Last Updated

15 Jan 2003

Source: Singapore Straits Times, March 14, 2002.

Smallpox more dreaded than anthrax

The disease is a bigger bio-terror threat, say experts

By Sharmilpal Kaur

THE anthrax threat is bad enough, but smallpox and botulism may pose a worse bio-terrorist threat, say disease experts.

In some ways, they dread a smallpox epidemic more than they do an anthrax outbreak, they said at a medical congress yesterday.

A smallpox outbreak would be devastating, said Professor Richard Wenzel, who chairs the department of internal medicine at the Medical College in Virginia, in the United States.

For every 10 people it infects, smallpox kills three and can leave the others blind and scarred.

'It is also highly communicable, unlike anthrax. So, with every case of smallpox, we can imagine up to 20 secondary cases,' he said.

And it can keep spreading at this rate.

If 100 people get it in Singapore at the same time, the virus, which takes two weeks to spread from person to person, could go through the four million people here in two months.

The virus is kept alive in only two countries - Russia and the US.

But it is feared that with 60,000 scientists out of work after the Soviet Union's break-up, the virus may have made its way to the Middle East and North Korea.

Botulism, a paralysing illness caused by a nerve toxin, is another threat.

In a large epidemic, many hospitals would run out of respirators needed for the patients.

There would be chaos and many deaths, Prof Wenzel told reporters yesterday after speaking on bioterrorism at the 10th International Congress of Infectious Diseases at the Raffles City Convention Centre.

Dr Nina Morano of the Centers for Disease Control and Prevention in Atlanta in the US, said there were not enough vaccines for anthrax and smallpox. The anthrax vaccine is supplied only to the military now, but will be available to the public once more is produced.

Work has also started on a second and improved generation of anthrax vaccines, which were discovered in 1970.

In an emergency, the US' 15 million doses of smallpox vaccine can be diluted to make 75 million doses, said Prof Wenzel.

Within a year, the US will stockpile 300 million doses of the vaccine, enough for its population. But there are no plans yet to make vaccination compulsory.

For every million people vaccinated for smallpox, 12 develop encephalitis, a swelling in the brain that can be fatal.

'You don't want to immunise everyone unless there is a credible threat,' he said.

The vaccine can be fatal to people whose immunity is suppressed, including Aids patients.

A new section of Pro-MED-Email, an online reporting system for outbreaks of infectious diseases, was also launched yesterday. It will carry updated information on bioterrorism.

Users need to register at the free website at www.promedmail.org to access the information.

Singapore is also gearing up to deal with the emergence of new viruses and threats.

The Health Ministry will spend $52 million to upgrade the Centre for Communicable Diseases.