Vaccinating hundreds of thousands of Americans would be more effective in the case of an intentional or accidental outbreak of smallpox than a more limited “ring” plan endorsed by the Centers for Disease Control and Prevention, some specialists believe. “Mass vaccination really leads to fewer deaths than the CDC interim plan,” Lawrence Wein of the Massachusetts Institute of Technology told Reuters. Besides, he said, if there were a smallpox attack, “I think it highly likely that people would take to the streets to demand vaccination, or would flee.” Of course, the smallpox vaccine could be fatal or severely debilitating for many people, including those with common skin conditions like eczema and psoriasis.
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Your articles are for when it absolutely, positively, needs to be understood onevright.
This is nonsense. There are more than a dozen computer models that show that selective vaccnantion of immediate contacts, coupled with rigorous isolation of patients, is faster and more efficient than mass vaccination. Indeed it was switching from mass vaccination to active search for cases, isolation, and “containment” vaccination just of contacts, that brought about the eradication of smallpox in the first place.
siga technologies has an antivral effective against smallpox and has applied for Emergency Use Authorization. http://www.siga.com
Selective vaccination of immediate contacts, coupled with rigorous isolation of patients will contain an outbreak. However, it will not prevent those within the secured ring from contracting smallpox. Mass vaccination would. Unfortunatly mass vaccination has many untoward effects both in public health and public and private budgets. A distributed stockpiling of the revolutionary small-molecule inhibitor of orthopox virus ST-246 is the safest and cheapest, approach, and is now being developed.
http://www.medscape.com/viewarticle/550582?rss/trackback/
This company has shown in every animal study, including multiple primate trials, that ST-246 is 100% effective, and safe, post exposure. The vaccines for smallpox have dangerous adverse side effects. SIGA has just completed its second human safety study, and has now applied for EUA. Can’t stop progress.
SIGA Initiates Manufacture of ST-246 NDA Registration Batches
8:00a ET April 4, 2008 (Business Wire)
SIGA Technologies, Inc. (NASDAQ: SIGA), a company specializing in the development of pharmaceutical agents to fight biowarfare pathogens and protect the population at large, today announced the company has initiated the activities necessary to produce the NDA registration batches of its lead smallpox antiviral, ST-246. In recent months, SIGA selected, following consultation with the FDA, the final chemical formulation for large-scale production. SIGA has also finalized the market image and packaging of the commercial material.
SIGA 246 is amazingly effective up to 10 days after exposure. It was granted emergency use to save a toddler who was exposed to the vaccine. It is now being manufactured in small batches. I doubt any mass vaccination program will ever happen given the advances of this new drug.
Ring vaccination was successful during the eradication campaign for a number of reasons that do not apply to a bioterrorist release of smallpox: Ring vaccination was used effectively during the last stages of the campaign when the number of cases occuring at any one time was low. It was used in rural Africa where the population density was low and villages were separated by vast distances. Also, there was a high level of “herd immunity” from prior smallpox vaccination and from those who had survived previous smallpox exposure. The virus was easier to contain by ring vaccination because the containment was augmented by geographical, sociological and immunological containment. The CDC models (“dozen computer models”) start with the assumptions that the number of people initially infected (index cases) will be low (~10) but it is likely that a bioterrorist release of smallpox will target 1000s. Also the models are based on low transmission rates suggesting that index cases will only infect 2-3 other people but during an outbreak in England in the 50s it was documented that in urban areas the index cases infected from 10 to 20 other people. The CDC maintains that even if you do come into contact with an infected person your chance of becoming infected (“attack rate”)is around 20% to 30% but it is also documented from an outbreak in Pakistan that the attack rate may be closer to 80%. So, in summary, a bioterrorist release of smallpox will infect a large number of people who incidentally are no longer immunologically protected, and the original cases will infect MANY others. Ring vaccination WILL NOT contain the virus in this scenario. Millions will die and the virus will once again become established as an endemic disease requiring many years to once again eradicate it. Now, I need to be careful as I step down off my high horse because if I fall from this height, it will definitely hurt.