Report calls for continued smallpox research

A recently released report - "Are We There Yet? The Smallpox Research Agenda Using Variola Virus" - warned that, despite considerable advances, the research agenda for the smallpox virus is not finished and that significant gaps remain.

The variola virus is unique among orthopoxviruses because it is known to be a sole human pathogen and the viral and host factors responsible for its human-specific tropism remain unknown. Greater exploitation of current technologies, the report says, may lead to additional therapeutic or diagnostic products to better response to future emergency situations resulting from smallpox.

After smallpox was declared eradicated in 1980, one WHO Collaborating Center lab in Russia and one lab in the U.S. remained approved for research with the live variola virus.

Following an independent report on variola research by the Institute of Medicine in 1999, WHO decided to increase the amount of research utilizing the live variola virus, subsequently forming the WHO Advisory Committee on Variola Virus Research, and significant advances have been made in diagnosing, treating and prevent smallpox disease. The vaccines that were used successfully in the 1960s and 1970s, however, are in limited supply and have what is now considered an unacceptably high rate of adverse events.

According to the report, more work needs to be done to fight smallpox, with certain key aspect of the original research goals, including the wider approval of accurate diagnostics to distinguish smallpox from other diseases and the full licensure of new antiviral drugs and vaccines against the variola virus not yet completed.

A decision will be made this month on whether to destroy the remaining stocks of live variola virus or to continue to research the live virus at the two WHO-certified sites.