Dr Zdenek Jezek - doctors will be in frontline of defence against bio-terror

My guest on this week's programme is Dr Zdenek Jezek, one of the Czech Republic's leading epidemiologists. He was the leader of the World Health Organisation team which announced to the world in 1980 that smallpox had finally been eradicated, ending centuries of misery and death for millions of people around the world. Few people have stared death in the face as often as Dr Jezek - in his long career he's watched thousands of smallpox victims die before his eyes. And few people can better understand the horror that could be unleashed by biological weapons, a term which we've now become used to hearing almost every day. When Dr Jezek visited the Radio Prague studios, I began by asking him why he'd decided to pursue a career in medicine.

"Actually I must say it was literature that attracted me to the study of medicine. Especially the books of the U.S. author Paul de Kruif such as 'Microbe hunters' and 'Man against Death', which were written sometime in the 1930s. It was also Victor Heiser and his 'An American Doctor's Odyssey'. And I must say I was also fascinated by the life story and achievements of Albert Schweitzer, who got a Nobel Prize in 1952. This was the same year I started my studies at Charles University in Prague."

Why the field of epidemiology?

"Yes, it's a little complicated. As you may know, at the end of the Second World War there were three armies operating on the territory of Czechoslovakia and many sick prisoners from Nazi concentration camps left these camps and mixed with the population. Therefore infectious diseases became a great health problem in the country. So at that time, public health and epidemiology attracted many Czech medical students."

You're best known as the man who led the World Health Organisation team that eradicated smallpox.

"Yes. In the past, smallpox was of great concern to all countries, because it could spread anytime and anywhere. Variola - variola is the Latin expression for smallpox - was the most feared of all infectious diseases. The history of smallpox was a saga of deaths, blindness and disfigurement. Even at the end of the 60´s variola affected yearly about 10 million people, 2 million died and many others were blinded and disfigured. Thanks to the World Health Organization I had the honour to participate for more than 15 years in the eradication of smallpox. In May 1980, the World Health Organization declared: 'smallpox eradication has been achieved worldwide'."

You've travelled widely around the world: what was your most wonderful and most depressing experience as a doctor?

"Actually, I must say the most wonderful occasion for me - as you can imagine - was to wipe up the last smallpox focus in the world and to see the last naturally infected case of smallpox. This was a very young, 23-year-old-cook, Ali Mao Maalin. It happened in October 1977 in the small port of Merca in southern Somalia. The most depressing experience in my work was to see thousands of victims of smallpox passing away, especially small children."

Of course the word "smallpox" has a special resonance at this moment in time, because it is alleged that smallpox is among the biological weapons which Saddam Hussein allegedly possesses. Do you think Saddam Hussein does have biological weapons, and that he is capable of launching an attack on his neighbours or even Europe?

"This needs a little explanation. As you probably know, from the 1980s it was known that Iraq had been developing biological weapons. After the Gulf War, it was learned that the Iraqi bio weapons programme was substantially larger and more advanced than expected. In 1996, as far as I know, the UN inspectors identified and destroyed Iraq's principal biological warfare facilities, but I doubt that all of them were identified and destroyed."

How much would he need to kill thousands, or hundreds of thousands of people?

"Imagine. His biologists were able to produce 20,000 litres of botulotoxin. Normally, one milligram of botulotoxin can kill 16,000 people. So you can imagine what he has in his hands. It is very probable that some facilities could remain hidden and intact. If this is so, then today Saddam Hussein may be able to launch a biological attack on his neighbours. But, I do not believe he will do that. If there is war in Iraq, then the progress of military operations will be so fast that Saddam will have no advantage from using biological weapons. Let me explain: the results of a bio-attack are delayed usually for days or weeks. It will be too late for his army. On the contrary, by using chemical weapons the results of an attack can be seen immediately - usually in minutes to hours after an attack. This may be the right option for Saddam. And furthermore, Iraq's army has substantial experience with chemical weapons, as they used them in the Iran-Iraq war and in Kurdish villages."

You are someone who's devoted his life to stamping out an awful disease, and indeed other diseases. Dictatorships such as Iraq and maybe other countries have developed ways to use these diseases to kill hundreds of thousands of people. How does that make you feel, as the man who helped eradicate smallpox?

"I am really scared. I am scared not of biological war, but of biological terrorism. I think this maybe even the option for Saddam Hussein, to support bio-terrorist groups. These terrorist groups are getting sufficient resources, and they can purchase the pathogens and transport them across the borders to any place in Europe or in North America. Now, to prevent bio-terrorism seems to be extremely difficult as the detection of those intending to use germs seems impossible. The first evidence of a bio-attack will be cases in medical emergency rooms. Physicians will constitute the front line of biological defence. The rapidity with which they reach a proper diagnosis and the speed with which they apply preventive and therapeutic measures will be crucial. They will decide whether there will be tens, hundreds, thousands or hundreds of thousands of victims."

Hopefully that scenario will never come true, but Dr Zdenek Jezek, thank you very much for coming in.

"Thank you very much for your invitation."