Ronald Rosenberg / Boston Globe 20nov00
Fresh concern about bio-terrorism is fueling development of new vaccines against the deadliest and most contagious diseases and prompting reexamination of whether enough of these new drugs are being stockpiled.
Unlike bullets and explosives, the traditional weapons of terror, bacteria and viruses released into the environment can create epidemics, spreading infectious diseases such as smallpox and anthrax.
Russia, Iraq, and North Korea all have sufficient quantities of the smallpox virus and other infectious agents to prompt the U.S. military to step up vaccine development.
While the Pentagon and others figure out ways to thwart would-be bio- terrorists from crossing U.S. borders, the Army and the Centers for Disease Control and Prevention are turning to microbiologists, chemists, and epidemiologists. Their mission is to develop vaccines and other medicines to thwart the spread of deadly viruses and reduce the chances of a catastrophe.
In August, BioReliance Corp., a biological testing and manufacturing company in Bethesda, Md., was awarded a contract to supply 300,000 doses of a new smallpox vaccine to the military. It marked the first time in nearly three decades that an updated vaccine against the disease had been produced.
And last month, OraVax Inc. of Cambridge, Mass., won a $343 million CDC contract to develop and stockpile 40 million doses of smallpox vaccine to be administered to the public in the event of a smallpox epidemic. Deliveries are scheduled to start in 2004.
The OraVax vaccine, which will have a five-year shelf life, will replace an aging supply of smallpox vaccine estimated at just over 7 million doses.
"We will be producing the same strain of vaccine that currently exists, although we will use more modern production techniques," said Lance R. Gordon, executive vice president of OraVax, a subsidiary of Peptide Therapeutics Group PLC of Cambridge, England.
The smallpox vaccine is the latest medical product to be stored to protect against biological or chemical attacks. The CDC, under the National Pharmaceutical Stockpile Program, has assembled other life-saving pharmaceuticals, including antibiotics, and surgical supplies that can be quickly airlifted to any part of the country.
The OraVax product will be the only vaccine stockpiled for the general population, though. All the other vaccines to treat rare infectious diseases are designated for military personnel.
At Fort Detrick in Frederick, Md., researchers at the Army Medical Research Institute of Infectious Diseases are developing a new anthrax vaccine to replace an older version that requires six injections and a booster shot every 18 months. Scientists hope to come up with a one-shot anthrax vaccine.
Anthrax is considered the second most deadly disease that terrorists would use -- after smallpox, which is more contagious.
"Our focus," said Lt. Col. George W. Korch, deputy commander at the Army institute, "is to develop new vaccines to protect against bio-terrorism and biological warfare using biotechnology, where we provide the candidate vaccines and hand it off for further human testing and manufacturing."
Army researchers are working with EluSys Therapeutics Inc., a small New Jersey company, to develop an early treatment for soldiers when they are first exposed to anthrax. Generally, major drugmakers do not see enough profit potential in rare, exotic diseases to bid on military and public health contracts.
The proposed treatment could also be used as a preventative for a short period of time, said Stephen Sudovar, EluSys's chief executive.
Under the contract, received last week, EluSys is developing monoclonal antibodies that bind to anthrax toxins and red blood cells. Then, the red blood cells carry the toxins to the liver, where they are destroyed.
"We will be testing our technology that provides an immediate way to get rid of a toxin like anthrax or a virus like the Ebola strain," said Sudovar, who licensed the basic technology from the University of Virginia.
The Army research institute is also working on vaccines against the two forms of plague, bubonic and pneumonic, and against other contagious diseases, Korch said.
Bubonic plague, once known as the Black Death, can be traced back to the Trojan War. The last significant plague epidemic was in India in the early 1900s; 10 million people died.
Plague comes from the bites of fleas that transmit bacteria from rodents. It can pass from person to person quickly unless treated with large amounts of antibiotics.
Scientists at Fort Detrick have recently begun working on a new vaccine against a virulent strain of botulism, an affliction in which tiny amounts of toxin in food lead to general weakness, respiratory failure and even death.
Korch said his research staff may also try to develop a vaccine against inhaled or typhoidal tularemia, which kills an estimated 35 percent of its victims, as well as other highly dangerous virus strains.
And while critics of the military's vaccine program are few, there is a growing concern over whether the federal government's various agencies -- as well as emergency centers in the 50 states and major cities like New York and Los Angeles -- would be able to respond to a bio-terrorist attack.
"Having 40 million doses of a smallpox vaccine stockpiled is simply too little," said Michael T. Osterholm, former Minnesota state epidemiologist and co-author of a new book, "Living Terrors: What America Needs to Know to Survive the Coming Bioterrorist Catastrophe."
Osterholm maintains that if a smallpox epidemic occurs overseas, the United States would ship large volumes of stored vaccine abroad, reducing the domestic supply to a dangerously low level.
He also argues that a forthcoming anthrax vaccine, like the smallpox vaccine, should be stockpiled for the general population, rather than just for the military.
A CDC spokeswoman, Barbara Reynolds, said that anthrax, plague and other infectious diseases can be treated with antibiotics. Smallpox lacks a specialized treatment, so a vaccine is the only course of action. Immunity, Reynolds said, develops quickly after an inoculation, generally protecting people already exposed to smallpox.
Like chicken pox, smallpox produces fever and headache, followed by a red rash on the mouth, throat and face. Eventually, the rash turns into bullet- shaped, puss-filled blisters on the face and body.
Proponents of the CDC vaccine program, such as Amherst College biology professor Paul W. Ewald, said it remains the best deterrent to the release of biological agents. Ewald contends that a threat continues to exist, because large stockpiles of smallpox virus remain in Russia.
Ewald and others also point to North Korea's growing stockpile of biological weapons and the threat from Iraq, whose bio-terrorist capabilities - - reportedly provided by former Soviet scientists -- were discovered during the Gulf War.
"By using a vaccine, you reduce the threat of an epidemic," said Ewald. "So a terrorist is less interested in causing an event that has less impact the more people are vaccinated."
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