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This weeks Biological Weapons stories for Friday, July 12, 2002.
Threat Assessment: Scientists Create Polio Virus From ScratchScientists at the State University of New York at Stony Brook have created a live polio virus out of chemicals and information available to the general public, the scientists reported yesterday (see GSN, July 9). The virus was created to demonstrate that terrorists seeking to conduct a biological weapons attack could develop disease agents without first obtaining a natural virus, said project leader Eckard Wimmer, professor of molecular genetics and microbiology at SUNY-Stony Brook. “You no longer need the real thing in order to make the virus and propagate it,” Wimmer said. Scientists were able to create the virus with knowledge of its genomic sequence, which can be found the Web, and genetic material available from one of several companies, according to the New York Times. It took about three years to develop the virus, but it probably could be done now in about six months, Wimmer said. After the virus was created, researchers injected it into the brains of mice, causing a paralytic disease equivalent to poliomyelitis, the Times reported. The synthetic virus, however, was weaker than naturally occurring polio, probably because the synthetic virus was created with several deliberate mutations to set it apart, Wimmer said. The U.S. Defense Department funded the project as part of efforts to develop defenses against biological weapons, according to the Times. The Defense Advanced Research Project Agency gave the project $300,000 over the last three years. It does not violate the Biological Weapons Convention, which provides allowances for conducting defensive biological research, according to experts. There is nothing sinister about the Pentagon being involved in this kind of research, said Stephen Morse, director of the Center for Public Health Preparedness at Columbia University and a former official at the Defense Advanced Research Project Agency. “Hopefully, this will help people to be realistic about assessing future threats,” Morse said. Potent Process The project has launched a debate among scientists over whether other viruses could be artificially created by the same process, the Times reported. “Could someone make a highly pathogenic virus like Ebola? Could you in fact make that in a rogue laboratory that doesn’t need more than two skilled workers? My feeling is you probably could,” said American Society for Virology President Robert Lamb. It is unlikely, however, that smallpox, which only exists in two stocks kept by the United States and Russia, could be synthesized due to the length of its genome sequence — about 200,000 bases, or “letters” in the DNA code, Wimmer said (see GSN, July 9). In addition, the smallpox virus uses some of its own proteins to replicate, so making the genes would not be sufficient, said Steven Block, a Stanford University expert on the applications of biotechnology for biological warfare. “You can’t take smallpox DNA, inject it into a cell and expect to get smallpox out,” Block said (Andrew Pollack, New York Times, July 12). To Publish or Not to Publish Some scientists have also questioned the publication of the research, calling it irresponsible, according to the Los Angeles Times. A spokeswoman for the American Association for the Advancement of Science, which published the research in Science magazine, said the association is examining adopting formal guidelines on how to handle potentially dangerous research. She added that the association was right to publish the work because it is an important scientific advance. Raymond Zilinskas, a biological and chemical weapons expert at the Monterey Institute of International Studies, agreed that the research should be published. “There [are] undoubtedly peaceful uses that will come out of that information,” he said. “The unfortunate part is that, with other powerful technologies, there may be misuse” (Usha Lee McFarling, Los Angeles Times, July 12). U.S.-Soviet Cooperation Led to Polio Vaccine U.S.-Soviet cooperation in the late 1950s led to the development of the polio vaccine, according to a June report prepared by the Chemical and Biological Arms Control Institute. A U.S. hospital gave strains of the polio virus to Soviet research facillities in 1956, and within four years the Soviets developed the oral polio vaccine and had begun administering it to millions of Soviet schoolchildren, according to the report. The United States, however, only began using the oral vaccine once its safety and effectiveness had been demonstrated through Soviet use, the report said. Polio was declared eradicated from the Western Hemisphere in 1994. Due to the effectiveness of the polio vaccine, the number of infections reported worldwide has dropped by 99 percent and the number of countries with polio infections has decreased from 125 to 20 the report said, adding that polio could be completely eliminated within the next 10 years (Chemical and Biological Arms Control Institute release, June 2002). For further information, see: Pentagon Executive Summary of BWC Journal of the American Medical Association Background on Smallpox
Smallpox: Researchers Begin Testing Vaccine StockpileResearchers yesterday began testing the effectiveness of a 50-year old stockpile of smallpox vaccine on more than 300 volunteers throughout the United States (see GSN, July 8). The tests, being conducted in Oakland, Calif., Iowa City, Iowa, Nashville and Houston, are to determine whether the vaccine doses found in storage at the pharmaceutical company Aventis Pasteur carry any side effects and whether they are still effective (see GSN, May 16). If the vaccine is found to be safe and effective, it could be diluted to provide enough doses for all of the United States, Canada and part of Mexico, said Steve Black, co-director of the Kaiser Permanente Vaccine Study Center in Oakland. The Oakland tests will involve injecting diluted vaccine into 40 to 50 volunteers aged 18 to 32, according to the Los Angeles Times. The volunteers will receive $50 for participating in the study and will keep a daily journal of any physical symptoms after receiving the vaccine. They will also return to the center for checkups and answer follow-up phone calls over six months. While the vaccine trials are not expected to cause adverse reactions, the smallpox vaccine can cause side effects that include rashes, brain swelling, and in some cases, death, according to the Times. Steven Pereira, an 18-year-old college student, said the potential benefits of the vaccine outweigh any dangerous side effects. “If there was a terrorist attack and the vaccine works, I’ll be the first one vaccinated and won’t have to worry about catching disease,” Pereira said. “Also, I’ll be one of the people to test it for other citizens of the United States” (Nerissa Pacio, Los Angeles Times, July 9). Researchers also plan to test Dryvax smallpox vaccine — which accounts for 15 million doses of the U.S. supply — through diluted injections given to volunteers, according to the Associated Press. Out of 700 previously unvaccinated young adults who were given Dryvax injections, one-third reported pains severe enough to cause them to miss school or work, according to two studies released in March by the New England Journal of Medicine. Although none of the people who took part in the studies became seriously ill, some reported fever, headaches, nausea, swelling and other side effects (Associated Press/New York Times, July 9). Four Vaccination Strategies Out of four vaccination strategies, a mass vaccination campaign before a smallpox outbreak would save the most lives, according to a study conducted by researchers at Yale University and the Massachusetts Institute of Technology and expected to be published this week in the Proceedings of the National Academy of Sciences (see GSN, June 21). “We find that mass vaccination results in both far fewer deaths and much faster epidemic eradication,” the authors of the study said. The researchers examined how four different vaccination strategies would combat a hypothetical smallpox outbreak that infected 1,000 people in a large U.S. city, according to the New York Times. Out of the four strategies examined, the ring vaccination plan — vaccinating only those whom come into contact with an infected person — was the least effective in stopping the smallpox outbreak. Use of the ring vaccination plan led to 367,000 infections, 110,000 deaths and an outbreak that lasted 350 days, according to the study. If officials began a mass vaccination strategy once an outbreak was detected — which would probably be about two weeks after infection — it would lead to 1,830 infections, 560 deaths and an outbreak that would last 115 days, the study says. If officials started with the ring vaccination plan and switched over to mass vaccination on the 33rd day of a smallpox outbreak, it would result in 15,570 infections and 4,680 deaths, according to the study. The most effective strategy is to conduct a mass vaccination campaign before an outbreak, according to the study. If 40 percent of the U.S. population were vaccinated before an outbreak, with follow-up mass vaccinations once an outbreak began, there would only be about 440 deaths, the study says. If ring vaccination were used instead as a follow-up once an outbreak began, however, it would lead to 40,000 fatalities, according to the study (William Broad, New York Times, July 9). Officials Examine Quarantine Measures Meanwhile, U.S. health officials have begun planning how to quarantine those who might come into contact with someone infected with smallpox, according to the Contra Costa Times (see GSN, Dec. 18, 2001). “It’s not pretty to think through these type of doomsday scenarios, but it’s important to start to put yourself there and imagine things unfolding if you want to anticipate how to react,” said Marty Cetron, a quarantine expert at the U.S. Centers for Disease Control and Prevention. The quarantine planning is still in its early stages and will include logistical and policy concerns, such as where people would be kept while officials determine whether a smallpox case has occurred, according to the Times. Health experts plan to give the quarantine plan to top U.S. officials and others who would be involved in preparations within the next few weeks, Cetron said. According to one part of the plan, officials would emphasize that people would be better off staying in quarantine because of increased access to smallpox vaccine and other medicines, the Times reported. That is a major shift from quarantines in the past, when people inside were discounted, Cetron said. “All the goodies will be delivered inside the box,” he said. “It’s a fundamental difference to spend as much, if not more attention, on monitoring and preserving the health of the people inside the box” (Laura Meckler, Contra Costa Times, July 9).
Smallpox: U.S. Plans to Vaccinate 500,000 Health Care WorkersThe United States plans to vaccinate 500,000 first responders and health care workers against smallpox, according to a U.S. official cited by the New York Times yesterday (see GSN, June 26). Previously, officials had said they planned to vaccinate only a few thousand. Rapid increases in supplies of smallpox vaccine have made it possible to boost the number of people vaccinated, officials said (see GSN, May 16). Studies have also discovered that the vaccine can be diluted several times and still remain effective, according to the Times. “Now we can act differently because we have more vaccine,” said D.A. Henderson, senior science adviser to Health and Human Services Secretary Tommy Thompson (William Broad, New York Times, July 7). U.S. officials are still exploring the best strategy for carrying out the vaccination program, according to the Washington Post. Each vial of smallpox vaccine contains 100 doses, which can be diluted five times (see GSN, March 29). That means, however, that 500 people would have to be given the vaccine at once since it loses effectiveness when opened, the Post reported. Most health care workers would have to be taught how to administer the vaccine, which requires about 15 quick injections to the arm. To prevent infecting patients with live vaccine, health care workers would have to leave work for 10 days after they are vaccinated, said Jerome Hauer, acting assistant Health and Human Services secretary for emergency preparedness. The U.S. Centers for Disease Control and Prevention will monitor all vaccine recipients for adverse reactions, Hauer said. Because the vaccine can be harmful to immunocompromised people, Health and Human Services is examining the possibility of requiring an HIV test before administering the vaccine, according to the Post (Ceci Connolly, Washington Post, July 8). The United States is also attempting to increase supplies of vaccinia immune globulin, which is used to reduce adverse vaccine effects in people with immune system problems, according to the New York Times (see GSN, Nov. 21, 2001). Currently, 700 doses are available and 3,000 doses are expected to be on hand by the end of the year, officials said. Strategies The United States also plans to increase preparations for a possible mass vaccination strategy if needed, according to the Times (see GSN, June 21). Health and Human Services is expected to distribute guidelines on conducting mass vaccinations to cities and states within the next two weeks, Hauer said. There are also logistical changes planned at CDC for conducting a mass vaccination campaign, he added. Other details of a mass vaccination strategy still need to be approved by Thompson, officials said. The United States has not given up on its plans to conduct a ring vaccination strategy — vaccinating those who came into contact with an infected person, health officials said. Preparations for mass vaccination, however, will enable workers to respond more quickly to an outbreak that infects more than 100 people, officials said. Critics of the ring vaccination approach have said the plan would do little against terrorists set on conducting a smallpox attack. “Unless the initial attack is very small and the infectiousness of the agent is quite mild, ring vaccination is not going to do much good,” said Edward Kaplan, a Yale University public health specialist (Broad, New York Times). A new study prepared by Yale University and the Massachusetts Institute of Technology says that a mass vaccination strategy would be a better response to a smallpox attack, according to Wall Street Journal. The study, expected to be released tomorrow, says that 4,000 people would die if a ring vaccination plan were used after a smallpox outbreak in a major U.S. city. The United States’ dense and mobile population would result in a larger outbreak that would cause fear and take too long to bring under control without a mass vaccination plan, according to the study (Lueck/Chase, Wall Street Journal, July 8). The increase in criticism of the ring vaccination strategy has had no role in the increased preparations for carrying out a mass vaccination plan, U.S. officials said. “The key to responding to any public health emergency is flexibility,” Hauer said. “You listen to critics, but you can’t let that drive policy. You have to do what’s best for public health and national security” (Broad, New York Times). Israel Stockpiles Vaccine Meanwhile, Israel has begun building a smallpox vaccine stockpile to prepare for a possible biological weapons attack, Clalit Health Services Chairman Dan Michaeli said today. “I know that decisions have been taken that have led to provisions for all the residents of the country,” said Michaeli, a former director general of the Israeli Health Ministry. “If and when it is decided to vaccinate, I hope they will do so quickly” (Ha’aretz, July 8). For further information, see: Journal of the American Medical Association Background on Smallpox
Anthrax: Some FBI Agents Believe U.S. Scientist Carried Out AttacksSeveral FBI agents increasingly believe that the person responsible for last fall’s anthrax attacks will be found among the small number of scientists who worked in the U.S. biological weapons research program, Newsweek reported this week (see GSN, June 28). The FBI is working from a shifting list of six to 20 people under investigation, according to Newsweek. Each name remains on the list until the person can be cleared in a process called Operation Elimination, Newsweek reported. Investigators recently searched the apartment of Steven Hatfill, a former researcher at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Md. Hatfill has strongly denied any role in the attacks and the search produced no evidence linking him, authorities have said. Some FBI agents want to increase the pressure on Hatfill, while others are advocating a more cautious approach, according to Newsweek. “I don’t want it coming to us that we created a (Richard) Jewell,” a senior law-enforcement official said, referring to the man once suspected, but later exonerated, of being responsible for the bombing at the Atlantic Olympics (Newsweek, July 15).
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