Does Smallpox Response Plan 'Sacrifice' First Responders?

Critics of the federal government's response plan to deal with a smallpox outbreak claim it will "sacrifice" the first healthcare workers responding to such an exposure.

The Jan. 5th issue of Bioterror Medical Alert, a new twice-monthly newsletter for doctors and other health professionals published by Atlanta-based National Health Information (NHI), examines the issue.

The current Centers for Disease Control and Prevention's (CDC) smallpox response plan relies on the concept of "ring vaccination," in which identification of smallpox cases is followed by vaccination of anyone who is likely to have been in or will be in contact with the affected individuals and those involved in their treatment.

Some infectious disease experts believe that healthcare providers should be given the option of receiving a smallpox vaccination before such an outbreak occurs. They claim that for some healthcare workers, exposure to smallpox, followed by a vaccination, means that they will still contract the often-fatal disease.

Paul W. Ewald is a professor of evolutionary biology at Amherst College and the author of Plague Time. He claims that a terrorist attack that exposes 10,000 people to smallpox would lead to as many as 2,000 to 3,000 deaths by the time the CDC mobilizes its response team and begins the "ring" vaccination effort. Widespread vaccination is the only true deterrent to a smallpox bioterror attack, says Ewald.

Criticism of the plan is even coming from J. Donald Millar, MD, former director of the CDC's Smallpox Eradication Program. Millar claims the policy condemns an unknown number of health workers to a sacrificial death as the "sentinel cases" when a smallpox outbreak is first identified.

The Jan. 5th issue of Bioterror Medical Alert also examines an experimental anthrax vaccine that is now available; the physician's role in bioterror preparedness; and the possible threat of food-borne attacks.

For more information about Bioterror Medical Alert, call (800)597-6300 or visit

edited by Sandy Smith ([email protected])

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