CDC Releases Smallpox Response Plan

WASHINGTON (AP) _ Health authorities should not force people to be vaccinated against smallpox, even if the virus reappears and begins to spread, the government's top bioterrorism adviser said Monday

Tuesday, November 27th 2001, 12:00 am

By: News On 6

WASHINGTON (AP) _ Health authorities should not force people to be vaccinated against smallpox, even if the virus reappears and begins to spread, the government's top bioterrorism adviser said Monday as officials released their response plan.

The plan, developed by the Centers for Disease Control and Prevention, calls for immediate vaccinations of people close to any patient who contracts the highly contagious smallpox virus. Disease detectives would retrace the victim's every move, searching for and vaccinating all those who may have been infected. The vaccination is still effective several days after the recipient has been exposed to smallpox.

People should not be forced to receive the vaccination, said Dr. D.A. Henderson, the top bioterrorism official at the Department of Health and Human Services.

``This really did not work well at all,'' said Henderson, who led the global campaign that succeeded in eradicating smallpox from the globe. ``Once you began compelling people and people began to try to escape from being vaccinated, you lost the confidence of the people, and it became a really, often, a very difficult situation.''

``I think that you're trying to persuade the population, trying to corral people in an appropriate way,'' he added. ``Without trying to do this by force, you get ahead a lot further.''

Smallpox hasn't occurred in the United States since 1949 and was declared eradicated from the globe in 1980. But bioterrorism experts worry that the virus could be obtained by terrorists and intentionally released in the general population.

The CDC response plan, first reported by The Associated Press in October, is based on Henderson's global campaign: Identify the victims, isolate them to keep them from infecting others, and vaccinate anyone with whom they have may come into contact. Investigators would interview each patient in order to retrace his or her steps over the last three weeks.

State and local officials _ who would be on the front lines of any attack _ are now reviewing the plan, which is an update from a version first written in 1972, when doctors stopped routinely vaccinating Americans for smallpox.

The original plan assumed that any new smallpox case would result from an individual being infected in another country and carrying the disease into the United States, Henderson said. The updated version takes bioterrorism into account, with the possibility that many people might be infected at once were the virus to be intentionally released. In this case, Henderson noted, special quarters might be needed to isolate the victims from those who are not infected.

But the plan makes clear that entire cities or states won't get vaccinated unless CDC has evidence of more than a few cases.

To breathe in the virus and catch smallpox, a person must be within about six feet of a patient suffering the characteristic rash. Those who live or work near a patient are vaccinated just as a precaution.

Smallpox symptoms include fever and a pock-like rash all over the body, appearing between seven and 17 days after exposure to the virus. People are contagious from the time the rash appears _ particularly in the first week of illness _ until the scabs fall off.

If someone had smallpox, he or she would immediately be quarantined. The CDC would send vaccine from the government's stockpile and alert the FBI and the White House.

The government has 15.4 million doses of smallpox vaccine on hand, though research has found that each dose could be diluted to vaccinate at least five people. HHS Secretary Tommy Thompson is completing negotiations to buy another 300 million doses.