Smallpox Vaccine Key Defense Against Attack
Nov. 8, 2001 -- A smallpox attack on the U.S. is by no means
certain -- or even likely. What is certain is that the nation isn't
fully prepared for this kind of catastrophe. Behind this truth lies a
little-appreciated fact that could tip the scales from mass terror to disease
This fact is that preparations begun prior to Sept. 11 lay the
groundwork for an effective response to a smallpox bioterror attack. We're not
there yet. But we're better off today than yesterday, and will be even better
There's a detailed plan for how to respond with today's limited
resources, according to officials at the U.S. Centers for Disease Control and
Prevention (CDC). Longer-term plans are in the works. Key parts of these mid-
and long-range plans -- readying millions of doses of smallpox vaccine and
training medical professionals -- already are underway.
"We have a smallpox plan that would come into play that the
states have also been reviewing, and have given us feedback on," CDC
Director Jeffrey P. Koplan, MD, MPH, tells WebMD. "It's operational today.
We could use it today if need be, but we are also trying to continue to improve
it with input from state-level health departments."
The key issue, of course, is how best to use the short supply
of smallpox vaccine now on hand. Who should be first to get the vaccine? Who
must be left unprotected?
"We're trying to get the states and local health
departments to think through that with us as that decision would get made,"
One decision has been made. The CDC announced this week that it
already is vaccinating first-response teams. These doctors, disease detectives,
and lab workers undergo training at CDC to identify and contain smallpox
outbreaks. They can be rushed to the site of a suspected case of smallpox, much
the same way anthrax first-response teams are sent to investigate suspected
Eradication of smallpox is one of civilization's greatest
achievements. It's hard to imagine how anyone could think of intentionally
bringing back this horrible disease. People, however, not only have thought
about it, but have developed weapons based on it. Reports from weapons experts
indicate that the former Soviet Union developed a smallpox weapon that would
release aerosolized smallpox from an intercontinental ballistic missile. Other
nations are thought to have had active smallpox weapons programs. It's not
clear whether any of these programs -- and their stocks of smallpox virus --
Efforts to put teeth into an international treaty that would
ban biological and chemical weapons would mandate open inspections of suspected
weapons laboratories. The U.S. continues to block these efforts -- even in the
wake of the recent anthrax attacks.