In the 1980s, the World Health Organization declared smallpox eradicated.

The last naturally occurring case of the disease was in 1977.

Twenty-five years later, the contagious and sometimes fatal disease is back in the headlines as the U.S. government is taking precautions against it to be ready to deal with a bioterrorist attack using smallpox as a weapon.

Wednesday, the Kosciusko County Board of Health discussed the threat and how it may affect the local community.

County Health Officer Dr. William Remington Jr. said after the disease was eradicated, there remained only two stockpiles of the virus. One was at the Centers for Disease Control in Atlanta, Ga., and the other was somewhere in Russia.

"Those were the two known collections of the smallpox virus," he said. A date was set when those collections would be eliminated.

But the nation of Russia declined and there remained many uncertainties about the future of the country. The CDC decided not to eliminate its stockpile and somewhere along the way, a country like Iraq may have gotten its hands on the virus.

Recently, Remington said, he's been receiving e-mails from the State Department of Health and has sat through teleconferences and telecasts about the disease as a bioterrorist threat following the Sept. 11, 2001, events. The basic message is that "Indiana really needs to get its act together," said Remington, and get prepared for a possible threat. He said there's a lot of educational effort going on in Indiana to get the word out about the virus.

According to information from the CDC, provided by the county health department, the deliberate release of smallpox as an epidemic disease is now regarded as a possibility, and the United States is taking precautions to deal with this possibility. Smallpox is classified as a Category A agent by the CDC. Category A agents are believed to pose the greatest potential threat for adverse public health impact and have a moderate to high potential for large-scale dissemination. Other Category A agents are anthrax, plague, botulism, tularemia and viral hemorrhagic fevers.

At the moment, according to the CDC information, the smallpox vaccine is not available for members of the general public.

Remington told the health board that in Indiana's proposed plan to the CDC, there could be a phased roll-out of vaccinations for the virus. The State Board of Health would be the recipient of the vaccine and then would distribute it to 10 separate districts in the state. Kosciusko County is in district two along with seven other counties.

In phase one of the roll-out, the vaccinations would be given to those on the smallpox response team, likely located in South Bend. Kosciusko County might receive its roll-out in the second phase, which could be as early as January, if the plan is accepted and initiated.

As for the immunizations, Remington said, nobody knows how long they last. The best estimate is a vaccination would protect a person from smallpox for at least three years. Those who were previously vaccinated would be more likely to survive the disease than those who were not.

"It is a good vaccine," he said. "There are problems."

According to the CDC, the majority of patients with smallpox recover, but death may occur in up to 30 percent of cases. Many smallpox survivors have permanent scars over large areas of their bodies, especially their face. Some are left blind.

One confirmed case of smallpox is considered a public health emergency.

The smallpox vaccine is the best protection a person can get if they are exposed to the smallpox virus. Most people experience mild reactions. In recent tests, according to the CDC, one in three people felt bad enough to miss work, school or other activities or had trouble sleeping. In the past, about 1,000 people for every one million people vaccinated for the first time experienced reactions that, while not life-threatening, were serious. Between 14 and 52 people per one million vaccinated experienced potentially life-threatening reactions. Based on these past experiences, it is estimated by the CDC that between one and two people out of every one million people vaccinated will die as a result of life-threatening reactions to the vaccine.

Remington said when the vaccines are rolled out, the State Board of Health and local health boards will have to be very involved in the matter. The state and local agencies need to have a plan in place to deal with the vaccinations and it may occur "quicker than we realize," he said. He said they are starting to get a list of names together for a smallpox vaccination team.

In other business, county health administrator Bob Weaver announced the health department received a one-time grant of $25,000 for the prenatal clinic.

The board set its next meeting for March 12 at 7 p.m.

Health board members are president Dr. Wymond B. Wilson, Dr. Karen Boling, Dr. Dennis Woodward, Robert Knudsen, Dr. John W. Jones, Dr. Thomas E. Howard and Joan Darr, Kosciusko Community Hospital. [[In-content Ad]]