SPRINGFIELD, IL – The Illinois Department of Public Health has developed a strategy to offer smallpox vaccinations to as many as 16,000 Illinois public health and hospital personnel to prepare for the possibility of a terrorist attack, Dr. John R. Lumpkin, state public health director, today announced.

The U.S. Centers for Disease Control and Prevention (CDC) has asked each state and some cities, including Chicago, to submit plans by today as part of an initial phase in an effort to strengthen the nation’s smallpox preparedness.

“The probability of an intentional release of the smallpox virus remains low but, since the consequences of such an attack would be so great, we must be prepared,” Dr. Lumpkin said. “This effort will focus on offering personal protection from smallpox disease to those who would be called upon to investigate and to provide treatment in the event of a smallpox release or outbreak.

“By protecting these individuals, we improve our ability to safeguard the public, and we increase the capacity and capabilities of the public health system and hospitals to respond to and control a smallpox outbreak.”

Dr. Lumpkin said the Illinois plan was developed with guidance from the CDC and relies on the state’s 93 local health departments (excluding Chicago) to offer vaccine to an estimated 8,000 to 16,000 public health smallpox response teams and hospital staff who would be involved in treating possible smallpox cases. The vaccination effort could begin as early as January and will require 30 days to complete. Individual and hospital participation will be voluntary.

The Illinois plan outlines the overall smallpox vaccination effort. However, local health departments will have until Friday (Dec. 13) to provide the Department with details on where the smallpox vaccine will be administered and how those receiving the shot will be evaluated for the week it takes to determine if the vaccine is effective. There is expected to be between 20 and 30 clinics organized throughout the state outside of Chicago.

It is estimated that as many as five to 10 staff at each local health department; about 20 state public health department staff; and 50 to 100 workers at 152 licensed Illinois hospitals that provide emergency care will be offered the vaccine. Due to a number of medical and family considerations, about 40 percent are expected to take advantage of the voluntary vaccination.

The vaccination, which was discontinued in 1972 in the United States, can cause serious, potentially fatal side effects and individuals with certain medical conditions or family considerations should not have the shot.

Those who have a higher-than-normal risk of a bad reaction include persons with weakened immune systems (cancer patients, organ transplant patients, persons infected with HIV, persons taking steroids), women who are pregnant or plan to become pregnant, nursing mothers and persons with eczema or certain other skin conditions.

In addition, people who share living quarters with persons in the higher-than-normal risk categories should not be vaccinated. For a week, persons who have been vaccinated may expose others to the vaccinia virus that is used to make the vaccine. Proper covering of the vaccination site should allow persons to continue working, but home exposure is thought to pose greater risk.

Plans for a second phase of the vaccination effort are not yet finalized, but information from the federal government indicates it will include all hospital workers and first responders (police, fire and paramedics). It has been suggested that the third phase would most likely include offering the vaccine to the general public. The Department has previously prepared a separate plan for the CDC that describes how Illinois would provide mass vaccinations in the event of a smallpox attack.

“Unless there is an actual smallpox attack or outbreak, the risk of become ill or dying from smallpox is zero,” Dr. Lumpkin said. “If an attack did occur, the vaccine can still protect people after exposure if they are vaccinated within three to four days. Vaccination within seven days will lessen the severity of illness.”

The primary reason for this initial phase, Dr. Lumpkin explained, is to ensure that people in critical positions are vaccinated so they can immediately respond to the needs of the public and not have to wait to be vaccinated.

“This pre-event vaccination plan will enable public health and hospital workers to rapidly take the steps necessary to protect the public, including identifying people who need to be vaccinated to control an outbreak, establishing vaccination clinics and providing care to those who may be ill,” he said.

Smallpox is a disease caused by a virus (variola) and characteristically includes skin lesions that eventually scab over; at times it has been confused for chickenpox. In most cases, smallpox is spread by an ill person to others through infectious saliva droplets, but also could be spread by contaminated clothing or bed linen.

If used in biowarfare, smallpox virus could be dispersed in the air and potential victims in the area of the release would breathe in the virus, or infected persons could be sent into a crowded areas to attempt to spread the disease to others.

The last cases of smallpox in Illinois were recorded in 1947. The last naturally acquired case of smallpox in the world occurred in 1977 in Somalia.