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TRENTON
-By the end of January or early February 2003, New Jersey plans
to begin vaccinating up to 15,000 public health workers and hospital
staff that have volunteered to be the front line of defense in the
state's smallpox preparedness effort, Health and Senior Services
Commissioner Clifton R. Lacy, M.D. announced today.
The
vaccinations will be the first phase of a voluntary immunization
program outlined in New Jersey's smallpox vaccination preparedness
plan to be submitted today to the federal Centers for Disease Control
and Prevention (CDC). Upon approval by the CDC, the plan will serve
as a blueprint for public health officials, hospital staff, emergency
workers and the public in the event of an outbreak of the deadly
disease.
"Although
there is no known imminent threat of a smallpox outbreak, New Jersey
must be prepared for this and other forms of bioterrorism,"
Commissioner Lacy said. "Our plan calls for vaccinating key
personnel now who would be involved in future investigations of
and care for any potential cases of smallpox."
Smallpox
is a highly contagious and deadly disease. In the past, approximately
one in three who contracted the disease died. Through a comprehensive
vaccination program beginning in the 1950s, the World Health Organization
and its member states were able to eradicate smallpox worldwide
by 1980. The last case of naturally occurring smallpox was in Somalia
in 1977, and the last case in the United States was in 1947. However,
experts believe smallpox may be possessed by individuals willing
to use it as a weapon in a bioterrorism attack, and New Jersey considers
it prudent to be prepared for the possibility of such an event.
"Smallpox
poses one of the most significant threats to health of any agent
of bioterrorism," said Lacy. "One confirmed case of smallpox
anywhere in the world constitutes a global public health emergency.
Last year, New Jersey was the epicenter of anthrax bioterrorism.
One lesson our state and our country learned is the value of being
prepared - through planning, training, and exercising for all possible
health threats. Smallpox vaccination is an important element of
New Jersey's Terrorism and Public Health Emergency Preparedness
and Response Plan."
Dr. Eddy Bresnitz, NJ State Epidemiologist, Assistant Commissioner,
and Smallpox Vaccination Plan Coordinator, said "New Jersey,
like the rest of the nation, has been working closely with the CDC
and is awaiting final decision on a national smallpox policy."
The
White House could make an announcement of its plan as early as this
week.
"We
are in the process of identifying public health and health care
workers who will volunteer to be vaccinated and become our core
team in response to a possible smallpox outbreak." Dr. Bresnitz
noted.
The plan details how vaccinations would be given to up to 15,000
hospital and public health care workers and to the public in the
event of an outbreak. To implement the plan, New Jersey requested
15,000 doses of smallpox vaccine from the federal government.
Currently,
about half of the United States population has never been vaccinated
for smallpox. The other half were vaccinated before 1972 and medical
experts say it is unknown whether those people who were vaccinated
are still protected.
There
are side effects associated with smallpox vaccination. Most people
experience mild reactions that include a sore and swollen arm, fever,
body aches, and swollen glands. Others, however, experience reactions
ranging from serious to life threatening. It is estimated from prior
experience with the vaccine that approximately 15 individuals per
million vaccinated will experience life threatening adverse effects
like encephalitis and that one or two per million will die as a
result of vaccination.
Education will play a key role in helping prospective vaccinees
to understand this deadly disease and the benefits and risks of
vaccination.
Those
contraindicated to be vaccinated as part of the pre-outbreak preparedness
plan include individuals with the following conditions and those
who live with people who have such conditions:
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Pregnant women or women with children under the age of one year
- People
with eczema / atopic dermatitis or other chronic skin conditions
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People being treated for cancer
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People who have had organ transplants or are on immunosuppressive
drugs
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People who have HIV or AIDS
-
People whose immune systems are compromised for any reason
The
first phase of voluntary vaccination would include Hospital Health
Care Response Teams -- physicians, nurses and other hospital staff
that would care for suspected smallpox patients and ensure appropriate
procedures were followed to prevent disease spread. Each of the
state's 85 acute care hospitals is being asked to identify up to
150 volunteers for those teams.
It would also include five Public Health Response Teams made up
of local, county and state public health workers such as physicians,
epidemiologists, public health nurses, and planners. These regional
teams would be involved in investigating suspected smallpox cases
as well as tracking potential contacts, vaccinating hospital workers
and providing supplies and logistic support if a case of smallpox
were confirmed.
One team will be responsible for each of the five regions. Clinics
will be located in all five regions -- the northeast, northwest,
central east, central west and southern regions of New Jersey -
with an additional clinic in Newark to cover Metropolitan Medical
Response System Personnel. Each clinic is expected to vaccinate
about 700 people a day and will, initially, operate one day a week
for four weeks.
New Jersey has partnered with Becton, Dickinson and Company, a world
renowned medical technology company headquartered in New Jersey,
to make New Jersey the first state in the nation to implement an
innovative system for tracking and managing smallpox vaccination.
The
system will undergo pilot testing on Wednesday, December 11, at
the Hunterdon County Administration Building in Flemington as 250
public health officials from around the state participate in simulated
smallpox vaccination.
As
part of the system, information on each person immunized is entered
into a statewide registry system that includes pertinent identification,
medical history, a digital photo of the person vaccinated, and a
photo of the vaccination site on the arm. Vaccinees will return
in seven days for a follow up visit to determine if the vaccination
was effective and to assess for adverse reactions.
"New
Jersey is far better prepared today for potential acts of terrorism
than we were last year. We cannot become complacent. We must continually
improve our state of preparedness and our ability to respond rapidly
and effectively to any and all health threats," said Dr.Lacy.
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