By Sara Strong
Although a terrorist attack of smallpox isn’t imminent, state and county health agencies are preparing for the worst.
Within the next few weeks, as many as 10,000 Minnesotans will start Phase I of the smallpox vaccination process, which is a part of the national effort.
Nobles-Rock Public Health Director Bonnie Frederickson said her counties and those in the southwest region are preparing for the risk of smallpox exposure.
The vaccination is voluntary, even in the first phase, which includes critical response personnel.
About 32 people in Nobles and Rock Counties will receive the vaccine initially.
"The people we’re considering for vaccination, during this initial phase, would have important jobs to do if we ever had to deal with an actual terrorist incident involving smallpox," said Dr. Harry Hull, Minnesota’s State Epidemiologist.
"They are the people who would be caring for the sick, investigating the outbreak and taking steps to control it. They are the people who would be coordinating our response to a bioterrorism attack, and maintaining public order."
Public agencies will administer the vaccine. It’s not available through local hospitals, and even if mass vaccinations are done, it would be through Public Health.
The Center for Disease Control now controls the availability of smallpox vaccine supplies.
Second phase
Phase II of the smallpox vaccination process would open to more emergency workers and critical care personnel, along with others who work with the public. But they also have the option of not getting the vaccine.
"It’s not the run-of-the-mill inoculation," Frederickson said. "It takes screening and careful thought."
The vaccine itself carries risks, and that’s why it was phased out of the immunization process in 1972.
Frederickson said the last case of smallpox was in the 1960s. Since the vaccine had side effects, and the disease was thought to be wiped out, the vaccine was taken out of circulation.
For those who’ve had the vaccine prior to 1972, it won’t work today, because the vaccine’s effects usually hold for three to five years.
The vaccines administered in this national program are the same as the previous vaccine. The same substance is administered on the upper arm for smallpox protection.
Part of the reason Nobles-Rock Public Health is working with counties in the region is because of its size. One vial of the vaccination immunizes 100 people, and the two counties can’t support that amount of vaccinations, with just 32 getting it in the first phase.
By the time Phase III hits, the vaccine will be available to the general public, but it’s not recommended.
Those who shouldn’t receive the vaccine include: people who might be allergic to it; pregnant and nursing women; people with medical conditions that could weaken the immune system; people taking medications or receiving medical treatment that could weaken the immune system and people with certain types of skin conditions.
"The actual likelihood of a terrorist attack involving smallpox can’t be known or calculated with any kind of precision," Hull said. "But if such an incident did ever occur, we know that the results would be devastating. That’s why we’re proceeding with this effort."
Frederickson said if the disease was spread, it would be a serious Public Health issue. "It has a 30 percent fatality rate and spreads very quickly."
Her agency’s role is to investigate possible cases and educate people, including doctors who haven’t seen it, on signs of the disease.
"If someone does come into contact with it, we do have three to four days to immunize, and it will still be effective," she said.
In the event of an actual outbreak most people would have to be vaccinated in a large Public Health effort, which is why vaccines aren’t recommended for everyone now, to conserve the supply.
If people in Nobles or Rock Counties would be infected with the disease, they would probably be transported to a hospital outside the counties to prevent outbreaks. Hospitals in Rock and Nobles Counties don’t have negative air pressure rooms to quarantine patients.