BIOTERRORISM: Threat versus reality of other diseases

Smallpox was eradicated as a naturally occurring disease more than 30 years ago, thanks to a determined vaccination effort from the World Health Organisation. Nevertheless, it remains on the radar of most health agencies and, just a few years ago, the New England Journal of Medicine ran a special edition on the subject.
The fear is not that the disease could spread from a developing country, as happened in 1970 when a man returned to Germany from Pakistan with smallpox. Today, the perceived threat is that the virus could be deliberately introduced as an act of bioterrorism or war. Some scientists alleged that Russia was producing the virus well into the 1990s. But the stock of smallpox remains tiny: only a couple of laboratories store and research it, including the Centers for Disease Control in Atlanta.
The idea that all remaining stocks could be destroyed was suggested a decade ago and then dismissed. If bioterrorist threats were real, the argument went, then research on smallpox was still needed. However, these storage facilities are an obvious terrorist target and can cause accidental damage. The year after the WHO declared the world smallpox-free, a case arose, traced to a laboratory. Polio, too, has been released via a lab worker.
So, intermittently, the prospect of mass vaccination against smallpox rears its head. The last mass immunisation took place in 1968 in the US, when 14.2 million people were vaccinated. As that last round showed, the side effects can be severe: nine people had a fatal reaction.
Smallpox isn’t the only bioterrorist threat. Anthrax spores were released in the US mail system in 2001, causing five deaths and great alarm. Thousands of people who had no risk of exposure took antibiotics to be “safe”. Investigations revealed that the real-life hazard of the spores was extremely remote. Nevertheless, the US went on to research a vaccine for anthrax, and public health departments worldwide retain a remit to ensure “preparedness” for bioterrorism.
But isn’t all this rather a waste of effort? Predicting even the partially predictable, as we have seen with swine flu, is a dangerous game. Right now, the evidence tells us that people get sick and die younger than they need to because of poverty, dirty water, smoking and alcohol abuse as well as treatable illnesses such as TB, HIV, or malaria. We are all facing sharp budget cuts and health spending is not going to be untouched. Let’s deal with the facts, not fear.
http://www.ft.com/cms/s/2/79dfdf26-679e-11df-a932-00144feab49a.html