ASPR’s Kadlec: Smallpox one of many biothreats U.S. must anticipate

The Sept. 14 gas explosion that stoked a fire at a Russian bioweapons facility in Siberia where viruses and bacteria including smallpox, Ebola and anthrax are stored reminded the world that humans are only one catastrophic biological event away from a pandemic that could kill tens of millions of people.

While no biological material was stored in the sanitary inspection room where the explosion occurred at the Russian State Centre for Research on Virology and Biotechnology, a.k.a. the Vector, the gas cylinder blast could have created a situation in which potentially deadly viruses or bacteria were unleashed to spread like wildfire.

The reason the Vector incident is so noteworthy is because it’s one of just two labs in the world that are approved to have the smallpox virus for research. The other approved lab is the Centers for Disease Control and Prevention (CDC) in the United States.

Smallpox scares public health authorities because, as the CDC says, it is a serious — even deadly — disease.

“Smallpox is one of the deadliest diseases known to mankind; the virus infected roughly 50 million people a year and killed an estimated 300 million people worldwide in the 20th century alone” before the World Health Organization deemed it eradicated in 1980, said Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services (HHS), in an interview with Homeland Preparedness News.

The CDC says there’s a credible concern that the virus could be used in bioterrorism, and Kadlec said the potential use of smallpox as a bioweapon means “the virus remains a potential threat to national and global health security.”

North Korea, in fact, has threatened such use of smallpox.

North Korean leader Kim Jong-un’s alleged doomsday arsenal — which many experts agree would be used by Pyongyang’s military in a war — includes a stockpile of smallpox, along with other biological agents.

“Having vaccines and treatments at-the-ready will be imperative to saving lives,” said Kadlec, adding that the United States is preparing to counter such a bioattack.

“We have a long-standing international commitment to develop vaccines and treatments for smallpox infections,” Kadlec explained, adding that over the past 12 years, the Biomedical Advanced Research and Development Authority (BARDA) at ASPR has worked with private industry to develop such products as part of ongoing preparedness efforts against biodefense threats.

“The U.S. has vaccines, treatments and other materials stockpiled for a nationwide smallpox response,” added Kadlec.

Earlier this month, for example, ASPR awarded approximately $170 million to Emergent BioSolutions of Gaithersburg, Md., to purchase its smallpox vaccine, called ACAM2000, which is the only vaccine licensed by the U.S. Food and Drug Administration for active immunization against smallpox disease for persons determined to be at high risk for smallpox infection.

Emergent’s vaccine will be used to build and replenish vaccines stored in the Strategic National Stockpile (SNS) over the next decade. ASPR, which oversees the SNS, may purchase additional vaccines over the next 10 years, with a target of $2 billion in procurement and surge options for up to a total of nearly $2.8 billion, according to HHS.

“The U.S. government’s long-term commitment to smallpox preparedness and the role ACAM2000 vaccine serves have been reinforced in guidance and legislation within the last two decades,” said Abbey Jenkins, senior vice president and vaccines business unit head at Emergent. “As the only smallpox vaccine administered in one dose, ACAM2000 vaccine remains the primary smallpox vaccine for general population use in the event of a smallpox emergency.”

Kadlec noted that “regardless of the size or the source” of such public health security threats, “smallpox is just one of the many threats our nation must be prepared for.”

So in addition to supporting the development and stockpiling of smallpox vaccine products, Kadlec said the U.S. is building on a concept that started as a tiered system of hospitals across the country to treat Ebola patients.

“We want those hospitals to be ready to handle all highly infectious diseases, including smallpox,” he told Homeland Preparedness News.

When asked about which other countries might pose similar biothreats to the U.S., Kadlec answered honestly.

“We do not know, for certain, that all virus samples were destroyed and only remain in the two high-security laboratories in the U.S. and Russia,” he said. “The global concern has been and continues to be that the [smallpox] virus could be released accidentally or intentionally.”

Tremendous and continuing advances in synthetic biology, also are making technologies easier and more accessible, said Kadlec.

“The world could see the virus created in laboratories by people who intend harm,” he said. “That ongoing concern is why we have continued to work on vaccines and treatments for the disease.”

Kadlec and other experts have been saying for years now that a pandemic is inevitable and close at hand.

Most recently, a new independent report warns that there is a “very real threat” of a pandemic that could cause the deaths of up to 80 million people and strangle almost 5 percent of the global economy.

“A global pandemic on that scale would be catastrophic, creating widespread havoc, instability and insecurity. The world is not prepared,” say report authors in A World at Risk: Annual report on global preparedness for health emergencies.

Compiled and published by the Global Preparedness Monitoring Board (GPMB), which was assembled last year in response to a request from the office of the United Nations secretary-general, and convened jointly by the World Health Organization (WHO) and the World Bank, the GPMB report provides a searing attack on the lack of political, financial and logistical will around pandemic preparedness efforts.

At the same time, the report also offers seven “urgent actions” for preparing against global health emergencies, including that heads of government “must commit and invest.”

Kadlec offered similar solutions.

“The threats our nation faces — natural or man-made — are serious and continue to evolve,” he said. “Constant vigilance — constant preparedness — for evolving threats requires substantial and sustained funding and interagency cooperation. We must do everything we can to be ready to save lives in any type of emergency, whether it’s the next pandemic or a bio-incident.”