Small pox

A quarter of a century has gone by since the last natural case of smallpox anywhere in the world. Ali Maow Maalin, a cook at the hospital in Merca, Somalia, and sometime vaccinator in a World Health Organisation eradication team, developed his rash on 27 October 1977. After this final hiccup smallpox joined the dodo and the dinosaur as life-forms extinct in the natural world.


Maalin was lucky: his case was mild. To be absolutely certain that the world was smallpox-free, surveillance went on for two years after his illness. There were no more ‘natural’ cases and on 8 May 1980, Resolution WHA33.3 was signed at the eighth plenary meeting of the 33rd World Health Assembly. It declared that ‘the world and all its people’ had ‘won freedom from smallpox . . . which only a decade ago was rampant in Africa, Asia and South America’.

Smallpox was only extinct by resolution and in ‘nature’, however. It lived on in laboratories in frozen form. It still does. There is currently concern that some of it may have fallen into the wrong hands. Laboratory stocks of smallpox are just as malevolent as their natural counterparts. The last human smallpox infections anywhere in the world were contracted from such stocks and occurred not in Africa, Asia or South America, but in England.


1978 Henry Bedson was professor of medical microbiology at Birmingham University. His father, Sir Samuel, had also been a microbiologist, whose work on psittacosis had been recognised by a proposal to call the group of organisms to which it belonged Bedsonia. Henry Bedson had been trained as a virologist by the doyen of British smallpox experts, Allan Downie of Liverpool University

The WHO had told Henry Bedson that his application for his lab to become a Smallpox Collaborating Centre had been rejected. This meant that in the fairly near future his lab’s work on the virus would have to stop. The WHO wanted as few sites as possible handling the virus. They had acceded, however, to his request to continue research until the end of 1978. Their safety inspectors would visit. Henry faced a dilemma. He wanted to finish his current research programme, which was significantly advancing our understanding of smallpox viruses. But Henry was also aware that the laboratory would fail the forthcoming WHO safety inspection and that there would be no money for an upgrade because of its imminent closure. Smallpox work continued in Birmingham, but the WHO inspectors were unhappy. Correspondence started with Geneva about safety problems. Although Bedson’s laboratory was not state of the art, it was a lot better than it had been. So Bedson gambled. To finish the project in time the pace of work intensified, and more and more virus strains were cultured. But the bet failed, disastrously.
On Friday, 11 August, Janet Parker, a medical photographer in the Anatomy Department, which was located directly above the poxvirus laboratory, developed a headache and muscular pains. Her husband had to drive her to work. On Saturday she felt better and went for a walk, and on Sunday she called on a neighbour, although she began to feel ill again. On Tuesday she developed spots. On Wednesday her GP prescribed an antibiotic. It was stopped on Friday because it was thought to be causing the rash. More spots developed and she went to stay with her parents. On the following Thursday, 24 August, she was admitted to hospital. Smallpox was suspected, and it was confirmed by electron microscopy of fluid from her rash. At 10 p.m. that night she was moved to the Catherine-de-Barnes smallpox hospital, where she died on 11 September. Mrs Parker had been joined there by her mother who, despite being vaccinated on 24 August, developed smallpox on 7 September. She recovered. On 6 September, after the Government announced an investigation into the outbreak, Henry Bedson went into the shed at the bottom of his garden and cut his throat.

The investigation concluded that Mrs Parker had probably been infected by a strain of smallpox called Abid (after one of its earlier victims, a three-year-old Pakistani boy), which was being handled in the smallpox laboratory on 24 and 25 July. The virus had travelled in air currents up a service duct from the laboratory below to a room in the Anatomy Department which was used for telephone calls; on 25 July Mrs Parker had spent much more time there than usual ordering photographic materials because the financial year was about to end.

Courtesy: Small Pox scares, Hugh Pennington http://www.lrb.co.uk/v24/n17/penn01_.html