Smallpox in the Garage

There are countless ways technology might enable attacks against us -- as shocking and unexpected at 9/11 had been. Some of those are so likely and so devastating that they haunt me still.
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I joined the Department of Homeland Security to create its Policy office in 2005, not long after the 9/11 commission ascribed those attacks to a failure of imagination on the part of counterterrorism officials. One of my jobs, as I saw it, was to head off future failures of imagination. We needed to spend some time thinking about how technology might enable other attacks -- as shocking and unexpected at 9/11 had been. We did indeed spend time thinking about other risks. Some of them were so likely and so devastating that they haunt me still. That's what led me to write Skating On Stilts: Why We Aren't Stopping Tomorrow's Terrorism. This chapter from Skating On Stilts offers a glimpse of the threat that worries me most.


In January 1970, a German electrician fell ill after a trip to Pakistan. He was hospitalized with what appeared to be typhoid fever. He had been isolated for several days when the doctors realized that he didn't have typhoid fever.

It was smallpox.

Fear riffled through the hospital, and the community beyond. Smallpox has probably killed more human beings than any other disease. And it kills them with particular cruelty. After starting out like a bad flu, after a few days the disease attacks the victim's skin. Tiny spots appear, spread, and then harden into pus-filled blisters. Gradually, with excruciating pain, the blisters pull the outer layer of skin away from the under-layers. Sometimes the skin pulls loose in sheets. Sometimes the blisters attack not just the skin but the eyes, the throat, and every other orifice, ripping loose skin inside the body as well. Desperate with thirst, the victims can't drink; swallowing is just too painful.

Throughout it all, the victim remains fully conscious. A third or more of the victims die. Those who survive are often permanently scarred, or blind or both.

The electrician lived. But many who came into contact with him were infected. Several died.What was most frightening was how the virus spread. One victim spent only fifteen minutes in the hospital. All he did was ask directions, briefly opening a door that led to a corridor thirty feet from the patient's room. That was enough. He came down with smallpox.

Three other victims were even farther away -- two floors above the electrician's isolation ward. It was January, but tests revealed that opening the hospital windows just a crack allowed currents of air to drift between rooms on different floors. The virus had floated out the patient's window and along the outside wall; it then slipped into three different rooms two stories above, infecting patients in each room.

Seven years later, in 1977, Ali Maow Maalin also fell ill with smallpox. This time, though, it turned out to be good news.

Maalin was a cook from Merca, Somalia -- where smallpox was making its last stand. Vaccination was slowly tightening a noose around the disease. Because smallpox reproduces only in humans, widespread vaccination left fewer and fewer places for the virus to reproduce and spread.

The first vaccination for smallpox--or indeed for any disease -- came in 1796. That was when Edward Jenner realized that milkmaids who caught cowpox seemed to be protected from smallpox, to which cowpox was related. Jenner's vaccine based on cowpox marked the beginning of man's counterattack on smallpox. By the 1970s, vaccinations had gradually reduced the disease's natural range to the wilds of Somalia and Ethiopia.

The World Health Organization hoped to make Ali Maow Maalin the last victim of smallpox in history. It quickly vaccinated everyone who had been in contact with him, then held its breath. Would other cases flare up?

WHO waited.

A year.

Two years.


At last, after three years with no natural cases of smallpox, the World Health Assembly declared victory. It triumphantly called a special 1980 meeting.

"[T]he world and all its peoples have won freedom from smallpox," the assembly declared. This was "an unprecedented achievement in the history of public health." Together, the nations of the assembly had "freed mankind of this ancient scourge."

Copies of the virus were locked away in Atlanta and Moscow for research purposes, but the disease was gone from nature. Vaccinations stopped. Few Americans born after the 1960s have the dimpled scar on their arm that is the last trace of mankind's worst nightmare.

It had taken a bit less than two centuries for vaccination to free the world from "this ancient scourge."

Today, the likelihood that the world will remain free from this ancient scourge is close to zero.

Smallpox is back, or nearly so.

Within ten years, any competent biologist with a good lab and up-to-date DNA synthesis skills will be able to recreate the smallpox virus from scratch. Millions of people will have it in their power to waft this cruel death into the air, where it can feed on a world that has given up its immunity.

How can I be so sure? Easy. I've seen the same thing happen already, and so have you. The very same revolution that made possible the explosion of information technology--and set the table for network attacks--is now transforming biology, with consequences that are both exalting and frightening.

The same relentlessly exponential improvement in technology that gave us Moore's Law and that democratized the computer is now democratizing the technology of life. It is empowering an army of biologists to tinker with biology in ways that will help us all live longer and more comfortable lives.

And then, unless we do something, it will kill us in great numbers.

"Synthetic biology" blends biology, chemistry, and engineering. The field really began to take off when it moved from laboriously replacing a single gene to building whole stretches of the genome from scratch.

DNA is organized like a spiral staircase, and each step on the stairs is called a base pair. Linking base pairs together into longer sequences allows researchers to make more complex genes--and ultimately more complex organisms. So progress in synthetic DNA is measured by how many base pairs have been successfully strung together. In recent years, progress has been exponential.

In 2002, after a two-year effort, a team of researchers announced that they had assembled the entire polio virus. To do that, the team had to assemble 7,500 base pairs of DNA, precisely in order. The next year, scientists managed to knock years off the process, assembling a bacteriophage with 5,300 base pairs in just two weeks.

Two years later, in 2005, researchers' capabilities had tripled. A team managed to synthesize an influenza virus with 14,000 base pairs. Just a year later, they had surpassed that mark by a factor of ten, synthesizing the Epstein-Barr virus, with 170,000 base pairs.

Smallpox has 180,000.

By 2005, whether smallpox would be synthesized was simply a matter of choice, not of capability.

The following year, the outgoing secretary general of the United Nations, Kofi Annan, grew alarmed. He pointed to researchers' successes in building an entire virus from scratch and said, "In the right hands, and with the appropriate safety precautions, these are sound scientific endeavours that increase our knowledge of viruses. But if they fall into the wrong hands, they could be catastrophic."

Too late. By 2009, the state of the art had left 180,000 base pairs in the dust. A team of researchers announced that it had assembled a bacterial genome with 583,000 base pairs. Creating smallpox from scratch was no longer even an interesting challenge.

Nor were these capabilities confined to a few specialty laboratories. Foundries sprang up to sell made-to-measure DNA, at ever-declining prices that put Moore's Law to shame. Synthesizing DNA cost $10 per base pair when George W. Bush ran for president in 2000. By the time of his second inauguration, the price was $2 per base pair. When he left office in 2009, the price was down to about 25 cents. For those who don't want to use a foundry, DNA synthesizers are available for sale on eBay.

Kofi Annan was wrong. This technology isn't going to fall into the wrong hands. Just like jet travel and powerful computers, it's going to fall into everybody's hands. The Mayo Clinic. Hezbollah. Pfizer. Al Qaeda. Apple. Ted Kaczynski, Timothy McVeigh, and the Fort Hood shooter.

They won't need their own labs to build bugs to order. Even today, it's possible to obtain long sequences of synthetic DNA simply by sending a message to the private "foundries" that assemble DNA to order.

Struggling to survive in a new market with thin margins, the foundries' sense of responsibility for what they make is, well, limited. The Guardian newspaper in Great Britain demonstrated this when one of its journalists successfully ordered a lightly modified piece of the smallpox genome over the web. The order was mailed to his home, no questions asked. When a dozen foundries were asked whether they screened DNA orders to see whether they were providing sequences that terrorists could turn into weapons, only five answered "yes."

As many as half the foundries questioned by journalists did not routinely screen their orders to make sure that they were not helping terrorists construct a dangerous virus. The order came in, and they filled it, often with no questions asked.

If current trends continue, anyone who can get his hands on a computer virus today will soon be able to get his hands on a custom built biological virus.

And who can get his hands on a computer virus today? In an age of drop-down-menu malware attacks, the answer is simple.

Anyone who wants to.

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