Assessment of Future Scientific Needs for Live Variola Virus (1999) / Chapter Skim
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1 Introduction
1 Introduction
Pages 7-14
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From page 7... ...
The WHO Committee on Orthopoxvirus Infections subsequently voted to destroy all variola virus stocks, all stored clinical materials containing variola virus, and all intact variola virus DNA held in the international repositories in June 1999. Since this decision will be reconsidered in May 1999, the Institute of Medicine was asked to assess future scientific needs for live variola virus.
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From page 8... ...
Secondary infection of lesions can lead to osteomyelitis and septic arthritis, resulting in bone shortening, flail joints, and gross bone deformities. Scanted lesions or pockmarks remain with those who have survived the disease.
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From page 9... ...
During the first half of the 20th century, all outbreaks of smallpox in Asia and most of those in Africa were due to variola major, with case-fatality rates of 20 percent or more, while variola minor win case-fatality rates of 1 percent or less was endemic in some countries of Europe and North and South America. After the global smallpox eradication program was begun by WHO in 1959, more careful examination revealed some outbreaks in central and eastern Africa and in Indonesia with case-fatality rates of between 5 and 15 percent, but with clinical characteristics indistinguishable from those of variola major [ 13.
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From page 10... ...
Whether continued existence of such stocks would produce human benefits and reduce potential harm depends, in part, on whether the known stocks in the two tightly controlled international repositories are in fact the only remaining samples. While there are many potential medical advances that could derive from studies using live variola virus, the risks of maintaining and working with the virus (ranging Tom release due to laboratory accidents to acquisition and use by terrorists)
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From page 11... ...
For this reason, and other reasons discussed more hilly in Chapter 12, the committee's findings and conclusions are expressed conditionally: If particular knowledge or capability were to be pursued, would the associated research require live variola virus? Moreover, although the committee did not directly address biological warfare as sue}', it did consider medical and scientific issues that would likely arise if this pathogen were used as a weapon.
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From page 12... ...
And because variola virus is human-specific and exhibits unique interactions duplicated by no other known pathogen, studies of variola are likely to provide singular insights. The variola virus genome is large enough to contain approximately 200 genes, about half of which are devoted to essential functions needed for viral replication and half to interactions with the host.
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From page 13... ...
Finally, while the eradication of smallpox was an unequaled public health success, the termination of widespread smallpox vaccination means that virtually the entire global population would now be susceptible should a smallpox outbreak occur. This vulnerability increases the importance of knowledge about variola virus, its pathogenesis, and antiviral strategies that can be employed against it.
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