Smallpox—eradicated, but a growing terror threat

Abstract

Smallpox is a disease that followed humanity for thousands of years up until 30 years ago. It was possible to eradicate, because an effective live vaccine from crossreacting vaccinia could be developed. Twenty years have passed since vaccinations stopped and very few people are protected against the disease today. Variola today has become an object of discussion due to the possibility that it can be used as a bioweapon. Due to the number of complications that can be expected a general vaccination is probably not possible. Research is ongoing to develop new vaccines. Many countries are improving their capabilities to respond to a renewed threat of a smallpox epidemic.

Coadministration of Cidofovir and Smallpox Vaccine Reduced Vaccination Side Effects but Interfered with Vaccine-Elicited Immune Responses and Immunity to Monkeypox

“…The development of safe and effective vaccines to defend against the spread of smallpox by bioterror remains one of the most important biodefense countermeasures (6,9,14,15,19,21,23,36). Dryvax or Dryvax-derived ACAM2000, the vaccine from vaccinia virus formulations that is associated with the global eradication of smallpox, may hold potential for public immunization against the spread of smallpox through bioterror (9,11,24,25), but there is concern about Dryvax vaccinationinduced side effects.…”

SARS, avian flu, bioterror: infection control awareness for the optometrist

“…In the days and weeks after September 11, the public got a glimpse of what may become a face of pandemic disease delivery in the 21st Century, that is, bioweaponry, as weapons-grade anthrax circulated through the US postal system. 10 The rapid evolution of basic microbiotechnology and hence, affordability of bioweapons, makes them accessible to virtually any group intent on inflicting mass casualties. An oft quoted 1969 study by the United Nations estimated the cost per square kilometre of a large-scale military attack on civilians to be US$2,000 for conventional weapons, US$800 for nuclear weapons, US$600 for nerve gas weapons and US$1 with biological weapons (cited by Pringle 11 ).…”

“…Even if an attack occurred outside our country, we might not be immune, as many diseases have long incubation periods, in the case of smallpox up to 19 days. 10 If one considers the ubiquitous presence of intercontinental flight, a disease outbreak in even a remote part of the world followed by aeroplane travel by an asymptomatic person could conceivably land that person in our office. Given the numerous possible weapons of bioterror 14 and their various modes of transmission, the practising optometrist should have a basic protocol for the control of infection, in case an attack occurs and a disease is spread.…”

Task Force III: Prevention and Control of Cardiovascular Complications of Emerging Infectious Diseases and Potential Biological Terrorism Agents and Diseases

“…Over the next 2 weeks, maculae and vesicles develop and eventually dry into crusts. A milder form of smallpox may occur in those who have been previously vaccinated (20,21).…”

“…Fast diagnostic tests based on deoxyribonucleic acid recognition have been developed, together with sequencing methods for rapid determination of the poxvirus type. Serum antibody levels suggest a specific humoral immune response to the variola virus (21).…”