Smithsonian.com

A 16th century illustration depicting smallpox victims. Photo: Florentine Codex

Planning for a bio-terrorism smallpox attack, the U.S. government just bought up enough smallpox medication supplies to treat two million people.  But given that smallpox was eradicated in 1980 and that the only known remaining samples of the disease are kept under lock and key in the U.S. and Russia, the New York Times points out, some critics are crying foul over the $463 million the government shelled out for the vaccines.

Experts fear, though, that terrorists may have secret stockpiles of the virus or could figure out how to reengineer smallpox in the lab. Two million doses of treatment, the Times writes, could contain an outbreak in a large city in the event of terrorists dousing an airport or stadium with pathogens. But around 12 million doses would be needed to combat a nation-wide epidemic.

Others argue that the spending is a bit extravagant since the U.S. keeps a stockpile of around 300 million smallpox vaccines, compared to just 15 million in 2001.

Left untreated, smallpox kills a third of victims. But prominent experts say the danger is overblown. Because it can take up to two weeks before an infected person becomes seriously ill, and up to five more days before he or she begins to infect others, there is time to respond, they said.

Also, they said, by the time smallpox victims reach the infectious stage, when their pox are erupting, they are too sick to wander around. That is why outbreaks in schools or factories were nearly unheard of.

Smallpox was eradicated by “ring vaccination” — finding each case and vaccinating just the 50 to 200 people closest to it.

If there were a lage-scale bioterrorism attack using smallpox, health officials could move quickly, some experts say.

Even if the U.S. doesn’t really need all of those treatments and vaccines, however, experts point out to the Times that the medications could be use to help other nations in need who come under a smallpox attack, since only the U.S., Japan and Israel reportedly have enough vaccine to cover their entire populations.

More from Smithsonian.com:

A Brief History of How Vaccines Work 
Battling Smallpox; Renovating Paris