Smallpox Threat Small but Worrisome

http://www.newsmax.com/archives/articles/2001/9/28/234101.shtml

Smallpox Threat Small but Worrisome

NewsMax.com Wires
Friday, Sept. 28, 2001

WASHINGTON -- The U.S. population is vulnerable to a terrorist attack using smallpox as a weapon, but the risk of it actually happening is reduced because of the difficulty in obtaining a sample of the virus.

The vulnerability stems from the eradication of the virus itself - the last case was found in Somalia in 1977 - with routine vaccinations ending in the United States 1972. Both the vaccinated and the unvaccinated are at risk, experts told United Press International, because the vaccination required periodic updates that did not occur.

The country also is at risk, these experts said, because of America's failure to upgrade and maintain its public health system and provide appropriate surveillance to quickly catch and contain any outbreak.

"The vulnerability absolutely is very high," said Michael Powers, a research associate with the Chemical and Biological Arms Control Institute in Washington.

"The United States is very susceptible to an outbreak of smallpox." Dr. Nils Daulaire, president and chief executive officer of the Global Health Council in Washington agreed although he said the actual risk is moderate.

"It would be low if we had big stockpiles of vaccine on hand," he said, adding that following the World Health Organization's declaration in 1980 that the deadly virus had been eradicated. "There was a sense of security. We did not need to maintain the relatively high cost to maintain a vaccine for a disease that no longer existed."

There are about 10 million doses of the vaccine in storage, but even if the United States had a huge stockpile from the 1970s, questions remain about its efficacy and whether its use would be acceptable today because of the side effects.

Daulaire said the vaccine causes a severe and sometimes fatal adverse reaction in people infected with humane immunodeficiency virus, which causes AIDS. That would mean it could not be used for all populations.

America's vulnerability, however, is counterbalanced by the difficulty in obtaining a sample of the virus. Jonathan Tucker, whose new book, "Scourge: The Once and Future Threat of Smallpox" comes out this month, said during a talk on his book that in 1976 the WHO urged the 75 laboratories around the world with stocks of the virus to destroy or transfer them to secure repositories at the Centers for Disease Control and Prevention in Atlanta or to a site in what was then the Soviet Union.

In 1983, South Africa became the last country to destroy its stock of virus, said Tucker, who also is director of the Chemical and Biological Weapons Nonproliferation Program at the Center for Nonproliferation Studies in Washington.

"It was possible that countries did not declare (their stock) for various reasons, possibly for nefarious reasons," Tucker said, adding it now is believed from three to eight countries - Iraq and North Korea often are mentioned - actually may have samples of the virus. In 1994, Russia moved its secured virus stock to a laboratory in Siberia known as Vector and Tucker said many experts who believe work was done there to develop a smallpox weapon.

Tucker said scientists believe a "viral slurry" was created at Vector and that perhaps 20 tons of a smallpox weapon, suitable for use on warheads, was maintained. He said while there is no "smoking gun" to indicate any undeclared stocks of virus, "the evidence is sufficiently compelling to make government officials concerned."

Knowing samples exist is one thing, but getting one and making it work as a weapon is another. "There are very significant technological hurdles that would have to be overcome," Tucker said, including ensuring the sample still is viable, finding a way to disseminate it -- such as in aerosol form or by having suicide terrorists infect themselves and walk through large crowds.

He noted, however, the methodical, long-term approach terrorists apparently took in the planning and execution of the attacks on the World Trade Center and Pentagon.

"This is ominous if they apply the save methodological approach to biologics" especially if they have any help from other countries or organizations, he said.

Powers said the chance of terrorists acquiring a virus sample are low because "even those countries that support terrorist organizations have been less than willing" to provide them with the best technology and weapons. He added even if Osama bin Laden, considered by the Bush administration to be a "prime suspect" in Sept. 11 terror attacks in New York and Washington, is involved and if Iraq has a smallpox sample, there is "no great love" between bin Laden and Iraq's Saddam Hussein.

"I don't think the public should be worried about it [smallpox], but I think we have been a bit behind the curve in our planning and action in this," Daulaire said. He said the United States needs a surveillance system geared toward picking up relatively common but serious diseases so that smallpox surveillance can be easily be added to it.

Powers said the U.S. health care system is not geared toward early detection of smallpox, which has a 10- to 12-day incubation period before symptoms occur.

He said more government support is needed at the state and local levels to create an infrastructure that can detect, contain and eradicate any smallpox outbreak.

Tucker said should smallpox be released into the general population, each person infected could infect 50 others - or more - before a diagnosis is made, creating waves of smallpox occurring in about two-week cycles, each wave larger than the previous.

Prior to its eradication, smallpox killed hundreds of millions of people over the ages, throughout the world. Still today, there is no effective treatment, only containment of an outbreak and vaccination.

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.