44

THE smallpox virus first became entangled with the human spe-cies somewhere between three

thousand and twelve thousand yearsago—possibly in Egypt at the time ofthe Pharaohs. Somewhere on earth atroughly that time, the virus jumped outof an unknown animal into its firsthuman victim, and began to spread.Viruses are parasites that multiply in-side the cells of their hosts, and they arethe smallest life forms. Smallpox devel-oped a deep affinity for human beings.It is thought to have killed more peo-ple than any other infectious disease,including the Black Death of the Mid-dle Ages. It was declared eradicatedfrom the human species in 1979, after atwelve-year effort by a team of doctorsand health workers from the WorldHealth Organization. Smallpox nowexists only in laboratories.

Smallpox is explosively contagious,and it travels through the air. Virus par-ticles in the mouth become airbornewhen the host talks. If you inhale a sin-gle particle of smallpox, you can comedown with the disease. After you’vebeen infected, there is a typical incuba-tion period of ten days. During thattime, you feel normal. Then the illnesshits with a spike of fever, a backache,and vomiting, and a bit later tiny redspots appear all over the body. Thespots turn into blisters, called pustules,and the pustules enlarge, filling withpressurized opalescent pus. The erup-tion of pustules is sometimes called the splitting of the dermis. The skindoesn’t break, but splits horizontally,tearing away from its underlayers. Thepustules become hard, bloated sacs thesize of peas, encasing the body withpus, and the skin resembles a cobble-stone street.

The pain of the splitting is extraordi-

nary. People lose the ability to speak, andtheir eyes can squeeze shut with pus-tules, but they remain alert. Death comeswith a breathing arrest or a heart attackor shock or an immune-system storm,though exactly how smallpox kills a per-son is not known. There are many mys-teries about the smallpox virus. Since the seventeenth century, doctors have understood that if the pustules mergeinto sheets across the body the victim will usually die: the virus has split thewhole skin. If the victim survives, thepustules turn into scabs and fall off, leav-ing scars. This is known as ordinarysmallpox.

Some people develop extreme small-pox, which is loosely called black pox.Doctors separate black pox into twoforms—flat smallpox and hemorrhagicsmallpox. In a case of flat smallpox, theskin remains smooth and doesn’t pustu-late, but it darkens until it looks charred,and it can slip off the body in sheets. Inhemorrhagic smallpox, black, unclottedblood oozes or runs from the mouth andother body orifices. Black pox is close to ahundred per cent fatal. If any sign of itappears in the body, the victim will al-most certainly die. In the bloody cases,the virus destroys the linings of thethroat, the stomach, the intestines, therectum, and the vagina, and these mem-branes disintegrate. Fatal smallpox candestroy the body’s entire skin—both theexterior skin and the interior skin thatlines the passages of the body.

Smallpox virus’s scientific name is va-riola. It means “spotted” in Latin, and itwas given to the disease by a medievalbishop. The virus, as a life form, comes intwo subspecies: Variola minor and Variolamajor. Minor is a weak mutant, and wasfirst described in 1863 by doctors in Ja-maica. People usually survive it. Classicmajor kills one out of three people if they

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THE DEMON IN

THE FREEZER

How smallpox, a disease officially eradicated twenty years ago,became the biggest bioterrorist threat we now face.

6

BY RICHARD PRESTON

46 THE NEW YORKER, JULY 12, 1999

haven’t been vaccinated or if they’ve losttheir immunity. The death rate with ma-jor can go higher—how much higher noone knows. Variola major killed half ofits victims in an outbreak in Canada in1924, and presumably many of them de-veloped black pox. Smallpox is less conta-gious than measles but more contagiousthan mumps. It tends to go around untilit has infected nearly everyone.

Most people today have no immu-nity to smallpox. The vaccine begins towear off in many people after ten years.Mass vaccination for smallpox came to aworldwide halt around twenty-five yearsago. There is now very little smallpoxvaccine on hand in the United States oranywhere else in the world. The WorldHealth Organization once had ten mil-lion doses of the vaccine in storage inGeneva, Switzerland, but in 1990 an ad-visory committee recommended thatmost of it be destroyed, feeling thatsmallpox was longer a threat. Nine and a

half million doses are assumed to havebeen cooked in an oven, leaving theW.H.O. with a total supply of half amillion doses—one dose of smallpoxvaccine for every twelve thousand peo-ple on earth. A recent survey by theW.H.O. revealed that there is only onefactory in the world that has recentlymade even a small quantity of the vac-cine, and there may be no factory ca-pable of making sizable amounts. Thevaccine was discovered in the age ofThomas Jefferson, and making a lot ofit would seem simple, but so far theUnited States government has been un-able to get any made at all. Variola virusis now classified as a Biosafety Level 4hot agent—the most dangerous kind ofvirus—because it is lethal, airborne, andhighly contagious, and is now exotic tothe human species, and there is notenough vaccine to stop an outbreak. Ex-perts feel that the appearance of a singlecase of smallpox anywhere on earth

would be a global medical emergency.At the present time, smallpox lives of-

ficially in only two repositories on theplanet. One repository is in the UnitedStates, in a freezer at the headquarters ofthe federal Centers for Disease Controland Prevention, in Atlanta—the C.D.C.The other official smallpox repository isin a freezer at a Russian virology insti-tute called Vector, also known as theState Research Institute of Virology andBiotechnology, which is situated outsidethe city of Novosibirsk, in Siberia. Vectoris a huge, financially troubled formervirus-weapons-development facility—a kind of decayed Los Alamos of vi-ruses—which is trying to convert topeaceful enterprises.

There is a growing suspicion amongexperts that the smallpox virus may alsolive unofficially in clandestine biowar-fare laboratories in a number of coun-tries around the world, including labs on military bases in Russia that are closedto outside observers. The Central Intel-ligence Agency has become deeplyalarmed about smallpox. Since 1995, anumber of leading American biologistsand public-health doctors have beengiven classified national-security brief-ings on smallpox. They have been shownclassified evidence that as recently as1992 Russia had the apparent capabilityof launching strategic-weapons-gradesmallpox in special biological warheadson giant SS-18 intercontinental missilesthat were targeted on the major cities ofthe United States. In the summer of lastyear, North Korea fired a ballistic missileover Japan in a test, and the missile fellinto the sea. Some knowledgeable ob-servers thought that the missile couldhave been designed to carry a biologicwarhead. If it had carried smallpox andlanded in Japan, it could have devastatedJapan’s population: Japan has almost nosmallpox vaccine on hand and its gov-ernment seems to have no ability to dealwith a biological attack. The UnitedStates government keeps a list of na-tions and groups that it suspects eitherhave clandestine stocks of smallpox orseem to be trying to buy or steal thevirus. The list is classified, but it is saidto include Russia, China, India, Pak-istan, Israel, North Korea, Iraq, Iran,Cuba, and Serbia. The list may also in-clude the terrorist organization ofOsama bin Laden and, possibly, theAum Shinrikyo sect of Japan—a quasi-religious group that had Ph.D. biologists

“I’d love to ask you in, Howard, but they start trading in Hong Kong in ten minutes.”

A COMFORTABLE FICTION 47

as members and a belief that an apoca-lyptic war will bring them worldwidepower. Aum members released nerve gasin the Tokyo subway in 1995, and, asthe year 2000 approaches, the group isstill active in Japan and in Russia. In anycase, the idea that smallpox lives in onlytwo freezers was never anything morethan a comfortable fiction. No one knowsexactly who has smallpox today, orwhere they keep the virus, or what theyintend to do with it.

THE man who is most widely cred-ited with the eradication of small-

pox from the human species is a doctornamed Donald Ainslie Henderson. Ev-eryone calls him D. A. Henderson. Hewas the director of the World HealthOrganization’s Smallpox EradicationUnit from its inception, in 1966, to1977, just before the last case occurred.“I’m one of many in the eradication,”Henderson said to me once. “There’sFrank Fenner, there’s Isao Arita, BillFoege, Nicole Grasset, Zdenek Jezek,Jock Copland, John Wickett—I couldcome up with fifty names. Let alone thetens of thousands who worked in theinfected countries.” Nevertheless, Hen-derson ran it. Smallpox killed at leastthree hundred million people in thetwentieth century. During that time,humanity was largely immune to small-pox, which is not the case today. WhenD. A. Henderson arrived on the scenein 1966, two million people a year weredying of smallpox. In the years since theeradication effort began, Henderson andhis team have effectively saved morethan fifty million lives. This could bethe most impressive achievement in thehistory of medicine. Henderson and hiscolleagues, however, have never receivedthe Nobel Prize for their work.

D. A. Henderson is now a professor at the Johns Hopkins School of PublicHealth. He is the founder and the direc-tor of the Johns Hopkins Center forCivilian Biodefense Studies, a think tankthat considers what might be done toprotect the American population duringa biological event. The term “biologicalevent” hardly existed two years ago, but itis now used by emergency planners andby the F.B.I. to mean a terrorist attackwith a bioweapon—an unnatural event,caused by human intent.

Henderson lives with his wife in alarge brick house in Baltimore. I arrivedthere on a cold, drizzly Saturday, and he

ambled to the door. Henderson is an im-posing man, six feet two inches tall. He isseventy years old. He has broad shoul-ders and a broad, seamed, angular face,pointed ears that stick out at angles fromhis head, a brush of gray hair, metal-framed eyeglasses, sharp blue eyes, andan easygoing voice that can flash withcalculation. He was wearing a red checkedshirt, with suspenders that held up Satur-day slacks.

“In the last ten days, we’ve had four-teen different anthrax scares,” he re-marked in an offhand way as we stoodin the front hallway of his house and heloomed over me. He has a top-secret-level national-security clearance, and hehears about little bioterror events thatdon’t get noticed by the media. He wenton to say, “Everybody and his brother is threatening to use anthrax. This week,it happened in Atlanta, in Washing-ton, D.C., in Michigan, and in Califor-nia. It’s largely hoaxes. Of course, a realbioterror event is going to happen oneof these days.”

We settled into easy chairs in thefamily room. The walls and shelves ofthe room were crowded with Africanand Asian sculptures and wooden Ethi-

opian crosses, which he had picked upin his global hunt for smallpox. A Japa-nese garden was visible through sliding-glass doors.

We ate ham and roast-beef sand-wiches, and drank Molson Ice beers.Henderson bit into a sandwich andchewed thoughtfully. Then he said,“Often, you get a worried look on yourface, with the first signs of rash. Wespeak of the ‘worried face’ of smallpox.That face is a diagnostic sign. The rashcomes up all at once. It’s more dense onthe face and the extremities. That’s howyou can tell smallpox from chicken pox.With chicken pox, the rash crops up overa period of days, and it’s more dense onthe chest and trunk of the body. Small-pox pustules have a dimple, a dent in thecenter. Doctors say that the pustules havea ‘shotty’ feel, like shotgun pellets. Youcan roll them between your fingertipsunder the skin.”

“How many doctors could recognizesmallpox today?” I asked.

“Virtually none. Smallpox takes formsthat even I can’t diagnose. And I wrotethe textbook.” He is a co-author of “Small-pox and Its Eradication,” a large book inred covers, which experts call the Big Red

“Consider yourself chased.”

• •

48

Book of Smallpox. It was supposed to bethe final word on smallpox—the tomb-stone of the virus.

ON February 15, 1972, a thirty-eight-year-old Muslim clergyman re-

turned to his home town of Damnjane,in Kosovo, Yugoslavia, after he’d beenon a pilgrimage to Mecca, stopping atholy sites in Iraq. I will call him the Pil-grim. A photograph of the Pilgrimshows a man who looks well educated,has an intelligent face, and is wearing aclipped mustache and a beret. He hadtravelled by bus for his entire journey.The morning after his return home, hewoke up feeling achy. At first, he thoughthe was tired from the long bus ride, butthen he realized that he had caught abug. He shivered for a day or two, anddeveloped a red rash brought on by hisfever, but quickly recovered. He hadbeen vaccinated for smallpox two monthsearlier. Indeed, the Yugoslav medicalauthorities had been vaccinating thepopulation of Yugoslavia relentlessly formore than fifty years, and the countrywas considered to be thoroughly immu-nized. The last case of smallpox in Yu-goslavia had occurred in 1930.

The Pilgrim’s family members andfriends came to visit him.They wanted tohear about his trip, and he enjoyed tell-ing them about it. Meanwhile, variolaparticles were leaking out of raw spots inthe back of his throat and mixing withhis saliva. When he spoke, tiny dropletsof saliva, too small to be seen, driftedaround him in a droplet cloud. If the per-son is throwing off a lethal virus, thecloud becomes a hot zone that can ex-tend ten feet in all directions. Althoughthe raw spots in the Pilgrim’s throatamounted to a tiny surface of virus emis-sion, smaller than a postage stamp, in abiological sense it was as hot as the sur-face of the sun, and it put enough small-pox into the air to paralyze Yugoslavia.

Variola particles are built to survive inthe air. They are rounded-off rectanglesthat have a knobby, patterned surface—agnarly hand-grenade look. Some expertscall the particles bricks. The whole brickis made of a hundred different proteins,assembled and interlocked in a three-di-mensional puzzle, which nobody has everfigured out. Virus experts feel that thestructure of a smallpox particle is almostbreathtakingly beautiful and deeply math-ematical—one of the unexplored wondersof the viral universe.The structure protects

the virus’s genetic material: a long strandof DNA coiled in the center of the brick.

Pox bricks are the largest viruses. If asmallpox brick were the size of a realbrick, then a cold-virus particle would bea blueberry sitting on the brick. But small-pox particles are still extremely small;about three million smallpox bricks laiddown in rows would pave the period atthe end of this sentence. A smallpox vic-tim emits several bricks in each invisibledroplet of saliva that spews into the airwhen the person speaks or coughs. When

an airborne smallpox particle lands on amucus membrane in someone’s throat orlung, it sticks. It enters a cell and beginsto make copies of itself. For one to threeweeks, the virus spreads from cell to cell,amplifying silently in the body. No onehas discovered exactly where the virushides during its incubation phase. Proba-bly it gets into the lymph cells, confusingthe immune system, and victims are saidto experience terrible dreams.

On February 21st, when the Pilgrimhad been feeling achy for almost a week, TH

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a thirty-year-old man, a schoolteacher,who is known to experts as Ljatif M., ar-rived in Djakovica, a few miles from thePilgrim’s town, to enroll in the HigherInstitute of Education. Doctors wholater investigated the schoolteacher’s casenever found out how he had come incontact with the Pilgrim. One of themmust have ended up in the other’s town.Possibly they stood next to each other ina shop—something like that.

On March 3rd, Ljatif developed afever. Two days later, he went to a local

medical center, where doctors gave himpenicillin for his fever. Antibiotics have noeffect on a virus.Then his skin broke withdark spots, and he may have developed aworried face. He felt worse, and a few dayslater his brother took him by bus to a hos-pital in the town of Cacak, about a hun-dred miles away. The dark spots were bythis time merging into blackened, mottledsplashes, which the doctors in Cacak didn’trecognize. Ljatif became sicker. Finally, hewas transferred by ambulance to Belgrade,where he was admitted to the Dermatol-

ogy and Venereal Diseases Department ofthe city’s main hospital. By then, his skinmay have turned almost black in patches.We don’t have access to his clinical reports,so I am describing a generalized extremesmallpox of the kind Ljatif had.

Inside the cells of the host, smallpoxbricks pile up as if they were coming off aproduction line. Some of the particles de-velop tails.The tails are pieces of the cell’sprotein, which the virus steals from thecell for its own use. The tailed smallpoxparticles look like comets or spermatozoa.They begin to twist and wriggle, and theycorkscrew through the cell, propelled bytheir tails toward the cell’s outer mem-brane. You can see them with a microscope,thrashing with the same furious drive assperm. They bump up against the insideof the cell membrane, and their headsmake lumps, and the cell horripilates.Then something wonderful happens.Finger tubes begin to extend from thecell.The tubes grow longer.The cell turnsinto a Koosh ball. Inside each finger tubeis a smallpox comet.The fingers lengthenuntil they touch and join nearby cells, andthe smallpox comets squirm through thefinger tubes into the next cell.The cometsare protected from attack by the immunesystem, because they stay inside the fingertubes, where antibodies and killer whiteblood cells can’t reach them. Then theKoosh ball explodes. Out pour heaps ofbricks that don’t have tails. These small-pox particles are wrapped in a specialarmor, like hand grenades. They floataway, still protected by their armor, andthey stick to other cells and go inside them,and those cells turn into Koosh balls.Each infected cell releases up to a hun-dred thousand virus particles, and they areadded to the quadrillions of particles rep-licating in the universe of the ruined host.

Ljatif ’s skin had become blackened,mottled, and silky to the touch, andsheets of small blood blisters may havepeppered his face. In a case of blackpox, variola shocks the immune systemso that it can’t produce pus. Small bloodvessels were leaking and breaking in hisskin, and blood was seeping under thesurface. His skin had developed largeareas of continuous bruises.

On March 9th, the Belgrade doc-tors showed Ljatif to students and staffas a case that demonstrated an unusualreaction to penicillin. (In fact, a very bad reaction to penicillin can look likethis.) Ljatif ’s eyes may have turned darkred. In hemorrhagic smallpox, one or two

this century, when most people were immune to the disease. Today, they no longer are.

50 THE NEW YORKER, JULY 12, 1999

large hemorrhages appear in each eye, inthe white encircling the iris, making theeyes look as if they could sag or leakblood. The eyes never do leak, but theblood in the eyes darkens, until the whitescan sometimes seem almost black.

During the day of March 10th, Ljatifsuffered catastrophic hemorrhages intothe intestines. His intestines filled upwith blood, and he expelled quarts of it,staining the sheets black, and he devel-oped grave anemia from blood loss. Forsome unknown reason, black-pox pa-tients remain conscious, in a kind of par-alyzed shock, and they seem acutelyaware of what is happening nearly up tothe point of death—“a peculiar state ofapprehension and mental alertness thatwere said to be unlike the manifestationsof any other infectious disease,” in thewords of the Big Red Book of Small-pox. We can imagine that Ljatif was ex-tremely frightened and witnessed hishemorrhages with a sense that his insideswere coming apart. During the final phaseof a smallpox intestinal bleedout, the lin-ing of the intestines or the rectum canslip off. The lining is expelled throughthe anus, coming out in pieces or in lengthsof tube. This bloody tissue is known as atubular cast. When a smallpox patientthrows a tubular cast, death is imminent.All we know about Ljatif is that his bleedswere unstoppable, that he was rushed to the Surgical Clinic of the Belgradehospital, and that he died in the eve-ning. The duty physician listed the cause

of death as a bad reaction to penicillin.“These hemorrhagic smallpox cases

put an incredible amount of virus intothe air,” D. A. Henderson said. Some ofthe doctors and nurses who treated Ljatifwere doomed. Indeed, Ljatif had seededsmallpox across Yugoslavia. Investigatorslater found that while he was in the hos-pital in Cacak he infected eight other pa-tients and a nurse. The nurse died. Oneof the patients was a schoolboy, and hewas sent home, where he broke withsmallpox and infected his mother, andshe died. In the Belgrade hospital, Ljatifinfected twenty-seven more people, in-cluding seven nurses and doctors. Thosevictims infected five more people. Ljatifdirectly infected a total of thirty-eightpeople. They caught the virus by breath-ing the air near him. Eight of them died.

Meanwhile, the Pilgrim’s smallpoxtravelled in waves through Yugoslavia. Arising tide of smallpox typically comesin fourteen-day waves—a wave of cases,a lull down to zero, and then a muchbigger wave, another lull down to zero,then a huge and terrifying wave. Thewaves reflect the incubation periods,or generations, of the virus. Each waveor generation is anywhere from ten totwenty times as large as the last, so the virus grows exponentially and ex-plosively, gathering strength like somekind of biological tsunami. This is be-cause each infected person infects an av-erage of ten to twenty more people. Bythe end of March, 1972, more than a

hundred and fifty cases had occurred.The Pilgrim had long since recov-

ered. He didn’t even know that he hadstarted the outbreak. By then, however,Yugoslav doctors knew that they weredealing with smallpox, and they sent anurgent cable to the World Health Or-ganization, asking for help.

Luckily, Yugoslavia had an authori-tarian Communist government, underJosip Broz Tito, and he exercised fullemergency powers. His government mo-bilized the Army and imposed strongmeasures to stop people from travellingand spreading the virus. Villages wereclosed by the Army, roadblocks werethrown up, public meetings were prohib-ited, and hotels and apartment buildingswere made into quarantine wards to holdpeople who had had contact with small-pox cases. Ten thousand people werelocked up in these buildings by the Yu-goslav military. The daily life of thecountry came to a shocked halt. At thesame time, all the countries surroundingYugoslavia closed their borders with it, toprevent any travellers from coming out.Yugoslavia was cut off from the world.There were twenty-five foci of smallpoxin the country. The virus had leapfroggedfrom town to town, even though thepopulation had been heavily vaccinated.The Yugoslav authorities, helped by theW.H.O., began a massive campaign torevaccinate every person in Yugoslaviaagainst smallpox; the population wastwenty-one million. “They gave eighteenmillion doses in ten days,” D. A. Hender-son said. A person’s immunity begins togrow immediately after the vaccination; ittakes full effect within a week.

At the beginning of April, Hender-son flew to Belgrade, where he foundgovernment officials in a state of deepalarm. The officials expected to see thou-sands of blistered, dying, contagious peo-ple streaming into hospitals any day.Henderson sat down with the Ministerof Health and examined the statistics. Heplotted the cases on a time line, and nowhe could see the generations of small-pox—one, two, three waves, each farlarger than the previous one. Hendersonhad seen such waves appear many timesbefore as smallpox rippled and amplifiedthrough human populations. Reading theviral surf with a practiced eye, he couldsee the start of the fourth wave. It wasnot climbing as steeply as he had ex-pected. This meant that the waves hadpeaked. The outbreak was declining. Be-

“Look, there is no right and wrong here, but I’m going to side with Helen because I’m a girl.”

• •

TSUNAMI 51

cause of the military roadblocks, peopleweren’t travelling, and the governmentwas vaccinating everyone as fast as possi-ble. “The outbreak is near an end,” he de-clared to the Minister of Health. “I don’tthink you’ll have more than ten addi-tional cases.” There were about a dozen:Henderson was right—the fourth wavenever really materialized. The outbreakhad been started by one man with theshivers. It was ended by a military crack-down and vaccination for every citizen.

AT the present time, the United States’national stockpile of smallpox

vaccine is a collection of four card-board boxes that sit on a single palletbehind a chain-link fence inside a walk-in freezer in a warehouse in LancasterCounty, Pennsylvania, near the Susque-hanna River, at a facility owned byWyeth-Ayerst Laboratories. The vac-cine is slowly deteriorating. The Foodand Drug Administration has put a holdon the smallpox vaccine, and right nowno one can use it—not even emergencypersonnel or key government leaders.

The vaccine is owned by the federalgovernment and is managed by Wyeth-Ayerst, which is the company that madeit, twenty-five to thirty years ago. It isstored in glass vials. The vials containfreeze-dried nuggets of live vacciniavirus. Vaccinia is a mild virus. When youare infected with it by vaccination, itcauses a pustule to appear, and afterwardyou are immune to smallpox for someyears. People who have been vaccinatedhave a circular scar the size of a nickelon their upper arm, left by the vaccinia-virus pustule they had in childhood aftervaccination. Some adults can rememberhow much the pustule hurt.

People from Wyeth periodically openthe boxes and send some of the vials outfor testing, to see how the vaccine isdoing. The vials once held fifteen milliongood doses, but now moisture has in-vaded some of them. The nuggets arenormally dry and white in color, but whenmoisture invades they turn brown andlook sticky, and the vaccine may be weak-ened. The vaccine was made by a tradi-tional method: the manufacturer had afarm where calves were raised.The calves’bellies were scratched with vaccinia virus,and their bellies developed pustules.Thenthe calves were killed and hung up onhooks, the blood was drained out ofthem, and the pustules were scraped witha knife. The resulting pus was freeze-

dried. The vaccine is dried calf pus. Ac-cording to one virologist who examinedit under a microscope, “It looks like nosesnot. It’s all hair and wads of crap.” Itwas a good vaccine for its time, but theF.D.A. would never clear it for generaluse today except in a national emergency.Furthermore, some people have bad orfatal reactions to the vaccine. There is anantidote, but the supplies of it have turnedstrangely pink, and the F.D.A. has put a hold on the use of these supplies, too.

D. A. Henderson believes that inpractice doctors could obtain about sevenmillion doses of vaccine from the vials.Unaccountably, most of the vaccine hasnot recently been tested for potency, so ithas not been absolutely proved to work.The experts believe that it would work,but there still isn’t enough.

Henderson explained the problemthis way: “If there’s a bioterror event,and someone releases enough smallpoxto create a hundred cases—let’s say inthe Baltimore area—it would be a na-tional emergency. The demand for vac-cine would be beyond all belief.” In Yugoslavia in 1972, the outbreak wasstarted by one man, and eighteen mil-

lion doses of vaccine were needed—onefor almost every person in the country.

“That first wave after the bioterrorevent could be a hundred people withsmallpox,” Henderson said. “It takes twoweeks after exposure before doctors candiagnose smallpox. Meanwhile, thosehundred people will give smallpox to athousand or two thousand people. That’sthe second wave. Some of those firsthundred people will go to other cities—to Washington, to New York, all over. Sothe second wave will include cases inother American cities, and probably inforeign countries. By then, it’ll be too lateto treat them, and we’ll lose the secondwave. We’ll be well into the third wave—ten to twenty thousand people with small-pox—before we can really start vaccinat-ing people. By then, we’ll begin to pickup so many cases in the Baltimore areathat we won’t be able to track cases, andwe’ll just have to vaccinate everybodyaround Baltimore. A lot of people in Bal-timore work in Washington. And soyou’re going to have a whole lot of peoplein Washington with smallpox. You cansee the deal. Immediately, you wouldhave to vaccinate Washington.” Hen-

52 THE NEW YORKER, JULY 12, 1999

derson thinks that a hundred milliondoses of vaccine would be needed in theUnited States alone to stop a surging out-break triggered by a hundred initial casesof smallpox from a bioterror event. Thatmuch vaccine could be stored in the spaceoccupied by a one-car garage.

Raindrops splattered on a woodendeck in Henderson’s garden, and theroom grew dark, until it was a pool ofshadows full of African masks. Hender-son’s voice came out of the gloom. Hedidn’t bother to get up and turn on thelights. He said, “The way air travel isnow, about six weeks would be enoughtime to seed cases around the world.Dropping an atomic bomb could causecasualties in a specific area, but droppingsmallpox could engulf the world.”

Henderson passionately wants to get rid of the virus. “What we need todo is create a general moral climatewhere smallpox is considered too mor-ally reprehensible to be used as a weapon.That would make the possession ofsmallpox in a laboratory, anywhere, ef-fectively a crime against humanity. Thelikelihood that it would be used as aweapon is diminished by a global com-mitment to destroy it. How much it isdiminished I don’t know. But it adds alevel of safety.”

IN the late seventeen-hundreds, the English country doctor Edward

Jenner noticed that dairymaids who hadcontracted cowpox from cows seemedto be protected from catching smallpox,and he thought he would do anexperiment. Cowpox (it probablylives in rodents, and only occa-sionally infects cows) produced amild disease. On May 14, 1796,Jenner scratched the arm of aboy named James Phipps, intro-ducing into the boy ’s arm adroplet of cowpox pus that he’dtaken from a blister on the handof a dairy worker named SarahNelmes. A few months later, hescratched the boy’s arm with deadly pushe had taken from a smallpox patient,and the boy didn’t come down withsmallpox. The boy had become im-mune. Jenner had discovered what hecalled vaccination, after the Latin wordfor cow. He saw the road to eradicationclearly. In 1801, he wrote, “It now be-comes too manifest to admit of contro-versy, that the annihilation of the SmallPox, the most dreadful scourge of the

human species, must be the final resultof this practice.”

A Soviet epidemiologist, Viktor Zhda-nov, deserves credit for kick-starting themodern effort. At the 1958 annual meet-ing of the World Health Assembly, inMinneapolis, he called for the globaleradication of smallpox. He spoke pas-sionately and logically, but the scientificcommunity was skeptical. Many biolo-gists held a common view that it was im-possible to separate a wild microorgan-ism from the ecological web it lived in. In1965, President Lyndon Johnson en-dorsed the idea of smallpox eradication.It was a political move to help improveAmerican-Soviet relations. D. A. Hender-son was then the head of disease surveil-lance at the C.D.C. He was given an orderto report to Geneva to head the W.H.O.’snew Smallpox Eradication Unit. Hedidn’t want the job, but he was told that ifhe didn’t take it he would have to resignfrom government service. He went toGeneva, where he formed a hand-pickedteam. “The World Health Assembly pro-posed a ten-year program, because Ken-nedy had said we could land a man onthe moon in ten years,” he recalled.

The team set a goal of vaccinatingeighty per cent of the population ofcountries that harbored smallpox. Hen-derson says that from the beginning theyhad another idea as well, and it proved tobe the key. The idea was to track small-pox outbreaks and vaccinate people in aring around any outbreak. This is knownas surveillance and ring vaccination. In

order to throw a ring aroundsmallpox, they had to know wherethe demon was moving at alltimes, and they started showing vil-lagers photographs of a baby withsmallpox, so that the villagerscould recognize and report casesto the authorities.

Henderson’s team needed away of vaccinating people fast.They tried a machine called thePed-o-Jet, which was operated

by foot pedal. It could shoot jets of vac-cine into the arms of thousands of peo-ple in a day, but it broke down. Thenthey tried a needle with two points. Itwas known as the bifurcated needle, andit looked like a tiny two-pronged fork.The points of the fork held a droplet ofvaccine, and the needle was to be jabbedrepeatedly into a person’s arm. It couldbe used by a volunteer who had no med-ical training.

They discovered that the virus rose andfell in seasonal waves, like flu. This led toan idea to attack the virus with a ring as-sault when it was at its ebb. The virus wasa wild organism that lived only in humans.It needed to find and invade a susceptiblehuman every fourteen days or it woulddie. If each outbreak of the virus could besurrounded by a ring of immune peopleduring the virus’s low season, the viruswould not be able to complete its fourteen-day life cycle. It would be cut off, unableto move to the next human host, and itschain of infection would be broken.

The ring had to be tight. If it devel-oped a leak, smallpox would blow out. InJanuary, 1975, smallpox blew out inBangladesh, after the eradicators thoughtthey were on the verge of stopping iteverywhere in Asia. Variola major sweptthrough more than five hundred townsand villages. Henderson began shuttlingbetween Geneva and Bangladesh, and inApril of that year, when things were stillnot under control, he visited the Infec-tious Disease Hospital in Dacca, the na-tion’s capital. He wanted to do rounds ina smallpox ward. “I went down the rowsof beds,” he told me. There were seventyor eighty people, and half of them weredying. “There is nothing you can do forany of these patients. They were afraidto move. There were a lot of flies crawl-ing all over the place. My God, they talkabout the odor of smallpox. It is an oddsmell, not like anything else.”

The skin gives off gases. “It’s a sicklyodor, like rotting flesh, but it’s not decay,because the skin remains sealed and thepus isn’t leaking out,” Henderson said.“That smell is one of the mysteries ofsmallpox. No one knows what it is. I waswith this British guy, Nick Ward, M.D.He had worked in Africa—he was atough guy. At the end, he stood by a fencelooking at the ground. Finally, he said tome, ‘I don’t know that I could go throughanother situation like that again.’ ”

Nicholas Ward, who now lives inFrance, remembered that moment. “I’vespent a fair amount of my life workingwith tropical diseases, and I can truly saythere is nothing so awful as a case of small-pox, particularly the type where a personbecomes a bloody mess,” he said. He knewthe odor. “I would have a shrewd idea ofa diagnosis after walking into a home. Icould smell it.”

Henderson and his team mountedring vaccinations across Bangladesh, andthey traced cases and contacts, trying to

TIGHTENING THE RING 53

surround the life form. Finally, inthe fall of 1975, they cornered vari-ola on an island off the coast ofBangladesh. It was a marshy, poorplace called Bhola Island, and there,on October 16th, a three-year-oldgirl named Rahima Banu brokewith the last case of naturally oc-curring Variola major anywhere onearth. She survived. Rahima Banuwould be twenty-seven years oldtoday; researchers have lost track ofher. Doctors from the SmallpoxEradication Unit collected six ofthe girl’s pustules after they haddried into scabs, peeling them offher skin gently, with tweezers. Twoyears later, on October 26, 1977,the last natural case of the mildtype of smallpox, Variola minor,popped up in a cook in Somalianamed Ali Maow Maalin. He sur-vived, and the last ring tightenedaround variola, and its life cyclestopped.

THE headquarters of the Cen-ters for Disease Control, in

Atlanta, is a jumble of old andnew buildings, joined by elevated walk-ways, which give the place the feel of amaze. The buildings sit along CliftonRoad, an artery that winds throughgreen neighborhoods in the northeast-ern part of Atlanta. I arrived at the C.D.C.on a perfect day in spring. Changeableclouds marched across a deep sky, andoak trees were shedding green flowers.Across the street from the entrance, ablue jay screamed in a pine tree, and thebranches glittered in the sun, throwingoff a scent of pitch.

Joseph J. Esposito, Ph.D., who is thechief of the C.D.C.’s Poxvirus Section,led me along an outdoor walkway towardhis laboratory and office. Esposito is astocky man of moderate height, in hismid-fifties, who runs to keep his weightdown, and he has a dark beard and wears eyeglasses over brown eyes that are perceptive and serious. I asked him ifwe could get closer to smallpox. Wepassed along an aerial walkway coveredwith a chain-link fence, and we turnedonto another walkway. We stopped andleaned on a railing. We were facing the C.D.C.’s Level 4 biocontainmentbuilding. It contains the Level 4 hotsuites—labs where researchers work withlethal viruses while wearing pressurizedspacesuits. The building has a line of

windows tinted blue-green, like fish tanks.“The variola is in there somewhere,” Joe

Esposito said, offering me a grave smileand nodding at the Level 4 building.“There is a kind of electricity in the airwhen we’re working with smallpox. Every-body around here always seems to know—‘Joe’s got the smallpox out of the freezer.’ ”

The smallpox freezer may be encircledby alarms and motion detectors. It mayor may not be wrapped in chains. It maybe a stainless-steel cylinder. Or it may bea white box intended to look like anyother freezer. Officials at the C.D.C.won’t comment.

Inside the freezer, the entire collectionof smallpox occupies a volume slightlylarger than that of a basketball. It con-sists of approximately four hundred littleplastic vials the size of pencil stubs, theresidue of D. A. Henderson’s war withvariola. They’re an inch long and theyhave plastic screw caps. They sit in sevenlittle white cardboard boxes, in a rack in-side the freezer, which keeps the virus notstrictly alive, not exactly dead, but potent.Most of the vials contain milky ice orbloody ice. The virus has been cultured inflasks of live cells (milky ice) or in livechicken eggs (live eggs have a blood sys-tem). Around twenty-five of the vialscontain human scabs—dried smallpox

pustules.The scabs look like pencil erasers.The six scabs that were collected from

the girl in Bangladesh named RahimaBanu used to sit in a vial, but recently Es-posito’s group used the last of her scabsfor research. The strain that came out ofher scabs is known as Bangladesh 1975—or, informally, as the Rahima. Now thatthe scabs are gone, the Rahima exists invials of milky ice.

Esposito sat hunched in his chair infront of his computer. His office is a win-dowless room with cinder-block walls. Atroll with Shocking-pink hair stood ontop of the computer, staring at him wide-eyed. “I like to think like a virus,” Espo-sito said. “If you can think like a virus,then you can begin to understand why avirus does what it does. A smallpox parti-cle gets into a person’s body and, in a way,it’s thinking, I’m this one particle sittinghere surrounded by an angry immunesystem. I have to multiply fast. Then Ihave to get out of this host fast. It es-capes into the air before the pustules de-velop.” By the time the host feels sick,the virus has already moved on to its nexthost. The previous host has become acast-off husk (and is now becoming satu-rated with virus), but whether the personlives or dies no longer matters to thevirus. However, the dried scabs, when

“Don’t sweat it. That’s Little League—your dad comes, you choke.”

• •

54 THE NEW YORKER, JULY 12, 1999

they fall off, contain live virus. The scabsare the virus’s seeds. They preserve it for along time, just in case it hasn’t managedto reach a host in the air. The scabs givethe virus a second chance.

POXVIRUSES move easily through the animal kingdom. Along with herds

of animals or swarms of insects comepoxviruses circulating among them likepickpockets at a fair. Esposito once clas-sified what he and other virologists haveglimpsed of the poxviruses in nature.He noted monkeypox, swinepox, buf-falopox, skunkpox, raccoonpox, ger-bilpox, a few deerpoxes, a sealpox,turkeypox, canarypox, pigeonpox, star-lingpox, peacockpox, dolphinpox, Nilecrocodilepox, penguinpox, two kanga-roopoxes, and a quokkapox. (Thequokka is an Australian wallaby.) Anyattempt to get to the bottom of the but-terflypoxes, mothpoxes, and beetlepoxeswould be something like enumeratingthe nine billion names of God.

A caterpillar that has caught an insect-pox dissolves into a liquefaction of insectguts mixed with pure crystals of poxvirus.This is known as a virus melt. The meltpours out of the dead caterpillar, andother caterpillars come along and acci-

dentally eat the crystals lying on a leaf,and they melt, and so it goes for millionsof years in the happy life of an insectpox.“It is a good thing no person has beenknown to catch an insectpox,” Espositoremarked. (You might avoid eating meltedcaterpillars.) The yellow-fever mosquito,Aedes aegypti, suffers from a fatal mosqui-topox. At least two midgepoxes tormentmidges. Grasshoppers are known to getat least six poxes. If a grasshopperpoxbreaks out in a swarm of African locusts,it can wipe them out with a plague.

Viruses have an ability to move fromone type of host to another in what isknown as a trans-species jump. The viruschanges during the course of a jump,adapting to its new host. The trans-species jump is the virus’s most impor-tant means of long-term survival. Speciesgo extinct; viruses move on. There issomething impressive in the trans-speciesjump of a virus, like an unfurling ofwings or a flash of stripes when a preda-tor makes a rush. Some fifty years ago, incentral Africa, the AIDS virus apparentlymoved out of chimpanzees into people.Chimpanzees are now endangered, whilethe AIDS virus is booming.

For most of human prehistory, peo-ple lived in small groups of hunter-

gatherers. The poxviruses didnot deign to notice Homo sapi-ens as long as the species con-sisted of scattered groups; therewas no percentage in it for apox. With the growth of agri-culture, the human populationof the earth swelled and be-came more tightly packed. Vil-lages became towns and cities,and people were crowded to-gether in river valleys.

Epidemiologists have donesome mathematics on the spreadof smallpox, and they find thatthe virus needs a population ofabout two hundred thousandpeople living within a fourteen-day travel time from one anotheror the virus can’t keep its life cycle going, and it dies out.Those conditions didn’t occurin history until the appearanceof settled agricultural areas andcities. At that point—roughlyseven thousand years ago—thehuman species became an ac-cident with a poxvirus waiting tohappen.

Smallpox could be describedas the first urban virus. It is thought tohave made a trans-species jump into hu-mans in one of the early agricultural rivervalleys—perhaps in the Nile Valley, or inMesopotamia, or in the Indus River Val-ley. In the Cairo Museum, the mummyof the Pharaoh Ramses V, who died as ayoung man in 1157 B.C., is speckledwith yellow blisters from face to scrotum.

In 1991, Joe Esposito and the molec-ular biologist Craig Venter, who was atthe National Institutes of Health, se-quenced the entire genome of the Ra-hima strain of smallpox; that is, theymapped all its DNA. They found thatthe virus contains a hundred and eighty-six thousand base pairs of DNA (eachbase pair being a step on the ladder ofthe molecule), and that the DNA con-tains about a hundred and eighty-sevengenes—making smallpox one of themost complicated viruses known. (TheAIDS virus has only ten genes.) A gene isa piece of DNA, which contains therecipe for making one protein. Esposito’steam noticed that smallpox has a genethat is also found in the placenta of amouse. Smallpox knows how to make amouse protein. How did smallpox learnthat? “The poxviruses are promiscuous atcapturing genes from their hosts,” Espo-

“Just where Dad said it would be.”

• •

LIQUEFACTION 55

sito said. “It tells you that smallpox wasonce inside a mouse or some other smallrodent.” D. A. Henderson speculates thatthe original host of smallpox may havebeen an African rodent that lived in acrescent of green forests along the south-ern Nile River. The forests disappeared,cut down by people, and possibly the ro-dent has gone extinct. This is only aguess. Smallpox moved on.

THE principal American biodefense laboratory is the United States

Army Medical Research Institute of In-fectious Diseases, or USAMRIID, in FortDetrick, Maryland—an Army base thatnestles against the eastern front of theAppalachian Mountains in the city ofFrederick, an hour’s drive northwest ofWashington. There is no smallpox atUSAMRIID, for only the two W.H.O.repositories are allowed to have it. Theprincipal scientific adviser at USAMRIIDis Peter Jahrling, a civilian in his fif-ties with gray-blond hair, PhotoGrayglasses, and a craggy face. Jahrling wasthe primary scientist during the 1989outbreak of Ebola virus in Reston, Vir-ginia: he discovered and namedthe Ebola-Reston virus.

“I don’t think there is anyhigher biological threat to thisnation than smallpox,” Jahrlingsaid to me, in his office, a win-dowless retreat jammed with pa-per. His voice was croaking. “Iwas over in Geneva for a meetingon smallpox, and I came backwith some flu strain,” he saidhoarsely. The flu strain had sweptthrough the world’s smallpox ex-perts. “Shows how fast a virus canmove. If we have some kind ofbioterror emergency with small-pox, there will be no time to startstroking our beards. We’d betterhave vaccine pre-positioned onpallets and ready to go.”

Jahrling opposes the destruc-tion of the official stocks of small-pox. “If you really believe there’s abioterrorist threat out there, thenyou can’t get rid of smallpox,” hesaid. “If smallpox is outlawed,only outlaws will have smallpox.”His group has been testing antivi-ral drugs that might work onsmallpox, and he feels that inorder to verify the effectiveness ofa new drug it would be necessaryto test it on live smallpox virus.

One of Jahrling’s researchers, JohnHuggins, led me into the central areas ofUSAMRIID. Huggins is a chunky manwith round Fiorucci eyeglasses. Heturned into a corridor leading to theLevel 4 spacesuit hot suites, or hot zones.The walls were cinder block, and thelight turned bile green. A smoky reekdrifted in the corridors, coming fromhuge autoclaves—pressure cookers—where contaminated equipment andwaste were being heated and sterilizedafter being brought out of a hot zone.We stopped at a door that had a windowof thick glass, looking into hot suiteAA5, the Ebola hot zone.

I pressed my nose against the glass.It was cool, and there was a faint rum-ble of blowers, keeping the zone at neg-ative pressure, so that no contaminatedair would flow out through cracks. Thesuite was dark and drowned in shadows,illuminated only by light coming fromlab equipment. I could see no one inthere but white mice in racks of plasticboxes. They were scribble-scrabbling inpine shavings.

“These mice are all infected with

Ebola,” Huggins said. “They bleed whenthey die. Like humans.”

The mice looked fine. I couldn’t seeany blood in the shavings.

“We’re giving them an antiviral drugthat saves their lives,” Huggins explained.“They’re kind of perky. It’s called anS.A.H. drug. It’s not ready for humantesting. It could work in humans, but wedon’t know.”

In 1995, Huggins spent time in aspacesuit at the C.D.C. Level 4 lab inAtlanta, testing drugs on live smallpox.He found that a drug called cidofovir canblock smallpox replication. Cidofovir,which is normally used against a virusthat infects AIDS patients, has drawbacks.It must be given to people by I.V. drip,and there is some concern that it mightdamage the kidneys. Huggins and Jahr-ling believe that within five years bettersmallpox drugs are likely to be discov-ered. They say they will need to test thedrugs directly on the virus. They add thatthe drug must be tested on the live virusin order to receive F.D.A. approval.

In March, a committee of the highlyrespected Institute of Medicine, in Wash-

“ ‘Well done’ lulled him into complacency.”

56

ington, D.C., concluded that one of themain reasons for retaining live smallpoxvirus would be to help develop drugsagainst it. D. A. Henderson, who was nota member of the Institute of Medicinecommittee and thoroughly disagrees withits conclusions, thought that Jahrling wasbeing too optimistic. “To get a new an-tiviral drug against smallpox is going to cost three hundred million dollars,”he said. “The money simply isn’t there.”

Jahrling stood his ground. “Cere-monial destruction of smallpox is thecrown jewel in D. A. Henderson’s ca-reer,” he said. “He would like to throwthe lever on smallpox himself. If I hadspent my life tramping the planet toeradicate the virus, I would want tothrow the lever, too. What he did was a great accomplishment, but he has become blinded by the last glitteringcrown jewel of total eradication.”

KEN ALIBEK, who was once Kanatjan Alibekov, a leading Soviet bio-

weaponeer and the inventor of theworld’s most powerful anthrax, shockedthe American intelligence communitywhen he defected, in 1992, and revealedhow far the Soviet Union had gone withbioweapons. In a new book of his, enti-tled “Biohazard,” Alibek says that therewere twenty tons of liquid smallpox kepton hand at Soviet military bases; it waskept ready for loading on biowarheads onmissiles targeted on American cities. Icontacted certain government sourcesand asked them if there was any evidenceto corroborate Alibek’s claims.

One person who asked not to benamed said, “I really have to be carefulwhat I say. Yeah, Alibek’s claims have beencorroborated in multiple ways. There’snot a lot of evidence. There’s some.”

Another person who asked not to benamed said that the Soviet Union hadput the biowarheads on ICBM missilesand test launched them sometime be-fore 1991 over the Pacific Ocean. TheUnited States—probably using spy sat-ellites that orbited near the tests—wasable to monitor the missiles as they soaredinto space and then punched backthrough the atmosphere and landed inthe sea. The warheads were spinningweirdly: they were unusually heavy, andthey had a strange shape. The warheadwas heavy because it had an active re-frigeration system to keep its tempera-ture near or below the boiling tempera-ture of water during reëntry. Nuclear

warheads don’t need to be actively cooled.Why would a warhead need to be cooled?Presumably, because it was designed tocontain something alive. But what? Theperson said, “The warhead was built tocarry a very small quantity of biologicalweapon. Anthrax wouldn’t have workedtoo well, because you need to put a lot ofanthrax in the air to kill people, and an-thrax isn’t contagious. With smallpox,you don’t need much. If you use small-pox, you get around the most difficulttechnical problem of bioweapons—theproblem of dissemination. With small-pox, you use people as disseminators.”

In 1989, a Soviet biologist namedVladimir Pasechnik defected to Britain.British intelligence agents spent a yeardebriefing him in a safe house. By theend, the British agents felt they hadconfirmed that the U.S.S.R. had biolog-ical missiles aimed at the United States.This information reached PresidentGeorge Bush and the British PrimeMinister, Margaret Thatcher. Mrs.Thatcher then apparently telephonedthe Soviet leader, Mikhail Gorbachev,and sternly confronted him. She was fu-rious, and so was Bush. Gorbachev re-sponded by allowing a small, secret teamof American and British biological-weapons inspectors to tour Soviet

3

PEONIES, UNCUT

It’s big (a hundred and sixty-pluscharacters, fifty-five scenes), it’s bad(Chinese officials labelled it “feudal,superstitious, and pornographic”),and it’s beautiful (with a lush Chi-nese garden replete with songbirdsand a fishpond, and five hundredand fifty hand-embroidered silkcostumes). And, finally, after beingforbidden last year by the Shang-hai Municipal Bureau of Culture to travel to the United States, it’scoming to a theatre near you. Be-ginning this week, Lincoln CenterFestival is presenting Chen Shi-Zheng’s staging of the Ming-dynastyopera “The Peony Pavilion,” TangXianzu’s epic story of the ghost of ayoung woman who returns to earthto consummate her love for a manfrom a long-ago dream. For the firsttime in almost four centuries, thetwenty-two-hour opera will beperformed in its entirety.

Photograph by Josef Astor

58 THE NEW YORKER, JULY 12, 1999

biowarfare facilities. In January of 1991,the inspectors travelled across theU.S.S.R., getting whirlwind looks atsome of the major clandestine bases ofthe Soviet biowarfare program, whichwas called Biopreparat. The inspectorswere frightened by what they discov-ered. (“I would describe it as scary, and Ifeel a responsibility to tell the worldmedical community about what I saw,because doctors could face these dis-eases,” an inspector, Frank Malinoski,M.D., Ph.D., said to me.) On January14th, the team arrived at Vector, themain virology complex, in Siberia, andthe next day, after being treated to vodkaand piles of caviar, they were shown intoa laboratory called Building 6, whereone of the inspectors, David Kelly, tooka technician aside and asked him whatvirus they had been working with. Thetechnician said that they had beenworking with smallpox. Kelly repeatedthe question three times. Three times,he asked the technician, “You mean youwere working with Variola major?” andhe emphasized to the technician that hisanswer was very important. The techni-cian responded emphatically that it wasVariola major. Kelly says that his inter-preter was the best Russian interpreterthe British government has. “There wasno ambiguity,” Kelly says.

The inspectors were stunned. Vectorwas not supposed to have any smallpox atall, much less be working with it. All theRussian smallpox stocks were supposedto be kept in one freezer in Moscow,

which was supposed to be under the con-trol of the World Health Organization.For Vector to have smallpox would be asupreme violation of rules set down bythe W.H.O.

Then they went upstairs into Build-ing 6, and entered a long corridor. Onone side was a line of glass windowslooking in on a giant airtight steel cham-ber of a type known as a dynamic aero-sol test chamber. The device is for test-ing bioweapons. Small explosives aredetonated inside the chamber, throwinga biological agent into the air of thechamber. The chamber in Building 6had an octopuslike structure of tubescoming out of it where sensors could beattached or monkeys could be clampedwith their faces exposed to the cham-ber’s air. An airborne bioweapon wouldget into the sensors or into the animals’lungs. On the other side of the corridorwas a room that Frank Malinoski said“looked like a NASA control room,” andvideo cameras provided views inside thechamber, so that Vector scientists couldwatch the release of a bioweapon.

Vector scientists later told the inspec-tors that the chamber was a ModelUKZD-25—a bioweapons explosion-test chamber. It was the largest and mostsophisticated modern bioweapons testchamber that has ever been found by in-spectors in any country. It was used fortesting smallpox.

The inspectors asked to put on space-suits and to go inside. (They had broughtalong Q-Tip-like swab kits: they would

have liked to swab the inner walls of thechamber, in the hope of collecting avirus.) The Russians refused. “They saidour vaccines might not protect us,” Mali-noski says. “It suggested that they had de-veloped viruses that were resistant toAmerican vaccines.” The Russians or-dered the inspectors to leave Building 6.

At a large gathering that evening,three inspectors—David Kelly, FrankMalinoski, and Christopher Davis—pub-licly confronted the head of Vector, a vi-rologist named Lev Sandakhchiev, aboutVector’s smallpox. (His name is pro-nounced “Sun-dock-chev.”) He back-pedalled angrily. Davis, a medical doc-tor with a Ph.D. who was then withBritish intelligence, now recalls, “Lev isgnomelike, a short man with a wizened,weather-beaten, lined face, and black hair.He’s very bright and capable, a tough in-dividual, full of bonhomie, but he can bevery nasty when he is upset.” Sandakh-chiev heatedly insisted that his technicianhad misspoken. He called on his deputy,Sergei Netesov, to support him. The twoVector leaders insisted that there had beenno work with smallpox at Vector. Theyhad been doing genetic engineering withsmallpox genes, they said, but Vector didn’t have any live smallpox, only thevirus’s DNA—and the more they spokethe murkier their statements seemed.David Kelly remembers, “They were bothlying, and it was a very, very tense mo-ment. It seemed like an eternity, but itonly lasted about fifteen minutes. Andthen there were so many other aspects

of Vector we had to explore.”“The brazenness of these

people!” one inspector laterfumed. “They had been test-ing smallpox in their explo-sion chamber the week beforewe arrived.”

Lev Sandakhchiev is stillthe head of Vector. He de-clined to be interviewed forthis account but has stead-fastly maintained that no of-fensive bioweapons researchoccurs now at Vector. In Janu-ary of this year, at the Genevameeting of smallpox experts,Sandakhchiev delivered apaper (and may have caughttheir flu). In his paper heclaimed that Vector did nothave any smallpox until 1994,when, he said, Vector had ob-tained it legally from Mos-

THE GREAT AND TRAGIC PARADOX 59

cow. D. A. Henderson was also at thatmeeting. “It was quite elaborate and quiteunbelievable,” Henderson said. “I rolledmy eyes, and saw other people rollingtheir eyes at me. We’re sitting there, he’spresenting us with all this horseshit, andhe knows it’s horseshit. Sandakhchiev islying flagrantly.”

Four sources have suggested to methat Lev Sandakhchiev was in charge ofa Vector research group that in 1990 de-vised a more efficient way to growweapons-grade smallpox in industrial-scale pharmaceutical tanks known asbioreactors.The Vector smallpox bioreac-tors had a capacity of six hundred andthirty litres—virus tanks big enough for amicrobrewery. Once the Vector scientistshad worked out the details of variolamanufacturing, the results were writtenup in master production protocols—recipe books—and these protocols endedup at the Russian Ministry of Defense, inMoscow. At the time, weapons-gradesmallpox was being manufactured by two older methods at a top-secret virus-munitions production plant near the city ofSergiyev Posad, forty-five miles northeastof Moscow. At another virus-munitionsplant, near Pokrov, about two hundredmiles southeast of Moscow, militaryvirus-production specialists converted theplant to the new Vector method of mak-ing smallpox in the large virus bioreac-tors, but apparently never started the re-action. When one considers that a singleperson infected with smallpox would beconsidered a global medical emergency,this is rather a lot of smallpox activity tohave bubbling near Moscow. It meansthat live smallpox virus and the protocolsfor how to mass-produce it had spread tovarious places in Russia by the nineteen-nineties. Indeed, live smallpox could bebubbling in reactors now at SergiyevPosad—no one in the United States gov-ernment admits to having a clue, and noRussian journalists have seen the place.Peter Jahrling said, “I really think thatVector is out of the offensive BW [bio-warfare] business. But Sergiyev Posad isthe black hole. We have no contactsthere, and the Russians won’t allow us tovisit the place.”

These days, Lev Sandakhchiev hascordial relationships with Peter Jahrlingand Joe Esposito. They are eager to drawtheir colleague into the circle of open in-ternational science. During their visits toSiberia, Sandakhchiev has come across tothem as warm and human, and desperate

for research money to support his institute.Sometimes, candid remarks slip out

from the Russians. Jahrling put it thisway: “There were tons of smallpox virusmade in the Soviet Union. We knowthat. The Russians have admitted that tous. I was in a room with one of the Vec-tor leaders when he said to us, ‘Listen,we didn’t account for every ampule of thevirus. We had large quantities of it onhand. There were plenty of opportuni-ties for staff members to walk away withan ampule. Although we think we knowwhere our formerly employed scientistsare, we can’t account for all of them—wedon’t know where all of them are.’ ”Today, smallpox and its protocols couldbe anywhere in the world. A master seedstrain of smallpox could be carried in aperson’s pocket. The seed itself could be afreeze-dried lump of virus the size of ajimmy on an ice-cream cone.

While I was sitting with D. A. Hen-derson in his house, I mentioned whatseemed to me the great and tragic para-dox of his life’s work. The eradicationcaused the human species to lose its im-munity to smallpox, and that was whatmade it possible for the Soviets to turnsmallpox into a weapon rivalling the hy-drogen bomb.

Henderson responded with silence,and then he said, thoughtfully, “I feel verysad about this. The eradication neverwould have succeeded without the Rus-sians. Viktor Zhdanov started it, and theydid so much. They were extremely proudof what they had done. I felt the viruswas in good hands with the Russians. Inever would have suspected. They madetwenty tons—twenty tons—of smallpox.For us to have come so far with the dis-ease, and now to have to deal with thishuman creation, when there are so many

“Something’s wrong with the broccoli. Please take it back to the kitchen and have it genetically modified.”

• •

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other problems in the world . . .” He wasquiet again. “It’s a great letdown,” he said.

For years, the scientific communitygenerally thought that biological weaponsweren’t effective as weapons, especiallybecause it was thought that they’re diffi-cult to disperse in the air. This view per-sists, and one reason is that biologistsknow little or nothing about aerosol-particle technology. The silicon-chip in-dustry is full of machines that can spreadparticles in the air. To learn more, I calleda leading epidemiologist and bioterror-ism expert, Michael Osterholm, who hasbeen poking around companies and labswhere these devices are invented. “I havea device the size of a credit card sitting onmy desk,” he said. “It makes an invisiblemist of particles in the one-to-five-micronsize range—that size hangs in the air forhours, and gets into the lungs. You canrun it on a camcorder battery. If you loadit with two tablespoons of infectiousfluid, it could fill a whole airport terminalwith particles.” Osterholm speculatedthat the device could create thousands ofsmallpox cases in the first wave. He feelsthat D. A. Henderson’s estimate of howfast smallpox could balloon nationally is conservative. “D.A. is looking at Yu-goslavia, where the population in 1972had a lot of protective immunity,” hesaid. “Those immune people are like con-trol rods in a nuclear reactor. The Amer-ican population has little immunity, so it’sa reactor with no control rods. We couldhave an uncontrolled smallpox chain re-action.” This would be something thatterrorism experts refer to as a “soft kill” ofthe United States of America.

The idea that a biological credit cardcould execute a soft kill of the UnitedStates has reached the White House.The chief terrorism expert on the Na-tional Security Council, Richard Clarke,has sent word through the federal gov-ernment that getting national stockpilesof smallpox vaccine is a top priority.

The effort started four years ago. Sofar, the government has little to show ex-cept numerous meetings among agen-cies, with no hope of vaccine anytimesoon. The Department of Defense hasput all its vaccine efforts into somethingcalled the Joint Vaccine Acquisition Pro-gram, which is run by the Joint ProgramOffice for Biological Defense. People in-side the military don’t want their namesused when they talk about the Pentagon’sefforts. “It’s a fucking disaster,” said oneknowledgeable military officer who has

had direct experience in the matter. Lastyear, the Pentagon hired a systems con-tractor called Dynport, headquartered inReston, Virginia, to develop and make anumber of different vaccines for troops.The smallpox-vaccine contract calls forthree hundred thousand doses, at a costof $22.4 million, or seventy-five dollars adose, with delivery now scheduled for2006. (The date has been pushed back atleast once already.) This amount of vac-cine could be made in about fifteen flasksthe size of soda bottles. There are 2.3million people in the armed forces, andthey have several million more depen-dents. “Three hundred thousand doses isnot enough vaccine to protect anyone—not even our troops. It totally ignores thefact that smallpox is contagious,” onemilitary man said. “These guys ought tobe buying tank treads and belt buckles.They know nothing about vaccines.”

The Department of Health and Hu-man Services (H.H.S.) has been giventhe responsibility by the White Housefor producing a stockpile of smallpox

vaccine large enough to protect theAmerican civilian population in case ofa bioterror event; originally, the idea wasfor H.H.S. to consider hiring the mili-tary’s contractor, Dynport, to makeforty million extra doses, in addition tothe three hundred thousand that Dyn-port was making for the Pentagon.(Any such initiative would require com-petitive bidding.)

At a series of meetings at H.H.S., atop Dynport executive said that fortymillion doses could be quite expensive.One scientist asked if a group of knowl-edgeable people could be drawn togetherto come up with an estimate of costs.The Dynport man answered, “Yes, wecan do a study that will list the questionsthat need to be asked. It will cost twohundred and forty thousand dollars andwill take six weeks.”

Somebody then asked how much itwould cost to answer the questions. TheDynport official responded, “That will bea different study. That study will cost twomillion dollars and will take six months.”

LOVE AND WORK

In an uncurtained room across the waya woman in a tight dress paints her lipsa deeper red, and sizes up her hipsfor signs of ounces gained since yesterday.

She has a thoughtful and a clever face,but she is also smart enough to knowthe truth: however large the brain may grow,the lashes and the earrings must keep pace.

Although I’ve spread my books in front of mewith a majestic air of I’ll show her,I’m much less confident than I’d prefer,and now I’ve started pacing nervously.

I’m poring over theorems, tomes and tracts.I’m getting ready for a heavy dateby staying up ridiculously late.But a small voice advises, Face the facts:

go on this way and you’ll soon come to harm.The world’s most famous scholars wander downthe most appalling alleyways in town,a blond and busty airhead on each arm.

There is an inner motor known as lustthat makes a man of learning walk a mileto gratify his raging senses, whilethe woman he can talk to gathers dust.

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With that, one scientist at the meet-ing burst out, “This is horseshit! We’reasking an encyclopedia salesman if weneed an encyclopedia!”

The C.E.O. of Dynport, StephenPrior, said that the situation is morecomplicated: “The civilian population isvery different from the military. There’san age spread from newborns to the el-derly; there’s more compromised immu-nity, with AIDS, chemotherapy, and or-gan transplants. And possibly thirty-fiveper cent of people have never been vac-cinated. So it’s not just scaling up themanufacturing.”

Another knowledgeable observer isthe retired Army General Philip K. Rus-sell, M.D., who gave the order to sendbiohazard troops into Reston in 1989to deal with a building full of mon-keys infected with Ebola. Russell saidto me, “Many of us are afraid that Dyn-port won’t deliver the goods withoutwasting an inordinate amount ofmoney.”

However, H.H.S. has quietly opened

talks with other potential contractors,preparing to solicit bids to make a civil-ian stockpile of smallpox vaccine,though there has been no announce-ment. “The effort at H.H.S. still isn’torganized,” D. A. Henderson said.General Russell said, “If smallpox reallygot going, people should be most con-cerned about a lack of effective leader-ship on the part of their government.”

I WANTED to get closer to smallpox virus. In Joe Esposito’s lab, at the

Centers for Disease Control, there was atest going of a biosensor device for de-tecting smallpox. It was a machine in ablack suitcase. It could detect a bioweap-on using the process called the poly-

merase chain reaction, or P.C.R.—thesame kind of molecular fingerprintingthat police use to identify the DNA of acrime suspect. The suitcase thing wascalled a Cepheid Briefcase Smart Cy-cler, and it had been co-invented byM. Allen Northrup, a biomedical engi-neer who founded a company to makeand sell biosensors. He was there, alongwith a cluster of other scientists.

Esposito, the official guardian of onehalf of the world’s official supply ofsmallpox, handed a box of tubes to a sci-entist in the room. Two of the tubes con-tained the whole DNA of smallpox virusbut not live smallpox. The DNA driftedin a drop of water; it was the Rahimastrain. Two other tubes contained an-thrax. The samples were snapped intoslots in the machine.

Northrup turned his attention to alaptop computer that nestled in the ma-chine. Northrup is a chunky man with amustache and reddish-brown hair. Hetapped on the keys.

We waited around, chatting. Mean-while, the Cepheid was working silently.It showed colored lines on its screen. Infifteen minutes, the anthrax lines startedgoing straight up, and someone said,“The anthrax is screaming.” Finally, oneof the smallpox lines crept upward,slowly. “That’s a positive for smallpox, notso bad,” a scientist said. Emergency-response teams could carry a Cepheidsuitcase to the scene of a bioterror eventand begin testing people immediately foranthrax or smallpox. The machine ispriced at sixty thousand dollars.

Afterward, Joe Esposito went aroundcollecting the used tubes. The smallpox-sample holder—a plastic thing the sizeof a thumbnail—had been left on acounter. I picked it up.

Esposito wasn’t about to let anyonewalk off with smallpox. “Leave me thattube,” he said. “You are not allowed to havemore than twenty per cent of the DNA.”

Before I handed it to him, I glancedat a little window in the tube. When Iheld it up to the light, the liquid lookedlike clear water. The water contained thewhole molecules of life from variola, aparasite that had colonized us thousandsof years ago. We had almost freed our-selves of it, but we found we had devel-oped a strong affinity for smallpox. Someof us had made it into a weapon, and nowwe couldn’t get rid of it. I wondered ifwe ever would, for the story of our entan-glement with smallpox is not yet ended. ♦

A chilling vision of the years aheadinvades my thoughts and widens like a stain:a barren dance card and a teeming brain,a crowded bookcase and an empty bed . . .

what if I compromised? I’d stay up lateto hone my elocutionary skills,and at the crack of dawn I’d swallow pillsto calm my temper and control my weight,

but I just can’t. Romantics, so far gonethey think their lovers live for wisdom, wooby growing wiser; when I think of youI find the nearest lamp and turn it on.

Great gods of longing, watch me as I work,and if I sprout a martyr’s smarmy grinplease find some violent way to do me in;I’m burning all these candles not to shirk

a night of passion, but to give that nighta richly textured backdrop when it comes.The girl who gets up from her desk and dumbsher discourse down has never seen the flight

of wide-eyed starlings from their shabby cage;the fool whose love is truest is the onewho knows a lover’s work is never done.I’ll call you when I’ve finished one more page.

—RACHEL WETZSTEON