Hospitals prepare for smallpox

If a terrorist wanted to again make a statement, embarrass the country and instill fear, the nation’s capital is a good place to strike, emergency service planners say.

“I would say we are ground zero,” said Dr. Jared Florance, director of the Prince William Health District.

Florance and other emergency officials who are proceeding with plans to start smallpox vaccinations locally are operating on a heightened sense of urgency.

The threat of bioterrorism is real but, to Florance’s way of thinking, bioterrorism is a state of mind.

Education and communication will go far to ensure that people do not buy into that fear, Florance said.

“We are not going to be terrorized. We are going to deal with this and move on,” Florance said. “Smallpox is an infectious disease. We know how to deal with it,” he said.

Prince William Health District officials have been trained, and, in some cases, retrained in how to administer smallpox vaccinations.

Voluntary vaccination of public health and hospital officials, who are first in line for inoculations, got under way in other states Friday.

About 20 officials from the Connecticut Department of Public Health and medical personnel from the University of Connecticut Health Center were inoculated. Vaccinations were also given in California on Friday.

Prince William and other health districts in Virginia expect to receive the vaccines within the month.

After all the necessary health care workers have been vaccinated, it will be offered to police officers, firefighters and rescue squad members on a voluntary basis.

The final stage of the vaccinations may include offering it to the general public late this year or in 2004, according to the Virginia Department of Health.

Kicking off the voluntary smallpox vaccination program is not designed to ignite fear that a smallpox attack is imminent, say county health officials.

Instead, it is to provide a level of comfort that in the event of an attack those most likely to be exposed first can deal with the afflicted with the full knowledge that they themselves are protected.

Taking precautionary measures now instead of simply reacting to a smallpox attack, if one occurred, will enable emergency health officials to contain the spread of the disease that much quicker.

“There is a lot of preparation going into all this,” said Ric Crosby, bioterrorism coordinator for the health district.

Smallpox does not exist today in the United States. The last case in this country was in 1949. With the disease eradicated, vaccination for smallpox was stopped in 1972.

The last natural case in the world occurred in Somalia in 1977. The World Health Organization declared the global eradication of smallpox in 1980.

The virus that causes smallpox officially exists in only two laboratories in the world — in the United States and Russia.

However, since the Sept. 11, 2001 terrorist attack and the anthrax scare, concern that smallpox may get into the hands of enemies of the United States who could use it as a bioterrorism weapon have increased significantly.

“The probability of an intentional release of smallpox is low but since the consequences of an outbreak would be great, it is important to prepare by vaccinating volunteer health care response teams in Virginia,” said Dr. Robert Stroube, state health commissioner.

National, regional and local health, law enforcement and rescue officials have been planning for a possible bioterrorism attack for years. That planning has been stepped up.

The state estimates that about 600 public health officials and about 12,000 hospital care providers will be vaccinated statewide.

The second stage of inoculations to first responders such as firefighters, police officers and emergency personnel is estimated to include up to 200,000 people in Virginia.

“This whole process is voluntary,” Florance said.

When the Prince William Health District made its first appeal for vaccination volunteers in December, the response was good. About 15 licensed health professionals within the office of the 100 employees signed up. All three of the health district’s doctors also agreed to be vaccinated.

“Some people were ready to make the decision [quickly],” Crosby said. “Others wanted to talk to their doctors first.”

Health officials expect more will agree to participate when the next request is made.

Florance said he is confident that they will have enough vaccinated volunteers to be adequately prepared in the case of a smallpox event.

“Absolutely,” Florance said. “We have enough volunteers every time we ask for them,” he said.

Those considering the vaccination listen to a presentation about the benefits, the protection it provides as well as the risks involved. Printed material, video and satellite broadcast of state-produced programming on the subject also are available.

“All of our staff have had an opportunity [to learn about the vaccine,]” Florance said.

This same information is being made available to Prince William and Potomac hospitals.

“We are now in the process of offering an information session for potential volunteers on the [risk factors], potential adverse reactions and necessary care of the vaccination site,” said Claye Avera, infection control practitioner at Prince William Hospital. “We have asked appropriate staff to volunteer.

Potomac Hospital is doing the same.

“We have had some people volunteer and we anticipate a great deal more will volunteer,” said Suzanne Davis, director of employee health and epidemiology at Potomac Hospital.

“Some [potential] volunteers are waiting for more information and I don’t blame them,” Davis said. “There is risk involved.”

The request for volunteers at the hospital goes beyond that of just doctors and nurses.

In the event of a smallpox attack, the hospital would have to continue to function, so radiology technicians, respiratory therapists, admissions staff, emergency room personnel, housekeeping and security officers are among those who will be asked to volunteer.

The smallpox vaccine does not contain the smallpox virus and cannot give the recipient smallpox. The smallpox vaccine contains a live “pox” virus that is related to smallpox and helps the body develop immunities.

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