Richard Preston on Smallpox...

Cohen · Oct 10, 2002

Anyone hear this guy on the Today show? Pretty scary stuff. I was admit a high level of ignorance of smallpox.

I know that he's trying to sell his new book, 'The Demon in the Freezer', but smallpox sounds very bad, the Russians admit to losing 'control' of their stock, and as bad as the virus is, it can be made worse by engineering it's genes.

THE DEMON IN THE FREEZER
How smallpox, a disease of officially eradicated twenty years ago,
became the biggest bioterrorist threat we now face.

_______________

BY RICHARD PRESTON

THE smallpox virus first became entangled with the human species somewhere between three thousand and twelve thousand years ago -- possibly in Egypt at the time of the Pharaohs. Somewhere on earth at roughly that time, the virus jumped out of an unknown animal into its first human victim, and began to spread. Viruses are parasites that multiply inside the cells of their hosts, and they are the smallest life forms. Smallpox developed a deep affinity for human beings. It is thought to have killed more people than any other infectious disease, including the Black Death of the Middle Ages. It was declared eradicated from the human species in 1979, after a twelve-year effort by a team of doctors and health workers from the World Health Organization. Smallpox now exists only in laboratories.

Smallpox is explosively contagious, and it travels through the air. Virus particles in the mouth become airborne when the host talks. If you inhale a single particle of smallpox, you can come down with the disease. After you've been infected, there is a typical incubation period of ten days. During that time, you feel normal. Then the illness hits with a spike of fever, a backache, and vomiting, and a bit later tiny red spots appear all over the body. The spots turn into blisters, called pustules, and the pustules enlarge, filling with pressurized opalescent pus. The eruption of pustules is sometimes called the splitting of the dermis. The skin doesn't break, but splits horizontally, tearing away from its underlayers. The pustules become hard, bloated sacs the size of peas, encasing the body with pus, and the skin resembles a cobbled stone street.

The pain of the splitting is extraordinary. People lose the ability to speak, and their eyes can squeeze shut with pustules, but they remain alert. Death comes with a breathing arrest or a heart attack or shock or an immune-system storm, though exactly how smallpox kills a person is not known. There are many mysteries about the smallpox virus. Since the seventeenth century, doctors have understood that if the pustules merge into sheets across the body the victim will usually die: the virus has split the whole skin. If the victim survives, the pustules turn into scabs and fall off, leaving scars. This is known as ordinary smallpox.

Some people develop extreme smallpox, which is loosely called black pox. Doctors separate black pox into two forms -- flat smallpox and hemorrhagic smallpox. In a case of flat smallpox, the skin remains smooth and doesn't pustulate, but it darkens until it looks charred, and it can slip off the body in sheets. In hemorrhagic smallpox, black, unclotted blood oozes or runs from the mouth and other body orifices. Black pox is close to a hundred per cent fatal. If any sign of it appears in the body, the victim will almost certainly die. In the bloody cases, the virus destroys the linings of the throat, the stomach, the intestines, the rectum, and the vagina, and these membranes disintegrate. Fatal smallpox can destroy the body's entire skin -- both the exterior skin and the interior skin that lines the passages of the body.

Smallpox virus's scientific name is variola. It means "spotted" in Latin, and it was given to the disease by a medieval bishop. The virus, as a life form, comes in two subspecies: Variola minor and Variola major. Minor is a weak mutant, and was first described in 1863 by doctors in Jamaica. People usually survive it. Classic major kills one out of three people if they haven't been vaccinated or if they've lost their immunity. The death rate with major can go higher -- how much higher no one knows. Variola major killed half of its victims in an outbreak in Canada in 1924, and presumably many of them developed black pox. Smallpox is less contagious than measles but more contagious than mumps. It tends to go around until it has infected nearly everyone.

Most people today have no immunity to smallpox. The vaccine begins to wear off in many people after ten years. Mass vaccination for smallpox came to a worldwide halt around twenty-five years ago. There is now very little smallpox vaccine on hand in the United States or anywhere else in the world. The World Health Organization once had ten million doses of the vaccine in storage in Geneva, Switzerland, but in 1990 an advisory committee recommended that most of it be destroyed, feeling that smallpox was longer a threat. Nine and a half million doses are assumed to have been cooked in an oven, leaving the W.H.O. with a total supply of half a million doses -- one dose of smallpox vaccine for every twelve thousand people on earth. A recent survey by the W.H.O. revealed that there is only one factory in the world that has recently made even a small quantity of the vaccine, and there may be no factory capable of making sizable amounts. The vaccine was discovered in the age of Thomas Jefferson, and making a lot of it would seem simple, but so far the United States government has been unable to get any made at all. Variola virus is now classified as a Biosafety Level 4 hot agent -- the most dangerous kind of virus -- because it is lethal, airborne, and highly contagious, and is now exotic to the human species, and there is not enough vaccine to stop an outbreak. Experts feel that the appearance of a single case of smallpox anywhere on earth would be a global medical emergency.

At the present time, smallpox lives officially in only two repositories on the planet. One repository is in the United States, in a freezer at the headquarters of the federal Centers for Disease Control and Prevention, in Atlanta -- the C.D.C. The other official smallpox repository is in a freezer at a Russian virology institute called Vector, also known as the State Research Institute of Virology and Biotechnology, which is situated outside the city of Novosibirsk, in Siberia. Vector is a huge, financially troubled former virus-weapons-development facility -- a kind of decayed Los Alamos of viruses -- which is trying to convert to peaceful enterprises.

There is a growing suspicion among experts that the smallpox virus may also live unofficially in clandestine biowarfare laboratories in a number of countries around the world, including labs on military bases in Russia that are closed to outside observers. The Central Intelligence Agency has become deeply alarmed about smallpox. Since 1995, a number of leading American biologists and public-health doctors have been given classified national-security briefings on smallpox. They have been shown classified evidence that as recently as 1992 Russia had the apparent capability of launching strategic-weapons-grade smallpox in special biological warheads on giant SS-18 intercontinental missiles that were targeted on the major cities of the United States. In the summer of last year, North Korea fired a ballistic missile over Japan in a test, and the missile fell into the sea. Some knowledgeable observers thought that the missile could have been designed to carry a biologic warhead. If it had carried smallpox and landed in Japan, it could have devastated Japan's population: Japan has almost no smallpox vaccine on hand and its government seems to have no ability to deal with a biological attack. The United States government keeps a list of nations and groups that it suspects either have clandestine stocks of smallpox or seem to be trying to buy or steal the virus. The list is classified, but it is said to include Russia, China, India, Pakistan, Israel, North Korea, Iraq, Iran, Cuba, and Serbia. The list may also include the terrorist organization of Osama bin Laden and, possibly, the Aum Shinrikyo sect of Japan -- a quasi-religious group that had Ph.D. biologists as members and a belief that an apocalyptic war will bring them worldwide power. Aum members released nerve gas in the Tokyo subway in 1995, and, as the year 2000 approaches, the group is still active in Japan and in Russia. In any case, the idea that smallpox lives in only two freezers was never anything more than a comfortable fiction. No one knows exactly who has smallpox today, or where they keep the virus, or what they intend to do with it.

THE man who is most widely credited with the eradication of smallpox from the human species is a doctor named Donald Ainslie Henderson. Everyone calls him D. A. Henderson. He was the director of the World Health Organization's Smallpox Eradication Unit from its inception, in 1966, to 1977, just before the last case occurred. "I'm one of many in the eradication," Henderson said to me once. "There's Frank Fenner, there's Isao Arita, Bill Foege, Nicole Grasset, Zdenek Jezek, Jock Copland, John Wickett -- I could come up with fifty names. Let alone the tens of thousands who worked in the infected countries." Nevertheless, Henderson ran it. Smallpox killed at least three hundred million people in the twentieth century. During that time, humanity was largely immune to smallpox, which is not the case today. When D. A. Henderson arrived on the scene in 1966, two million people a year were dying of smallpox. In the years since the eradication effort began, Henderson and his team have effectively saved more than fifty million lives. This could be the most impressive achievement in the history of medicine. Henderson and his colleagues, however, have never received the Nobel Prize for their work.

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Loger excerpt: http://www.condenet.com/mags/newyorker/asme/categories/artwork/pdf/07_12_99_Preston_Smallpox.pdf

The only 'good' I can thinks of, is if terrorists release this plague on humanity, all of humanity will consider the terrorists to be a plague needing eradication also.

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Richard Preston on Smallpox...

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