Bella Silverstein

By Bella Silverstein

Tired, achy, maybe a temperature and a sore throat; it starts out like the flu, and ends nine days later in the most horrible death known to mankind. Red blotches turn into hard, pus-headed pimples, clustered most thickly on the face and extremities. Within hours they'll coat the palms of your hands, the soles of your feet, your scalp, your mouth, your private parts, the lining of your rectum. They enlarge into boils; then your body becomes a mass of knob-like blisters. The pustules start to touch each other, then converge into confluent sheets that rip the skin off your body, inside and out. Your face detaches and becomes a pus-filled bag hanging on the tissues of your head.

Wait, there's more. And don't put down that coffee and doughnut, because with this disease, your appetite remains hearty right up to the end, despite your horrifying awareness of what is happening to you.

In its hemorrhagic form, your skin turns deep red and your face purplish-black. Thick, dark blood may drip or gush from your nose, mouth, rectum. Mouth membranes disintegrate. The whites of the eyes become blood red and grotesquely swollen around the corneas, making the corneas seem sunken inside of dark, red pits. Eventually the whites of the eye turn black.

There is no doctor or medicine that can do anything for you. The pain is indescribable. Unfortunately, you are not blessed with any kind of semi-conscious stupor. On the contrary, you are acutely conscious, in unimaginable pain, and terrified.

These are just some of the cheerful facts you'll learn in Richard Preston's new book, "The Demon in the Freezer," about the worst disease ever, one that's highly contagious and more devastating than the Bubonic Plague. In India it even has its own deity: the god of smallpox, also known as variola.

If you're old enough, a circular scar on one of your upper arms is a permanent reminder of the vaccine, which remained much the same thing in the 20th century as it was back when it was invented by Edward Jenner, in 1796. As vaccinations go it was pretty extreme; blood dripped down your arm afterwards. Thank goodness it's all a thing of the past, since smallpox was eradicated in the late '70s.

Except for a few small vials in freezers.

And the story of those few vials, as described by Preston, makes his riveting pre-eradication description of smallpox seem like a Sunday stroll in the park.

Smallpox happened 30 years ago, he reminds us; today, no one remembers or even understands how bad it is or how fast it spreads. Preston is convinced that it's only a matter of time. A bioterrorism event will happen, and it's a much more likely scenario than nuclear war. Although dropping the A-bomb would kill a lot of people, admits Preston, it would be limited to one area, albeit large. Dropping a smallpox bomb could bring the entire world to its knees.

If this nonfiction account reads like a thriller, it's with good reason: Preston is the author of "The Hot Zone" and "The Cobra Event," both New York Times bestsellers. He doesn't disappoint.

After the worldwide eradication of smallpox, it was debated whether variola, the demon of viruses, should be deliberately made extinct from the planet. Why not at least store some in freezers, to study its DNA? The thought of bioterrorism had not entered the collective consciousness in 1979, although the horror of smallpox was fresh in scientists' minds. If vaccines should ever be needed in the future, at least some vials, safely frozen, ought to be kept. Two smallpox repositories were designated by the World Health Organization (WHO), one in Moscow and one in Atlanta, at the Centers for Disease Control. We know now this was the wrong decision.

After the Soviet Union fell apart, Russian scientists illegally moved vials of smallpox to Vector (the State Research Center of Virology and Biotechnology near Novosibirsk, Siberia) without the permission of the World Health Organization. They lied about it to WHO and to the United States. Credible evidence exists, says Preston, that some of those vials found their way into the hands of scientists from countries like Iran and Iraq, and elsewhere. Currently there is no way to know how many vials exist, where they are hidden, or who has them.

But that's not the scary part. The scary part is what can be done with them these days.

Genetic engineering has given us more than great, fat, insect-resistant vegetables and hoaxes about cloned babies. It has also given us the power to make a virus more "energetic" and "hotter." In other words, we can now create a superpox.

"Energetic" refers to the contagious quality of a virus, its ability to disperse, travel, and spread more speedily from host to host. For example, smallpox can be made finer, more powder-like and invisible, easier to distribute, harder to detect. From just sitting like a lump in the bottom of a test tube, it can be made to "climb the walls" of the tube and spill out over the edge, seeking new horizons.

"Hotter" is science slang for a virus that's more virulent, more infective, more lethal than that found in nature. By splicing one human gene, for instance, into the variola virus's DNA, smallpox can be made to deactivate the entire human immune response the moment it infects a person, thus blasting through any vaccination the person might have.

We'd like to believe this is rocket science, something not within the capabilities of third-world crazies. But viruses are the easiest life forms to genetically engineer. Preston shows us how any smart grad student could do it, using publicly available books and ingredients easily obtained from places like the Internet and Home Depot.

It would take about five months to do, and cost about a thousand dollars per strain. "Virus engineering is cheaper than a used car, yet it may provide a nation with a weapon as intimidating as a nuclear bomb," says Preston. The Chinese believe that Russia already has a superpox, a genetically modified and weaponized strain of, you guessed it, smallpox.

"The virus's last strategy for survival was to bewitch its host and become a source of power," says Preston. We wiped it out, and now it's back in the headlines, lurking silently in the shadows alongside Ebola and anthrax. Who knows what evil lurks in the hearts of men? Richard Preston knows, and this book will make your skin crawl. If only he had stuck to fiction.

"Demon in the Freezer" by Richard Preston, Random House, 240 pages, $24.95.