He who prepares a defense where the enemy will not attack, and leaves vulnerabilities open to attack, hastens the downfall of his own country.

There are two aspects to the risk/threat of bioterrorism.

The first is the capacity of the terrorists.
The second is the impact of the act.

A terrorist who used small pox, would also be killing the people upon whose support the terrorist depends.

The government and people of the United States could contain the spread of the disease, within a year under a worst case scenario.  The people of less developed countries would be likely ravenged by the small pox virus, which eventually would infect most of these populations.  Under a worst case scenario we might lose two thousand (2,000) people, in the United States.  In places, like Indonesia, the number would probably run into the millions (1,000,000's).

If the al Qaeda puts in an order, with the one or two firms that make the inoculation for small pox, we might have reason to worry.

Yet, the first problem would be for the terrorist to get the small pox.

Who would sell small pox to a terrorist?

If someone came up to you and offered you a million dollars for something that is as liable to result in your own death, and to everyone you love, and in a death sentence besides, when you are tracked down, would you take the money?

Let's say that the terrorist buys a vial, that reads, small pox virus.  Is it real or a con?  The only way to know for sure is to test it.  To test it you need a hermetically sealed room with effective biofiltering and a test subject....

Once confirmed that is was small pox, then you would need to test your vaccine.  So you get more test subjects.  Then you need to repackage the virus.  And distribute the vaccine, without word getting out.

Of all terrorist organizations, only the al Qaeda terrorist network had the financial capacity to attempt to engage in these kind of actions.  And there is no evidence, thus far presented, that they went after small pox.

It is extremely unlikely that terrorists will or are cappable of engaging in these actions, that are just as likely (and perhaps more likely) to bring to harm to their supporters, than to those they regard as the enemy.
 

The Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons of Mass Destruction-- "The Smallpox Issue"

"Members of this panel are well versed in the risks posed by smallpox. Those risks-though real but, according to most experts in the field, admittedly of extremely low probability-do not justify the current reaction. A dispassionate approach is in order.

In the view of experts on our panel and others with whom we have consulted, #108 it is not necessary and may not be advisable to vaccinate the entire U.S. population before an outbreak.

The strategy of "circling" or "ringing" cases with vaccination for the adjacent population was the basis for the global eradication of smallpox and is a logical basis for responding to a biological attack. A smallpox vaccine produces virtually complete immunity after a single inoculation and is effective even when given two to three days after exposure.

Sounds arguments can be made for vaccinating "emergency responders" in communities across the country, as a preemptive measure. There are currently, however, statistically significant risks in vaccinating millions of Americans before an outbreak. While the percentage risk is small, vaccinating 300 million people would likely result in a 300 to 600 deaths just from reaction to the vaccine. That figure does not take into account those who may be at risk from immunodeficiencies, such as victims of HIV.

More research is required to develop a vaccine without adverse side effects.

Deliberate planning is required for the potential vaccination of large segments of our population if an outbreak does occur, including prudent increases in the stockpile of vaccines, storage and distribution, the physical aspects of vaccinating vast numbers of people, and related legal authorities. #109

Such plans, when developed, must be exercised.

#108 Including Dr. William Foege, who helped eradicate smallpox.
#109 See draft Executive Summary for CDC Interim Smallpox Response Plan and Guidelines, at Appendix T.
page 57
http://www.rand.org/nsrd/terrpanel
 

Interim Smallpox Response Plan &  Guidelines
http://www.cdc.gov/nip/smallpox/

CDC -- Smallpox News
http://www.cdc.gov/nip/smallpox/News.htm

Incubation of the virus is 9-13 days during which time the infected person becomes ill.
An individual, who is infected with small pox, does not readily transmit the virus until after incubation, and the development of the pox itself.
 

"Just over 70% of these cases incubated 9 to 13 days, with an average of 11.5 days (range 7 to 19 days; median approximately 11 days; 5th percentile 8 days; and 95th percentile 14 days). Others have observed similar lengths of incubation. For example, by examining the time between onset and "brief and only possible contact with a known case," Singh (18) determined the possible length of incubation of six cases of smallpox (mean 11 days; median 12 days). Rao (6) used data from 50 first-generation cases to determine that the mean "fever-to-fever" (i.e., onset of fever to onset of fever) interval was 16 days (range 12 to 21 days for 80% of cases).

Modeling Potential Responses to Smallpox as a Bioterrorist Weapon
http://www.cdc.gov/ncidod/EID/vol7no6/meltzer.htm

See also:
Smallpox: An Attack Scenario
http://www.cdc.gov/ncidod/EID/vol5no4/otoole.htm

And:
Modeling Potential Responses to Smallpox as a Bioterrorist Weapon

  "We constructed a mathematical model to describe the spread of smallpox after a deliberate release of the virus. Assuming 100 persons initially infected and 3 persons infected per infectious person, quarantine alone could stop disease transmission but would require a minimum daily removal
rate of 50% of those with overt symptoms. Vaccination would stop the outbreak within 365 days after release only if disease transmission were reduced to <0.85 persons infected per infectious person. A combined vaccination and quarantine campaign could stop an outbreak if a daily
quarantine rate of 25% were achieved and vaccination reduced smallpox transmission by >33%. In such a scenario, approximately 4,200 cases would occur and 365 days would be needed to stop the outbreak. Historical data indicate that a median of 2,155 smallpox vaccine doses per case were given to stop outbreaks, implying that a stockpile of 40 million doses should be adequate."
http://www.cdc.gov/ncidod/EID/vol7no6/meltzer.htm

A Final Word -- Anthrax was used to kill five innocent persons, including a ninety-four year old Connecticut Woman.  Additional cases of cutaneous anthrax have infected numerous individuals including a seven month old baby in New York City. The antrax appears to have been distributed, by the US Army, to a researcher, who, after seeing the events of 9-11, determined to distribute the anthrax in order to profit.  Now, there is an effort to conduct small pox research.........

US Anti-terrorism Threat/Risk Policy
Mitigating Risk/Threat of Terrorism and Other Risks
The risk/threat of bioterrorism -- Small Pox as a Weapon of Mass Destruction
The Disaster Center

Christopher Effgen
host@disastercenter.com
January 31, 2002