Vials labeled "smallpox" and "vaccinia" found in a freezer in a lab near Philadelphia

It happened at a Merck facility, which was placed on lockdown until authorities deemed it not dangerous.

I have never believed that the virus only existed in two high-security labs, and this incident in 2014 proved otherwise.

If a case of smallpox is ever diagnosed, the WORLD will go on lockdown, and rightfully so. I hope we never have to do anything like this.

Yep. And here is another incident in 2003 where some scabs were found in an envelope tucked into an old book. If anyone is into old books from the pre-smallpox vaccine era, be careful!

While far more deadly I think an isolated outbreak of small pox would be much more easily contained than was Covid. Unlike Covid smallpox isn’t transmissible until its symptomatic, and its symptom profile doesn’t match other common ailments (like the flu). In this way its more similar to the situation with Ebola.

Also unlike Covid and Ebola, we have a vaccine ready to go and it is effective in reducing or eliminating symptoms even after exposure. Small pox is also scarier than Covid and the ability of vaccinate it into non-existence is better known. So while it would probably still exist (alas there is no vaccine against willful ignorance), vaccine hesitancy would be much reduced.

We managed to turn it from a disease that was everywhere to complete elimination, so there is no reason to think we couldn’t do it again if a small isolated pocket occurred. In fact the last small pox death was from an accidental laboratory release was stopped with only two infections a medical worker who died, and her mother who lived.

I used to believe this, but not any more.

Hopefully for us old-timers, we may still have some residual immunity from the old days when we all got smallpoxvaxxed.

(ETA: Not sure why this thread is in the Pit? Seems more like MPSIMS material to me so far.)

‘Smallpox is a bio-weapon from Ginah that’s no worse than the flu!’

Nope, we don’t.

After even 10 years with no virus exposure there is little immunity left, and now it’s been decades for us old-timers. Back in the old days re-vaccination of exposed people was routine during outbreaks.

Originally vaccination was thought to be life-long, but that was back in the days when the vaccinated were still exposed by the outbreaks that occurred in society continuing to “remind” their immune systems. As outbreaks ceased this reminder no longer occurred and immunity waned. This is also seen in other diseases, hence the need for boosters at various intervals.

Well… yes… but stockpiles of the vaccine are far too small to vaccinate all but a small minority of people immediately. It would be a very ugly race between producing more/sufficient vaccine and the virus spreading. It’s also a live vaccine, and also one that historically had one of the higher complication/mortality rates for a vaccine, which means the immunocompromised (cancer patients, people with HIV, organ transplant recipients, and others) can’t use it. It’s also contraindicated for anyone with a history of eczema or atopic dermatitis because it can lead to a horrifying death for them (although for some reason I got vaccinated as an infant despite my eczema - it was a different era, I think, and fortunately I survived the experience. Lethal side effects were not universal, but there were some cases). Unfortunately, people with those conditions aren’t going to surive a smallpox infection, either. There is a very limited supply of a new version of a smallpox vaccine that can be used by such people, but I expect it wouldn’t be sufficient for a world-wide outbreak. The newer versions of smallpox vaccine haven’t been tested in humans against actual smallpox, although they have been used against monkeypox in recent decades.

A lot would depend on which variety of smallpox gets loose. Some varieties have a relatively low fatality rate, about 10 times that of covid (hence my use of the term “relative” - it’s low only compared to its nastier cousins). The problem with the less evil version, sometimes called alastrim or Variola minor, is that being less nasty people were less likely to be completely knocked over by it and thus more likely to be and around and spreading it. All those yahoos wandering around with active covid ignoring that they don’t feel good (as opposed to genuinely asymptomatic cases) would be wandering around with this, spreading it far and wide.

Variola major strains had fatality rates between 30-90%, with survivors always left scarred. Blindness and joint damage can also occur and when it does it’s permanent, leaving a certain percentage of survivors permanently disabled. The “upside” - if you can call it that - is that V. major makes a person so sick that they tend to go to bed and not wander around as much as in the milder version, so it doesn’t spread quite so fast. Also, unlike covid, it’s not infectious before symptoms show. It still spreads very nicely, though, because it can survive outside the body on surfaces for significant periods of time.

In sum: If V. minor gets loose it will be something like covid with 10 times the death rate. So… instead of 750,000 dead Americans you’d see 7,500,000 dead. If V. major gets loose you’d see between 99 million dead and 297 million dead. Just in the US. Worldwide that would be between two and a quarter billion dead, and six and three-quarters billion dead. Think that’s unrealistic? Remember - the vast majority of the world is, at this point, unvaccinated (the jab I got 55+ years ago is now largely useless… I might have a tiny greater chance of surviving an infection, that’s the most it would give me at this point) and few have any sort of immunity. It’s hard to prove at this point due to time and lack of written records, but a LOT of people in the Americas were wiped out by disease shortly after the Europeans arrived, perhaps as many as 90% of the pre-contact population, and smallpox is a leading candidate for having done the deed (measles is also a possible contributor). There are historical instances of outbreaks leaving a high percentage of people in an area dead.

Humans of course will fight back. It will be a little harder to call a smallpox outbreak a “hoax” with “bring-out-your-dead” levels of mortality. But not all the deaths will be from infection because if you think covid disrupted supply lines and lead to shortages well… you ain’t seen nuthin’ yet!

A distant upside would be that the severe version with 90% of humans dead there will be a lot more resources for the survivors, greenhouse emissions and other forms of pollution will drop, and basically a lot of problems in the modern world related to too many people and not enough to go around, as well as waste disposal, will be greatly alleviated. The situation will be hellish for a generation, maybe two, but eventually those who remain may live in a better world. Unless/until we find some other way to fuck it up (such as nuking infected cities, which would be a Bad Thing).

(Bolding mine)
I wouldn’t be so sure (with nice pictures!):

The parallels between anti-vaxxers now and then are illuminating.

I like your optimism.

It’s based partly on a study of history. A pandemic plague is nothing anyone would want to directly experience, but in many (though not all) cases there can be some positives for the descendants of survivors.

Which is a little like saying, after the tornado has ripped the roof off your house “well, at least we got rid of the junk piled up in the attic”. Yeah, you have. Not convinced that makes up for everything else destroyed.

I still disagree that it would be able to expand from a single case to Covid levels of without being shut down. You won’t have to wait until dozens of people have died from lung failure before you figure out that this isn’t normal you have an outbreak of a dangerous disease. After the first pathology test is done on the first seriously ill patient you will know what you’ve got and how it should be dealt with.

Its a lot easier to ignore general respiratory symptoms that mimic the cold than it is a rash, and since a rash is apparent to outside observers it can be used to screen people for enforced quarantine, or to deny entry. And while we don’t have enough doses the vaccinate the world, we certainly have more than enough to handle an endemic outbreak.


A physical stockpile of vaccine held by WHO Headquarters in Switzerland, which is composed of calf-lymph smallpox vaccines from a variety of sources dating from the final years of the eradication program that are regularly tested for potency. It is estimated to consist of approximately 2.4 million doses when reconstituted and delivered by bifurcated needle.

A pledged stockpile held by Donor countries in their respective national stockpiles for use in time of international need upon request by WHO , which currently consists of 31.01 million doses of smallpox vaccine held by France, Germany, Japan, New Zealand, and the United States.

A lot depends on where the outbreak takes place.

If it gets loose in a technologically advanced nation with intact political, medical, and security institutions I agree, it will be rapidly contained and shut down.

If it gets lose somehow in an unstable region, though, things could get very ugly. Think about some of the large refugee camps in war-torn and/or less stable regions of the world.

Or if some Very Bad People get ahold of this, don’t mind risking death for themselves, infect themselves, disperse widely during the incubation period, then start outbreaks in multiple locations near simultaneously. Do that in major air transport hubs and that could be a big problem. Sure, the disease will probably be identified fairly rapidly, but if you get outbreaks centered on airports like Heathrow in London, Charles DeGaulle in France, JFK and LAX in the US, Frankfort in Germany, Tokyo airport in Japan, and so on all at the same time… how much damage? What if you get infectious people mingling in the crowd during the annual haj in Mecca? That would be an unmitigated disaster. Sure, the infected/ill/infectious folks won’t be functioning or moving real well, but they’re the biowarfare equivalent of suicide bombers, there is a window of time between becoming ill/infectious and collapse when they could get into a crowd and share a virus with a lot of other people.

If I can think of these sorts of things I assume the Very Bad People can, too, and probably be even more clever and malicious about this than I am. Which is why it’s so very important to locate and destroy unauthorized caches of this sort of thing. I’m sure there are some inherent difficulties to developing and deploying a bioweapon which is at least part of the reason we haven’t seen this sort of thing (yet) but the potential certainly exists.

Even if people vaccinated decades ago do not have sufficient residual immunity to ward off infection, it’s quite possible that there’s enough to prevent serious illness and death in a significant number of people.

Outside of mad scientist/SPECTRE-type scenarios, it’s difficult to conceive of a “successful” smallpox revival* by malefactors that would 1) only affect the enemy, and 2) evade a concerted ramp-up of vaccine(s) made possible by modern technology.

At any rate, it’s well down my list of apocalyptic worries.

*wouldn’t it be hell if cackling conspirators thawed out their illicit vials of pox virus, only to find that they’d gone bad in the intervening years?

There’s an Ebola vaccine, approved in 2019.

I get what you are saying here, but hasn’t ebola emerged more than once in West Africa and still been able to be contained there? I would imagine smallpox, for the reasons mentioned, would be able to be contained similarly, even in an unstable part of the world.

I’m not an epidemiologist or whatever, but my understanding is that smallpox is much more transmissible than Ebola. I don’t think Ebola is air transmissible, for example, but smallpox is.

I disagree. Ebola lives in bodily fluids, and bodily fluid contact is how it’s spread. While someone might conceivably cough and send droplets into the air, they are too large to hang in the air for long and thus it’s not considered airborne.

Smallpox, though, can go airborne, in that particles can stay in the air for prolonged periods of time and move around like smoke. The last outbreak, in England, involved it traveling from a lab on one floor to a room above it, which is not something ebola seems capable of doing.

Bottom line, smallpox transmits a lot easier between people.

Note: there’s a drug approved to treat smallpox (tecovirimat). While clinical testing has been constrained by the impracticality of full-scale trials in infected people, it does appear to have solid efficacy against monkeypox and rabbit pox in those animals, and a good safety profile in humans.

*while I haven’t been able to bring myself to view the video, a popular online purveyor of supplements, alt health advice and virulent political spewings has announced that the gummint is planning a mass smallpox release to cover up Covid-19 vaccine deaths and force cancellation of the 2022 elections. You have been warned. :grimacing:

Sure, OK.

How soon can we manufacture several million doses? Maybe even a billion or two?

I would hope that we can do them faster than we’ve been able to manufacture Covid treatments and vaccines, because we’ve been building up the infrastructure for that over the past year and a half.

However, that might just be wishful thinking on my part. And it might also depend on timing. Let’s say that smallpox gets out into the population as we finally have a handle on Covid and it’s finally in permanent decline, I think we could just use the same facilities, procedures, and supply lines we’ve recently put together and get them out swiftly.

But if the pandemic winds down and something pops up 5 years later? 10 years? Longer? We might have dismantled and/or repurposed much of that infrastructure.

I would like to think that if anything happened within a generation or two we’d still be better prepared than we were at the beginning of 2020 because it will still be part of the public consciousness. I don’t know how much better, but better.

Speaking of which . . .