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Smallpox Vaccine Key Defense Against Attack

WebMD Health News
Reviewed by Gary D. Vogin, MD


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 control.


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 off tomorrow.


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," Koplan says.


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 anthrax exposures.


The Threat


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 -- still exist.

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