Smallpox virus was one of the most fearsome pathogens of all time; in the 20th century alone, it was responsible for over 100 million deaths. The naturally occurring disease was eradicated from the planet by the World Health Organization through an intensive vaccination campaign. Yet the threat of smallpox looms large, because of its potential to be used as a weapon of bioterrorism. Intensive vaccination will probably not control a deliberate release, and the vaccine has serious side effects for immunocompromised individuals. Thus an improved vaccine and antiviral drugs are urgently needed to counter the threat. How does one study an eradicated disease? An interagency group has developed a primate model using authentic smallpox virus in closely controlled studies at the Centers for Disease Control. Through evaluation of infected primates, we now have insight into the nature of the "toxemia" clinicians used to describe fatal smallpox decades ago. By comparison with other exotic and lethal viral infections, Ebola in particular, we have identified some common threads of pathogenesis which provide targets for generic intervention into entire classes of viral agents with bioterrorist potential.
Peter Jahrling is Scientific Adviser and Senior Research Scientist at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID). He is Head of the WHO collaborating centre on arbovirus and hemorrhagic fever virus research at USAMRIID, a member of the Committee on Return of Biological Samples of the National Research Council, CDC/NIH Guest Editor for Biosafety in Microbiological and Biomedical Laboratories, 3rd and 4th editions, and Chairman, Subcommittee on Laboratory Safety, American Committee on Arthropod-borne Viruses.
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