Eradicating an ancient scourge

By Fergus Walsh
Medical correspondent, BBC News

Smallpox was a major killer

Ask anyone in which country the world's last victim of smallpox died and they are unlikely to choose England.

But 30 years ago on Thursday Janet Parker, a medical photographer, died in Birmingham, weeks after being infected with the virus.

She had been working in a room above the smallpox laboratory at the University Medical School.

The smallpox lab had been earmarked for closure within months because of safety concerns.

The incident claimed two lives - the head of smallpox research, Professor Henry Bedsen, committed suicide.

Thousands of people in Birmingham were immunised as a precaution.

It was an unexpected reminder of a deadly and ancient scourge.

Smallpox had been killing and disfiguring people for thousands of years.

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The site of the last smallpox outbreak

First vaccine

There is evidence of smallpox from lesions on the mummy of Ramses V, who died in Egypt in 1157 BC.

It was almost impossible to treat smallpox, so when it was finally eradicated it really was a medical milestone Professor Lawrence Young University of Birmingham

But the disease provided the stimulus for one of the great advances in medicine - it was the subject of the first ever vaccine.

In 1796 Edward Jenner, a doctor in Gloucestershire, discovered that immunity to smallpox could be produced by inoculation with the mild related infection of cowpox.

He was testing the theory that since milkmaids rarely got smallpox, perhaps cowpox gave them some protection.

Nonetheless it took nearly 200 years for the disease to be finally eradicated.

In 1980, the World Health Organisation declared that the planet was free of smallpox.

Professor Lawrence Young, of the University of Birmingham, says this was a great achievement: "In the 20th Century alone smallpox killed around 300 million people.

"And those who survived were often left disfigured by scars on the face and body.

"It was almost impossible to treat smallpox, so when it was finally eradicated it really was a medical milestone which was of huge benefit to the entire world."

Success predicted

After the success of smallpox eradication global health officials were confident other diseases would follow.

You have to get everybody on board if you are to eradicate a disease - public and politicians Professor Hugh Pennington University of Aberdeen

Like smallpox, polio and measles do not infect animals, so once they are wiped out in humans the viruses should die out.

Although cases of polio have declined by 99%, there are still pockets of infection in Nigeria and three other countries - in part due to opposition to immunisation.

Measles is another virus which could be wiped out - but a health scare over MMR 10 years ago has helped the disease stage a comeback in the UK.

Professor Hugh Pennington, from the University of Aberdeen, says all the targets for disease eradication of recent decades have been missed.

"You have to get everybody on board if you are to eradicate a disease - public and politicians.

"There are people in the UK who think it is an acceptable risk to have your child get measles - I strongly disagree.

"That means even in the UK were can't get rid of measles."

Professor Pennington says there is some good news on the horizon.

Guinea Worm disease - a parasitic infection - looks close to eradication.

This will not be the result of vaccination but through filtering the infected fleas out of drinking water.