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Health workers get smallpox shots

By BRIAN LEAHY
of The Gazette
Local public health and safety agencies are continuing to prepare for incidents of terrorism.

At the Portage County Health and Human Services Department, public health workers have been vaccinated against smallpox. Firefighters at the Stevens Point Fire Department are taking part in a four-hour, state-mandated course on terrorism awareness.

The county public health staff received the smallpox vaccination on Monday, said Faye Tetzloff, Portage County health officer. Each state had to submit a smallpox vaccination plan to the federal Center for Disease Control and has received federal funding to carry out its plan.

"We're not aware of any increased threat at this point, it's just that the federal government is asking all states to do this," Tetzloff said.

President George Bush made a request a couple of months ago that states begin vaccinating public health workers against smallpox, Tetzloff said. Some states are further along than Wisconsin. States have been cautious about the smallpox vaccination plan because a small percentage of people who receive it can suffer adverse reactions.

"This is a huge issue," she said. "For childhood immunizations, there is federal funding should there be an adverse reaction. Families are compensated. There is not a similar fund at this point for this vaccination. It's unclear where that compensation is coming from."

The president has proposed creating a compensation fund similar to the one covering childhood immunizations, she said.

Volunteers who received the smallpox vaccine went through a medical screening to make sure they and their household members did not have any contraindications to the vaccine, Tetzloff said. Contraindications are medical conditions - such as eczema, having a weakened immune system or being pregnant - that increase the risk of having a severe adverse reaction to the vaccine. Those public health staff members with contraindications weren't vaccinated. The staff members who were vaccinated are being monitored.

Besides all of the normal childhood immunizations, the only other vaccine public health workers routinely receive is one for hepatitis B, Tetzloff said. Hepatitis B is a blood-borne pathogen and workers, primarily those who come in contact with bodily fluids or are at risk of accidental needle sticks, are vaccinated against it.

While some members of the military have been vaccinated against anthrax, there is no plan to vaccinate public health workers against it, she said.

"With smallpox, one person can give the disease to another," Tetzloff said. "With anthrax, you have to be exposed to the spore. You can't spread the anthrax person to person."

The last case of smallpox in the United States was in 1949 and the U.S. stopped routine vaccinations in 1972, she said. Smallpox was declared eradicated worldwide in 1980, but there is a concern terrorist or other countries could use the virus as a weapon.

Public health workers have been receiving the smallpox vaccine because of concerns someone would come in for treatment with an unknown rash that is later determined to be smallpox, she said. Members of the general public are not included in this phase of the smallpox vaccination plan. If a case of smallpox were identified, the general public would receive the smallpox vaccination. People who receive the vaccination four days after exposure to the smallpox virus have a greatly reduced risk of getting smallpox. Those who receive it four to seven days after exposure receive some protection. About 30 percent of unvaccinated people exposed to smallpox will die. The rest can suffer scarring.

"It is truly a devastating disease," Tetzloff said. "If there's a case anywhere in the world, we're going to respond because in today's world of global travel, smallpox is going to spread."

Tetzloff hopes that any terrorist group or country that releases smallpox realizes they would put their own population at risk.

"If you open this can, there's no closing it, because it will come back to affect your country," Tetzloff said.

Members of the Stevens Point Fire Department, who also staff the Portage County Ambulance Service, are not receiving the smallpox vaccine.

"We're following the lead of our medical control officer, and his position is it's not worth the risk," said Stevens Point Fire Chief Mark Barnes. "When you weigh the benefit, as opposed to the risk, it's just not there."

If smallpox does become an increased risk, public safety personnel would need protection because of the possibility of losing personnel to the disease and not having enough on hand to respond to emergencies, Barnes said.

With the war on terrorism, the Fire Department has received additional funding, Barnes said. The Fire Act Grant placed $750 million into the Federal Emergency Management Agency to be given to fire services nationwide. The funds are not just for weapons of mass destruction (WMD), but WMD-related applications receive more points in the process used to rate applications.

"I don't think it would have been funded to that $750 million level had it not been for the need to make some WMD improvements," Barnes said.

The Fire Department has received funds for communication equipment and breathing apparatus upgrades it may not have otherwise without the increased funding, Barnes said.

One impact of the war on terrorism and possible military action is firefighters who are members of military reserve components being called to active military service. One, Mike Wheeler, has been called to active duty with the Army Reserve's 432nd Civil Affairs Battalion based in Green Bay. Two or three other firefighters are in reserve units, but have not received any mobilization orders.

Compensating for the loss of a mobilized employee means overtime for other personnel, Barnes said.

"This is just an extremely difficult job to get temporary help," Barnes said. "Training certification requirements are so high and you truly have to know the area."

Civil Affairs units help to restore order and government services in an area, so Wheeler would most likely remain overseas after any fighting stops.

To firefighters, terrorism incidents are essentially hazardous material incidents, with a few extra concerns thrown in, Barnes said. One is a secondary explosive device at an incident scene.

"It's 'still go in,' but you certainly have your eyes open to the possibility of that," Barnes said. "The first device might have been nothing more than bait to draw in emergency services, but the second one might be a catastrophic device."

Bombs can also be used as a delivery device to spread another agent, he said.

While terrorism may be in the spotlight now, Barnes said he isn't "lying awake at night worrying about it."

"I have more concerns for everyday events," Barnes said. "We have a highway in this town. We have a railway in this town. The routine accident can turn into a significant event."



	Health workers get smallpox shots By BRIAN LEAHY of The Gazette Local public health and safety agencies are continuing to prepare for incidents of terrorism. At the Portage County Health and Human Services Department, public health workers have been vaccinated against smallpox. Firefighters at the Stevens Point Fire Department are taking part in a four-hour, state-mandated course on terrorism awareness. The county public health staff received the smallpox vaccination on Monday, said Faye Tetzloff, Portage County health officer. Each state had to submit a smallpox vaccination plan to the federal Center for Disease Control and has received federal funding to carry out its plan. "We're not aware of any increased threat at this point, it's just that the federal government is asking all states to do this," Tetzloff said. President George Bush made a request a couple of months ago that states begin vaccinating public health workers against smallpox, Tetzloff said. Some states are further along than Wisconsin. States have been cautious about the smallpox vaccination plan because a small percentage of people who receive it can suffer adverse reactions. "This is a huge issue," she said. "For childhood immunizations, there is federal funding should there be an adverse reaction. Families are compensated. There is not a similar fund at this point for this vaccination. It's unclear where that compensation is coming from." The president has proposed creating a compensation fund similar to the one covering childhood immunizations, she said. Volunteers who received the smallpox vaccine went through a medical screening to make sure they and their household members did not have any contraindications to the vaccine, Tetzloff said. Contraindications are medical conditions - such as eczema, having a weakened immune system or being pregnant - that increase the risk of having a severe adverse reaction to the vaccine. Those public health staff members with contraindications weren't vaccinated. The staff members who were vaccinated are being monitored. Besides all of the normal childhood immunizations, the only other vaccine public health workers routinely receive is one for hepatitis B, Tetzloff said. Hepatitis B is a blood-borne pathogen and workers, primarily those who come in contact with bodily fluids or are at risk of accidental needle sticks, are vaccinated against it. While some members of the military have been vaccinated against anthrax, there is no plan to vaccinate public health workers against it, she said. "With smallpox, one person can give the disease to another," Tetzloff said. "With anthrax, you have to be exposed to the spore. You can't spread the anthrax person to person." The last case of smallpox in the United States was in 1949 and the U.S. stopped routine vaccinations in 1972, she said. Smallpox was declared eradicated worldwide in 1980, but there is a concern terrorist or other countries could use the virus as a weapon. Public health workers have been receiving the smallpox vaccine because of concerns someone would come in for treatment with an unknown rash that is later determined to be smallpox, she said. Members of the general public are not included in this phase of the smallpox vaccination plan. If a case of smallpox were identified, the general public would receive the smallpox vaccination. People who receive the vaccination four days after exposure to the smallpox virus have a greatly reduced risk of getting smallpox. Those who receive it four to seven days after exposure receive some protection. About 30 percent of unvaccinated people exposed to smallpox will die. The rest can suffer scarring. "It is truly a devastating disease," Tetzloff said. "If there's a case anywhere in the world, we're going to respond because in today's world of global travel, smallpox is going to spread." Tetzloff hopes that any terrorist group or country that releases smallpox realizes they would put their own population at risk. "If you open this can, there's no closing it, because it will come back to affect your country," Tetzloff said. Members of the Stevens Point Fire Department, who also staff the Portage County Ambulance Service, are not receiving the smallpox vaccine. "We're following the lead of our medical control officer, and his position is it's not worth the risk," said Stevens Point Fire Chief Mark Barnes. "When you weigh the benefit, as opposed to the risk, it's just not there." If smallpox does become an increased risk, public safety personnel would need protection because of the possibility of losing personnel to the disease and not having enough on hand to respond to emergencies, Barnes said. With the war on terrorism, the Fire Department has received additional funding, Barnes said. The Fire Act Grant placed $750 million into the Federal Emergency Management Agency to be given to fire services nationwide. The funds are not just for weapons of mass destruction (WMD), but WMD-related applications receive more points in the process used to rate applications. "I don't think it would have been funded to that $750 million level had it not been for the need to make some WMD improvements," Barnes said. The Fire Department has received funds for communication equipment and breathing apparatus upgrades it may not have otherwise without the increased funding, Barnes said. One impact of the war on terrorism and possible military action is firefighters who are members of military reserve components being called to active military service. One, Mike Wheeler, has been called to active duty with the Army Reserve's 432nd Civil Affairs Battalion based in Green Bay. Two or three other firefighters are in reserve units, but have not received any mobilization orders. Compensating for the loss of a mobilized employee means overtime for other personnel, Barnes said. "This is just an extremely difficult job to get temporary help," Barnes said. "Training certification requirements are so high and you truly have to know the area." Civil Affairs units help to restore order and government services in an area, so Wheeler would most likely remain overseas after any fighting stops. To firefighters, terrorism incidents are essentially hazardous material incidents, with a few extra concerns thrown in, Barnes said. One is a secondary explosive device at an incident scene. "It's 'still go in,' but you certainly have your eyes open to the possibility of that," Barnes said. "The first device might have been nothing more than bait to draw in emergency services, but the second one might be a catastrophic device." Bombs can also be used as a delivery device to spread another agent, he said. While terrorism may be in the spotlight now, Barnes said he isn't "lying awake at night worrying about it." "I have more concerns for everyday events," Barnes said. "We have a highway in this town. We have a railway in this town. The routine accident can turn into a significant event."