smallpoxmaster

Media SmallpoxSeminar: 

Media Smallpox Seminar North Dakota Department of Health

Smallpox Overview: 

Smallpox Overview Terry L. Dwelle, MD, MPHTM State Health Officer North Dakota Department of Health

History: 

History 1977 – Last naturally acquired case in Somalia 1978 – Laboratory-related death at the University of Birmingham, England 1980 – Global eradication certified by the World Health Organization Method of eradication – Ring vaccination, not mass vaccination

Ring Vaccination Concept: 

Ring Vaccination Concept Isolation of confirmed and suspected cases Identification, vaccination and surveillance of significant contacts of proven cases Vaccination of household contacts of contacts Contacts Case Contacts Household Contacts of Contacts

Smallpox – Basic Facts: 

Smallpox – Basic Facts Cause – Variola Virus Can infect only humans Transmission – Close face to face (generally within 6 feet) via respiratory droplets of a person who has the disease

Smallpox - Disease: 

Smallpox - Disease Onset is 12 to 14 days after exposure Days 2 to 3 – High fever, bed-ridden, headache and backache Days 4 to 5 – Onset of the rash (small bump – blister – pustule – scab) Most infectious during the first week of the rash. No longer infectious once the scabs fall off ( 3 to 4 weeks) Death rate is about 30 percent

Smallpox: 

Smallpox

Smallpox Vaccination: 

Smallpox Vaccination Live virus vaccine – Vaccinia (this is not the smallpox virus) Highly effective in preventing illness or severe disease if given within 3 to 4 days of definite exposure to smallpox

Smallpox Vaccination: 

Smallpox Vaccination Skin reactions are an indicator that the vaccine was effective (vaccine “take”) 3 to 4 days – Redness and itching 7 to 11 days – Vesicle (blister) develops into a pustule, redness increases 14 to 21 days – Pustule dries, scab forms 21 days – Scabs falls off, leaving a permanent scar Commonly see fever and tender, enlarged lymph nodes

Vaccination – Adverse Reactions: 

Vaccination – Adverse Reactions Death – 1 / million Accidental infection of other body part (i.e. eye) – 1 / 2000 Generalized vaccinia – 1 / 5000 Eczema vaccinatum – 1 / 26,000 Post vaccination encephalitis – 1 / 300,000 Progressive vaccinia – 0.83 / million

Vaccination Site Progression: 

Vaccination Site Progression

Vaccination Site Progression: 

Vaccination Site Progression

Vaccination Site Progression: 

Vaccination Site Progression

Vaccination Site Progression: 

Vaccination Site Progression

Surveillance for Smallpox: 

Surveillance for Smallpox Larry A. Shireley, MS,MPH State Epidemiologist North Dakota Department of Health

Early Detection: 

Rule Out Chickenpox (Varicella) Reporting of hospitalized patients Consult with Infectious Disease Physicians/Dermatologists ND Public Health Laboratory Free testing Consultation/Confirmation Centers for Disease Control and Prevention “Atypical” Rash Illnesses Early Detection

Syndromic Surveillance: 

Syndromic Surveillance Regional Ask-A-Nurse Emergency Room Others Ambulance “Runs” Pharmaceutical Sales

Case Investigation: 

Case Investigation Ring Vaccination

Smallpox Plan Overview: 

Smallpox Plan Overview Tim Wiedrich, Director Bioterrorism Preparedness and Response North Dakota Department of Health

Smallpox Plan Categories: 

Smallpox Plan Categories Pre-event Phase I Initial Responders Public Health Hospital About 2,000

Smallpox Plan Categories: 

Smallpox Plan Categories Pre-event Phase II All Responders Public Health Hospital Clinic/Physician Public Safety Law enforcement Fire EMS

Smallpox Plan Categories: 

Smallpox Plan Categories Pre-event Phase III Public

Smallpox Plan Categories: 

Smallpox Plan Categories Post-event Ring vaccination Mass vaccination

Slide25: 

Bioterrorism Regional Planning Areas North East North East Central North West Central North West South West South West Central South East Central South East

Public HealthRegional Resources: 

Public Health Regional Resources Lead Public Health Units Bioterrorism Directors Field Epidemiologists Medical Consultants Public Information Officers

Phase I Pre-event Vaccination Clinics: 

Phase I Pre-event Vaccination Clinics State Responsibilities Receipt and delivery of vaccine Establishment of regional consultants Data registration Training Public education Regional and Local Responsibilities Identification of public & hospital response teams Clinic Planning Site selections Supply acquisitions Staffing Schedule planning Supervision and evaluation

Smallpox Communications: 

Smallpox Communications Loreeta Leer Frank Public Information Officer North Dakota Department of Health

Emergency Communication Response: 

Emergency Communication Response The NDDoH Office of Public Information supports state and local public health officials in their efforts to protect the public in the event of a public health emergency

Objectives: 

Objectives To provide the public and the media access to accurate, consistent, comprehensive and timely information To minimize, as much as possible, public panic and fears To coordinate public information response with other local, state and federal partners

Guiding Principle: 

Guiding Principle The public will need information that will help them minimize their risk

Not Business as Usual: 

Not Business as Usual A public health emergency: Triggers a level of public interest and media inquiry that requires a response beyond normal operations and resources. Requires a significant diversion of department staff from regular duties.

Recent Events: 

Recent Events Anthrax concerns ~ 2001 West Nile virus ~ 2002

Smallpox Communication Plan: 

Smallpox Communication Plan Within 30 minutes of notification of a smallpox case: All media calls to NDDoH routed to Office of Public Information

Smallpox Communication Plan: 

Smallpox Communication Plan State health officer or designee will act as official spokesperson for the department News conference held as soon as possible Any subsequent news conferences held at consistent, central location

Smallpox Communication Plan: 

Smallpox Communication Plan Regular briefings held as warranted If few new details, then news releases and news conferences as necessary Updates posted to NDDoH website at least daily Public health experts will be available for interviews with media

Confidentiality Issues: 

Confidentiality Issues By law, NDDoH cannot release patient-identifying information Ex. – West Nile virus

Confidentiality Issues: 

Confidentiality Issues During smallpox event, confidentiality issues will be balanced with public safety Smallpox cases will be identified by county Condition of cases will be described Name, age and gender not released

Emergencies Are Media Events: 

Emergencies Are Media Events Emergency response would be hampered if media not involved People rely on media for up-to-date information during an emergency Media relay important protective actions for the public Media know how to reach their audiences and what their audiences need

Pledge to Media: 

Pledge to Media The NDDoH will: Respond to your requests for information Arrange access to public health experts Know your deadlines and work to accommodate them Provide accurate facts and information Work to ensure all media has the same access at the same time

Public Health’s Goal in Emergency Response: 

Public Health’s Goal in Emergency Response To efficiently and effectively reduce and prevent illness, injury and death and to return individuals and communities to normal

Contact Information: 

Contact Information Loreeta Leer Frank, public information officer 701.328.1665 rfrank@state.nd.us Patience Hurley, public information coordinator 701.328.4619 phurley@state.nd.us