The Demon in the Freezer (10 page)

Battle in Geneva

PETER JAHRLING,
the senior scientist at U
SAMRIID
who was called to the office at four in the morning on October 16th, 2001, when the Daschle letter full of anthrax was being analyzed at the Institute, is the codiscoverer and namer of the Ebola Reston virus, the only type of Ebola that has ever been seen in the Western Hemisphere. Ebola is an emerging virus from the rain forests and savannas of Africa that causes people to die with hemorrhages flowing from the openings of the body. There are now five identified species of Ebola. The hottest of them, Ebola Zaire, kills up to ninety-five percent of its infected victims, and there is no cure for it. Jahrling discovered the Ebola Reston virus in 1989, during an outbreak of Ebola in Reston, Virginia, a suburb of Washington, D.C. Before he knew what the virus was, he inadvertently inhaled a whiff of it from a small flask. Tom Geisbert, the U
SAMRIID
microscopist whom Jahrling would later ask to examine the Daschle anthax, also took a whiff. The two scientists tested their blood every day for a while after that, but they never became sick. They are the official codiscoverers of Ebola Reston, and they have continued to collaborate on research into Ebola. Peter Jahrling also discovered that an antiviral drug called ribaviran can be used successfully to cure people who are infected with Lassa, the Level 4 virus that turns people into bleeders.

In the nineteen nineties, as the presence of biological weapons in Russia and other countries became more obvious and more alarming, Peter Jahrling expanded his interests beyond Ebola and began to study smallpox. He worked with the Cooperative Threat Reduction Program, and he flew frequently to Vector, where he got to know Lev Sandakhchiev, Sergey Netesov, and many other Vector people. He exchanged Christmas cards with them every year and drank vodka with them when he visited. He liked them personally and tried to get along with them.

In the late nineties, there was virtually no smallpox vaccine on hand in the United States—at any rate, nowhere near enough to stop even a small outbreak. Jahrling got involved in efforts to create a national stockpile, but he came to believe that the vaccine would not be sufficient if there was a bioterror attack on the United States. The traditional vaccine, vaccinia, has a rate of bad reactions, including brain disease and death, that probably makes it unacceptable by modern standards of pharmaceutical safety. About one in five people couldn’t receive the vaccine under current rules. The vaccine is a live virus, and it can sicken or kill people who have lowered immune systems. Today, many people have lowered immunity, including those who are taking immunosuppressive drugs, such as people in chemotherapy or people with inflammatory diseases. Many people also have lowered immunity because they are HIV-positive. The vaccine can’t be given to people with eczema, or to family members of someone with eczema or other skin conditions, and it can’t be given to pregnant women or to families that have a baby in the house. The pustule formed by a vaccination is contagious if it oozes. If the smallpox vaccine was given indiscriminately to everyone in the United States, it is suspected that at least three hundred people would die, or perhaps one thousand or more—no one really knows—and many other people would be sickened. If a pharmaceutical company marketed a drug that killed a thousand people, it would be one of the biggest scandals in the history of the drug industry.

Peter Jahrling had a loose-knit group of researchers around him, and he pushed them to develop other ways of protecting people against smallpox. He was encouraged by the increasing success of antiviral drugs in fighting HIV.

One of Jahrling’s collaborators at
USAMRIID,
a virologist named John Huggins, ran some experiments and found that a drug called cidofovir (which is marketed under the brand name Vistide) could be used to successfully treat monkeys infected with monkeypox. Working in the Maximum Containment Lab at the CDC in 1995, Huggins also found that cidofovir seemed to work against smallpox in a test tube. Cidofovir might help people with smallpox, and possibly other smallpox drugs could be found. An antiviral drug for smallpox could also be used to treat people who had bad reactions to the existing vaccine; it could be a safety net for immune-compromised people in case millions of people needed to be vaccinated for smallpox quickly.

In order to develop drugs and a new vaccine for smallpox, it would be necessary to do experiments with live variola. The Food and Drug Administration would never license a drug or vaccine for smallpox unless it had been tested and shown to work on at least one type of infected animal. Two centuries ago, Edward Jenner had tested his vaccine in a human challenge trial. Human challenge trials with real smallpox today would be unethical and highly illegal, and might well be considered a crime against humanity. There were going to have to be other ways to test cures for variola besides Edward Jenner’s way.

SHORTLY BEFORE
the Eradication was formally declared complete in December 1979, D. A. Henderson moved to Baltimore and became the dean of the School of Public Health at Johns Hopkins University. He and his family settled into a solid brick Georgian house near the campus. They built a Japanese garden along the side of the house, and D.A. enjoyed entertaining students and faculty there. He loved to spend a Saturday in the family room, in a big easy chair by the sliding glass doors that looked out on the garden. For years, his wife, Nana, had been asking him if he had any plans to retire; he said he would like to retire, but not immediately. He served as a presidential science adviser in the Bush, Sr., White House for a while, and he has a top secret–level national-security clearance. He began hearing about the Soviet/Russian biowarfare program in the mid-nineties. Starting in 1995, the government gave national-security clearances to people involved with public health, microbiology, and smallpox. Many of them were taken into a conference room at U
SAMRIID
and briefed by Peter Jahrling and others who had special knowledge. They were also briefed by Ken Alibek, the second major defector to come out of Biopreparat after Vladimir Pasechnik.

D. A. Henderson was dismayed by what he learned. He was slow to accept the disturbing information that he was getting about smallpox in the Soviet Union, and he could hardly bear to confront it. Soviet public health doctors had been the early driving conscience behind the Eradication, and the country had donated much vaccine to the effort. Svetlana Marennikova, the keeper of the WHO’s smallpox in Moscow, had seemed to be a thoroughly professional scientist. It wounded Henderson to accept this, but by early 1997, he had concluded that smallpox was by no means under control in just two freezers. What shocked him the most was the revelation of the twenty tons of smallpox at Zagorsk. In his mind, this was an obscenity. As early as 1998, he became alarmed about Osama bin Laden, and he began making public statements about the possibility that bin Laden’s organization would acquire smallpox. He began working behind the scenes to encourage the U.S. government to build up a stockpile of the smallpox vaccine, but he found this hard going, since no one seemed to take the threat very seriously. Nobody, except for a handful of people like Peter Jahrling, seemed to understand how bad the disease was or how fast it would spread. Increasingly concerned about the threat of biological terrorism, Henderson founded the Johns Hopkins University Center for Civilian Biodefense Strategies and became its first director.

One gray winter day in 1999, I visited Henderson in his house, and we sat in the family room and ate ham sandwiches and drank Molson beers. He was older yet the same man—six feet two, broad shouldered, with a seamed, angular face, pointed ears, and a thick brush of hair, though now gray. He filled the room with his gravelly voice and an aura of human power. He was the medical doctor who had driven variola out of humanity. The walls and shelves of the room were crowded with African and Asian sculptures and wooden Ethiopian crosses that he had picked up during his travels. “If smallpox were to appear anywhere in the world today, the way airplane travel is now, about six weeks would be enough time to seed cases around the world,” he said. “Dropping an atomic bomb could cause casualties in a specific area, but dropping smallpox could engulf the world.” He sipped his Molson, and the sky turned the color of bluestone, and raindrops splattered across the wooden decks in the Japanese garden.

At that time, very few public health experts or government officials took D. A. Henderson seriously when he said he thought a global smallpox outbreak could really happen. He was viewed in Washington as an older guy who had become a pain in the neck. Henderson intended to remain a pain in the neck for the foreseeable future. He had preserved his top-secret national-security clearance, because he believed that if a bioterror event occurred, the government might want to pull him in to help, and he would need a security clearance in order to serve. Because he had the clearance, he heard about little bioterror threats that didn’t get into the news. He felt they were harbingers of something bigger. “In the last ten days,” he remarked to me, “we’ve had fourteen different anthrax scares. Everybody and his brother is threatening to use anthrax. Of course, a real bioterror event is going to happen one of these days.”

In a calm, persistent voice, he argued for the destruction of the official stocks of variola. “What we need to do is create a climate where smallpox is considered too morally reprehensible to be used as a weapon,” he said. “It would make the possession of smallpox in a laboratory a crime against humanity. The likelihood that the virus would be used as a weapon is diminished by a global commitment to destroy it. How much it is diminished I don’t know. But it adds a level of safety.”

HENDERSON
was a member of the Ad Hoc Committee on Orthopoxvirus Infections, the smallpox advisory panel for the WHO. The committee was composed largely of veterans of the Eradication, and they met at irregular intervals in Geneva. Starting in 1980, they began to discuss getting rid of the two repositories of the virus—the one at the CDC and the one in Moscow. Henderson now says that at that time he didn’t care much one way or the other whether the stocks were destroyed, since the disease had been eradicated, and that was the main thing. Between the CDC freezer and the Russian freezer, there were not more than a couple of pounds of frozen smallpox material, all told. The vials would have fit into a few cardboard boxes, and heating them in an oven would seem to be easy.

Some of the committee members felt that destroying the stocks of smallpox in Atlanta and Moscow amounted to the purposeful extinction of a species. Even though it was variola, the worst human disease, would it be proper to send it to extinction? (They didn’t know that the Soviet Union was then making variola by the ton for loading into ICBMs.)

In 1990, the U.S. secretary of health, Louis Sullivan, asked the WHO what its position was: should smallpox be made extinct as a species? The Ad Hoc Committee solicited the views of the major societies of microbiology, along with the Russian academy of medical sciences. The answers came back, and they were unanimous: variola should die. Nobody wanted variola kept around. Even so, the committee proposed that the information in the DNA of smallpox be preserved. In 1991, the CDC pox virologist Joseph Esposito and the genomic scientist J. Craig Venter decoded the entire DNA of the Rahima strain of smallpox. The genetic information in the Rahima strain could be kept, while Rahima and its fellow strains could be made extinct.

In 1994, the committee and the World Health Assembly voted unanimously to destroy all the stocks of smallpox, and they set a deadline of June 30th, 1995, for the execution. The official stocks would be cooked in autoclaves—ovens that would make the vials of smallpox sterile. But then, abruptly, the British Ministry of Defence and the U.S. Department of Defense began to object to the plan. The 1995 deadline passed, and the stocks of smallpox still sat in the freezers.

The governments of nonindustrial countries that had suffered from smallpox didn’t like the idea of American and British military people keeping smallpox: it made them very nervous. In 1996, the WHO General Assembly voted for the total destruction of the official stocks and set a new deadline of June 30th, 1999, but as that deadline approached, opposition to the destruction persisted. It was now coming both from Russia and from some members of the American scientific community, mainly virologists, who wanted to study smallpox for pure scientific curiosity. In the summer of 1998, the Institute of Medicine, a branch of the National Academy of Sciences, formed a panel of experts to explore the question of what sorts of important research might require real variola. D. A. Henderson smoldered about it. He objected to the very way in which the panel was posing the question: “If you ask a scientist what research could be done if he had the live smallpox virus, of
course
he’s going to tell you a lot of research could be done.” In his view, there was no good scientific justification for research into real variola. He had no illusions any longer that variola sat in only two freezers, but he felt that the United States and Russia had an opportunity to show the world the moral high ground. He felt that the traditional vaccine had worked in the Eradication and would work again if there ever was a bioterror attack with smallpox. He thought that an antiviral drug for smallpox was a long shot that would waste resources, and that the research would interfere with the far more important task of showing the world that the United States and Russia could get along fine without smallpox. “To get a new drug for smallpox will cost three hundred million dollars, and the money simply isn’t there,” he said.

ON
January 14th, 1999, the Ad Hoc Committee on Orthopoxvirus Infections met at the WHO, in a conference room in an annex building. The meeting was chaired by D. A. Henderson. The participants were the inner circle of the committee. There were also a number of straphangers—people sitting in chairs at the edges of the room, sometimes asking questions. One of them was Peter Jahrling. Lev Sandakhchiev, the head of Vector was in the inner circle of the eradicators. Sandakhchiev is a chain-smoker, and at every break he went outdoors and paced along a walkway in the cold, wreathed in a cloud of pungent blue smoke from his Russian cigarettes.