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Smallpox: An Attack Scenario

By premier in MLP
Thu Oct 04, 2001 at 11:43:34 AM EST
Tags: Science (all tags)
Science

Lately there has been alot of media hype regarding possible Bio-Terrorism attacks, stemming largely from the inflammatory warnings being issued by the US Attorney General, John Ashcroft.


As with any hot topic in the US, the media has followed their usual tendency to exaggerate and create and almost war propaganda like campaing in an effort to "inform" citizens. Knowing that there were hard facts out there, minus the inflammatory rhetoric, I did some research of my own. In investigating possible scenarios, I discovered a very well researched and detailed attack and response scenario by a noted senior member of Johns Hopkins Center for Biodefense Studies.

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Poll
Do you consider BioTerrorism a serious threat?
o Yes. 25%
o No. 29%
o Yes, but not to the extent created by the media. 44%

Votes: 54
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o attack and response scenario
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Smallpox: An Attack Scenario | 36 comments (31 topical, 5 editorial, 0 hidden)
Smallpox availability (4.00 / 2) (#3)
by Ludwig on Thu Oct 04, 2001 at 05:08:47 AM EST

I might be mistaken, but I seem to recall reading an article in Scientific American two or three years ago about the fate of the last known living smallpox culture. Apparently it existed only in a few vials in one very well-secured (think The Andromeda Strain (minus the last twenty minutes)) freezer in a CDC or NIH lab somewhere. The controversy was over whether to eradicate the last known instance of the disagreeable organism, or whether there was still some scientific knowledge to be gained by its study, or whether there were perhaps rogue vials of smallpox floating around somewhere where they use a different alphabet than ours (in which case destroying our own supply would leave us unable to formulate a vaccine,) or whether the smallpox would eventually come to forcibly relieve us of our Precious only to accidentally fall into a big thing of like lava or something with it after we had found ourselves unable to dispose of it.

Anyway. I can't find a link, but I distinctly remember smallpox being in very short supply. But just replace "smallpox" with "anthrax" or "The Stuff" and the uncomfortable jittery tension that's been so lacking in our lives recently will come blowing back into town like that gang of creepy-looking men on dirtbikes that you'd just begun to hope had left for good.

More info (4.66 / 3) (#5)
by premier on Thu Oct 04, 2001 at 05:15:52 AM EST

You can find more information on the locations of the smallpox 'seed' at the following link

http://www.cdc.gov/ncidod/EID/vol5no4/henderson.htm

[ Parent ]
Christ! (none / 0) (#19)
by M0dUluS on Thu Oct 04, 2001 at 01:43:32 PM EST

I wish I hadn't read that. I remember being told in freshman virology that there were only two stocks left. I don't think I agree with the idea of destroying it. I'd rather they worked like crazy to vaccinate us all and did some work work on it. Similar to the Yersinia pestis "mining" that was said to be taking place in permafrost graves.
I was always skeptical that smallpox had been "eradicated". It's much more likely that there are resevoirs which initiate spread in the right conditions.
Useful post, thanks.

"[...]no American spin is involved at all. Is that such a stretch?" -On Lawn
[ Parent ]
Re: Christ! (none / 0) (#23)
by Fenian on Thu Oct 04, 2001 at 02:52:53 PM EST

Yeah, I had heard the same thing in my international health course. And I agree that they aught to be studying the hell out of the beast. If they could come up with a better (and better understood) vaccine, that might be nice. Especially if they could synthesize it in less than 36 months! A cure might be a nice thing to have in the arsenal (in a medical sense) too.

[ Parent ]
Black death/Influenza (none / 0) (#25)
by M0dUluS on Thu Oct 04, 2001 at 03:08:22 PM EST

whaddya know! Just browsing Wired and found that the Yersinia pestis (Black Death) genome has been fully published. I was babbling when I was talking about the permafrost graves being geared towards this though. I had confused it with the attempts to get hold of the virus which was responsible for the post WW1 influenza deaths. Now, that's another scary one!
I wonder can I get a job that would get me vaccination.....

"[...]no American spin is involved at all. Is that such a stretch?" -On Lawn
[ Parent ]
Cures (5.00 / 1) (#26)
by wiredog on Thu Oct 04, 2001 at 03:10:16 PM EST

Good luck. It's a virus. No cure has ever been developed for a virus. There are drugs that suppress AIDS for a while, at high expense, and drugs that ameliorate the symptoms of viral infections. But,when you get a virus, it's up to your immune system to deal with it.

The idea of a global village is wrong, it's more like a gazillion pub bars.
Phage
[ Parent ]

Okay... (none / 0) (#34)
by Fenian on Fri Oct 05, 2001 at 01:53:44 PM EST

Okay, you're right, no cures. But at least antiviral drugs to help reduce the effects. The immune system can fight smallpox, it just isn't always successful, and it's usually not as effective as we'd like (scarred for life and excruciating pain). The New Yorker article I've linked to in a couple of other comments talks about some of the possibilities for smallpox. Mabye we can't cure it outright, but we might be able to do the next best thing.

[ Parent ]
If Ken Alibek's book is to be believed.... (5.00 / 5) (#8)
by claudius on Thu Oct 04, 2001 at 08:03:25 AM EST

...then the former Soviet Union was able to "weaponize" smallpox and even develop more virulent strains of the virus. Presumably this capability still exists in some capacity. IIRC, both the United States and the Soviet Union each held stashes of smallpox for research purposes. Ken Alibek, apparently, used to be a major player in the Soviet bioweapons program prior to his defection in the 1990s--his book provides a chilling overview of the programs and capabilities of the former Soviet state during his tenure with Bioprepart. If even 25% of what he says is to be believed, then the Soviet bioweapons program far outpaced anything we had in the West, and the proliferation of this capability to parties who wish to develop a bioweapons program is to be feared. Moreso, I would argue, than even the proliferation of nuclear weapons knowledge.

[ Parent ]
Anthrax (5.00 / 4) (#9)
by theR on Thu Oct 04, 2001 at 08:34:21 AM EST

From what I've read, anthrax is a smaller threat than smallpox. This Newsweek article, which touches on several of the points already made here, mentions that anthrax is not contagious. You apparently have to inhale the spores, but the spores will degrade in sunlight within minutes. I would be much more concerned about something like smallpox, which has been proven to be a huge people killer in the past.

The other main thing the Newsweek article talks about is the difficulty in delivering biological weapons in a form that will be effective. Assuming the research in this article is accurate, which it seems to be, it is a good read. Usually I read Newsweek more as an entertainment and popular culture magazine, but this article was good.



[ Parent ]
Nitpicking (3.50 / 2) (#6)
by Best Ace on Thu Oct 04, 2001 at 06:37:21 AM EST

John Ashcroft? Secretary of State? Has there been a sudden reshuffle since I went to bed last night?

LOL (none / 0) (#7)
by premier on Thu Oct 04, 2001 at 06:52:49 AM EST

Yea, stupid mistake on my part. Should have been Attorney General.

[ Parent ]
The Book To Read (4.66 / 3) (#10)
by wiredog on Thu Oct 04, 2001 at 08:48:09 AM EST

Living Terrors by Michael T. OsterholmPh.D., former Minnesota State Epidemiologist, and John Schwartz, a science reporter for The Washington Post.

Smallpox is easy to distribute. All you need is someone who is willing to die for the cause, infect them, and turn them loose. It spreads by airborne contaigon, like the flu, so all he has to do is breathe on people to give it to them.

If there's a choice between performance and ease of use, Linux will go for performance every time. -- Jerry Pournelle

It is even worse. (5.00 / 1) (#17)
by Aldreis on Thu Oct 04, 2001 at 12:20:48 PM EST



> All you need is someone who is willing to die for the cause, infect them, and turn them loose.

No need for suicide agents. Only a battery-powered timer, a solenoid and a breakable involucre. Set it to 12 hours, hide it on a rooftop somewhere and catch the first plane out.

Truly scary.

[ Parent ]
Even worse (5.00 / 1) (#22)
by Fenian on Thu Oct 04, 2001 at 02:38:52 PM EST

Set it up in an airport. It's very difficult to track everybody, and you've managed to spread contagion all over the country (and possibly world). You'll probably still get enough from the area of the airport for it to be a major outbreak just for that area much like the one in the article. This stuff scares the piss out of me.

[ Parent ]
Lee Gets Pedantic (Or Why Lee Voted -1) (4.00 / 1) (#13)
by Anonymous 242 on Thu Oct 04, 2001 at 10:21:44 AM EST

I discovered a very well researched and detailed attack and response scenario
This isn't an attack and response scenario, only a response to an outbreak scenario. The scenario could have come about by an attack and in fact the scenario tried to imply that such was the case. However, what is not mentioned is how the smallpox is acquired or introduced to the USA. This scenario could be the result of an attack, a mistake, or even a natural resurgence of the smallpox virus.

Further, the article does not detail how smallpox is spread. Instead we are given a conjecture on how fast it might spread. Given that smallpox outbreaks have occurred multiple times in Europe since the 1950's, I find it doubtful that smallpox in the US will follow the scenario developed by the CDC. It seems to me to be more imaginative thinking than anything else.

It is an interesting imaginative scenario, but I don't buy it. We're told what will happen without being told why it will happen that way. This lack of explanation leads me to doubt the credibility of the scenario. An outbreak of smallpox could turn out just as illustrated in the article, but without comparing how the current USA differs from areas in Europe that have recently had outbreaks and without explanations of transmission vectors and what puts people at risk, I do not find a compelling reason to believe the scenario.

Regards,

Lee Irenæus Malatesta

Pretty well informed (5.00 / 1) (#21)
by Fenian on Thu Oct 04, 2001 at 02:08:54 PM EST

The people who wrote this article are pretty well informed about such things. As far as Europe, the last confirmed case of smallpox occurred in Somalia in 1977. This was on the tail end of the major World Health Organization smallpox eradication campaign when vaccine would have been far more readily available than it is now. And far more people had been previously vaccinated for it. Now we don't even bother vaccinating children. Those who were alive and durring the campaign were probably vaccinated, but it is extremely unlikely that the vaccines are still effective. Smallpox has approximately a 30% mortality rate, and spreads like chickenpox or the flu. In those it doesn't kill, it is extremely debilitating and usually leaves the victim horribly scarred for life. There is no cure, and we're not really sure how the vaccine works. Smallpox and antrhax are the two biological agents most likely to be used for a terrorist (or military) attack. It is the job of the author of this article to study such things. This isn't creative writing. The author knows the medical charactaristics of smallpox and the procedures of the various public organizations involved. As in any hypothetical situation, there was obviously some creativity involved, but this is an extremely plausible scenario. The one aspect I'm left wondering about here is the availability of smallpox. Once the WHO succeeded in eradicating it, supposedly only the US and Soviet Union kept samples (and for obvious reasons, that decision was heavily criticized). Those samples are presumably kept under extremely tight security. I pray that smallpox is not available in any form or for any price on the black market. If it is, we're in some pretty serious trouble. I have felt for quite some time that the United States should start manufacturing more vaccine and possibly even researching how it works some more. Cure research might be nice too. If I remember correctly, US vaccine stockpiles account for about 1/3 of the military. That's a pretty scary thought. I assume there are also stockpiles in other countries, but I don't know how large they are. Smallpox is one of the most frightening things I learned about as a student.

[ Parent ]
Smallpox in Europe (none / 0) (#24)
by Anonymous 242 on Thu Oct 04, 2001 at 03:03:59 PM EST

As far as Europe, the last confirmed case of smallpox occurred in Somalia in 1977.
According to a link from premier's comment, there were smallpox outbreaks in Germany in 1970 and Yugoslavia in 1972.
Smallpox has approximately a 30% mortality rate, and spreads like chickenpox or the flu.
According to that same article, smallpox has closer to a 5-10% mortality rate.
There is no cure, and we're not really sure how the vaccine works.
True, the current smallpox vaccine is often deadly.
The author knows the medical charactaristics of smallpox and the procedures of the various public organizations involved. As in any hypothetical situation, there was obviously some creativity involved, but this is an extremely plausible scenario.
The scenario, as written, is a fluff piece with no analysis of the patterns of transmissions of outbreaks of smallpox in modern times. It could be accurate. It could be inaccurate. It isn't supported, so I have no way of telling. It seems sensationalist to me and I consider that it was most likely written to get the budget for the CDC raised. If the scenario is as well researched as some seem to think, I do not understand why the facts and figures and analysis wasn't put into foot notes or a sidebar.
The one aspect I'm left wondering about here is the availability of smallpox.
The same article that premier pointed to briefly discusses that question:
However, as reported by the former deputy director of the Russian Bioweapons Program, officials of the former Soviet Union took notice of the world's decision in 1980 to cease smallpox vaccination, and in the atmosphere of the cold war, they embarked on an ambitious plan to produce smallpox virus in large quantities and use it as a weapon. At least two other laboratories in the former Soviet Union are now reported to maintain smallpox virus, and one may have the capacity to produce the virus in tons at least monthly. Moreover, Russian biologists, like physicists and chemists, may have left Russia to sell their services to rogue governments.
Not a cheery though, eh?
If I remember correctly, US vaccine stockpiles account for about 1/3 of the military.
Per the abovementioned article, in 1999 vaccine stocks in the USA were sufficient to vaccinate between six and seven million individuals, approximately 1 out of fifty US citizens.

I never said that I don't think smallpox is a serious threat. My contention is that the article that was linked to had few if any hard facts and if it is based on research it doesn't show it. It reads to me like sensationalism.

Regards,

Lee Irenæus Malatesta

[ Parent ]

Response (none / 0) (#32)
by Fenian on Fri Oct 05, 2001 at 12:26:36 PM EST

"According to that same article, smallpox has closer to a 5-10% mortality rate."

The article isn't very clear on this point. I suspect that the figure you mention is actually referring to black smallpox (referring to the flat and hemoragic variants). Cases of black smallpox are pretty much always fatal. The more common infections of smallpox are considered to be at least 30% fatal and have potential to be much higher. I'll post a top-level comment on this, but this is a long article on smallpox published in the New Yorker in 1999. (disclaimer: I am not responsible if you can never sleep soundly again after reading this.)

"According to a link from premier's comment, there were smallpox outbreaks in Germany in 1970 and Yugoslavia in 1972."

I am aware of those outbreaks, I just wante to point out that it's a very different situation now because we haven't had a smallpox outbreak in almost 25 years.

"True, the current smallpox vaccine is often deadly."

Excluding cases of immune deficency (which we should be able to anticipate), serious complications occurr in about 3 patients per million. I would hardly call this often. And it's not always deadly. In fact, I believe that the article I linked above mentions an antidote of some sort.

"Not a cheery though, eh?"

Not even a little bit. :-(

"Per the abovementioned article, in 1999 vaccine stocks in the USA were sufficient to vaccinate between six and seven million individuals, approximately 1 out of fifty US citizens."

You're right. I should have researched that a little better. I think what I had heard was probably in reference to the military's current contract to acquire more vaccine. Of course that's also a Charlie Foxtrot, so who knows if it'll ever come through.

[ Parent ]
Kill 1/3 of the human race with a 50 kilobyte file (5.00 / 2) (#28)
by sigwinch on Thu Oct 04, 2001 at 03:45:55 PM EST

The one aspect I'm left wondering about here is the availability of smallpox. Once the WHO succeeded in eradicating it, supposedly only the US and Soviet Union kept samples (and for obvious reasons, that decision was heavily criticized). Those samples are presumably kept under extremely tight security. I pray that smallpox is not available in any form or for any price on the black market.
You can download a variola genome off the Internet. Poxvirus.org has links to a variety of poxviri, including the preceeding. Variola consists of a mere 200 000 base pairs, or 50 kilobytes, of genetic information. A good university library will teach you how to synthesize genes and put them in living cells. Anybody want to work up resource requirements and a development schedule?

By the way, that variola 'source code' page is published by the US government. The same government that will send you to prison for publishing a data processing program. <cue laugh track>

--
I don't want the world, I just want your half.
[ Parent ]

Outbreaks in Europe (none / 0) (#29)
by free779 on Thu Oct 04, 2001 at 04:06:02 PM EST

For smallpox, the difference between Europe of '50's and America of today is incredibly different. Many people had been vaccinated, slowing the spread of the virus.

The link below (from another k5 article), talks about an outbreak in Yugoslavia in the '70's, which is probably reminiscent of the rest of Europe. An attack on modern American would be completely different.

Demon in the Freezer

[ Parent ]

Part two of the scenario (4.00 / 1) (#14)
by wiredog on Thu Oct 04, 2001 at 10:58:29 AM EST

Aftermath of a Hypothetical Smallpox Disaster

Pictures of smallpox.

The idea of a global village is wrong, it's more like a gazillion pub bars.
Phage

Why an auditorium? (3.50 / 2) (#15)
by Merc on Thu Oct 04, 2001 at 11:47:47 AM EST

I liked the article. It seemed like a pretty well researched scenario. The one thing that didn't convince me was that the attackers would try to infect a small auditorium the Vice President was visiting.

But why attack an awards ceremony at an auditorium? Why attack something where there are Secret Service people nearby?

I think a more likely scenario would be attacking the crowd at a sporting event, or a subway station, or an airport. Even if the terrorists couldn't affect as many people, they would make it harder to identify who might have been exposed. They would also have a better chance of spreading the disease to a wider area instead of just a university campus.

Any opinions why an auditorium would be a more likely target?



Reasons (4.00 / 1) (#16)
by wiredog on Thu Oct 04, 2001 at 12:07:21 PM EST

The primary reason would be that it would be the best chance to infect the veep. Since he would be contagious before he showed serious symptoms this would increase the chance for infecting the President, the various cabinet secretaries, and the congressional leadership. It's called "decapitation". Kill off the leadership, and there's no one to co-ordinate the response.

And why worry about the Secret Service? They're not going to notice the person spreading the disease. He may be in asymptomatic smallpox himself, or using a very small device carried in his pocket that they can't see. The dispersal device could be a small aerosol sprayer used for spraying breath freshener.

The idea of a global village is wrong, it's more like a gazillion pub bars.
Phage
[ Parent ]

Vice President (4.00 / 1) (#18)
by sigwinch on Thu Oct 04, 2001 at 12:21:07 PM EST

The one thing that didn't convince me was that the attackers would try to infect a small auditorium the Vice President was visiting.
The VP has no official duties, so he tends to attend more public functions, which makes him a more accessible target. If you could infect him, he could spread the infection to the President, Joint Chiefs, Secretary of State, Congress, ... The mention of an auditorium is just because the poor VP gets dragged into them so often.

What this really points out is that everybody in the national chain of command needs to be vaccinated. Military chain of command and state gov'ts would probably be a good idea too. Possibly major currency, stock, bond, and commodity traders too.

--
I don't want the world, I just want your half.
[ Parent ]

Beat's me (4.66 / 3) (#20)
by Anonymous 242 on Thu Oct 04, 2001 at 02:01:20 PM EST

I can think of two ways to have a decent shot of infecting the VP.
  1. Use some sort of aresolizer.
  2. Infect an suicide-ready individual.
The first method seems to me to be prone to discovery if one wants to make certain of getting the VP. Given that vaccines work after infection but before onset of symptoms, hitting the VP with an aerosolizer of some sort would give a very large clue to the Secret Service as to what was happening.

The second method presents difficulty of timing. I believe that smallpox is only contagious after symptoms develop. While in theory it would be a (relatively) simple matter to arrange an infected individual to shake hands with the VP at some sort of function, figuring out the exact timing would be difficult. Not to mention that the severity of symptoms might make execution a wee bit difficult.

OTOH, if the VP was just incindental, a college auditorium makes sense. If one wants wide dispersal, one wants to target an event where people are gathered from all over. Sporting events, airport concourses, auditoriums packed with students and the like would make the desirable targets for someone that wants smallpox to be widespread.

Personally I think the NCAA final four, a pro golf tour, spring break at Daytona Beach, or the food court of the Mall of America would be more likely targets. But who knows?

Regards,

Lee Irenæus Malatesta

[ Parent ]

Evil idea (5.00 / 2) (#30)
by sigwinch on Thu Oct 04, 2001 at 07:12:21 PM EST

If one wants wide dispersal, one wants to target an event where people are gathered from all over.
How about graduation ceremonies for a large university? Many of the students and visitors would scatter across the continent and even world within a couple of days. Similar to an airport, but security is almost nonexistent. Good bang/buck ratio, assured dispersal.

--
I don't want the world, I just want your half.
[ Parent ]

two points (okay three) (5.00 / 2) (#31)
by Anonymous 242 on Fri Oct 05, 2001 at 09:13:19 AM EST

(1) If we keep this up we're likely to get our phones tapped if they aren't already under the new war on terrorism. :(

(2) Depends on the goal. I would think that universities would be a bad target for Islamic Extremist because of the high number of Islamic students and the likelihood that one of those students might go home before symptoms develop. On the other hand, a university graduation would be a excellent target for a wacked out individual with an ax to grind such as the Unabomber.

(3) And at a good deal of graduation ceremonies, you could get the students to do the infecting for you by manufacturing cans of silly string that contain the virus and passing them out to the students as they walk in.

Regards,

Lee Irenæus Malatesta

[ Parent ]

Extremists (4.00 / 2) (#35)
by sigwinch on Sat Oct 06, 2001 at 12:44:47 AM EST

I would think that universities would be a bad target for Islamic Extremist because of the high number of Islamic students and the likelihood that one of those students might go home before symptoms develop.
What matters to them is not how many believers go to paradise, but how many infidels are destroyed.

--
I don't want the world, I just want your half.
[ Parent ]

Hey everybody, read this! (5.00 / 3) (#27)
by Anonymous 242 on Thu Oct 04, 2001 at 03:11:01 PM EST

Anyone want an actual case study?

The 1998 July/September issue of contains the article Bioterrism as a Public Health Threat by John Hopkins professor D.A. Henderson.

This article discusses actual smallpox outbreaks in Germany in 1970 and in Yugoslavia in 1972, as well as, the accidental release of weaponized Anthrax spores in the former Soviet Union in 1979.

Don't blame me if you don't sleep well tonight.

Regards,

Lee Irenæus Malatesta

Here's a link to the best article I've read on SP (5.00 / 1) (#33)
by Fenian on Fri Oct 05, 2001 at 12:28:24 PM EST

This is a long article on smallpox published in the New Yorker in 1999. It's the most comprehensive article on the subject that I've found. (disclaimer: I am not responsible if you can never sleep soundly again after reading this...I don't think I'll be able to.)

hehe (none / 0) (#36)
by AgentGray on Fri Dec 21, 2001 at 04:47:39 PM EST

I just like your sig on the original post!

Good article...

Smallpox: An Attack Scenario | 36 comments (31 topical, 5 editorial, 0 hidden)
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