Nurse's Notes
2002 View
SMALLPOX—A POTENTIAL PLAGUE
For 30 years the world basked in the knowledge that one of the
worst plagues of mankind had been put to rest—around 1970
researchers announced that the dread disease smallpox no longer
existed outside certain laboratories and thus there was no need for
anyone to receive a vaccination against it. As it happens,
vaccination against smallpox was the world’s first public health
success—when a Scots physician named Edward Jenner realized that
infection of cowpox protected one from smallpox and thus developed
the process we call vaccination in 1796.
However, researchers failed to consider terrorism. All the smallpox
virus was not destroyed in the 1970’s—although there were many who
felt it should be. Instead, samples were stored here in the United
States and in the then USSR, against a time when it might be
necessary to resurrect the virus to test a vaccine or for some other
reason. There was fear that somewhere there might be a hidden
reservoir of the disease—maybe even in space!
Today the fear is more realistic—that terrorist groups will get
their hands on the stored virus and spread it by “bio-bomb” in a
large city or congregation of people. The disease is
deadly—approximately 40% of the unvaccinated die and those who don’t
are usually left with horrible scars . In 2002 the unvaccinated
population includes almost everyone—even those of us previously
vaccinated probably are no longer protected, and for the most part
no one born after 1972 has ever been vaccinated.
Unfortunately smallpox vaccine itself is not benign. It is
considered the most dangerous of any vaccine. About 2% of those
receiving it will become ill, and possibly 1% or less will die.
Those that are likely to die are the immunosuppressed—folks on
chemotherapy, those with AIDS and other such diseases. Usually these
people cannot take the risk of vaccination. Millions of people with
skin disorders, like eczema or even acne, are also at risk.
Smallpox is a much more dangerous problem that anthrax and our
public health folks are considering reinstating a vaccination
program. Recent studies are showing that those of us who previously
were vaccinated may be able to have just a “booster” vaccine and it
seems that the recommendation may be that all of us (those who are
able) be vaccinated. Vaccinations will start with “first
responders”, ie: doctors, nurses, other health care professionals,
and police and fire department personnel.
My prayer, and the prayer of most health care professionals, is that
this potential plague remains just that—potential. September 11 and
the anthrax deaths were a wake-up call for us to be ever vigilant in
protecting ourselves, our families and our nation. An out-of-control
virus attack would be a horror no one wants to contemplate.
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