[TomB]

A couple of points on smallpox, and its vaccine.

The decision to end immunizations for smallpox after eradication was the only logical choice considering there is a (very) small chance of sickness or death from the vaccination. While the risks were worth it compared to the mortality rate of the disease, it is not worth it to continue it just for piece of mind.

As far as the disease itself, the most important thing to remember is that it is NOT contagious in its initial stages. Only after the appearance of the telltale rash, usually after 10 or 12 days, does the disease become contagious. However, once the rash does appear, the patient becomes very weak and is likely to be bedridden by that time. This means that containing the disease is much easier that you've been led to believe.

Also, as we are seeing with anthrax, the mortality rate is going to be much lower than expected because of newer treatments.

On the whole, smallpox, while potentially dangerous, is very controllable.

[RANGERAIRBORNE]

"On the whole, smallpox, while potentially dangerous, is very controllable"

Pretty optimistic assumptions in your post- I think TOO optimistic. Read a journal called "EMERGING INFECTIOUS DISEASES" (available on the web- type that into GOOGLE).

My optimism derives from the fact that I cannot see any head of State authorizing such an attack, and I don't think freelancing terrorist groups can pull this off.

If they did use this as a weapon, and spread it widely right at the start, I would be surprised to escape with less than 25-30% fatalities.

[Sabertooth]

As far as the disease itself, the most important thing to remember is that it is NOT contagious in its initial stages. Only after the appearance of the telltale rash, usually after 10 or 12 days, does the disease become contagious.

You sure about that?

I've read that smallpox is contagious during incubation, prior to the manifestation of symptoms. There were also several smallpox threads on the subject last week, with comments from doctors, and none suggested that the virus wasn't contagious prior to the development of pustules.

[aruanan]

I wonder, though, if they had actually determined that smallpox virus couldn't be shed through seminal secretions before the pustule stage. Which reminds me of a joke...

[Stefan Stackhouse]

As far as the disease itself, the most important thing to remember is that it is NOT contagious in its initial stages. Only after the appearance of the telltale rash, usually after 10 or 12 days, does the disease become contagious. However, once the rash does appear, the patient becomes very weak and is likely to be bedridden by that time. This means that containing the disease is much easier that you've been led to believe.

Easier if you are talking about ONE patient who is promptly placed in an isolation ward, and all attending nurses, physicians, etc., follow protocols EXACTLY and without any mistakes.

If you are talking about hundreds or thousands of cases happening simultaneously in one city, however, then keeping all patients completely isolated becomes extremely difficult. We simply don't have the isolation wards, equipment, training, etc. to do it.