Scourge: The Once and Future Threat of Smallpox (Paperback)

by Jonathan B. Tucker (Author) "In a maximum-security facility in Atlanta, the world's most dangerous prisoner sits in solitary confinement, awaiting execution..." (more)
Key Phrases: variola virus stocks, live variola virus, smallpox issue, United States, World Health Assembly, Soviet Union (more...)

Editorial Reviews

From Library Journal
A political scientist and an expert on bio-weapons analysis, Tucker provides an engrossing look at the continuing debate over the destruction of smallpox. The author uses numerous interviews with key players to look at the political and social aspects of the disease. Although a brief history of smallpox is included, the strength of the book lies in the author's description of the process used to eradicate naturally occurring smallpox. Equally valuable is the last section that considers the pros and cons of destroying the laboratory stockpiles of the virus. Postponed several times, the elimination of the remaining virus is now set for 2002. Concern remains among experts that if smallpox were somehow reintroduced into society, the public health system would not be able to contain the disease. The potential viability of smallpox as a biological weapon is covered in reasonable depth. Light on technical language, this accessible book is highly recommended for all libraries. Tina Neville, Univ. of South Florida at St. Petersburg Lib.
Copyright 2001 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

From The New England Journal of Medicine
Without the smallpox virus, the world today would be exceedingly different. Although issues surrounding smallpox have been the subject of speculative fiction, Scourge is a superb and engaging factual treatise -- both historical and scientific -- dealing with the impact of this highly contagious and often lethal infection from ancient times to the present. Beginning with the opening sentence, in which smallpox is denoted as "the world's most dangerous prisoner," the author relates a fascinating tale in which it is not armies and conquest that repeatedly change the course of civilization, but the variola poxvirus, manifested as two forms of disease: variola major and variola minor. Although the historical vignettes are interesting, no attempt is made to provide an in-depth analysis of many events that are themselves the subject of entire books. Instead, some of the initial purported forays into the field of biologic weapons involving smallpox are highlighted. However, it is clear that these anecdotes are a prologue to an unexpected series of much more serious recent events. Thus, the author sets the stage for the real story -- that of three centuries of valiant attempts by the global medical community to eradicate this terrible scourge, albeit without complete success. The heroes of the story are physicians who work tirelessly to rid the human population of this disease, often against strong political countercurrents and under dangerous circumstances. From the discovery of vaccine prophylaxis by Edward Jenner to Donald A. Hendrickson's tireless efforts to see the disease abolished, a massive assault on this pathogen was launched. This humanistic work, often conducted under extreme conditions in the field by a global health care team involving as many as 150,000 persons, culminated in the World Health Organization's announcement in 1980 that smallpox disease had been wiped out -- a singular, historic event. Just a little over a decade previously, it had been estimated that 10 to 15 million people in 43 countries had smallpox, a statistic of which even recent medical school graduates may be unaware. Furthermore, eradication of smallpox transpired in the midst of the Cold War, so it is perhaps even more surprising that Soviet and U.S. teams found common ground in developing strategies to contain outbreaks of disease and jointly supply vaccine. Intriguingly, the real villain, the virus itself, had not been eradicated, since it was stockpiled at that time in any number of secure and not-so-secure facilities. The descriptions of the biologic-warfare programs conducted by one major world power -- and perhaps more than one -- are both terrifying and appalling. In the latter portion of the book, the author reconstructs the way in which biologic-warfare agents based on the variola virus were developed behind the Iron Curtain, apparently on the mistaken assumption that the United States was doing the same as part of a biologic-arms race occurring in parallel with the proliferation of nuclear weapons. The scientific and political debate over whether the remaining stocks of virus should be destroyed makes interesting reading, particularly in relation to the disparate views of basic-science researchers, World Health Organization physicians, politicians, and military personnel. The work of judging the actions of the principals in what seem to be morally ambiguous events is left in large part to the reader. Written before the tragic events of September 11, 2001, and the sporadic cases of anthrax infection that were subsequently identified, the cautionary note in the final chapters of the book concerning the potential use of smallpox as a biologic weapon looms even larger on today's world stage. In summary, Scourge is a well-written, informative history of the eradication of smallpox disease. The author's authoritative command of the intrigue surrounding the "stay of execution" of the virus itself and its potential use as an agent for biologic warfare makes the latter portion of the book read much like a modern spy thriller, one that is difficult to put aside as recent events continue to unfold. David L. Dunn, M.D., Ph.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.

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Product Details

• Paperback: 304 pages
• Publisher: Grove Press (August 12, 2002)
• Language: English
• ISBN-10: 0802139396
• ISBN-13: 978-0802139399
• Product Dimensions: 8.8 x 5.9 x 0.9 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 4.6 out of 5 stars See all reviews (22 customer reviews)
• Amazon.com Sales Rank: #393,384 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

23 of 25 people found the following review helpful:

5.0 out of 5 stars Completely absorbing, October 10, 2001

By	Bucky (Haunted Mansion, The Magic Kingdom) - See all my reviews

This review is from: Scourge: The Once and Future Threat of Smallpox (Hardcover)

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.

9 of 10 people found the following review helpful:

5.0 out of 5 stars Provides Answers And Provokes More Questions, November 27, 2001

By	taking a rest - See all my reviews (TOP 100 REVIEWER)

This review is from: Scourge: The Once and Future Threat of Smallpox (Hardcover)

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.

8 of 9 people found the following review helpful:

5.0 out of 5 stars Fast moving...and MORE TIMELY EACH DAY, July 9, 2002

By	Joel L. Gandelman (San Diego, CA USA) - See all my reviews (REAL NAME)

This review is from: Scourge: The Once and Future Threat of Smallpox (Hardcover)

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.