A pox on all our houses

In what should be today's top news story, a World Health Organization (WHO) committee has recommended allowing genetic alterations to variola, the virus which causes smallpox. According to WHO spokesman Dick Thompson, "They recommended that experiments be done that would speed the screening of drugs for anti-smallpox activity."

Thompson confirmed this would constitute genetic manipulation — as reported early Thursday morning by National Public Radio — but stressed that the purpose of the experiments would be to try to improve smallpox treatment.

The World Health Assembly — the ruling body of the 192-nation WHO — would make a final decision on whether to approve the experiments. "It will go through the bureaucratic process," Thompson said. "It will be a political decision."

In the United States, however, a senior smallpox expert said he was wary. "I think that it is unwise for us to be continuing research with a smallpox virus," NPR quoted Dr. Donald Henderson, President Bush's former bioterrorism czar, as saying. Henderson ran the successful WHO campaign to wipe out smallpox in the developing countries of Africa, Asia and Latin America from 1966 to 1977.

The aim of the genetic alteration is to speed up the screening of anti-smallpox drugs and help to use up the last remaining stocks of the virus, which are being held in secure laboratories because the disease is so virulent. The modified version of the virus would only be used in testing drugs for people who already have the virus and not for smallpox vaccines. Currently no treatment is available for small pox and the only vaccine is unsafe for people with weakened immune systems, and can seriously harm some healthy people, because it is made with a live virus.

Historically the mortality rate for smallpox was 20% to 40%, however in non-immune populations like the native Americans of the Sixteenth Century the mortality rate has been estimated between 50% and 75%; as the disease swept through North and South America ahead of the Europeans tens of millions of people died.

The last naturally occurring case of Variola Minor was diagnosed on October 26, 1977 and the last naturally occurring case of the more deadly Variola Major was detected two years earlier in November 1975. In 1978 the virus escaped from a research laboratory in the United Kingdom; one person died from the disease, and a second killed himself because he accidentally let it out.

Today no one has a natural immunity, and very few people outside the military have recieved vaccination recent enough to have effect (10 years). Despite recent attempts of the US government, private citizens are less concerned about the potential for smallpox release than about potential side-effects from vaccination (which in the case of smallpox can be quite substantial). Consider then, the disaster of a more widespread smallpox release; 50% to 75% of the US (or even world) population dead within months!

Following the 1978 accident, and because of such concerns, all known smallpox stocks were destroyed except those at the Centers for Disease Control (CDC, in Atlanta) and the Moscow Institute for Viral Preparation. Under such tight control, smallpox would, it was thought, never be let out again. Even though the WHO ordered variola's destruction was ordered in 1993, 1994, 1995, and 1996, the stores continue to be maintained in Atlanta and Moscow. Additional collections of the virus almost certainly exist as the result of military and biological warfare programs, such as the Soviet State Research Center of Virology and Biotechnology (also known as Vector) labs. Smallpox scabs were also recently found in an envelope in a book on Civil War medicine in Santa Fe, New Mexico, and it is extremely likely that other remnants exist outside of medical settings.

Edward Jenner, discoverer of the smallpox vaccine, said, "The annihilation of smallpox - the dreadful scourge of the human race - will be the final result of vaccination." Sadly, that day has not yet come.