http://www.nytimes.com/aponline/national/AP-Smallpox-Survey.html

Doctors Lack Smallpox Knowledge, Agency Finds

By THE ASSOCIATED PRESS

Filed at 4:17 p.m. ET

ATLANTA (AP) -- Doctors are poorly informed about the dangerous side effects of the smallpox vaccine and the government's plan to control an outbreak if terrorists release the deadly germ, a survey found.

The survey, commissioned by the Centers for Disease Control and Prevention, found that young doctors in particular -- those too young to remember the last human case of smallpox -- have relatively little knowledge of the disease.

The CDC hired a company last month to conduct one-hour interviews with 17 physicians in Philadelphia, Chicago and San Francisco. The findings were released Thursday.

The interviews revealed that many doctors mistakenly believe smallpox vaccine is as safe as common childhood vaccines, such as measles shots. In fact, smallpox vaccine can cause crippling and sometimes fatal side effects.

``This is not something doctors have received formal training on,'' said Glen Nowak of CDC's National Immunization Program, which ordered the survey. ``It highlights that we have some education challenges ahead of us.''

Smallpox was eradicated more than two decades ago. The U.S. and Russian governments hold small stockpiles of the virus, and some experts fear it could fall into the hands of terrorists seeking to kill thousands.

The government's plan in case of a smallpox bioterrorism attack calls for rapid isolation of any cases of the disease, with quick vaccinations of only those people believed to have come in contact with those victims.

There are no plans to carry out mass vaccinations, mostly because health officials worry about unnecessarily putting people at risk for the hideous side effects, which can include open wounds and gruesome rashes.

Most doctors interviewed in the survey at first were unfamiliar with this ``ring vaccination'' strategy, which goes against medical logic of vaccinating many people just in case.

``Ring vaccination hasn't been employed anywhere in the world in 20-some years,'' Nowak said. ``One of our challenges will be finding ways to provide busy doctors with information about a disease they may never see.''

The CDC's National Vaccine Advisory Committee is meeting this week in Atlanta to hear presentations on smallpox. Next month, the group will issue recommendations on whether the current vaccination strategy should be changed.

The three-city interviews were conducted April 15-24. They were conducted by the Oak Ridge Institute, a science survey group.

The survey also included 20 public focus groups, each with about eight people, to gauge how much work the CDC needs to do to correct misconceptions about the dangers of smallpox.

Blacks and Hispanics who took part in the focus groups told interviewers they were concerned that because of the ring vaccinations, minorities might not be protected as fairly.

During the anthrax-by-mail attacks last fall, black Washington postal workers complained that white Capitol Hill employees were getting better and faster antibiotics.

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