Scourge: The Once and Future Threat of Smallpox

by Jonathan B. Tucker

Overview

A Washington Post Best Book of 2001, Scourge provides a definitive account of the dramatic story of smallpox by a leading "expert on biological and chemical weapons" (The New York Times). Jonathan B. Tucker traces the history of the smallpox virus from its first recorded outbreak around 3700 B.C. through its use as the first biological warfare agent in human history, and draws some decisively important lessons for the future. In a timely debate, Tucker addresses the ever-growing concerns about the proliferation of the deadly smallpox virus and its use by terrorist organizations. Explaining how the eradication of the disease in the late 1970s encouraged military research and production of the virus, he exposes the failure of the Russian government to secure its remaining cold-war stockpiles, and evaluates the past and present measures undertaken by the United States to counter the existing dangers of a smallpox attack. Ultimately, he passionately argues for the strengthening of the existing legal ban on the development and possession of biological weapons. Impeccably researched, Scourge is as arresting as it is indispensable, and as William Beatty in Booklist raves, Tucker "has a sense of ... history that helps him make the story of smallpox as disease and ... weapon fascinating and frightening." Scourge has been acclaimed as "a concise, suspenseful and scientifically accurate narrative." — The New York Times Book Review" Tucker's fascinating, revealing book affords the reader a sobering look at this new type of warfare...." — Chris Patsilelis, Houston Chronicle — "[Tucker] reports the debate evenhandedly and with telling detail." — David Brown, The Washington Post Book World

Product Details

ISBN-13:	9780802139399
Publisher:	Grove/Atlantic, Inc.
Publication date:	08/12/2002
Edition description:	First Grove Pess Edition
Pages:	304
Product dimensions:	6.00(w) x 9.00(h) x 0.90(d)

Read an Excerpt

Chapter One

MONSTER ON DEATH ROW

    In a maximum-security facility in Atlanta, the world's most dangerous prisoner sits in solitary confinement, awaiting execution. Wanted for the torture and death of millions of people, this mass murderer was captured in a global dragnet lasting more than a decade. Although the prisoner has been condemned to death, the jailers are debating whether or not to carry out the sentence. Some believe that studying the killer's methods could help to develop better defenses against such crimes, yet others fear that the prisoner could escape and wreak mayhem on an even greater scale. While the debate continues, the execution has been postponed.

    The world's most dangerous prisoner is the smallpox virus, and it is held inside two padlocked freezers in a secure room at the U.S. Centers for Disease Control and Prevention in Atlanta. Some 450 samples of the virus in neatly labeled, half-inch plastic vials are arrayed on metal racks and immersed in a bath of liquid nitrogen that keeps them deep-frozen at -94 degrees Fahrenheit. Access to the smallpox repository requires two sets of keys controlled by different people; closed-circuit television cameras and electronic alarm systems maintain continuous surveillance. A second set of smallpox virus stocks lies in a similar vault at a Russian laboratory in Siberia.

    The scientific name for the smallpox virus is variola, the diminutive of the Latin word varius (spotted) or varus (pimple). Consisting of little more than a set of geneticinstructions in a long ribbon of DNA, coiled up inside a biscuit-shaped protein shell, the variola virus cannot grow or metabolize and has no means of locomotion. Its sole function is self-replication, which it accomplishes by entering human cells and commandeering their biochemical machinery to churn out more virus particles. When variola existed in the wild, it came in two distinct varieties: Variola major caused a serious disease that killed between 10 percent and 30 percent of its victims, whereas variola minor gave rise to a much milder illness called alastrim, with a case mortality rate of less than 1 percent. Because the two types of smallpox virus produced similar symptoms, it is not known why one was so much more lethal than the other.

    Now confined to a few laboratory freezers, variola major once rampaged through the human species and caused the most feared of deadly scourges. After a two-week incubation period, smallpox racked the body with high fever, headache, backache, and nausea, and then peppered the face, trunk, limbs, mouth, and throat with hideous, pus-filled boils. Patients with the infection were in agony—their skin felt as if it was being consumed by fire, and although they were tormented by thirst, lesions in the mouth and throat made it excruciating to swallow. The odor of a smallpox ward was oppressive: The rash gave off a sweetish, pungent smell reminiscent of rotting flesh. For those who survived, the disease ran its course in a few weeks. Pustule formation concluded on days eight to ten of the illness, after which the boils scabbed over and were gradually reabsorbed. On days fifteen to twenty, the crusty dry scabs separated and fell off, leaving depigmented areas of skin that later turned into ugly, pitted scars.

    Even as smallpox victims were suffering the torments of the disease, they were spreading it to others. Lesions in the patient's mouth and throat shed millions of virus particles into the saliva and mucus, so that talking or sneezing expelled virus-laden droplets that floated in the air and could be inhaled. The virus was also present in patients' urine and in pus from unhealed skin lesions. When clothing and bed linens contaminated with dried pus were handled, virus particles could be resuspended in the air, so that laundry workers who washed the sheets and blankets of smallpox patients were at great risk of infection. The corpses of smallpox victims were also dangerously contaminated and could spread the disease to undertakers or to family members who prepared a loved one's body for ritual burial.

    Over the course of human history, smallpox claimed hundreds of millions of lives, far more than plague—the dreaded Black Death of the Middle Ages—and all the wars of the twentieth century combined. Although those lucky enough to survive a bout with smallpox acquired lifelong immunity, they usually suffered some type of permanent damage. Nearly all were disfigured with pockmarks, and one in ten was rendered partially or completely blind. Smallpox often caused miscarriage in pregnant women and stunted the growth of young children.

    As recently as 1967, the disease sickened between ten million and fifteen million people each year in forty-three countries and caused an estimated two million deaths. On May 8, 1980, however, the World Health Organization (WHO) declared that humanity had finally been freed from the torments of smallpox, the culmination of a global campaign lasting more than a decade and employing up to 150,000 health workers at various times. The conquest of smallpox, the first—and so far, only—infectious disease to have been eradicated from nature by human effort, was among the greatest medical achievements of the twentieth century.

    After the WHO formally certified the eradication of smallpox in May 1980, all member countries agreed to stop vaccinating their civilian populations because the potential risk of complications from the vaccine now outweighed the tiny chance that smallpox might re-emerge from natural sources. Since then, the horrors of the disease have faded from public consciousness like the memory of a nightmare. Fewer and fewer individuals bear the round, mottled scar of a smallpox vaccination on their upper arm or thigh, let alone the disfiguring pockmarks that were once the hallmark of the disease. But although some would relegate the history of smallpox to the dusty shelves of a medical library, such complacency would be premature. In 1992, a senior Russian official defected to the United States and told the CIA that the Soviet Union, even as it had supported the smallpox eradication campaign with vaccine and expertise, had secretly developed the virus into a military weapon and stockpiled enough of it to kill millions of people. News of the Soviet betrayal sparked official concern in Washington, London, and other capitals that samples of the virus might fall into the hands of "rogue" states and terrorist organizations.

    Because the immunity induced by the smallpox vaccine fades after about a decade, most of the world is now susceptible to infection. Responding to this potential threat, the United States and other countries are undertaking urgent efforts to strengthen their medical defenses against this supposedly eradicated disease. Every human being on the planet has a stake in the fate of the smallpox virus, for we are all ultimately at risk.

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Excerpted from Scourge by Jonathan B. Tucker. Copyright © 2001 by Jonathan B. Tucker. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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Making Ends Meet
How Single Mothers Survive Welfare and Low-Wage Work

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By Kathryn Edin and Laura Lein

Russell Sage Foundation

Copyright © 1997 Russell Sage Foundation. All rights reserved.
TAILER

Table of Contents

	Acknowledgments	vii
1	Monster on Death Row	1
2	Smallpox and Civilization	5
3	Dr. Jenner's Vaccine	23
4	Launching the Crusade	39
5	Global Eradication	61
6	Long Road to Zero	90
7	Realm of the Final Inch	119
8	The Soviet Betrayal	139
9	Stay of Execution	166
10	Washington Reconsiders	190
11	Decision in Geneva	209
12	The Unfinished Conquest	231
	Source Notes	253
	Author Interviews	273
	Index	275

Editorial Reviews

Unlike most of its victims, smallpox has had a long life: The scourge appeared at least as early as 8000 B.C., and it wasn't declared eradicated until 1980. Dr. Jonathan Tucker, director of the Chemical and Biological Weapons Nonproliferation Program at the Monterey Institute, is convinced that we still stand in peril of its death force. He cites disturbing evidence about a Russian bioweapons program launched in 1973. Called Biopreparat, it was described by a Russian defector as "our Manhattan Project." Its scientists, like diabolical plotters in a graphic novel, researched the genocidal potential of Black Death, Marburg, smallpox, and other scourges. They even prepared a giant popsicle of death: a 20-ton freeze-dried batch of smallpox. Terrifying as it is, Scourge draws you in.

bn.com

The most recent 10 years of smallpox's 6,000-year history. He reports the debate evenhandedly and with telling detail.

Washington Post Book World

The eradication of smallpox was one of the great medical successes of the 20th century. As Tucker (Toxic Terror) explains, smallpox has devastated humankind throughout most of its history. Highly contagious and with a fatality rate of about 30%, smallpox killed three times more people than did wars during the last century. Tucker describes the ravages caused by the disease and succinctly traces its role in history: its use as a biological weapon (by colonists against Native Americans, the British against American colonists during the Rwevolution and by both sides during the American Civil War) and the World Health Organization's remarkable battle, waged largely under the direction of Dr. D.A. Henderson, against naturally occurring smallpox (the battle was won in 1980). Even as the last traces of smallpox were being destroyed, however, the Soviets were experimenting with military uses for the deadly virus. Drawing on popularly published sources, Tucker argues that such research continued at least until the Soviet Union disbanded, and probably beyond. Other than mentioning that President Nixon prohibited such research in the United States, Tucker remains silent about any U.S. offensive strategies involving the disease. Warning that terrorists might well have access to samples of the smallpox virus, he remarks that, if successfully unleashed, the virus could decimate the world's population. Even though a naturally occurring case of smallpox has not been seen in more than 20 years, the government spends millions of dollars annually researching treatment strategies and producing vaccines for storage. Tucker breathes new life into mostly familiar material; the book is difficult to put down.(Sept.) Copyright 2001 Cahners Business Information.

Publishers Weekly

A political scientist and an expert on bio-weapons analysis, Tucker provides an engrossing look at the continuing debate over the destruction of smallpox. The author uses numerous interviews with key players to look at the political and social aspects of the disease. Although a brief history of smallpox is included, the strength of the book lies in the author's description of the process used to eradicate naturally occurring smallpox. Equally valuable is the last section that considers the pros and cons of destroying the laboratory stockpiles of the virus. Postponed several times, the elimination of the remaining virus is now set for 2002. Concern remains among experts that if smallpox were somehow reintroduced into society, the public health system would not be able to contain the disease. The potential viability of smallpox as a biological weapon is covered in reasonable depth. Light on technical language, this accessible book is highly recommended for all libraries. Tina Neville, Univ. of South Florida at St. Petersburg Lib. Copyright 2001 Cahners Business Information.

Library Journal

Smallpox is the only infectious disease to have been eradicated, but the virus still exists in laboratories. Following a 1992 revelation that the Soviet Union had secretly developed smallpox into a military weapon, officials around the globe expressed concern that samples of the virus could fall into the hands of "rogue" states and terrorist organizations. Since vaccination stopped in 1980, most of the world is now susceptible to infection. Tucker (Monterey Institute of International Studies) provides a history of the horrific disease and analyzes urgent efforts by the US and other countries to strengthen their medical defenses against it. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Biological- and chemical-weapons expert Tucker offers a chilling account of smallpox's history, eradication, and temporary reprieve from total extinction, in virology labs in the US and Russia. Beginning with the biological origins of smallpox, Tucker (Toxic Terror, not reviewed) traces civilization's battle against this particularly disgusting disease. Noting its profound effect on historic events, from Athens' defeat in the Peloponnesian War to Cortez's subjugation of the Aztec empire, the author goes on to document humankind's battles against it, leading up to the World Health Organization's triumph of eradication in the 1960s and '70s. The author spins an engaging tale of the gritty conquerors and accidents of history that allowed smallpox to become a focus of global efforts, narrowly beating out malaria as the scourge of choice for the international community. From African deserts to Bangladeshi slums, untold thousands worked to follow chains of infection and to inoculate in the most trying conditions, many destroying their own health in the quest to break the back of the disease. As told by Tucker, it's a stirring tale, equaled in emotional impact only by horrifying saga of what happened after the WHO Nairobi field office documented the world's last known smallpox case in 1978. "The Kremlin cynically viewed this triumph of international public health as a military opportunity," he writes. The Soviets had incorporated biological weapons research into their military agenda beginning in the 1930s, and it remained on their five-year plans through the 1991 dissolution of the USSR. Tucker's in-depth report on the tremendous resources and scientific brainpower toiling away inmaximum-security Russian labs is mightily compelling, and his command of the myriad international political players and details is masterful. His vivid descriptions of the disease's symptoms, revolting and riveting in equal measure, ensure that only the most jaded reader could lay the book aside. A true-life tale of heroes and villains, frighteningly real and marvelously told.

Kirkus Reviews