Tuesday, December 22, 2015
Smallpox
A child infected with smallpox in Bangladesh, 1973. Patients with ordinary-type smallpox usually have bumps filled with a thick and opaque fluid, often alongside a depression or dimple in the center. This is a major distinguishing characteristic of the disease. Source: Wikipedia - Smallpox,
Two-year old Rahima Banu of Bangladesh (pictured) was the last person infected with naturally occurring Variola major, in 1975
Research Notes for Anthrax Attack Challenged, by Dahbud Mensch, Archived,
March 4, 1979, AP - Lawrence Journal-World, page 6B, Smallpox virus escapes; Tragedy trails lab's error,
February 17, 2011, BBC News, Smallpox: Eradicating the Scourge, by Colette Flight, Archived,
June 2, 2011, Birmingham Mail, When Birmingham was gripped by deadly smallpox virus, diigo, Archived,
Professor Henry Bedson was committed to finding out more about the deadly smallpox virus.
It was 1978 and it seemed the disease and its various strains, such as white pox and monkey pox, was on the verge of extinction.
For centuries smallpox had rampaged across the world and was the curse of both the rich and poor.
Bedson, a medical researcher at Birmingham University Medical School, had been working with other specialists and he told friends he was on the brink of a major breakthrough.
The World Health Organisation wanted him to continue his research but they were not satisfied with the condition of his laboratory facilities.
The lab was due for closure and Bedson knew he would not receive any further funding so he worked more rapidly, storing more samples and increasing the likelihood of an accident.
Conditions were not as stringent as now, but researchers were still confident that the virus could not escape the confines of the lab.
However, minute particles crept into an airduct which led directly up to the room where Janet Parker worked.
The Kings Norton photographer regularly used a darkroom above the research laboratory used by Bedson.
On August 11 1978, Mrs Parker fell ill. She initially thought it was a cold, but then she developed spots and the symptoms got worse.
She was first admitted to East Birmingham (now Heartlands) Hospital, and six days later diagnosed as suffering from smallpox, even though she had been vaccinated 12 years previously.
Health officials now had a major alert on their hands and Mrs Parker was placed in isolation at the previously redundant Catherine-de-Barnes hospital in Solihull.
Bedson and his family were placed in quarantine at their family home in Harborne and 500 other people were also isolated.
When smallpox was diagnosed, Bedson was horrified. Friends said he was a broken man. He took his work very seriously and felt he had done nothing which could have resulted in the tragedy.
His home and family were besieged by camera crews and reporters and the pressure on him became unbearable.
On September 1, while his wife was taking a telephone call, the professor walked out to his garden shed and cut his throat.
He survived in hospital for five days but became the first fatality of the outbreak – killed not by the virus he battled to defeat for so long, but by the panic it caused.
In a suicide note he apologised to his family and friends for the strain he had placed them under.
It read: “I am sorry to have misplaced the trust which so many of my friends and colleagues have placed in me and my work and above all to have dragged into disrepute my wife and beloved children. I realise this act is the last sensible thing I have done but it may allow them to get some peace.”
Just four days later, Mrs Parker’s father, Fred Whitcomb, died of a heart attack. He and his wife Hilda had been placed in quarantine at the same hospital as their daughter but the strain of the ordeal had become too much for him.
The city was gripped with panic and a month after she initially fell ill, Mrs Parker lost her battle for life. She remains the last person to die from smallpox.
Former hospital domestic worker Katie Conlon, of Quinton, said her mother worked at East Birmingham Hospital when Mrs Parker was first admitted. “She never came into contact with the woman but she was vaccinated in case the virus spread. It was terrifying and a very sinister time,” said Mrs Conlon.
Birmingham University was cleared of any blame regarding the photographer’s death, but her husband Joseph received a payout of £26,500 over her death.
Catherine-de-Barnes hospital is now a luxury housing estate and many of Mrs Parker’s former neighbours in Burford Park Road have moved on.
Young families now occupy the houses next to Mrs Parker’s former home unaware of the drama that unfolded over 30 years ago.
But the awful memory of the time a city was under the shadow of the world’s biggest killer disease will never die.
August 18, 2013, i09, The horrifying story of the last death by smallpox, by Esther Inglis-Arkell, Archived,
Smallpox has been around for a millennium, and claimed hundreds of millions of lives. Each death was tragic, but the last person to die by smallpox left behind one of the most wrenching tragedies of them all.
Smallpox was one of the most feared killers the world over. Those it didn't kill it often blinded or left sickened for life. It was also one of the most celebrated triumphs of any international medical effort. In 1959, the World Health Assembly officially announced a drive to eradicate smallpox. In 1977, Ali Maow Maalin, a hospital cook in Somalia, became the last person get a natural case of smallpox. The world waited for the official announcement of its eradication. A year later, another case was reported.
Janet Parker was a medical photographer who worked at the University of Birmingham medical school. From the moment she was diagnosed, there was no question where she got the virus. She worked directly above a laboratory studying smallpox. The lab, headed by Professor Henry Bedson was winding down its research. Bedson was caught between competing demands. He believed he was on the verge of a breakthrough in smallpox research, and the World Health Organization believed him. It believed him enough to send him samples of the virus. It, however, couldn't keep sending him samples of the virus because his lab didn't meet safety requirements, and no one was willing to put up the money to make the improvements in his lab for a virus that was all-but-eradicated. As a result, the researchers in the lab worked on an airborne virus without air locks and without separate showers or changing facilities, and without special clothing in the lab to prevent contamination. Because Bedson knew his time was running out, they also handled the virus in the main lab, away from safety cabinets.
The horrifying story of the last death by smallpox
The researchers in the lab, however, kept current on their vaccinations. The smallpox vaccine requires renewing every few years. Janet Parker hadn't had a vaccination in twelve years. In the investigation, after she was diagnosed, no one could determine exactly how the virus got into the air system, but once it had it traveled up the vents into her work space.
At first she thought she had a cold. Then doctors thought it was a drug rash. Then the pustules started appearing. Janet was treated and her parents, with whom she had had contact, were quarantined. The first person to die was Henry Bedson. While his wife was distracted, he went into his garden and cut his throat. A few days later, Janet Parker's father died of a heart attack. The stress and worry of the ordeal killed him. Janet herself eventually succumbed to smallpox. Her mother was diagnosed with smallpox, but was treated and survived the illness.
Today, people who want to eradicate the last strains of smallpox - all housed in labs - point to Janet Parker as an example of how a virus can escape a lab. After the tragedy, health guidelines and monitoring for labs receiving these kinds of illnesses grew more stringent.
July 9, 2014, USA Today, Forgotten vials of smallpox found near D.C., by Liz Szabo, diigo,
Scientists last week discovered several vials of smallpox — one of the deadliest diseases known to man — in an unused storage room at the National Institutes of Health in Bethesda, Md., according to officials at the Centers for Disease Control and Prevention.
Officials say there's no health risk from the vials — either to NIH employees or the public. The vials of smallpox, which apparently date to the 1950s, were "immediately secured" in a CDC containment lab, according to a CDC statement. NIH officials alerted the CDC about the smallpox July 1.
Smallpox killed about one-third of its victims and is estimated to have killed up to 500 million people in the 20th century. It devastated populations around the world for at least 3,000 years until being officially eradicated by vaccines in 1980. There is ongoing concern that smallpox could be used in a bioterrorist attack.
The smallpox samples were found in a lab run by the Food and Drug Administration. Scientists discovered the vials when preparing to move to the FDA's main campus in Silver Spring, Md.
A government aircraft took the smallpox vials to CDC's high-containment facility in Atlanta on Monday, according to the CDC statement. Overnight genetic testing in a top-security lab confirmed that the vials did indeed contain smallpox, but CDC officials say they will need to do additional tests to find out whether the smallpox is viable or able to reproduce and spread. Testing could take up to two weeks. CDC scientists will destroy the smallpox samples after finishing the tests.
The World Health Organization has designed two storage sites for smallpox, one at the CDC in Atlanta and one at the State Research Center of Virology and Biotechnology (VECTOR) in Novosibirsk, Russia. The WHO oversees the inspection of both facilities and certifies their safety and security.
CDC has alerted WHO about the discovery and has invited the WHO to join its investigation of how the smallpox wound up in Bethesda. If the vials contain viable smallpox, the CDC will invite WHO officials to witness their destruction, the usual practice when smallpox has been found outside of official storage sites, the CDC says.
The CDC's Division of Select Agents and Toxins and the Federal Bureau of Investigation are investigating how the smallpox vials were originally prepared and stored in Bethesda.
The discovery marks the second episode this summer in which federal agencies were concerned about potential exposure to a killer bug. In June, the CDC announced that up to 75 of its scientists may have been exposed to live anthrax bacteria after a safety lapse. Many were treated with antibiotics as a precaution, although none had symptoms.
Infectious disease expert Michael Osterholm says the smallpox discovery did not pose a safety risk.
"If smallpox were to occur in a few people in a lab because they handled a vial of variola," the scientific term for smallpox, "I am convinced that the global public health community would squelch that very quickly," says Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Osterholm, who served as an adviser to the Bush administration on bioterrorism, says smallpox is far less contagious than influenza. Its telltale symptoms of body-wide blisters would allow patients to be diagnosed and treated. Osterholm notes that that vaccination is effective even after exposure. An accidental release of a killer flu strain would be far more difficult to control, he says, because the flu spreads much more easily and because its symptoms can mimic those of other respiratory bugs. He praised the way NIH handled and publicized the discovery.
Osterholm says it's not totally surprising to find smallpox in an unused storage area. Still, he says it's likely that other labs will look a bit more carefully to see if they also have any aging vials with surprising labels.
"The freezers of the microbiology labs of the world are a lot like the trunks in your attic. When you open them up, sometimes you are surprised," Osterholm says. "Most people have already gone through their freezers, but some freezers get missed."
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