Jewish World Review Nov. 16, 2001 / 1 Kislev, 5762
Drs. Michael A.Glueck & Robert J. Cihak
http://www.NewsAndOpinion.com -- IN 1957 we had Sabin Oral Sundays (SOS) to inoculate against the scourge of polio. With the current smallpox scare-athon do we now need Super Smallpox Saturdays (SSS)?
Dr. Donald A. Henderson, director of the new Office of Public Health Preparedness, and a recognized smallpox expert, says, No, it would do more harm than good. But the Centers for Disease Control has proposed state governments set up emergency blanket powers to control citizens in order to control disease. We go with Dr. Henderson.
The last known case occurred twenty-five years ago in Somalia. The only acknowledged remaining samples of the virus are stored in two laboratories, one in Atlanta and one in Siberia.
Why do people die of smallpox? In 1999, the "Consensus Statement of the Working Group on Civilian Biodefense" wrote that death from smallpox "most likely results from the toxemia associated with circulating immune complexes and soluble variola antigens." This roughly means that we don't have a very good understanding of how the smallpox virus kills people. Yet in the decades since smallpox was eradicated, the power of basic supportive medical treatment (such as the use of IV fluids and medicine to help control fever and pain) has exploded. Many of these new treatments would help treat smallpox victims, reduce the severity of infection, and save lives.
Terrorists would most likely release smallpox at a crowded public event or in a densely populated area. We estimate that simultaneous attacks releasing the virus at several major sports stadiums would likely infect less than one out of a thousand Americans.
Smallpox patients can be very sick as soon as a week after infection with the virus but - this is vital - don't spread the virus until after they're sick in bed and the spots on the skin start to develop. One patient may infect two or three others on average, before the disease is recognized and quarantine procedures initiated, but these patients are not out spreading the disease. Advances in hospital construction such as air flow control and filtering also help prevent spread of the virus.
Antibiotics don't control the smallpox virus. Other anti-viral treatments are available, but testing could take years. Although about half of all living Americans were vaccinated prior to 1972; no one knows how much residual protection these old vaccinations provide.
If smallpox does break out, vaccination within four days after exposure can prevent or significantly reduce the severity of illness. Over ten million doses of vaccine are available in this country, although its effectiveness is a bit uncertain because many doses are old and of uncertain activity. The federal government recently ordered forty million new doses. Delivery of the first batch was originally scheduled for 2004; officials now hope for earlier delivery.
As with all medical treatments, smallpox vaccination has complications, including death. About one in one thousand people had complications in the past. About two out of a million vaccinated people died of these complications.
However, because the risk of smallpox exposure, although low and uncertain, is nonetheless real, we conclude that there might be a need for a Super Smallpox Saturday. But only in places where actual cases of smallpox occur. The general public should not be encouraged or required to risk injury or death from treatments for still hypothetical risks.
THERE THEY GO AGAIN …
And governments, like doctors, should - First, Do No
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