Shapona, the West African God of Smallpox (1969). Image Source: CDC (ID #15226).
Caption for the above photograph: "This is a statue of Shapona, the West African God of Smallpox. It is part of the CDC’s Global Health Odyssey (GHO) collection of artifacts. A uniquely carved wooden figure, it is adorned with layers of meaningful objects such as a monkey skull, cowrie shells, and nails. Donated in 1995 by Ilze and Rafe Henderson, it was created by a traditional healer who made approximately 50 Shaponas as commemorative objects for the CDC, WHO, and other public health experts attending a 1969 conference on smallpox eradication."
Officially, smallpox was eradicated in 1979. One of the most feared of illnesses, it still exists in disease research centres in the United States and Russia. The disease was eradicated through a global mass vaccination campaign in the 1960s and 1970s. To see photos of the disease symptoms, and of the gruesome occasional reactions to the vaccinations, go to the Centers for Disease Control site (here). The images are not for the faint-hearted.
The last people who naturally contracted two variations of smallpox both survived and are still alive. One was Rahima Banu Begum, who had the last known case of naturally occurring Variola major smallpox in 1975, on Bhola Island in the Bangladesh district of Barisal. In a 2009 interview, she stated that she is still treated poorly by villagers and family members because she once had the disease. The other is Ali Maow Maalin, a Somalian cook who contracted the last case of naturally occurring Variola minor smallpox in 1977. Interviewed most recently in 2006, he now works for the World Health Organization to promote vaccination campaigns.
Smallpox and humans have a long history. The virus emerged around 10,000 BCE. Wiki notes some of the virus's modern history: the disease devastated Native American populations with the arrival of European colonists in the 16th century; with no previous exposure, they died at the rate of 80 to 90 per cent. Sometimes, Europeans infamously spread smallpox to Native Americans on purpose, although historians debate the degree to which this occurred. Smallpox killed about 400,000 Europeans annually at the end of the 18th century. It killed between 300 million and 500 million people in the 20th century.
Vaccination against the disease also had a long history. Intentional exposure of healthy people to another's smallpox scabs was practiced as far back as 1,000 BCE in India; this exposure might cause death, but usually brought on a mild form of the disease, which one might survive, thereafter becoming immune. The smallpox vaccine was the world's very first vaccine to be developed, by Edward Jenner in 1796, through his use of the milder cowpox virus. Similar treatments had preceded Jenner's work as early as the 1770s. The term 'vaccine' comes from the Latin vacca for cow.
The development of a stable vaccine in the 1960s led to the World Health Organization's innoculation campaign between 1967 and 1977. After a fatal 1978 accident at a UK repository, only two repositories of the disease remained: the Centers for Disease Control in Atlanta, Georgia and the State Research Center of Virology and Biotechnology (VECTOR) in Koltsovo, Russia.
Since then, smallpox lurks in hideous sleeping afterlife, always promising to reemerge as the ultimate bio-threat. When one considers that smallpox was humanity's constant companion for some twelve millennia and has only been at bay for a mere 33 years, it is easy to see why it is still a cause for worry. Most disturbing, perhaps, is the possibility that weaponized artificial smallpox could be created as bioengineering gathers pace. But another thread appears through all the fears of pandemics, the politics, the foreign policy and secrecy: the smallpox vaccine offers a potential cure for some cancers.
Below the jump, see some points about smallpox which have come to light since 1990.
- 1991: "Responding to international pressures, in 1991 the Soviet government allowed a joint US-British inspection team to tour four of its main weapons facilities at Biopreparat. The inspectors were met with evasion and denials from the Soviet scientists, and were eventually ordered out of the facility. In 1992 Soviet defector Ken Alibek alleged that the Soviet bioweapons program at Zagorsk had produced a large stockpile—as much as twenty tons—of weaponized smallpox (possibly engineered to resist vaccines, Alibek further alleged), along with refrigerated warheads to deliver it."
- 1990s: There are worries about Russian or American scientists with access to smallpox, who might take it to other countries: "Twenty miles south-east of Novosibirsk, in Siberia, several dozen concrete buildings have been erected outside the town of Koltsovo. The settlement is ringed with triple rows of barbed wire fences. Video cameras and motion sensors monitor any activity near the wires while soldiers from an elite Russian army unit patrol its perimeter.This is Russia's State Research Centre of Virology and Biotechnology – or Vector, as it is usually known. ... Vector contains a number of unsettling scientific secrets, with the most sinister being housed in bio-containment laboratory P-4, in Building 6. Here a small storage plant, chilled by liquid nitrogen, holds phials of one of the deadliest pathogens known to medical science: the smallpox virus. ... [M]any senior scientists and defence officials in Russia and the US – who say it would be a calamity if the smallpox pathogen was destroyed. These virus supporters, who are known as 'retentionists', argue there is a strong prospect that smallpox samples may already have been obtained by terrorist groups and that the Vector and CDC stocks will therefore be needed to help defend the world from bio-terror attacks. To back this point, the Russians say Iran made several attempts in the 1990s to recruit some of their Vector scientists – efforts that may have been successful in a couple of instances."
- Late 1990s: "U.S. intelligence reports suggest that undocumented smallpox cultures exist in four countries [besides the US]: Iraq, North Korea, Russia and France. If an active French research program actually exists, it is believed to be defensive, but is nonetheless illegal under current conventions, a matter of some sensitivity given France's opposition to war with Iraq. There appears to be some evidence that Osama bin Laden was pursuing weaponized smallpox development, but it is not believed that he has succeeded."
- 1997: "[T]he Russian government announced that all of its remaining smallpox samples would be moved to the Vector Institute in Koltsovo. With the breakup of the Soviet Union and unemployment of many of the weapons program's scientists, US government officials have expressed concern that smallpox and the expertise to weaponize it may have become available to other governments or terrorist groups who might wish to use virus as means of biological warfare."
- 1999: "At a meeting of experts convened by the CDC in June 1999, of all the potential biological weapons identified, smallpox was unanimously determined to pose the greatest threat to the United States."
- 1999: Consensus statement from the Journal of the American Medical Association, Smallpox as a Biological Weapon, Medical and Public Health Management: informs health care workers what to do in the event of a smallpox bioterrorist attack.
- 1999: Emerging Infectious Diseases issue describes a whole array of bioterrorist events and potentials, including Nuclear Blindness: An Overview of the Biological Weapons Programs of the Former Soviet Union and Iraq: "Of overwhelming importance has been the capability to undertake a strategic attack using plague or smallpox. Intercontinental ballistic missiles with MIRVed warheads containing plague were available for launch even before 1985, and SS-11 and SS-18 missiles have been mentioned in this connection."; also included in this journal issure are - Smallpox: An Attack Scenario; and Aftermath of a Hypothetical Smallpox Disaster.
- 2000: Oxford University gets a generous amount of funding from the National Foundation for Cancer Research to set up the Centre for Computational Drug Discovery. Oxford forms partnerships with IBM, United Devices, Accelrys, Evotec, and the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) to form the Smallpox Protection Project, which aims to preserve smallpox for research - notably cancer research.
- 2001 (December): The Lancet comments that USA will stockpile smallpox vaccines.
- 2002: The WHO publishes genome-wide analysis of the impact of smallpox infection on the human body.
- 2002: US Army publishes research on lethal infection of primates with smallpox as a model for human infection.
- 2002: New Zealand "infectious diseases committee made the decision to import ... [10,000 doses of smallpox] vaccine without telling the prime minister. 'My understanding is that the ministry believes that the threat of the virus being used in New Zealand is remote but they have made a decision and directors of public health do have statutory rights to make decisions,' [PM Helen] Clark said. The move has brought criticism from national. 'What we're unhappy about is the fact the government doesn't seem to have a plan and doesn't seem to know what it's doing,' Bill English, leader of the Opposition said."
- 2002: The German government asks the Robert Koch Institute to prepare a plan in the event of a smallpox bioterrorist attack.
- 2002: The Sunshine Project and Third World Network prepare a report criticizing the WHO's retreat from a worldwide vaccination campaign.
- 2002: The same report by The Sunshine Project and Third World Network, entitled The Genetic Engineering of Smallpox, WHO’s Retreat from the Eradication of Smallpox Virus and Why it Should be Stopped, expresses concern "that artificial gene synthesis could be used to recreate the virus from existing digital genomes, for use in biological warfare. Insertion of the synthesized smallpox DNA into existing related pox viruses could theoretically be used to recreate the virus. The first step to mitigating this risk, it has been suggested, should be to destroy the remaining virus stocks so as to enable unequivocal criminalization of any possession of the virus."
- 2002: UK Prime Minister Tony Blair pushes through £79 million for smallpox vaccines; but £32 million of that money goes to a company owned by Labour donor Paul Drayson, who is later linked to a 2005 TB vaccine medical funding controversy.
- 2002: Fearful UK docudrama, Smallpox 2002, produced before 9/11, depicts a fictional act of bioterrorism in which weaponized smallpox creates global devastation. See a clip here.
- 2002: Pravda: "One day after the British authorities announced a mass vaccination programme against smallpox, the USA, France and Canada ha[ve] confirmed plans to carry out a large-scale inoculation project against the same disease."
- 2002: France denies that it possesses a smallpox stock: "Somebody in Washington's national security establishment just stuck it to France. In the Nov. 5 Washington Post, Barton Gellman reports that a U.S. intelligence review has found that four nations possess covert stockpiles of smallpox. Three of these nations are entirely predictable: Iraq, North Korea, and Russia. The fourth, France, is not."
- 2002-2003: Conspiracy theorist skeptics react to the government calls for smallpox vaccines and the potential of bioterrorism, regarding it as a scary story to appropriate public monies: "From 9/11 until early 2003, popular media employed a brilliant menage of pseudoscience and well-edited history to concoct a new myth out of thin air: terrorists were about to release smallpox as a bioweapon that could decimate our population. Government leaders with degrees in law, not science, decided to prepare enough vaccine to inoculate every American. And to empower themselves to legislate the vaccine’s administration, sanctioned by severe penalties for refusal. ... Price tag for the new doses: over $3 billion. But what is money when compared with the health and security of the American people? Answer: it’s still money. Post-9/11 politics created marketing niches the likes of which the world had never seen. The illusion of a smallpox threat was crafted – a $3 billion dream. ... Throughout 2002, the unlettered public were unrelentingly terrorized with media scenarios of crazed Muslims unleashing weaponized smallpox into metropolitan areas, supposedly resulting in epidemics of smallpox spreading like wildfire through an unvaccinated population, etc. ... Despite all this, the FDA, CDC, HHS, Office of Homeland Security, plus many of the new offices which suddenly emerged at the trough, decided that a few companies should produce enough vaccine to give all 280 million Americans ‘protection.’ ... The companies included Aventis in France, Acambis in England [by 2008, both Aventis and Acambis fell under the name of the Sanofi multinational company], and Wyeth in the US [which, as of 2009, belonged to Pfizer]."
- 2002-2003: Australia stockpiles smallpox vaccine against a national emergency.
- 2003: AP: "Germany plans to stockpile enough smallpox vaccine by the end of the year to protect its entire population of 82 million from a terrorist attack with the virus, the government said Wednesday.The government has 36 million doses of the vaccine and will increase that to 100 million this year, Health Minister Ulla Schmidt said. The program's cost has been estimated at up to $169 million."
- 2003: Canada begins vaccinating first responder workers against smallpox, but institutes no vaccination plan for the general population, implementing instead a 'search and contain' policy in the event of an outbreak: "On a voluntary basis, a number of 'first responders' will be pre-vaccinated for smallpox, beginning in early 2003. First responders, such as laboratory workers and emergency public health workers, among others, would be the first to respond in the unlikely event of smallpox appearing in Canada."
- 2003: Hundred-year-old smallpox scabs found inside a book in a New Mexico university library: "[F]ound March 31 by librarian Susanne Caro in an 1888 book on Civil War medicine at the College of Santa Fe's Fogelson Library. An inscription on the envelope reading, 'scabs from vaccination of W.B. Yarrington's children,' was signed by Dr. W.D. Kelly, the book's author. Caro e-mailed the Frederick museum the same day, asking, 'could these be dangerous?' Her second question: 'would the museum want them?'" Two FBI agents pick up the scabs and send them to the CDC.
- 2003-2004: Guardian report: "[In January 2011], an unnamed US scientist – who was also a former UN inspector – told the Wall Street Journal that inspections in Iraq in 2003 and 2004 provided some 'credible intelligence that suggests it [the virus] was there'. Hence the need to retain smallpox samples and to continue testing drugs and vaccines that could counter the disease if a release occurred."
- 2003: NYT: Smallpox Virus: The Secret Stocks: "Official supplies of the variola virus that causes smallpox are confined to two high-security laboratories in the United States and Russia, but the virus is still regarded as one of about 20 pathogens that could be used in a biological attack. A recent Bush administration intelligence review reportedly concludes that stocks of the live virus are also held by Iraq, North Korea and, more surprisingly, France, and that Osama bin Laden had devoted resources to developing smallpox as a biological weapon. The French government vigorously denied the report, but the growing indications that the genie is at least partly out of the bottle is likely to cause governments to review and step up procedures for dealing with infectious threats."
- 2004: The WHO reports to the World Health Assembly on the destruction of smallpox stocks (subsequent reports on the same topic from 2005 and 2006 are no longer online).
- 2004: Project Bioshield Act, United States: "The Project Bioshield Act was an act passed by the United States Congress in 2004 calling for $5 billion for purchasing vaccines that would be used in the event of a bioterrorist attack. This was a ten-year program to acquire medical countermeasures to biological, chemical, radiological and nuclear agents for civilian use. A key element of the Act was to allow stockpiling and distribution of vaccines which had not been tested for safety or efficacy in humans, due to ethical concerns. Efficacy of these agents cannot be directly tested in humans without also exposing humans to the chemical, biological, or radioactive threat being treated."
- 2005: University of Minnesota, Center for Infectious Disease Research and Policy report, Smallpox exercise shows shortages of vaccine: Top officials from several countries participate in a smallpox pandemic mock-up, called Atlantic Storm: "A recent exercise that confronted international leaders with a hypothetical smallpox attack showed the potential for tensions between countries that have enough smallpox vaccine and those that don't, according to news reports. In the exercise, called Atlantic Storm, about 10 current and former high-ranking US and European officials grappled with an imaginary release of smallpox virus in major cities in Germany, Poland, the Netherlands, Turkey, and the United States. The scenario had the leaders gathered at a mock Washington summit meeting at the time of the attack. As imaginary smallpox cases mounted, so did worries over whether and how to share limited supplies of vaccine, according to media reports and a news release from the University of Pittsburgh Medical Center (UPMC) Center for Biosecurity, which cosponsored the exercise. US health officials have repeatedly said the nation has enough smallpox vaccine for the entire population. The UPMC said Britain, France, Germany, and the Netherlands are in the same position, but Italy and Sweden could vaccinate only about 10% of their populations. The Washington Post said Canada and Japan could vaccinate only about 20% and Turkey only 1%. In the exercise, Turkey, a NATO member, demanded immediate shipments of vaccine from its NATO partners, according to Post columnist Anne Applebaum. But former US Secretary of State Madeleine Albright, playing the role of US president, said the American public objected to sharing vaccine with countries that didn't support the United States in its war in Iraq. The participants also argued about whether to use targeted or mass vaccination strategies and about which institution the United Nations, the European Union, NATO, or others should lead the global response. A Post report by John Mintz said possibly the major lesson of the exercise was that there is 'no playbook anywhere' to guide leaders on how to share supplies of vaccine or who should make such decisions. Participants eventually agreed that the World Health Organization (WHO), part of the UN, should take the lead ... . But because of pressure from US groups that distrust the UN, Albright went along with that only reluctantly. Further, former WHO Director-General Gro Harlem Brundtland cautioned that the WHO has a budget 'about as big as that of a middle-sized English hospital' and was already under strain because of the recent tsunami in Asia, according to the UPMC release. Another contentious issue was whether it is safe to dilute smallpox vaccine by 5 to 1 to stretch supplies, the Post reported. US scientists supported dilution, but the Europeans opposed it. (Recent US clinical trials of the Dryvax vaccine showed that it remained effective when diluted 5 to 1.)"
- 2005: Danish company Bavarian Nordic, with German and Finnish links, develops smallpox vaccine with lower risk and begins filling orders to 30 different governments worldwide: "Clinical studies have compared traditional Vaccinia smallpox vaccines, such as Dryax manufactured by Wyeth-Ayerst, with the Bavarian Nordic MVA-BN third generation smallpox vaccine IMAVMUNE and have found there are far fewer side effects. The new vaccine is safe to be given to patients in known high-risk groups such as immune compromised, elderly, pregnant and young patients, along with those suffering from atopic dermatitis. The previous vaccines were known to elicit a very severe response in, or be dangerous to, these high-risk patients. The US government is seriously considering using this 'safer' vaccine for the entire nation. Bavarian Nordic was awarded a contract from the US Department of Health and Human Services in May 2005 for 80 million doses (RFP-III draft contract). The plant can produce 60 million doses per year."
- 2005: The UK Department of Health vaccinates 516 volunteer first responders against smallpox, but fails to renew their vaccinations between 2006 and 2011.
- 2006: President Bush requests over $4 billion "for the 2006 budget for biodefense at the Department of Health and Human Services. Much of this money is targeted to the National Institute of Allergy and Infectious Diseases ( NIAID) component of the National Institutes of Health ( NIH) and the Centers for Disease Control and Prevention ( CDC)." A portion of NIAID funding goes to the Baylor College of Medicine in Houston, Texas, whose "Investigators in the Department of Molecular Virology and Microbiology (MVM) ... study immune responses to the smallpox virus and for vaccine development studies." (Their research is outlined here.) They have already found in 2004 that they can reduce smallpox vaccine morbidity by lowering the dose of vaccine, without diminishing the effectiveness of the vaccine.
- 2006: ABC News: "U.S. intelligence believes four nations other than the United States — Iraq, North Korea, Russia and France — probably possess samples of the smallpox virus, a U.S. official said."
- 2009: CBS News: "France said Wednesday that it does not have any samples of the smallpox virus, strongly denying United States assertions that France has retained supplies in violation of international rules. ... However, U.S. intelligence officials said Tuesday they believe that four nations have hidden unauthorized samples of the deadly virus - Russia, Iraq, North Korea and France. France 'strongly denies' the accusation, said Foreign Ministry spokesman Bernard Valero. 'France scrupulously respects its international engagements,' Valero said. 'Therefore, France does not possess any stocks of smallpox in its laboratories, either civilian or military.' U.S. officials said they believe France has small amounts of the virus for use in programs aimed at researching and mounting a defense to an outbreak of the disease. Valero said France has limited its smallpox research to the search for a new-generation vaccine. Researchers have used only 'authorized animal samples, which are not dangerous to man,' he said. The Bush administration is concerned that Iraq and North Korea could develop potent biological weapons with their samples, which are believed to exist in small amounts. Officials also fear lax security in Russia could allow other nations to obtain the deadly disease for use as a weapon. Russia is thought to have a great deal more smallpox in its stockpiles than the small amount allowed for them under international agreements, according to the officials. Al Qaeda is also believed to have sought samples of smallpox for weaponization, but U.S. officials don't believe the terror network is capable of mounting an attack with smallpox."
- 2009: Japan develops a smallpox vaccine without the frightening side effects of the earlier vaccines, and uses human test subjects: "'Developing a vaccine that is safer than first-generation vaccines yet highly immunogenic is crucial to constructing a prevention plan in the event of a bioterrorist attack,' wrote the authors of the study, which was published in the Journal of the American Medical Association.In the trial, scientists tested a smallpox vaccine which was first given to infants in Japan in the 1970s. They gave single shots of the LC16m8 vaccine – which uses a live, attenuated virus – to 3,221 participants from the Japan Self-Defense Forces between 2002 and 2005, wrote the researchers, led by Tomoya Saito of Keio University in Tokyo."
- 2010: Dr. Sanjoy Bhattacharya joins the University of York in the UK and begins a dedicated project examining the history of smallpox and its eradication, funded by the Wellcome Trust, and complementing the WHO Global Health Histories (GHH) project.
- 2010: Grant McFadden article in PLoS Pathog 6 (1): Killing a Killer: What Next for Smallpox?: "As clearly pointed out in a recent book by D. A. Henderson, one of the leaders of the global smallpox eradication program, this task of ridding Homo sapiens from the curse of this ancestral disease was neither easy nor without controversy. In fact, the history of the many consequences of smallpox on humankind reads like a long litany of human misery and calamitous events, but is juxtaposed with the more noble accomplishments that began with the discovery of vaccination by Jenner in 1798 and culminated with the World Health Organization (WHO) certifying the world free of smallpox in 1980. With this singular accomplishment, as many as 60–100 million individuals who would have been predicted to die of smallpox have been spared from a truly gruesome death. Nevertheless ... the narrative of smallpox did not stop with its eradication as a pandemic human disease. Instead, we find ourselves still wrestling with an issue that intermingles public health policy, philosophy, national security, and bioterrorism, and affects our perceptions of research ethics with extreme pathogens in general. It boils down to a not-so-simple question: What exactly should the Victor do with the Vanquished?"
- 2010: The WHO conducts a major review of smallpox research (published here) in order to assess the timing for destruction of existing smallpox virus stocks. The report notes slow efforts to improve the original vaccine, which was dangerous: "New generation vaccines consisting of live vaccinia virus with specific gene mutations, DNA (deoxyribonucleic acid) encoding poxvirus genes and purified proteins have all shown promise in animal models, but none have reached clinical testing." The conclusion confirms that the stumbling block is the inability to test new treatments; which are limited to being tested on people who have contracted monkeypox: "It is not currently possible to predict how much longer work with live VARV will be required. However, it would certainly be required until at least two drugs are approved for treatment of clinical smallpox. The USFDA has repeatedly stated that it does not see a path to drug approval that does not require efficacy data in a VARV challenge model. Because it will not be possible to conduct clinical trials against smallpox in humans, demonstration of efficacy must use the USFDA animal rule (US 21CRF310.610) or other processes mandated by other countries’ drug regulatory agencies for approval in their country. Given the uncertainties in the practicalities of the animal rule, due to its infrequent use to date, and the fact that there is no drug currently approved for smallpox, it is difficult to provide firm estimates on the time line or the data required for USFDA approval. Approval in other countries is at least as uncertain."
- 2011: Third World Network revisits fears about genome sequencing, synthetic biology and smallpox and demands the destruction of smallpox stocks in a Briefing Paper.
- 2011: BBC reports that the WHO hesitates to destroy smallpox stocks: "Professor John Oxford, a virologist at Queen Mary University of London, believes the bioterrorism threat is 'a load of old tosh' but still argues in favour of keeping the virus. He said the decision was 'tricky' but added: 'I don't think there's a strong argument to destroy stocks, just an instinctive feeling to do it, which is misplaced. It's eradicating a whole species and you never know what the future might hold.'"
- 2011: The WHO initiates a program to facilitate smallpox research.
- 2011: Is Bizarre Smallpox Drug Deal Obama Administration's Next Solyndra?: "David Williams of The Los Angeles Times has uncovered a $433 million dollar government contract to purchase a smallpox anti-viral drug that may, or may not, be necessary in the case of a bioterrorist attack. For that matter, we are not even sure if the drug will work. ST-246, a pill to be manufactured by Siga Technologies, Inc., would come into play as a second level of defense in the event of a smallpox attack. Currently, the nation has stockpiled some $1 billion in smallpox vaccines, enough to inoculate the entire U.S. population and treat those who have contracted the disease. But there is the catch. The vaccine is only effective if provided within four days after the disease is contracted. And that is where ST-246 comes into play. According to Siga Technologies, the pill would save the lives of those afflicted with smallpox that are not treated within the four day window. Yet, we are not sure the treatment will work. Ethical considerations (we do not permit healthy people to be infected with a dose of smallpox) prohibit testing the drug on humans and successful testing on animals is no guarantee that human recipients will respond in the same way."
- 2011: RSC report: Smallpox vaccine puts cancer in its sights: "The results of a human cancer therapy trial show for the first time that tumours can be targeted and infected by engineered viruses, without damage to surrounding tissues. The approach, which uses the virus used in smallpox vaccinations, provides a means to deliver a wide variety of different anti-cancer molecules to tumours."
- 2012: CDC and Saint Louis University School of Medicine scientists publish research in Clinical and Vaccine Immunology on markers which enable development of effective third generation vaccines, even if human tests cannot be used or if existing smallpox stocks are destroyed.
- 2012: Forbes report: When Americans Rejected Smallpox Vaccines: A look back at the 1900 smallpox epidemic shows a long history of popular dislike of innoculations and vaccinations, which persists to the present, on both the political left and right.
- 2012: ABC News report: Smallpox Virus May Help Treat Deadly Form of Breast Cancer.
- 2012: SFGate report: Smallpox Vaccine Kills Liver Cancer.
- 2013: Washington-based think tank, Center for New American Security publishes a Policy Brief: Renewing the Project BioShield Act, What has it Brought and Wrought?: "Project BioShield was conceived over a decade ago in the aftermath of the 9/11 terrorist and anthrax letter attacks, when the perceived risks of CBRN [chemical, biological, radiological or nuclear] attacks on the homeland loomed large. It was viewed an essential element step in acquiring 'effective vaccines and treatments against agents like anthrax, botulinum toxin, ebola and plague' by creating a guaranteed market for such products that otherwise lacked a commercial market. Since BioShield became law, enabled by additional legislative authorities, the U.S. government has demonstrated a commitment and ability to discover, develop and procure MCMs [Medical Counter Measures] for a variety of CBRN threats. In the eight years of BioShield funding, MCMs against four threats have been procured, and advanced development investments are projected to yield MCMs addressing several others. The handful of companies initially involved has grown to over 70 companies and institutions that have received procurement awards or advanced development contracts. Less tangible, but potentially more significant, is the public-private partnership that BioShield created by promoting and fostering a CBRN MCM industry that simply did not exist before. The capacity and capability of this national security partnership is a strategic hedge against an uncertain future created by the increasing availability of the technologies that would permit potential perpetrators to develop CBRN weapons."
- 2013: Fox News report: Man infected with smallpox-like virus through sex: "A man in San Diego was infected with the vaccinia virus — the virus in the smallpox vaccine — in June, 2012 after having sexual contact with someone who'd recently been vaccinated, according to a new report from the Centers for Disease Control and Prevention. What's more, the infected man also passed the virus along to another unvaccinated individual during sexual activity, a phenomenon known as tertiary transmission, the report said." The CDC report in fact dates from June 2012. Five similar cases were reported in 2010 by people who had sex with military smallpox vaccinees.
- 2013: Incidents of Cowpox and Monkeypox on the Rise: "Smallpox, once a major scourge on humanity, was eradicated in 1979 following widespread vaccination programs. Vaccination against smallpox stopped then (the vaccine sometimes had severe side effects) and people lost immunity, not only against the smallpox virus, but also against related pox viruses such as monkeypox and cowpox; viruses against whom the smallpox vaccine had also afforded protection. These now pose a new danger to humans and could become a major problem. The full story is recounted by Sonia Shah in Scientific American, March 2013."
- 2013: Siga qualifies for $79M smallpox drug payment: "Shares of Siga Technologies Inc. climbed Tuesday after the company said it qualified for about $79 million in payments after delivering more doses of its smallpox drug to the government. Siga said it has delivered about 590,000 courses of its drug Arestvyr to the government in the last five months. Arestvyr has not been approved by the Food and Drug Administration, but the government is stockpiling it and another drugs in case of a terrorist attack, biological attack, or a natural outbreak."
- 2013: Ore. company gets first payment for smallpox drug: "CORVALLIS, Ore. — A Corvallis-based company that has developed a drug to treat smallpox as part of U.S. defenses against terror and biological attacks says it has qualified for an initial payment of about $79 million. The money, when it arrives, will be the first cash payment for a deliverable product ever received by Siga Technologies, which has been working to bring a drug to market since its founding in 1995, the Corvallis Gazette-Times (http://bit.ly/16JCGH8) reported. Siga's Corvallis laboratories employ about 70 scientists and technicians. The company consistently spends more on developing the drugs than it generates in grants and other revenues, and reported a net loss in four of its last five fiscal years. According to the company's latest annual report, it finished more than $14 million in the red for 2012, a loss of 27 cents per share.Arestvyr (ah-REHST'-ah-vir) has the potential to change that. While it has yet to be approved by the U.S. Food and Drug Administration for general use, the Biomedical Advanced Research and Development Authority has ordered 2 million courses of the drug for a national stockpile. The drug was developed under Project BioShield, a federal defense program authorized after the 9/11 terrorist attacks."
- 2013: More vaccine research, this time from the CDC and the Epidemic Intelligence Service, tests how the vaccinia virus is transmitted through smallpox vaccines.
- 2013: Brits remain skeptical of use of smallpox in a bioterrorist attack: "Even if potential terrorists were able to get their hands on samples of smallpox, they would also need exceptional knowledge of the virus.‘ Criminals would need the virological knowledge to grow the virus in a lab,’ said bacteriology professor Thomas Pennington at the University of Aberdeen. ‘Current UK examples of bio-terrorist plots (for example, the manufacture of ricin) show a very low level of technical knowledge. It’s also worth noting that the ‘just in case’ argument isn’t necessarily a good one. In the cases that occurred in the UK after World War II – which were usually imported from the Indian subcontinent – more people died from vaccination complications than from smallpox,’ said Prof Pennington."
- 2013: Modified smallpox vaccine found to shrink liver cancer tumours.
- 2013: UC San Diego report: Clinical Trial Evaluates Engineered Smallpox Vaccine as Potential Liver Cancer Killer.
- 2013: The Daily Beast report: Godzilla versus Mothra: Scientists enlist viruses to fight cancer: Could a smallpox shot kill cancer?
- 2013: Fox News report: "Scientists at the University of California San Diego are conducting a clinical trial to see if genetically engineered smallpox virus can be used to fight liver cancer. 'This clinical trial is evaluating a drug already known to be safe as a vaccine. We are applying it as a potential destructive agent for liver cancer,' said Tony Reid, MD, PhD, a professor of medicine at the UCSD School of Medicine. 'The goal of the trial is to evaluate if (the vaccine) can extend patients’ survival through its ability to selectively target and kill cancer cells, cut off the tumor’s blood supply, and activate the body’s own immune system to fight the cancer.' The scientists hope that Pexa-Vec, a genetically engineered virus used in smallpox vaccine, will slow the progression of liver cancer. To qualify for the randomized clinical trial, liver cancer patients have to be unresponsive to sorafenib, the only drug treatment currently approved by the FDA for liver cancer."