ANALYSIS: THE
MOST CHILLING CONSEQUENCES
OF A SMALLPOX ATTACK
by WebToday Editor Lawrence J. Joyce Pharmacist/Attorney-at-Law author of LESSONS FROM DUGWAY: What I Learned About Surviving Germ Warfare At The U.S. Army Proving Grounds (www.germwarfarebook.com)
(WebToday, April 6, 2002)-- The aftermath of September 11th brought American consciousness of the possibility of a germ warfare attack to a previously unseen height. Yet even in the terrorist-astute society in which we now find ourselves, something remains hidden: the most chilling consequences of a smallpox attack.
The last known endemic case worldwide was in 1977, and there are only two official repositories of smallpox virus at the moment: one in the U.S., and one in Russia. But money talks, especially in Russia, and we cannot know for certain how many secretive laboratories worldwide still maintain the virus. North Korea, for instance, is believed to have the virus in its laboratories.
Throughout history, communities which suffered a smallpox outbreak suffered a 20 to 50 percent fatality rate. Some who contracted smallpox in each outbreak, however, had had a mild brush with it earlier in life and had lived to contract it again, developing only mild symptoms in subsequent epidemics. Abe Lincoln may have been one such case. He is believed to have been suffering from a fever caused by smallpox the day he gave his Gettysburg Address. For two days later, he developed a mild form of the characteristic rash.
The last endemic case in the U.S. was in 1949. On this basis, the U.S. medical community decided to stop giving routine smallpox vaccinations to infants in 1972. Those born in the U.S. from that time on have no immunity against smallpox.
The implications of this may be seen in the affect of smallpox on societies which were afflicted with it for the very first time. The Americas had been free of smallpox prior to the arrival of the first Europeans, and whole villages of American Indians were wiped out when the Europeans arrived. Fatality rates are believed to have been as high as 80 percent.
Those Americans most at risk from smallpox today would include those with compromised immune systems. Patients suffering from cancer and AIDS would be hard hit. Also severely affected would be organ transplant patients, who must take immunity-suppressing drugs to prevent rejection of the donated organ, and certain diabetics.
Those least at risk would be healthy individuals born prior to 1972, when infant smallpox vaccinations were still being routinely given. Such vaccinations are not commonly thought to be reliable after ten years. But a study by the Israeli Defense Force found that even 30 years after booster shots of such vaccinations, many patients still show a titer of antibodies against smallpox in their blood streams sufficient to resist the disease. The study also left open the possibility that such immunity may last even longer. And even among such persons, if they were in fact to contract the disease now, they would undoubtedly have a much better chance of survival than those who were never immunized.
Those born from 1972 on, however, may suffer the same fatality rate as the American Indians. The consequences, the most chilling affects of a smallpox attack, would be devastating in a two-fold way. First, such a disaster must spell doom for the Social Security system, and no doubt for all private pension plans as well. For if there is no next generation coming along to work to support the retirees, there simply is no such thing as a retirement system.
Perhaps mass immigrations could fill in the gap in the labor force. But that is only a small portion of the story: Mom and Dad without children. Grandparents without grandchildren. Home videos, pictures, and other such items of sentimental value will remain, but they will be no substitute for the loss of an entire generation of a family.
Why, then, in the wake of the discovery last month of millions of doses of smallpox vaccine, does our government continue to block access to it? Studies have now shown that the vaccine can be diluted to provide more than enough doses to treat every person in the United States. Our government has balked at distributing them now, however, on two grounds. First, the vaccine is produced from a live virus very similar to the smallpox virus, albeit one which is much less virulent. This virus can be shed for a few days from the sore which the vaccination shot produces, and it would probably prove fatal to hundreds of Americans nationwide if done in an unsupervised manner. Yet persons who want the shots could be given the choice of being quarantined while potentially contagious, or at least be required to take training in how to properly bandage the vaccination site, thereby preventing such dire consequences.
Our government has also seen fit to object to immediate distribution on the grounds that the shot can still be effective if given within four days after exposure to the virus. But it takes seven days at a minimum for symptoms to develop (10 to 14 days, on average). So who is going to know who has been exposed and who hasn't been among those who are showing no symptoms? And if you then distribute the vaccine in panic mode (with attendant riots, perhaps, by panicky civilians at distribution centers), how could you possibly expect to keep the vaccine's virus from being shed by the recipients, thereby causing the death of the very persons you were trying to protect in the first place?
Even in light of that possibility, our government seems to have forgotten that being prepared ahead of time will diminish the odds that the attack might actually take place. Those in our government who seem to think that this would not work unless the shots were mandatory for everybody seem to miss the nature of the case. Conventional wisdom holds that for a vaccination program to be effective, virtually everyone must be required to receive the vaccine. The conventional wisdom is probably wrong on that point; the full benefits should be seen so long as the vast majority of the at-risk population is vaccinated. Even so, the conventional wisdom is an attempt to define the nature of the case in a naturally-occurring outbreak. But just the doubt and uncertainty as to whether the desired effects for the terrorist will take place may be enough to cause him to rethink his plans and conclude that it is not worth his risk and his effort. For if his attack achieves only mediocre success, the terrorizing of the population---the true goal of every terrorist---may not occur. For if hope does indeed exist in the form of the vaccine, people will simply clamor for an immediate release of the available vaccine instead of bowing to the terrorist. Such would be a humiliating defeat for him. And that possibility can exist only if we are allowed to receive the vaccine now.
You may email Lawrence Joyce at: germwarfarebook@aol.com
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