Typhoid terror: Isolation meant friends and families could only talk to patients through closed hospital windows.
Damaged cans of corned beef were held to blame.
Having completed his examination of what went wrong in Lanarkshire, where the
E coli outbreak claimed 21 lives in 1996, the eminent consultant microbiologist Professor Hugh Pennington is about to embark on a study of another outbreak which killed no one but caused considerable long-term damage.
Professor Pennington has been awarded a grant from the Wellcome Trust to research and then write a detailed historical study of the typhoid outbreak in Aberdeen in 1964, to which the medical officer of health, Ian MacQueen, reacted with extraordinarily inappropriate measures.
For several weeks, the people of Aberdeen were treated as if they were victims of a plague. Schools, cinemas and meeting halls were closed; peak- time nightly television bulletins issued graphic warnings of the dangers; and plans were even in hand to wash the main streets of the granite city with disinfectant.
Aberdonians were decidedly unwelcome in other parts of the country. The local store of national supermarket chain William Low closed its doors, never to re-open. Dr MacQueen's actions even damaged the beef industry in four countries, three of them totally unconnected with the problems in Aberdeen.
Professor Pennington intends to carry on from the report of Sir David Milne, a senior civil servant who chaired the official inquiry into the event. As he points out, the Milne report was a contemporary account which did not include details that are available now, such as what civil servants were doing behind the scenes and what the international repercussions were.
'We also want to interview people who were involved, including patients and their relatives, and to look at how the media of the day handled the outbreak - it was probably the first big outbreak where television had such a prominent role.'
Dr MacQueen died a few years ago. 'So we can say things about how he handled the situation which we might not have wanted to say while he was still alive,' Professor Pennington adds.
The drama began when Dr MacQueen was notified on 20 May 1964 that two university students at the City Hospital had typhoid fever. An assistant was sent immediately to try to establish the source of the disease. He found that 10 more people suspected of having typhoid had been admitted.
Eleven of the 12 patients had a common history of eating canned meat bought from an Aberdeen supermarket. As more patients were admitted, the history was repeated. Most said they had eaten corned beef.
Nine days after the first notification, 65 patients had been admitted and only 12 had no clear history of having eaten meat from the supermarket. Dr MacQueen was convinced that the supermarket's stock of 6lb cans of corned beef, canned in Argentina, was responsible for the infection. It was subsequently discovered that the canning plant had been using untreated river water, containing raw sewage, to cool the cans.
Cattle raisers in Paraguay, Kenya and Tanganyika, completely unconnected with the outbreak, suffered a massive reduction in demand for their animals because of the huge drop in the consumption of corned beef that resulted from the Aberdeen outbreak.
Over 500 cases of typhoid fever were finally confirmed in Aberdeen, but there were no directly attributable deaths. During the course of the epidemic, more than 4,000 people who had in some way had contact with typhoid patients were kept under close surveillance by the public health department.
That was not enough for Dr MacQueen. He estimated that up to a further 48,000 people could have been affected, so he began a massive health education campaign using all possible media, with nightly television broadcasts warning of the dangers of typhoid and how to avoid catching it.
Dr MacQueen later defended his actions by saying that he believed the greatest danger lay in the possible development of an unknown number of contacts and carriers of the disease. The Milne report said that the chance of the original patients transmitting the disease before admission to hospital was 'remote'.
'The result was to confuse the risk of spreading typhoid with that of a highly contagious disease such as smallpox. The outbreak and the possible dangers were exaggerated, and the incident received publicity out of all proportion to its
Professor Pennington says that Aberdeen 'became a beleaguered city, as if its citizens were suffering from the plague. Letters were even sent to those outside the city who were marking examination papers from Aberdeen schoolchildren, warning them to wear white cotton gloves when holding the papers in case the disease was spread by perspiration.'
The Milne report says that once the national media started to cover the story, the impact was felt not just in Aberdeen, but throughout Scotland and further afield. It 'was given the status of a national disaster'.
Dr MacQueen was 'well meaning but silly', says Professor Pennington. 'A great deal of nonsense was stimulated by his over-the-top publicity.
'He didn't read his textbooks. He acted independently without informing his colleagues, and his word was law. He had formidable power.'
But his actions had little impact on the course of the disease, Professor Pennington points out. 'The meat had been consumed. The infection was self-limiting. He probably stopped about 20 cases out of 500.'