WASHINGTON — After the Sept. 11 attacks, fears that terrorists or the regime in Iraq might unleash a secret stash of the smallpox virus led Vice President Dick Cheney to call for a mass vaccination of the American public, an action President George W. Bush rejected.
No such stash was ever found. But it turns out the Bush administration was looking too far afield.
Only 11 miles from the White House, officials reported last week, six glass vials of variola, the smallpox virus, had been squirreled away for decades in an unguarded cardboard box in a storage room on the National Institutes of Health campus in Bethesda, Md. They had apparently been forgotten since they were prepared back in 1954, a time when many laboratories around the world worked with variola (pronounced buh-rye-oh-la).
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The discovery marked the third major safety breach in recent weeks at government health and research laboratories. What made it especially embarrassing was that the United States had assured the World Health Organization that the country’s only remaining store of variola was at the Centers for Disease Control and Prevention in Atlanta. (A second official store, by international agreement, is at a Russian government laboratory in Siberia.) Dr. Thomas R. Frieden, the C.D.C.’s director, angrily announced last week that he was temporarily closing two laboratories at the centers while safety measures were strengthened.
Though no harm has resulted from the breaches (the others involved avian influenza virus and anthrax), it certainly could have. In particular, smallpox was one of the worst scourges in history, killing hundreds of millions of people worldwide until the W.H.O. certified it eradicated in 1981.
Beyond the risks to lab employees and the public, the breaches will only intensify a fierce debate among scientists and public policy experts about what to do with microbes that have so much potential for harm. Should all known stocks of variola have been destroyed, rather than preserved at government labs? Should scientists be allowed to manipulate genes in influenza viruses to study their virulence and transmissibility? What happens if a mutant microbe escapes?
Before smallpox’s demise, laboratories in many countries kept variola for needed diagnostic and research purposes. Scientists tested it and other dangerous microbes at open benches in laboratories that seem primitive by today’s standards, without protective ventilation, space-age protective gear or biohazard hoods to prevent dispersion.
For example, in 1954, two Dutch virologists started doing annual tests on scabs from smallpox patients, in part to determine how long the virus could be detected in the material. They kept the scabs in unsealed envelopes.
At Yale in 1970, two of the discoverers of Lassa fever virus contracted the infection in their laboratory and one of them died before the university halted the research and transferred it to the C.D.C. By that time, laboratory accidents around the world had already caused at least 2,700 viral infections and 107 deaths. (When The New York Times published a front-page article of mine about the Lassa breach, we were accused of sensationalism. Critics, I replied, overlooked the fact that when the researchers went out into the community, they could have infected outsiders.)
A laboratory accident caused the last outbreak of smallpox, in England in 1978, a year after the world’s final transmission in nature. At a W.H.O. smallpox lab at the University of Birmingham, variola escaped through a ventilation system, infecting a medical photographer, who died. Days later, the laboratory director, Dr. Henry S. Bedson, committed suicide.
Widespread publicity about the deaths embarrassed the W.H.O., which had led the smallpox eradication program. In 1979, responding to growing concerns about the potential laboratory hazards of smallpox, California health officials found 12 unrecorded vials of variola. The incident renewed calls for all scientists to check the inventories of their freezers and laboratories for variola.
But accidents and near misses occur more often than scientists and health officials admit, and now the three major government health agencies involved in the lapses — the C.D.C., the N.I.H. and the Food and Drug Administration — are scouring their inventories. In an interview on Sunday, Dr. Frieden said he would be “shocked” if his agency found any more unauthorized vials.
In its various plans to eradicate smallpox, the World Health Organization distinguished between the end of the clinical illness (smallpox) and extinguishing the virus (variola). Countries where smallpox was endemic needed supplies of the virus to study. Gradually, the organization strengthened recommendations to limit the number of laboratories authorized to work with variola.
Yet even as the eradication program took hold in the 1970s, no one knew how many laboratories held the virus. The W.H.O. scoured scientific journals to identify all laboratories that had published on variola and then asked them to destroy their stocks, and member countries to verify destruction. But lacking staff and enforcement authority in autonomous nations, the agency could only take each country’s word on faith.
In the long term, the W.H.O. has said it would destroy the two authorized variola stocks in Atlanta and Siberia. Meanwhile, scientists have continued to study the virus. But the plan to destroy it has set off intense debate.
Proponents say its destruction would be a natural finish to the eradication program and would prevent terrorists from getting their hands on variola. Opponents say that no one can predict future scientific advances that might offer benefits from studying the virus — and that as far as terrorists are concerned, it may well be possible to build variola from published molecular sequences, whether or not the natural virus continues to exist.
The opponents add that it would be arrogant to eradicate a species, however dangerous, at a time when environmentalists fight to prevent extinction of so many other species. (One thing is certain: If the official variola stocks had been destroyed, there would be all sorts of wild theories about the six vials found this month.)
But regardless of the outcome of the debate, some common-sense precautions are in order for labs that store and handle variola and other dangerous microbes.
Scientists display the same range of behaviors as other professionals; they are just as apt to be cavalier, naïve or hubristic. Many may think they know best and do not need “cookbook” procedures. But many surgeons were the same way before widespread publicity about lapses led them to adopt checklists to avoid operating on a wrong leg or mixing up patients’ X-rays. Similar lists are needed for laboratories.