The Last Remnants of the Smallpox Virus
On the 8th of May 1980, the World Health Organization declared smallpox to be eradicated. It is the only infectious human disease in history to have this status.
The WHO started their Intensified Eradication Program in 1967 following an earlier campaign that failed due to lack of funds, personnel, and commitment from the affected countries.
At the time there were still millions of cases occurring annually. Smallpox had been eradicated from North America and Europe. Asia, South America, and Africa, however, were still facing regular outbreaks.
The program turned out to be successful. By using techniques such as mass vaccinations, isolation, and a surveillance system where rewards were given to people who reported cases, they were able to completely eradicate the deadly disease.
Rahima Banu in 1975 and Ali Maow Maalin 1977 were the last naturally occurring cases of the smallpox virus. The cases were in Bangladesh and Somalia respectively. Both of them were treated and they survived.
The WHO were close to announcing that smallpox had been eradicated. But in 1978, there was an outbreak in Birmingham during which the virus claimed its final victim.
Janet Parker was the last person to die due to smallpox. She was infected by a strain of the virus grown in the research lab at the University of Birmingham medical school where she worked as a medical photographer. How she contracted the virus remains unknown.
The outbreak was controlled by quarantining and vaccinating over 500 people. Birmingham was declared smallpox free a month later.
The head of the microbiology lab at the University committed suicide as a result of the events that took place.
Following this outbreak, all the existing stocks of the virus were destroyed.
Today, only two stocks remain. One at the CDC in the USA and the other at the Vector Institute in Russia. The samples are stored under the highest level of biosafety precautions, BSL-4.
Whether to destroy or retain the samples has been an ongoing debate.
Since the 1980s, the WHO has advocated for the destruction of the existing stocks of the virus. But due to resistance from parties arguing for retaining the virus, the deadlines set for destruction have been continually extended.
The most recent meeting in 2017 for the matter resulted in the same conclusion.
Those in favour of destruction of the virus claim that there is a possibility of accidental release and that there is no compelling reason why the stocks should be kept. A sentiment shared by the head of the smallpox eradication program.
A recent explosion in 2019 at the Russian lab storing the samples once again brought up the question of destroying the samples. They also fear that it could be used as a bio-weapon. Something that smallpox has been used as in the past.
The advocates of retaining virus have stated that destruction of the remaining samples would be nothing but a symbolic move as forgotten old stocks outside the two controlled locations may still exist. And such stocks of smallpox have been found over the years. They say that the samples have research value and point to the number of anti-viral drugs that have come out of the studies.
While there are arguments to be made on both sides, the entire debate may be unnecessary considering that science has progressed to the point where genetically engineering something like smallpox by using a closely related virus is possible.
Still, the debate raises interesting questions. Who owns these resources? Should total eradication of viruses be the norm? And if research is the primary motive for retaining such samples, who is in charge of weighing the value against the risks?
As the debate has gone on for almost 40 years, it is clear there is no consensus on such matters.
Smallpox was one of the worst diseases to plague humanity. Judging by the lesions on the mummified head of Ramesses V, it has been around for, at least, 3000 years. And since then it has killed millions of people in numerous plagues over the ages. It killed at least 300 million people in the 20th century alone.
Eradicating it was a great feat. It was the first, and remains the only time, that eradication of an infectious human disease has happened.
The debate surrounding these last samples of the smallpox virus gives us a glimpse into what it might be like when we manage to eradicate other viruses.
