Smallpox as a Biological Weapon

British soldiers were possibly the first to use smallpox as a weapon during the French and Indian Wars (1754-1767) in North America. Intending to cause disease and mortality, the soldiers took blankets used by smallpox patients and gave them to American Indians. The resulting epidemics killed more than 50% of many of the tribes. Nine years later, Jenner discovered that inoculation of cowpox protected recipients from getting smallpox. The resulting worldwide dissemination of vaccination with cowpox diminished the potential of smallpox as a bioweapon (26). 

Three years after smallpox eradication, in 1980, the World Health Organization (WHO) recommended that aU countries cease smallpox vaccination. In addition, WHO recommended that all laboratories destroy stocks of the virus or transfer them to either of two WHO reference laboratories, the Institute of Virus Preparations in Moscow, Russia, or the Centers for Disease Control and Prevention (CDC) in the United States. However, there may have been stocks of virus elsewhere (26,27). Although the WHO Advisory Committee on Variola Virus research recommend eradication of aU smallpox stocks by June 30,2002, the WHO Health Assembly has delayed this each year because of concerns that stocks of virus are needed for continued study (28). 

Acute smallpox symptoms resemble those of other acute viral infections such as influenza. After an incubation period of 12-14 days (range 7-17 days), smallpox begins with a 2-4 day nonspecific prodrome of fever, myalgias, headache, and backache. Severe abdominal pain, nausea, vomiting, prostration, and delirium may be present. Patients are not infectious until the end of the prodrome (25), when a maculopapular rash begins on the oral and pharyngeal mucosa, face and forearms, and spreads to the trunk and legs. 

---

Henderson, Donald A., Thomas V. Inglesby, John G. Bartlett, Michael S. Ascher, Edward Eitzen, Peter B. Jahrling, Jerome Hauer, Marcelle Layton, Joseph McDade, Michael T. Osterholm, Tara O Toole, Gerald Parker, Trish M. Perl, Philip K. Russel, and Kevin Tonat. "Smallpox as a Biological Weapon Medical and Public Health Management." Journal of the American Medical Association 281 (1999) 2127-137. 

Henderson, D., Inglesby, T., Bartlett, J., Ascher, M., Eitzen, E., Jahrling, P., et al. (1999). Smallpox as a biological weapon Medical and public health management. Journal of the American Medical Association, 281(22), 2127-2137. 

Henderson DA, Inglesby TV, Bartlett JG, Ascher MS, Eitzen E, Jahrling PB, Hauer J, Layton M, McDade J, Osterholm MT, O Toole T, Parker G, Perl T, Russell PK, Tonat K. Smallpox as a biological weapon medical and public health management. Working Group on Civilian Biodefense. JAMA 1999 281(22) 2127-37. 

Henderson DA, Inglesby TV, Bartlett JG, et al. Smallpox as a Biological Weapon Medical and Public Health Management. JAMA, 281 2127-2137, 1999. Also available at http //www. bt.cdc.gov (last accessed 4/15/06)... 

The first use of smallpox as a biological weapon dates back to the American Revolution, when Lord Jeffrey Amherst, the British commander of the Army fighting against a contingent of French soldiers, which together with the Delaware Indians were helping the Continental Army, decided to contaminate the tents of the... 

A. Characteristics. The smallpox virus is an orthopoxvirus with a narrow host range confined to humans. Eradication of the natural disease was completed in 1977. Appearance of human cases would signal use of the virus as a biological weapon. Under natural conditions, the virus is transmitted by direct contact with an infected case, by fomites, and occasionally by aerosols. Smallpox virus is highly stable and retains infectivity for long periods outside of the host. A related virus, monkeypox, clinically resembles smallpox and causes sporadic human disease in West and Central Africa. The incubation period is typically 12 days (range, 10-17 days). 

Smallpox has been effectively used as a biological weapon since the 1500s when Pizzaro used contaminated clothing to infect South American natives. During the French and Indian War (1754—1757) the British used contaminated blankets to infect Indians loyal to the French (50% of some Indian tribes died). Japan experimented with smallpox as a bioweapon in World War 11, and many other countries are thought to have developed offensive bioweapons using smallpox. 

---