Smallpox

PRESIDENT BUSH has announced plans to allow voluntary vaccination of all who want it, but some things are worth remembering in deciding whether to volunteer: Smallpox is a very nasty disease. The variola major form of the virus, which affects 90 percent of those who have contracted the disease, kills one-third of its victims. There is no proven treatment once you are ill with smallpox. Smallpox generally spreads slowly. In a crowded municipality in Bangladesh in which I worked in 1972, only 3 percent of inhabitants became infected, the vast majority before we began vaccine control activities.

This month, leaders from around the globe announced a road map for ending preventable child deaths within a generation. Essentially, the ambitious plan aims to assure that every child has the same opportunity for a fifth birthday and a future beyond childhood, thereby ending one of the most obvious social injustices in the world today. Some will question whether this period of austerity is the time for an ambitious new global health goal. If skepticism had prevailed a half-century ago, it would have derailed one of humanity's great victories: smallpox eradication.

Between 5,000 and 6,000 doctors, nurses and other health care workers in Maryland would be vaccinated against the deadly smallpox virus under a plan submitted this week to the U.S. Centers for Disease Control and Prevention. The plan calls for the vaccination of about 5,000 hospital workers across the state, Arlene Stephenson, acting secretary of the state Department of Health and Mental Hygiene, said yesterday. Smaller hospitals might vaccinate teams of 50 doctors and nurses, she said, while larger ones might vaccinate as many as 250. About 80 six-person "public health teams" at local health departments and at the state health department also would be vaccinated under the plan.

Arthur G. "Whitey" Mansberger, one of Baltimore's great collectors and dealers of what he called "old stuff" for more than 30 years, was mentioned last week in Jacques Kelly's column. I became acquainted with Mansberger in the early 1970s, through Earl Arnett, who was then a Sun feature writer. Earl said that Mansberger was a character, and he wasn't kidding. He proposed a lunch at the now-gone and much-lamented Schellhase's Restaurant on Howard Street, to talk about the bundles and bundles of old City Hall papers, mainly canceled checks, that Mansberger had purchased for $50 from a foreman overseeing restoration of the building.

ARE YOU worth $1.70? That's the $10 million question the Maryland government must soon decide. Before it answers that question, it must answer another one: Is Maryland ready for smallpox? My answers to the first and second questions are a resounding yes and no, respectively. In my experience I unfortunately found that government doesn't usually act unless there is a major crisis or a major fear or threat of one. What can you do now? To make knowledgeable decisions, you must be well informed about smallpox, and there should be public discussion about what should be done.

BOSTON - In light of our recent experience with anthrax, should we vaccinate all Americans against the more deadly bio-weapon, smallpox? Despite efforts to fit ourselves with new layers of protection - National Guard units in airports, stockpiles of Cipro, irradiated mail - a sense of heightened risk remains in the air. The remedies themselves are alarming, and so we reach for the comforting absolute of vaccination, as evidenced by the federal government's move...

IN A startling and puzzling reversal of policy, the Clinton administration has taken the position that the two known remaining stocks of smallpox virus -- one here, one in Russia -- should be kept indefinitely for possible research purposes.The U.N. World Health Assembly had recommended destroying stocks of the virus by June 30. However, it is to meet in Geneva, Switzerland, later this month to vote again.The assembly's position had been firmly supported by the United States since 1990 when then-Secretary of Health and Human Services Louis Sullivan first proposed destruction of the stocks to the assembly.

More than 1,800 health care workers in Baltimore will be vaccinated against the smallpox disease under the first phase of a plan to prepare for a potential bioterror attack, the city's health commissioner announced yesterday. Dr. Peter L. Beilenson said that 1,750 hospital workers and 78 Health Department staff will be vaccinated, probably beginning soon after Jan. 24. That's when a provision in the federal Homeland Security Act takes effect that protects those who make or give the vaccine from lawsuits if those who receive it experience adverse reactions.

The smallpox virus got an unexpected stay of execution yesterday from the governing board of the World Health Organization.The last known stocks of the deadly virus were to be destroyed in June, but the latest decision puts off its demise for at least a year, and perhaps indefinitely.In 1980, after a worldwide vaccination program, the World Health Organization declared the eradication of natural smallpox, one of the biggest killers in history. But samples of the virus have been kept frozen in laboratories in the United States and Russia.

Anne Arundel County Health Officer Frances B. Phillips remembers being vaccinated for smallpox as a child. A nurse pricked her arm with a forked needle, and days later the site blistered and scabbed. A scared child no longer, Phillips again is dealing with smallpox. This time she is part of a nationwide effort to inoculate roughly 500,000 health care workers against the disease as a precaution against potential terrorist attacks. "It was a huge development in public health to eradicate the disease," said Phillips, who is overseeing the vaccination of 218 county health professionals, a process set to begin next month.

The Colony By John Tayman From 1866 through 1969, the Hawaiian and American governments banished nearly 9,000 leprosy sufferers into exile on a peninsula on the Hawaiian island of Molokai. Former Outside editor Tayman crafts a tale of fear, endurance and hope in telling the story of these unfortunate victims of ignorance (leprosy is caused by a simple bacterium and isn't nearly as contagious as was long believed). After a smallpox epidemic wiped out a fifth of the Hawaiian population in the 1850s, leprosy was seen as the next cataclysmic threat, and drastic measures were taken.

Rise and fall of Joppa A land certificate dated July 28, 1661, shows 300 acres on the north side of the eastern branch of the Gunpowder River laid out for John Taylor, a planter. This tract, known as "Taylor's Choice," became the thriving town of Joppa. Joppa was destined to become the county seat of old Baltimore County from about 1710 or 1712 to 1768. According to The Story of Harford County, the original Joppa was a booming seaport, where ships from Europe and the West Indies brought manufactured goods and took away great quantities of tobacco and corn.

The failed smallpox inoculation campaign of two years ago could hinder future efforts to vaccinate volunteers in the event of bioterrorism because federal officials never really explained why thousands needed to be inoculated, experts said yesterday. Panelists from the Institute of Medicine who wrote recommendations to the Centers for Disease Control and Prevention, the agency leading the campaign, issued their final word yesterday during a news briefing and in a 270-page report. "The way the policy and the rationale for the smallpox vaccination initiative were communicated may have negatively affected the program's implementation and outcome," said Dr. Brian Strom, a vice dean at the University of Pennsylvania School of Medicine and chairman of the institute's panel.

IT KILLED MORE than 30 million people in the 20th century. Its capacity to injure quickly and spread widely once sent cold shivers down the spine. Its endurance confounded scientists. Most Americans assumed they had heard the last of smallpox nearly three decades ago when, after a global vaccination campaign, the disease was declared eradicated - save two remaining stocks left purposely in deep freeze. Now with post-9/11 debates about bioterrorism the norm, smallpox fear is back. This time however, it's an international health agency raising anxieties.

Despite pledges two years ago to maintain a stockpile of drugs to protect Americans in the event of a bioterrorism attack, the federal government has so far set aside only 159 vials of anthrax vaccine for the civilian population, enough for only 530 people, according to congressional and administration officials. The officials said the failure to transfer more of the vaccine from military to civilian control was caused by legal and bureaucratic wrangling among government agencies. They also cited the government's desire to buy a new vaccine that is potentially both cheaper and more efficient.

CHICAGO - Baxter International Inc. disclosed plans yesterday to eliminate up to 4,000 jobs - nearly 8 percent of the company's work force - as the next phase of an extensive restructuring that the struggling global health-care company hopes will strengthen its profit margins. The Deerfield, Ill.-based maker of medical products announced the latest retrenchment nine months after it began cutting 3,000 jobs. Half of the 4,000 additional job cuts will be borne by U.S. workers. Baxter is cutting back in a turbulent period marked by investor dismay over a series of quarterly earnings disappointments.

A worker at a city laboratory was injured yesterday morning when a pressurized 55-gallon drum containing smallpox vaccine ruptured, and its lid struck him in the head, fire officials said. The worker, whose name was not released, was taken to Maryland Shock Trauma Center for treatment. Authorities said no smallpox vaccine escaped during the incident. Even if it had, experts said, it would not have posed a health threat. Fire officials said the worker attempted to open the drum about 9 a.m. at Chesapeake Biological Laboratories Inc. at 1111 S. Paca St. Due to built-up pressure inside the drum, the lid popped off and hit him in the head, officials said.

McDaniel College student C.J. Schleicher gave Carroll County sheriff's deputies a scare yesterday when he apparently took a hostage at gunpoint before giving up and bolting out of a Carroll County high school. But when Schleicher was escorted back into Winters Mill High School in handcuffs, classmates cheered him for his performance. It was all an act. Schleicher's gun was his hand, his hostage was an employee of the Carroll County Health Department and his run-in with the law was just one of the many scenarios at a mock smallpox vaccination clinic - a first in Carroll.

McDaniel College student C.J. Schleicher gave Carroll County sheriff's deputies a scare yesterday when he apparently took a hostage at gunpoint before giving up and bolting out of a Carroll County high school. But when Schleicher was escorted back into Winters Mill High School in handcuffs, classmates cheered him for his performance. It was all an act. Schleicher's gun was his hand, his hostage was an employee of the Carroll County Health Department and his run-in with the law was just one of the many scenarios at a mock smallpox vaccination clinic - a first in Carroll.