Tuesday, January 28, 2003

BY ANGELA STEWART AND KEVIN COUGHLIN
Star-Ledger Staff

As New Jersey bioterrorism experts prepare for the worst, a Hoboken man has some words of hope.

There is life after smallpox.

Sometimes.

"I don't know why they're making it such a big thing," said Rajnikant Amlani, 62, who survived smallpox as a boy in India.

The state plans to start smallpox vaccinations for public health workers on Friday, when 100 people, including state epidemiologist Eddy Bresnitz, are scheduled to get the immunization. Today, state officials will train 50 vaccinators on how to give the smallpox vaccine.

It's all part of a controversial federal program. New Jersey hasn't lost anyone to smallpox since 1914, and the world's last natural case of smallpox occurred in Somalia in 1977. In rare cases, the vaccine itself can be fatal.

But smallpox, the disease, is far deadlier, typically killing a third of its victims. With the threat of war in Iraq fanning bioterror fears, the federal Centers for Disease Control and Prevention is urging inoculations of key health volunteers.

Amlani said he never will forget the scorching fever and red, itchy, rash that nearly drove him crazy as a boy of 7 or 8. Several of his six siblings caught the disease, too.

"In India, it was very common," said Amlani, a medical technician at Hoboken's St. Mary Hospital. He came to America in 1970 and has two grown children.

Smallpox has no cure. You survive, or it kills you.

Amlani recalls herbal treatments.

"I had to be put in a room by myself at home," he said, noting the disease was highly contagious. He missed weeks of school.

Yet common as smallpox was, Amlani didn't know anyone who died from it. And he escaped the gruesome scars that mark many of his friends who survived the deadly virus.

"I never really considered it dangerous," said Amlani.

Officials from the state's 85 acute-care hospitals have been calling the New Jersey Hospital Association with questions about the vaccine, and about legal protections and health coverage for immunized workers who become ill or infect others.

"As people step forward to participate in the program, they want assurances they will be afforded some protection," said Valerie Sellers, the association's senior vice president for health planning and research.

State health officials met yesterday with more than 300 hospital personnel and regional epidemiologists from county health departments to brief them on potential adverse effects of the vaccine and what medications may be used for treatment.

Across the state, some hospitals have been coming up with dozens of volunteers, only to find out later through screening that many of their employees are not eligible.

The vaccine is not recommended for people with skin problems, such as eczema, or those with weakened immune systems from HIV, organ transplants or cancer. People with close family members in those categories should avoid the vaccine, too.

In addition to the first wave of health care workers, the state is also planning to immunize as many as 200,000 police, firefighters and emergency medical personnel, but that will not likely occur before spring.

Because Amlani has had smallpox, he is immune now.

But one of his colleagues at the hospital, emergency room doctor Achyut Gandhi, is ready to be re-immunized.

He treated smallpox victims in India in the 1970s and doesn't take the disease lightly.

"It's better to be prepared than be caught unaware," Gandhi said.