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The world we live in

Smallpox is arguably the most dreaded disease of all time, but did you know that smallpox was first used as a biological weapon during the French and Indian Wars (1754-67)? British forces in North America distributed blankets that had been used by smallpox patients to the American Indians who supported the French.In 1967, under the auspices of the World Health Organization, a global campaign began to eradicate the disease. They succeeded in 1977. In 1980, the World Health Assembly recommended that all countries cease vaccinations.A World Health Organization expert committee recommended that all laboratories destroy their stocks of the virus or transfer them to one of two World Health Organization reference laboratories, 1) The Institute of Virus Preparations in Moscow, Russia; or 2) the Centers for Disease Control and Prevention (CDC) in Atlanta, Ga. All countries worldwide reported compliance.The World Health Organiz-ation committee later recommended that all virus stocks be destroyed, and the World Health Assembly concurred. Obviously, this is not what transpired, and as a result, we face the specter of the deliberate reintroduction of smallpox as an epidemic disease.But just how informed is the average American about this disease? According to a survey at the Harvard School of Public Health, a majority of Americans believe that the disease still breaks out naturally. While the last reported case of naturally occurring smallpox was 50 years ago (U.S. News & World Report), 30 percent of Americans believe that smallpox has occurred in the U.S. during the 1990s.What is more alarming, however, is that almost 80 percent believe that smallpox is treatable. It’s not! It makes me wonder if that bit of misinformation is the reason why only 55 percent of Americans surveyed said they would choose to be vaccinated against the disease.However, vaccinations carry risk. According to the RAND Center for Domestic and International Health Security, if 60 percent of Americans were vaccinated, it would result in about 500 deaths. That means if all of the 10 million American health workers were vaccinated, about 25 would die, not to mention those who would contract the disease.The disease viciously attacks the specialized tissues that cover the body, (mouth, air passages, cornea), is fiercely contagious and is particularly deleterious to the young and infirm. So I pose the question: In light of the above, do mass vaccinations make sense?Obviously a deliberate attack using smallpox as a bio-weapon would be enormously disruptive to our society. In light of that, the president’s plan for mass vaccinations appears to make sense. As a sidebar, I find it interesting is that President Bush has said that he will be vaccinated, but not his immediate family, nor many of his Cabinet members. Personally, I think that’s a pretty courageous move.Immunizations are beginning for military personnel and will soon begin on a voluntary basis for “front line” responders here at home – firefighters, police, emergency medical technicians.The president’s plan is being phased in for several reasons, mostly to protect the general population, not to mention the fact that health officials have not mounted a smallpox vaccination campaign in decades. The phase in process will allow American health officials to monitor the results for deleterious effects before 270 million Americans are offered vaccinations.There are also severe risks to inoculation outside the predicted deaths due to adverse reactions to the vaccine. Anyone with immune system problems or those taking medications that suppress the immune system will be at higher risk than the general population.A partial list of those high risk people include those who have contracted HIV, those taking medications to prevent organ transplant rejection, certain cancer patients including those being treated by chemotherapy, as well as those with Crohn’s disease, rheumatoid arthritis and serious skin disorders. Finally, under the president’s plan, children under 18 will not be vaccinated unless there’s an outbreak and further testing is completed.I don’t think many of us disagree that the president needs to make this vaccine available, but the general populace also needs to know the risks involved. If there is an outbreak, people exposed to the virus will have about four days to get the vaccine to be protected.There is no reason to panic, but it wouldn’t hurt to speak with your family physician about the matter. I’ve already spoken to my doctor about being vaccinated and his advice was to “wait and see.”The government isn’t going to make this a “Hobson’s choice.” Therefore, it is important for all of us to understand the specific risks and our alternatives. Unfortunately, this is the world we live in today.Butch Mazzuca of Singletree writes a weekly column for the Daily. He can be reached at bmazz@centurytel.net


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