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CDC's Monkeypox Plan Offering smallpox vaccine

By Delthia Ricks

STAFF WRITER

June 12, 2003

In a bold response to the monkeypox outbreak, federal health officials yesterday recommended smallpox vaccinations for anyone exposed to the monkeypox virus, imposed an embargo on the sale of prairie dogs and banned the importation of six species of rodents from West Africa.

The government's action comes in the wake of 54 possible cases of human monkeypox in four states in recent days. No one has died of the disease. The outbreak was triggered by infected prairie dogs captured in a burgeoning trade of exotic pets. Infected rodents were shipped to more than a dozen states since April 15, federal health officials said yesterday.

"We cannot confirm there has been any movement of infected prairie dogs into New York at this time. That's something we're still trying to get our arms around," said Llelwyn Grant, spokesman for the Centers for Disease Control and Prevention.

Smallpox vaccine, medicine's riskiest inoculation, is the only treatment available to stave off a full-blown case of monkeypox, federal health officials say. The inoculation can prevent infection within a range of a few days to two weeks after exposure.

Federal vaccine experts who gathered in an emergency session this week decided it was prudent to offer the vaccine in the new outbreak and to make the inoculation available through state and local health departments. The vaccine recommendation and ban on the animals were announced by Health and Human Services Secretary Tommy Thompson as a major step toward stopping the outbreak's spread.

Thompson said the current monkeypox outbreak is considered an interstate problem that requires the use of federal authority.

"The current outbreak of monkeypox in humans has the potential to pose a threat to public health in the United States," Thompson said in a statement. "Today's action is an important step we must take in order to help prevent further spread of this virus."

CDC officials say the vaccine is being offered only to those in need of protection and to those who have had confirmed exposure to infected animals. That would include animal handlers, outbreak investigators, pet store owners, veterinarians and pet owners. The inoculation also is being offered to pet owners exposed to infected animals even if those people may be considered at high risk of vaccine complications. Such people would include children and pregnant women. The live-virus inoculation can cause a potentially fatal infection, can lead to miscarriages and in rare instances can cause brain inflammation. The vaccine carries a 1 in 1 million chance of death.

"We feel the risk of the disease is sufficient to make that recommendation," Dr. David Fleming, deputy director for public health at the CDC, said in a news briefing. Fleming said the vaccine is 85 percent effective in preventing monkeypox and that supplies of the vaccine are sufficient in all states because of stockpiling for preparedness against bioterror.

Monkeypox, smallpox's milder cousin, mimics many of smallpox's symptoms, such as fever, rash and pus-filled blisters. It has a mortality rate ranging from 1 percent to 10 percent, based on studies in Africa.

The vaccine has been at the center of a controversial Bush administration plan to inoculate thousands of health care workers. Its new - and substantially more limited use announced yesterday - marks the first time the vaccine is being used to inoculate the public since routine vaccinations ceased in 1972.

Meanwhile, Fleming said, federal health officials are still trying to determine the extent to which infected prairie dogs were shipped around the country. Yesterday, health investigators cited a growing cottage industry in the capture and sale of prairie dogs, rodents indigenous to the nation's Great Plains.

Health officials speculate the animals may have been penned near giant Gambian rats - another species of exotic pets - that may have carried the virus. Six rodent species were imported from Africa in recent months, and have since been sold in the United States, officials said. The CDC is investigating which species of rodents imported from Africa may be playing a role in the outbreak.

Dr. Julie Gerberding, the CDC's director, said in a statement yesterday that the agency is prepared to do everything possible to protect the public from the new viral threat. The virus is one of several unusual pathogens, she said, that have appeared in recent years and have caused human disease.

The virus is common throughout parts of Africa and has been detected in squirrels and other small rodents. Monkeypox infections have been widely diagnosed in humans throughout parts of Africa.

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