within four days of first exposure has been shown to offer some protection against acquiring the infection and significant protection against a fatal outcome. An emergency vaccination program should include all health workers at clinics or hospitals that may receive such patients and all disaster workers such as EMS, hospital staff, police, public health staff, and mortuary staff. These personnel should be vaccinated as soon as the first case is diagnosed, irrespective of prior vaccination status. Vaccination should be considered for any other persons who would be responsible for patient care during a suspected outbreak of smallpox and for the investigation and control of suspected outbreaks of smallpox.
Contraindications to Smallpox vaccine
Some important features of these efforts are:
Sharing of disease data ODRS Ohio Disease Reporting System - (electronic reporting mechanism for Ohio Department of Health)
The idea behind this pre-event vaccination program within the civilian community is to produce a cadre of medical and emergency personnel who would be able to investigate index cases of smallpox and care for smallpox victims while not becoming casualties themselves.
Based on current ACIP (Advisory Committee on Immunization Practices)
CDC has released an updated version of the post-event Smallpox Response Plan and Guidelines. This is the second revision to these guidelines since they were released in November 2001.
Version 3 of the guidelines contains an important addition---the "Smallpox Vaccination Clinic Guide." This guide provides the operational and logistical considerations associated with implementing a large-scale, voluntary vaccination program as part of a multifaceted response to a confirmed smallpox outbreak.
Following a confirmed smallpox outbreak within the United States, rapid, voluntary vaccination of a large segment of the population might be required to
1) Supplement priority surveillance and containment control strategies in areas with smallpox cases.
2) Reduce the at-risk population for additional intentional releases of smallpox virus if the probability of such occurrences is considered significant
3) Address heightened public concerns about access to voluntary vaccination.
The most important component of smallpox containment is the rapid identification, isolation, and vaccination of close contacts of infected patients and contacts of their contacts (i.e., ring vaccination).
This strategy involves identification of infected persons through intensive surveillance, isolation of infected persons, vaccination of household contacts and other close contacts of infected persons (i.e., primary contacts), and vaccination of household and other potential contacts of the primary contacts (i.e., secondary contacts).
The clinic guide will assist planning for larger-scale, post-event vaccination when exposure circumstances indicate the need to supplement the ring vaccination approach with broader protective measures. The clinic guide describes the activities and staffing needs associated with large-scale smallpox vaccination clinics, including suggested protocols for vaccine safety monitoring and treatment. The clinic guide provides an example of a model smallpox clinic and provides samples of pertinent clinic consent forms and patient information sheets that would be used at a clinic.
The clinic guide and the Smallpox Response Plan and Guidelines, Version 3 are available at http://www.cdc.gov/smallpox.
CDC will take additional steps to increase preparedness to respond to a smallpox exposure of any magnitude, including updates to the Smallpox Response Plan and Guidelines. Updates on infection control, in-hospital isolation recommendations, post-event vaccination protocols, and outbreak response strategies are under way and will be posted on the CDC website.
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Pharmacotherapy 23(3):271-273, 2003. © 2003 Pharmacotherapy Publications