PRO/EDR> Smallpox rumors - Pakistan: unconfirmed

ProMED-mail ^ | Jume 12, 2002 | ProMED-mail

[Sweet_Sunflower29]

Archive Number 20020612.4479 Published Date 12-JUN-2002 Subject PRO/EDR> Smallpox rumors - Pakistan: unconfirmed

SMALLPOX RUMORS - PAKISTAN: UNCONFIRMED *************************************** A ProMED-mail post ProMED-mail is a program of the International Society for Infectious Diseases

[We at ProMED-mail go through special efforts to try to ensure that we do not contribute to "rumor mills" on disease outbreaks. Given the amount of attention and high volume of emails we have received related to this current rumor, we feel obligated to post these newswires (with moderator comments) below, as part of a rumor control effort. - Mods.MPP/LM/JW]

[1] Date: 11 Jun 2002 From: ProMED-mail Source: World Net Daily [edited]

WHO probing smallpox claim; World Health Organization suspects Pakistan outbreak chickenpox -------------------------------------------------------------------------------- Officials from the World Health Organization are "on the ground" in Pakistan investigating a claim first reported in the Pakistan Dawn newspaper that an "epidemic" of smallpox is threatening the Swabi district of the country.

"There has not been a case of smallpox anywhere in the world since the late 1970s, and all rumors since then have been proved to be false," Iain Simpson, a spokesman for WHO, told WorldNetDaily.

"There have been several recent rumors from Central Asia and the Middle East. In all cases, it has turned out to be the result of poor translation. In each recent case, the disease was actually chickenpox. It is likely that this is again chickenpox in Pakistan, especially as the report itself comments that those infected are mainly children."

According to the 9 Jun 2002 Pakistan Dawn story, "a large number of children have suffered from smallpox." The story adds, "A health official said that the dilemma of the people was that they were not aware of the danger aspects of this ailment as the children suffering from it have neither been kept in isolation nor properly treated."

While smallpox is a deadly disease, there is no mention in the story of any deaths attributed to the outbreak.

Added Simpson, "For the moment, we are investigating, but have so far received no information to indicate that this is in fact smallpox."

A spokesman for the Centers for Disease Control also was skeptical of an actual smallpox outbreak. "There are so many poxes out there that are sometimes misdiagnosed," said the CDC's Llelwyn Grant. "It could be a number of things."

There also have been reports on the Internet recently about "smallpox" outbreaks in India. Peter Friedlander translates Indian news stories into English and says terminology can be a problem. "The Hindi/Urdu term 'cecak' covers smallpox and anything that looks similar," he explained.

[2] Date: 9 Jun 2002 From: ProMED-mail Source: Dawn 8 June 2002 [edited]

[We at ProMED-mail have been awaiting official reports ruling out smallpox as the etiology of this outbreak in Sindh Province Pakistan so that we could prepare a posting titled "Rumors dispelled, smallpox - Pakistan: NOT". Needless to say we have received numerous emails from our subscribers related to the initial newswire posted in Dawn on Sun 9 Jun 2002. When we saw this report, we were fairly sure that this was not due to smallpox due to the age distribution of cases, and quite possibly due to an error in translation where one word might be used for general pox-like illnesses (vesicular eruptions). We had had a similar report from a Kurdish newspaper where the word used for smallpox was speculated to have been a generic word for pox-like illnesses.

The original Dawn article mentions that this outbreak is occurring in children. Were this to be a smallpox outbreak, the odds of the cases occurring only in children would be very low. Smallpox eradication was declared in 1979 (the last case reported in Somalia in October 1977). In 1979, WHO recommended that vaccination against smallpox be stopped in all countries, the only exception being special groups, such as researchers working with smallpox and related viruses. By 1982, routine vaccination had been officially discontinued in 149 of the 158 member countries of WHO. By 1986, routine vaccination had ceased in all countries. ().

Hence, even before estimating the numbers of susceptibles due to waning immunity, all individuals born post 1986 (16 years of age or younger) would be susceptible to smallpox. Adding on those with waning immunity, it would be very unlikely not to have cases in older age groups.

It is unfortunate when reports such as this hit the newswires, especially in today's environment with heightened concerns re: bioterrorism. The amount of fear and concern generated by a single newswire report that may be unfounded due to an incorrect translation seems unjustified. This last comment works under the assumption that most languages do/did distinguish between smallpox and chickenpox.

We will post the official "NOT" as soon as it is available. - Mod.MPP]

[Sweet_Sunflower29]

Additional unidentified disease references previously mentioned on FR are also included in the original ProMed post.

~A

[Jen]

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[Mitchell]

ProMED is skeptical for the same reasons we discussed on an earlier thread.

[Sweet_Sunflower29]

Agree. Have to admit though, it is something to see the officials 'on' this now...despite the immediate denials.More proof of the squeaky wheel getting the grease.

I will be most anxious to see the results and the final outcome.

~A

[Mitchell]

Agree. Have to admit though, it is something to see the officials 'on' this now...despite the immediate denials.More proof of the squeaky wheel getting the grease.

Well, I don't think there were any earlier denials. The response you got was a form letter re-stating the fact that smallpox has been eliminated in the wild.

Moreover, there still are no denials. What there is, finally, is the recognition that some investigation is in order.

In fact, there still is nothing from "officials." Officials would mean perhaps CDC, or a department of health in India or Pakistan. ProMED is not official in the least; it's a non-profit professional organization associated with the Federation of American Scientists. (This is not meant to be a criticism of ProMED, which does an excellent job. But it's not an official governmental organization.)

I will be most anxious to see the results and the final outcome.

It will be quite interesting. Contrast the slow response here with the very quick reaction to what turned out to be saltpeter poisoning in New York City a month or so ago. (In that case, in which cyanide poisoning was initially feared, there was an immediate quarantine and investigation.)

And thanks for posting this article.

[Terridan]

True or not... I still say its "Poetic Justice" ;)

[Cascadians]

Good for you, SweetSunflower, for all the pro-active work you've done to MAKE folks acknowledge that there's something here worth investigating and correcting if necessary!

Thanks for breaking this little news here and around the Net. Keep the pressure for the truth on :-)

[Cascadians]

NOT, Pakistan = NOT smallpox

http://www.promedmail.org/pls/askus/f?p=2400:1001:255009::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,18488

Archive Number 20020613.4486
Published Date 13-JUN-2002
Subject PRO/EDR> Smallpox rumors - Pakistan: NOT

Date: Thu, 13 Jun 2002 18:22:30 +0200
From: WHO Outbreak Response Team
Outbreak Verification Team
Department of Communicable Disease
Surveillance and Response (CSR)
World Health Organization
Geneva
outbreak@who.ch

Smallpox rumors - Pakistan: NOT

Rumours reported by the media of a cluster of smallpox cases in Swabi district, Pakistan have been investigated by a team from National Institute of Health (NIH), Islamabad, health officials from the North West Frontier Province and WHO. All cases were children and showed typical features of chickenpox. No evidence of smallpox was found.
Samples are being tested at NIH.
---------------------------

Good news! Hope they get to India too, where latest report was 3 children had died. The India report has not gotten as much media attention.

[Sweet_Sunflower29]

You give me too much credit Caskie, you're too kind. :*)

This biowarfare 'threat' and all it entails just fascinates me to no end as it does many. We all need to continue the quest to do what we must to remain vigilant, stay informed and spread the word--Who knows, the time may come when our collective lives depend on it!

Have a great night Cas and everyone!

~Ami