Over the course of a few weeks, 19 people were infected and six died – including a doctor, four nurses, and a hospital laundry maid.
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It was the final resurgence in the west of Scotland of an epidemic that once killed a third of its victims and left many survivors disfigured, blind, or infertile.
More than 70 years on, the story of that outbreak is being told in a new exhibition at Glasgow Royal Infirmary organised by the Friends of GRI, a charity set up in 2020 by doctors Kate Stevens and Hilary Wilson to celebrate the hospital’s heritage through the creation of an on-site museum.
The smallpox exhibition is the result of the chance discovery of a box of photographs dating back to the city’s last major eruption of the disease between 1900 and 1902, discovered at the Brownlee Centre in Gartnavel hospital by nurse Gillian Mulholland.
The harrowing images, many of which are now on display at the Friends of GRI museum, show patients – including young children – covered in the pus-filled blisters characteristic of infection with variola, the virus behind smallpox.
A total of 2,255 people were infected and 238 died during the outbreak which saw patients treated at the 150-bed Belvidere Smallpox Hospital in the east end of the city.
A male patient with smallpox during the 1900-1902 outbreak in Glasgow (Image: Supplied)Ms Mulholland passed the photographs onto Dr Peter Davies, a infectious diseases specialist at Gartnavel with an interest in medical history.
In turn, he contacted Dr Stevens and Dr Wilson, asking whether the material could be of interest to the museum.
Dr Stevens, a consultant nephrologist, said: “Initially we thought we could do something very small, like maybe having a talk one evening and show some of the photos.
“But as we started looking through everything, it started growing arms and legs – in a good way.
“There were so many links with things we have in the museum and people associated with the Royal Infirmary, and also the parallels with the Covid pandemic.”
Their research led them to investigate the region’s last smallpox outbreak, which began in March 28 1950 when an Indian seaman, Mussa Ali – who was visiting the city – was admitted to Glasgow’s Knightswood hospital with symptoms of what was initially suspected to be pneumonia and chickenpox.
At the time, smallpox was still endemic in his homeland.
The alarm was only raised when Dr Janet Fleming, a doctor who had treated Mr Ali, fell ill and was diagnosed with smallpox – leading to the sailor being identified as the index case.
He was subsequently isolated at the Robroyston fever hospital.
As with Covid, which claimed the lives of hundreds of frontline healthcare workers, Dr Fleming was the first casualty, followed by four of the hospital’s nurses and the laundry maid.
All six had had direct contact with Mr Ali, but none had been vaccinated against smallpox.
The rapid public health response was spearheaded by Dr Stuart Laidlaw, who had been appointed in 1945 as the Medical Officer of Health for Glasgow.
Dr Stuart Laidlaw died in 1955, five years after leading Glasgow’s smallpox response (Image: Supplied) He had began his career in 1926 as a house surgeon at Glasgow Royal Infirmary and would tragically die from a heart attack in 1955, aged just 53, days after being awarded a PhD for pioneering research into the spread of tuberculosis in the city’s overcrowded lodging houses.
But in the Spring of 1950, Dr Laidlaw was credited with swiftly containing the smallpox outbreak.
Displays at the GRI museum tell how “mass contact tracing and vaccination campaigns” were launched, resulting in an estimated 250,000 people being immunised in the space of 12 days via seven emergency vaccination centres which operated 12 hours a day.
Close contacts of infected individuals were “taken to local hospitals for checks and their houses and clothes were disinfected”, while dozens of known and suspected cases – including an 18-year-old girl from Hamilton – were isolated in Robroyston.
From Oban to Dumfries, hospitals closed to visitors.
Newsreel footage from the time, leased to the museum by British Pathé, shows crowds queueing outside vaccination hubs and children and infants being inoculated.
An ‘Jenner vaccinator’, circa 1900, bequeathed to the museum (Image: Colin Mearns) Newspaper cuttings also reveal fascinating parallels with the Covid experience, as articles warn that “smallpox has not stopped Glasgow Easter holiday crowds”.
It notes that Dr Laidlaw has advised anyone going away for Easter to be vaccinated first, and for close contacts “not to leave the city at all”.
Another highlights the implications for the Scotland-England international at Hampden, due on April 15, adding that Dr Laidlaw “suggested to the English and Scottish FA’s that it would be safer for both teams to be vaccinated”.
Thanks the the rapid response, the outbreak was declared officially over on April 17.
“We thought it was an important story to tell,” said Dr Wilson, a consultant rheumatologist who first came up with the idea for a GRI museum in 2017.
“There were parallels in the whole vaccination programme in how it was similar to Covid – people queueing for ages, fear of the vaccine running out, health professionals being infected, and people not being able to visit loved ones in hospital.”
Dr Stevens added: “As soon as they realised Mussa Ali had smallpox, the infection control measures were fantastic – isolating people and shipping everyone off to Robroyston, which was like a sanatorium, then the vaccination rollouts.
“The public health measures were extremely impressive, especially when you think that there was no social media, no internet.”
The exhibition is packed with insights and artefacts charting the horror of smallpox through the ages, and how the science which finally eradicated it also unleashed the world’s first anti-vax movement.
A patient with smallpox during Glasgow’s 1900-1902 outbreak (Image: Supplied) 
Newspaper cuttings record the public health response during the 1950 smallpox outbreak (Image: HelenMcArdle) No disease has had a greater impact on the course of human history. For thousands of years, it was a “constant terror”.
When the Europeans invaded the Americas they brought smallpox with them, wiping out 80% of the Native Americans it infected.
Colonisers saw this “divine proof of the favour for European settlers by God”.
During the 18th and 19th centuries, Glasgow was plagued by “frequent and devastating” outbreaks. Between 1783 and 1800, smallpox was responsible for 20% of all deaths in the city.
Glasgow Royal Infirmary’s most famous doctor, Joseph Lister – the father of antisepsis – survived a mild case of smallpox while he was still a medical student in 1848, but the stress of his studies and the death of his brother to the disease plunged him into a nervous breakdown which almost ended his career.
On display are stamps commemorating the discovery of the smallpox vaccine in 1796 by Edward Jenner, as well as a Jenner vaccinator – a pioneering bifurcated needle designed for mass vaccination – which was bequeathed to the museum by the late renal physician, Marjorie Allison.
Jenner had noticed that milkmaids exposed to cowpox – a related disease in animals – did not get smallpox.
Suspecting it induced immunity, he tested his theory by cutting his gardener’s nine-year-old son so that he could be infected first with cowpox, and later with smallpox.
Dr Hilary Wilson and Dr Kate Stevens with an electron micrograph image of the vaccinia virus isolated from a patient post-vaccination against smallpox. The virus is 250 times smaller than a human hair (Image: Colin Mearns) The experiment succeeded, but the enforcement of mandatory vaccination in the UK – initially in England in the 1850s, and in Scotland in 1864 – provoked a backlash from religious groups who viewed vaccines as “disrupting God’s natural law of who suffers and who dies”, and vegetarians who objected to the use of animal material.
By the 1890s “vegetarian restaurants and anti-vaccination activities” – for the two went hand-in-hand – “were firmly established in Dundee, Edinburgh, and Glasgow”.
Agnes Hunter, who headed the Scottish Health Reformer and Advocate of Rational Living magazine – a pamphlet first published in 1903 which advocated for a vegetarian lifestyle – attacked vaccination as “a legal fraud, a medical delusion, an illogical absurdity, and an abominable crime against the nation”.
In 1907, Scots were granted the right to opt out of vaccination.
Yet it is thanks to Jenner’s breakthrough that smallpox remains the only human disease ever to have been eradicated.
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Medical historian, Dr Lindsey Fitzharris – pictured with her husband Adrian Teal, who illustrated ‘Plague Busters’ – gave a talk at the GRI museum on October 26, ahead of the launch of its new smallpox exhibition (Image: Fabrizio Fella)
Dr Lindsey Fitzharris, whose children’s book Plague Busters is on sale in the museum, said the triumph “cannot be overstated”.
She added: “Thomas Jefferson, the third president of the United States, told [Jenner] in a letter that ‘mankind can never forget that you have lived’.
“His lifelong dream of ridding the world of smallpox was fulfilled in May 1980, when the World Health Organization announced that the virus had at long last been conquered.
“It was an extraordinary moment in the history of medicine.”
Today, the only remaining samples of smallpox anywhere in the world are confined to research centres in Atlanta, USA, and Russia.
Let’s hope it stays that way.
As the museum’s final stand ominously observes: “Today, with global instability, until the final laboratory stocks have been destroyed, there is still a chance that smallpox could return.”
The Friends of GRI museum is open Wednesdays 1-3pm; 11am-3pm Tuesdays, Thursdays, and Fridays; and 12-2pm on Saturdays. Entry is free
