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A team of researchers working in a high containment laboratory at the Centers for Disease Control and Prevention in Atlanta, GA, have solved a fundamental mystery about smallpox that has puzzled scientists long after the natural disease was eradicated by vaccination.
In a new research report appearing online in The FASEB Journal , researchers describe how the virus cripples immune systems by attacking molecules made by our bodies to block viral replication. This discovery fills a major gap in the scientific understanding of pox diseases and lays the foundation for the development of antiviral treatments, should smallpox or related viruses re-emerge through accident, viral evolution, or terrorist action.
In a high containment laboratory at the Centers for Disease Control and Prevention in Atlanta, scientists produced the recombinant proteins from the variola virus and a similar virus that affects monkeys, causing monkeypox. The researchers then showed that cells infected with variola and monkeypox produced a protein that blocks a wide range of human interferons, which are molecules produced by our immune systems meant to stop viral replication.
Note: Content may be edited for style and length. Science News. Over the next few decades, more of Europe, and then the US and Canada, joined them. Data is spotty — this is before there was any international authority on infectious disease statistics worldwide — but it is estimated that 10 to 15 million people caught smallpox annually, with 5 million dying of it, during the first half of the 20th century. It was not until the s that a truly global eradication effort began to appear within reach, thanks to new postwar international institutions.
The World Health Organization WHO , founded in , led the charge and provided a framework for countries that were not always on friendly terms to collaborate on global health efforts. Even then, there were skeptics.
After all, no disease had ever been eradicated before. There were billions of people in the world, under myriad governments, many of them in regions actively at war. Global coordination on the scale eradication would demand was unprecedented. Plus, there had already been a failed attempt to eradicate malaria. The goal of eliminating every smallpox case in the world, rather than just suppressing the virus, sounded implausibly lofty.
But other advances had brought it within reach. Needle technology had improved, with new bifurcated needles making it possible to use less vaccine. Overseas travel improved, which made it easier to ship vaccines and get public health workers where they were most needed, and provided impetus for worldwide eradication as it made it more likely that a smallpox outbreak anywhere in the world could spread.
A outbreak in New York City, traced back to a traveler from Mexico , resulted in a frantic effort to vaccinate 6 million people in four weeks. Europe, Henderson says, repeatedly saw the virus reintroduced by travelers from Asia, with 23 distinct importations different occasions of someone bringing smallpox into the country in five years.
As Henderson and Foege detail in their books , there were extraordinary challenges that often looked utterly insurmountable in the quest to eradicate smallpox. In poor corners of the world, there were no roads or hospitals and no infrastructure to notify the WHO of a smallpox outbreak.
Civil wars, famines, and refugee crises made disease surveillance and vaccination very difficult. But other features of smallpox made it easier to eradicate than many other diseases. That meant that once it was destroyed in humans, it would be gone forever. And, once a person has survived it, they are immune for life.
Only one vaccine is needed for immunity in almost all cases. Henderson calls the switch to ring vaccination a pivotal strategic change for the fight against smallpox. Instead of fighting for percent vaccination, which was proving unachievable in low-income countries, it let public health teams focus their resources where they were needed most. As large parts of the world were declared smallpox-free, resources could be more intensively focused in the areas where outbreaks were still happening.
Contact tracers tried to identify everyone exposed and figure out where the virus might have come from. Communities were swiftly vaccinated. Case numbers kept declining. In , the world marked the last wild Variola major case, in Bangladesh. In , it marked the last wild Variola minor case, in Somalia. Doctors tracked down and vaccinated every potential contact of the case; none of them contracted the disease.
Surveillance around the world found no more cases anywhere. It called on scientists and researchers from around the world, including collaborations between rival countries in the middle of the Cold War. Wild polio has been eradicated in Africa and remains only in conflict-torn regions of Afghanistan and Pakistan.
Why has it been so hard to build on our success with smallpox? One part of it is that many diseases present all the challenges that smallpox did — plus some additional ones. Some, like HIV or Covid, have asymptomatic transmission, which makes disease surveillance trickier. But as far as things that we can control, there are some takeaways.
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