Scourge: The Once and Future Threat of Smallpox

Rating:
Summary: "The Pox on both your houses"
Review: A book that is timely in consideration of the current crisis. Well documented and microbiology majors will appreciate all the WHO accounts. It is understandable even by a layman and is a book of warning. This dreaded disease is one of the worst to be faced by humanity and the book delves into the terrible history and the valiant fight to eradicate it. The folly of course, is that it is a political weapon of terror and nations violated obligations to "preserve" specimens for war use. This brings us to the dangers of today and how rogue nations might unleash this plague again where it could have a "doubling" effect in that many have ancient vaccinations that have worn out and others that have never known the disease are therefore prime meat for infection. A gripping account and well worth the read.

Rating:
Summary: Different viewpoint of the same problem.
Review: 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

Rating:
Summary: words alone can't express how well written this book is!
Review: i never thought i would have a book about smallpox on my must-read list! (but the world HAS changed since 9/11, hasn't it?) from the 1st murderer-on-death-row page (so well done, it made me check the title page to make sure i was reading a NON-fiction book!), to the tracing of its historical roots in africa, to its spread throughout the world & subsequent eradication by a few determined scientists (heroes we've never heard of until now), to the ultimate betrayal by the former soviet war machine, i found that i couldn't put this book down until i had read the last thrilling word. it's also been a real comfort to me as i listen to all the conflicting information put forth by the "experts" in the media, because i feel like i've already gotten the REAL scoop on the whole smallpox thing. it's also kind of fun to actually know who ken alibek is every time i hear his name mentioned in the news, (another hero hardly anyone cared about until now!) it also makes me sad to find out that politics became more important than ridding the planet of this menace forever, thus setting the stage for its once-&-future-threat yet again. the more the world changes, the more it stays the same.

Rating:
Summary: Timing isn't everything, content makes this book a no miss!
Review: 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.

Rating:
Summary: Provides Answers And Provokes More Questions
Review: 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.

Rating:
Summary: Completely absorbing
Review: 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.

Rating:
Summary: You think small pox is totally eradicated-think again!
Review: Ok, so I'm on a Disease kick right now. After reading "The Hot Zone" and "Virus Hunter" I moved on to "Scourge: the once and future threat of smallpox." Quite and interesting read, this last book proved to be. The author is extremely knowledgeable about the subject matter and manages to keep the reader engaged for well over 200 pages.

The one thing these three books have in common, and the one feature I could do without is the "modeling" that come in the last chapter. This is where the author models the outbreak of some disease (in this case smallpox, go figure) to show the reader how unprepared we are, and how virulent the disease actually is. Although it was quaint in the first book, by the third it is tired.

Aside from that, I would encourage anyone with a passing interest in infectious disease or bioterrorism to take a closer look at "Scourge."

Rating:
Summary: Interesting and Informative
Review: Ok, so I'm on a Disease kick right now. After reading "The Hot Zone" and "Virus Hunter" I moved on to "Scourge: the once and future threat of smallpox." Quite and interesting read, this last book proved to be. The author is extremely knowledgeable about the subject matter and manages to keep the reader engaged for well over 200 pages.

The one thing these three books have in common, and the one feature I could do without is the "modeling" that come in the last chapter. This is where the author models the outbreak of some disease (in this case smallpox, go figure) to show the reader how unprepared we are, and how virulent the disease actually is. Although it was quaint in the first book, by the third it is tired.

Aside from that, I would encourage anyone with a passing interest in infectious disease or bioterrorism to take a closer look at "Scourge."

Rating:
Summary: No Longer an Epidemic, Forever a Threat
Review: One of the achievements of which humans can be truly proud is the elimination of smallpox. It is a great, centuries-long story of a scientific triumph over an apocalyptically powerful disease. The smallpox virus is easily caught from other people, or even from those it has killed, or their clothes. It kills a third of those who get it, and if it doesn�t kill, it can blind or disfigure. It has changed history � the New World would not have been conquered so thoroughly, perhaps, if the conquerors were not helped by the virus they brought with them. The last naturally occurring case was in Somalia, a cook who was thereupon vaccinated and cured. In 1980, the World Health Organization declared smallpox eradicated. It was a real scientific victory, but as the subtitle of _Scourge: The Once and Future Threat of Smallpox_ (Atlantic Monthly Press) by Jonathan B. Tucker indicates, victory may have been declared early. Especially with current terrorist threats, we would be wrong to say we have no reason to worry about smallpox.

Tucker is an expert on biological and chemical weapons, and directs a nonproliferation program concerning them. The first half of his book is a fascinating history of the interaction of humans and the virus, with various vaccination programs eventually wiping out the natural disease. The battle began even before Jenner�s inoculation by cowpox, inoculating people with material from others who had a mild form of the illness. Our technological competence in administering the inoculations improved, but Tucker�s narrative takes off in describing the efforts of the World Health Organization to get to areas of the world where the disease was endemic. This is a great story, with real heroes fighting not only natural forces but governmental and societal inertia.

So smallpox was eradicated, and since vaccination was no longer needed, it was halted. And herein is the problem: vaccination confers only a temporary immunity, and now, if somehow the virus were released into the population, it would find no resistance at all. Research on the virus stopped, and the institutions that had samples of the virus destroyed them or turned them into the only two repositories, one in the US and one in Russia. There they sit in cold storage, safe from anyone. But the safety may be an illusion. In 1989, a defector from the USSR alerted US intelligence to a huge Soviet bioweapons program. Tons of smallpox virus had been manufactured, with the idea of sending it to America on ballistic missiles, �a devastating blow to the United States, perhaps destroying it as a functioning society.� The bioweapon program vanished with the Soviets (or did it?), and eradication of even the two stored samples of the virus was scheduled for 1995. But in a blow-by-blow account of how the various involved agencies of the US government faced each other off on the issue, Tucker shows how there was a stay of execution. There are good reasons for destroying the virus once and for all, but there are good reasons not to, and so the debate is running not on objective data but on emotional fear, made worse in the current atmosphere of terror. Right now, all experimentation with the virus is to end this year, and thereafter it could be autoclaved into oblivion, but there will undoubtedly be just another round of debate between the �destructionists� and the �retentionists.� Hanging over the argument will be the irony that conquering the illness was just a step along the way to making it a possible agent of biological terrorism. Tucker�s fascinating and scary history shows that for all our scientific competence, and for all our understanding of microscopic life forms, we have not conquered our own baser impulses, and so smallpox is still a danger.

Rating:
Summary: No Longer an Epidemic, Forever a Threat
Review: One of the achievements of which humans can be truly proud is the elimination of smallpox. It is a great, centuries-long story of a scientific triumph over an apocalyptically powerful disease. The smallpox virus is easily caught from other people, or even from those it has killed, or their clothes. It kills a third of those who get it, and if it doesn't kill, it can blind or disfigure. It has changed history ' the New World would not have been conquered so thoroughly, perhaps, if the conquerors were not helped by the virus they brought with them. The last naturally occurring case was in Somalia, a cook who was thereupon vaccinated and cured. In 1980, the World Health Organization declared smallpox eradicated. It was a real scientific victory, but as the subtitle of _Scourge: The Once and Future Threat of Smallpox_ (Atlantic Monthly Press) by Jonathan B. Tucker indicates, victory may have been declared early. Especially with current terrorist threats, we would be wrong to say we have no reason to worry about smallpox.

Tucker is an expert on biological and chemical weapons, and directs a nonproliferation program concerning them. The first half of his book is a fascinating history of the interaction of humans and the virus, with various vaccination programs eventually wiping out the natural disease. The battle began even before Jenner's inoculation by cowpox, inoculating people with material from others who had a mild form of the illness. Our technological competence in administering the inoculations improved, but Tucker's narrative takes off in describing the efforts of the World Health Organization to get to areas of the world where the disease was endemic. This is a great story, with real heroes fighting not only natural forces but governmental and societal inertia.

So smallpox was eradicated, and since vaccination was no longer needed, it was halted. And herein is the problem: vaccination confers only a temporary immunity, and now, if somehow the virus were released into the population, it would find no resistance at all. Research on the virus stopped, and the institutions that had samples of the virus destroyed them or turned them into the only two repositories, one in the US and one in Russia. There they sit in cold storage, safe from anyone. But the safety may be an illusion. In 1989, a defector from the USSR alerted US intelligence to a huge Soviet bioweapons program. Tons of smallpox virus had been manufactured, with the idea of sending it to America on ballistic missiles, 'a devastating blow to the United States, perhaps destroying it as a functioning society.' The bioweapon program vanished with the Soviets (or did it?), and eradication of even the two stored samples of the virus was scheduled for 1995. But in a blow-by-blow account of how the various involved agencies of the US government faced each other off on the issue, Tucker shows how there was a stay of execution. There are good reasons for destroying the virus once and for all, but there are good reasons not to, and so the debate is running not on objective data but on emotional fear, made worse in the current atmosphere of terror. Right now, all experimentation with the virus is to end this year, and thereafter it could be autoclaved into oblivion, but there will undoubtedly be just another round of debate between the 'destructionists' and the 'retentionists.' Hanging over the argument will be the irony that conquering the illness was just a step along the way to making it a possible agent of biological terrorism. Tucker's fascinating and scary history shows that for all our scientific competence, and for all our understanding of microscopic life forms, we have not conquered our own baser impulses, and so smallpox is still a danger.