John Lee
Department of Histopathology, Rotherham General Hospital 

https://doi.org/10.36866/pn.46.17

Following a sustained campaign by the World Health Organisation, the last naturally occurring case of smallpox was reported in Somalia in 1977. No new cases were detected over the next three years and so it was that on May 8th 1980 the WHO announced that smallpox had been eradicated from planet Earth. Simultaneously they recommended that the smallpox immunisation programme should be discontinued, since it was no longer necessary to subject people to even the minimal risk associated with vaccination. The WHO also adopted a resolution which restricted the world stocks of smallpox to four sites, where small quantities of the virus would be available for research purposes only. A few years later, the sites were narrowed down to two: the Centres for Disease Control in Atlanta and the Ivanovsky Institute of Virology in Moscow. Over the same period, smallpox gradually gave up its once prominent place in medical textbooks. In the text I used for finals (published in 1983) there is a full entry – signs, symptoms, diagnosis, treatment, the lot. But in the text I bought recently (published in 2000) smallpox is relegated to a single word in a table.

If only things were that simple. One of the most chilling statements in this generally horrifying book is made in the chapter on smallpox. “Where other Governments saw a medical victory,” says Alibek, “the Kremlin perceived a military opportunity. In 1981, Soviet researchers began to explore what the Kremlin hoped would be a better version of a smallpox weapon that had been in our arsenal for decades.” He goes on to explain how he personally took charge of this project, which was such a success that by December 1990 the Soviet Union was capable of manufacturing between 80 and 100 tons of smallpox virus a year, at a time when immunity of the general population around the world had declined to low levels and quantities of vaccine available were so small as to essentially be negligible from a military perspective. The author invites us to “consider the damage Smallpox attack would do in a densely populated commuter city like New York” – a particularly disturbing thought in the aftermath of September 11th.

There is, in fact, a small nugget of consolation in the smallpox story, which is that smallpox degrades over time, necessitating regular restocking of biological weapons arsenals. So we might hope that in the new world order following the collapse of the Soviet Union, this particular threat will gradually fade away. But to believe this would, almost certainly, be a triumph of hope over experience. The things that administrations will do in the name of self-defence is unbelievable. And to prove the point, Alibek tells us about the jaw-dropping catalogue of all the other biological weapons the Soviet Union was actively developing over the same period: tularemia, Marburg and Ebola viruses, Lassa fever, haemorrhagic fevers anthrax … the list goes on and on. In spite of international surveillance and inspections, tens of thousands of people were working on these projects within the last decade. How many are still active today?

Of the pathogens discussed, anthrax in particular is a serious worry. The spores remain viable for years or even decades. If dispersed as an aerosol and inhaled, the resulting pulmonary version of the disease produces no specific symptoms until it’s too late. And another thing which makes pulmonary anthrax ideal for military purposes is that it is one of those rare diseases which has a mortality approaching 100%. In another project, Alibek directed the development of a facility that could make 2 tons of anthrax a day. No, that is not a typo: 2 tons of anthrax spores every day. And the Soviets also perfected aerosol dispersal methods. The chaos recently caused by a few envelopes of spores rather puts in perspective what could happen if real anthrax weapons ever got into the wrong hands. Alibek was Deputy Chief of the Soviet Union’s Biological Weapons Agency from 1988 to 1992, when he defected to the United States. His book is part catharsis and part biography. Apart from the slight anti-Russian spin which can be detected in some of the language used by the American ghost writer, every word of this book has the stamp of authenticity. It is certainly not to be dismissed as the disgruntled ramblings of a disenchanted apparachnik. For me, the most worrying chapter of all was the final one on Bio-Defence. There are various suggestions as to what might be done in terms of preparation for attack by a biological weapon. Unfortunately, the bottomline seems to be that if a nation decided to launch an attack with a well-developed biological weapon, there would inevitably be a huge death toll despite any of the options currently available. So here’s a research area which is wide open. If this book had been presented as Science Fiction, it would have been dismissed as incredible. As Science Fact, it is a thoroughly disturbing read.

Arrow Books. ISBN 0 09 941464 3. 2000, £6.99