Forum

Smallpox disease is still a threat, especially to me

Editorials featured in the Forum section are solely the opinions of their individual authors.

Content warning: nasty-ass descriptions of smallpox

Why in God’s good name is our government holding on to a ridiculously infectious and deadly disease that was meant to have been eradicated 50 years ago? The Center for Disease Control in Atlanta has stores of smallpox that they can’t realistically do anything with, and they refuse to get rid of it. They say they’re keeping it in case someone else decides to weaponize smallpox; however, that’s a stupid justification for a few reasons.

But first, a brief intro to smallpox. Smallpox is a terrible illness which ravaged the world for many centuries. The most common form of smallpox, variola major, presents initially with symptoms such as fever and body aches, along with red spots which develop into a rash on the tongue and in the mouth. Anytime the afflicted coughs, they send millions of little smallpox particles into the air around them. As the disease incubates, the rash spreads to the hands and forearms, before slowly working its way inwards until your entire body is covered in pustules. The pustules will then scab over and eventually flake off, showering everyone around you with highly infectious variola confetti. This form has a mortality rate of approximately three in ten, and that’s not even the scariest version.

Hemorrhagic smallpox is much rarer, but truly the stuff of nightmares, with a 100 percent mortality rate. Luckily for us, pox viruses are highly specific to individual species, so they can’t really spread to any other species. This means that a super awesome team of World Health Organization (WHO) doctors were able to eradicate smallpox from the natural world, and we haven’t had a case since 1977! These WHO scientists are literally my heroes, and it is honestly so disrespectful for the CDC to just spit in their face by hanging onto live samples of a disease that they worked so hard to eradicate. Before the eradication, a man named Edward Jenner noticed that French dairy maids who had been exposed to cowpox never got smallpox. In an insanely ballsy and unethical move, Jenner inoculated his gardener’s son. The boy never got smallpox after that, even after Jenner straight up injected the kid with variola. This was pretty much the first vaccination ever, and we literally get our word vaccination from variola vaccinia, the proper name for cowpox. Vaccination against smallpox via cowpox became common practice for a really long time after this, and it worked super well. However, since smallpox has been eradicated, most people born after the early 1970s weren’t vaccinated. Now that you have all the context, let’s get back to why the CDC makes me shake with rage.

As soon as smallpox was eradicated, there was a big push to destroy any stores of variola. We’ve gotten to the point where (theoretically) there are only two places in the world which still have stores of live smallpox: the CDC lab in Atlanta, Georgia, and the State Research Center of Virology and Biotechnology [VECTOR] in Novosibirsk, Siberia. There is no use for them, since there should theoretically never be another outbreak. This subject has been hotly debated since the 1980s, and is unfortunately still ongoing. Since the first meeting of smallpox experts and scientists, anyone who participated in the eradication effort (such as D.A. Henderson, my hero) has adamantly argued against retention, but Peter Jahrling (the true villain of this story) and his band of silly little military scientists want to keep on holding on to it just in case, because they’re like, pretty sure that smallpox probably exists outside of the two places it’s supposed to. They argue that it’s important to keep our variola, because it’s needed for research into potential vaccine improvements, as well as a possible alternative form of smallpox prevention for people who can’t get the vaccine (a.k.a., ME, stick around to find out why). However, this is very stupid of them. Even if they do somehow synthesize something that might possibly be effective against smallpox, there’s no way in hell it’s ever getting approved by the FDA because there are no humans with smallpox to test it on! Furthermore, the FDA will sometimes approve things before they’ve been tested on humans if they prove to be effective in animals which are affected in similar ways to humans, such as monkeys.

Attentive readers will already see the problem with this: smallpox should only exist in humans. Unfortunately, Jahrling once again reared his ugly head and urged on more smallpox research. In summer of 2001, Jahrling and his team were able to do the impossible and managed to give smallpox (a HUMAN POX VIRUS) to a monkey (NON-HUMAN). I am so unbelievably angry about this every time I think about it. Are you fucking kidding me? The only redeeming quality of smallpox is that it has no carriers, and can really only survive in humans, and these bastards gave it to monkeys! The real kicker is that even though the monkeys got smallpox and presented symptoms similar to those in humans, they still can’t use it for research because in order to make the disease present as severely as it does in humans, they had to expose it to a horrifically massive amount of smallpox (somewhere around 100,000,000 times the infectious dose for humans). And guess what… the symptoms still weren’t close enough for the FDA. So now I just have to live with the knowledge that people are giving smallpox to monkeys for no good reason other than to try and make the monkey as sick as possible, with very little chance of actually getting something useful out of it. The research is literally going nowhere, and so there is no reason to keep holding on to the samples. Furthermore, a group from Canada in 2018 managed to recreate an honest to god extinct disease (horsepox) in a lab with relatively little funding and not much specialization. This literally sends every single reason for holding onto smallpox down the toilet. You can literally make smallpox in a lab cheap and easy if it really comes down to us really needing it for some reason. There is not a single reason left to hold onto variola.

While I do admit that there is good reason to believe that other countries have worked on weaponizing smallpox, the CDC as a whole is still on my shitlist. Even as they hold onto their stores of smallpox, just in case of a hypothetical bioterrorism event, they GOT RID OF MOST OF THEIR STORES OF THE VACCINE! This left me utterly flabbergasted when I found out. At one point, the stockpile was as low as 15 million doses of vaccine. If someone was to target a big city such as New York, with a population of 8.38 million people, do you have any clue how many people you would have to vaccinate to contain that outbreak? The main containment strategy for smallpox is called a ring vaccination; essentially, you just vaccinate every single close contact of anyone who’s been infected, and then you vaccinate the close contacts’ close contacts. That is such a ridiculously large number of people. What if multiple cities had been targeted at once? The CDC loves to act like they’ve really got a handle on the situation at all times but we would’ve been caught with our pants down for real if something had happened. Thankfully the CDC came to their senses in 2000 and ordered 40 million vaccines to be added to the stockpile, plus 155 million more after the anthrax attacks in 2001.The Strategic National Stockpile now has enough vaccines in storage to vaccinate every single person in the United States in the event of a smallpox outbreak. While this is great news for you, it unfortunately doesn’t actually help me that much.

Ever since I learned that people with eczema (a.k.a. me) are ineligible to receive the smallpox vaccine, the thought of bioterrorism has been lurking in the back of my mind. You see, the smallpox vaccine causes a quite nasty infection in people with eczema, and it’s risky to even come into contact with people who’ve had the smallpox vaccine in the last 30 days if you’ve got eczema. Basically what this means is that in the event of a smallpox outbreak, I’m screwed. Even if everyone around me gets vaccinated (which I now believe is unlikely to happen, given recent events), I’ll still have to basically go into quarantine for a good long while as everyone stops being a threat to me just because they’ve been vaccinated. Pretty much my options are to get smallpox or get eczema vaccinatum (EV). Furthermore, EV is contagious to people without eczema! So just existing around the world where smallpox is no longer eradicated not only puts me at greater risk, but it puts my friends and family at risk also. It’s honestly so frightening to think about, and I’d really prefer it if this wasn’t something that I had to actually entertain the thought of.

I honestly believe that the best way to convince other people to destroy their stocks of variola is for the CDC to lead the way and get rid of theirs first. It’s like some sort of messed up smallpox game of chicken, where no one wants to be the first ones to get rid of their supply. The CDC and VECTOR both need to man up, have some goddamn common sense, and destroy their stocks of variola so that people like me can just have one moment of peace, and smallpox can finally just go to hell and stay eradicated for good.