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Destroying the last samples of smallpox virus could prove short-sighted | Destroying the last samples of smallpox virus could prove short-sighted |
(about 1 month later) | |
I confess that, while I'm a middle-aged mother in a fairly typical family, I am not the world's best housekeeper. It is not unusual, in a rare turning of sofa cushions, for me to find several leaky biros and a small fortune in pocket change. I'm pretty sure I've discovered entire mutant food groups while defrosting my freezer. | |
So I felt some sympathy when it was announced that last week employees at the National Institutes for Health in Bethesda, Maryland, had found some vials of variola from the 1950s in an unused part of an old store room. It's easily done. | |
The only problem with this generational episode of forgetfulness is that variola is otherwise known as smallpox, the notoriously lethal disease that was declared in 1980 to have been eradicated in the wild. The NIH immediately contacted the Centers for Disease Control and Prevention, and the vials were securely transported to the CDC secure facility in Atlanta for testing on Monday. | |
It has since been confirmed that the vials do indeed contain smallpox DNA, but it will take another two weeks before analysts discover whether the virus inside is still viable. The vials will then be destroyed in the presence of officials from the World Health Organisation. | |
The CDC assures in its press release that employees were highly unlikely to have been exposed, but the discovery will be a worry to anyone concerned about the threat of biological terrorism. And while in this case the vials do not appear to have posed any threat to employees, in the past scientists have died as a result of smallpox kept in laboratories for the purposes of scientific research. | |
A medical photographer at the University of Birmingham, Janet Parker, was killed by smallpox in 1978. It is thought the virus travelled through air ducts from a smallpox laboratory to her darkroom on the floor above. Her mother also contracted the disease, but survived. | |
This week's announcement will no doubt embarrass the CDC which, just three weeks ago, had to admit that 75 scientists in three laboratories had been accidentally exposed to live, rather than inactivated, anthrax samples sent out from its Atlanta facility. | |
The WHO programme to eradicate smallpox was a brilliant example of steadfastness, surveillance and human ingenuity. It has been estimated that 300 million people died of smallpox in the 20th century alone. Through the late 1960s and early 1970s, an international team of health workers – under the guidance of the brilliant American physiologist and epidemiologist Donald Ainslie Henderson – adopted a method that could only be described as “good old-fashioned shoe leather detective work”. | |
They travelled the world and visited local communities asking people if they had seen cases of smallpox, and when they found one operating a system of ring vaccination (vaccinating everyone who had contact with the case) to prevent the virus from spreading. | |
Incredibly, they succeeded. The last naturally acquired case of smallpox was in a Somalian cook named Ali Maow Maalin in October 1977. The team waited for new cases to appear. And waited. But none came. Smallpox was officially declared eradicated three years later. Maalin survived, but died last year after dedicating the remainder of his life to the eradication of another major killer – polio. | |
That's not to say that the smallpox virus has been wiped from the face of the planet, even allowing for chance finds like last week's. There are two secure facilities that still hold samples of the virus – the aforementioned CDC facility in Atlanta, and one at the Russian State Research Centre for Virology and Biotechnology in Koltsovo (an interesting reflection of the cold war still raging when the virus was declared eradicated). These samples were scheduled to be destroyed in 1993 but they still exist and there is some debate about what should happen to them. | |
Many developed nations, led by the USA, argue that there is still much research to be done and that the current vaccine needs to be refined to work better in those with compromised immune systems (such as those with HIV). Yet developing nations, with so much more to lose from a new outbreak, argue that the risk outweighs the benefit. | |
The man who did so much to destroy smallpox, Donald Henderson, has stated that he thinks it's time for the virus to be destroyed and that all productive research on it has been done. We sequenced the smallpox genome in 1994 and if we need to, the argument runs, we can bring it back for further investigation. | |
But there can be no doubt that recreating the virus from scratch would be hugely controversial – scientists at the University of Wisconsin-Madison recently provoked a storm of criticism when they recreated the deadly Spanish influenza virus that killed millions in the aftermath of the first world war, using fragments of avian flu viruses found in wild ducks. The researchers claimed the virus could inform influenza vaccine development. | |
The question will always be “does the risk of accidental release outweigh the benefits of research, or the other way around?” And, as with so many decisions in medical research, the answer is not clearcut. | |
But while we wonder what on earth to do with the official stocks of smallpox, maybe we should also wonder what the next office move or clearout of an old laboratory space will bring. Last week's incident shows that smallpox could still pop up from time to time. And if we can't guarantee it has been wiped out elsewhere, why wipe out our own highly secure, controlled supply? | |
Any (rare) accidents at controlled facilities could be ringfenced immediately and their impact minimised. If anything, the destruction of the vials found on 1 July will be proof that we really are quite safe from another epidemic. | |
The biggest development in the world of infectious diseases since the eradication of smallpox has been the appearance of HIV, a completely new kind of human immune deficiency, and we don't know what else may be around the corner. So destroying the smallpox virus for good – effectively closing down a whole avenue of vaccine research – may be a terrible idea. | |
In the meantime, I have a freezer to defrost. | |