Should The Last Smallpox Vials Be Destroyed?

Smallpox may be a thing of the past, but it still exists in laboratories. In late May, members of the World Health Organization are scheduled to meet to vote on whether or not the U.S. and Russia should destroy their stockpiles of the smallpox virus, the deadly disease that has killed millions of people worldwide. More than three decades since the virus was completely eradicated, Russia and the United States are the only countries in the world that still have vials of the smallpox strain in their laboratories, as mandated by the WHO.

This isn't the first time the WHO has discussed the fate of these two countries' smallpox stockpiles. The issue was taken up when the World Health Assembly met in Geneva, Switzerland, in 2011. The assembly decided then to defer the debate — a decision that was met with some criticism by public health advocates.

"To me, this is regrettable but perhaps not surprising," physician Donald Henderson told Science magazine in 2011. "There's just a determination to hold on to the virus."

For centuries, smallpox was the leading cause of death in both the Western and developing worlds. According to the National Institutes of Health, smallpox has killed more people than all other infectious diseases combined.

There's no treatment for smallpox, but symptoms can be controlled and alleviated with various pain medicines. However, the smallpox vaccine, which was first created in 1796 by Edward Jenner, helped prevent the spread of the disease. A widespread outbreak search and prevention program developed by the WHO in the late 1960s led to the eventual eradication of the virus. U.S. schoolchildren stopped receiving the smallpox vaccine in 1972, and by 1980, smallpox was wiped out across the globe.

During the Cold War, U.S. and Russian scientists stowed away vials of the frozen virus — allegedly, for the Russians, to be used as a method of biological warfare. Fortunately, that didn't come to pass, but the two countries still kept their smallpox vials for research and medical purposes, which makes the decision to incinerate the virus samples for good even tougher. Smallpox may be gone, but it's return still poses a threat, scientists say.

“The hazard is, could it ever by accident or by evil design leave those two containments and actually be introduced into the population again and spread?” Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center, told ABC News.

In recent years, it's evident that smallpox as an act of warfare hasn't been ruled out. According to the Centers for Disease Control and Prevention, the U.S. government tightened their biological warfare preparedness after 9/11 by increasing the amount of smallpox vaccines. The United States now has enough to vaccinate every citizen in case of an emergency.

In 2011, Secretary of Health and Human Services Kathleen Sebelius defended the need for smallpox samples in an op-ed for The New York Times:

Those who advocate immediate destruction would have us believe that another smallpox outbreak is unthinkable. They want us to believe that there is no need to ensure the global community is adequately prepared to deal with an outbreak and that the only risk comes from maintaining the highly secured samples. For these reasons, they argue that the World Health Assembly should set an immediate date for destruction.

It should not. Although keeping the samples may carry a miniscule risk, both the United States and Russia believe the dangers of destroying them now are far greater.

While keeping vials of the smallpox virus around in case of biological warfare may seem like an act of paranoia, many scientists are also arguing that there's still research that needs to be done. In a recent report in the journal PLOS Pathogens, researchers Inger Damon, Grant McFadden and Clarissa Damaso argue that smallpox remains a threat until there is "sufficient protection" in the international community:

While certain aspects of the original research goals using live virus have been met, other key items, like the wider approval of accurate diagnostics that can distinguish smallpox from other orthopoxvirus diseases or the full licensure of new antiviral drugs and vaccines that are effective against variola virus, have not yet been completed.