Variations on Variola (review)

Smallpox, the sole infectious disease to have been globally eradicated, remains a topic of continuing interest for reasons of historical importance and bioterrorism threat. Only two nations—the United States and the former Union of Soviet Socialist Republics—were authorized to retain reference samples of the live virus after eradication in 1980, but it has long been rumored that up to seven nations still secretly keep virus stocks. Routine vaccination in most nations ended by the early 1970s, leaving a largely susceptible world population today. In the meantime, the entire smallpox genome has been sequenced, confusing traditional concepts of eradication.

Smallpox is thus important not only to historians but also to scientists, physicians, policymakers, antiterrorism experts, and the public, few of whom have ever seen a case or dealt with the many related medical, public health, and social issues. There is an obvious need for easy access to smallpox information and at different levels of comprehensiveness and complexity. Examination and comparison of five existing Web sites offering smallpox information is discussed below.

All of the Web sites examined contain useful information for readers without scientific or historical training. Among the most interesting is the Wikipedia site, which offers seventeen well organized pages addressing history, epidemiology, virology, clinical medicine, eradication, and biological warfare. The site's links to additional resources could be better, a problem largely offset by the inclusion of seventy-two references, many citing valuable scholarly works. A unique feature of the Wikipedia site is the availability of information in forty-three different languages as diverse as Lietuvių and Esperanto. However, many of these non-English articles are considerably abbreviated yet fitted out with additional information not in the English original, for example, in the six-page French entry (variole) and the five-page German entry (Pocken). Some of the additional information would have improved the English language article.

The BBC site, based partly on a 2002 television show, offers a standard and anglocentric "history lite" discussion filed under (British) "Empire and Seapower" but also links to the authoritative 1988 WHO publication discussed below. The BBC site seems best suited to early teenage readers whose imagination can be captured by personal stories and photographs (none graphic or unsuitable for children). As might be expected, the Wellcome Trust Centre Web site information, though brief, focuses on history and includes several interesting images (one possibly unsuitable for some small children). The focus here is on modern history, especially eradication efforts in the mid-twentieth century. An internal link to "Global Smallpox Histories" seemed promising but revealed only a pledge of future expansion.

None of the above three sites contains information useful to the professional historian, but all have something to offer students and the public. Of possible interest to historians are the U.S. HHS and the WHO Web sites, each of which contains internal links to valuable smallpox-related documents. For example, the WHO site links to a World Health Assembly publication on destruction of virus stocks and to information on preparedness for bioterrorist-caused smallpox outbreaks. Further navigation within the WHO system reveals much more of interest, but this is not obvious from the site page. The HHS site is organized in a unique and useful manner: by affiliation/status of the site visitor, for example, military, laboratory professional, media, clinician, public health official, and even "kids." Under each of these categories are links to other sites, mostly at the U.S. Centers for Disease Control and Prevention (CDC). Although the HHS Web site suffers from its general exclusion of discussions beyond public health issues, its monochromatic "CDC speak," and its structure as merely a tree of links to other sites, it has the great advantage of allowing visitors to rapidly...