Of all the diseases that have tormented mankind, Ken Alibek explains (in Biohazard), smallpox has left the oldest and the deepest scars:
Recorded as early as 1122 B.C. in China, it altered the course of history, ravaging eighteenth-century Europe and decimating the native populations of North America. Smallpox comes from the pox family of viruses, which assault the upper respiratory tract. Variola major, the scientific name by which the smallpox virus is known, is patient and systematic. It will begin by insinuating itself into cells close to the surface of the skin and in the neural system. The smallpox virus sheds its shell as soon as it enters a live cell, and quickly begins to multiply. Viral transcription begins almost immediately, inhibiting DNA synthesis and thereby preventing the cell from activating its defense mechanisms. Once the virus has inserted its genetic information into the host cell, proteins and enzymes are created to help it mature and develop. The progress of the virus can be mapped by the spread of tiny pink spots from the face and arms to the lower regions of the body.
Smallpox symptoms were once familiar to every doctor. After a quiet incubation period of five to ten days, the virus manifests itself suddenly. The first stage of the disease brings high fever, vomiting, headache, and a strange stiffness. This can last from two to four days. Within less than a week, small spots will begin to develop, forming a rash around the face. As the rash spreads over the following week these spots will develop into painful blisters. In the normal course of the illness, the blisters form scabs that linger for several weeks until they dry and fall off, leaving scars. More severe forms of black or red pox can lead to death within three to four days.
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On May 8, 1980, the World Health Organization announced that smallpox had been eradicated from the planet. The last naturally occurring case was reported in Somalia in 1977, and no new cases had been detected in three years. The WHO recommended the discontinuation of smallpox immunization programs, observing that there was no longer any need to subject people to even the negligible risk connected with vaccination.
The international agency simultaneously adopted a resolution restricting the world’s stocks of smallpox to four sites, where limited quantities would be available for research purposes. A few years later, the sites were narrowed down to two: the Centers for Disease Control in Atlanta and the Ivanovsky Institute of Virology in Moscow.
The conquest of smallpox generated a special feeling of accomplishment in the Soviet Union: the worldwide crusade against smallpox had been a Soviet initiative. Moscow first proposed the campaign at a World Health Organization meeting in 1958, and its sponsorship of vaccination programs in the third world won it admirers everywhere. Russia had suffered its share of smallpox outbreaks over the centuries, finally managing to eliminate the disease in 1936, after a decade-long immunization program sponsored by the fledgling Bolshevik government.
Soon after the WHO announcement, smallpox was included in a list of viral and bacterial weapons targeted for improvement in the 1981–85 Five-Year-Plan.
Where other governments saw a medical victory, the Kremlin perceived a military opportunity. A world no longer protected from smallpox was a world newly vulnerable to the disease.
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In 1947, the Soviet Union established its first smallpox weapons factory just outside the ancient cathedral town of Zagorsk, forty minutes’ drive northwest of Moscow. Zagorsk (now Sergiyev Posad) is the site of the
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A few miles away, in another walled compound, Soviet army scientists at the Virological Center of the Ministry of Defense devoutly cultivated smallpox, Q fever, and Venezuelan equine encephalitis in the embryos of chicken eggs.
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Using tiny syringes, laboratory workers injected microscopic amounts of smallpox virus into eggs and sealed each egg with paraffin. The eggs were placed inside thermostatic ovens for several days while the embryo host cells stirred the virus into life. As it monopolized the cells’ normal growth mechanisms, the virus spawned successive replications of itself until the host was engulfed or destroyed. The eggs were then punctured and the liquid inside poured into special vats and mixed with stabilizing materials. The resulting weapon could remain potent in refrigerated conditions for at least a year.
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Under a state-controlled agricultural system it was easy to conceal the purpose of hijacking so many eggs from the marketplace.
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In 1959, a traveler from India infected forty-six Muscovites with smallpox before authorities realized what had happened. The traveler had been vaccinated, but smallpox vaccinations lose their effectiveness over time, and while his weakened immunity was enough to protect him from suffering the symptoms of the disease, he could still pass it on to others. The strain of Variola major in his system was so virulent that an epidemic was only narrowly averted. Partly in response to this incident, the Soviet government sent a special medical team to India to help purge the virus from the subcontinent.
KGB agents went with them.
They returned to Russia with a strain of Indian smallpox excellently suited to weapons production.
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In the 1970s, smallpox was considered so important to our biological arsenal that the Soviet military command issued an order to maintain an annual stockpile of twenty tons. The weapons were stored at army facilities in Zagorsk. Annual quotas of smallpox were required as it decayed over time.
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The smallpox virus is so hardy that it can remain infectious for long periods, even in the soiled linen of those who have been infected. Smallpox victims are infectious from the moment of their first symptoms until the healing of the last scar, two to three weeks later, and they can transmit the disease to others with as little as a cough.
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Humans are the virus’s only natural hosts. There is no way, therefore, for the disease to propagate in nature.
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There are no therapeutic measures currently available to treat smallpox once symptoms develop.
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Smallpox kills between 30 and 50 percent of unvaccinated victims, a low mortality rate, but its morbidity rate ranges from 60 to 90 percent. For many people, contracting smallpox amounts to a life sentence. Some victims are permanently blinded. Others will bear scars as long as they live.
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Schoolchildren in the United States, Russia, and elsewhere around the world are not vaccinated against the disease, and international travelers are no longer required to show proof of smallpox immunity.
Today there are twelve million doses of smallpox vaccine on hand in the United States—of which only seven million are fully reliable, according to the Centers for Disease Control in Atlanta—a portion of the roughly two hundred million doses available in the world. This sounds like a comfortable amount to meet an emergency, until you consider the damage a smallpox attack would do in a densely populated commuter city like New York.
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During World War II the Western allies explored the possibility of weaponizing several viral diseases, including Venezuelan equine encephalitis and smallpox. American, Canadian, and British scientists found to their frustration that viruses were far more difficult to manipulate than bacteria.
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Aerosols were still in the early stages of development in the 1940s, and most of the approaches considered by the Allies for weaponizing smallpox seem strange today. One method involved grinding an Asian strain of smallpox into a fine powder to dust over letters. By the time the war ended, the Allies had largely given up on weaponizing viruses.
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Fewer than five viral particles of smallpox were sufficient to infect 50 percent of the animals exposed to aerosols in our testing labs. To infect the same percentage of humans with anthrax would require ten thousand to twenty thousand spores. For plague, the comparable figure is fifteen hundred cells. The differences in quantity are too minute to be discernible to the naked eye, but they are significant if you are planning attacks on a large scale. Smallpox requires almost no concentration process.
While we had clung to our egg-and-conveyor-belt method of making smallpox, Western pharmaceutical labs were manufacturing vaccines in special reactors from cultures grown in tissue cells obtained from animals or humans. This technique required expertise.