Scourge: The Once and Future Threat of Smallpox

Stella Daily writes: "Had Jonathan Tucker's Scourge: The Once and Future Threat of Smallpox been released just a few months ago, it might have been of interest only to a few outside of the world of epidemiology, but now that anthrax scares have reawakened public interest in biowarfare, it's hardly surprising that Scourge has been flying off the shelves." Read on for the rest of her review of this sobering non-fiction technothriller. Scourge: The Once and Future Threat of Smallpox author Jonathan B. Tucker pages 291 publisher Atlantic Monthly Press rating 9 reviewer Stella Daily ISBN 0-87113-830-1 summary The history and potential horrors of a vanquished killer

Tucker clearly wrote the book believing that the use of smallpox as a biological weapon was a worrisome, but not especially likely, threat, and on September 10th, most of us would not only have concurred, but would probably never have thought that such a thing could happen; after all, smallpox remains the only infectious disease to have been eradicated by humans. After reading Scourge, you will be grateful that the mysterious sender of anthrax-laced mail doesn't have the power of this infinitely worse pestilence in his or her hands.

The smallpox virus, or variola, is a biscuit-shaped bundle of DNA and protein casing, so tiny it can only be viewed with an electron microscope, yet devastating to the human body. The disease kills up to thirty percent of its victims and leaves the rest permanently scarred after battling fever, nausea, and boils so painful that thirsty patients often refused water, unable to swallow without excruciating hurt. Perhaps to be merciful, Tucker has included no photographs of suffering victims covered in the gruesome pustules of the disease, but should you have a morbid curiosity to see one, visit the Polio Eradication Photo Gallery.

Scourge is not a story about a virus, however; it is a story about people. Tucker tells of the history of smallpox and civilizations, how political machinations combined with idealism to bring about the global cooperation that removed smallpox from the earth, and the elaborate subterfuge used by the Soviet Union to hide its research on smallpox as a potential biological weapon. Fans of Laurie Garrett's (The Coming Plague, Betrayal of Trust) journalistic style will appreciate Tucker's treatment; the major figures in the history of smallpox are presented in terms of their personalities and personal struggles, rather than in simple obituary-style listings of what they did.

In describing the early history of the disease, Scourge is fascinating. You may have known that smallpox helped Hernando Cortes conquer the Aztecs in the sixteenth century, but perhaps you didn't know that smallpox may have been the Athenian epidemic Thucydides describes in his account of the Peloponnesian war. The superstitions that existed prior to the germ theory of disease - and, in some areas, long enough to hinder the last stages of the smallpox eradication campaign in the late 1970s - seem truly impossible now, but such was belief prior to the germ theory of disease.

The conquering of smallpox remains one of the great triumphs of mankind - the only infectious disease successfully eradicated by humans. The history of the eradication campaign is one of cooperation between nations and between scientists, but it is also a story of obstacles placed in the way by reluctant governments, the rapid spread of disease due to world travel, and the stubbornness of the superstitious. Here, you will meet such figures as D.A. Henderson, the reluctant leader of the World Health Organization campaign, and Viktor Zhdanov, the man who first proposed a global eradication campaign to the WHO in 1958, then, ironically, became the first chairman of the Soviet council that oversaw the secret biowarfare program beginning in the 1970s.

The clash between the traditional openness of the scientific community, where information is shared relatively freely, and the secretiveness of bureaucracies, where being in the know is a mark of power, is a recurring theme. Often, you'll find yourself rooting for the researchers, who frequently had to reason with government officials who knew nothing about science, but you may be surprised to find yourself agreeing with the government - specifically, the Department of Defense - a time or two.

The story of the Soviet Union's successful cover-up of its research into the use of smallpox as a biological weapon is unsettling, to say the least. Do you find the aftermath of a nuclear bomb impressive? Imagine that bomb followed by an ICBM bearing smallpox - a disease that kills nearly a third of its victims in a normal situation, but would be attacking survivors of a nuclear attack, whose immune systems would be severely compromised by radiation damage. Lest you think that earlier vaccinations might have helped, the smallpox vaccine is effective for only about ten years before revaccination is required, and the United States had stopped mandatory vaccinations long before the last known case of naturally occurring smallpox was diagnosed in 1978. Such a warhead was one of the foci of the Soviet program, even as facilities were carefully disguised so as to give the appearance of compliance with the Biological Weapons Convention treaty. Western governments did not learn of the full scope of the Soviet effort until 1989, and kept the information classified until former Soviet smallpox research scientist Ken Alibek (ne Kanatjan Alibekov) told the story to the American press in 1998.

Although, officially, the last remaining stores of variola virus are kept in Moscow and at the Center for Disease Control in Atlanta, Tucker raises the possibility that other governments - particularly Iraq - may have retained secret stores of smallpox virus, citing enough circumstantial evidence to keep his speculation from being easily discounted. He also brings up the possibility that a government might, to avoid the certain retaliation that would come from launching a smallpox attack, supply the virus to a group like al-Qaeda, then deny responsibility when the terrorists release the disease. Tucker finished documenting these speculations well before the September 11th attacks; now, one hopes they aren't prophetic.

In the case of smallpox, the truth is as morbidly fascinating as any fiction could possibly be, and Tucker tells the story of those who fought to end the scourge and those who would have preserved it as a weapon with equal aplomb, yet from the perspective of a world where smallpox was a piece of history and sophisticated biological attack a back-burner phenomenon. Now that fears of biological warfare are all too real, Scourge is exceptionally relevant - and hopefully not a prediction of what is to come.

You can purchase this book at Fatbrain.

Comments

biowar link-o-rama

[wiredog]

The Specter of Biological Weapons
Scientific American, Dec 1996
http://www.sciam.com/1296issue/1296cole.html

Living Terrors
Living Terrors

by Michael T. OsterholmPh.D., former Minnesota State Epidemiologist, and John Schwartz, a science reporter for The Washington Post.

Lays out scenarios for anthrax and smallpox, some history of biowar, why public health system needs to be restored.

The Johns Hopkins University Center for Civilian Biodefense Studies:

home

Smallpox

CDC reports on smallpox attack scenarios:
The scenario

Aftermath of a Hypothetical Smallpox Disaster

Part Two

CDC

Home

S,mallpox

Picture

Modeling Attacks

Public Health Links:
The Coming Plague: Newly Emerging Diseases in a World Out of Balance

by Laurie Garrett

Covers emerging and re-emerging diseases such as HIV, Ebola, Tuberculosis, Smallpox.

Betrayal of Trust : The Collapse of Global Public Health

by Laurie Garrett, Steven M. Wolinsky

How the public health system, in USA and abroad, was allowed to disintegrate.

And the Band Played On: Politics, People, and the AIDS Epidemic

by Randy Shilts

A chronicle of the first 5 years of the aids epidemic.

Richard Preston (Hot Zone author) on smallpox

Demon in the Freezer

[Exmet Paff Daxx]

The New Yorker's The Demon in the Freezer is mirrored at Cryptome, and is an excellent online read about smallpox; it takes about half an hour. And it is truly disturbing.

If you only read a few parts, read two things:
- the part where Russian scientists warn western observers that "your vaccines won't protect you" against the Soviet's new breed of smallpox.
- the part about insect poxviruses, which turn caterpillars into pure crytstallized virus.

Blech. I hope we have the courage as a nation to go ahead and make the vaccine, in mass quantities, the same way it used to be made. The main objection raised in the article is that "by today's standards" cow puss is an unacceptable vaccine. Hopefully "today's standards" are that life without a vaccine is unacceptable. But that's just my opinion.

Really?

[jabbo]

I guess we didn't bomb Iraq, Afghanistan, and Sudan in the last 15 years. Nor did $300M of Saudi inheritance and an organization devoted to the destruction of the USA (and by proxy, our Western allies) spring up. Right?

The huge difference between an entity like the Soviet Union and a network like Al Qaeda is that, while the USSR was highly prepared and enamored of the will to power, the people holding the reins were not particularly interested in dying as a means of killing others. So while the cynical machinations of the Soviet power elite produced the finest weaponization programs for biowarfare yet seen, they were only intended for use as mop-up agents after a nuclear attack.

The Islamic fundies (not particularly worse than Christian fundies or ultranationalist Israelis, just more prominent) that have taken center stage lately are perfectly willing to die for their cause, as long as they can kill a few unarmed women and children while they're at it. What better for the slaughter of innocents than an epidemic? It worked for Genghis Khan (cf. catapulting plague-ridden corpses into sieged cities). These are not conventional enemies and they are not limiting themselves to conventional warfare. Moreover, a network of semi-autonomous individuals without a distinct nationality, i.e., nothing to lose, is a much more elusive target than a static nation-state like Iraq, Libya, or Afghanistan. So the consequences of being "caught" are also different.

That, in conjunction with the underfunding and collapse of the public health systems around the world, is why I submit that a response to biowarfare is more crucial now than 15 years ago.

And the rebuilding of a worldwide public health infrastructure would be a damn nice side effect of this new urgency, IMHO.

You forgot the most substantial one out there: PBS

[jabbo]

Frontline special: Plague Wars

This is the most balanced, incisive, and original presentation I've seen on the topic. It was written several years ago and was not rushing to meet some deadline or focused on the current agent du jour. It's fantastic.

Anyone who likes Laurie Garrett's work (or Ken Alibek's) will find this site worth digging into, deeply.

Have "fun".

An interesting philosophical question...

[jd]

In order to be able to prevent an attack from weapon X, we must have a supply of weapon X, to develop a defence. In so doing, we also provide a known and ready source of weapon X, for someone to use.

This was the case with the Anthrax, which I believe has been identified as an artificial strain, traced to a US Govt. laboratory.

We also create a motive. Fear. There are many who fear the US, who believe that it is an ego-centric culture, which will crush any other culture it encounters, given time. (Honestly, I've not seen much evidence to the contrary.) The assumption that American culture is "superior" to all others does piss off a lot of people, all over the world.

(The current President's view that International Law and International Treaties are only valid if convenient, and disposable otherwise, has sparked off two International incidents and is likely to fuel further crises, as the EU takes on Microsoft, the Kyoto Accords are implemented in other countries, and Germany takes the US to court.)

In short, our very protectionistic, defensive attitude is our own worst enemy. Smallpox, Ebola, Genetically Modified insects or plants that replace native life with stuff deadly to humans... All this and more is possible, today.

And what reason, exactly, are we giving other nations, other societies, to NOT use such weapons? It seems to me that we're not only giving others plenty of reasons, we're also determined to give them the means, too. Most other countries abandoned such warfare as too random, too unpredictable, and too slow, to be of any military value, and gave up such work.

In the US, we're keeping stockpiles of deadly organisms, and are conducting GM research which would be considered unethical anywhere else in the world. We don't protect the environment (which makes it hard to detect intrusions when they can still be dealt with), and we ensure that health coverage of any quality goes to the well-off. (Who probably need it a lot less, than those who aren't!)

In short, then, we're practically giving away weapons that can be used against us, giving others reasons to use those weapons, and we're then making it impossible for us to genuinely do anything that might protect us, by pricing it out of existance.

IMHO, there is only one solution to this, and a lot of pro-Corporate people are not going to like, or understand, it. We have to take care of what we have - people, fauna, flora, habitats, EVERYTHING - as well as, or better than, ourselves.

THEN, we can detect the threats long before they even become threatening. We would be more likely to have the means to deal with it, because we would catch the problem sooner. The same way that cancer is a whole lot easier to treat, when it's starting, than when it has completely run rampant.

Further, if we learn to be more aware of our surroundings, we're much less likely to incite the kind of fanatical hatred that we have seen. Directly, or indirectly. Our fear incites the fear of others. Our awareness might, then, incite awareness in others, which might even reduce global suspicion and hostility.

Sounds utopian? Probably. Nobody said I was a realist. I am merely a software engineer, who knows that Output = fn(Input), that if you want to change the output, you must change the input, and that if you keep getting outputs you don't like, then don't keep changing the input the same way.