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Severe epidemics of variola have been recorded in medical annals of Guatemala during the last 300 years. From 1879 to 1881 smallpox swept over the entire republic, and in 1883 obligatory vaccination for all inhabitants of Guatemala was decreed. Vaccination is under the control of a sanitary commission. Since the institution of vaccination, the morbidity and mortality rate has decreased constantly and consistently. At the present time variola occurs only in sporadic form, and the actual number of persons suffering from this dread disease is small. These experiences are quite like those of other countries where widespread vaccination is the rule.
La viruela y su profilaxia en Guatemala. JAMA. 1935;104(18):1663. doi:10.1001/jama.1935.02760180095035