WHEN Ismat Khan died on 7 January, staff at London airport were vaccinated: the gateway by which smallpox had entered the country had been identified. At a time when air travel was expanding, the risk that travellers could unknowingly carry the virus with them became suddenly – and alarmingly – clear.
The official Government report on the 1962 outbreaks compared a ‘smallpox invasion’ by air with an importation by sea, which would – in previous years – have been the more typical route. In a later case that year, the disease had developed before the ship entered the port of London. The patient and his family, who had shared a cabin with him on board, were isolated in a smallpox hospital while the rest of the passengers and crew were kept under surveillance. Two of the family developed the disease, but no other cases came to light.
In the early 1950s, airports around the world handled fewer than a million travellers a year; but by 1961, more than 100 million passengers used international air services and London airport recorded 6 million passenger movements. At a time when there was an epidemic of smallpox in the Pakistani port of Karachi and immigration from the Indian subcontinent to Britain was growing, the implications were serious.
According to the official report, the passengers and crew who travelled on the same aeroplanes as the five infected Pakistanis had a lucky escape. So far as is known, none contracted the disease; nor (it concludes) did they carry it into the many parts of the country to which they dispersed. The report spells out the fear: other immigrants from Pakistan, travelling on these planes, might have been unsuccessfully vaccinated before leaving Karachi. They could have caught the virus on board and spread the disease in the areas of Britain to which they travelled – before developing symptoms themselves. More worryingly, they might have become ‘modified’ cases, their smallpox modified by vaccination, something which might never have shown up in them, but could have infected others. The report’s conclusion that the carriers did not infect anyone else during their flights and that no further cases resulted must remain subject to question. When it comes to the south Wales outbreak, the possibility of one or more ‘modified’ cases spreading the virus is the only viable explanation for the otherwise inexplicable spread of smallpox from one area to another.
By 12 January it was very clear that smallpox had been getting into Britain from Pakistan. Procedures at London airport were tightened and all travellers from Pakistan were directed to the Port Health Authority for surveillance. From 16 January, medical officers at airports were instructed to examine all passengers arriving from Pakistan, whether they had valid international certificates or not. Unless there was clear evidence of successful revaccination, they were vaccinated in Britain and isolated until the vaccination proved successful. Anyone refusing vaccination was isolated for 14 clear days at the Denton Isolation Hospital. No doubt these tightened measures prevented further importations.
Dr Roberta Bivins has researched the impact of the 1962 smallpox outbreak on attitudes to immigration. She is Associate Professor at the University of Warwick’s Centre for the History of Medicine.
Her work was published in the journal Immigrants & Minorities in 2007 under the title “The People Have No More Love Left for the Commonwealth”: Media, Migration and Identity in the 1961–62 British Smallpox Outbreak.
Abstract: In the last days of 1961, with a Conservative government gingerly guiding highly controversial immigration restrictions through Britain’s Parliament, another unwanted immigrant to the UK suddenly made its presence felt: smallpox. Media reportage, in both Pakistan and Britain, immediately intertwined legislation and outbreak. This article explores the interplay between these two sets of events, and their mutual impact on public, political, and medical perceptions of and responses to post-colonial immigration and immigrants in Britain.
The full paper can be downloaded here.