was relatively low among young people; however, between 1870 and 1872, over half of all deaths among those aged 30 to 60 years were due to smallpox. The reason for this was because smallpox vaccination in infancy did not guarantee lifelong protection, therefore immunity often wore off in adulthood. In the 1830s and 1840s, several German armies started to vaccinate new recruits regardless of whether they had been vaccinated in infancy or not; when scientists compared the smallpox death rates in the army with that of the civilian population during this pandemic, they noticed that it was much lower in the army, due to these revaccination policies. This discovery helped many scientists in Europe recognize the need for revaccination, which greatly contributed to the eradication of the disease across most of Europe in the early twentieth century.

A simple susceptible–infectious–removed epidemic model for smallpox, with birth and death rates based on historical data, produces oscillatory dynamics with remarkably accurate periodicity. Stochastic population data cause oscillations to be sustained rather than damped, and data analysis regarding the oscillations provides insights into the same set of population data. Notably, oscillations arise naturally from the model, instead of from a periodic forcing term or other exogenous mechanism that guarantees oscillation: the model has no such mechanism. These emergent natural oscillations display appropriate periodicity for smallpox, even when the model is applied to different locations and populations. The model and datasets, in turn, offer new observations about disease dynamics and solution trajectories. These results call for renewed attention to relatively simple models, in combination with datasets from real outbreaks.

INFORMATION The indicators are derived from data from the monitoring of monkeypox smallpox (Monkeypox virus infection) via mandatory declarations (DO) of “orthopoxviroses including smallpox”, transmitted to ARS and then centralised by Santé publique France. These mandatory declarations are completed by clinicians and/or biologists from a dedicated form. The information on certain reported cases, in particular at the beginning of the epidemic, may be partial as directly transmitted by the laboratories to the ARS. Cases are presented per week of reporting. A confirmed case of monkeypox smallpox is a person with a positive result of qPCR or RT-PCR specific to Monkeypox virus, or a positive result in generic qPCR of the genus Orthopoxvirus associated or not with a specific partial sequencing result of the Monkeypox virus. — Only confirmed cases for which the patient’s region of residence (or otherwise the reporting region) is known are indicated. Persons domiciled abroad are not counted. As a result, the sum of the cases indicated in the regions may be less than the total number of cases recorded in France. — The time limit for reporting cases may exceed 15 days in certain situations. The indicators are updated weekly. Coding of age classes: ‘0 = all ages’

Project Tycho data include counts of infectious disease cases or deaths per time interval. A count is equivalent to a data point.

Project Tycho level 2 version 1.1.0 data include data counts that have been filtered from the raw data to render standardized data that can be used immediately for analysis. All level 2 data were originally reported in a consistent format and have not been transformed into a standard format by Project Tycho staff, except for smallpox records that included repeated counts for the same location and week, but sometimes with different numbers. These duplicate smallpox records have been averaged into one count for each location and week. Level 2 data include counts for a wide variety of diseases and locations for varying time periods. Because we removed data in an inconsistent format from level 2 data, counts may be missing for certain diseases, locations, or years. For the most complete collection of standardized data, we encourage users to use Project Tycho version 2.0 datasets.

More detailed methods and additional information about the origin of Projec Tycho level 2 version 1.1.0 data can be found in our original publication in the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMms1215400

Level 2 version 1.1.0 data is represented in a CSV file with 11 columns:

• epi_week: a six digit number that represents the year and epidemiological week for which disease cases or deaths were reported (yyyyww)
• country: a two digit country abbreviation, only including "US" in version 1.1.0
• state: the two digit postal code state abbreviation that represents the state for which a count has been reported
• loc: the name of a state or city for which a count has been reported, capitalized
• loc_type: the type of location (STATE or CITY) for which a count has been reported
• disease: the disease for which a count has been reported, in all capitals
• event: an indicator representing the disease outcome reported, including "CASES" or "DEATHS"
• number: the reported number of cases or deaths
• from_date: the start date of the time interval for which a count was reported, as yyyy-mm-dd
• to_date: the end date of the time interval for which a count was reported, as yyyy-mm-dd
• url: the URL of the source document from which the count was obtained

Smallpox Treatment Market Outlook

The global smallpox treatment market size is projected to grow significantly from USD 1.2 billion in 2023 to approximately USD 2.5 billion by 2032, reflecting a robust CAGR of 8.3% over the forecast period. The primary growth factors driving this market include the re-emergence of smallpox-like infections due to bioterrorism threats, advancements in antiviral therapies, and increased governmental and non-governmental initiatives for epidemic preparedness.

One of the pivotal growth factors for the smallpox treatment market is the heightened awareness and preparedness for potential bioterrorism threats. With the eradication of smallpox in 1980, routine vaccinations ceased, leaving a significant portion of the global population susceptible to the disease. Governments and health organizations across the world are now prioritizing the development and stockpiling of effective smallpox countermeasures, including antiviral drugs and vaccines, to mitigate the risks associated with a potential outbreak. This increased focus on preventative measures is expected to drive substantial investments and innovation in the smallpox treatment market.

Advancements in medical research and technology represent another key growth factor for the smallpox treatment market. Recent developments in antiviral therapies and immunomodulators have shown promising results in treating smallpox and other related viral infections. Furthermore, the application of advanced biotechnological techniques has led to the creation of more effective and safer vaccines, which are critical in controlling the spread of the disease. This continuous innovation and the introduction of novel treatments are likely to fuel the market's expansion over the forecast period.

Additionally, the global collaboration between governmental and non-governmental organizations plays a crucial role in the growth of the smallpox treatment market. Initiatives by entities such as the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and various national health agencies aim to bolster research, development, and distribution of smallpox countermeasures. These collaborations often involve substantial funding, resource sharing, and joint research efforts, which collectively enhance the market's growth prospects. With ongoing support and funding from these organizations, the smallpox treatment market is poised for significant growth.

Regionally, North America currently dominates the smallpox treatment market, driven by substantial government funding and advanced healthcare infrastructure. Europe follows closely, with numerous research initiatives and strategic stockpiling of smallpox vaccines and treatments. The Asia Pacific region is expected to witness the highest growth rate due to increasing government focus on healthcare advancements and epidemic preparedness. Latin America and the Middle East & Africa are also projected to experience steady growth, fueled by international support and improving healthcare systems in these regions.

Antiviral Drugs Analysis

Antiviral drugs form a critical segment of the smallpox treatment market, primarily due to their role in managing and mitigating the effects of viral infections. The market for antiviral drugs is driven by the need for effective treatments that can be quickly administered in the event of an outbreak. Technological advancements have led to the development of new antiviral compounds that target the virus at various stages of its lifecycle, thereby improving efficacy and reducing the risk of resistance. The ongoing research and development activities in this segment are expected to contribute significantly to market growth.

Several antiviral drugs have been approved or are in the pipeline for their effectiveness against smallpox. These include drugs like Tecovirimat (ST-246), which has shown efficacy in animal models and is approved for emergency use. The development of such potent antiviral drugs has been bolstered by government funding and support, particularly in regions like North America and Europe, where there is a high focus on biodefense mechanisms. This support not only aids in the development but also in the rapid deployment of these drugs in case of an outbreak.

The commercial availability and distribution of antiviral drugs are also crucial factors influencing this segment's growth. Hospital and retail pharmacies, along with online distribution channels, play a vital role in ensuring the availability of these drugs to the public. The ease of acce

In the eighteenth century, before vaccination was introduced to Sweden, smallpox epidemics were much more severe and regular than in the nineteenth century. Between 1774 and 1802, epidemics in Sweden peaked roughly every five years, with the toll reaching over seven thousand deaths per million people in some years. When vaccination was introduced to Sweden in the early 1800s, it greatly decreased the total number of smallpox deaths per million people, with the number never exceeding one thousand deaths per million people in any year after 1809. In actual numbers, there were roughly two thousand smallpox deaths per year in Sweden during the pre-vaccination era; optional vaccination helped bring this average down to 623 deaths between 1802 and 1811, while the number dropped to 176 between 1857 and 1866 when compulsory vaccination was introduced. Vaccination in Sweden became enforced in 1880, where parents were punished with fines or imprisonment for failing to immunize their child, and this helped bring the average number of smallpox deaths to just two deaths per year over the next two decades. Although there were some cases and fatalities recorded in the late 1890s, naturally occurring cases of smallpox were eliminated in Sweden in 1895, which made Sweden the second country in the world (after Iceland in 1872) to successfully eradicate the disease.

In nineteenth century Belgium, smallpox vaccination was available but was never made compulsory. For this reason, the number of deaths due to smallpox fluctuated regularly (although data before 1864 is scarce*), and the Great Pandemic of the 1870s caused the number of smallpox deaths in Belgium to skyrocket to 4.2 thousand per million people in 1871. Several sources suggest that smallpox had a similar impact in the Netherlands throughout the early and mid-1800s, however the Netherlands introduced mandatory vaccination for all children who were to be enrolled in school in 1873, and following the Great Pandemic the Netherlands' death rate was much lower than that of Belgium. The last natural case of smallpox was recorded in the Netherlands in 1900 (making it the fourth country in the world to eradicate the disease on a national level), while the last endemic case of smallpox in Belgium occurred in 1926. Data for Italy and Hungary is also scarce throughout the century, however Hungary introduced mandatory vaccination and revaccination in 1887, while Italy did the same in 1888; over the next decade we can see that the average number of smallpox deaths in these countries decreased greatly, and endemic cases of smallpox were eliminated in Hungary in 1923, and in 1947 in Italy.

Project Tycho data include counts of infectious disease cases or deaths per time interval. A count is equivalent to a data point. Project Tycho level 1 data include data counts that have been standardized for a specific, published, analysis. Standardization of level 1 data included representing various types of data counts into a common format and excluding data counts that are not required for the intended analysis. In addition, external data such as population data may have been integrated with disease data to derive rates or for other applications. Version 1.0.0 of level 1 data includes counts at the state level for smallpox, polio, measles, mumps, rubella, hepatitis A, and whooping cough and at the city level for diphtheria. The time period of data varies per disease somewhere between 1916 and 2011. This version includes cases as well as incidence rates per 100,000 population based on historical population estimates. These data have been used by investigators at the University of Pittsburgh to estimate the impact of vaccination programs in the United States, published in the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMms1215400. See this paper for additional methods and detail about the origin of level 1 version 1.0.0 data. Level 1 version 1.0.0 data is represented in a CSV file with 7 columns:

epi_week: a six digit number that represents the year and epidemiological week for which disease cases or deaths were reported (yyyyww) state: the two digit postal code state abbreviation that represents the state for which a count has been reported loc: the name of a state or city for which a count has been reported, capitalized loc_type: the type of location (STATE or CITY) for which a count has been reported disease: the disease for which a count has been reported: HEPATITIS A, MEASLES, MUMPS, PERTUSSIS, POLIO, RUBELLA, SMALLPOX, or DIPHTHERIA cases: the number of cases reported for the specified disease, epidemiological week, and location incidence_per_100000: the number of cases per 100,000 people, computed using historical population counts for cities and states as reported by the US Census Bureau