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Poxvirus Dilemmas =97=20 Monkeypox, Smallpox, and Biologic Terrorism

 
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More=20 than 20 years have passed since the last case of smallpox was = confirmed and 18 years since the International Commission for = the=20 Certification of Smallpox Eradication of the World Health=20 Organization (WHO) concluded that the global eradication of=20 smallpox had been achieved.1,2=20 Now, new dilemmas confront the world. Could recent outbreaks = of human=20 monkeypox in the Democratic Republic of the Congo (known as = Zaire=20 from 1971 to 1997)3,4,5=20 represent the return of another form of smallpox?6=20 Could variola (smallpox) virus be used as a weapon of = biologic=20 terrorism? And what are the implications of the decision of = the WHO=20 to advise the destruction of all isolates of the smallpox = virus=20 in June 1999?7=20

Monkeypox in=20 Humans

Recent reports of large outbreaks of possible cases of monkeypox = in the Democratic Republic of the Congo have raised questions = as to whether monkeypox could sustain itself as an infection=20 transmitted from human to human, in the same way as smallpox.3,4,5=20 Smallpox vaccine protects against monkeypox, but no one is = being=20 immunized against smallpox anymore. Might monkeypox soon take = over the ecologic niche left vacant by smallpox?6=20 The available data do not support this possibility. =

The first case of human monkeypox was identified in 1970, and=20 through 1979, 55 cases of monkeypox were confirmed by the WHO = in forested areas of western and central Africa, of which 44=20 cases (80 percent) occurred in the Democratic Republic of the = Congo.8,9,10=20 The clinical picture of monkeypox (Figure = 1)=20 resembles that of smallpox in Central Africa.9=20


View = larger=20 version (143K):
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  		Figure 1. Human Monkeypox = in a=20 Six-Year-Old Girl in Zaire, Now the Democratic Republic of = the=20 Congo.

In the photographs, taken on about the eighth day of = rash, the=20 lesions are all in the same vesiculopustular stage and are=20 concentrated on the extremities, lips, nares, and palms. The = child=20 also had cervical and inguinal lymphadenopathy. (Photographs = by Mark=20 Szczeniowski.) =

 
The = intensified WHO-sponsored field studies between 1980 and 1986 = detected an additional 349 cases; virtually all were = laboratory-confirmed.=20 The case fatality rate among patients not vaccinated against=20 smallpox was 11 percent (15 percent for children under five=20 years of age).10=20 Of patients from the Democratic Republic of the Congo, 72 = percent=20 represented primary cases and were presumably infected from = an animal=20 source; the others represented spread to a second, third, = fourth, and=20 fifth generation of patients.10,11=20 Among 431 unvaccinated household contacts, the secondary = attack=20 rate was only 9 percent, far lower than the rates of 25 to 40 = percent seen with smallpox.12,13=20

Computer simulations were carried out to determine the = likelihood=20 that human-to-human transmission of monkeypox would continue, = assuming that vaccination-induced immunity to smallpox fell = to=20 zero and secondary attack rates were at the upper 95 percent=20 confidence limits of the observed attack rates =97 14 percent = for=20 household contacts and 5 percent for nonhousehold contacts.10,14,15=20 The model forecast that individual outbreaks might last as = long=20 as 14 generations of human-to-human transmission before dying = out, but that continuing transmission was highly unlikely. =

Only 13 cases of monkeypox were reported from 1987 through 1992, = and none from 1993 through 1995.16=20 Beginning in February 1996, monkeypox outbreaks in the = Democratic=20 Republic of the Congo were reported, but investigations were = limited=20 because of civil disorder.3,4 A=20 joint team from the WHO and the Democratic Republic of the = Congo=20 visited the province of Kasai Oriental and concluded that 511 = cases=20 of suspected monkeypox had occurred between February 1996 and = October=20 1997.5,16=20 Laboratory studies have since revealed that a substantial = proportion=20 of the suspected cases were actually cases of varicella; = hence, the=20 observed high incidence of possible household transmission = (42=20 percent) was not surprising. Moreover, the disease was = relatively=20 mild, and overall case fatality rates were about 1 percent. = On the=20 basis of the available data, one cannot conclude that = monkeypox has=20 changed genetically or in its pathogenesis, severity, or = propensity=20 for human-to-human spread. Careful field studies, to provide = more=20 definitive answers, are planned by the WHO.

Smallpox as a = Biologic=20 Weapon

There is increasing concern that biologic weapons might be = deployed=20 in warfare or for terrorist purposes. Terrorism has become = more=20 dramatic and destructive in recent years.17,18,19,20,21,22=20 State sponsorship of terrorism has risen, and there is = worldwide=20 diffusion of technology both through the Internet and because = experts have left laboratories in Eastern Europe. Until = recently,=20 smallpox was considered an unlikely agent of bioterrorism = because=20 of the high level of population immunity to the disease, the=20 availability of a vaccine, and the knowledge that vaccination = of=20 patients' immediate contacts could rapidly control = outbreaks.=20

Circumstances have changed. All vaccination against smallpox=20 ceased after eradication of the disease was affirmed.1,23=20 All countries realized substantial savings, both in the costs = of=20 vaccine administration and in vaccination-caused illnesses = and=20 deaths that were averted.24=20 Virtually all children and many adults are now fully = susceptible to=20 smallpox. Only limited supplies of vaccine (vaccinia virus) = are=20 available. The WHO retains about 500,000 doses of vaccinia, = and 60=20 million to 70 million doses are retained elsewhere, not all = of which=20 are properly stored or monitored regularly for potency. The = U.S.=20 stocks might be adequate to vaccinate 5 million to 10 million = persons. Facilities for manufacturing smallpox vaccine have = been=20 converted to other uses or destroyed. The production of = vaccine in=20 cell culture is under study in the United States, but = large-scale=20 manufacture is years away. Genetically engineered vaccinia = strains=20 are being investigated, mainly as vectors for other = antigens.25,26=20

Where might smallpox virus be obtained? In 1980, the WHO's = international=20 commission recommended that "all institutions maintaining = stocks=20 of variola virus destroy or transfer these stocks to WHO=20 collaborating centers equipped with adequate security" and = that such=20 laboratories be visited at least every two years to evaluate = security=20 and adherence to WHO safety directives.23=20 Of 76 laboratories identified as having variola virus by = 1980, 74=20 destroyed their stocks or transferred them to a WHO = collaborating=20 laboratory.2=20 Currently only two laboratories are known to retain variola = virus:=20 the Centers for Disease Control and Prevention (CDC) in = Atlanta,=20 and the Russian State Research Center of Virology and = Biotechnology=20 in Koltsovo, Novosibirsk Region, Russian Federation. Both are = WHO collaborating centers and have biosafety-level 4 = facilities.=20

Some speculate that there are additional variola-virus isolates, = either long-held unreported stocks or those obtained from a = WHO=20 reference center through a lapse in security.27,28=20 It has also been hypothesized that smallpox virus has been=20 recombined with other dangerous pathogens for use as a = biologic=20 weapon, but the accuracy of these scenarios is unknown. =

Were smallpox virus released as an act of terrorism, the results = could be catastrophic. A large proportion of the population = has=20 no immunity. There is little available vaccine and no effective=20 treatment. The expected case fatality rate would be higher = than=20 25 percent. Although there are no simple measures to detect = or=20 prevent biologic terrorism with smallpox (or other agents),29=20 four specific actions could diminish this risk.

First, the WHO should call on all countries to destroy = immediately=20 all stocks of variola virus. This would be a clear signal to=20 any group or nation contemplating the use of the virus that=20 such action would be the most reprehensible of crimes.

Second, efforts should be intensified to secure international=20 agreements enforcing inspection of all suspect facilities = anywhere=20 in the world. This would include strengthening the Convention = on the Prohibition of the Development, Production and = Stockpiling=20 of Bacteriological (Biological) and Toxin Weapons and on = Their=20 Destruction.30=20

Third, the capacity for large-scale manufacture of additional=20 smallpox vaccine should be developed. Production, with use of = WHO-approved vaccinia strains and cell culture, should begin = at=20 selected sites and should include the planning of an emergency=20 vaccine-distribution system.

Fourth, a plan to cope with an attack with smallpox virus should = be developed as part of a national plan to confront the = release=20 of biologic agents. Such an initiative was announced recently = by President Bill Clinton.31=20 Vaccination should be considered for persons who would be = responsible=20 for the investigation and control of suspected outbreaks of = smallpox=20 and for patient care.

Although smallpox virus represents an extremely serious threat,=20 the same cannot be said for monkeypox. The effect of an = aerosol=20 of monkeypox released among humans is difficult to predict, = but=20 case fatality rates would probably be below 15 percent, = substantially=20 lower than the rate expected among unvaccinated smallpox = victims.1=20 Moreover, monkeypox virus is difficult for humans to acquire=20 naturally and has a limited capacity for spread.

Destruction of = Variola=20 Virus

At meetings in 1986 and 1990, a WHO expert committee on = orthopoxvirus=20 infections affirmed the desirability of destroying stocks of=20 Variola major and V. minor, but recommended = additional=20 mapping, cloning, and sequencing studies. By 1994, this work = was=20 virtually completed, and the committee recommended the = destruction=20 of all stocks of variola virus. This decision was supported = in=20 1993 by the Council of the American Society of Microbiology,=20 the executive board of the International Union of = Microbiological=20 Societies, the board of scientific counselors of the National = Center for Infectious Diseases of the CDC, the board of = directors=20 of the American Type Culture Collection, and the Russian = Academy=20 of Medical Sciences.

There are cogent arguments for both the destruction and the=20 retention of smallpox virus. Opponents of destruction argue=20 that the unique host specificity of variola virus is = justification=20 for its preservation32,33,34=20 and that the virulence segment of the variola-virus genome = has not=20 been identified. Studies of variola-virus=96encoded proteins = that might=20 alter host immune and regulatory functions have been = proposed, in the=20 belief that such studies might improve our understanding of = human=20 defense mechanisms and help society cope with new poxviruses = and=20 other emerging infections.

Proponents of destruction argue that the genomes of reference=20 strains have been cloned and sequenced,35,36,37=20 through cooperative efforts of American and Russian = scientists.38,39,40,41,42=20 Moreover, monkeypox virus has proved a valuable surrogate for = variola: its genomic DNA has more than 90 percent homology = with=20 that of variola virus. Monkeypox illness in humans and in=20 macaques closely resembles smallpox in humans, and the = disease can=20 be prevented in animals by vaccination. In contrast, there is = no=20 satisfactory animal model of smallpox. Work with variola = virus=20 must be performed in a biosafety-level 4 laboratory, whereas=20 studies with monkeypox require less stringent precautions. = The=20 views of developing countries where smallpox was formerly = endemic=20 must also be weighed, since they contributed the most money = and=20 human resources to the eradication of smallpox. These countries = have=20 advocated the destruction of variola-virus stocks.7=20

During 1995, scientists from the Department of Defense and the=20 Department of Health and Human Services undertook to = determine=20 what, if any, studies involving the use of intact variola = virus=20 would be critical to public health and national security. It=20 was decided that if a model of monkeypox infection in = macaques=20 proved unsatisfactory, studies would be warranted to find a=20 technique to grow variola virus in a genetically or = chemically=20 altered mammalian host. The macaque monkeypox model indicated = that studies of pathogenesis, the protective efficacy of = vaccines,=20 and the therapeutic potential of antiviral compounds could be = conducted successfully (Jahrling P, U.S. Army Medical = Research=20 Institute for Infectious Diseases: personal communication). =

Furthermore, 23 antiviral compounds were evaluated in tissue=20 culture, with comparison of their action against variola, = monkeypox,=20 vaccinia, camelpox, and cowpox viruses. Three compounds had=20 significant antiviral activity against variola virus but only = moderate inhibitory activity against the other = orthopoxviruses.=20 Cidofovir, its cyclic derivative, and ribavirin are in = advanced=20 clinical testing or are approved for other viral infections.=20 Further studies of these compounds have begun, with use of a=20 mouse model of cowpox and the macaque monkeypox model = (Jahrling=20 P: personal communication). A hypothetical case can be made = for=20 the retention of intact variola virus for as yet incompletely = defined=20 research that cannot be conducted with monkeypox virus, = cloned=20 variola fragments, or sequence data. This possible use must = be=20 balanced against the benefits of a global decision to destroy = all=20 stocks of the virus.

Conclusions

Reports suggesting that monkeypox might replace smallpox as = a=20 serious epidemic threat are unsubstantiated, but the threat = posed by=20 the possible use of smallpox as a terrorist weapon is = genuine.=20 Because of the gravity of this threat, all known stocks of = variola=20 virus should be destroyed as soon as possible. The deliberate = deployment of this virus must be discouraged by whatever = means=20 possible.


Joel G. Breman, M.D., D.T.P.H.
National Institutes of=20 Health
Bethesda, MD 20892-2220


D.A. Henderson, M.D., M.P.H.
Johns Hopkins University = School=20 of Hygiene and Public Health
Baltimore, MD = 21205-2179=20

The views expressed in this article are those of the=20 authors and do not necessarily reflect the views of the=20 institutions with which they are associated.

We are indebted to Joseph J. Esposito, Karin Esteves, Frank=20 Fenner, David L. Heymann, John W. Huggins, Peter B. Jahrling, = Catherine Laughlin, Brian W.J. Mahy, Bernard Moss, and Mark=20 Szczeniowski for their thoughtful comments on the manuscript. =

References

  1. Fenner F, Henderson DA, Arita I, Jezek Z, Ladnyi ID. = Smallpox and=20 its eradication. History of international public health. No. 6. = Geneva: World=20 Health Organization, 1988.=20
  2. Breman JG, Arita I. The confirmation and maintenance of = smallpox=20 eradication. N Engl J Med 1980;303:1263-1273.[Abstract]=20
  3. Mukinda VB, Mwema G, Kilundu M, Heymann DL, Khan AS, = Esposito JJ.=20 Re-emergence of human monkeypox in Zaire in 1996. Lancet = 1997;349:1449-1450.[Medline]
  4. Human monkeypox in Kasai Oriental, Zaire, 1996-1997. = MMWR Morb=20 Mortal Wkly Rep 1997;46:304-307. [Erratum, WR Morb Mortal Wkly Rep=20 1997;46:706.][Medline]
  5. World Health Organization. Human monkeypox in Kasai = Oriental,=20 Democratic Republic of the Congo (former Zaire): preliminary report of = October=20 1997 investigation. Wkly Epidemiol Rec 1997;72:369-372.[Medline]
  6. Cohen J. Is an old virus up to new tricks? Science=20 1997;277:312-313.[Full Text]=20
  7. WHA resolution no. 49.10. Agenda item 18.1. Sixth = Plenary Meeting=20 A49/VR/6. Geneva: World Health Organization, 1996.
  8. Ladnyi ID, Ziegler P, Kima A. A human infection caused = by=20 monkeypox virus in Basankusu Territory, Democratic Republic of the = Congo. Bull=20 World Health Organ 1972;46:593-597.[Medline]
  9. Breman JG, Kalisa-Ruti, Steniowski MV, Zanotto E, = Gromyko AI,=20 Arita I. Human monkeypox, 1970-79. Bull World Health Organ = 1980;58:165-182.[Medline]
  10. Jezek Z, Fenner F. Human monkeypox. Vol. 17 of = Monographs in=20 virology. Basel, Switzerland: Karger, 1988.
  11. Jezek Z, Grab B, Szczeniowski MV, Paluku KM, Mutombo M. = Human=20 monkeypox: secondary attack rates. Bull World Health Organ = 1988;66:465-470.[Medline]
  12. Rao AR, Jacob ES, Kamalakshi S, Appaswamy S, Bradbury = BD.=20 Epidemiological studies in smallpox: a study of intrafamilial = transmission in=20 a series of 254 infected families. Indian J Med Res = 1968;56:1826-1854.[Medline]
  13. Foster SO, Smith EA. The epidemiology of smallpox in = Nigeria. J=20 Nigeria Med Assoc 1970;7:41-5.
  14. Fine PE, Jezek Z, Grab B, Dixon H. The transmission = potential of=20 monkeypox virus in human populations. Int J Epidemiol = 1988;17:643-650.[Abstract]=20
  15. Jezek Z, Grab B, Dixon H. Stochastic model for = interhuman spread=20 of monkeypox. Am J Epidemiol 1987;126:1082-1092.[Abstract]=20
  16. Heymann DL, Szczeniowski M, Esteves K. The resurgence = of=20 monkeypox in Africa. Br Med Bull 1998;54:691-700.
  17. Kupperman RH, Smith DM. Coping with biological = terrorism. In=20 Roberts B, ed. Biological weapons: weapons of the future. Washington, = D.C.:=20 Center for Strategic and International Studies, 1993:35-46.
  18. Betts RK. The new threat of mass destruction. Foreign = Aff=20 1998;177:26-41. =
  19. Simon JD. Biological terrorism: preparing to meet the = threat.=20 JAMA 1997;278:428-430.[Abstract]=20
  20. Henderson DA. Bioterrorism as a public health threat. = Emerg=20 Infect Dis (in press).
  21. Zilinskas RA. Iraq's biological weapons: the past as = future? JAMA=20 1997;278:418-424.[Abstract]=20
  22. Simon JD. Terrorists and the potential use of = biological weapons:=20 a discussion of possibilities. Santa Monica, Calif.: RAND Corporation, = 1989.
  23. The global eradication of smallpox: final report of the = Global=20 Commission for the Certification of Smallpox Eradication, Geneva, = December=20 1979. History of international public health. No. 4. Geneva: World = Health=20 Organization, 1980.
  24. Lane JM, Ruben FL, Neff JM, Millar JD. Complications of = smallpox=20 vaccination, 1968: national surveillance in the United States. N Engl = J Med=20 1969;281:1201-1208.[Medline]
  25. Sutter G, Moss B. Novel vaccinia vector derived from = the host=20 range restricted and highly attenuated MVA strain of vaccinia virus. = Dev Biol=20 Stand 1995;84:195-200.[Medline]
  26. Moss B. Genetically engineered poxviruses for = recombinant gene=20 expression, vaccination, and safety. Proc Natl Acad Sci U S A=20 1996;93:11341-11348.[Abstract/Full Text]<= /A>=20
  27. Garrett L. Inside a biowar lab. Newsday. August 10, = 1997:1.
  28. Preston R. Annals of warfare: the bioweaponeers. New = Yorker.=20 March 9, 1998:52-65.
  29. Franz DR, Jahrling PB, Friedlander AM, et al. Clinical=20 recognition and management of patients exposed to biological warfare = agents.=20 JAMA 1997;278:399-411.[Abstract]=20
  30. Kadlec RP, Zelicoff AP, Vrtis AM. Biological weapons = control:=20 prospects and implications for the future. JAMA 1997;278:351-356.[Abstract]=20
  31. Remarks by the President at the United States Naval = Academy=20 commencement, May 22, 1998. White House press release, Washington, = D.C., May=20 22, 1998.
  32. Joklik WK, Moss B, Fields BN, Bishop DH, Sandakhchiev = LS. Why the=20 smallpox virus stocks should not be destroyed. Science = 1993;262:1225-1226.[Medline]
  33. Roizman B, Joklik W, Fields B, Moss B. The destruction = of=20 smallpox virus stocks in national repositories: a grave mistake and a = bad=20 precedent. Infect Agents Dis 1994;3:215-217.[Medline]
  34. Joklik W. The remaining smallpox virus stocks are too = valuable to=20 be destroyed. Scientist 1996;10:11.
  35. Mahy BWJ, Esposito JJ, Venter JC. Sequencing the = smallpox virus=20 genome: prelude to destruction of a virus species. ASM News = 1991;57:577-80. =
  36. Mahy BW, Almond JW, Berns KI, et al. The remaining = stocks of=20 smallpox virus should be destroyed. Science 1993;262:1223-1224.[Medline]
  37. Mahy BWJ. The WHO recommendations to destroy all = smallpox stocks=20 should be enacted without delay. Rev Med Virol 1993;3:131-132.
  38. Massung RF, Liu L, Qi J, et al. Analysis of the = complete genome=20 of smallpox variola major virus strain, Bangladesh-1975. Virology=20 1994;201:215-240.[CrossRef][Medline]
  39. Massung RF, Loparev VN, Knight JC, et al. Terminal = region=20 sequence variations in variola virus DNA. Virology = 1996;221:291-300.[CrossRef][Medline]
  40. Senkevich TG, Bugert JJ, Sisler JR, Koonin EV, Darai G, = Moss B.=20 Genome sequence of a human tumorigenic poxvirus: prediction of = specific host=20 response-evasion genes. Science 1996;273:813-816.[Abstract]=20
  41. Massung RF, Esposito JJ, Liu LI, et al. Potential = virulence=20 determinants in terminal regions of variola smallpox virus genome. = Nature=20 1993;366:748-751.[Medline]
  42. Shchelkunov SN, Massung RF, Esposito JJ. Comparison of = the genome=20 DNA sequences of Bangladesh-1975 and India-1967 variola viruses. Virus = Res=20 1995;36:107-118.[CrossRef][Medline]

 
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Related Letters:=20

Poxvirus=20 Dilemmas
Hooper C., Breman J. G., Henderson = D.A.
Extract<= /A> | Full = Text=20  
N Engl J Med 1998; 339:2027-2028, Dec 31, 1998.=20 Correspondence

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