Decision on destroying last of the stored small pox virus samples

By Dr. Ananya Mandal, MDMay 17 2011

Health experts from all over the world are to decide this week whether to hold on to the last remaining stockpiles of smallpox, one of the deadliest diseases in history – or to proceed with their destruction.

According to US scientists, future researchers need access to the virus for just a while longer -- saying they need more time to develop antiviral drugs and vaccines in preparation for a potential terrorist attack that everyone hopes never comes.

U.S. Health Secretary Kathleen Sibelius told reporters Tuesday that the World Health Organization has been asked to decide whether the stockpiles held in secure U.S. and Russian labs should remain in place for at least another five years, when experts could again review the situation.

At stake in the discussion – taking place at an annual meeting of the World Health Organization – are stockpiles at the U.S. Centers for Disease Control and Prevention in Atlanta and at a Russian government laboratory.

Smallpox, caused by the variola virus, infected – and killed -- people for thousands of years, as the World Health Organization reports, “For centuries, repeated epidemics swept across continents, decimating populations and changing the course of history. In some ancient cultures, smallpox was such a major killer of infants that custom forbade the naming of a newborn until the infant had caught the disease and proved it would survive.” The disease left many survivors blind or pockmarked. “The symptoms of smallpox begin with high fever, head and body aches and sometimes vomiting. A rash follows that spreads and progresses to raised bumps and pus-filled blisters that crust, scab, and fall off after about three weeks, leaving a pitted scar.” Smallpox was fatal in up to 30% cases. In the 18^th century, about one in 10 children in Sweden and France died of smallpox, according to the World Health Organization. However with the development of the smallpox vaccine, there was a reversal of this trend and the disease was finally declared eradicated from the world. The last natural case in the world was in Somalia in 1977, and one last case—fatal—was contracted in a laboratory in the U.K. in 1978. The disease was declared eradicated in 1980.   

The CDC says, “In the aftermath of the events of September and October, 2001, the U.S. government is taking precautions to be ready to deal with a bioterrorist attack using smallpox as a weapon.” The CDC even outlines its response plan—including how to use the remaining stockpiles to vaccinate the country’s population.

A scientific review completed late last year by a WHO advisory committee agreed the stocks are still needed to develop vaccines and antiviral drugs. But another review by independent experts argued that the only “compelling” reason to keep the live virus is to meet regulatory requirements for testing vaccines and drugs, and new methods for meeting regulatory approval should be developed that don't require the live virus.