Here's a very recent article:
The return of a vanished virus
WE just completed a century that saw more than 65 million people die in two world wars. But that toll pales compared
with the carnage caused by the smallpox virus. Best estimates indicate that 300 million to 500 million people died from
smallpox in the 20th century -- several times the number of deaths from all wars combined.
Humankind's greatest single accomplishment of the last century arguably was the eradication of smallpox. Thanks to the
smallpox vaccine and a global immunization campaign, the World Health Organization in 1980 certified the world
smallpox-free. So vanished a virus that caused disfiguring pustular rash, internal hemorrhage and excruciating death.
Now, smallpox is back.
Since the 1991 fall of the Soviet Union, many of its military secrets have been divulged. One disturbing revelation is that
a Soviet biological warfare program produced millions of infectious doses of smallpox virus that still exist today.
Intelligence officials and world health experts are convinced that, through black markets, the virus is in the hands of
terrorist and rebel groups, possibly even lone individuals. It would be simple for any of these to mount a devastating
terrorist attack with smallpox.
It's as important to prevent an attack of bioweaponry as of nuclear weaponry. Militaries spend billions to develop and maintain "stealth"
technologies, such as aircraft invisible to radar that can strike with little or no warning. Smallpox may be the ultimate stealth weapon.
Tens of millions of smallpox virus particles will easily fit into a hand-held container. Using store-bought materials assembled into a primitive
aerosol device, a terrorist could spray the virus in a public building. The microbe, invisible and odorless, could be unnoticed.
The consequences are starkly illustrated in "Living Terrors," a new book by bioterrorism expert Michael T. Osterholm. With no explosion or
sound, a smallpox attack would go unnoticed by either security personnel or its victims. Only eight to 16 days later, when victims show up in
emergency rooms, would the magnitude of the attack become apparent. By then, it would be too late. Highly contagious, the smallpox virus
from a single assault could strike hundreds of thousands of people. More than 30 percent would die. Survivors would suffer a permanent and
disfiguring rash on the face.
Hospitals are unprepared to deal with such an onslaught, and the contagion would decimate the ranks of front-line health care workers.
Confidence in public institutions and elected officials would erode. We would fear going outside our homes, never knowing when and where
the next invisible, lethal attack would happen. Work force and productivity would dwindle.
The United States is dangerously underprepared to combat a bioterrorist attack using smallpox. Few individuals have been vaccinated against
smallpox since 1972, when eradication allowed immunization to be discontinued. And protective immunity is thought to have worn off for all
but 10 to 20 percent of those who were vaccinated. Thus, approximately 90 percent of the U.S. population is susceptible to smallpox. Our
stores of available vaccine are inadequate to handle an outbreak.
The government has taken the first steps to prepare for and prevent such an attack. The Centers for Disease Control received funds in 1999
to develop coordinated federal, state and local plans, educate health care and public health professionals about handling such an attack, and
develop and strengthen surveillance systems for early detection of outbreaks. Last week, the government ordered 40 million doses of
smallpox vaccine for a stockpile.
Much more must be done. The smallpox vaccine stockpile should have at least 100 million doses. The estimated cost for this expansion of the
stockpile is less than $100 million -- cheap compared with the costs of nuclear preparedness. Accelerating vaccine research and development
for other potential bioterrorism agents should be seriously considered.
The United States -- indeed, the world -- is vulnerable to a catastrophic bioterrorist attack. Production of economical, effective vaccines to
prevent the calamity is a feasible and easily attainable countermeasure.
R.H. Shepherd and Peter J. Hotez writes for The Washington Post. Shepherd is chairman of the Albert B. Sabin Vaccine Institute. Hotez,
M.D., Ph.D., is an institute adviser and chair of the Department of Microbiology and Tropical Diseases at George Washington University
Medical Center. |
