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Smallpox and bioterrorism.

Hugh Pennington1

  • 1Department of Medical Biology, University of Aberdeen, Medical School Building, Foresterhill, Aberdeen AB25 2ZD, United Kingdom. t.h.pennington@abdn.ac.uk

Bulletin of the World Health Organization
|February 6, 2004
PubMed
Summary
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Smallpox poses a lower bioterrorism risk than feared, with limited spread requiring close contact. Public health measures like isolation and tracing are more effective than mass vaccination for control.

Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Disease Control

Background:

  • Smallpox was eradicated in 1980, but bioterrorism concerns have resurfaced.
  • Current populations have declining immunity, increasing vulnerability.
  • Historical outbreak data offers insights into smallpox transmission dynamics.

Purpose of the Study:

  • To assess the risk of smallpox transmission from a deliberate release.
  • To evaluate the effectiveness of different public health interventions.
  • To inform current public health strategies against potential bioterrorism threats.

Main Methods:

  • Review of historical smallpox outbreak data from the 20th century.
  • Comparative analysis of smallpox's R value against other infectious diseases.

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  • Assessment of transmission patterns, including the role of hospital exposure.

    • Main Results:

    • Smallpox has a lower R value than many common infectious diseases, indicating less efficient spread.
    • Close person-to-person contact is essential for transmission, similar to SARS.
    • Hospital settings played a significant role in past smallpox outbreaks.

    Conclusions:

    • Smallpox is less contagious than its reputation suggests, acting as a 'plodding nuisance'.
    • Mass vaccination carries dangers; focus should be on case isolation, contact tracing, and quarantine.
    • Rapid diagnosis and maintaining electron microscope networks are crucial for outbreak control.