May 16th, 2011
04:31 PM ET
Health officials from 193 countries are gathering in Geneva, Switzerland, this week for the World Health Organization's annual meeting to discuss myriad health threats of today. Among the many topics on the agenda is the question – when should the last remaining samples of Variola, the virus that causes smallpox, be destroyed?
The decision to destroy the known remaining virus samples was made back in 1996. But the actual destruction date has been delayed four times – most recently in 2007. So these samples of the virus – 451 at the Centers for Disease Control and Prevention in the United States and about 120 stored in a lab called "Vector" in a remote Siberian town in Russia - continue to hibernate in liquid nitrogen.
Smallpox has been described as the world's worst diseases. It infected only humans and 30% of those sickened died. Many who survived were horribly scarred or became blind or both. Up to half a billion people died from the disease just in 20th century alone.
Dr. D.A. Henderson, who was in charge of the WHO's global smallpox eradication program, saw firsthand what this virus could do. "Probably the worst experiences I've ever had were going into smallpox wards. I've never seen anything so pitiful in all my life. It has the odor of dying flesh, nasty odor," he said. "You have these people who are pathetic – they just want water, but they can't drink; they want food but you can't provide it to them. There's nothing you can do for them – nothing at all."
The WHO's massive vaccination program was a success and led to the eradication of smallpox in 1980. The last naturally occurring case was in 1977, and the final cased occurred in 1978, when a laboratory accident led to the exposure and the death of one person from the disease, explains Dr. Inger Damon, chief of the Poxvirus and Rabies Branch at the CDC. Damon is one of a handful of people at the CDC who has access to virus, which is kept under the most extreme safety and security measures.
She says that although multiple research labs across the world once had the virus, the WHO worked to consolidate the locations and by 1984 only the United States and the Soviet Union (now Russia) remained. More could still be learned from this incredibly deadly virus, so it wasn't until 1990, that the WHO decided the smallpox virus should be destroyed, explains Jonathan Tucker, author of "The Once and Future Threat of Smallpox."
The deadline was set for the end of 1993. Tucker describes how a Soviet defector suggested that his country as well as others may have hidden stocks of smallpox and that it could be used for bioterrorism.
While experts agree smallpox would not be an effective bioweapon because once you unleash it, you can't just target a specific population, the more likely scenario for a new outbreak would be a release by someone with an undeclared stash. The WHO inspects the two known stockpiles.
There's always the chance that someone could bioengineer a smallpox virus because modern technology has allowed for the genetic sequencing of the virus' DNA. But finding someone who could do it would be very difficult, as would actually doing it, Damon says.
Damon believes that more work needs to be done on the actual virus and that now is not yet the time to destroy the stockpiles. She says new drugs or vaccines need to be tested on the virus to determine whether they work, since this is not the type of experimentation that can be done on humans.
If there were an outbreak of smallpox, which everyone appears to agree is unlikely but cannot be ruled out, it would pose a major threat. "We estimate that 75% of the population is fully susceptible to smallpox," says Henderson. WHO recommended against vaccination when the disease was declared eradicated in 1980. Even those who were vaccinated 30 years ago would have little immunity remaining.
However, Henderson and other advocates for destroying the stockpiles believe that since two new vaccines have now been developed and development of two new antiviral drugs is almost complete, it's time to let go of these stockpiles.
Russia and the United States disagree. Some are suggesting that drastically reducing the number of strains in each lab may be a compromise, if destroying them entirely is not agreed upon. The WHO's World Health Assembly is meeting all week in Geneva. The smallpox issue is expected to be debated by Wednesday or Thursday.
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