Posted on 11/03/2001 2:49:26 PM PST by samtheman
ATLANTA, Nov. 3 — The government has begun taking steps to cope with the possibility of a terrorist attack involving smallpox by training doctors to recognize the disease and by vaccinating small teams of experts who would rush to any part of the country to contain and treat a suspected outbreak.
Officials at the Centers for Disease Control and Prevention, which is taking the steps, say they have no evidence that anyone is readying a terrorist attack using smallpox, a disease that was eradicated worldwide 21 years ago. But they say smallpox is so deadly that it is important to prepare for any attack.
The smallpox virus is known to exist only in laboratories in the United States and Russia. But germ warfare experts suspect that other countries, including North Korea and Iraq, may have secretly obtained stocks. It is greatly feared as a weapon because it is contagious and has a high death rate. And much of the world's population is susceptible.
Last week, the disease centers vaccinated about 140 members of epidemiologic teams that can be summoned at a moment's notice to examine a suspected case anywhere in the country.
This week, the centers will begin a series of training courses in smallpox for certain of its own employees and state and local health workers. Additional courses will be held over the next several weeks at the federal agency's headquarters here.
The vaccinations and course are part of a broader effort by health officials to respond quickly to any new bioterrorism threats that might follow the recent deliberate spread of anthrax through the mail.
"Our concerns are not limited to anthrax," said Dr. James M. Hughes, who directs the federal agency's center for infectious diseases. Those concerns include diseases like botulism, plague, tularemia and smallpox.
Smallpox is of particular concern because of its potential to spread quickly. In a military exercise this past summer called Dark Winter, researchers conducted a simulated smallpox attack on Oklahoma City. The epidemic quickly soared out of control, spreading to 25 states and millions of people.
Tens of millions of Americans under the age of 30 are susceptible to smallpox because they were never vaccinated; the United States stopped smallpox immunizations in 1972. Tens of millions of older people who were vaccinated decades ago are thought to have decreased protection because the vaccine may have worn off.
Another major concern is that generations of American doctors have never seen a case of smallpox. The only ones who have are a few hundred doctors who participated in the World Health Organization's smallpox eradication program decades ago.
Smallpox patients are usually quite sick. The infection is characterized by a rash and a fever of at least 102 degrees. The rash and symptoms begin to develop 11 or 12 days after a person is exposed to the virus. The characteristic lesions can occur anywhere on the body, but they usually appear on the face first, and they tend to appear more on the arms and legs and less on the chest, abdomen and back. Palms and soles are favorite areas. The earliest lesions tend to appear as raised bumps that often contain fluid. Over a period that can last as long as 19 days, the lesions become firm, filled with pus, and then form scabs. The illness can leave its victims blind and scarred.
Smallpox can be confused with chickenpox. In making the diagnosis, a doctor touches the skin. Smallpox lesions tend to feel as if they are deep in the skin, in contrast to the lesions of chickenpox, which feel superficial. Chickenpox itches; smallpox lesions can be very painful.
But because the earliest stage of smallpox can resemble rashes caused by many other diseases besides chickenpox, identification can be difficult without laboratory tests.
Since smallpox was eradicated, the centers have sent epidemiologists to investigate suspect illnesses a few times a year. Dr. Hughes said that the centers had already dispatched smallpox experts on short notice three times in the last month to evaluate specific cases.
None of the patients had smallpox. Instead, they had problems like allergic rashes or shingles, an illness in adults that is caused by the same virus that caused chickenpox early in life.
Dr. Jeffrey P. Koplan, the director of the disease centers, said that his agency expected false alarms as a necessary part of the efforts to encourage doctors to heighten their suspicion of anthrax, smallpox and other so-called exotic diseases.
Dr. Koplan likened the extra caution to programs that encourage patients with chest pain to seek medical attention to determine if they are having heart attacks. Many patients who are admitted to coronary care units turn out not to have had heart attacks.
Even doctors who have seen smallpox cases have been wrong. Doctors at the disease centers misdiagnosed a case of chickenpox as smallpox in Washington in the mid-1960's. And earlier this year, epidemiologists at the centers responded to a call from health officials in a Central American country where a missionary doctor who had seen smallpox became suspicious about several cases of rash and fever in a remote village. But the rash turned out to be from something else.
Dr. Stanley O. Foster and Dr. J. Michael Lane, two former disease centers employees who are smallpox experts, are helping with the centers's course on the disease. They said in interviews that they would show course participants pictures of smallpox lesions at various stages of development.
The course leaders are also trying to find ways to put photographs of smallpox lesions on the Internet so that doctors anywhere will recognize it if they see a real or suspected case.
Participants will also learn how to use the two-pronged needle required to administer smallpox vaccine.
But disease centers officials are not planning mass smallpox vaccinations at this time. One reason is that not enough vaccine exists. Another is that the risks of mass vaccination could outweigh any benefits, particularly if no smallpox case appears.
Smallpox vaccine, made from a different virus, has risks that are difficult to quantify for today's population.
Among the 5.5 million Americans who received their first smallpox vaccination in 1968, Dr. Lane said, eight died as a result. About two people per million who were vaccinated had an often fatal reaction known as vaccinia necrosum, which destroyed flesh and muscle. About four per million developed encephalitis, or inflammation of the brain.
Today, a particular concern is the hundreds of thousands of Americans with weakened immune systems from H.I.V. and other viruses, as well as drugs used to treat cancer and prevent rejection of organ transplants. The danger is that such people can become ill from the vaccine itself, and transmit the vaccine virus to other people, including those with impaired immune systems.
The standard epidemiologic response to smallpox is to identify the disease, isolate cases, vaccinate everyone known to have had direct contact with infected people since the first week of symptoms and then monitor their state of health.
Mass vaccination is not considered the appropriate medical response to an outbreak of smallpox. But if epidemiologic information determines that the virus was introduced widely through the air — at a public gathering, for instance — then mass vaccination might be required.
I hate foreboding thoughts -but- if the search for Ben Laden where to continue for a couple years (all the while giving Ben Laden more time to acquire his own nuke or two/suitcase type/for taking to U. S. soil) -would it then be time for Mr Neutron? (Poohbah, you might have some thoughts on this. If God Forbid the United States finally has to resort to small, tactical nukes on varying groups of mountains - how would this playout? Is it reasonable to say that one particular type of nuke mighht be better then another ie. radiation/winds/kills only people type nuke? Or is it actually the case -that nukes can't be used at all -under any circumstances, because of the wind and because of the fact that the land area where any such nuke explodes, would be contaminated for 20, 50, 100's of years?)
Second, the issue is one of "can we afford the international intangibles associated with first nuclear use?" more than any specific issues of contamination.
Third, the contamination issue is still a problematic one even after all that.
The Plowshare Sedan crater is still off-limits at the Nevada Test Site, and that shot was in 1962. (Plowshare Sedan was a "peaceful" test, intended to examine the efficacy of a nuclear device for large-scale excavation work.)
Smallpox is of particular concern because of its potential to spread quickly. In a military exercise this past summer called Dark Winter, researchers conducted a simulated smallpox attack on Oklahoma City. The epidemic quickly soared out of control, spreading to 25 states and millions of people.
Right. So why hasn't it been done? People in the know have been warning about this for at least five years.
Oh. I forgot. The globalists and eco-wackos think there are too many people on the earth today. Hmmmm...
Same here. Perhaps smallpox vaccine can, if need be, be easily and quickly produced??? (anyone??)
They are really whipping up everything they can, IMO. Every little tidbit seems to deserve DAYS of discussion. It's almost like a fad.
Discouraging news. Thanks for the info, Chase.
Alibek goes on to say that they(Russians) developed more powerful strains of the virus. I suspect that this could mitigate the effectiveness of current vaccines.
There is a reduced amt of vaccine because of the irradication of the disease. Also, only a portion (who knows how much) of the vaccine which currently exists is still viable.
Lastly, when considering mass vaccination, you have to realize that the immunosuppressed (HIV, transplant folks, chemo patients) run a much higher risk of becoming very ill from the vaccine itself. This isn't the only thing to be considered when weighing whether to give mass vaccinations, but it is one of the significant things to give credence to when considering whether to vaccinate someone for smallpox.
Ken Alibek's book is one I really feel ALL Americans should be reading right now. Information is a good defensive weapon. There are risks in life and none of us gets out of this alive. But we are all better off knowing what we may face. I strongly recommend this book. Even if half of it is true (and I suspect most if not all of it is) we must make ourselves aware of what these terrorists are capable of and therefore enable us all to take careful measures, where possible and appropriate, to counter them.
Alibek goes on to say that they(Russians) developed more potent strains of the virus. I suspect that this could mitigate the effectiveness of current vaccines.
There is a reduced amt of vaccine because of the irradication of the disease. Also, only a portion (who knows how much) of the vaccine which currently exists is still viable.
Lastly, when considering mass vaccination, you have to realize that the immunosuppressed (HIV positive, transplant folks) run a much higher risk of becoming very ill from the vaccine itself. This isn't the only thing to be considered when weighing whether to give mass vaccinations, but it is one of the significant things to give credence to when considering whether to vaccinate someone for smallpox.
Ken Alibek's book is one I really feel ALL Americans should be reading right now. Information is a good defensive weapon. There are risks in life and none of us gets out of this alive. But we are all better off knowing what we may face. I strongly recommend this book. Even if half of it is true (and I suspect most if not all of it is) we must make ourselves aware of what these terrorists are capable of and therefore enable us all to take careful measures, where possible and appropriate, to counter them.
To a degree, this may be true. But I think the media is doing us a favor on this - already the CDC is getting out ahead on this one, with a plan that they're acturally communicating to us. Also, we as a people, have GOT to inform ourselves about what we could conceivably face from the terrorists. I believe we must be self responsible to learn what we may be facing, and on this one, I think the media is playing a positive role. Their harping is producing real time results - the CDC and HHS knows they are being held accountable and this fact alone - their not wanting to be caught w/their pants down - works to our benefit.
You know, Boris, one of the things I wrote in the margins of Ken Alibek's book as I read it, is very similar to your point - our general hubris in thinking we, with our superior attitudes regarding our own scientific capabilities and our assumptions about the "limited understanding and capabilities" of our enemies is very much a part of what has contributed to our current "behind the eight ball" situation. Sometimes we're too smart for our own good. And, we assumed that our future (now current) enemies would play by some minimal moral standards. We now face an enemy which has proved it has NO moral standards. It definately does not lend itself to a "home field" advantage for us. BUT we are a resourceful and clever people, and we will turn this situation around.
In the autumn of 1863, beset as always by office seekers, Abraham Lincoln's physician told him that he was suffering from varioloid, a mild form of smallpox. "Is it contagious?" asked the president. "Very contagious," the doctor assured him. Lincoln seemed oddly pleased. The doctor asked why. "There is one good thing about this," the president told him. "Now I have something I can give everybody."
Who in their right mind would've thought a human being would've ressurected something like SP on purpose?
The people behind these insideous schemes must be exterminated just as thoroghly as an infestation of cockroaches.
Nothing less will do.
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