Alasdair Macintosh Geddes

Alasdair Macintosh Geddes (born May 1934) is Emeritus Professor of Infection at the University of Birmingham Medical School.

Alasdair Geddes was born in Fortrose, near Inverness, Scotland, in May 1934, to Angus and Isabella Geddes.

His early education was at the Fortrose Academy, the local school.

In 1957 he graduated in medicine from the University of Edinburgh, where his interest in antibiotics later originated.

He completed his early medical posts at the Royal Infirmary in Edinburgh and then in Perth, following which he spent two years completing National Service in the Royal Army Medical Corps, and rose to the rank of captain.

Subsequently, he gained experience in infectious diseases and general medicine first at Edinburgh and then as a medical registrar at Aberdeen and began research on antibiotics, with publications in the British Medical Journal and The Lancet.

After a visit to the United States, he returned to Britain and took up a post as one of two consultants in infectious diseases at the East Birmingham (now Heartlands) Hospital in May 1967, at the same time as the local smallpox hospital, Witton Isolation Hospital, was deemed unnecessary and therefore demolished by fire.

Geddes, at the time, settled in Solihull.

He later recounted that when "I told my friends in Edinburgh that I was going to work in infectious diseases, they thought I was a bit stupid. They said you’re mad, infectious diseases are disappearing, we have antibiotics and vaccines, why don't you do something more interesting!"

She was found to be the index case of the outbreak and became the world's last reported fatality due to the disease, five years after he had gained experience on the frontline of the WHO's smallpox eradication programme in Bangladesh in 1973.

His early research included work on drug discovery and antibiotics, and the definitions and management of bacterial meningitis and pneumococcal disease.

In 1973, the Department of Health assigned Geddes as a visiting fellow with the World Health Organization (WHO) smallpox eradication effort in Bangladesh, where he spent seven weeks under the leadership of Nick Ward, travelling through villages and gaining frontline experience in smallpox vaccination.

He later recalled "I saw many cases of smallpox."

In October 1973, as a consequence of the oil crisis, he was called to return to England.

In the same year, he was designated Birmingham's smallpox consultant.

The following year, in an article in the British Medical Journal, he described signs and symptoms of smallpox and wrote that

"the possibility of smallpox should be considered in every patient with unexplained fever who has recently visited the five countries of the world where this disease is still endemic-namely, India, Pakistan, Bangladesh, Nepal and Ethiopia. The likelihood of smallpox re-appearing in countries other than these five should always be remembered."

In 1975, he became Chairman of the first editorial board of the Journal of Antimicrobial Chemotherapy.

In the same year he was co-editor of the best seller book titled Control of Hospital Infection, later known as Ayliffe's Control of Healthcare-Associated Infection: A Practical Handbook.

Following the September 11 attacks, Geddes became an adviser on bioterrorism for the UK's Department of Health, his chief role being in the national smallpox plan and in biodefence training.

In 1975, Geddes became Chairman of the first editorial board of the Journal of Antimicrobial Chemotherapy.

In the same year, he co-edited the best-seller Control of Hospital Infection, later known as Ayliffe's Control of Healthcare-Associated Infection: A Practical Handbook.

In 1976 L. P. Garrod stated in his review of the book that it made much "of how to cope with a suspected case of smallpox. As the WHO claims that this disease is on the verge of extinction, even in Bangladesh, may future editions safely omit this?"

Throughout his career, Geddes authored almost 200 scientific publications covering a wide range of infectious disease topics.

His early research included work on drug discovery and studies on the use of cephaloridine.

Pertaining to trials of what became known as Augmentin, a combination of amoxicillin and clavulanic acid, he later recalled that “getting the right dose of amoxicillin proved important for efficacy and getting the right dose of clavulanic acid was key to tolerability”.

In 1977, he published on the efficacies of cephamycins, including their parenteral administration, dosages and penetrations through normal and inflamed blood–brain barrier.

He made comparisons of clindamycin with lincomycin against H. influenzae in vitro, and later demonstrated that clindamycin was active against Coxiella burnetti, the cause of Q fever.

Other research has included studies on the antiviral aciclovir.

With the WHO about to announce the eradication of smallpox, it was widely thought that the last ever case of smallpox had occurred the previous year, in 1977 in Somalia.

In 1978, as the World Health Organization (WHO) was shortly to announce that the world's last case of smallpox had occurred a year earlier in Somalia, Geddes diagnosed a British woman with the disease in Birmingham, England.

In August 1978, five years after returning from Bangladesh, Geddes diagnosed smallpox in Janet Parker, a medical photographer working in the East Wing of the medical school in Birmingham.

She had been admitted to Ward 32 at East Birmingham Hospital after being diagnosed with at first chickenpox and then a drug reaction.

Several physicians saw her before Geddes was called to the hospital for an opinion.

Aware that Parker also worked in a room above the regional smallpox laboratory, he in turn called upon virologist Henry Bedson and both confirmed their suspicions that same day when they examined fluid from Parker's blisters and saw brick-shaped particles under the electron microscope, compatible with smallpox.

Until this time, all the call-outs he received for suspected smallpox cases were false-alarms such as erythema multiforme and Stevens–Johnson syndrome.

Parker later died on 11 September 1978 and became the last reported fatality due to the disease.

Later, in an interview in 2004, when asked if Parker's case had any link with the 1966 smallpox outbreak in Birmingham, he replied "it is probably significant that the initial case in the variola minor outbreak in the West Midlands in 1966 was, like Janet Parker, a photographer in the Birmingham Medical School, where research was being carried out on smallpox viruses."

In 2015, he retired from his position as Editor-in-Chief of the International Journal of Antimicrobial Agents, having served the journal for the previous 10 years.

His recollections of smallpox in Birmingham inspired Mark Pallen to write The Last Days of Smallpox: Tragedy in Birmingham, published in 2018.