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Scourge: The Once and Future Threat of Smallpox

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Mr. Tucker has written a highly readable account of one of the great killers of human history. Starting with background on smallpox: the course of the disease, its effect on humnan history, its use as a biological weapon, and moving through to the early work of Jenner in the field of vaccination, and the awe-inspiring triumph of the campaign to eradicate this terrible disease, this riveting account paints a portrait of one the great public health achievements of the 20th, or any, century. From that high point, the author then goes on to describe the hideous betrayal of that achievement by the very people who had first proposed undertaking the eradication of smallpox: the former Soviet Union. He lays out the Soviet bioweapons program that secretly kept the virus alive and kicking, and the Soviets' attempts to combine the virus with other viruses to create an even more powerful bug. Given recent events, this book's timing and message could not be better. Scourge is not an alarmist book, rather, a sobering one.

Smallpox is back into the news with a VENGEANCE these days...and Scourge's theme becomes as timely -- informative, troubling and, when you ponder it, TRAGIC -- as ever.

But make no mistake about it: this book is NOT just doom-and-gloom: the underlying message is that man battled smallpox -- the airborne, spitting cobra of diseases --throughout the centuries and eventually won. And even though it looks like a merciless segment of mankind (terrorists or terrorists-sympathizing governments) could WITTINGLY unleash this disease that already killed millions, mankind conquered smallpox once -- and it can do so again......but it will cost many lives.

Just look at some recent news stories. It recently was revealed that some Russians died during the 70s of what was suspected to have been a "perfected" form of weaponized
smallpox secretly developed by their own government to use against the United States. July 2002: a news story notes a US plan to immunize nurses doctors and other health workers first and provide for treatment and mass vaccination AFTER the fact. July 2002: a news story says volunteers are trying a 50-year-old smallpox vaccine in the US, where vaccinations haven't been offered since 1972 (and they wear off after 10 years).

In Scourge, biological and technical weapons expert Jonathan Tucker gives you the PERFECT briefing book on how the disease works, how it is spread, how doctors have painstakingly battled to decrease its murderous capacity over the centuries, and how, in 1978 under WHO's remarkable Dr. DA Henderson, international doctors proclaimed a relentless campaign against the disease over and successful: smallpox was completely erradicated.

One of the book's most fascinating parts is how he traces smallpox's use(with little remorse) as an early biological weapon by colonists against Native Americans, by the British against Americans and others. And why not? The disease kills 30 percent of the people who get it in the most horrific, painful ways: it would literally bring an enemy to its knees.

This clearly-written, fast moving book then shifts: to one of the greatest betrayals of mankind. And when the shift comes you are shocked...and sickened.

Tucker outlines in great detail how the rumors were confirmed: yes, the Soviet Union had LIED -- and HAD maintained smallpox stocks and HAD worked on developing it for use as The ULTIMATE biological weapon (confirmed by recent news reports). The Soviets wanted to "perfect" smallpox as a lethal weapon that could kill up to 100 percent of the time (in other words 30 percent was too low a death rate for them) -- to spray or bomb via missile or plane to finish off an already-reeling US population after a catastrophic nuclear attack.

Today, Tucker notes, it's feared that virus stocks are held by North Korea, Iran, Iraq and China. Even worse: there are fears that terrorists can get -- or already have -- the
smallpox weapon. All this in a world in which countries have stopped smallpox vaccinations.

PERSONAL NOTE: I can personally attest to some of this book's accuracy. In 1974, as a freelance correspondent for the Chicago Daily News, I went down to Patna, Bihar with WHO teams as they went into tiny villages to find smallpox cases, isolate them, and vaccinate other areas. It wasn't pretty. But the doctors were so inspiring: they BELIEVED they had an unparalleled medical achievement within their grasp and that, for the good of humanity, they were close to totally exterminating this disease. And by 1978 they announced that they did.

But in the end, as this book shows, they -- and centuries of dedicated medical workers, doctors and smallpox victims -- were betrayed. Yes, the doctors killed smallpox. But the military and governments kept it on life support. A pox on both their houses.

Mr. Jonathan B. Tucker has not offered readers a rapidly compiled, superficial report, in response to the attacks of September 11 and the concerns raised since then. This work is not sensationalized although the effects of certain strains of this disease are hard to describe without appearing gratuitously graphic. There are a wide variety of strains of this virus provided by nature that are truly horrific. Then there are engineered strains that are man-made for use only as weapons that justify questioning how we as a species have survived this long, and how easily the time for many could be abbreviated.

The author traces the disease from Ancient Egypt, to, and until the successful end of an international effort to remove the disease from the planet. This particular member of The Pox Family of viruses does not have a host, like Malaria's Mosquito. It exists only in humans, and unlike Anthrax that can remain dormant; when Smallpox is killed it stays that way. The eradication of this health menace is one of the great accomplishments of medicine and of mankind; unfortunately the story does not yet have a happy ending.

Until 1992 when a Russian Scientist defected and brought the story of Russia's massive Bio-Weapons program in Siberia to the world's attention, it was widely believed that there were only two relatively small amounts of the virus in existence. One location was at The Center For Disease Control in Atlanta, and a single locale in Russia, which in reality was more than one, inclusive of a massive facility for engineering new strains of the virus and the means to deliver them at a facility in Siberia. The Soviets were not content with a virus that countries had stopped protecting their populations with; they were creating more vicious strains by adding, in one example, a Hemorrhagic aspect to the disease. This is the type of virus associated with Ebola.

When the USSR imploded there was technology for sale, scientists, and the diseases they had created. It now is believed that North Korea, Iraq, and Iran have the virus, and other nations may have it as well. The World Health Organization had been attempting to destroy all the viral stocks, however they have been blocked not only by The United States and Russia, but many in the scientific community as well. Spring of 2002 was to be the date for final destruction of all stockpiles; this date would now appear highly unlikely.

The book gives a very good historical overview of Smallpox and the effects it has had on history. Smallpox has been used as a weapon in war and the effects were devastating. The only technology involved was giving away blankets that the sick had been wrapped in, or sending carriers of the disease amongst the enemy. This was Smallpox as nature created it, and how 17th and 18th century warfare delivered it. The book also goes into great detail about the delivery systems that could be launched upon missiles with multiple warheads, which could release the virus over large areas.

Unlike Anthrax, Smallpox is extremely contagious depending on the strain involved. All strains are contagious; some produce more in aerosol form from an infected person than others. This book also makes it very clear that a person who shows no signs of having the disease can transmit it.

The frustrating part of this book and others sources I have reviewed is that there is no agreement on how much vaccine The United States has at present. I have read numbers from 16 million to 90 million doses. The US Government is authorizing production of enough vaccine for the entire US Population as a result of September 11th. Another point that is bothersome, is that once vaccinated, how long is a person protected? No one will state a time frame. The answer is generally phrased as, after x number of years the resistance of the person vaccinated will decrease. I have read numbers from as low as 5 years to as high as 12. Even after these points it appears to be the consensus the person is still afforded some protection.

The one fact that is not in dispute, is that with the exception of military personnel, those who work around the disease, and others who may serve overseas, no one has been vaccinated in this country since 1972. So leaving aside how long those who have been vaccinated at one time may still have some protection, and dealing only with those who have zero resistance, we have a nation with a group from birth to age 29, and that population is unprotected.

ICBM laced Smallpox missiles are probably not worth a great deal of concern. However in this book you will read of scenarios where extremely low-tech methods could spread the disease, for example, in an Airport, and within 24 hours there would be few states that would not have people incubating and spreading the disease.

The book is not alarmist, however after the attacks of the 11th of September, the number of scenarios that once appeared fantastic, must now be viewed with reasonable amounts of serious thought. The manner that the disease was originally destroyed is not only remarkable; it was done in a manner you will not expect. This book may have had a very narrow audience some months ago, now it should be of interest to everyone.

This book was written from extensive interviews with Dr. Henderson, the CDC and Johns Hopkins public health physician who headed up the program to eradicate smallpox from the world, believed to be successful as of 1980. So the stories from that fight to rid the world of smallpox are fascinating and authoritative.

The story continues through Henderson's effort to get rid of the last government storage freezers of the virus -- and his failure, because of what the government knew and he didn't: the Russians had been growing tons of smallpox for years and loading them in ICBMS aimed at the U.S. It was a terrific betrayal.

Big, big question facing us today: When the Russians dismantled their biowarfare program, did anyone get some leftovers?

So now the entire world, completely unvaccinated, is vulnerable to this terrible disease, just as the Aztecs were when a handful of armored Spanish soldiers (and one slave with smallpox) destroyed their entire civilization.

In the wargames played with biowarfare using smallpox attacks on American cities, the outcome was not favorable. And at the end, players were using ancient techniques because the vaccine had quickly run out: arm-to-arm vaccination, variolation, the goal at that point just being to save as many people as possible. This book tells how to do those easy and old techniques.

History, descriptions, facts, transmittal, symptoms, all you need to know about smallpox should there actually be some out there after all.

It is to be hoped that no one will never actually need any of the information in this book. If not, the historical record of the eradication of the disease makes vivid reading in itself.

There are already a number of great Amazon[.com] reviews on this book; I just wanted to add my voice and say how much I enjoyed it. It is incredibly well written and very difficult to put down. Tucker does a fantastic job of presenting the harsh history of small pox as well as alerting the reader the to potential modern-day threat. It is immensely interesting and informative. I've leant this book to a couple of friends, and they both were very pleased with it.

This fascinating book is the story of smallpox. Starting with the distant past, the author traces the history of smallpox's relationship with mankind. Then, the book goes into luxurious detail on the World Health Organization's campaign to stamp smallpox out. But, just when it seems that the story should be over, it takes an ominous turn when the author begins chronicling the Soviet Union's nightmarish program of breeding smallpox as a weapon. This horrendous project is traced from its genesis after World War 2, through the use of modern genetic splicing to enhance the disease's lethality under Mikhail Gorbachev, to its continuance even after the fall of the Soviet Union.

This is a fascinating book! Unlike some books I've read recently, this one dragged me along, keeping me up at night when I could not put it down. As I know little about the topic, I appreciated the way the author made the whole subject clear to me, educating me while keeping me entranced. Overall I would say that this is a great book, one well worth the cost. I highly recommend it!

The author, Jonathan Tucker is an expert on biological and chemical weapons. He studied biology at Yale University, received his Ph.D. in political science from MIT, and served in the State Department, the Congressional Office of Technology Assessment, and the Arms Control and Disarmament Agency. So, although his descriptions of past epidemics are horrible enough, it's the present and future threat of smallpox---the second half of this book---where Tucker really scared the bejabbers out of me. I had no idea that the Soviet bioweapons program, Vector, had gone as far as it did in developing viral weapons. According to the author, "Some 4,500 people, including about 250 Ph.D.-level scientists, worked at Vector in the late 1980s...One goal of the...program was to develop a smallpox-based biological weapon containing virulence genes from Ebola hemorrhagic fever virus. At least theoretically, such a viral chimera would combine the hardiness and transmissibility of smallpox with the lethality of Ebola, which was between 90 percent and 100 percent fatal, resulting in an 'absolute' biological weapon."

The real irony of the Vector bioweapons program was that the Soviet Union (along with the United States) was a major factor in eradicating the scourge of smallpox from the world in the 1970s.

Where are those 4,500 people who worked at Vector, now? Where is the twenty tons of smallpox virus formulation that was stocked at the Center of Virology in Zagorsk? The Soviets supposedly destroyed the stockpile in the late 1980s, but the smallpox seed cultures and the expertise to manufacture biological weapons from them still remain.

The author clearly presents the arguments for and against retaining the known remaining smallpox virus stocks in Atlanta and Moscow. However, I believe he sides with the 'destructionists' rather than the 'retentionists': "From a practical standpoint, now that the DNA sequences of representative strains of variola virus hade been determined, the live virus was no longer needed to identify smallpox if it were to reappear in the future. Nor would live variola [smallpox] virus be required to protect against a future outbreak of smallpox, since the small pox vaccine--based on the distinct vaccinia virus--could be retained and stockpiled for insurance purposes."

The long, difficult task of eliminating smallpox from the world (as thrillingly described in "Scourge") will not be complete until all known and rogue virus stocks (believed held by North Korea, Iran, Iraq, and possibly China) are destroyed. The world's population has grown increasingly vulnerable to the disease since the last official vaccination programs were eliminated in 1984, as the protective immunity induced by the vaccine lasts only about seven to ten years. Nor is there an effective medical treatment for smallpox.

As Tucker states in his closing sentence: "Until humanity's legal and moral restraints catch up with its scientific and technological achievements, the eradication of smallpox will remain as much a cautionary tale as an inspirational one."

I just recently finish Preston's book 'The Demon in the Freezer'. You would think that would fulfill my appetite for knowledge concerning smallpox, right? But that particular book and this one, Scourge, are very different. While Preston writes for the masses, often in a very novelistic, suspenseful way to bring information concerning microbial dangers to everyone, this particular book is more for those whose interests and avocations and jobs lie in these fields. This does not mean the book is written boringly. Both books deserved the five stars for different reasons. 'Demon...' was exciting and horrifying in it's details concerning smallpox, this book brings to life the unfortunate politics played behind the scenes by physicians, by government entities such as the Defense Department, by politicians who do not understand the full implications of most biological and bioethical discussions, by entire countries (U.S. and Russia the worst as per usual).

Though Tucker and Preston mention a few names and incidents in common in their books, their writing is very different. Tucker is deeply involved in bioweapons development as a member of an elite group that monitors this type of problem internationally. Preston writes like a journalist. So the impact of their writing is completely different and I personally think anyone interested in this problem is well-served by reading both books.

Scourge tells the story of the political problems not only in eradicating the smallpox worldwide, but the current problem concerning the existence of stocks at the CDC and VEctor, and whether they should be destroyed. Tucker goes into far more detail concerning the problems in India and Bangladesh that made that country one of the last to contain smallpox (and bodes ill should smallpox ever raises its head there again). He also goes into much more detail concerning Russia's two-faced behavior in supplying the world with the vaccine that led to eradication, but in secret continuing to work on smallpox and genetic variations in order to have them for biological weaponry.

Tucker also gives a good warning at the end chapter, that while the ability to use smallpox as a weapon is more difficult then imagined, the possibility of using it still exists. He emphasizes that panic does not contribute anything useful, but awareness and preparation for the possibility does. I am glad that the smallpox vaccinations are there, and I think more physicians and other medical personnel should be prepared for seeing these cases, and being able to differentiate between smallpox, flu, and chickenpox.

Karen Sadler,
Science Education

I read this book on the flight to NYC where my husband and I viewed the remains of the World Trade Center. A memorable event. Tucker's book is a memorable reading event for anyone interested in public health, bioweapons, US and world policy, and anyone who wants to read a darn good story! The book can be divided into three parts; the history and impact of smallpox on the human race, the unprecidented efforts to successfully eradicate this disease from the earth, and its real potential for reintroduction as a potent bioweapon. Tucker is a careful researcher as well as a wonderful storyteller, an unbeatable combination considering the nature of the topic he chose to write about. You like Tom Clancy? The story told here is real. Don't let the non-fiction designation deter you from reading this page-turner.

This book discusses the natural history of smallpox, its use as a military weapon, the dramatic campaign that eliminated it in nature, the debate about eliminating it in known laboratories, and the threat of its use in bioterrorism.
Tucker introduces the reader to interesting but little-known facts about smallpox in history. For example, during the Revolutionary War, Benedict Arnold laid siege to Quebek City. The commander of Quebek sent smallpox-variolated civilians to mingle among the Continental Army troops, and within weeks a massive epidemic broke out. The Continental Army burried its dead in mass graves and retreated in disorder. The author concludes that "Were it not for that epidemic, Quebek and perhaps all Canada might be part of the United States today."
The discussion of smallpox as an instrument of terrorism is chilling. For example, Tucker reports a Pentagon adviser's concern that "if a ruthless tyrant like Saddam Hussein had his back to the wall and nothing left to lose, he might consider unleashing smallpox against his enemies as a final instrument of revenge." Indeed, Iraq is suspected of harboring secret smallpox stocks, based on circumstantial evidence discussed in the book. Another expert characterizes the threat of a smallpox attack as a "low probability, high impact" risk.
"Scourge" is relevant, timely and a pretty good read.