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Smallpox as a Bioweapon

Although naturally occurring smallpox has been eradicated, there is still heightened concern that the variola virus might be used as an agent of bioterrorism. In the first documented case of biological warfare, in the 18th century, contaminated blankets used by smallpox patients were distributed among Native American Indians by the British with the intent of initiating outbreaks. A smallpox epidemic occurred, killing more than 50% of affected tribes. If a strain of the variola virus could be obtained, it could be manufactured easily and disseminated widely in an aerosol release. A release of smallpox could escalate to a catastrophic global epidemic unless effective control measures can be implemented quickly. Smallpox has been identified by the Centers for Disease Control and Prevention (CDC) as a "Category A" agent, meaning it has been given high priority due to its potential threat to national security. The following references provide information on the use of smallpox as a bioweapon and associated issues to be considered during a smallpox outbreak.

  • Smallpox. Centers for Disease Control and Prevention (CDC). Contains extensive smallpox information, including fact sheets, overviews, FAQs, diagnosis and evaluation, infection control, laboratory testing, surveillance and investigation, selected publications, and education and training materials.
  • Henderson, Donald A. and Inglesby, Thomas V., et al. "Smallpox as a Biological Weapon: Medical and Public Health Management." Journal of the American Medical Association (JAMA) 281.22(June 9, 1999): 2281-2290. Considers the prospect of an aerosol release of variola virus, and provides information on epidemiology, infection signs and symptoms, diagnosis and monitoring, vaccination, medical treatment, infection control, environmental decontamination, and more.
  • Medical Aspects of Chemical and Biological Warfare: Chapter 27 - Smallpox. U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID). Provides a thorough review of smallpox, including its history and epidemiology, as well as biological warfare and clinical issues.
  • Medical Management of Biological Casualties Handbook, Seventh Edition. U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), (September 2011). Contains specific information on a number of potential bioterrorist agents.
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