World Health Assembly votes not to destroy smallpox virus

World Health Assembly votes not to destroy smallpox virus

The world’s two remaining stocks of smallpox virus, kept in Russia and in the United States, should not be destroyed just yet, the World Health Assembly decided last week at its meeting in Geneva. Scientists may be allowed to genetically manipulate fragments of the virus to evaluate new drugs and treatments.

Smallpox was eradicated 25 years ago. Because vaccination stopped, many people lack immunity to the virus. Smallpox kills about a quarter to a third of those infected and leaves many survivors scarred or blind.

Both the United States and Russia spoke in favour of keeping the virus and extending the research period, but experts are concerned. Dr Georges Benjamin, head of the American Public Health Association, said, "This is a disease that doesn’t exist anywhere in the world. Nobody would want it to get out of the lab accidentally. The only rational reason [to do research] is if there’s a re-emergence of the disease … It would take a lot to convince me that it’s a good thing to do research and keep the virus." Dr Benjamin said he thought the chance that there was smallpox virus outside the two repositories was "not zero, but low."

However, Dr John Deutch, former director of the US Central Intelligence Agency and now a professor at the Massachusetts Institute of Technology, said, as he recently told a Senate subcommittee, that everyone in the United States should be vaccinated against smallpox "because of the threat of a bioterrorist attack … There’s a reasonable chance that smallpox virus is out there, uncontrolled."

A national vaccination programme in the US aimed at healthcare workers and "first responders" began in 2003, but concern over side effects slowed the project (BMJ 2004;328:1220).

WHO will stockpile smallpox vaccine in Geneva for use in an emergency. About 2.5 million doses are stored, and another 31 million doses have been donated, including 20 million from the United States and five million from France. Reuters reported a rise in shares of Acambis and Bavarian Nordic, who may make additional doses of vaccine for the US Department of Health and Human Services. The US has enough vaccine to protect its citizens, Dr Benjamin said.

Proposed testing of the virus may use a common microbiological test that inserts a gene into the virus causing green fluorescence. If the virus is exposed to a drug but the drug is ineffective the virus remains alive and glows green. If the drug kills the virus, the virus does not glow green.

The Sunshine Project, a non-governmental organisation concerned with issues relating to biological weapons (www.sunshine-project.org), said that many scientists oppose the "green gene" experiment and other experiments using the smallpox virus and any relaxation of restrictions on distribution of smallpox virus DNA to other laboratories.