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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