A Plague on All Your Houses

Denver readies itself for a bio-bomb but is the federal program behind this exercise a dud?

But the plague is treatable with antibiotics, and labs in Denver are equipped to test for it. And while some doctors harbor concerns about the possible manufacture of drug-resistant strains of plague, Hoffman points out that there hasn't been a person-to-person spread of the disease in this country since 1924. The killer plague was the pneumonic type, which can be spread through coughing; our Western plague is much more difficult to catch.

Smallpox is a more vicious killer. "It did not, as was typical for most infectious diseases, preferentially attack the most impoverished members of society," Laurie Garrett wrote in her 1994 book The Coming Plague. "In A.D. 165, the Roman Empire was devastated by an epidemic now believed to have been smallpox. The pestilence raged for fifteen years, claiming victims in all social strata in such high numbers that some parts of the Roman Empire lost 25 to 35 percent of their people. It is believed that the virus struck a completely nonimmune population ..."

Over subsequent centuries, smallpox claimed millions of lives. In 1958, the disease was still killing two million people annually; that year, cases were reported in 33 countries.

A worldwide effort was launched to eradicate the disease, with doctors from the U.S. and the U.S.S.R. joining together in the fight. Consultants for the World Health Organization, including the late Gordon Meiklejohn, onetime chairman of the University of Colorado's department of medicine, fought smallpox outbreaks in Africa from 1968 until 1977, when the last known case was reported in Somalia.

In 1980, the WHO declared that the disease had been eradicated and recommended the discontinuation of smallpox immunization programs.

What that means is, if smallpox were reintroduced, few people would be immune. No one has been vaccinated against smallpox for decades, and those who were vaccinated years ago are long overdue for a booster. Even health-care workers are no longer vaccinated. Vaccines are available but in relatively short supply; at present, there are none in Colorado. As a result, Hoffman explains, our population is vulnerable, in much the same way that the Roman Empire represented "virgin soil" for the disease.

Smallpox's dangerous potential as a weapon was driven home in 1992, when Ken Alibek, first deputy chief of a Soviet state pharmaceutical agency, defected to the U.S. In subsequent debriefings, Alibek outlined details of the U.S.S.R.'s decades-long involvement with biological weapons, including experiments with smallpox, plague and anthrax. Only a microscopic amount of the smallpox virus is needed to infect a human; according to Alibek, the Soviets were under orders to stockpile twenty tons of smallpox virus. And soon after the WHO declared that smallpox had been eradicated, the Soviets reaffirmed their commitment to researching it.

After learning this, American scientists who'd urged the destruction of what they had believed was the last vestige of smallpox in this country -- a legal cache kept at the Centers for Disease Control in Atlanta -- began to rethink their position. Eventually, it was decided to keep the stores of the virus for research and to beef up the nation's store of vaccines. (A second lethal cache is kept in Moscow.) The government is now looking to stockpile forty million doses of the vaccine "just to get us started," says CDC spokeswoman Barbara Reynolds. There are currently fewer than seven million doses now available, according to one unofficial estimate.

Even before Alibek spilled the beans, though, this country was growing increasingly concerned about bioterrorism. In December 1989, hundreds of tropical-disease experts gathered for their annual convention; activities this time included a tabletop exercise in which a virulent and deadly epidemic broke out in war-torn Africa. The scenario was designed to reveal gaps in the public-health response system so that those weaknesses might be eliminated. What the experts learned, however, was that the weaknesses were so pervasive that despite their best efforts, the mythical microbe spread around the world.

The Honolulu exercise spurred a handful of studies regarding the country's readiness to fight biowarfare. The solutions recommended by these studies, skeptics noted, tended to fit the agendas of the people who'd conducted them. Some scientists favored worldwide surveillance and a monitoring network of satellites and laboratories that could track reports of emerging diseases and bioweapons; others recommended a combination of public-health and military preparedness. In 1995, a report submitted to the Senate Permanent Subcommittee on Investigations identified seventeen countries believed to possess biological weapons -- Libya, North Korea, South Korea, Iraq, Taiwan, Syria, Israel, Iran, China, Egypt, Vietnam, Laos, Cuba, Bulgaria, India, South Africa and Russia.

But it wasn't until 1998 that President Bill Clinton began pushing for millions to combat what the administration called the "growing threat" of bioterrorism.

"The Clinton administration, as well as many outside analysts, developed their threat assessments and response strategies in an empirical vacuum," responded scientists with the Chemical and Biological Weapons Nonproliferation Project at the Center for Nonproliferation Studies in Monterey, California. "Lacking solid data, they fell back on worst-case scenarios that may be remote from reality...The tendency of U.S. government officials to exaggerate the threat of chemical and biological terrorism has been reinforced by sensational reporting in the press and an obsessive fascination with catastrophic terrorism in Hollywood films, best-selling books and other mainstays of pop culture."

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