The spectre of smallpox has haunted humanity for more than three millenniums and this year should have marked its final, irrevocable demise. However, a plan to destroy remaining stocks of the virus is about to be abandoned because of fears that one of history's greatest scourges may now be in the hands of a rogue state.
| Smallpox: a brief history
* Smallpox, one of the most devastating diseases known to humanity, originated more than 3,000 years ago. It was first described by the ancient Egyptians at the time of the Pharaohs.
* Sanskrit medical texts in India describe smallpox epidemics in 1500BC and Thucydides wrote about an outbreak in 430BC that killed one-third of the population of Athens.
* The army of Alexander the Great, above right, was ravaged by smallpox, as were the Abyssinian troops who besieged Mecca on elephants AD570, an incident described in the Koran.
* As late as the 18th century, smallpox killed 10 per cent of children in Sweden and France, and every seventh Russian child.
* Among the virus's more famous victims are: Queen Mary II of England, right, Emperor Joseph I of Austria, King Luis I of Spain, Tsar Peter II of Russia, Queen Elenora of Sweden, King Louis XV of France and George Washington, below right.
* Edward Jenner invented the first vaccine when he demonstrated that cowpox, a related virus, could be used to inoculate against the human disease.
* In the early 1950s, there were still an estimated 50 million cases of smallpox each year. By 1967, these fell to about 15 million cases a year thanks to a global vaccination programme.
* Smallpox was finally declared eradicated in the wild in 1979, two years after the last natural outbreak in Somalia and a year after the last accidental infection in a laboratory at Birmingham University.
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The spectre of smallpox has haunted humanity for more than three millenniums and this year should have marked its final, irrevocable demise. However, a plan to destroy remaining stocks of the virus is about to be abandoned because of fears that one of history's greatest scourges may now be in the hands of a rogue state.
An international panel of senior scientists is expected to ask the World Health Organisation (WHO) this month to postpone indefinitely its propos-al to destroy smallpox stored at two high-security laboratories in America and Russia.
They fear that destruction might ultimately play into the hands of terrorists by hampering future attempts at developing new vaccines and anti-viral drugs to protect a population that has never been more susceptible to a deliberate smallpox attack.
The WHO's variola virus advisory committee, which includes scientists from America, Russia, Japan and India, was asked to make recommendations before a meeting of the world health assembly in May when the final decision on smallpox eradication is due to be made.
This was supposed to have been the year when smallpox was finally to be wiped from the face of the planet – the first deliberate extinction of a lifeform in modern times – after a global immunisation campaign led to the successful elimination of the virus from the wild.
When the world was declared free of smallpox virus after the last natural outbreak in Somalia in 1977, the WHO oversaw the movement of the remaining stocks to two secure laboratories, one run by the US Centres for Disease Control (CDC) in Atlanta, Georgia and the other run by the Russian Vector institute for virology in Novosibirsk, Siberia.
Britain's own smallpox stocks, held at Porton Down in Wiltshire, were moved to the CDC in the late 1970s. They too were due to be destroyed in the belief that the world would be a better place for eliminating one of man's most infectious diseases.
However, sources close to the WHO committee said the events of 11 September and the subsequent anthrax attacks in America have now made it politically impossible for the committee to recommend destruction of the remaining smallpox stocks.
Some scientists on the committee believe further development of vaccines and drugs cannot occur without experiments on the live virus. Destruction, they believe, could ultimately aid terrorists who may have gained illicit access to the virus.
The committee reviewed the chilling testimony of Ken Alibek, a former first deputy director of the Soviet biowarfare agency, Biopreparat, who claimed the supposedly secure Russian smallpox stocks might have leaked to agents acting for rogue states. Dr Alibek, who defected to America in 1992, said Russian scientists had "weaponised" smallpox virus and moved samples away from the Novosibirsk facility to other, less secure laboratories in Russia, contravening international agreements.
Smallpox is one of the most efficient killers known and if it ever fell into the hands of suicidal terrorists its high infectiousness makes it an ideal candidate for a biological weapon of mass destruction. Anthrax, by contrast, does not spread from person to person.
A study by Porton Down scientists published in the journal
Nature
in December found that there is now so little immunity to smallpox in the general population that a deliberate release could quickly cause a substantial epidemic before public health measures could be mobilised to stop it. "Although our estimate for smallpox represents a relatively modest transmission rate by comparison with some other infectious diseases, such as measles or chickenpox, significant epidemics could result, particularly if there were delays in detecting the first cases or setting up effective public health interventions," the report said.
American health officials are also keenly aware of the dangers of smallpox if it were to get into the wrong hands. Tommy Thompson, the American Health and Human Services Secretary, recommended in November that the US should not destroy its remaining repositories of smallpox "until adequate medical tools are available to counter any future outbreak of this disease".
Mr Thompson articulated the fears of many experts who are concerned that stocks of the virus may have been illicitly sequestered by potential terrorists. "While known repositories of smallpox exist only in the United States and Russia, it is possible that the virus may also have been acquired by others," he said. "Until we have developed our defences, we must keep this killer secure but available for needed research. We must be able to counter this virus as well as any altered variant that might be produced."
Some doctors believe there is an urgent need to improve existing smallpox vaccines. Although the vaccines were effective in wiping out the virus from the wild, they cause severe side-effects that limit their use in mass vaccination campaigns against a theoretical threat. As a result, the WHO says that existing smallpox vaccines should be used for only those people exposed to a real threat, such as scientists working in a laboratory where the virus is handled. With safer vaccines it would be easier to authorise future mass vaccination in the event of a terrorist threat.
The WHO estimates there are about 90 million doses of the smallpox vaccine in the world, but their potency would depend on how well they have been stored and for how long. America has a stockpile of about 15 million doses but the government intends to increase this to 300 million doses – an indication of the seriousness with which it is viewing the smallpox threat.