Posted on 12/15/2002 11:01:56 AM PST by oceanperch
GUIDELINES ISSUED in September by the federal Centers for Disease Control and Prevention say that in some cases, the isolation of a small number of smallpox patients may be sufficient to control an epidemic. But in other situations, far-reaching quarantines might be required.
State governments recently submitted draft plans for responding to a smallpox outbreak but, citing security concerns, most states are saying very little about their plans.
Professor Lawrence Gostin, director of the Center for Law and the Public's Health at Georgetown University Law School, said "there are huge logistical problems" with a quarantine, "not to mention the civil liberties implications of taking away people's liberties en masse." The smallpox threat An MSNBC special report
• States prepare to give smallpox vaccinations
• The how and why of smallpox shots
• Questions and answers • Outbreak: Would quarantine work? • Abroad: Allies taking no chances • WP: Areas of concern Asked whether he can envision troops being called in to enforce a quarantine after an outbreak, Gostin answered, "Sure.
Just consider what might happen if a smallpox carrier landed at Kennedy Airport in New York. If you were the governor of New York, would you close down JFK? Would you stop travel between New York and New Jersey? There is a whole range of options."
Indeed, the National Guard could be called in to set up roadblocks, as the Yugoslav government did when a smallpox epidemic broke out in that country in 1972. Possible quarantine measures
Suspension of large public gatherings.Closing of public places.Restriction of travel."Cordon sanitaire," a line around a quarantined area guarded to prevent spread of disease by restricting passage into and out of the area.Source: CDC Smallpox Response Plan and Guidelines, Sept. 23, 2002
At the behest of the CDC, Gostin and others have drafted a model emergency medical statute that more than 20 states have already adopted in whole or in part. The law spells out the powers that governors and public health officials would have to impose quarantines, commandeer materials and hospitals, and take other steps to respond to a smallpox epidemic.
In 1999, a group of leading epidemiologists painted a grim picture of how an epidemic would unfold:
"A clandestine aerosol release of smallpox, even if it infected only 50 to 100 persons to produce the first generation of cases, would rapidly spread in a now highly susceptible population, expanding by a factor of 10 to 20 times or more with each generation of cases." WHEN TO IMPOSE QUARANTINE?
The experts noted that during the 1960s and 1970s, when natural smallpox outbreaks still occurred in Europe, "widespread concern and sometimes panic occurred, even with outbreaks of fewer than 100 cases, resulting in extensive emergency control measures."
When would U.S. officials consider imposing a quarantine if there were an outbreak today? The CDC guidelines say a number of factors would determine whether a city or state had reached that threshold, including:
The number of cases and the number of people exposed.
The projected morbidity and mortality of those infected.
The expected ease and rapidness of the spread of the disease. The risk for public panic.
Forty years ago, quarantines were not seen as critical to stemming the spread of smallpox. During the international campaign against the virus that culminated in 1977 when the disease was eradicated, health officials used a "surveillance-containment" strategy to combat the disease, isolating infected people and watching them closely for the fever and skin rash that characterize smallpox.
People who had been in contact with those infected were immediately vaccinated because inoculation within four days of exposure provided some protection against smallpox and prevented people from dying from the disease.
TRACING VS. VACCINATING
But a recent study led by Professor Edward Kaplan at Yale University's Department of Epidemiology and Public Health concluded that a "race to trace" everyone who had been in contact with an infected person might not stem an epidemic today.
Tracing people in isolated villages could be effective, but in a teeming city with millions of residents and visitors this approach could be all but impossible, the study said.
Kaplan's study recommends mass vaccination of the local population in the face of a smallpox outbreak.
In an interview with MSNBC.com, he said that unlike the relatively small isolated outbreaks of 40 years ago, a terrorist attack using smallpox might be widespread and coordinated.
"At the time the attack is detected you don't know if it is big or small," he said. Instead of a couple of infections in any one place there might be a couple of thousand.
Kaplan also raised what he calls "a nightmare scenario."
"What would happen if it were determined that the smallpox vaccinations weren't working right — if you had been attacked with a strain of smallpox engineered to defeat the vaccine? Then a quarantine becomes of tremendous importance," Kaplan said, as the only way to contain the disease and let it run its course in those infected, while not allowing it to spread to others.
The Bush administration is soon expected to announce its policy on smallpox vaccinations, in light of concerns that terrorists might seek to trigger a smallpox epidemic in the United States. At first, only police, emergency medical workers and members of the military are likely to be vaccinated. Here are some questions and answers about smallpox and the vaccine., What is smallpox?
Smallpox is a contagious and sometimes fatal disease caused by a virus and marked by fever and a distinctive progressive skin rash. It is thought to have killed more people throughout history than any other epidemic disease. In 1980, the World Health Organization declared the disease eradicated following vaccination programs, but the Soviet Union maintained an active smallpox weapons development program and other countries such as Iraq may have similar programs.
, How is smallpox spread?
Smallpox spreads from contact with infected persons. Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox. It also can be spread through contact with infected bodily fluids or contaminated objects such as bedding.
, When do symptoms appear?
After exposure, it takes between seven and 17 days for symptoms to appear. During this time, the infected person feels fine and is not contagious.
, Is smallpox fatal?
Most patients recover, but death may occur in up to 30 percent of cases.
, Why not vaccinate everyone right now?
The smallpox vaccine is very effective, so the Bush administration is planning to offer it widely. But many are urging caution because the vaccine itself, made with a live virus called vaccinia, carries rare but serious risks.,
Can the vaccine hurt anyone?
Based on studies from the 1960s, experts estimate that 15 out of every million people vaccinated for the first time will face life-threatening complications, and one or two will die. ,
Who is at risk of vaccine side effects?
According to the Centers for Disease Control, those who have any of the following conditions, or live with someone who does, should not get the smallpox vaccine unless they have been exposed to the smallpox virus.
The conditions are:
Eczema or atopic dermatitis.
Skin conditions such as burns, chickenpox, shingles, impetigo, herpes, severe acne, or psoriasis. Weakened immune system.
Pregnancy or plans to become pregnant within one month of vaccination. ,
Can vaccine help someone exposed to smallpox?
Vaccination within three days of exposure will completely prevent or significantly modify smallpox in the vast majority of persons. Vaccination four to seven days after exposure likely offers some protection from disease or may modify the severity of disease
., Are there other treatments?
Cidofovir, a drug currently used for treatment of opportunistic infections in AIDS patients may be an effective treatment against smallpox, European researchers recently reported.
The Bush administration is soon expected to announce its policy on smallpox vaccinations, in light of concerns that terrorists might seek to trigger a smallpox epidemic in the United States. At first, only police, emergency medical workers and members of the military are likely to be vaccinated. Here are some questions and answers about smallpox and the vaccine.,
What is smallpox?
Smallpox is a contagious and sometimes fatal disease caused by a virus and marked by fever and a distinctive progressive skin rash.
It is thought to have killed more people throughout history than any other epidemic disease. In 1980, the World Health Organization declared the disease eradicated following vaccination programs, but the Soviet Union maintained an active smallpox weapons development program and other countries such as Iraq may have similar programs
., How is smallpox spread?
Smallpox spreads from contact with infected persons. Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox. It also can be spread through contact with infected bodily fluids or contaminated objects such as bedding.
, When do symptoms appear?
After exposure, it takes between seven and 17 days for symptoms to appear. During this time, the infected person feels fine and is not contagious.
, Is smallpox fatal?
Most patients recover, but death may occur in up to 30 percent of cases.,
Why not vaccinate everyone right now?
The smallpox vaccine is very effective, so the Bush administration is planning to offer it widely. But many are urging caution because the vaccine itself, made with a live virus called vaccinia, carries rare but serious risks.,
Can the vaccine hurt anyone?
Based on studies from the 1960s, experts estimate that 15 out of every million people vaccinated for the first time will face life-threatening complications, and one or two will die. ,
Who is at risk of vaccine side effects?
According to the Centers for Disease Control, those who have any of the following conditions, or live with someone who does, should not get the smallpox vaccine unless they have been exposed to the smallpox virus.
The conditions are:
Eczema or atopic dermatitis.
Skin conditions such as burns, chickenpox, shingles, impetigo, herpes, severe acne, or psoriasis. Weakened immune system.
Pregnancy or plans to become pregnant within one month of vaccination. ,
Can vaccine help someone exposed to smallpox?
Vaccination within three days of exposure will completely prevent or significantly modify smallpox in the vast majority of persons. Vaccination four to seven days after exposure likely offers some protection from disease or may modify the severity of disease., Are there other treatments?
Cidofovir, a drug currently used for treatment of opportunistic infections in AIDS patients may be an effective treatment against smallpox, European researchers recently reported.
Lastly what good is having these inspectors when a virus can be kept anywhere for safe keeping.
The first step toward deployment of smallpox against an enemy would be vaccination of the agressor nations' military and emergency medical personel. the second would be vaccination of the civilian population. I don't see this happening anywhere in the enemy world, so I am assuming that smallpox is not a realistic threat from our enemies. I find the idea that some small civilian terrorist group could develop smallpox as a weapon to be absurd.
There's no guarantee
you'd recognize what you see
if biowar preps
were happening now.
Genetic engineering
changes everything.
Protection (and death)
could ship openly. Think of
corn. And the X-Files...
How many are going to die from it...? Apparently the virus is live on the skin for several days after the shot..if you touch it it is mushy after the vacination and can spread to contaminate others. The children are given bandaids to prevent this but they usually pull them off or fall off etc.
Anyway in 2004 it will be offered to everyone. There are some dangers and think that Bush said it will not be offered to children.
I'm concerned that even the religious addicts aren't feverish about Tommy Thompson's statement;
"..every shot will have your name on it...
Aluding to Hitachi's MU chip (.04mm transparent transponder) to small to see(so how do we know it not in there?).
There are upsides, you'll be able to program locks & things to activate when you get within two feet of them.
For folks like me, it's great to have hands full and "poof", my car opens & starts without me having to fumble for keys, which may or not be in my pocket.
Why, (hand on cheek, Jack Benny style) just imagine the possibilities.
Now, that is interesting. Very interesting. Wonder why this isn't on the news?
Panic my boy... panic. The media will not report a wide-spread epidemic to help LE keep strict control.
The cops and National Guard will have the road-blocks in place with orders to shoot-to-kill.
After agonizing weeks, a house-to-house search will be done and a vaccine administered if deemed worthwhile.
With marshall law in place, curfews, etc... the everyday business of life comes to a standstill.
Recession, depression and riots.
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