How contact tracing stopped a deadly smallpox outbreak in London

Miles Ellingham tells the story of how a smallpox epidemic was averted by his grandfather’s swift and meticulous tracing of contacts in London

A baby is vaccinated in St Pancras town hall (Getty)

Lockdown life has thrown families together again and doubtless revealed many a forgotten episode as lofts have been braved, photo albums revisited and talk of generations renewed. My own finding is an extraordinary and timely one: the report of a smallpox epidemic that my grandfather managed in Harrow. The episode was Britain’s last-but-one outbreak of smallpox, in 1973. If it was not swiftly contained, and all contacts found and treated, there was a threat of smallpox breaking out across London and potentially beyond. The World Health Organisation (WHO) was alerted.

Few diseases are more frightening than smallpox. It is extraordinarily infectious – spread in the air or on surfaces from the tiniest of particles – and obscenely painful. If the smallpox is variola major, the dominant strain, its first signs are high temperatures and vomiting. At five days, the distinctive smallpox rash spreads and sores break out in and around the mouth, arms, legs, hands and feet. At eight days these sores turn to pustules “like peas under the skin”. Death follows shortly, generally from multi organ-failure.

With Coronavirus dominating our lives, my mother recalled that her father, who died when I was two, had left a printed report of the smallpox outbreak. She also recalled that period well herself, as her father, Dr Clifford Jansz, had been on call 24-hours a day as chief medical officer for Harrow. The phone had been off limits to the family in case of an emergency call, and for three weeks her father had worked around the clock.