This gripping narrative traces the history of the efforts to eradicate smallpox in the 1970s, the top-level decisions to keep a few vials of it for emergency purposes in American and Soviet freezers, and the reemergence of smallpox not only as a health threat, but as a potential bioweapon of unequaled destructive power. Preston details maverick natural cases that surfaced after worldwide eradication efforts, how it was discovered that undocumented reserves of smallpox were not only being kept, but researched and possibly "weaponized," and how hotly, in the US, teams of scientists and military intelligence personnel debated funding new smallpox research in the US with a view to developing a new vaccine as a defense.
The ethical issues in those debates are unprecedented in the scope of the possible public health threat and the variables that might make traditional vaccination ineffective against the weaponized virus. As in his previous books on biological threats, The Hot Zone and The Cobra Event (see annotation), Preston follows the work and lives of several key scientists and includes scenes from interviews with a variety of persons involved in confronting the political, ethical, and medical dilemmas posed by smallpox research and efforts to track and control it.
The threat of biotechnological warfare and/or terrorism is the focus of this carefully researched and riveting novel by the author of The Hot Zone. The term "science fiction" doesn't quite do justice to this tale which lies just to the other side of Preston's usual domain of literary nonfiction. Though the particulars of this story of a genetic engineer who designs lethal virus bombs to thin the population and the counterterrorist group of scientists who attempt to stop him are fictional, the possibilities of such threats are real.
The counterterrorists are a motley and sometimes contentious group of recruits from the FBI, the Centers for Disease Control (CDC), and the U.S. military. Their agendas and methods differ, but the immediate death threat to the unsuspecting inhabitants of New York and Washington D.C. unifies them into an effective if not always efficient team. They discover the virus when five cases appear of what seems to be an acute and horrifying permutation of a rare neurological dysfunction that induces violent seizures and compulsive self-destruction by chewing on one's own flesh. The virus turns out to be a graft that could only have been produced by artificial means.
The search for the "mad scientist" with equipment capable of this sophisticated work takes weeks during which a handful of people have to live with the secret that a potential pandemic could literally explode in a local subway. The resolution, while in some ways satisfying, hardly dispels the uneasy implications which invite readers not only to serious reflection on our collective attitudes toward weapons research and development, but to activism.
