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Local public health
officials have provided the following answers to basic questions about
Small Pox. These questions and answers will be
updated as frequently as possible to provide up-to-date public
information. Except for those questions that pertain to local concerns, the following are taken from the
CDC
Smallpox Web Site. If you have additional questions, please call the Public
Health Dept. at 831-454-4339.
How serious is the smallpox threat?
The deliberate release of smallpox as an epidemic disease is now regarded as a possibility, and the Unites States is taking precautions to deal with this possibility.
What should I know about smallpox?
Smallpox is an acute, contagious, and sometimes fatal disease caused by the variola virus (an orthopox virus), and marked by fever and a distinctive progressive skin rash. In 1980, the disease was eradicated following worldwide vaccination programs. However, in the aftermath of the events of September and October , 2001, the U.S. government is taking precautions to be ready to deal with a bioterrorist attack using smallpox as a weapon. As a result of these efforts: 1) There is a detailed nationwide smallpox response plan designed to quickly vaccinate people and contain a smallpox outbreak and that includes the creation of smallpox healthcare teams that would respond to a smallpox emergency and the vaccination of these teams. 2) There is enough smallpox vaccine to vaccinate everyone who would need it in the event of an emergency.
What is Santa Cruz County doing to prepare for a possible smallpox attack?
The County is implementing Phase I of the Smallpox Preparedness Program as directed by the Centers for Disease Control (CDC). There are 3 phases of the CDC plan. Vaccination of teams of health care workers is the first of the three phases. During the second phase, police officers, firefighters, emergency medical technicians and other “first responders” who would be likely to respond to an outbreak of smallpox, will be asked to volunteer for vaccination. Vaccination will be open to the public during Phase Three. This is a voluntary program and no one is required to receive the vaccination, regardless of their position as a health care worker.
What are the symptoms of smallpox?
The symptoms of smallpox begin with a high fever, head and body aches, and sometimes vomiting. A rash follows that spreads and progresses to raised bumps and pus-filled blisters that crust, scab, and fall off after about three weeks, leaving a pitted scar.
If someone comes in contact with smallpox, how long does it take to show symptoms?
After exposure, it takes between 7 and 17 days for symptoms of smallpox to appear (average incubation time is 12 to 14 days). During this time, the infected person feels fine and is not contagious.
Is smallpox fatal?
The majority of patients with smallpox recover, but death may occur in up to 30% of cases. Many smallpox survivors have permanent scars over large areas of their body, especially their face Some are left blind.
Can anyone get a smallpox vaccination?
At this time, only those health care workers who are employed by certain hospitals, or the Public Health Department are eligible to volunteer to receive a vaccination. In the event of a smallpox outbreak, there is enough vaccine to vaccinate everyone who would need it.
Is there a treatment for smallpox?
Smallpox can be prevented through the use of the smallpox vaccine. There is no proven treatment for smallpox, but research to evaluate new antiviral agents is ongoing. Early results from laboratory studies suggest that the drug cidofovir may fight against the smallpox virus. Patients with smallpox can benefit from supportive therapy (e.g., intravenous fluids, medicine to control fever or pain).
If I was vaccinated as a child, does that protect me now?
Past experience indicates that the first dose of the vaccine offers protection from smallpox for 3 to 5 years, with decreasing immunity thereafter. If a person is vaccinated again later, immunity lasts longer.
Is smallpox contagious before the symptoms show?
A person with smallpox is sometimes contagious with onset of fever (prodrome phase), but the person becomes most contagious with the onset of rash. The person is contagious until the last smallpox scab falls off.
How is smallpox spread?
Smallpox normally spreads from contact with infected persons. Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing. Indirect spread is less common. Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains. Smallpox is not known to be transmitted by insects or animals.
If smallpox is released in aerosol form, how long does the virus survive?
The smallpox virus is fragile. In laboratory experiments, 90% of aerosolized smallpox virus dies within 24 hours; in the presence of ultraviolet (UV) light, this percentage would be even greater. If an aerosol release of smallpox occurs, 90% of virus matter will be inactivated or dissipated in about 24 hours.
If someone is exposed to smallpox, is it too late to get a vaccination?
Vaccination within 3 days of exposure will completely prevent or significantly modify smallpox in the vast majority of persons. Vaccination 4 to 7 days after exposure likely offers some protection from disease or may modify the severity of disease.
How is the vaccine given?
The smallpox vaccine is given using a bifurcated (two-pronged) needle that is dipped into the vaccine solution. When removed, the needle retains a droplet of the vaccine. The needle is then used to prick the skin a number of times in a few seconds. The pricking is not deep, but it will cause a sore spot and one or two drops of blood to form. The vaccine is given in the upper arm.
If the vaccination is successful, a red and itchy bump develops at the vaccination site in 3 to 4 days. In the first week after vaccination, the bump becomes a large blister, fills with pus, and begins to drain. During week two, the blister begins to dryup and a scab forms. The scab falls off in the third week, leaving a small scar. People who are being vaccinated for the first time may have a stringer “take” (a successful reaction) than those who are being revaccinated.
What is the smallpox vaccine made of?
The vaccine is made from a virus called vaccinia, another “pox”-type virus related to smallpox but that does not cause smallpox. The smallpox vaccine helps the body develop immunity to smallpox. It does not contain the smallpox virus and cannot spread smallpox.
Is it possible for people to get smallpox from the vaccination?
No. The smallpox vaccine does not contain smallpox virus and cannot spread or cause smallpox. However, the vaccine does contain vaccinia, which is “live” in the vaccine. Because the virus is live, it can spread to other parts of the body or to other people from the vaccine site. This can be easily prevented through proper care of the vaccination site (e.g. hand washing and careful disposal of used bandages).
Is it possible to get vaccinia, the virus in the vaccine, from someone who has recently been vaccinated?
Yes. Vaccinia is spread by touching a vaccination site before it has healed or by touching bandages or clothing that have become contaminated with live virus from the vaccination site. Vaccinia is not spread through airborne contagion. The vaccinia virus may cause rash, fever, and head and body aches.
How safe is the smallpox vaccine?
The smallpox vaccine is the best protection you can get if you are exposed to the smallpox virus. Most people experience normal, usually mild reactions that include a sore arm, fever, and body aches. In recent tests, one in three people felt bad enough to miss work, school, or recreational activity or had trouble sleeping after receiving the vaccine. However, the vaccine does have some risks. In the past, about 1,000 people for every 1 million people vaccinated for the first time experienced reactions that, while not life threatening, were serious. These reactions include a vigorous (toxic or allergic) reaction at the site of the vaccination and spread of the vaccinia virus (the live virus in the smallpox vaccine) to other parts of the body and to other people. These reactions typically do not require medical attention. Rarely, people have had very bad reactions to the vaccine. In the past, between 14 and 52 people per 1 million vaccinated experienced potentially life-threatening reactions, including eczema vaccinatum, progressive vaccinia (or vaccinia necrosum), or postvaccinial encephalitis. Based on past experience, it is estimated that between 1 and 2 people out of every 1 million people vaccinated will die as a result of life-threatening reactions to the vaccine. Careful screening of potential vaccine recipients is essential to ensure that those at increased risk do not receive the vaccine.
Who should not get the vaccine?
Individuals who have any of the following conditions, or live with someone who does, should not get the vaccine unless they have been exposed to the smallpox virus:
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Eczema or atopic dermatitis. (This is true even if the condition is not currently active, mild or experienced as a child.)
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Skin conditions such as burns, chicken pox, shingles, impetigo, herpes, severe acne, or psoriasis. (People with any of these conditions should not get the vaccine until they have completely healed.)
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Weakened immune system. (Cancer treatment, an organ transplant, HIV, or medications to treat autoimmune disorders and other illnesses can weaken the immune system.)
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Pregnancy or plans to become pregnant within one month of vaccination.
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An allergy to polymyxin B, streptomycin, chlortetracycline or neomycin (all of these antibiotics are ingredients in the vaccine)
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Are younger than 12 months of age. The Advisory Committee on Immunization Practices (ACIP) advises against non-emergency use of smallpox vaccine in children younger than 18 years of age.
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Have a moderate or short term illness.
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Are currently breastfeeding.
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Chemotherapy or radiation therapy in the last three months.
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