By JOHN RICHARD SCHROCK
Concerns about “monkeypox” are closely tied to the eradication of smallpox. But American’s recent impression of viruses as rapidly developing variants and our immunity only lasting months do not apply to either of these members of the Poxviridae family. They are double-stranded DNA viruses while the coronaviruses are completely unrelated single-stranded RNA viruses.
I saw a survivor of smallpox in 1976 on the cobblestone streets of Macao, then a Portuguese colony across the Pearl River delta from then-British Hong Kong where I taught. The deep pock marks on his face were unmistakable. China had eradicated smallpox in the 1960s, yet his disfigurement remained from decades before. One year later, the last case of naturally occurring smallpox was diagnosed in Somalia on Oct. 26, 1977. Global eradication of smallpox was achieved by the World Health Organization where Dr. Isao Arita of Japan oversaw vaccine production from 1967 to 1979 and managed the $112 million dollars and 687 WHO workers. Affected countries provided over 200,000 local health workers and over $200 million.
Every high school biology class should describe Edward Jenner’s observation that milkmaids who developed the mild and temporary cowpox infection never got smallpox, a disease fatal about 30 percent of the time. Jenner took material from the cowpox lesion and scraped it on the arm of 8-year-old James Phipps on May 14, 1796. Jenner then “challenged” the young Phipps with material from a smallpox lesion (both arms) on July 1. The boy had complete immunity. The practice of immunization would eventually become widespread.
Some vaccines such as the injected Salk polio vaccine are “killed” viruses that present foreign materials that we respond to with antibodies. The Sabin oral vaccine is a “live” but weakened virus that is proliferated in our body, also triggering our antibody response. But the cowpox vaccination is a “similar-pathogen” vaccine, a different virus containing some of the same surface antigens to trigger our antibody production, but not causing any serious disease. The cowpox virus is a close relative of the smallpox virus. Both belong to the Orthopox genus, along with the monkeypox.
Therefore, when most of the world’s population underwent mass immunization against smallpox, we were likewise immunized against monkeypox. But when smallpox was eradicated in nature, we had to consider the very rare risks of smallpox vaccination. About one in a million died from a rare reaction to the vaccine. Vaccination of children was discontinued in the U.S. in 1971 and for hospital workers in 1976. By the 1990s, undergraduates in my college classes had no longer been vaccinated. Smallpox vaccination appears to provide immunity for a very long time. But as our young unvaccinated generation grows, so does their susceptibility to monkeypox. Fortunately, this poxvirus has mild symptoms and does not appear to be easily transmitted. But while smallpox could be eradicated because it did not have an animal reservoir, monkeypox is a zoonosis that circulates within rats and some other wildlife. Fortunately, the vaccines and drugs for smallpox are effective against monkeypox.
But why do we still have huge smallpox vaccine stocks after smallpox was eradicated? Only two labs, the CDC in Atlanta, Georgia and the Research Institute of Viral Preparations in Moscow contain remaining cultures of smallpox virus. And considerable discussion did occur about destroying those cultures. But then the U.S.S.R fell apart by 1992.
In 1969, Pres. Nixon signed a germ warfare weapons ban that over 100 other countries including the U.S.S.R. also signed. But after the fall of the U.S.S.R., Soviet military facilities were left abandoned in former Soviet countries including a germ warfare lab built in 1982 at Stepnogorsk in Kazakhstan. In the book “Scourge: The Once and Future Threat of Smallpox” by Jonathan B. Tucker and in “Bioterror,” a WGBH NOVA program broadcast in 2001, the ex-director of the lab explains how they could have killed everyone in the world 9-10 times over (including themselves). They had weaponized smallpox! While those facilities are now shut down, questions remain on whether third parties could have stolen cultures. Further details are provided by the book “Germs: Biological Weapons and America’s Secret War.”
So we have maintained vaccines and drugs for smallpox “just in case.” And now they will be useful against monkeypox should it continue to spread.
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John Richard Schrock has trained biology teachers for more than 30 years in Kansas. He also has lectured at 27 universities during 20 trips to China. He holds the distinction of “Faculty Emeritus” at Emporia State University.