Friday, December 19, 2014

The US Should Not Destroy its Smallpox Stock

In July this year, some employees at the National Institute for Health (NIH) in Bethesda Maryland came across something startling when they were cleaning out an old storeroom.  They found a half-dozen vials of variola, also known as the smallpox virus, from the 1950s.  Smallpox is one of the deadliest and most infectious diseases on the planet.  These samples were sent to the CDC (Center for Disease Control) in Atlanta to be tested, and as it turns out, they were indeed active.  That’s a little disturbing.  After being confirmed active, the samples were destroyed in the presence of WHO (World Health Organization) officials.  Sounds like there are some trust issues.

But who can blame them for not trusting us?  After all, the CDC has maintained a large cache of variola samples against the WHO recommendation.  These two organizations are on opposite sides of a decades long debate that has just been reignited -- Should all known samples of smallpox be destroyed or not?
The United States should not destroy its stock of variola, the viral pathogen that causes smallpox, but maybe not for the reasons you think.
Those on one side of the fence argue that the risk associated with maintaining the deadly virus is greater than the potential benefits from it.  Accidents pose the primary risk, though theft and weaponization are a concern, albeit farfetched given the security levels at the CDC and at the Russian State Research Center for Virology and Biotechnology in Koltsovo, where the only other known stock is.  That argument will always be there, unless we make it a common practice to vaccinate populations against smallpox again, but that seems unlikely.  
Unfortunately, destroying the two remaining known stocks of variola is not the same as destroying all remaining variola, just as the rediscovery of those long forgotten vials at the NIH iterates.  The security provided by destroying them is only psychological.  There are undoubtedly other samples out there, and they are likely to be held at less secure locations and discovered by clumsier and more nefarious individuals than those roaming the halls of the NIH.  Additionally, it could always pop up in nature (you know, like it did in the first place) either in the same form or a different strain from the same, still-existent progenitors of variola.  
What’s even less comforting is that it has a carrier that will never die; the Internet.  The genome of smallpox (and many other deadly pathogens like the 1918 flu and poliovirus) is freely available in online public databases.  A quick web search shows that The Guardian was able to obtain a strain of it through mail order.  If you’re willing to pay a small rush fee, there’s still time to order your favorite uncle a stocking-stuffer for Christmas!  If a bad guy really wants to get his mitts on a smallpox virus, he doesn’t have to break into the CDC, he can do it from a public login at his local library.
Now that the myth of security has been debunked, it’s time to look at the benefits the variola stocks can provide.  While it’s true that the samples are not necessary for making small-scale amounts of vaccines, they are still hugely valuable in studying the mutation and evolution of viruses and in techniques for developing new vaccines.  For example, the virological study of smallpox identified a genetic mutation found in some people that gave them a marked resistance to smallpox coincidently also gave them nearly complete immunity from HIV.  
smallpox virusIronically the appearance HIV is the biggest development in the realm of infectious disease since the eradication of smallpox.  The irony would turn tragic if destroying the smallpox specimens cut off life-saving developments.  But the virus is not limited to helping with HIV studies, it is one of the most well followed virus strains, which allows us to gain better insights about innumerable diseases, both infectious and autoimmune.  Given the minute risks posed by housing the smallpox virus at a careful and secure facility like the CDC, it would be reckless and foolish to cut off all future benefits by destroying them.

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