NEWSBYANDRE BLACKMAN

(photo credit: Andres Rueda)

This is a guest post from Andre Blackman, who  blogs at Pulse+Signal.

In the public health world, the past few months have seen several concerned discussions surrounding the impact of the H1N1 (swine) flu virus. The disease has been cropping up in many countries around the world and reports of "first deaths" due to the virus are routinely making headlines. Recently, the impact of the disease on large cities was analyzed. The seemingly obvious take-away: we are living in a time where the world is a lot smaller and disease transmission takes place rapidly.

Infectious diseases can also be  used as weapons with malicious intent as a form of terrorism. As much of a concern as the spread of H1N1 is, the use of the disease smallpox as a biological weapon is more threatening because it would spread quickly and cause much more damage among the populations affected. The first line of defense against these diseases are vaccines. Recently, countries have begun to move quickly to line up the development of H1N1 vaccines, including the US and UK.  But they have also worked to make sure that there is a stockpile of vaccines against smallpox - and are working on stockpiles for progressive vaccinia, which is a possible negative reaction to current smallpox vaccines.

If an attack using smallpox occurred, infections would most likely be in the millions. The problem with smallpox is that it takes up to eight days for symptoms to appear - giving time for transmission to continue.  Smallpox vaccination ended in the 1960s, but the Department of Health and Human Services decided that prevention strategies, including stockpiling vaccines, should be put into place once again after the 9/11 tragedy, and fortunately.

Unfortunately, one of the drugs currently under consideration for stockpile by the US against the progressive vaccinia, ST-246, would be useless for roughly 80 million Americans who are immunosuppressed - those who have compromised immune systems - according to the chairman of the drug company (at minute 21). Immune systems that are compromised range from those living with HIV/AIDS to those who have eczema. Here are a couple stats on this excluded group:

• An estimated 894,543 Americans are currently living with leukemia, Hodgkin and non-Hodgkin lymphoma, myeloma and myelodysplastic syndrome
• In 2008, it was reported that 1.1 million Americans were living with HIV in 2006, up 11% from 2003
• Approximately 1.4 million Americans are chronically infected with hepatitis B, and more than 4 million Americans have been infected with hepatitis C.  It is estimated that up to 25 million Americans have chronic liver disease

The US federal government is currently reviewing possibly multiple products in place that could hopefully be all inclusive vaccines. The US based company SIGA is in the lead for producing the vaccine that excludes the immunosuppressed. Now is the time to raise awareness of this issue so that we can make sure all Americans are eligible for this vaccine. Maybe this something for our new CDC director to look into?