Bioterrorism and smallpox planning: information and voluntary vaccination

Both public and private deliberation on the question of smallpox vaccination require information disclosure by the intelligence community SMALLPOX, PAST AND PRESENT The US government’s preparation for a possible bioterrorist smallpox attack received high profile American news-paper attention during 2002 and early 2003. While the weaponisation of small-pox raises a number of ethical issues, a central concern is the question of who should be vaccinated in the ‘‘preattack’’ scenario.1 Often considered the most dreaded human disease, smallpox killed more people than the plague or any other infectious disease.2 During the 20th century alone it killed between 300 and 540 million people, which is more than were killed by ‘‘all the wars and epidemics’ ’ of that period.3 Following heroic global vaccination efforts, the last (reported) ‘‘natural occurring’ ’ case of the disease occurred in Somalia in 1977. The World Health Organization (WHO) officially declared smallpox eradicated in 1980. This is a great success story of medicine. Upon eradication it was agreed that all remaining samples of the smallpox virus, called variola, be kept under tight security at two facilities: the Centers fo