Smallpox virus retention debate

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The smallpox virus retention debate has been going on among scientists and health officials since the smallpox virus was declared eradicated by the World Health Organization (WHO) in 1980. [1] [2] The debate centers on whether or not the last two known remnants of the Variola virus known to cause smallpox, which are kept in tightly controlled government laboratories in the United States and Russia, should be finally and irreversibly destroyed. Advocates of final destruction maintain that there is no longer any valid rationale for retaining the samples, which pose the hazard of escaping the laboratories, while opponents of destruction maintain that the samples may still be of value to scientific research, especially since variants of the smallpox virus may still exist in the natural world and thus present the possibility of the disease re-emerging in the future or being used as a bio-weapon.

Contents

Background

In 1981, the four countries that either served as a WHO collaborating center or were actively working with variola virus were the United States, the United Kingdom, the Soviet Union, and South Africa. The last cases of smallpox occurred in an outbreak of two cases, one of which was fatal, in Birmingham, United Kingdom, in 1978. A medical photographer, Janet Parker, contracted the disease at the University of Birmingham Medical School and died on September 11, 1978. [3] In light of this incident, all known stocks of the smallpox virus were destroyed or transferred to one of two World Health Organization reference laboratories which had BSL-4 facilities—the Centers for Disease Control and Prevention (CDC) in the United States and the State Research Center of Virology and Biotechnology VECTOR in Koltsovo, Soviet Union. [4] Since 1984, these two labs have been the only ones authorized by the WHO to hold stocks of live smallpox virus.[ citation needed ]

In 1986, the WHO first recommended destruction of all smallpox samples, and later set the date of destruction to be 30 December 1993. This was postponed to 30 June 1999, [5] then again to 30 June 2002. Due to resistance from the U.S. and Russia, in 2002 the World Health Assembly agreed to permit temporary retention of the virus stocks for specific research purposes. [6] Destroying existing stocks would reduce the risk involved with ongoing smallpox research; the stocks are not needed to respond to a smallpox outbreak. [7] Some scientists have argued that the stocks may be useful in developing new vaccines, antiviral drugs, and diagnostic tests. [8] A 2010 review by a team of public health experts appointed by the WHO, however, concluded that no essential public health purpose is served by the American and Russian laboratories continuing to retain live virus stocks. [9] The latter view is frequently supported in the scientific community, particularly among veterans of the WHO Smallpox Eradication Program (1958–1979). [10]

History

Ad Hoc Committee on Orthopox Infections

An Ad Hoc Committee on Orthopox Infections, advising the WHO, has debated the fate of the remaining samples of smallpox in the remaining two official repositories since 1980. Smallpox expert D. A. Henderson has been foremost in favor of destruction, while U.S. Army scientist Peter Jahrling has argued against it on the basis that further research is needed, since he believes that smallpox almost certainly exists outside of the repositories. [11] Other scientists have expressed similar opinions. [12]

U.S. pro-retention argument (2011)

In 2011, Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services, laid out the rationale of the administration of President Barack Obama in a New York Times op-ed piece. She said, in part:

The global public health community assumes that all nations acted in good faith; however, no one has ever attempted to verify or validate compliance with the WHO request.... Although keeping the samples may carry a minuscule risk, both the United States and Russia believe the dangers of destroying them now are far greater.... It is quite possible that undisclosed or forgotten stocks exist. Also, 30 years after the disease was eradicated, the virus' genomic information is available online and the technology now exists for someone with the right tools and the wrong intentions to create a new smallpox virus in a laboratory.... Destroying the virus now is merely a symbolic act that would slow our progress and could even stop it completely, leaving the world vulnerable.... Destruction of the last securely stored viruses is an irrevocable action that should occur only when the global community has eliminated the threat of smallpox once and for all. To do any less keeps future generations at risk from the re-emergence of one of the deadliest diseases humanity has ever known. Until this research is complete, we cannot afford to take that risk. [13]

Post-1984 discovery instances

WHO 2018 position

As of May 2018, based on the latest (19th) meeting of the WHO Advisory Committee on Variola Virus Research (1–2 November 2017), the question remained as to whether the use of live variola virus for their further development was "essential for public health." [18]

2019 lab explosion

In September 2019, the Russian lab housing smallpox samples experienced a gas explosion that injured one worker. It did not occur near the virus storage area, and no samples were compromised, but the incident prompted a review of risks to containment. [19]

2021 Pennsylvania discovery

In November 2021 the CDC announced that several frozen vials labeled "Smallpox" were discovered in a freezer in a Merck & Co. vaccine research facility at Montgomery County, Pennsylvania. [20] [21] [22] The vials were determined to contain the vaccinia virus, used in making the vaccine, not the variola virus, which causes smallpox. [23]

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">Smallpox vaccine</span> Vaccine against Variola virus

The smallpox vaccine is the first vaccine to have been developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox virus. Cowpox served as a natural vaccine until the modern smallpox vaccine emerged in the 20th century. From 1958 to 1977, the World Health Organization (WHO) conducted a global vaccination campaign that eradicated smallpox, making it the only human disease to be eradicated. Although routine smallpox vaccination is no longer performed on the general public, the vaccine is still being produced to guard against bioterrorism, biological warfare, and mpox.

<span class="mw-page-title-main">Biosafety level</span> Level of the biocontainment precautions required to isolate dangerous biological agents

A biosafety level (BSL), or pathogen/protection level, is a set of biocontainment precautions required to isolate dangerous biological agents in an enclosed laboratory facility. The levels of containment range from the lowest biosafety level 1 (BSL-1) to the highest at level 4 (BSL-4). In the United States, the Centers for Disease Control and Prevention (CDC) have specified these levels in a publication referred to as BMBL. In the European Union, the same biosafety levels are defined in a directive. In Canada the four levels are known as Containment Levels. Facilities with these designations are also sometimes given as P1 through P4, as in the term P3 laboratory.

<span class="mw-page-title-main">Biological hazard</span> Biological material that poses serious risks to the health of living organisms

A biological hazard, or biohazard, is a biological substance that poses a threat to the health of living organisms, primarily humans. This could include a sample of a microorganism, virus or toxin that can adversely affect human health. A biohazard could also be a substance harmful to other living beings.

<span class="mw-page-title-main">Vaccinia</span> Strain of poxvirus

Vaccinia virus is a large, complex, enveloped virus belonging to the poxvirus family. It has a linear, double-stranded DNA genome approximately 190 kbp in length, which encodes approximately 250 genes. The dimensions of the virion are roughly 360 × 270 × 250 nm, with a mass of approximately 5–10 fg. The vaccinia virus is the source of the modern smallpox vaccine, which the World Health Organization (WHO) used to eradicate smallpox in a global vaccination campaign in 1958–1977. Although smallpox no longer exists in the wild, vaccinia virus is still studied widely by scientists as a tool for gene therapy and genetic engineering.

<span class="mw-page-title-main">1978 smallpox outbreak in the United Kingdom</span> Event resulting in the last known death from smallpox

The 1978 smallpox outbreak in the United Kingdom resulted in the death of Janet Parker, a British medical photographer, who became the last recorded person to die from smallpox. Her illness and death, which was connected to the deaths of two other people, led to the Shooter Inquiry, an official investigation by government-appointed experts triggering radical changes in how dangerous pathogens were studied in the UK and named after the panel's leader.

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Orthopoxvirus is a genus of viruses in the family Poxviridae and subfamily Chordopoxvirinae. Vertebrates, including mammals and humans, and arthropods serve as natural hosts. There are 12 species in this genus. Diseases associated with this genus include smallpox, cowpox, horsepox, camelpox, and monkeypox. The most widely known member of the genus is Variola virus, which causes smallpox. It was eradicated globally by 1977, through the use of Vaccinia virus as a vaccine. The most recently described species is the Alaskapox virus, first isolated in 2015.

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<span class="mw-page-title-main">Rahima Banu</span> Last known person to have been infected with naturally occurring Variola major smallpox

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<span class="mw-page-title-main">Smallpox</span> Eradicated viral disease

Smallpox was an infectious disease caused by variola virus which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980, making smallpox the only human disease to be eradicated.

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Isao Arita was a Japanese physician, virologist and vaccination specialist who headed the World Health Organization (WHO) Smallpox Eradication Unit in 1977–85. During this period, smallpox became the first infectious disease of humans to be eradicated globally. For this work, he and his colleagues were awarded the Japan Prize in 1988. He also advised the successful programme to eradicate poliovirus from the Western Pacific region.

<span class="mw-page-title-main">Keith Dumbell</span>

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References

  1. ↑ "Smallpox". WHO Factsheet. Archived from the original on 21 September 2007.
  2. ↑ Fenner F (2006). Nature, Nurture and Chance: The Lives of Frank and Charles Fenner. Canberra, ACT 0200: Australian National University Press. ISBN   978-1-920942-62-5.{{cite book}}: CS1 maint: location (link)
  3. ↑ Pennington, Hugh (2003). "Smallpox and bioterrorism" (PDF). Bull. World Health Organ. 81 (10): 762–767. PMC   2572332 . PMID   14758439.
  4. ↑ Connor, Steve (2002-01-03). "How terrorism prevented smallpox being wiped off the face of the planet for ever". The Independent. London. Archived from the original on February 11, 2009. Retrieved 2008-10-03.
  5. ↑ Altman, Lawrence (1996-01-25). "Final Stock of the Smallpox Virus Now Nearer to Extinction in Labs". The New York Times. Retrieved 2007-11-23.
  6. ↑ MacKenzie, Debora (2002-01-26). "Stay of execution". New Scientist. Retrieved 2007-11-23.
  7. ↑ Hammond, Edward (2007). "Should the US and Russia destroy their stocks of smallpox virus?". BMJ. 334 (7597): 774. doi:10.1136/bmj.39155.695255.94. PMC   1851992 . PMID   17431261.
  8. ↑ Agwunobi, John O. (2007). "Should the US and Russia destroy their stocks of smallpox virus?". BMJ. 334 (7597): 775. doi:10.1136/bmj.39156.490799.BE. PMC   1851995 . PMID   17431262.
  9. ↑ Comments on the Scientific Review of Variola Virus Research, 1999‐2010. Advisory Group of Independent Experts to review the smallpox research program (AGIES) WHO document WHO/HSE/GAR/BDP/2010.4
  10. ↑ Lane, J.Michael; Poland, Gregory A. (2011). "Why not destroy the remaining smallpox virus stocks?". Vaccine. 29 (16): 2823–2824. doi:10.1016/j.vaccine.2011.02.081. PMID   21376120.
  11. ↑ Preston, Richard (2002), The Demon in the Freezer .[ page needed ]
  12. ↑ Damon, Inger k; Damaso, Clarissa R; McFadden, Grant (May 1, 2014). "Are we there yet? The smallpox research agenda using variola virus". PLOS Pathogens. 10 (5): e1004108. doi: 10.1371/journal.ppat.1004108 . PMC   4006926 . PMID   24789223.
  13. ↑ Sebelius, Kathleen, (2011), "Why We Still need Smallpox", The New York Times (25 April 2011).
  14. ↑ "Smallpox eradication: destruction of variola virus stocks Report by the Secretariat" (PDF). World Health Organisation Executive Board EB134/34 134th session. 20 December 2013. 134th session.
  15. 1 2 Reardon, Sara (2014-10-30). "'Forgotten' NIH smallpox virus languishes on death row". Nature. 514 (7524): 544. Bibcode:2014Natur.514..544R. doi: 10.1038/514544a . PMID   25355337.
  16. 1 2 Centers for Disease Control and Prevention "CDC Media Statement on Newly Discovered Smallpox Specimens" (July 8, 2014).
  17. ↑ "FDA Review of the 2014 Discovery of Vials Labeled "Variola" and Other Vials Discovered in an FDA-Occupied Building on the NIH Campus" (PDF). Director of Laboratory Science and Safety, FDA. 13 December 2016. Retrieved 21 May 2017.
  18. ↑ "WHO Advisory Committee on Variola Virus Research Report of the Nineteenth Meeting". World Health Organization. May 2018. Archived from the original on May 5, 2018. Retrieved May 31, 2018.
  19. ↑ Kritz, Fran (September 19, 2019). "Russian Lab Explosion Raises Question: Should Smallpox Virus Be Kept Or Destroyed?". NPR.
  20. ↑ "Vials labeled 'Smallpox' found in Pennsylvania lab freezer". The Associated Press. 2021-11-17. Retrieved 2021-11-18.
  21. ↑ Fox, Maggie (17 November 2021). "Vials labeled 'smallpox' found at vaccine research facility in Pennsylvania, CDC says". CNN. Retrieved 2021-11-18.
  22. ↑ Fieldstadt, Elisha (17 November 2021). "Vials labeled 'smallpox' found by lab worker cleaning freezer in Pennsylvania". NBC News. Retrieved 18 November 2021.
  23. ↑ Maggie Fox (19 November 2021). "Vials marked "smallpox" contained virus used in vaccine, not smallpox virus, CDC finds". CNN. Retrieved 2021-11-19.
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