On Thursday, May 16, 2002, NBCs E.R. TV show aired a 2-part season finale
with a storyline that focused on a suspected case of smallpox at the fictional
Chicago hospital. Briefly, a U.S. family living abroad returned to the United
States, and the children were brought to the emergency room with symptoms that
included a rash that was initially suspected to be smallpox.
As in real life, the ER physicians first notified local public health
officials about the suspicious rash illness, and, in turn, the public health
officials determined it was appropriate to notify the CDC. A CDC team was called
and sent to the hospital with smallpox vaccine. While health officials waited
for the CDC to determine if the childrens illness was smallpox, the hospitals
emergency room was closed and quarantine procedures were activated.
E.R. is a fictional television show that dramatizes medical and health
emergencies. Storylines like the one in the E.R. episode can serve to heighten
public awareness about smallpox disease (e.g., symptoms, vaccine,
etc.) and the need for public health systems that can effectively address a
smallpox emergency, if the need should ever arise.
Smallpox
Smallpox is no longer naturally occurring anywhere in the world. The last
natural case of smallpox occurred in 1977, and in 1980, the World Health
Organization (WHO) declared the global eradication of smallpox and recommended
that all countries cease vaccination. The U.S. government currently provides the
smallpox vaccine only to a few hundred scientists and medical professionals who
work with viruses related to smallpox.
Bioterrorism preparations
There are concerns that the smallpox virus could be used for bioterrorism.
The risk for smallpox occurring as a result of a deliberate release by
terrorists is not known, but is considered very low. On May 8-9, 2002, a joint
working group consisting of members of the Advisory Committee on Immunization
Practices (ACIP) and the National Vaccine Advisory Committee (NVAC), two groups
that provide recommendations to the CDC and Department of Health and Human
Services (DHHS) on vaccine use and policies, met in Atlanta as part of their
review of the current smallpox vaccine recommendations. This working group was
convened to review the June 2001 ACIP recommendations on smallpox vaccination in
light of recent events, including the expected availability of about 286 million
doses of smallpox vaccine by the end of the year. This stockpile would be enough
to protect every United States citizen, if needed.
Public comment forums
The ACIP-NVAC review will also involve four public forums that will be held
in June to solicit feedback and information on the use of smallpox vaccine from
healthcare providers, public health departments, and emergency responders,
policymakers, community-based organizations, other non-governmental
organizations, and the general public. The forums will be held
June 6, 2002, in San Francisco and New York
June 8, 2002, in St. Louis
June 11, 2002, in San Antonio.
Any interested individual can attend these meetings to provide their comments
and suggestions regarding the use of smallpox vaccine.
Following these forums, the ACIP will convene in Atlanta on June 19-20, 2002,
to discuss and review information provided from the working group and the public
forums. Then, if needed, the ACIP will make modifications to the 2001
recommendations on smallpox vaccination.
Additional information
More information about smallpox is available online at the CDC Public Health
Emergency Preparedness and Response site.
You can also contact the CDC Public Response Service (Monday-Friday, 8 am-11
pm; Saturday-Sunday, 10 am-8 pm) for free health information and referrals
related to bioterrorism and emergency preparedness, smallpox, anthrax, botulism,
and other biological and chemical agents.
Phone: 888/246-2675 (English)
888/246-2857 (Spanish)
888/874-2626 (TTY)
E-mail: cdcresponse@ashastd.org
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