Cape health workers get first shots for smallpox

Five nurses and one doctor from Cape Girardeau County's Public Health Center will be among about 100 of the state's front-line health-care workers to receive the smallpox vaccination today, representing the first concrete effort to protect Missouri from a possible bioterrorism attack.

"We're not even speculating as to whether or not smallpox will ever be used as a weapon or make a re-entrance into our lives as a disease," said center director Charlotte Craig, who is also getting the vaccine. "But we have to be ready. If public health people aren't immunized, we'd be unable to deliver the vaccine, and that would mean we wouldn't be able to fulfill our responsibilities."

Health-care workers from across Southeast Missouri will be given the vaccine at the Butler County Health Department in Poplar Bluff, Mo. Health-care workers in St. Louis, Kansas City, Columbia and Springfield will also be given the vaccine today that would help protect them from the infectious virus, which kills about 30 percent of its victims and scars the remainder for life.

By the end of March, the people who are getting the vaccine now will administer the inoculations to about 2,400 others, including hospital workers, state health department employees and other county public health workers. The state recently received 5,000 doses of smallpox vaccine from the Centers for Disease Control and Prevention in Atlanta.

"They would be the first ones to investigate and take care of a case or cases of smallpox should we get one," said Mary Kay Hagar, a spokeswoman for the Missouri Department of Health and Human Services. "If the worst happens, they'll be the ones on the front lines."

Available to public

The CDC plans to administer the vaccine in phases. President Bush has said all Americans should have access to the vaccine, if they want it, in 2004. The next phase is getting 150,000 doses to Missouri's first-responding emergency personnel -- firefighters, police, hospital staff and ambulance drivers.

"We're going to have a lot of work to do and quickly," Hagar said. "But it can be done."

So far, 11 states and one city have vaccinated 432 people, said Joe Henderson, bioterrorism chief at the CDC. Forty-three states and large cities have requested 368,700 doses of the vaccine. Everyone who takes the vaccine will do so voluntarily, he said.

He said that no serious side effects have been reported by those already vaccinated, which also will include half a million military personnel as well as an estimated 450,000 nurses and doctors.

More than three decades have passed since the last natural case of smallpox was reported in the world, in Somalia in 1977. The last case in the United States was confirmed in 1949, and routine smallpox vaccinations ended in 1972. But experts fear the potentially fatal infectious disease could be released again in an act of bioterrorism.

Calculating risks

Those who agree to be vaccinated are not doing so without risk. The CDC reports that about one in 1,000 can become seriously ill and about one in 1 million can die from the vaccine's side effects. Most people experience normal, usually mild reactions that include a sore arm, fever and body aches.

However, other people can experience serious to life-threatening reactions.

The vaccine being used contains a live smallpox-related virus that can cause brain damage or even death in a small percentage of those inoculated, usually children and people with weak immune systems.

People who are more likely to become sick are being screened out, Craig said. People who have had skin conditions such as eczema or atopic dermatitis, and people with weakened immune systems, like recent transplant patients or people with HIV, should not get the vaccine. The vaccine could also have adverse effects on fetuses, so pregnant women should not take the vaccine.

The threat was real enough for some health-care workers in other states to refuse the vaccine.

It will also be important for those who receive the vaccine to know how to take care of themselves -- and the vaccinated area -- after they get the shot, Craig said. The area tends to ooze and if others come into contact, they could become infected with the virus vaccilia -- not smallpox -- through the vaccine. That would inoculate some from smallpox, but put those in high-risk categories in danger.

Craig said a seminar will be held Monday with the vaccinated nurses showing other area health-care workers how to tend to bandages to cut down the spread of the vaccine.

"So there is a risk," Craig said. "But we believe it's a minor one. We all got the smallpox vaccine when we were younger. It is my expectation that there will be no problems."

smoyers@semissourian.com

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