The Ghost of Smallpox Past
Despite its being dead for 25 Years, the specter of a smallpox pestilence -- via terrorism -- haunts the public.
Nobody doubts that smallpox is a terrible disease. It kills
some 30% of people who get it, and leaves many more terribly scarred for life.
There's no drug that can cure the disease.
It's quite contagious but generally, direct and fairly
prolonged face-to-face contact is required to spread smallpox from one person
to another. Smallpox also can be spread through direct contact with infected
bodily fluids or contaminated objects such as bedding or clothing. Rarely,
smallpox has been spread by virus carried in the air in enclosed settings such
as buildings, buses, and trains, according to the CDC.
It takes about 12-14 days for infection to incubate -- and by
the time a person is ready to spread the disease, that person is very ill. Most
cases are spread at bedside. That's why smallpox should be treated at home or
in special facilities, not in hospitals.
Here's the most important fact. For about four days after
exposure to smallpox, a person can still prevent disease by getting vaccinated.
So if there is an exposure, public health officials have at least a week to
find people who are exposed and to vaccinate them. They have at least several
more days to find their close contacts and vaccinate them, too.
"Conventional methods of containment -- vaccination of
contacts and isolation of the ill -- work reasonably well," Bozzette says.
"Smallpox is a devastating disease. But it is not an instant killer. It
spreads slowly. An epidemic would build over months, and there wouldn't' be any
cases at all right after first exposure. It is scary, but it doesn't move like
Dangerous But Not Easy to Get
If this doesn't sound like the smallpox you've come to fear,
listen to Thomas Mack, MD, MPH, professor of preventive medicine at the
University of Southern California, Los Angeles. Mack led teams that traced some
100 smallpox outbreaks as part of the world war to eradicate the disease. He
uses the same words as Bozzette: Smallpox doesn't spread like wildfire.
"People greatly exaggerate the danger to the population not
directly affected," Mack tells WebMD. "It is more like a grenade than
like a dirty bomb. Once the initial wave of infections is over, mopping up is
relatively simple. It is hard work, but having a couple of weeks between
infection and symptoms makes it possible to respond. I won't say we can protect
the people hit in an initial attack. But even if the virus did get a lot of
people, we could still contain it. And it would be over in a matter of
Here's the bottom line. If you're worried about smallpox, talk
to your doctor about it. Find out about your risk from the vaccine. If you feel
it's worth it for your family's peace of mind and safety, learn how to get the
vaccine. In some areas you can sign up for clinical trials of a new, possibly
safer vaccine. And if you're willing to fill out the paperwork, you can get
unlicensed vaccine next year or wait to get licensed vaccine sometime in