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Area of Science:

  • Virology
  • Public Health
  • Infectious Diseases

Background:

  • Smallpox was globally eradicated by the World Health Organization (WHO), with no cases since 1978.
  • Viable variola virus (VARV) is intentionally retained in high-security labs in Russia and the USA.
  • Clandestine VARV stocks may exist, posing a global health emergency risk due to decreased vaccination and increased travel.

Purpose of the Study:

  • To review the status of smallpox in the post-eradication era.
  • To highlight the need for research in diagnostics, antiviral drugs, and safer vaccines against VARV.
  • To address the risks associated with potential intentional VARV release.

Main Methods:

  • Review of the current status of variola virus (VARV) in the post-eradication era.
  • Discussion of advancements in synthetic biology enabling in vitro reconstruction of VARV.
  • Analysis of public health implications of potential VARV release.

Main Results:

  • The variola virus (VARV) is still maintained in secure laboratories, with the possibility of clandestine stocks.
  • Synthetic biology advances allow for the in vitro reconstruction of VARV.
  • The global population is more vulnerable to VARV due to lapsed vaccination programs and increased travel.

Conclusions:

  • Despite smallpox eradication, the risk of VARV re-emergence necessitates ongoing research.
  • Development of diagnostic tests, antiviral drugs, and improved vaccines is essential for public health preparedness.
  • The WHO's authorization of VARV retention supports critical research for global health security.