Fw: A New Smallpox Era Begins

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----- Original Message ----- From: ilena rose

Sent: Friday, January 31, 2003 1:49 PM

Subject: A New Smallpox Era Begins

A New Smallpox Era Begins

http://www.zwire.com/site/news.cfm?BRD=1615 & dept_id=387671 & newsid=6890122 & PAG=461 & rfi=9By: January 31, 2003 EXCERPT: Perhaps as many as 30 million Americans should not getvaccinated. They include pregnant women; people with compromisedimmune systems, including chemotherapy patients; those withtransplanted organs; and anyone with HIV. People with Crohn's diseaseand certain skin ailments are also on the list of those who shouldforgo immunization.There is another distinct downside to immunization. Because the siteof the vaccination will typically become inflamed, people who arevaccinated need to keep the site covered for several weeks to preventcontaminating others who have not been vaccinated, especially youngchildren and those with compromised immune systems.~~~~~~~~~~~The threat of bioterrorism, even if remote, has persuaded PresidentBush to make one of the toughest decisions yet regarding homelandsecurity: a voluntary smallpox immunization program.Unfortunately, the decision cuts two ways when it comes to protectingAmericans.Bush's announcement that the government will offer smallpoxvaccinations to targeted groups, such as health workers, and otherswho want them is the surest way to protect the nation from thisincurable disease, eradicated 32 years ago.But because the vaccine carries risks of serious complications and, invery rare cases, death, people will have to think carefully beforethey make the decision to have themselves or their loved onesinoculated. Perhaps as many as 30 million Americans should not getvaccinated. They include pregnant women; people with compromisedimmune systems, including chemotherapy patients; those withtransplanted organs; and anyone with HIV. People with Crohn's diseaseand certain skin ailments are also on the list of tho se who shouldforgo immunization.Commendably, the administration is moving cautiously. The medicalcommunity is divided as to whether millions of Americans ought to beexposed to a high-risk vaccine in order to protect them from ahypothetical and perhaps unlikely risk.We side with the administration and pro-vaccination advocates. Theyargue that because this highly contagious disease kills one-third ofthose who contract it and can permanently scar survivors, a phased-in,voluntary vaccination program is smarter than waiting until anoutbreak occurs and then scurrying to vaccinate most of the country.But the government must first undertake an intensive public educationcampaign to help people make well-informed decisions. That need wasdemonstrated when a survey by the Harvard School of Public Healthshowed that most Americans are ill informed about smallpox. Mostmistakenly thought it could be cured and that it still occurrednaturally around the world.While the threat of a smallpox attack may be unlikely, it's not beyondpossibility. Many terrorism experts point out - convincingly, we think- that if many Americans are immunized, or soon could be, there isless chance terrorists would use the virus.The government will make the vaccine available to the generalpopulation later in 2003. But Bush appropriately emphasized that itwill not be recommended for most people. He said last week that hewould be vaccinated, but not his family or most of his staff orcabinet.Data suggest that for every 1 million people vaccinated, 1 or 2 willdie and as many as 50 others will have serious complications,including encephalitis and a condition in which the live but weakenedcowpox virus used in the vaccine eats away healthy issue. Becausemiddle-aged and older Americans were vaccinated years ago, they wouldbe less likely to experience the se complications, assuming they arehealthy, according to G. Olds, an authority on smallpox at theMedical College of Wisconsin.There is another distinct downside to immunization. Because the siteof the vaccination will typically become inflamed, people who arevaccinated need to keep the site covered for several weeks to preventcontaminating others who have not been vaccinated, especially youngchildren and those with compromised immune systems.One remedy would be for public health officials to follow Olds'suggestion to draw blood from a pool of vaccinated individuals inorder to gather antibodies that could be used to treat the vaccine'scomplications in others. Considering the vaccine's significant risks,it's an idea worth pursuing.©The Herald Chronicle 2003

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