Smallpox Pre-Event In-Service for Fire and Rescue Staff Bob Mauskapf State Emergency Planning Coordinator Virginia Department of Health Bob Mauskapf State Emergency Planning Coordinator Virginia Department of Health

April, 2003 Dedication …To the fire and rescue professionals, paid and volunteer, who regularly respond to the publics call, and who venture into situations of great risk, in the hope that their work can be made more safe

April, 2003 VDH EP&R Mission …effectively respond to any emergency impacting public health through preparation, collaboration, education and rapid intervention.

April, 2003

DepComm EP&R ExecPlanner Reg Planners (5) HospCoordAdminAsst Bus MgrPIOTrainer

April, 2003 Regional MD Consultant PlannerEpidemiologistTrainerPIO

April, 2003 Regional Planner Coordinate Collaborate Facilitate Liaison Oversight Represent Coordinate Collaborate Facilitate Liaison Oversight Represent

April, 2003 Regional Planner Backup Prioritize Reinforce Plan Talking Head / Burning Bush / SME Backup Prioritize Reinforce Plan Talking Head / Burning Bush / SME

The Strategic National Stockpile is designed to… maintain a national repository of life- saving pharmaceuticals and medical material that will be delivered to the site of a chemical or biological terrorism event in order to reduce morbidity and mortality in civilian populations. The Strategic National Stockpile is designed to… maintain a national repository of life- saving pharmaceuticals and medical material that will be delivered to the site of a chemical or biological terrorism event in order to reduce morbidity and mortality in civilian populations. Strategic National Stockpile (National Pharmaceutical Stockpile) Distribution Planning & Logistics

April, 2003 The Need The President of the United States has identified a risk of Smallpox being re- introduced by a terrorist action Should a Smallpox case be identified in the Commonwealth, it is likely that a police, fire or rescue responder will have contact with that case The President of the United States has identified a risk of Smallpox being re- introduced by a terrorist action Should a Smallpox case be identified in the Commonwealth, it is likely that a police, fire or rescue responder will have contact with that case

April, 2003 Smallpox - Why a threat? Last case in US in 1949 Last naturally acquired case in 1977 Disease declared eliminated by WHO in 1980 Stocks of Variola virus held by U.S. & Russia Last case in US in 1949 Last naturally acquired case in 1977 Disease declared eliminated by WHO in 1980 Stocks of Variola virus held by U.S. & Russia

April, 2003 Smallpox - Why a threat? Bio weapons programs in several countries Concern… former Soviet Union bio weapons may have been sold. To whom?? Bio weapons programs in several countries Concern… former Soviet Union bio weapons may have been sold. To whom??

April, 2003 Smallpox vaccination Dec, 2002: President Bush announced plan to vaccinate civilian response teams and military personnel Pre-event smallpox vaccination Stage 1: Hospital and public health response teams State 2: Other health care providers, first responders Stage 3: Offer to general public when enough licensed vaccine available Dec, 2002: President Bush announced plan to vaccinate civilian response teams and military personnel Pre-event smallpox vaccination Stage 1: Hospital and public health response teams State 2: Other health care providers, first responders Stage 3: Offer to general public when enough licensed vaccine available

April, 2003 Smallpox Vaccination: Phase 1 Health Department Responsibilities Education and training, providing education materials Contraindications Complications Vaccine site management Responsible for vaccine and vaccine administration Education and training, providing education materials Contraindications Complications Vaccine site management Responsible for vaccine and vaccine administration

April, 2003 Smallpox Vaccination: Phase 1 Health Department Responsibilities Collect information and report on adverse vaccine events Identify consultants to assess and manage adverse events Collect information and report on adverse vaccine events Identify consultants to assess and manage adverse events

April, 2003 Smallpox Vaccination: Phase 2 To include other health care providers (not included in Phase 1) and first responders This will include much larger number of vaccinees than Phase 1 Time frame and logistics not established at present To include other health care providers (not included in Phase 1) and first responders This will include much larger number of vaccinees than Phase 1 Time frame and logistics not established at present

April, 2003 Smallpox Vaccination: Phase 3 Offer vaccine to members of the general public Date for initiation unknown Adequate supply of licensed vaccine will not be available until early 2004 Smallpox vaccination now available through clinical trials Offer vaccine to members of the general public Date for initiation unknown Adequate supply of licensed vaccine will not be available until early 2004 Smallpox vaccination now available through clinical trials

April, 2003 What About Vaccination If An Event Takes Place? If you are a true contact to a case, the risk of Smallpox far outweighs the risk of vaccination If you are not a contact, but Smallpox is in the area, you will need to reconsider the risk If you are a true contact to a case, the risk of Smallpox far outweighs the risk of vaccination If you are not a contact, but Smallpox is in the area, you will need to reconsider the risk

April, 2003 Dip needle Retained vaccine Proper position 15 insertions Post-insertion Absorb excess Discard properly Sterile cover