In August 1978, a medical case unfolded in Birmingham, England. Janet Parker, a 40-year-old medical photographer, became the last person to die of smallpox, a year after the disease was thought to have been eradicated in the wild. Her case was perplexing, as the source of the infection was not immediately apparent, creating a puzzling scenario for public health officials.
An Unlikely Diagnosis in a Post-Smallpox World
Janet Parker was a medical photographer at the University of Birmingham Medical School. On August 11, 1978, she began experiencing symptoms, including a headache and muscle pains. Initially, her condition was not considered alarming, and the spots that appeared were thought to be a benign rash or possibly chickenpox. However, her condition worsened, and on August 20, she was admitted to East Birmingham Hospital.
By the time she was hospitalized, the rash had spread across her entire body. Medical professionals, including consultant Alasdair Geddes, made the diagnosis of Variola major, the most severe form of smallpox. The diagnosis was shocking because the World Health Organization was on the verge of declaring the world free from smallpox. Parker had been vaccinated in 1966, but the immunity had waned over time.
The confirmation of smallpox triggered immediate public health protocols. Parker was placed in strict isolation to prevent any further spread of the virus. The situation was tense, as the public had believed the threat of smallpox was a thing of the past. The re-emergence of the disease created a sense of urgency.
The Laboratory and the Source of Infection
The investigation into how Janet Parker contracted smallpox led to the University of Birmingham Medical School, where she worked. Attention turned to a research laboratory located on the floor directly below her darkroom. This lab, run by Professor Henry Bedson, was one of the few places still conducting research on live smallpox viruses. Bedson’s work was under pressure, as the success of the global eradication campaign meant funding was diminishing.
An official government investigation, the Shooter Inquiry, was launched to determine the source of the outbreak. The inquiry concluded that Parker was likely infected through airborne transmission. The virus is believed to have traveled from the laboratory on the first floor to Parker’s workplace on the second floor through a poorly maintained service duct. This finding highlighted significant safety lapses.
The Shooter Inquiry revealed that the laboratory’s safety standards were not adequate for handling smallpox. A World Health Organization inspection team had previously warned that the facilities were outdated. The pressure to complete experiments before the lab’s scheduled closure may have contributed to a rushed environment where safety protocols were not rigorously followed. While the university was later acquitted of breaching health and safety laws, the general consensus remains that the lab was the source of the infection.
Public Health Response and Tragic Aftermath
The confirmation of a smallpox case prompted an immediate public health response. To contain the potential outbreak, health officials quarantined approximately 500 individuals who had been in contact with Janet Parker. These individuals were required to remain in their homes for two weeks. The quarantine included family members, colleagues, and ambulance workers.
On September 11, 1978, after a month-long battle with the disease that led to pneumonia and renal failure, Janet Parker died. Her mother, who had been caring for her, also contracted a mild case of smallpox on September 7. Despite having been vaccinated just weeks earlier, she later recovered and was discharged from the hospital.
The tragedy was compounded by the death of Professor Henry Bedson. Overwhelmed by guilt and distress over his role in the outbreak, Bedson took his own life on September 1, 1978. His death underscored the personal and professional weight of the incident.
Legacy of the Birmingham Outbreak
The events in Birmingham had a lasting impact on how dangerous pathogens are handled worldwide. The official investigation, the Shooter Report, detailed serious deficiencies in the safety and containment procedures at the University of Birmingham’s laboratory. The report’s findings demonstrated that even with a disease on the brink of eradication, the risk posed by laboratory stocks remained significant.
The inquiry’s conclusions prompted a global reassessment of safety protocols in laboratories. The incident led to the implementation of stricter regulations for facilities conducting such research. The goal was to prevent a similar laboratory-acquired infection from ever happening again.
A direct policy change resulted from the Birmingham outbreak. The events spurred a global consensus that the number of laboratories holding smallpox virus stocks needed to be drastically reduced. This led to the decision to consolidate all remaining virus samples into two designated high-security repositories. Today, the only two locations authorized by the World Health Organization to store smallpox are the Centers for Disease Control and Prevention (CDC) in Atlanta, USA, and the State Research Center of Virology and Biotechnology (VECTOR) in Koltsovo, Russia.