Smallpox Would Spread Very
Quickly In Modern World
By Suzanne Rostler

NEW YORK (Reuters Health) - If introduced into America or Europe, smallpox would spread rapidly at first, infecting 6 to 12 people for each individual already infected.
As steps were taken to stymie the spread of the disease--including mass vaccination campaigns, restriction of infected individuals' movement and quarantines--the rate of disease spread would fall and eventually be contained.
Nonetheless, "significant epidemics could result, particularly if there were delays in detecting the first cases or in setting up effective public health interventions," Drs. Raymond Gani and Steve Leach of the Centre for Applied Microbiology and Research in Salisbury, UK, write in the December 13th issue of Nature.
Smallpox was eradicated by 1979 and vaccination against the disease gradually ended around the world. But stockpiles of the smallpox virus remain in laboratories in the US, Russia and possibly other nations. Recent fears of bioterrorism have ignited concerns that these stockpiles could be used to introduce the potentially deadly disease into the population, which is at present ill-prepared to deal with a potential outbreak, according to researchers.
In the US, Health and Human Services Secretary Tommy Thompson announced plans to buy as many as 300 million doses of smallpox vaccine. But several health experts have warned against a national vaccination program, citing potentially serious side effects including as many as 300 deaths.
Other experts argue that once an outbreak has occurred, restricting mass transportation and informing the public about the nature of the outbreak and how to minimize the risk of illness may more effectively prevent the spread of disease than isolating everyone who has been exposed.
The smallpox vaccine can also be used to treat the infection if given in the days immediately after exposure.
The study findings are based on a mathematical model the researchers created to calculate how fast smallpox would spread in Western populations that have little natural immunity and in the absence of public health interventions.
"This helps scope the potential intensity of the public health interventions that might subsequently be needed," Leach told Reuters Health. "The end result would depend on many factors, including the scale and extent of the outbreak, (but) the most important aspect will be that the outbreak will have ended."
SOURCE: Nature 2001;414:748-751.
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