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'Scourge': Killing the Disease - The Once and Future Threat of Smallpox
The New York Times ^ | 10/27/01 | Ed Regis

Posted on 10/27/2001 3:20:55 PM PDT by ppaul

ALTHOUGH it marked an event of far greater importance to human well-being and happiness than the moon landing, the date May 8, 1980, was largely unheralded at the time and is now mostly forgotten. That was when officers of the World Health Organization certified that smallpox had been eradicated from planet Earth. It was the first, and so far the only, infectious disease to have been eliminated from nature by human effort.

Before its eradication, smallpox had been one of the world's greatest killers: it had ''claimed hundreds of millions of lives,'' Jonathan B. Tucker writes in ''Scourge,'' ''far more than plague -- the dreaded Black Death of the Middle Ages -- and all the wars of the 20th century combined.'' At its worst, the disease had a 30 percent mortality rate, but it produced horrific effects even among those who survived, most of whom were scarred for life with pockmarks and some of whom were rendered permanently blind.

The ailment extended back through recorded history to the ancient Egyptians, and its disfiguring effects are clearly visible today on the mummified face and hands of the Pharaoh Ramses V, who died in 1157 B.C. and whose corpse is in the Cairo Museum. Until 1796, when Edward Jenner developed a smallpox vaccine, successful attempts to combat the illness were limited to quarantine and inoculation, a somewhat risky practice. In inoculation, also called variolation, people were deliberately infected with smallpox pus through skin incisions, in hopes they would be immune thereafter. Variolation was highly effective, causing a milder form of the disease with only a 1 percent mortality rate, but it still killed 1 out of 100 recipients, who also ran the risk of acquiring other diseases carried by the donor, such as syphilis. In vaccination, by contrast, people were infected with cowpox, similar enough to smallpox to confer immunity to it but without any chance of causing smallpox itself.

Tucker, a biological and chemical weapons researcher at the Monterey Institute of International Studies, has produced a concise, suspenseful and scientifically accurate narrative that ranges from the obscure beginnings of smallpox as an affliction of wild rodents in Africa to its eradication to its possible future use as a biological weapon. Public health officials in the grip of ''eradication fever,'' he tells us, were fearsome to behold, not above using force when necessary. Mohan Singh, a religious leader in India, opposed vaccination as an intolerable interference with God's will (as had European prelates a century earlier) and refused to be vaccinated -- to no avail. In the dead of night a government vaccinator burst through the door of Singh's house and pounced on the recalcitrant cleric. ''Singh's wife, Lakshmi, awoke screaming and scrambled to hide herself while Mohan leaped out of bed, grabbed an ax and chased the intruder into the small courtyard. There, a waiting team of doctors and policemen quickly overpowered him, pinning him to the ground while a vaccinator jabbed a bifurcated needle repeatedly into his arm.'' The other family members, biting at their captors, were finally subdued and held down long enough to be given their medicine.

Although the disease has been eradicated for more than two decades, its cause, the variola virus, still exists, raising the possibility that smallpox might eventually reappear in humans (there are no known animal hosts of smallpox). Officially there are only two stocks of the virus, one at the Centers for Disease Control and Prevention in Atlanta, the other at a Russian laboratory in Siberia. Unfortunately, there are several other potential sources. Corpses of smallpox victims preserved in permafrost or dry crypts might hold intact virus particles. Lost, forgotten or intentionally withheld samples left over from the global eradication campaign might be waiting in freezers somewhere in the world, unrecognized but still viable. More speculatively, there is the prospect of constructing the virus afresh from the DNA sequence data that have been available in the open literature since 1993.

Those sources of variola virus pale to insignificance in light of the fact that a number of countries might be sequestering undeclared smallpox stocks from the abandoned Russian biological warfare program, and might even now be developing them for use as weapons. Tucker describes how the Soviet Union -- despite having signed the 1972 Biological Weapons Convention, which banned the development, production and stockpiling of germ weapons -- manufactured 20 metric tons of military-grade smallpox, salting it away at an army facility 45 miles northeast of Moscow. ''In wartime, the smallpox agent would have been loaded into various types of strategic delivery systems, including aerial bombs delivered by long-range bombers and warheads for intercontinental ballistic missiles targeted on U.S. cities,'' Tucker says. Filled with 20 tons of variola, those bombs and warheads would have been able to cover approximately 4,000 square miles, potentially exposing millions of people to the virus, perhaps destroying the United States ''as a functioning society.''

Supposedly, the Soviets destroyed their variola supplies in the late 80's, but it is possible that some Russian bioweapons scientists withheld small samples of those stocks and then sold them to rogue states seeking to develop their own germ weapons. Tucker emphasizes that there is no hard evidence that any such sales occurred, or that there are illicit stocks of variola virus anywhere. He therefore assesses the threat of a bioterrorist attack using smallpox as slight: ''Given the significant technical challenges involved in acquiring and delivering variola virus, the risk of a deliberate reintroduction of smallpox remains quite low, but it is not zero -- particularly if terrorists received assistance from a former Soviet scientist who had done military work on the virus.''

Because smallpox vaccinations offer immunity for only seven to ten years, and because routine vaccinations stopped in 1980, the world is in effect a virgin population, and highly susceptible to a reintroduction of the virus. There are now some 7.5 million doses of smallpox vaccine stored in the United States. In the aftermath of the Sept. 11 terrorist attacks, the federal government announced plans to have 40 million additional doses stockpiled by the summer of 2002, so that this disease, should it ever reappear, can be eradicated a second time.

SCOURGE: The Once and Future Threat of Smallpox.
By Jonathan B. Tucker.
291 pp. New York: Atlantic Monthly Press.

Ed Regis is the author of ''The Biology of Doom: The History of America's Secret Germ Warfare Project.''


TOPICS: Culture/Society; Extended News; News/Current Events
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Comment #21 Removed by Moderator

To: Theresa
Yes, and don't you think at the first record of anyone with a disease like smallpox that was declared non existent, the vaccine would be standard procedure for everyone immediately. They shouldn't be able to kill anymore than the WTC, if we respond properly, although 1 is too many. RIP for those with anthrax.
22 posted on 10/27/2001 8:19:57 PM PDT by CoolH2OH
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To: CoolH2OH
"Yes, and don't you think at the first record of anyone with a disease like smallpox that was declared non existent, the vaccine would be standard procedure for everyone immediately. "

Right. It could kill some people. But I think we could get it under control very quickly. It would not be like in the Dark Ages when plague wiped out 1/3 of the population. The whole world would go into a panic if they tried small pox. There would such a fear that it would spread accross the globe even to the Middle East. I think the terrorists would worry about blow back on that one. I really am not so worried about smallpox.

23 posted on 10/27/2001 8:52:47 PM PDT by Theresa
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To: hogwaller
we have only just begun to fight

How did you come by the link?

24 posted on 10/27/2001 8:54:54 PM PDT by Ernest_at_the_Beach
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Comment #25 Removed by Moderator

To: ppaul
All of this recent crap with Bush cozying up to Putin makes me want to vomit right in GWBs face !!! Does he not understand that the Russians . . . just like the Arabs, et al., want us all to be DEAD . . . DEAD . . . DEAD ?!?!?!
26 posted on 10/27/2001 9:24:07 PM PDT by GeekDejure
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To: ppaul
All of this recent crap with Bush cozying up to Putin makes me want to vomit right in GWBs face !!! Does he not understand that the Russians . . . just like the Arabs, et al., want us all to be DEAD . . . DEAD . . . DEAD ?!?!?!
27 posted on 10/27/2001 9:25:12 PM PDT by GeekDejure
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Comment #28 Removed by Moderator

Comment #29 Removed by Moderator

Comment #30 Removed by Moderator

To: GeekDejure
Does he not understand that the Russians . . . just
like the Arabs, et al., want us all to be DEAD . . . DEAD . . . DEAD ?!?!?!

He may not ,but I do

31 posted on 10/27/2001 9:31:10 PM PDT by apackof2
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To: Interesting Times
Aggg! That second article was depressing. Here's a quote that shows that the expert I saw on TV was wrong.

"For years, the scientific community generally thought that biological weapons weren't effective as weapons, especially because it was thought that they're difficult to disperse in the air. This view persists, and one reason is that biologists know little or nothing about aerosol-particle technology. The silicon-chip industry is full of machines that can spread particles in the air. To learn more, I called a leading epidemiologist and bioterrorism expert, Michael Osterholm, who has been poking around companies and labs where these devices are invented. "I have a device the size of a credit card sitting on my desk," he said. "It makes an invisible mist of particles in the one-to-five-micron size range—that size hangs in the air for hours, and gets into the lungs. You can run it on a camcorder battery. If you load it with two tablespoons of infectious fluid, it could fill a whole airport terminal with particles." Osterholm speculated that the device could create thousands of smallpox cases in the first wave. "

Well ignorance was bliss.

32 posted on 10/27/2001 9:50:07 PM PDT by Theresa
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To: Theresa
About an attending physician being able to recognize smallpox -- not necessarily. It hasn't been around for quite awhile. It could have symptoms similar to other types of illnesses. It may not be easily detectable.

I just asked my husband, who's in family practice, if he'd pick up on it immediately -- he said probably not off the top of his head. That it is extremely uncommon even with folks on alert.

Don't forget -- we've had people die of Anthrax after seeing their health professional.

A terrorist doesn't have to necessarily catch smallpox to pass it along -- it could be passed via other means.

33 posted on 10/27/2001 10:39:00 PM PDT by alethia
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To: alethia
Yeah I think you are right.
34 posted on 10/27/2001 11:36:30 PM PDT by Theresa
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To: hogwaller
I've seen it. Black pox is the most severe form of small pox. The pustules are black due to blood. As black pox is is hemoragic, like ebola.
35 posted on 10/28/2001 12:27:22 AM PDT by tallhappy
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To: Theresa
You are completely wrong in what you are saying.

Do not say things that are so inaccurate.

Small pox can be spread by people who don't yet know they have it and even by people who are infected but do not come down with the disease.

36 posted on 10/28/2001 12:28:52 AM PDT by tallhappy
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To: tallhappy
"You are completely wrong in what you are saying. "

I was just repeating what an expert said on TV. Now I know that was wrong. See my post where I said, "Ignorance was bliss."

37 posted on 10/28/2001 12:45:38 AM PDT by Theresa
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To: tallhappy
"Small pox can be spread by people who don't yet know they have it and even by people who are infected but do not come down with the disease."

Right. I was misinformed.

38 posted on 10/28/2001 12:46:43 AM PDT by Theresa
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To: Theresa
See my post where I said, "Ignorance was bliss."

I didn't see that post.

I am glad to hear you say that.

Some people spread misnfo either purposely or out of an unwillingness to not believe what they have set in their minds.

In times of peace that sort of thing is frustrating but not harmful.

39 posted on 10/28/2001 12:48:50 AM PDT by tallhappy
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To: hogwaller
Horrible. A vision of hell.
40 posted on 10/28/2001 1:33:47 AM PDT by ppaul
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