Smallpox

Smallpox is something that has been forgotten. Dr Grumble's students puzzle over smallpox vaccination scars that are an incidental finding in many patients over a certain age. Amazingly, Dr Grumble is yet to find a new student who can even guess what causes these scars.

Dr Grumble is not an expert on smallpox but it is one of the first diseases that he learned about. He remembers well the fearfulness, almost terror, smallpox caused in 1962 when he was a young child in South Wales. Dr Grumble can remember his father telling him that a South Wales obstetrician had contracted smallpox after attending a post mortem on a pregnant patient who had died unexpectedly. It turned out that she had had smallpox. Smallpox, you see, does not necessarily present with all those ghastly pustules you see in the pictures of old. As far as Dr Grumble can recall, the disease had been spread around by the index case, a recent immigrant from Pakistan, who had visited various prostitutes. This made any idea of contact tracing awkward.


Medical people don't much get frightened by medical scares that appear on a regular basis in the press. Dr Grumble works daily alongside patients with nasty pathogens. It doesn't worry him. But it used to. He can remember, as a student, trying to hold his breath as he went into cubicles in the infectious diseases ward. He used to wonder how the old professor that used to teach him so well could possibly have lived so long working with infectious diseases every day.

But smallpox is another thing altogether. That still frightens Dr Grumble - even though it is long gone. And in 1962 the Grumble family was, well, scared. Dr Grumble's father was, you see, an obstetrician so it could easily have been him. Except that, unlike the obstetrician who died, Dr Grumble's father had been vaccinated many times. But, though a live vaccine, immunity following smallpox vaccination wanes. In a very short time Dr Grumble's father came home with some vaccine and he immunised us all. The public, some of whom had previously unwisely shunned vaccination, were soon clamouring for it and 900,000 people were eventually vaccinated. But 25 people contracted smallpox and 9 died.


Smallpox was a most terrible scourge which used to cause widespread fear, maiming and terrible death on a grand scale. Its eradication has been a most fantastic achievement. We have Edward Jenner and his vaccination and the World Health Organisation to thank.

Dr Grumble saw one of the very last cases of smallpox while working as a medical student in Ethiopia. He hopes he has seen his last case of measles. He hasn't seen one for a very long time. We must eradicate this disease. We owe it to the people of the third world. There is hope. Here's what they have achieved in Yemen.

From 2006 to 2007, reported cases of measles nationwide plummeted from 30,000 cases, 5,000 of which were fatal, to 13 cases only.

“In 2008, there were three reported cases of measles, and no fatalities,” said Dr Mohammad. (Source)

Well done Dr Mohammad. Persuading primitive people to be immunised can be a problem in the third world where you may have to combat ignorance or strange traditional beliefs.