Smallpox Information Sheet for APWU Members
by
Terry Stapleton
APWU Southern Region Coordinator
and
Bob Del Prete
Southern Region Safety & Health Rep
(as of December 16, 2001)

Smallpox is a virus that is usually spread through close contact with an infected person. It is spread when that person coughs or speaks. The virus is invisible, odorless and colorless.

It can also be spread as an aerosol and it can be contracted from infected clothing or linen.

It has recently been estimated that one person with the disease can infect four to six others, on average. (Source: Study made on spreading smallpox. Associated Press, December 16, 2001)

With the onset of smallpox, the symptoms are as follows: backache, headache, vomiting, exhaustion, high fever, possible abdominal pain, and delirium.

These symptoms can occur about 12 days after one is infected. Then a flat red rash appears mainly on the face and extremities. About 2-4 days after this, the person is at his most contagious stage; spots then grow larger, they may connect and fill with puss. They are round and firm, deeply embedded in the skin. They first appear in the mouth and face, and unlike chicken pox, routinely appear on the palms and soles. This activity can last about 7 days and this is when death most often occurs because of the toxic substances in the blood. The spots then scab and fall off three to four weeks after forming, leaving scars. The person remains slightly contagious until the scabs are gone.

From the time a person is exposed, until the time a person is no longer at all contagious, the disease can debilitate someone for as long as 50-60 days.

The last case of smallpox in the world was recorded in 1978. Yet, some say that this disease is the biggest killer of all time. Most experts agree it is the biggest threat to this country’s security. (Source: Smallpox and bioterrorism: a growing threat. S. Van McCrary, Health Law and Policy Institute, August 3, 1999)

The smallpox virus can kill more than 30% of those not vaccinated. Complications or death arise from blood poisoning, hemorrhaging from the lungs and intestines, and secondary infections of the skin.

According to some bio-terrorism experts, the smallpox virus is not one that can be spread through the mails as was the case with anthrax. However, at least one report stated that it can be spread with the assistance of the postal system.

The U.S. stopped vaccinating against the disease in 1972. About half of the U.S. population has never gotten the smallpox vaccination. (Source: Frequently asked questions about smallpox. www.legalconsumerguide.com)

If you were vaccinated against the disease before 1972, you retain only 10% of the antibodies that can fight the disease.

For those who got the vaccination, most estimates suggest that the vaccination lasts 3-5 years. (Source: Frequently asked questions about smallpox. www.legalconsumerguide.com)

Immunization against the disease was no longer required for military personnel after 1990.

Prior infection with the disease grants lifelong immunity. (Source: Frequently asked questions about smallpox. 
www.legalconsumerguide.com)

Those never vaccinated can still gain protection by being vaccinated just before or after exposure. Secretary of Health and Human Services Tommy Thompson said if one is vaccinated within 4 days after exposure, the disease can be prevented. Most experts agree with this and add that if it doesn’t prevent the disease, it can lessen the severity. (Sources: U.S. ready to order smallpox vaccine. USA Today, November 21, 2001, page 3A; Frequently asked questions about smallpox. 
www.legalconsumerguide.com)

Current protocol for an outbreak appears simple. Once symptoms manifest themselves, a team from the CDC Emergency Response Office would race to the scene. The surrounding area would be quarantined and vaccinations would begin. The Legal Consumer Guide reports that the CDC has emergency smallpox vaccine. (Source: Frequently asked questions about smallpox. www.legalconsumerguide.com)

By international agreement, the smallpox virus is kept in an institute in Moscow and at the CDC in Atlanta (Source: U.S. on bioterrorism alert for smallpox. Newsmax.com, June 1, 2001). However, some countries and terrorist groups are suspected of having the virus.

There is a smallpox vaccine but it could have side effects. Because it is made from a live virus related to smallpox, experts estimate that if every American were vaccinated against the disease, some 400 would die from the vaccination itself. (Source: Getting smallpox vaccine popular idea, poll shows. South Florida Sun-Sentinel, November 19, 2001, page 10A.

Various agencies are currently working on tests that can determine if smallpox is in the environment. (Source: Frequently asked questions about smallpox. www.legalconsumerguide.com)

At the annual meeting of the American Medical Association, it was decided that they would not endorse a plan to inoculate all Americans against the disease. They decided this because the vaccine could kill about 300 and because it is not known for certain if terrorists have the virus. They also feel the vaccine could kill infants under the age of one and those with weakened immune systems couldn’t withstand the inoculation either. (Source: AMA rejects nationwide smallpox vaccinations. CNN.com, December 5, 2001.)

The CDC also recommends that no vaccinations should be given unless an outbreak occurs. (Source: AMA rejects nationwide smallpox vaccinations. CNN.com, December 5, 2001.)

The United States, as of October 17, 2001, had 15.4 million smallpox doses. It is actively seeking to increase smallpox reserves.

(Source when not otherwise indicated: A distant disease. South Florida Sun-Sentinel, November 18, 2001, page 6F.)