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Article Last Updated:
Friday, October 18, 2002 - 7:49:09 AM MST

Bush might urge smallpox shots
President , some experts worry Iraq has arsenal with deadly virus
By Ian Hoffman - STAFF WRITER

 

Worries that Saddam Hussein will threaten a smallpox attack to deter an invasion force -- or launch a swan song assault with the virus -- are contributing to the Bush administration's growing willingness to consider voluntary smallpox shots for the public.

Bush's bioterrorism experts stress that they began looking at a new smallpox policy long before the campaign to unseat Saddam. They found they could cobble together more than 430 million doses, by dilution and donation, that make widespread vaccinations feasible.

But the latest rapid evolution of inoculation policy also comes amid growing concern in Washington that the world's last smallpox never really was safely locked away in U.S. and Russian freezers but probably exists in suspected biological arsenals in North Korea, Iraq and elsewhere.

When North Korean officials boasted two weeks ago of having "more powerful weapons" than nuclear bombs, it dredged up recollections of a confidential report by Russian scientists that they once briefly lost control of their tons of weaponized smallpox -- a virus that kills a third of its victims -- and that some may have gone to North Korea. Yet the bigger, more immediate worry is Iraq.

"Clearly, Iraq is of concern. They clearly have a bioweapons program," said Assistant Health Secretary Jerome Hauer, who is in charge of public health preparedness. "There's a sense that smallpox is one of the agentsthat Saddam has been able toget access to."

The case for Saddam's possession of a smallpox weapon is strictly circumstantial. It is a mosaic of the same hints by former Soviet weapons scientists about loose smallpox plus clues gathered by U.N. weapons inspectors in Iraq, glued together largely by speculation among several bioweapons experts.

To believe Iraq does not have smallpox, several say, means trusting Iraq to have obeyed a 1976 order by the World Health Organization to destroy its smallpox samples, eight years after Saddam's Baath Socialist Party came to power and at least two years after Iraq, by its own admission, started a bioweapons program.

"The problem with Iraq is not anthrax, it's not plague, it's not botox. It's smallpox," said smallpox expert Dr. Alan Zelicoff, a senior scientist at Sandia National Laboratories' Center for National Security and Arms Control in Albuquerque, N.M.

"I think it's very likely that's his ace in the hole. And if he were to be attacked, my personal fear is he would release smallpox by any of several methods and that would change everything. If that is what he does, he wins, there is no way out. Even if the United States had 300 million doses of vaccine, what about Europe and Asia? There's nothing there," he said.

But the United Nations' former chief bioweapons inspector in Iraq is certain that Saddam both has smallpox and has managed to weaponize it.

"My gut says they were beginning to work on smallpox and by 2002, they have it," said Richard Spertzel, a microbiologist who worked in the U.S. bioweapons program in the 1950s, then switched to biodefense. He is a veteran of more than three dozen trips to Iraq, from 1994 until inspectors pulled out in 1998.

Others are not so sure. They say the intelligence and evidence on Iraq's program is soft enough to allow analysts to read in their own biases.

"The pessimist looks at all these uncertainties and says we can't have any assurance whatsoever that there are not unapproved stockpiles of virus in the world. The fact is, we don't know," said Mark Wheelis, a UC-Davis microbiology professor who studies the history and control of bioweapons.

"There is not an imminent threat as far as we know. We don't know of anyone who has smallpox outside of the approved World Health Organization stocks, so it's an entirely theoretical possibility," he said.

The case for an Iraqi smallpox program begins with a 1972 outbreak that spread across the Fertile Crescent, from Iraq into Iran. Hospitals typically would have kept tissue samples containing the virus, experts say.

In the mid-1990s, U.N. weapons inspectors found a freeze-dryer labeled "smallpox" in a maintenance shed. It was not large enough to handle bomb quantities of smallpox, but the freeze-dryer was precisely what weapons scientists would use to preserve "seedstocks" of the virus and fill tubes for storage, Spertzel said.

In 1995, Saddam's son-in-law defected and gave unprecedented details about Iraq's bioweapons program. Perhaps anticipating his disclosures, Iraq admitted to making biological weapons such as anthrax and botulinum toxin in enormous quantities.

One top Iraqi scientist, English-trained virologist Hazem Ali, denied working with smallpox but admitted that his scientists were making camelpox into a biological weapon. Camelpox is a close kin of smallpox that is deadly for camels but almost never infects humans. Only one person is suspected to have died of camelpox in history. Because it is so like smallpox and so safe for humans, however, camelpox makes an excellent laboratory surrogate for bioweapons research.

Seven years after his interviews with Ali, Spertzel is still steaming over the inanity of the explanation.

"His account of why he was working with camelpox did not make any sense whatsoever," Spertzel said. "He's too good of a virologist. Most of us concluded that was most likely a cover in case we uncovered their smallpox program."

Inspectors also learned that Ali's researchers had been trying to acquire several egg incubators inside Iraq. Viruses such as smallpox grow only in living tissue, and eggs provide an easy growth medium that the United States used to grow bacteria for its biological program in the 1950s.

-byline-examining documents and performing tests, UNSCOM's inspectors also found that a select unit of Saddam's Special Republican Guard had been immunized right up until the Gulf War against both anthrax and smallpox.

"Since they weaponized anthrax," Spertzel said, "it made sense they might have weaponized smallpox."

Proving Iraq does or does not have smallpox will be exceedingly difficult, even with no-holds-barred inspections. A single vial of seed virus could easily be grown to strategic quantities in a small room or a mobile laboratory of the kind that Iraq is rumored to use. U.S. authorities find those reports credible, partly because the defunct U.S. bioweapons program once built mobile laboratories to demonstrate their feasibility.

So far, the Bush administration is headed for a policy of vaccinating core emergency health personnel and their families, then expanding the inoculations to roughly 510,000 members of the medical profession and first responders, such as police and firefighters. The White House is considering a policy option that would then offer smallpox vaccine to the general public on a voluntary basis, as early as 2004.

Medical professionals look askance at large-scale vaccinations without evidence that smallpox, a disease deemed eradicated in 1978, has returned. Because smallpox incubates for 12 to 15 days before a victim shows symptoms, it could be very difficult to have that evidence in time to vaccinate enough people to halt transmission of the disease, Zelicoff said.

"Most of the time, people say the risk of attack is low," he said. "I agree the chance of an attack between now and Christmas is low, but what about between now and the next 20 Christmases?"

My gut sense is, if you believe that over the lifetime of the efficacy of the vaccine, there is more than a few percent chance that smallpox will be reintroduced into the environment, then it makes sense to do pre-attack vaccination."

UC Davis' Wheelis said the administration faces a classic policy dilemma.

"You have a low probability, high impact event," he said. "If we inoculate everybody in the country and have hundreds of deaths and thousands of serious side effects, then we go into Iraq and find no smallpox then somebody's head is going to roll," Wheelis said. "And if we decide not to vaccinate the general population and go to war with Iraq and smallpox does break out, then heads are going to roll. It's a no-win situation."

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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.