Such a program would be part of a normal increase in any preparation for an anticipated biological attack on the United States, they said, adding warnings about such a possibility have been made for years.
Public health departments in Los Angeles, Chicago and New York all received money from the Centers for Disease Control and Prevention this spring to boost surveillance and preparedness. Jonathon E. Fielding, director of public health for Los Angeles County, told United Press International the smallpox watch was part of a larger program and not a response to any specific threat.
"We had no specific information. Simply because it's a potential agent of bioterrorism and we're really the first line of defense, working with the medical community, we thought it was prudent to reinstitute surveillance, but we didn't have any information about an imminent threat, " Fielding said.
There has not been a naturally occurring case of smallpox in the world since the late 1970s.
Fielding said there was a general surveillance and preparedness program for bioterrorism in Los Angeles and smallpox was just one of the agents. Ebola, other hemorrhagic fever viruses, plague, anthrax and botulinum are some of the other diseases on the program list, he said.
Even prior to Sept. 11, a broad preparedness program would necessitate surveillance and reporting of a number of potential biowarfare diseases.
Charles Bailey, commander of the U.S. Army Medical Research Institute of Infectious Diseases during the Desert Storm War, said there "was not any specific information" that led to the surveillance programs.
"It was just precautionary measures. They need to get people in place," Bailey told UPI. "There is suspicion among some that not all the countries destroyed their smallpox isolates at the time that the World Health Organization declared that's what everyone is supposed to do, except for the United States and the Soviet Union."
There is no hard evidence secret stocks exist, Bailey said, just reports from time to time. Bailey is vice president of Hadron Advanced Biosystems, specializing in biodefense.
The World Health Organization in 1976 asked all countries to either destroy their smallpox virus stocks or transfer them to secure facilities at the CDC in Atlanta or a laboratory in the Soviet Union.
"There's fear that the virus is located in parts of the world other than the United States and Russia," Bailey said.
Many countries still may have stocks of the smallpox virus, according to Anthony H. Cordesman, Arleigh Burke chair and specialist in strategic assessment at the Center for Strategic and International Studies in Washington. "Virtually every country that's worked on biological warfare may have a smallpox culture. Nobody can be sure that they weren't kept in reserve."
He said questions remain whether North Korea, South Korea, Taiwan, China, Iran, Iraq, Egypt, Israel, Syria or other counties may still have virus stores.
Cordesman attended a recent meeting with Pentagon officials and said there is no hard evidence of ties between these countries and people who might want to use smallpox as a weapon.
"The Russians see the risk, just as much as we do," Cordesman told UPI. "This (smallpox) is a risk, but the thing to remember is that Russia weaponized some 37 agents during the Cold War and we tend to discover them one by one. The problem of the threats involved in bioterrorism and biological warfare is far more complex than one or two diseases."
Jonathan Tucker, author of "Scourge: The Once and Future Threat of Smallpox," maintains that although there is a high degree of suspicion that Iraq and North Korea maintain stocks of smallpox there is no direct evidence. Tucker, who is based in Washington, is director of the chemical and biological weapons nonproliferation program at the Center for Nonproliferation Studies at the Monterey Institute of International Studies.
Gigi Kwik, a biologist and a fellow at the Johns Hopkins University Center for Biodefense Studies in Baltimore, Md., said she could only surmise the reason the smallpox surveillance was instituted was because officials were concerned about its use as a biological weapon. Kwik said she doubted there was specific information.
"This is something we've been concerned about for a while. Ever since ... people defected from the former Soviet program and revealed that they had grown smallpox for weaponization and had deteriorating security in that area of the world, I think it's been a big concern, at least a concern for people who know enough to be concerned about it," Kwik told UPI.
A smallpox case in Birmingham, England, in 1978 showed just how uncertain the location of smallpox virus stocks might be. A laboratory worker getting supplies was unwittingly infected from a vial of smallpox virus no one knew had been placed in a freezer. It had apparently been there for years and had been forgotten. The worker died.
Smallpox spreads rapidly from person to person in droplets or aerosol form. A person infected with smallpox usually shows symptoms of fever after 12 to 14 days. About two days later a rash begins to develop over the entire body. Blister-like vesicles form and turn into pustules. Scabs start to form after about 10 to 14 days and then fall off after about 14 to 28 days. The disease is fatal about 30 percent of the time for most strains. It leaves victims badly pocked with scars.
If smallpox were used against people in America, it would not be the first time the continent has seen smallpox as a bioweapon. According to Tucker's book "Scourge," after the French and Indian War, the British intentionally gave smallpox-contaminated blankets to Native American tribes and during the American Revolutionary War the British deliberately spread smallpox during the sieges of Boston and Quebec.
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