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Out of all of the possible organisms causing disease
and death, smallpox has been deemed one of the most serious biological
threats to the United States. This is largely due to smallpox’s
30% case-fatality rate - an ability to kill 30% or more of those
that come in contact with the virus - and its ability to spread
in any climate and season (1). This is not the first time smallpox
has been considered for use as a biological weapon. During the French
and Indian War in the 1700s, British troops initiated outbreaks
of smallpox to American Indians by distributing blankets that had
been used by smallpox patients. This caused the death of more than
50% of affected tribes (2). But when Edward Jenner discovered cowpox
protected against smallpox in 1796, the threat of smallpox diminished.
The last known case of smallpox occurred in 1977 and
in 1980 the World Health Assembly declared the world free of all
naturally occurring cases of smallpox. At that time, a World Health
Organization (WHO) committee decided that all laboratories should
destroy their stocks of the virus or transfer them to either the
Institute of Virus Preparations in Moscow, Russia, or to the Centers
for Disease Control and Prevention (CDC) in Atlanta, GA. Vaccine
production facilities were also taken apart.
Routine vaccinations have not been recommended for
over 25 years. Despite terrorist threats today, smallpox vaccination
is still not recommended for the general public. Since there are
no reported cases of smallpox, there is not a need to be vaccinated
against it (3). The CDC currently has 110 million vaccines for smallpox
and estimates that by the end of the year, they will have well over
250 million vaccines for emergency post-exposure vaccination. The
vaccine is not being administered because it does have some risks.
One person in 10,000 who receives the smallpox vaccine
will have serious side effects; which means that an estimated 350
to 500 people would die if everyone in the United States were administered
the vaccine (3). These numbers prove that at this time, the benefits
of the vaccine do not outweigh the risks for the general public.
The vaccine is only being provided to scientists and medical personnel
who work with smallpox-type viruses.
The Bush Administration is currently determining whether
or not to take the CDC’s suggestion for allowing emergency
responders; including first responder teams and some designated
hospital employees, to receive the smallpox vaccination (4). These
individuals have a greater chance of dealing with emergency situations
where patients may have smallpox. The decision should be made within
a few weeks.
Sources:
- Smallpox, http://www.hopkins-biodefense.org/pages/agents/agentsmallpox.html
- Smallpox as a Biological Weapon: Medical and Public Health
Management, http://jama.ama-assn.org/issues/v281n22/ffull/jst90000.html
- FAQ’s About Smallpox, http://www.bt.cdc.gov/DocumentsApp/FAQSmallpox.asp?link=2&page=bio#Q3
- White House smallpox vaccination policy announcement expected
shortly,
http://www.washingtonfax.com
- Vaccine Reaction Images,
http://www.bt.cdc.gov/Agent/Smallpox/VaccineImages.asp
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