Getting hold of the smallpox virus would be just about impossible for even the most determined bio-terrorist, but all the same, they can only obtain it for as long as it exists
Terror is such an intangible thing, and what more terrifying prospect is there than the innocent opening of the mail, only to discover it contains a lethal disease? Anthrax is not that deadly, and easily treated if caught in time. Nor is it contagious. These points do not make the fear recede, and what if the maniacs doing these awful things should decide to up the stakes?
Ali Mao Maalin,a cook in Somalia contracted smallpox in 1977, a deadly virus that had already devastated humanity from the dawn of history. Ali's case was different. The World Health Organization confidently claimed that this was the last known case of smallpox on planet Earth. Mankind could forever rid the world of this deadly virus?
September 11th, 2001 brought a naturally heightened fear of anything that could be used by terrorists against large populations, such as American cities. Smallpox, because of its deadly reputation and history, has become the prime focus of this fear. But is this fear justified?
The last known case of Smallpox in the US was in Texas in 1949. Smallpox gets into the body via the breath and when established causes skin eruptions - papules and pustules, which are lumps either solid or filled with liquid. An infected person is only contagious AFTER the skin eruptions have started.
The disease usually runs a course of two weeks, punctuated by high fever. Early symptoms often resemble the flu. Affected skin is usually left with multiple scars. Mortality from smallpox varies between 10 and 30 percent, depending on age. Death is usually the result of generalized toxemia or complications of skin sloughing, similar to a severe burn. Once infected, there is immunity to further infection.
There is no known cure for smallpox. Treatment usually tends toward reducing fever and controlling symptoms. Carbolic acid is applied to the skin, and confinement is mandatory to prevent infecting other people. This disease, officially one of the biggest killers in man’s history was 'eradicated' in 1980, worldwide, but it not made extinct, because laboratories kept stocks, for research.
Even though it is was officially set for total destruction at the end of 2002, when the last research projects 'ended', the fact is that this stuff is still around today, and when you consider that the US government has ordered 300 million vaccination packs – just in case – you can’t help wondering.
This disease always carried a social stigma with it, and was probably largely responsible for epidemics in the Roman Empire, which led to its decline. The disease probably got there from Egypt, where it was known 1000 years before Christ. Christopher Columbus, in 1492, then Herman Cortes in 1521 almost certainly introduced it to the Americas.
Three and a half million Aztecs are thought to have died, 90% of their population lost to the disease over the following three centuries. Smallpox decided the outcome of the Franco-Prussian war of 1870, devastating the French army, and in the 17th and 18th centuries, it killed off many heads of state, including Louis XV of France in 1774, and English monarchs William and Mary in 1650 and 1660. George Washington, Andrew Jackson and Abraham Lincoln all caught the disease but recovered from it.
The entire world, it seemed, was helpless to fight this malicious virus which had no respect for age or rank, until somebody noticed that people working with cattle seemed immune. In May of 1796, Edward Jenner, surgeon, naturalist, and member of the Royal Society in England, inoculated eight-year-old James Phipps with material from a ‘cowpox’ abcess on a milkmaid’s hand, using a thorn as a needle.
Later, he injected the boy with smallpox, but he remained well. This success marked a breakthrough, but smallpox inoculation wasn't new. Nearly 80 years before, English Lady Montague (1689-1762) had given her children a mild form of smallpox to demonstrate her faith in the Turkish method of inoculation, by inserting pus from disease victim into cuts on their arms.
Smallpox symptoms include high fever, chills, nausea, and a raised, red rash on the face, inside the eyes, and the whole body. Lady Montague herself had contracted smallpox at 26, only 18 months after losing her younger brother to the same disease. Her method of inoculation became popular in England after a controlled trial, known as the royal experiment, in which six convicts were inoculated with mild cases of small pox without dying.. Though variolation(as it came to be known) reduced the death rate, it was still fatal in 1-3 percent of cases.
Jenner carried on his work, and after publication of his results in 1798, vaccination began to get he better of the disease. Incidence of it dropped dramatically in the western world, but it wasn’t until the late 50’s that the World Health Organization began to push for a global campaign to vaccinate, and thus eradicate smallpox altogether. So successful was this that the last recorded case in Latin America was in 1971, in India in 1975, and Somalia in 1977.
In 1980, the WHO officially declared smallpox being globally eradicated. At that time, 76 labs around the world held stocks of the virus, but today, there are only two – officially – at the Center for Disease Control and Prevention, Atlanta, USA and the State Research Centre of Virology in Koltsovo, Russia, though illicit supplies may well be held elsewhere.
The startling fact is that, since 1971, there have been no immunization programmes carried out in the UK or USA, and labs that produced the vaccine have been allowed to fall into disuse, as nobody saw a need for them, when the disease had been all but wiped out. The US government could easily find that they have trouble getting the quantities of vaccine that they want.
Estimates put the worldwide availability of doses at far fewer than would realistically be needed, and since it would take some time to get production underway again, it isn’t hard to see that any country affected would have great difficulty in protecting its population. This was dramatically illustrated in February 1972, when a pilgrim returned from Mecca to his home in Yugoslavia, carrying the disease.
Because smallpox was so rare then, and the symptoms little recognized, it was four weeks before the proper diagnosis was made. The government launched a huge immunization programme on a population that was already vaccinated, but even so, in the nine weeks that it lasted, the outbreak claimed 35 lives, out of 175 people infected.
It is not all bad news though. Many older people will still bear scars of smallpox vaccinations from their youth, and at least 20% of those will still have a decent resistance to it. The problem with testing new vaccines is that you cannot use animal subjects, because the disease only affects humans. Some serious thinking needs to be done.
Getting hold of the smallpox virus would be just about impossible for even the most determined bio-terrorist, but all the same, they can only obtain it for as long as it exists. I’m with Dr Heyman, when he says that ‘Any possible benefits are outweighed by the potential danger, however minimal the chances of its escape from confinement’.
The smallpox virus, and indeed humanity itself, have been living on borrowed time for far too long. The disease needs to be consigned to history once and for all, before the unthinkable happens for real. That, and only that should be the clear message, and those in power need to listen. Hear, hear, doctor.