U.S. Refuses to Destroy Its Rare Smallpox Stocks

In a decision certain to provoke controversy within the world public health community, the Clinton administration on Thursday announced that the United States will retain its sample of smallpox virus, one of the only two known remaining in the world, the other being in Russia.

President Clinton, defying the World Health Organization, decided to preserve the stock in case scientists need to develop new vaccines against a possible bio-terrorist attack.

“We are relatively sure that most of the virus is in the two declared stocks, but we can’t be certain,” said Dr. Ken Bernard of the National Security Council, Clinton’s advisor on international health affairs. “There’s just no way to ensure that if we destroy the two declared stocks that we will destroy every smallpox virus that exists.”

The issue of what to do with the world’s only known remaining stocks has been under intense international debate for more than a decade, with powerful arguments on both sides.

Those urging destruction of the virus say there is no reason to retain it, since the scourge of smallpox was eradicated worldwide in 1980. Moreover, keeping the virus could always raise the potential of its falling into the wrong hands and escaping into the environment, they say.

But others counter that this is precisely the reason to hang on to it: that rogue countries already have or could obtain secret stockpiles that could wreak serious disease and death in the event of a bio-terrorist attack.

No one younger than 20 has been vaccinated against the disease; such vaccination, once routine, was abandoned two decades ago when the world officially was declared smallpox-free.

Proponents of keeping the virus say further study of the samples could provide scientific information that could lead to more effective vaccines and drugs that do not exist today. There is no treatment for the disease.

The old vaccine is made of live but weakened virus and cannot be taken safely by everyone; also, advances in biotechnology in recent years make it possible to develop better vaccine products that do not contain live virus.

“Some argue that we already have a vaccine, but it’s a crude vaccine,” Bernard said. “We need to develop vaccines using new technology.”

He said the administration budget proposal for fiscal 2000 includes $30 million for research into vaccines for anthrax--another germ agent--and smallpox.

Smallpox, caused by the variola virus, is highly contagious and very hardy, making it desirable to those who would wage germ warfare. It has killed millions of people over the centuries.

Like chickenpox, it produces a dramatic, pustular rash, but unlike chickenpox, it can be fatal in up to 30% of cases.

Last month, a panel convened by the Institute of Medicine, part of the National Academy of Sciences, issued a report leaning toward preserving the remaining strains, saying that further research on live smallpox virus “could lead to new and important discoveries with real potential for improving human health.”

But opponents such as Dr. D.A. Henderson, director of the Johns Hopkins Center for Civilian Biodefense Studies in Baltimore, believes that all known remaining stocks should be eliminated as a prudent measure to protect against its reintroduction into the population.

Henderson, who has led the effort to destroy the virus, told a WHO panel in January that the best prevention against a possible bioterrorist attack would be to carry out a campaign that would “destroy all remaining stocks” globally.

The microbe is known to exist at only two sites: the federal Centers for Disease Control and Prevention in Atlanta, which has about 450 samples, and a Russian government laboratory in the Siberian city of Koltsovo, where about 120 samples are stored.

The decision defies WHO, which three years ago recommended that the only known remaining stores of the virus be destroyed in June.

WHO’s governing body is scheduled to meet in Geneva in May to take up the issue, and the United States is expected to defend its position then. Russia also opposes destroying its stocks of the smallpox virus.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Smallpox: From Epidemic to Eradication

WHAT IT IS: A highly contagious, often fatal virus.

EPIDEMICS: Africa, Asia and Europe suffered periodic outbreaks for centuries. Spanish explorers brought the virus to the Western Hemisphere in the 16th century; within 100 years, it had decimated more than half the native populations of Mexico and Haiti. The disease also killed millions of Native Americans.

CONTAMINATION: It is possible to contract the disease by inhaling smallpox-carrying particles or by coming in contact with anything touched by a person with smallpox or the bodies of victims.

SYMPTOMS: A high fever from the infection lasts about four days and is followed by red pustules all over the body. Survivors were frequently left with permanent, deep-pitted scars.

PREVENTION: About 1500 B.C., the Turks began a form of vaccination called variolation--pricking the skin with a very small amount of smallpox. The practice didn’t spread to Europe until the early 17th century. Vaccination came to the U.S. in 1706, when the Rev. Cotton Mather learned about it from his slave Onesimus, who had been inoculated as a child.

CURES: None. Certain antibiotics make the disease milder, and quarantine of the sick person helps slow the rate of contagion.

LAST RECORDED CASE: In Merka, Somalia, in October 1977. In 1979, the World Health Organization pronounced smallpox eliminated.

Sources: Centers for Disease Control and Prevention, Encyclopedia Americana, Post Graduate Medicine

Compiled by Times researcher Tricia Ford