Erin Capina, 127 YinD

In 1966, the world declared war on smallpox, a virus that stalked humanity for thousands of years, and in the years that followed aggressive surveillance, containment and vaccination campaigns lead to smallpox being wiped out region by region. On December 9, 1979, the global eradication of smallpox was officially certified. Nineteen seventy-nine should have marked the end of smallpox but it did not.

Before eradication scientists around the world did research with smallpox virus in an attempt to figure out how to beat it and in the wake of eradication experts gathered to discuss destroying smallpox stocks in research labs but some experts balked at complete destruction, insisting that keeping smallpox alive in labs had scientific value. So smallpox continues to live on to this very day, officially it exists in two separate locations: Corpus 6 at Vector in Siberia and the Maximum Containment Laboratory at the Centers for Disease Control in Atlanta. However, as one of the smallpox researchers Peter Jahrling says, “If you believe that smallpox is sitting in only two freezers, I have a bridge for you to buy. The genie is out of the lamp.”
Richard Preston’s The Demon in the Freezer is the true story of how smallpox went from a feared disease found in nature to a feared biological weapon. Despite the scientific nature of this topic Preston writes in a way that is easy for a layperson to understand and does not bog down the reader with unnecessary technical jargon. To be quite honest, technical jargon often does a horrible job at conveying the seriousness of something since these words and phrases are only known to a particular group of people. Even as someone very familiar with medical and scientific jargon that populates the world of medicine and public health, I appreciated the fact that Preston made his writing accessible. So please do not be afraid to tackle this book if you are intimidated by medical and scientific terminology.

Unless you were alive pre-smallpox eradication you probably have no memory or knowledge about what smallpox can do to a person; so Preston details an outbreak of smallpox in Germany during the midst of the World Health Organization’s (WHO) global smallpox eradication program. If you are prone to hypochondriasis or medical students’ disease you might want to skim that portion of the book because Preston does describe what happens to a person on a biological level when he or she gets smallpox. Preston also describes what happens to a human who develops hemorrhagic smallpox, a nearly always fatal variety of smallpox, and after reading that section I was sufficiently disturbed. When the outbreak was finally contained it served as a lesson to people who plan for smallpox emergencies that smallpox virus particles can drift long distances infecting people who never had direct contact or even saw the original patient and that it can be difficult to tell who has smallpox in the early stages because the early symptoms are also the symptoms for any other diseases such as the flu. As disturbing as this section might be to readers I felt that it was necessary so that people can understand why smallpox was so feared before eradication and it shows readers why just regular smallpox can already be considered a devastating biological weapon.    

After the section on the smallpox outbreak in Germany, there is a brief history of smallpox and pox viruses in general. His main point is to illustrate that smallpox is an ancient disease that managed to haunt humanity wherever humans settled and proved that even in the early days humans saw that smallpox was an effective biological weapon. This leads to a discussion of the WHO smallpox eradication effort and Preston interviews key players in the program such as D. A. Henderson and some who worked under him. D. A. Henderson was the leader of the WHO smallpox eradication program; Preston even calls him the Eisenhower of eradication. As the eradication program won more and more victories in the fight against smallpox WHO formally asked all laboratories with smallpox virus to either destroy their stocks or send them to one of the two collaboration centers in America or Russia; the eradication team proved to be just as relentless in pursing this as they were in eradication. Preston ends this section by telling us that one by one the laboratories either send their smallpox stocks to America or Russia, had them destroyed  or claimed to have destroyed them.

For the rest of the book Preston details what is known about smallpox biological warfare programs. He talks with researchers knowledgable of biological warfare programs or those who work(ed) in the intelligence community. He focuses on strategic warfare programs developed in the Soviet Union because Russia is one of the official stockpiles of smallpox. Much of the information about the Russian strategic biological warfare program in this book comes from defectors. These being western scientists who had working relationships with Russian scientists or defectors, and others within the intelligence community with knowledge about these clandestine activities.

Preston writes how American and British scientists tried to get concrete evidence that Russia was producing weapons grade smallpox, to this day Russia officially denies such claims. However, the Western scientists interviewed for the book discuss how they saw Level 4 space suit rooms that had been stripped and sterilized showing indications of recent use. Biosafety level 4 agents are bacteria or viruses that can be fatal to humans and for which there are no known vaccines or treatments. Smallpox is considered a biosafety level 4 agent because it has been eradicated but is still contagious enough to require additional precautions. Special safety measures are taken to work in biosafety level 4 labs (personal positive pressure space suits, entrances and exits to the lab with multiple showers, vacuum and ultraviolet light rooms, etc.). Western scientists and outside agencies such as the WHO have never been able to fully inspect the Russian facilities that are allegedly part of the Russian biological warfare program nor have they been able to get Russian scientists to admit that they created tons of weapons grade smallpox but the few that Preston interviewed are confident that the program continued long after the initial allegations and possibly continues to this day.

There is a brief interlude where Preston discusses anthrax and its use as a biological weapon. I believe that this is because at the time of publication the anthrax mailings were in the news. Frankly, I think this interlude is unnecessary and does not fit the overall flow of the narrative. Preston tries to connect anthrax to smallpox by talking with researchers who say that if they were to create a biological weapon that could travel far but do the most damage ,they would mix smallpox with anthrax since the latter disperses easily into the air. While I do not doubt the validity of this claim I was more interested and invested in the story of smallpox and cared little for anthrax.

While much of the attention in the latter part of the book goes towards the attempts of verifying biological warfare programs in countries such as Russia or Iraq. Preston also discusses smallpox research within the United States. The smallpox vaccine was developed in 1796 and American smallpox researcher Peter Jahrling wanted to see if he could create new smallpox drugs by doing research on live smallpox. This move proved to be controversial because in order to create new drugs live animal models have to be used. As far as anyone knew at that time, the only species that could be infected with smallpox were humans. This move proved to be controversial, people involved in eradication such Henderson believed that this experiment was a fool’s errand. Why go through the trouble of creating a new vaccine for an eradicated disease when a vaccine already exists? The book ends with more unanswered questions about the future of smallpox in the age of genetic engineering. As researchers have said even if America and Russia were to commit today to destroy all stocks of smallpox and have independent agencies verify the destruction that does not guarantee the complete elimination of smallpox from the planet. In the summer of 2014 smallpox vials were discovered in a forgotten an unsecured National Institutes of Health (NIH) freezer. They were only discovered because the NIH was preparing to move and had to clean out its freezers, proving that smallpox can just as easily be the victim of human memory as it can be a victim of human ingenuity.  

Overall, I felt that this was a well written book with a gripping story. Readers familiar with The Hot Zone will not be surprised; Preston uses the same writing technique in The Demon in the Freezer as he did in The Hot Zone. Even though this book was published over 10 years ago the topic is still as relevant today as it was back in 2002. It is a warning of sorts, today scientists all over the world do research with viruses that are familiar to us, such as influenza. These familiar enemies may one day be the end of us. Humanity tried once to rid the world of smallpox but only partially succeeded. Despite the destruction, smallpox left in its wake managed to bewitch us into keeping it alive.