The government has announced that it “requires a new smallpox vaccine
to deal with the consequences if smallpox were used as a terrorist
weapon against the civilian population.” That announcement, via the
Commerce Daily Bulletin, was the first time the government has asked for
smallpox vaccine to be manufactured in over 26 years. The virus is
supposed to have been officially eradicated from the face of the earth
in 1972, but few believe that it was.
There have long been reports that some countries and terrorist
organizations have secret smallpox samples and have been developing the
virus as a bio-weapon. The United States currently has only 15.4 million
doses of vaccine and last Wednesday the government not only put out a
call for a minimum of 40 million additional doses of vaccine, but also
said it sought vaccine manufacturers who could “achieve FDA licensure
and initiate large-scale production of a new vaccine in the shortest
time possible.”
The government is finally acting, say observers, because fears of
bio-terrorism are now no longer being quietly contained within the
intelligence and scientific communities but are crashing into the
national consciousness. For example, last week’s New Yorker magazine
cover story “Demon in the Freezer” gave shattering new facts about the
terrorist threat posed by smallpox.
According to the articles’ writer, Richard Preston (author of the
best-selling “The Hot Zone,” about the deadly African Ebola virus) the
U.S. government has a classified list of over 11 nations or groups
suspected of either already having a secret stockpile of smallpox, or of
trying to steal, or buy one. This list includes Russia, China, India,
Pakistan, Israel, North Korea, Iraq, Iran, Cuba and Serbia. Also
suspected are the terrorist organization of Osama bin Laden and the Aum
Shinrikyo sect of Japan which released nerve gas in a Tokyo subway in
1995.
Preston points out that last year “North Korea fired a ballistic
missile over Japan in a test. … Some knowledgeable observers thought
that the missile could have been designed to carry a biologic warhead.
If it had carried smallpox and landed in Japan, it could have devastated
the Japanese population.”
The tragic irony is that it is mainly because of the highly effective
humanitarian effort to eradicate smallpox during the ’60s and early ’70s
that the virus is now poised to become one of the greatest threats to
mankind — greater perhaps even then thermonuclear war. That’s because
today, should there be an outbreak, there is barely enough vaccine to
keep a handful of the planet’s population alive. Incredibly, the
thinking was, if technically there’s no longer any virus in the world,
why keep the vaccine? Therefore in 1990, most of the World Health
Organization’s store of vaccine was destroyed.
To grasp the danger now posed by a hostile force with secret stores
of both the virus and the vaccine, consider that before it was
eradicated in 1972, smallpox was estimated to have killed at least 300
million people in the 20th century alone. And that was when much of the
world was immunized. The reverse is true today. Immunization lasts only
about 10 years, so the vaccine most middle-aged Americans remember
getting in grade school has long since worn off.
Since the World Health Organization (WHO) declared the virus
officially eradicated, samples of it theoretically only exist in two
carefully monitored laboratories, one in the U.S. Centers for Disease
Control facilities (CDC) in Atlanta, and one in a Russian virology
institute called Vector, situated in Siberia. But, Preston writes, this
was “never anything but a comfortable fiction. No one knows exactly who
has smallpox today, or where they keep the virus, or what they intend to
do with it.”
According to Russian defector Ken Alibek who, as Kanatjan Akibeko,
was one of the Soviet Union’s top bio-weaponeers and the inventor of the
world’s most powerful anthrax, “Few Americans are aware that they are
living under a state of national emergency relating to weapons of mass
destruction.” Alibek says that Russia kept literally tons of liquid
smallpox ready for loading onto missiles aimed at American cities.
Although Alibek left Russia eight years ago, in his recently
published book, “Biohazard,” he writes of ample evidence, gleaned from
intelligence sources and scientific journals, that his former homeland’s
bio-weapons program has never been dismantled as promised by a
procession of Russian leaders through to Boris Yeltsin.
D.A. Henderson, who was the director of WHO’s Smallpox Eradication
Unit and is now a professor at Johns Hopkins School of Public Health and
the founder of the Johns Hopkins Center for Civilian Biodefense Studies,
is quoted in the New Yorker as admitting that “the way air travel is
now, about six weeks would be enough time to seed cases around the
world. An atomic bomb could cause causalities in a specific area but
dropping smallpox could engulf the world.”
Leading epidemiologist and bio-terrorism expert, Michael Osterholm,
reports in “Demons in the Freezer” that conventional wisdom about the
ineffectiveness of biologic weapons because of the difficulties of
dispersing them on the air no longer holds in the face of recent
aerosol-particle technology. Osterholm says he now has sitting on his
desk a device no bigger than the size of a credit card that “makes an
invisible mist of particles in the one-to-five micron size range — that
size hangs in the air for hours and gets in the lungs. … If you load
it with two tablespoons of infectious fluid it could fill a whole
airport terminal with particles.”
In the light of these and other recent revelations, WorldNetDaily
senior editor Betsy Gibson spoke to Dr. James Leduc at the CDC in
Atlanta about how prepared America is for a bio-terrorist attack using
smallpox. Dr. Leduc spent over 20 years in the military in the field of
virology and bio-warfare defense and is now the Associate Director for
Global Health at the National Center for Infectious Diseases.
Question: Do you have any fears that bio-weapons research is going on
in the Soviet Union?
Answer: The Soviet Union is a big place, I have no idea — I would
hope not. … A lot of things have been going on in the past year based
on some congressional funding to the CDC to help prepare ourselves in
case of problems. There is now much tighter control of the shipment of
pathogens that could be used as a terrorist organism. Today it’s much
more difficult to get a hold of plague, for example. If you would like
to have a strain of plague you have to be a well-respected scientist
working in an academic institution which has the appropriate safety
conditions in place. … And you have to be inspected and … it has to
be clear that you are who you say you are. This is a new rule that
Congress put in place … which gives us a little bit of confidence that
not just anyone can pick up a pathogen and use it in their own backyard,
so to speak.
Q: But at the same time, pathogens can be refrigerated and stored. If
the controls have only been in place for about a year, how do we know an
enemy of America doesn’t have pathogens stored?
A: I suppose that’s possible, but I don’t think it’s likely.
Microorganisms have to either be stored in special ultra-low temperature
freezers or continually kept in some sort of growth culture so they
remain viable — generally speaking they don’t do very well in just your
kitchen refrigerator.
Q: But Alibek points out that bio-weapons totally fit the bill of the
Soviet Union’s special military needs. For instance, Russia faces the
threat of regional conflicts more than that of one all-out war. And then
there are their personnel problems of an unpaid, undisciplined military.
Surely Russia’s brilliant military strategists have long understood that
bio-weapons are an answer to their problems and so, for a very long time
have gone to whatever lengths necessary to develop them?
A: It’s certainly possible, that’s correct. And that’s part of our
concern today and part of the national efforts to try and improve our
defensive posture against this threat. I started to tell you some of the
things we’re doing. One of them, as I said, is control of access. One of
the others is to work very closely with each of the states’ public
health departments to make sure that they have the ability to diagnose
some of these more exotic thread agents and have in mind a
well-articulated plan on how to manage cases. This is a program that’s
ongoing: trying to augment the resources of each individual state so we
have diagnostic capability and a political plan in place. We’re also in
the process of developing a national stockpile primarily of drugs and
also vaccines for smallpox to be used in the event of a terrorist
attack.
Q: But right now aren’t we completely vulnerable to a smallpox
attack?
A: We, like every other country in the world, no longer vaccinate
anyone against the virus and we haven’t for many years. So from that
perspective we’re all pretty much in the same boat — we do have some
vaccine that is stockpiled away and has been for many years.
Q: In Pennsylvania, that’s the only place in America there’s any
vaccine, right?
A: That’s correct. There are 15.4 million doses of vaccine there.
Q: So, technically speaking, if there were a smallpox attack tomorrow
we could only save 15.4 million of our population.
A: 15.4 million could get the vaccine, assuming it was used in the
most efficient way possible. But, in the case of emergency need, we
would consider diluting that vaccine. Let me explain. The vaccine is
freeze dried: When it’s reconstituted a single dose can immunize 100
people. But we haven’t done these experiments yet to clearly show that
would work, those are actually planned for the very near future.
Q: How near?
A: The protocols are being written at NIH (National Institutes of
Health) right now so I would expect that would be done by the end of the
calendar year.
Q: Why, suddenly, are we concerned about our supply of smallpox
vaccine?
A: Well, we’ve all seen the articles in the newspaper and Alibek’s
comments and all the rest has certainly got the attention of Congress,
the public health community in general and the Department of Defense and
everybody else. …
Q: So this represents something of a sea change? Whereas in the past
we believed that agreements with the Russians kept us safe, now we see a
lot of signs that we can’t depend on the non-use of bio-weapons just
because we have signed agreements against them?
A: I think you could say that, absolutely.
Q: Is there any chance that those who have been willing or even
planned to use bio-weapons will now react to our attempts to defend
ourselves? In other words, is there now a similar dynamic, as is being
feared with Russia’s nuclear weapons — i.e., that with Y2K computer
problems possibly undercutting Russia’s only real remaining strength,
its nuclear weapons — its leaders will adopt a “use it or lose it
strategy” before the year 2000 arrives this December? Could this
strategy now also extend to their bio-weapons — that is, as they see
America waking up to the threat, there will be a race to the finish, and
a feeling on the part of Russia and other countries who might wish us
ill that, “Well, we have to unleash these weapons now before America is
immunized?”
A: (Laughter) Well, I guess that is one interpretation, yeah. You
know we are a very open society and it’s public knowledge how the
government spends its money. So you don’t have to be very inquisitive to
find what we’re doing. I don’t envision a situation where we will
proactively immunize the entire population of the United States with the
smallpox virus. The vaccine itself has some adverse complications and
reactions. So without any clear evidence of disease, the risk/benefit
ratio simply wouldn’t be there. We would be making many more people sick
than we would be protecting, unless we knew for sure that there was a
threat.
Q: If Russia has been developing bio-weapons, they will use them if
they ever end up in a military conflict with us. That could happen
either, as some people say, because Russia has been planning an attack
on America since the ’40s, or just because Russia is now so paranoid
about their financial and other weaknesses, and maybe what they see as
our NATO expansion. Surely if we were not vaccinated beforehand the very
infectious nature of smallpox on our un-immunized population would
decimate this country?
A: That’s certainly the case. If the intelligence community tells us
a threat is imminent then maybe the national leaders would decide to
immunize everyone, but that would be a very difficult decision to take,
I think.
Q: So if it (the decision to immunize) is taken between now and the
end of the year, we don’t know if the vaccine we have now is 1) safe or,
2) strong enough, is that right?
A: We know it is safe … and we would know very early on whether the
diluted vaccine were working. And if it weren’t, we would turn around
and use the more concentrated vaccine.
Q: But if we use the more concentrated vaccine that would only be
enough for 15.4 million people.
A: That’s it exactly.
Q: But that wouldn’t leave much of our population alive. …
A: I think our strategy would have to be to identify cases as soon as
possible and then immunize their contacts very quickly. Now one of the
unique characteristics of the smallpox infection is that you can immunize
people after they have been exposed to the disease but before they
become clinically ill. So there is a window of about four days in which,
even if you were in contact with an infected individual, you could
receive the vaccine and be protected.
Q: But how would you know? If people don’t have any symptoms at all
at first, how would we know in time that they had it? It talks in the
New Yorker article about this smallpox detector that’s been developed,
is that how we’d tell?
A: I think that, generally speaking, patients are most infectious
when they are clinically ill, sick in bed.
Q: And, then, after they took to their beds you’d have four days to
protect yourself if you’d been in contact with them?
A: [When they were so sick they were in bed] is when they would be
MOST infectious, so people who came in contact with them at that time
would be at the highest risk of being infected.
Q: And if they took the vaccine, they’d survive?
A: Now, granted, this is a very tenuous situation. Clearly we need
additional vaccine and we are in the process — in fact we have in the
Congress Daily Bulletin an announcement seeking manufacturers of
additional vaccine and that request calls for manufacturers of a minimum
40 million additional doses of vaccine.
Q: According to the New Yorker article this company called Dynaport
was going to be the only company making additional smallpox vaccine
A: That is the company working for the Department of Defense to meet
their requirements.
Q: Oh, just the Department of Defense?
A: What we are doing is a requirement for the U.S. public in general.
Ours will be a national stockpile, not for the Department of Defense.
Q: But here’s the thing: according to the New Yorker that smallpox
vaccine contract for the armed forces costs $75 a dose.
A: (Laughter) Well, we’re hoping not to pay quite that much.
Q: (Laughter) Well, if it were $75 a dose, that would be practically
more money than we have to pay for it, wouldn’t it?
A: Yeah, sure. You’re absolutely right. You have to think in terms of
vaccine production in general. Today no one is making smallpox vaccine
— there is no market for it. So consequently the first doses are going
to be extremely expensive because we have to, in essence, make the
production capacity and validate it with all of the FDA requirements.
But once that’s in place it is substantially less expensive to produce
the vaccine.
Q: But IF there were enemies of ours who had smallpox — even
forgetting some hybrid combination of Ebola and smallpox [which the New
Yorker article said Russia had been working on] — IF they loosed even
just garden variety smallpox on us, in this moment in time we don’t have
the vaccine, or the money to buy the vaccine.
A: We don’t have the vaccine; that’s absolutely true. I think we will
have the money to purchase additional vaccine.
Q: So if a missile loaded with smallpox struck America now, what
would be the chain of the events?
A: There are lots of variables there. Number one, you have to assume
that if it’s classic smallpox, there is a two-week incubation before
those people [near where the missile hit] would develop symptoms.
Q: No one would even know they had smallpox at first, right?
A: Correct, but if a missile landed here someone would be very
excited and out sampling it to find out what was in that missile, and
we’d have two weeks to figure it out. Then it’s a question of whether
our physicians will recognize smallpox, most of them have not seen
clinical smallpox ever in their career. A few of them will recall it
from their textbooks, so there is going to be some scratching of heads,
of “What this is?”
A lot of people are going to say, “This is chicken pox.” If there is
more than one case, especially if they are clustered in one area, I
suspect the public health community will pick it up and realize
something unusual has occurred. Then we’ll have the focus — there would
be an outbreak and we would respond and use our 15 million doses of
vaccine just as prudently as possible.
Q: But isn’t it possible that the virus could be carefully snuck in
via little suitcase pathogen bombs and carefully plotted to be released
in hundreds of little towns so there would never be the number of
initial cases necessary to figure out it was smallpox before it was too
late?
A: Absolutely. You can envision all sorts of scenarios where things
would just not go very well at all. I think one of the things you need
to remember is that anyone who is going to perpetrate this is going to
be at risk of the disease themselves.
Q: But not if they have the vaccine —
A: — But no one in the world has [access] to the vaccine.
Q: How do we know that?
A: (Laughter) WHO has done a survey that shows there are about 60
million doses globally.
Q: But I understand the vaccine we keep in Pennsylvania is kept in
the equivalent of a couple of card files?
A: That was from the New Yorker article. It is very adequately
stored. I’ve seen it; it’s not in cardboard boxes.
Q: Oh no, no, no, no, I don’t mean that it isn’t adequately stored, I
mean that it doesn’t take up much space.
A: Well, that’s absolutely right.
Q: So how hard would it be to hide it?
A: Hide the vaccine? You’re talking about some adversary hiding their
store of vaccine?
Q: Yes! How does WHO know that there are only 60 million doses of the
vaccine if it’s that small and easy to hide?
A: Why would anyone hide it? This is an inquiry that WHO made to
ministries of health just asking them how much vaccine they held.
Q: Yes, but if an adversary was ever thinking of using smallpox, they
would have the vaccine and they wouldn’t tell WHO.
A: Sure, well, maybe that’s the case. But I would suspect that anyone
who would want to do that would have their team immunized before they
started to spread it around.
Q: Right. But who is to say that hasn’t happened? In his book
“Biohazard,” Alibek talks about how, when Russia was developing its
smallpox bio-weapons, they were very concerned that their scientists not
be seen with the telltale mark of a smallpox vaccination (for instance
on their arms, where many Americans over the age of 40 can remember
getting it). So Russia made its bio-weapon scientists be vaccinated on
their bottoms.
A: You can envision all sorts of scenarios.
Q: But it would not be hard, surely, to hide the fact that even
thousands of peoples hadn’t been vaccinated, if the mark was on their
bottoms?
A: (Long chuckle) Well, I suppose, that’s certainly possible, I’ll
give you that, but it’s not very likely.
Q: Why?
A: You get a pretty good-sized pustule as the vaccine develops, and I
think people would be pretty uncomfortable, but that’s neither here nor
there — I mean your point is well taken, and if someone wanted to do
that (immunize a group of people) it could absolutely be done. You’re
right. The bottom line is that we as a nation now recognize our
vulnerability and are working as quickly as we can to resolve it.
Q: But how did it come to pass that we were this vulnerable?
A: Well you’re looking at 20 years worth of — remember, America got
out of the offensive biological warfare business in 1969, the formal
treaty was signed in 1972. Since then we have systematically stopped all
offensive programs. Now it turns out that, unbeknownst to us, Russia and
some of the other nations continued. Now whether or not that’s true
today, I don’t know.
Q: But surely why, if in the early ’90s Russia was insisting it was
innocent and Alibek says they were lying, would they tell the truth now?
A: I don’t know — this is not a public health question.
Q: But during your time with the military did they just assume that
if the Russians said they had stopped working on bio-weapons, they were
telling the truth?
A: No, but those are questions you need to direct to the military.
There has always been an active contingency debate and defensive program
against biological warfare.
Q: But if that was the case, how come we’re sitting with no vaccine
for smallpox?
A: Well, there’s a fairly convincing argument for why smallpox is not
an especially good biological warfare agent. Certainly during the ’80s
it was not considered to be a threat. That decision has obviously been
reversed in the ’90s.
Q: Why in the ’80s was it not considered a threat?
A: It’s not especially easily transmitted; plus, I think there was a
feeling that (it wasn’t a threat) because it would be such an
unthinkable crime against humanity to ever use smallpox as a weapon when
the whole world had worked so closely together to eradicate it. …
Network ‘news judgment’ depends on who benefits
Tim Graham