State lays plan for smallpox immunization

By Abby Morris

The Tennessee Department of Health announced Thursday that it is developing a plan for mass vaccination against the smallpox virus in the event of a breakout of the virus.
   In September of this year, the Centers for Disease Control and Prevention sent out guidelines to the states detailing how the states should handle the mass vaccinations.
   According to the CDC's information listed on the organization's Web site about the smallpox virus and vaccine, "The deliberate release of smallpox as an epidemic disease is now regarded as a possibility and the United States is taking precautions to deal with such an eventuality."
   The last case of smallpox in the United States was in 1949. The last naturally occurring case in the world was in Somalia in 1977. In the 1980s, the World Health Organization declared the disease eradicated.
   At that time, the only known locations of the virus were in laboratories in the United States and the Soviet Union. After the Soviet Union split up, there was some fear that scientists studying the virus had taken samples with them when they left the country.
   In recent months, the United States government announced that it believed as many as four other countries also had samples of the virus.
   "Iraq is one of the four countries that we're pretty sure has the smallpox virus," said Dr. Fredia S. Wadley, commissioner of the Tennessee Department of Health. "That, needless to say, stirs you to want to have a plan for mass vaccination."
   According to Dr. Wendy Long, assistant commissioner of the TDOH, the plan being developed by the state to handle such an event would allow for all of the residents of Tennessee to receive the smallpox vaccine within 10 days.
   The plan calls for 117 mass vaccination clinics to be created across the state. The clinics would operate in two shifts a day and be able to vaccinate 5,000 people a day. The clinics would be run by trained health care professionals and community volunteers. It is estimated that 25,000 people would be needed to operate these clinics.
   According to Long, in the next month, regional health offices will announce where the locations of the planned clinics will be in the event of an outbreak.
   "We're going to rely on local public health officials to help us get this done," Long said. "We have asked the areas to get their volunteers together by January 31 and then we would use the month of February to train those volunteers."
   According to the CDC, even one case of smallpox is enough to have the situation considered a public health emergency.
   In the event that a hospital in Tennessee believes it has come across a case of smallpox, the hospital will contact the TDOH who will have tests sent to the CDC headquarters in Georgia to positively identify if it is the smallpox virus.
   "Only a few labs in this country -- government and military -- can identify this virus," Wadley said.
   Once the virus has been identified, that is when the clinics would open and begin vaccinating people against the virus.
   "There is no reason to be alarmed until we have identified a case," Wadley said.
   All of the plans currently being formulated for mass vaccination deal only with a post-even scenario, according to Wadley. No plans are in place for a pre-event mass vaccination, she said.
   Under normal conditions, the smallpox virus is spread from close personal contact with an infected person. The disease is spread through face-to-face contact and through direct contact with infected bodily fluids or infected objects such as clothing or bedding, according to the CDC.
   "The thing we worry about is weaponizing it (the virus), finding a way to suspend it in the air and let it hang in the air," Wadley said.
   According to the CDC, the smallpox virus is fragile and in the event of an aerosol release, approximately 90 percent of the virus would be inactivated and dissipate in about 24 hours.