Preparing for patient zero: the government must prepare for the possibility of a terrorist-unleashed smallpox epidemic that could kill millions and overwhelm the U.S. health-care system

0 Comments | Insight on the News, Dec 10, 2001 | by Timothy W. Maier

Frederick Harchelroad, director of medical technology at Allegheny General Hospital, says that recently he had a patient come in with a rash and wondered if the outbreak had started. Fortunately, the patient did not have smallpox. But "we will quickly be depleted of health-care professionals if there is an outbreak," Harchelroad says. "It is going to take a million dollars per hospital to get up to speed to handle an outbreak."

While Congress is considering a number of bills to pump millions of dollars into the public-health industry, there appears to be some hope for possible treatment. Epidemiologists tell INSIGHT they believe the vaccine itself, if given three or four days after infection, may prevent or reduce the seriousness of the illness.

In addition, cidofovir, an antiviral drug produced by Gilead Sciences of Foster City, Calif., holds some promise. Sold under the name VISTIDE, the drug won FDA approval in June 1966 for treatment of cytomegalovirus retinitis, a sight-threatening illness associated with AIDS. Since then, the U.S. Army Medical Research Institute of Infectious Disease has reported that cidofovir has been used to prevent death and disease linked with a pox illness in monkeys (monkeypox, which is similar to smallpox in humans).

In the meantime, Harchelroad says Americans should listen to what "your mother told you" for your own protection. "Wash your hands, don't drink from the same cup, don't cover your mouth when you cough but cough away from yourself" he advises. "And if someone coughs in your face, slap them silly"