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The Last Days of Smallpox: Tragedy in Birmingham
The last naturally occurring case of smallpox was diagnosed in Ali Maow Maalin, a hospital cook in the picturesque seaport of Merca, Somalia, on 26 October 1977. But in August 1978, the smallpox virus crept like a thief in the night from a laboratory in Birmingham to re-inhabit human flesh and blood...
What happened next has all the hallmarks of a Greek drama or Shakespearean tragedy, with the shocking but mysterious appearance of a dreaded disease in the heart of England; a frantic effort to save a city—and the world—from disaster; a tragic heroine, a photographer, who suffered a hideous fate; and a tragic hero, a virology professor, driven to mortifying despair, treated as a scapegoat during an official enquiry, but later exonerated in a court of law.
Here, I give a full account of the 1978 Birmingham smallpox outbreak and the ensuing court case, drawn from records of the time and the reminiscences of those who lived through it.
"A complete and rational account… sets the record straight, provides closure"Keith Dumbell, University of Cape Town
"A riveting account of the mystery, the politics and the legal implications of the Birmingham event." Stanley Falkow, University of Stanford
"Thoroughly engrossing—a high-quality detective story, with a nice human touch" Robin May, University of Birmingham
"A book full of humanity… and of anger at the smallpox virus and the misery it caused." Soad Tabaqchali, emeritus professor, St Bartholomew’s Hospital
"An engaging book that weaves the scientific, social, political and historical context into a multi-layered narrative." Conall McCaughey, Queens University Belfast
"The biographical material on the protagonists is superb. It makes it come alive. Janet Parker is not just a name, a Madonna to be sacrificed, but a real person." Brian Escott-Cox QC
- GenresScienceNonfictionHistory
337 pages, Paperback
Published April 9, 2018
35 people are currently reading
121 people want to read
About the author
Mark Pallen
8 booksMark Pallen is a Research Leader at the Quadram institute in Norwich and professor of Microbial Genomics at the University of East Anglia. He completed his undergraduate medical education in Cambridge and London and his specialist training in microbiology at St. Bartholomew's Hospital. While working on a PhD at Imperial College in the mid-1990's, Mark led a team to victory in the TV quiz show University Challenge. Shortly afterwards, he gained his first professorship at Queen's University Belfast, before taking up a chair at the University of Birmingham in 2001. During his twelve years in Birmingham, Mark developed a keen interest in the 1978 smallpox incident.
Mark's academic interests include microbial genomics, bioinformatics, ancient DNA, public understanding of science and the life and legacy of Charles Darwin. Mark is married with four children and two dogs and divides his time between Worcestershire and East Anglia.
Mark's academic interests include microbial genomics, bioinformatics, ancient DNA, public understanding of science and the life and legacy of Charles Darwin. Mark is married with four children and two dogs and divides his time between Worcestershire and East Anglia.
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Displaying 1 - 8 of 8 reviews
October 25, 2018
It's very rare that I find a medical popular science book unputdownable (in fact it's my least favourite sub-genre of popular science) - but it's an adjective I'd apply to Mark Pallen's The Last Days of Smallpox. This horrible disease was eradicated worldwide in 1977 - and a story of its background, including the last natural outbreaks in the UK, makes up the opening section of this book, but the main focus is an exploration of the last ever outbreak in the UK in Birmingham in 1978 - one year after the disease was eradicated.
Pallen takes us through in immaculate detail the escape of smallpox from a lab at Birmingham University, the sad cases of Janet Parker, a photographer who worked in the same building and died of smallpox, and Henry Bedson, the microbiologist in charge of the lab who committed suicide as a result of the stress of the outbreak. Pallen covers the possible ways that Parker could have become infected and gives a blow-by-blow account of the court case when the Health and Safety Executive took the University to court over the outbreak.
All of this could have been rather dull, despite the gruesome topic. However, Pallen has a gift for dramatisation and the account, often in the present tense, gives a sense of urgency and reality to the narrative, in a way that I've rarely seen in a science book. A few years ago I was taken on a tour of Porton Down to record a radio programme and remember the stomach churning frisson of looking through glass at people handling deadly diseases. I was taken straight back to that corridor and the feeling of tension I felt there by Pallen's excellent descriptive writing.
The book is self-published, but has been proof read and copy edited well. It only really shows in the print size, which is smaller than I would have liked. A publisher might have tightened up a few parts, notably the account of the court case, which perhaps went into a little too much detail, but if you like legal stories (which I do), it was no problem.
The combination of the account of the defeat of the deadly virus that inspired the process of vaccination with the particular and very human happenings at Birmingham in 1978 makes this book a real winner.
Pallen takes us through in immaculate detail the escape of smallpox from a lab at Birmingham University, the sad cases of Janet Parker, a photographer who worked in the same building and died of smallpox, and Henry Bedson, the microbiologist in charge of the lab who committed suicide as a result of the stress of the outbreak. Pallen covers the possible ways that Parker could have become infected and gives a blow-by-blow account of the court case when the Health and Safety Executive took the University to court over the outbreak.
All of this could have been rather dull, despite the gruesome topic. However, Pallen has a gift for dramatisation and the account, often in the present tense, gives a sense of urgency and reality to the narrative, in a way that I've rarely seen in a science book. A few years ago I was taken on a tour of Porton Down to record a radio programme and remember the stomach churning frisson of looking through glass at people handling deadly diseases. I was taken straight back to that corridor and the feeling of tension I felt there by Pallen's excellent descriptive writing.
The book is self-published, but has been proof read and copy edited well. It only really shows in the print size, which is smaller than I would have liked. A publisher might have tightened up a few parts, notably the account of the court case, which perhaps went into a little too much detail, but if you like legal stories (which I do), it was no problem.
The combination of the account of the defeat of the deadly virus that inspired the process of vaccination with the particular and very human happenings at Birmingham in 1978 makes this book a real winner.
July 26, 2018
Smallpox is one of the worst and most thoroughly forgotten infectious diseases. Infection with variola major virus causes around 30% death rate, not much lower than for plague and ebola and frequent disfigurement because of the pox scars concentration on the face. Many a classic literature book mentions a character - a villain or a beggar - covered with pox marks. But as a result of the global eradication programme, the last natural case of the pox was reported in 1977. I still have s skin bump of pox vaccination on my left hand. It would allow determining my age if necessary, but present generation knows nothing about the former killer.
11th August 2018 marks 40th anniversary of the last outbreak of smallpox in Britain and the book broadly describes the accident. The book is based on the author’s experience in virology - he is a Professor of Microbial Genomics at the University of Warwick, UK - and his research in archives and interviewing witnesses. The book is a cross between a detective story with horror elements and a procedural in the vein of John Grisham’s novel.
The book strong points are in the description of smallpox origins, epidemiology, history of treatment and the Birmingham incident. From the hindsight health and safety procedures a mysterious case of pox infection of the medical photographer who was vaccinated and shouldn’t have been nowhere near the live virus read like a horror story - no airlock in the lab that worked with the most dangerous infections, mouth aspiration of human pox virus.
Additionally to summarising the government report on the case and the trial (which the author allows to skip, but I don’t recommend it) the book offers a new and highly plausible hypothesis of the accident.
However, unlike other reviewers that awarded the book five stars, I cannot say that the book is perfect. While the epidemiology and disease cases described vividly, a brief description of the virus and its mechanism of action beyond “its genome is too big to use in bioweapons” would have been useful. It’s mentioned that vaccination had its own drawbacks, but there’s no explanation of how a live vaccine works. The reassurance that just as microbiological practices have improved significantly much since the accident, the vaccines have also improved wouldn't have gone amiss.
The story would have benefited from a few of the tricks of thrillers. For example, the parade of pox cases would have benefited from joining them into the narrative and teasers along the lines “This case will be an important argument for prosecution in the Birmingham trial.”
The personal interludes, interspersed with the main narrative, become more and more self-indulgent. For example, there’s a meandering narrative about going to pubs and meeting ‘who is who’ of microbiology, the punchline being that the last encounter is close to one of the very few remaining deposits of the smallpox samples. I would have instead read instead about more cases in an Appendix
However, all the “buts” are mostly to explain the four-star verdict. All in all, a very worthy book that may be a sleeper - not many people are interested in “historical diseases” - but extremely valuable for the future researchers.
Read less
11th August 2018 marks 40th anniversary of the last outbreak of smallpox in Britain and the book broadly describes the accident. The book is based on the author’s experience in virology - he is a Professor of Microbial Genomics at the University of Warwick, UK - and his research in archives and interviewing witnesses. The book is a cross between a detective story with horror elements and a procedural in the vein of John Grisham’s novel.
The book strong points are in the description of smallpox origins, epidemiology, history of treatment and the Birmingham incident. From the hindsight health and safety procedures a mysterious case of pox infection of the medical photographer who was vaccinated and shouldn’t have been nowhere near the live virus read like a horror story - no airlock in the lab that worked with the most dangerous infections, mouth aspiration of human pox virus.
Additionally to summarising the government report on the case and the trial (which the author allows to skip, but I don’t recommend it) the book offers a new and highly plausible hypothesis of the accident.
However, unlike other reviewers that awarded the book five stars, I cannot say that the book is perfect. While the epidemiology and disease cases described vividly, a brief description of the virus and its mechanism of action beyond “its genome is too big to use in bioweapons” would have been useful. It’s mentioned that vaccination had its own drawbacks, but there’s no explanation of how a live vaccine works. The reassurance that just as microbiological practices have improved significantly much since the accident, the vaccines have also improved wouldn't have gone amiss.
The story would have benefited from a few of the tricks of thrillers. For example, the parade of pox cases would have benefited from joining them into the narrative and teasers along the lines “This case will be an important argument for prosecution in the Birmingham trial.”
The personal interludes, interspersed with the main narrative, become more and more self-indulgent. For example, there’s a meandering narrative about going to pubs and meeting ‘who is who’ of microbiology, the punchline being that the last encounter is close to one of the very few remaining deposits of the smallpox samples. I would have instead read instead about more cases in an Appendix
However, all the “buts” are mostly to explain the four-star verdict. All in all, a very worthy book that may be a sleeper - not many people are interested in “historical diseases” - but extremely valuable for the future researchers.
Read less
December 17, 2020
An account of the last occurrence of smallpox, written by a biologist who later happened to work at the same university and became fascinated by the story. It gives a historical overview of smallpox and its outbreaks, then jumps into the last case of smallpox, and concludes with a brief alternative perspective on the case and some discussion on bioweapons and fighting diseases.
The writing isn't bad, but is a bit idiosyncratic. Almost every chapter (of which there's 69) reads like the beginning of a new novel. It was also a bit daunting to read how the authors preferred (probably correctly) side, during court proceedings, "deftly demonstrates", "rams the point home", "clarif[ies]", while the other side "[is] rambling", "haggles", "grills", "[discusses] fruitlessly", and "[does yet another] meander". In the end, I had to push myself to finish the book.
The content in itself is quite interesting, especially the initial exposition. As far as I can tell, the facts all line up, there was a fair amount of original research that went into this, and I very much appreciated the alternative explanation the author provides at the end. I think the sourcing is a bit ad-hoc, but better than nothing, which I think would be the baseline.
The books is printed on really nice paper, but there are a lot of clubs and widows, which is unfortunate and (to me) distracting.
I'd recommend this book to anyone who needs the information it contains or enjoys books of this type and is more tolerant to its specific writing style.
The writing isn't bad, but is a bit idiosyncratic. Almost every chapter (of which there's 69) reads like the beginning of a new novel. It was also a bit daunting to read how the authors preferred (probably correctly) side, during court proceedings, "deftly demonstrates", "rams the point home", "clarif[ies]", while the other side "[is] rambling", "haggles", "grills", "[discusses] fruitlessly", and "[does yet another] meander". In the end, I had to push myself to finish the book.
The content in itself is quite interesting, especially the initial exposition. As far as I can tell, the facts all line up, there was a fair amount of original research that went into this, and I very much appreciated the alternative explanation the author provides at the end. I think the sourcing is a bit ad-hoc, but better than nothing, which I think would be the baseline.
The books is printed on really nice paper, but there are a lot of clubs and widows, which is unfortunate and (to me) distracting.
I'd recommend this book to anyone who needs the information it contains or enjoys books of this type and is more tolerant to its specific writing style.
July 11, 2022
A interesting, but tragic account of the 1978 outbreak of smallpox which took the life of Janet Parker, the last person to die of smallpox.
Obviously due to the subject matter the book can be distressing in places with some graphic medical detail in places, I also found myself affected by being able to put a face to Janet Parker's name and to experience her final days through this book.
I had heard about the outbreak before, but as I have previously mentioned I didn't understand the full impact of the incident, both on Parker and her family involved, but also the lab and its staff, one of whom sadly took his own life due to the stress of the situation.
The book was informative and I learnt a great deal, but I wouldn't say it was a book I could say I enjoyed due to the subject matter.
Obviously due to the subject matter the book can be distressing in places with some graphic medical detail in places, I also found myself affected by being able to put a face to Janet Parker's name and to experience her final days through this book.
I had heard about the outbreak before, but as I have previously mentioned I didn't understand the full impact of the incident, both on Parker and her family involved, but also the lab and its staff, one of whom sadly took his own life due to the stress of the situation.
The book was informative and I learnt a great deal, but I wouldn't say it was a book I could say I enjoyed due to the subject matter.
May 17, 2018
Fascinating story of the last smallpox outbreak in Birmingham, England. As I am a virus researcher, this was very interesting.
December 8, 2018
An extraordinary account of an extraordinary event. But it’s much more than that ..... an education in all sorts of ways!
November 24, 2022
Fascinating
January 20, 2019
This book reminded me of The Emperor of All Maladies: A Biography of Cancer but with a narrower focus. Interesting and informative.
Some surprising information in this book. The system of vaccination I was familiar with in the U.S. at that time was "herd immunity" and all school children were vaccinated. But I was surprised that so few people in England were vaccinated. This book explains "ring vaccination" that is used when diseases have a relatively low transmission rate and spread slowly. This involves vaccinating only selected groups of people who might possibly be exposed. England put smallpox in this category when the U.S. did not. They also considered the risk posed by the vaccine. In a ten year period, 300 people in the U.S. died from the smallpox vaccine when it was very unlikely that they would ever be exposed to smallpox.
For those of us who like to follow up for more information on specific events, it is a little frustrating that the author's footnotes rely so heavily on wikis and blogs that have changed or disappeared since the book was written. While the footnote still lets the reader know the source of the information, follow up is frustrating.
PERSONAL INTERLUDE
I have had a mild interest in smallpox since I was little because a vaccination was required for children to start school back in the day. My family doctor spilled the bottle of vaccine on me (today that would probably result in a lawsuit). As a result, I started kindergarten wearing my brother's long sleeved shirts, all buttoned up with a colorful bandana around my neck, to hide the pustules. I don't remember any on my face. The doctor assured the principal and my teacher that the additional pustules didn't make me any more contagious than my classmates who had been recently vaccinated. Booster vaccinations that I had after that didn't "take" so I was apparently immune.
By coincidence, I was traveling in England twenty years later when smallpox escaped from the lab in Birmingham. It was front-page news in the papers in England and we heard that a few countries were banning flights from the U.K. When we got back to the U.S. we were surprised to find nothing whatsoever in the local newspaper. They say "Bad news travels fast" but sometimes it doesn't travel at all. Smallpox could have flown here very easily with none the wiser.
Some surprising information in this book. The system of vaccination I was familiar with in the U.S. at that time was "herd immunity" and all school children were vaccinated. But I was surprised that so few people in England were vaccinated. This book explains "ring vaccination" that is used when diseases have a relatively low transmission rate and spread slowly. This involves vaccinating only selected groups of people who might possibly be exposed. England put smallpox in this category when the U.S. did not. They also considered the risk posed by the vaccine. In a ten year period, 300 people in the U.S. died from the smallpox vaccine when it was very unlikely that they would ever be exposed to smallpox.
For those of us who like to follow up for more information on specific events, it is a little frustrating that the author's footnotes rely so heavily on wikis and blogs that have changed or disappeared since the book was written. While the footnote still lets the reader know the source of the information, follow up is frustrating.
PERSONAL INTERLUDE
I have had a mild interest in smallpox since I was little because a vaccination was required for children to start school back in the day. My family doctor spilled the bottle of vaccine on me (today that would probably result in a lawsuit). As a result, I started kindergarten wearing my brother's long sleeved shirts, all buttoned up with a colorful bandana around my neck, to hide the pustules. I don't remember any on my face. The doctor assured the principal and my teacher that the additional pustules didn't make me any more contagious than my classmates who had been recently vaccinated. Booster vaccinations that I had after that didn't "take" so I was apparently immune.
By coincidence, I was traveling in England twenty years later when smallpox escaped from the lab in Birmingham. It was front-page news in the papers in England and we heard that a few countries were banning flights from the U.K. When we got back to the U.S. we were surprised to find nothing whatsoever in the local newspaper. They say "Bad news travels fast" but sometimes it doesn't travel at all. Smallpox could have flown here very easily with none the wiser.
Displaying 1 - 8 of 8 reviews