http://foxnews.com/story/0,2933,36866,00.html
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Smallpox Contigency Plan Revealed
WASHINGTON — A single case of smallpox would
trigger a federal emergency plan to vaccinate people close to the victim
while detectives retraced the patient's every step over the previous three
weeks. Despite the likely panic over a disease not seen in the
United States in half a century, the government would not resort to citywide
mass vaccinations unless absolutely necessary. The plan, obtained by The Associated Press, is a
long-awaited set of step-by-step instructions for state health workers who
would have to battle the highly contagious disease if bioterrorists ever
unleashed smallpox. The Centers for Disease Control and Prevention is putting
final touches on the plan, work that was accelerated after the Sept. 11
terrorist attacks in New York, Washington and Pennsylvania. Officials say
they consider the plan already operational, and have begun sending it to
state health departments, who are supposed to begin the requested
preparations now. Some government officials are raising the possibility of
one day resuming routine vaccinations of Americans against smallpox, which
kills three in every 10 victims. Mass inoculation ended in the U.S. in 1972,
almost a quarter-century after the disease last appeared in the United
States. The government has 15.4 million doses of smallpox vaccine
and hopes to buy an additional 300 million. "It is the intention to
determine, after we have sufficient supplies available to commence
inoculation, to make the decision at that time," Homeland Security
Director Tom Ridge said Thursday. But Tommy Thompson, secretary of Health and Human
Resources, said this week his department has no plans to implement a
mandatory vaccination program and cited horrendous side effects as the
principal reason. Chilling photographs in the CDC document show children
with severe, sometimes fatal, vaccine side effects, which illustrates why it
would be a difficult decision to renew routine inoculations unless smallpox
were to reappear. "You're always hesitant to immunize people against
the disease unless you're fairly certain that there is going to be a
risk," Surgeon General David Satcher said. The plan makes clear that the entire populations of cities
or states will not be vaccinated unless CDC has evidence of more than a few
cases. Instead, CDC will carefully apportion vaccine to family, friends,
co-workers and others in close contact with a smallpox patient, as well as
health workers and people who come in contact with a patient in a hospital. It takes fairly close proximity, within about six feet of
a person suffering the characteristic rash, to breathe in the smallpox virus
and catch the disease. Quickly vaccinating those who live with or work around
a patient is protective. But, "a single case of smallpox would require an
immediate and coordinated public health and medical response to contain the
outbreak and prevent further infection," the plan's opening page warns. Smallpox hasn't occurred in the United States since 1949;
the world's last naturally occurring case was in Africa in 1977. When smallpox
was declared eradicated in 1980, all research stocks of the virus were
supposed to have been contained at the CDC's Atlanta laboratory and a similar
lab in Russia. But the Soviet Union instead produced smallpox for their
biological weapons program in the 1980s, and bioterrorism experts fear some
may have spread to terrorist-sponsoring countries. Smallpox symptoms include fever and a pock-like rash all
over the body, which appears seven to 17 days after exposure to the virus.
People are contagious from the time the rash appears, particularly in that
first week of illness, until the scabs fall off. The CDC's emergency plan would kick in when a doctor
alerted state or federal health officials that a patient should be tested for
smallpox, a test that can be confirmed only at CDC or at the Army's Fort
Detrick, Md. If smallpox were confirmed, he or she would be quarantined
immediately. CDC Director Jeffrey Koplan would send vaccine from the
government's stockpile while alerting the FBI and White House. Disease detectives would grill the sick person and his
family about every step taken over three weeks before becoming ill. They also
would want addresses and phone numbers of every person who had close contact
with the patient. CDC then would have state health officials track down all
of those people, vaccinate those who needed it, and do daily monitoring of
whether they get a fever -- a sign they, too, might be sick with smallpox and
require quarantine. The plan instructs how to give the hard-to-handle vaccine.
It is made with a live version of a virus related to smallpox, and thus can
cause serious reactions in certain people, including people with faulty
immune systems or those with the skin condition eczema. The document pictures
a child covered in eczema-like lesions after contact with a recently
vaccinated sibling. The worst reaction is a very rare -- one in 300,000
vaccinated babies -- but deadly encephalitis. |
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