Public health authorities in the US are too busy vaccinating people against smallpox to watch for an actual outbreak. Yet if terrorists ever did release the virus, spotting the disease early would be the most effective way of containing an outbreak.
In December 2002, President Bush announced that 500,000 鈥渇irst responders鈥�, mainly hospital and ambulance staff, would be offered smallpox vaccination by the end of February. By the middle of 2003, 10 million are meant to have been vaccinated.
These healthcare workers are the people most likely to come into early contact with infected people in any outbreak, and if they are not immune they could quickly spread the disease. But as 快猫短视频 went to press fewer than 5000 had been vaccinated, in just 27 states.
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Many hospitals are refusing to take part in the scheme, fearing that vaccinated staff might infect vulnerable patients with the live vaccinia virus used for the vaccine. Health workers are also reluctant to be vaccinated because there is no compensation scheme in place for the sometimes serious reactions to the vaccine.
A certain irony
Meanwhile, public health officials are being overwhelmed by the task of organising the vaccination programmes. A survey by the National Association of County and City Health Officials (NACCHO), the Washington-based umbrella organisation for the country鈥檚 public health agencies, shows that the workload has forced four out of five of them to delay or scrap projects aimed at responding to bioterror attacks.
鈥淭here鈥檚 a certain irony,鈥� says Pat Libbey, head of NACCHO. 鈥淭he most important determinant for how well we manage any smallpox outbreak is how fast we detect and respond to it.鈥�
It is not just other bioterror precautions that are being hindered by the vaccination programme. NACCHO鈥檚 survey shows 59 per cent of the authorities have had to cut back on routine public health work. Bruce Clements of the Center for the Study of Bioterrorism at St Louis University in Missouri points out that with bioterror attacks still no more than a theoretical threat, measures to prepare for them should not come at the expense of dealing with real illnesses today.
State agencies were allocated extra funds for biodefence in 2002, but in many cases this money is not going to local public health agencies, Libbey says. The Centers for Disease Control and Prevention pays public health agencies only $13 per vaccination, while Libbey says the real cost can be $400, because of the special needles, counselling and follow-up measures needed.