The smallpox vaccine is a live-virus vaccine.  Smallpox infections have a
morbidity of 30%.  You are correct that cases anywhere in the world should
be the trigger for vaccination.  Apparently the vaccination was much less
dangerous when given to children (I haven't updated my aging memory!).

The CDC has addressed worker safety in the following PDF:

http://www.cdc.gov/ncidod/hip/bio/13apr99apic-cdcbioterrorism.pdf

Any local hospital plan should include, as a minimum criterion for
preparation, sufficient vaccine AT SITE AND ON HAND to provide coverage for
workers at risk.  The nature of the threat leaves hospital and first contact
workers at highest risk, and it is obvious that those who wait for the
"APPEARANCE" of the disease will be among the first to be infected sans
vaccination IF the onset occurs within their area of
coverage/responsibility.  In other words, you are either prepared OR you are
NOT.  One cannot ever wait to BE prepared.  A perfect example of a CATCH-22.

There is an HTML version of Dr. Anthony Fauci's recent testimony before
Congress concerning Smallpox and the vaccine.  Dr. Fauci is the Director of
the National Institute of Allergy and Infectious Diseases (NIAID) of NIH.

http://www.hhs.gov/asl/testify/t011102b.html

Hope this helps,

Fred Monson

Frederick C. Monson, PhD
Center for Advanced Scientific Imaging
Mail to Geology
West Chester University of Pennsylvania
Schmucker II Science Center, Room SS024
South Church Street and Rosedale Avenue
West Chester, PA, 19383
Phone:  610-738-0437
eMail:  fmonson@wcupa.edu
An FEI (Quanta 400 and Technai 12T), 
Oxford INCA Energy 400, and 
Olympus FV-300 Shop.




-----Original Message-----
From: Carpenter, Judith A. [mailto:Jude.Carpenter@vtmednet.org]
Sent: Friday, January 10, 2003 7:29 AM
To: 'NSH'
Subject: Smallpox protocols


Does anyone have an established or proposed protocol for how
they will deal with tissues from a "suspicious case" in which the
clinician might suspect smallpox and who at their facility will be
vaccinated up front ?
Our facility is working on a Bioterrorism matrix determining who needs up
front
vaccinations should a smallpox threat present itself anywhere in
the world including the USA (our Level one).  We will be given limited
vaccine initially.
The plan goes from Level one ("Convincing Threat" up to Level six where we
have multiple
cases at our facility.
We must determine who would get the limited number of vaccinations at Level
one
(once we go beyond that the state will institute their plan).
We have chosen autopsy personnel and a few individuals in the Surgical
Dissection area
who might do frozen sections on suspicious cases.
Of course anytime a case is confirmed small pox we will cease to do frozens
on any
suspicious cases and will not autopsy deceased small pox victims.
I was asked to throw this question out to you folks to see if anyone else
has a protocol
we may learn from.
Appreciate your help and Happy Friday-
Jude 
Jude Carpenter, BS, HTL(ASCP)
Chief Technologist
FAHC Histopathology
111 Colchester Ave.
Burlington, VT  05401
(802)847-5116
FAX(802)847-3509
jude.carpenter@vtmednet.org