Variola, CDC

I was away reporting most of today, and while I was out, a few federal emails landed in my mail with what probably sounded like a  thud. One was an official announcement from the Food and Drug Administration; the others were copies of FDA and NIH emails that people there thought I should see.

They all said the same thing: The six vials of smallpox virus found in an FDA cold-storage room on the National Institutes of Health campus July 1 and announced by the CDC last week had company. A lot of company: 321 other vials. Some of them contained other “select agents,” infectious pathogens considered serious enough — for the illness they create, or the lack of a vaccine to prevent or drugs to treat them — to be considered potential bioterror agents.

(If you’ve missed this story so far, catch up here, here, here and here.)

Here’s the gist of the FDA’s external announcement:

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Variola, CDC

Those of us who write about infectious diseases faced a conundrum last week, when the news broke that 60-year-old vials containing viable smallpox virus had been found on the National Institutes of Health campus. A responsible reporter always wants to talk to the experts in any subject. But when it comes to smallpox, experts can be hard to find.

Smallpox was one of the world’s worst killers, from prehistory through the first half of the 20th century. Yet there has not been a case of the dreadful disease anywhere since 1978, so few physicians working today have seen one. The virus is supposed to exist in only two highly secure stockpiles, so few scientists do research on it. And the aggressive campaign that chased the disease from the globe — the only human infection for which that claim can be made — ended 34 years ago. Many of the men and women who led it are in retirement, and a number have died.

Fortunately, the physician who headed that international campaign — 85-year-old Donald Ainslie Henderson, universally known as D.A. — is still working in public health, as a distinguished scholar at the bioterrorism-focused Center for Health Security of the University of Pittsburgh Medical Center. Henderson literally wrote the book on smallpox — twice, in fact: He co-authored the World Health Organization’s definitive 1,500-page reference, Smallpox and its Eradication (known in public health as the Red Book), and in 2009 wrote a personal reminiscence of the global battle, Smallpox: The Death of a Disease. Just last month, he published a lengthy, closely argued essay in the journal he co-edits, Biosecurity and Bioterrorism, urging the WHO to finally consent to destroying the last stocks of smallpox virus. (A decision the international agency declined to take; instead, for the sixth time in a row, it postponed a vote on destruction in favor of more study.) There are only a few people working in public health — not just in the United States, but in the world — who possess equivalent knowledge of smallpox, its eradication, and the persistent fears afterward that it could be used as a bioterror agent.

Last week, I talked to Henderson about the live-virus discovery and whether it will affect calls for all stocks of smallpox to be destroyed. He had some surprising things to say, particularly about the availability of smallpox vaccine. I edited our conversation for clarity and length.

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