The Once and Future Threat of Smallpox

By Maruyama, Xavier | Naval War College Review, Spring 2002 | Go to article overview

The Once and Future Threat of Smallpox


Maruyama, Xavier, Naval War College Review


Tucker, Jonathan B. Scourge: The Once and Future Threat of Smallpox Berkeley, Calif.: Atlantic Monthly Press, 2001. 304pp. $26

In real estate, the three most important things are "location, location, location." In nonfiction book writing, the counterpart is "timing, timing, timing." The publication of Scourge in early September 2001 could not have been more timely. The book is not a rapidly compiled, superficial response to the attacks of 11 September but an in-depth study of smallpox. Jonathan B. Tucker traces the history of the disease from ancient Egypt through India to China, where it was called "Hunpox," apparently because it was believed to have been imported by the Huns. Smallpox, we are reminded, contributed to the defeat of Athens by Sparta in the Peloponnesian War.

Unlike anthrax, smallpox is extremely contagious, and it is readily transmitted from one human to another. It can have a fatality rate of greater than one third, making it a candidate as a weapon of mass destruction. However, as a weapon, it is uncontrollable, and the using side may become victim to it unless its members have been inoculated.

In 1790 an English country doctor named Edward Jenner noticed that milkmaids appeared not to contract the disease, an observation that ultimately led to the use of the cowpox virus as a vaccine against smallpox. The science of the mechanism was not understood until recently, but over the next 170 years vaccination banished smallpox in industrialized countries, although it continued to infect the developing world. (In 1939 it was discovered that the vaccine in use was "vaccinia," which was genetically distinct from both smallpox [variola] and cowpox. Where vaccinia had come from and how it became the standard inoculant remains a mystery.)

In 1967 the World Health Organization launched a global campaign to eradicate smallpox, and within a decade the last natural outbreak was snuffed out. The success of the eradication program was to a great extent owed to the leadership of D. A. Henderson. The history of smallpox might have ended there, but for the defection of the Soviet military scientist Kanatjan Alibekov (a. …

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