- The Washington Times - Friday, February 21, 2003

ANNAPOLIS Republican Gov. Robert L. Ehrlich Jr. said yesterday Maryland will begin a smallpox-vaccination program to protect its roughly 5.3 million residents from a biological attack by terrorists.
"We live homeland defense these days at the state level," Mr. Ehrlich said.
The three-phase plan follows the national plan and begins this week by vaccinating about 6,000 health officials and workers on smallpox-response teams in Baltimore and 23 counties.
The teams will investigate suspected smallpox cases know to cause fever, oral blisters and a telltale body rash of fluid-filled bumps that cover the body. The virus kills about one in three people who become infected.
If smallpox is confirmed, the crews will begin by vaccinating everyone potentially exposed to the disease.
"These 6,000 people will be prepared to vaccinate everyone in the state within four days if there is an outbreak," said Health and Mental Hygiene Secretary-designate Nelson Sabatini.
Medical staff at 48 Maryland hospitals will also be among the first to receive the vaccine.
In the second phase, the state's remaining health care workers will be immunized later this year.
The final phase will be to offer the shots in 2004, when the U.S. Centers for Disease Control and Prevention disseminates a new vaccine.
The vaccine is considered safe, though one in a million can die from it. The military has vaccinated about 100,000 soldiers, and only three developed serious but nonfatal complications, Mr. Sabatini said.
President Bush introduced the national smallpox-vaccination program in December. The plan was created by the CDC and the Department of Health and Human Services after the September 11 terrorist attacks and the anthrax mail attacks in October 2001.
U.S. intelligence officials think terrorists and some countries have the means to cultivate and spread smallpox and other germs as a means of biological warfare.
"There is information that some countries you don't want to have their hands on it, have their hands on it," acting Health and Mental Hygiene Secretary Arlene H. Stephenson said yesterday.
Maryland is the 28th state to initiate a smallpox-vaccination program. So far, 4,213 persons, mostly emergency and medical workers, have been immunized nationwide. Tennessee and Florida have vaccinated the most, with 881 and 789, respectively. Virginia has vaccinated 87; Delaware, 11; and Pennsylvania, four, according to the CDC.
Naturally occurring smallpox was eradicated in the 1970s after a worldwide vaccination program. The United States has not had a smallpox case since 1949. The last naturally occurring case in the world was in Somalia in 1977, according to the CDC.
Routine vaccination against smallpox was stopped when the disease was eradicated, though the school-based vaccination clinics used in the 1950s could reappear in the event of a smallpox attack.
Smallpox is a contagious disease that is usually passed through face-to-face contact. The first symptoms include fever, tiredness, head and body aches, and sometimes vomiting. Then a rash of small red spots forms on the victim's tongue and in the mouth. When the lesions burst, they spread large amounts of the virus and the victim becomes extremely contagious.
A rash then appears on the skin, starting on the face and spreading over the body within 24 hours. By the third day, the rash becomes raised bumps. By the fourth day, the bumps fill with a thick, opaque fluid and they often have a depressed center resembling a bellybutton, another distinguishing characteristic of smallpox.
The most common strain of smallpox is lethal in 30 percent of the cases, but rarer strains are almost always fatal, according to the CDC.
If smallpox breaks out in another state, the federal government will decide whether to initiate mass immunization in Maryland and elsewhere, state health officials said.
Mr. Ehrlich discussed the plan at a news conference, in which he made several other announcements, among them that the drought emergency in effect since April has been lifted in parts of Maryland, including Baltimore, Frederick, Howard and Montgomery counties. Restrictions on such activities as watering lawns and washing cars remain in place in the city of Baltimore, where the reservoir system has yet to recover from the record drought of 2002.

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