For thousands of years, people had observed symptoms like yellowing eyes, dark urine, and unexplained liver disease, yet no one knew the cause. Ancient Chinese texts mention outbreaks of jaundice dating back nearly 5,000 years, and Babylonian records from over 2,500 years ago describe similar ailments. Despite this, hepatitis remained one of medical science’s greatest mysteries for centuries.
Doctors could recognise the disease, but they did not know how it spread. Some blamed foul air, while others suspected contaminated food or water. The true answer, that distinct viruses were responsible, emerged only after decades of rigorous research in the twentieth century.
A Strange Illness Following a Smallpox Vaccination Changed Everything
One of the most crucial clues emerged in 1885 at a shipyard in Bremen, Germany. After workers were vaccinated against smallpox, 191 of them developed a condition then known as “catarrhal jaundice.” The vaccine itself was not causing the hepatitis, as people had initially feared. Instead, later researchers realised that contamination during the vaccination process, common before the advent of modern sterile techniques, had likely spread an infectious agent through the human lymph used in the vaccines.
At that time, doctors lacked laboratory tests, microscopes capable of identifying viruses, and any understanding of blood-borne infections. They had just one puzzling observation: people who had undergone the same medical procedure fell ill with jaundice. That illness became the earliest recorded evidence of the potential for hepatitis to spread through contaminated blood or biological materials. It took decades to understand what had actually happened.
Wars Turned Hepatitis Into a Global Medical Challenge
This mystery was not confined to Germany alone. Major wars repeatedly demonstrated how easily hepatitis could spread. During the American Civil War, it is reported that approximately 40,000 Union soldiers contracted a hepatitis-like illness.
The problem escalated further in the twentieth century. In 1942, more than 28,000 soldiers contracted hepatitis following yellow fever vaccinations. Subsequent investigations revealed that certain batches of the vaccine had been stabilised using human serum, inadvertently spreading the disease now identified as hepatitis B.
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