Smallpox, the CDC and Casual Conduct

On October 10, 1562, the anointed and reigning queen of England, Elizabeth I, became ill.  What was first thought to be a common cold soon turned into a raging fever and debilitating sickness.  A queen, unmarried and without an heir was on the point of death.   A German, Dr. Burcot, was brought in at the request of Sir William Cecil, Elizabeth’s trusted advisor.  The new doctor immediately diagnosed smallpox—a disease for which, even today, there is no cure.  It kills a third of all who contract it, and disfigures all. 

            The doctor ordered Queen Elizabeth wrapped in red flannel and placed next to a roaring fire.  He left one bare arm exposed to the naked heat.   Soon the arm and the side of Elizabeth’s face were covered with the pustules that mark both smallpox and the victim.  Miraculously, the disease spent itself out and Elizabeth lived.

            We, in the 20^th century, conquered smallpox.  We now have two generations of children who have not even been vaccinated against this killer.  We thought we were safe.  We were wrong.

            On February 10, 1954 a lab worker placed 16 vials marked, “variola” (smallpox) along with various other pathogens inside 12 boxes and stored them in a cold storage lab in building 29A of the National Institute of Health in Bethesda, Maryland.  They were then—unaccountably—forgotten.  But they sat there, and they waited, and last month when a government scientist was cleaning out the storage room—that spring cleaning we all put off too many times—he discovered them. 

            The 16 vials where flown to Atlanta for testing and six were able to reproduce in a Petri dish.  They are, indeed, alive.  Since then we have also discovered similar vials of germs for dengue fever, rikettsia (spotted fever), and Q fever. 

            Smallpox virus was supposed to exist in viable form in only two ultra-secure locations, one in the CDC headquarters in Atlanta, Georgia, the other in a virology and biotechnical research facility in Novosibirsk, Russia.  Smallpox was supposed to exist in no other place on the planet.  But humans are fallible creatures and the word, “never” is a very big word. 

            This news is folded into the fact that weeks ago a CDC lab was closed because of improperly transferring live anthrax bacteria to another lab both unprepared and unauthorized to deal with it.  There has been the usual array of hearings featuring all of the usual characters from central casting.  Someone wants accountability, someone wants to cover their ass, someone wants to assure us that, “steps will be taken,” someone wants to blame the amorphous past and someone wants to get more money to magically solve the problem. 

            We are in an era where adherence to rules, standards of conduct and protocols for behavior are given short shrift.  Doing things, “by the book” is considered old school and lacking in creativity.  The assumption, and the hubris, of this thinking, is that we are all so damn smart that we can make up the rules as we go along and do just fine. 

I do not believe that this attitude has served us well.  There is a reason that we have rules, laws, governance, even ethics and a tidy list of 10 Commandments.  People work better within proscribed limits of conduct.  Guidelines mean less room for error and a better chance for success.   The workers who found these dangerous vials followed a protocol about how to handle them, and we are all better off because of it.  Everyone at CDC needs to pay attention to that.

Work for good health and keep the faith.