Article

US Civilian Smallpox Preparedness and Response Program, 2003

National Vaccine Program Office, US Department of Health and Human Services, Washington, DC, USA.
Clinical Infectious Diseases (Impact Factor: 8.89). 04/2008; 46 Suppl 3(s3):S157-67. DOI: 10.1086/524751
Source: PubMed

ABSTRACT

Variola virus, the cause of smallpox disease, has been deemed a possible bioterrorism agent. Since November 2001, federal,
state, and local public health partners implemented activities to prepare for a possible smallpox outbreak. The Centers for
Disease Control and Prevention (CDC) produced and delivered training and educational materials for smallpox preparedness in
many formats, developed detailed smallpox vaccine information statements about vaccine contraindications and vaccination site
care, and established mechanisms to monitor and respond to adverse events after smallpox vaccination. The last included enhancements
to the Vaccine Adverse Event Reporting System, a pregnancy registry for inadvertently vaccinated pregnant women, and a Clinician
Telephone Information Line to collect reports about adverse events. The civilian responder vaccination program was conducted
with rigorous safety procedures, and few historically recognized adverse events were observed. However, myocarditis and/or
pericarditis was newly recognized as an adverse event caused by the New York City Board of Health vaccinia vaccine strain.
This smallpox preparedness program put into place a number of measures to advance the United States' readiness for a smallpox
outbreak that have assisted in preparedness for other threats.

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Available from: Walter A Orenstein, Dec 07, 2015
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    • "In addition, their assumptions regarding the control strategies implemented (for instance, vaccination of susceptible individuals ) are not suitable in the case of smallpox. In particular, any vaccination campaign against smallpox should take place within 10 days because the incubation period of smallpox is usually 12–14 days (Strikas et al., 2008). Other weak aspects, besides the poor description of epidemiological characteristics, of these studies are the lack of adherence to smallpox control guidelines published by national or international organisations worldwide, the absence of robust control scenarios and their assessment and, finally, their limited applicability. "
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    ABSTRACT: Effective control of an infectious disease outbreak calls not only for a rapid response but also for the establishment of an emergency supply chain. During the control effort, huge amounts of medical supplies should be distributed from central warehouses to local points of dispensing. In this paper, the case where a large-scale deliberate smallpox attack occurs is considered. For changes in various baseline assumptions (possible delays in response actions, limited response capacities, etc.), the logistical requirements and subsequently the flow of materials for implementing a regional mass vaccination campaign are assessed. For capturing the disease's dynamics, a transmission mathematical model is used. In addition, a linear programming model for optimally distributing a predetermined vaccine stockpile to several affected subpopulations is also used. A numerical example is finally presented illustrating the methodology proposed. The proposed methodology could serve as a sound operational planning tool for health-care personnel as well as medical decision-makers.
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    • "Nevertheless , the last decades have encountered a renewed scientific interest in the use of vaccinia virus. The resurgence of biomedical science employing vaccinia virus or related orthopoxviruses has taken two divergent routes: 1) as a biosecurity concern, identified by the National Institutes of Health/Department of Defense as Category A biosecurity concerns (NIAID, 2014), particularly after the events ofSeptember 11, 2001(Strikas et al., 2008), and 2) as a research model because of the beneficial capabilities as recombinant vectors for disease prevention or therapeutics. These include applications for other human orthopoxvirus infections, various infectious diseases including hemorrhagic fever viruses and HIV, and cancer immunotherapy (Moss, 2011;Walsh & Dolin, 2011). "
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    ABSTRACT: The vaccinia virus vaccine was effectively used during the 19th and 20th centuries to eradicate smallpox. Over the last decade, vaccinia virus and derived recombinant vectors have been increasingly used in biomedical research, in preclinical animal studies, as well as in clinical trials. While laboratories engineer and test orthopoxvirus vaccine vectors against infectious diseases and tumors, or develop countermeasures against inadvertent or bioterrorist-intended release of poxviruses, laboratory workers handling non-highly attenuated viruses are at risk of potential occupational exposure. This article describes an employee’s percutaneous exposure to a recombinant non-highly attenuated vaccinia virus with subsequent infection. Lessons learned from the incident investigation set the basis for improved work practices, refinements in the medical surveillance plan, and proactive measures to preclude recurrence.
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    • "of research related to OPV posed another concern and vaccination of laboratory workers is nowadays highly recommended in science centers of the USA and Europe [6] [7] [8]. "
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    ABSTRACT: Extensive use of Vaccinia virus (VACV) in research has led to associated accidental human exposure in laboratories worldwide. In spite of the social and economic relevance of Bovine Vaccinia outbreaks in Brazil, national data concerning laboratory workers handling these infectious agents are relatively scarce. Therefore, a serological survey was conducted in a Brazilian laboratory to evaluate staff exposure to orthopoxviruses (OPVs). Information concerning direct work with OPVs, vaccination status and laboratory accidents was collected and correlated to serology results. This study presents an opportunity for discussion of routine procedures involving OPVs in laboratories and their intrinsic risks. Aspects of the live attenuated smallpox vaccine are also discussed.
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