CDC experts have occasionally been called upon to examine suspected cases of the disease. Three of those occurred in the last month and all resulted in false alarms. CDC director Jeffrey Koplan told the New York Times Nov. 4, he considers these calls an essential part of the effort to make doctors more aware of exotic diseases like anthrax and smallpox.

The response teams are being trained to differentiate smallpox from diseases that cause similar symptoms. The most confusion is between smallpox and chickenpox. Both result in skin lesions, but smallpox lesions are deep in the skin and painful. Chickenpox lesions appear on the surface and can itch. Smallpox lesions have also been confused with allergic rashes or shingles, a disease in adults caused by the chickenpox virus.

Members of these teams have been vaccinated against smallpox and trained in how to use a special needle to administer more vaccinations. Yet, mass vaccination is not in the CDC’s preparation plan. The two reasons given are a lack of vaccine supplies and the unknown risks of administering the vaccine.

Dr. Michael Lane, who is helping the CDC design its training program, says vaccinations can cause unintended consequences. The vaccine is made from a different virus. Among the more than five million people who received smallpox shots in 1968, eight died. There were also some reports of people having a reaction that destroyed flesh and muscle and some others who contracted encephalitis, a swelling of the brain.

The medical world has changed dramatically since 1968. Experts are unsure how people with weakened immune systems, such as from HIV, would react to the shot. Also of concern is the interaction between the vaccine and drugs used to treat cancer or prevent rejection of transplanted organs.

What would doctors do if confronted with a confirmed outbreak of smallpox? In isolated cases, everyone who is known to have contact with the victim would be vaccinated and monitored closely. Mass vaccination would only be called for if experts found the virus had been widely distributed.

The biggest challenge to terrorists may be attempting to obtain the smallpox virus. Known samples exist only in U.S. and Russian laboratories. Some experts believe other countries may have found a way to obtain the virus, including Iraq and North Korea.

Read more on this subject in related Hot Topics:

Bioterrorism

Homeland/Civil Defense

War on Terrorism

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