Connecticut Laying Out Smallpox Plan
By Marty Toohey
WASHINGTON, Oct. 16, 2002–The Connecticut Public Health Department is nearly finished with a comprehensive smallpox vaccination and counter-bioterrorism plan, and full details should be announced by the second week of November, public health commissioner Dr. Joxel Garcia said Wednesday.
Use of smallpox in bioterrorism has concerned public health officials nationwide since the attacks of Sept. 11.
Garcia’s plan includes a comprehensive education campaign and the means to vaccinate all of the state’s 3.4 million residents within a 30-day period. Although most of the framework will be in place by mid-November, some key details, such as the number of immunizations and exact dates, are contingent on whether President Bush enacts a nationwide vaccination plan. Garcia said he’s particularly eager to know if “mass vaccinations or only a limited amount” will be available from the federal government.
There is widespread speculation that Bush could implement the nationwide plan by December, but Garcia and other Connecticut medical workers said they haven’t heard any more than rumors.
“None of us [in the hospitals] know for sure,” said Louise-Marie Dembry, director of the epidemiology laboratory at Yale-New Haven Hospital.
Garcia had a guess, though.
“The federal government, through the Centers for Disease Control [and Prevention], is asking us to have a plan by December, so I would assume December is a good bet,” Garcia said.
The CDC asked each state to present a comprehensive plan by December, and Garcia wanted Connecticut’s plan finished early “to act as a template for other states. We have a lot of knowledge about the proper way to vaccinate. We want to share that.”
Garcia has a statewide group of advisers, including public health, National Guard and law enforcement officials and emergency medical personnel, helping him craft the plan.
The plan would call for federal workers to administer a “first wave” of vaccinations to key medical personnel across the state. Garcia gave 100 to 250 as a rough number for the first wave, but the numbers are still far from certain, he said. People vaccinated would include core personnel from hospitals, such as lab technicians and emergency medical units. They would also receive immunization-related training.
The first wave would then be responsible for vaccinating about 10,000 selected people in the event of an outbreak, and those 10,000 in turn would be responsible for vaccinating the rest of the population.
Under the plan the entire state would be immunized within 30 days, Garcia said.
“It is comprehensive, and it should fit into any guidelines the [federal] government creates” if Bush implements a nationwide plan, he said.
The state health department’s plan would incorporate the Yale-New Haven and Hartford Hospitals as “bases” in the event of bioterrorism. The bases would also help with things like training, technology and surveillance, Garcia said.
Individual “sentinel” healthcare workers across the state would also be trained to spot cases or potential outbreaks. An area’s population density and number of at-risk workers will determine the number of its sentinels, Garcia said. The sentinel workers would not necessarily be among the first people immunized, he said.
The names of the sentinel providers will be kept secret for security reasons, Garcia said.
The plan would also include a statewide education campaign. Smallpox vaccinations must be carefully applied, and the state wants to ensure the vaccine is administered properly.
“This is not as simple as going to the shopping center for the flu,” Garcia said.
The state’s current outbreak plan is to isolate a diagnosed carrier, find and test individuals the carrier had contact with and work outward until all carriers have been located. A CDC team should arrive within a few hours of the first diagnosis and administer the vaccine, which is usually effective up to four days after contraction of the disease, Garcia said.
A smallpox vaccine hasn’t been administered in the United States since 1972, and the disease was declared eradicated in 1980.
Previous vaccinations may provide limited protection, but probably wouldn’t offer full protrection, Yale-New Haven’s Dembry said.
About one-third of all smallpox cases in the 1960s were fatal, but Dembry said modern methods may reduce that percentage.
“Or it may not,” she said. “We just don’t know at this point.”
The United States and Russia are known to possess small amounts of the virus, but defense experts fear terrorist organizations or enemy nations may acquire it.
Published in The New Britain Herald, in Connecticut.
