Smallpox-free for 25 years

It was in May 1980 that the World Health Assembly certified the world free of naturally occurring smallpox and the war against smallpox was won. Eradication was achieved through international vaccination programmes, global disease surveillance and public health logistics systems.

Since this certification, there has not been a single reported case of smallpox infection. Had smallpox not been eradicated, the past 25 years could have witnessed some 300 million new victims and an estimated 100 million deaths.

After eradication, storage of the smallpox virus was restricted to two World Health Organization (WHO) reference laboratories - one in the USA and one in Russia. However, there are concerns that bioweapons resources and expertise may have become accessible to terrorist groups. As a result, governments around the world are re-assessing their capabilities to deal with the threat of the re-emergence of smallpox.

Drs Jill Dekker-Bellamy, Biodefence consultant, New Defence Agenda, Brussels reports, "The lack of appropriate counter measures against the threat of bio-terrorism has placed the global community at an unacceptable risk. The threat of an attack is a low probability but a high consequence event. Governments must stockpile vaccines and start putting policies in place to run vaccination campaigns in the event of a bioterrorist attack using the smallpox virus."

If used as a biological weapon, smallpox would represent a serious threat. Its high fatality rate and our increasingly mobile world mean smallpox could spread far more widely and rapidly, especially since vaccination programmes ended once the disease was eradicated.

The full potential impact of a smallpox release became starkly apparent during a simulated outbreak in Washington, DC in January this year.

During the table-top exercise 'Atlantic Storm', led by former US Secretary of State, Madeleine Albright, retired politicians and senior diplomats struggled to contain the 'situation' as smallpox rapidly spread across the globe. They were warned of 660,000 potential victims, major political upheaval and a collapsing world economy in the weeks that followed.

The exercise identified that over 30 countries hold some stocks of smallpox vaccine as part of their preparedness plans. However, the US National Intelligence Council concluded that no country was adequately prepared. For further information, please visit www.upmc-biosecurity.org