CDC issues battle plan for confronting smallpox: feds to stockpile available vaccine. (Containing Outbreaks).

Teams of specialists from the Centers for Disease Control and Prevention were vaccinated against smallpox and began training in November to prepare for rapid deployment in the event a suspected case of smallpox is reported.

"There has been no credible threat [of smallpox bioterrorism] that we know of," Curtis Allen, a spokesperson for the CDC in Atlanta, said in an interview.

But in the context of a widening investigation into a bioterrorist attack using anthrax, "it is prudent to be vigilant and prepare for all possibilities," he said.

CDC's new draft plan for a federal response to a bioterrorist attack using smallpox acknowledges the limited supply of smallpox vaccine--about 15 million doses--and the agency's decision to stockpile the vaccine in the event a smallpox outbreak occurs before more vaccine can be produced. (The vaccine works if given within a few days after exposure.)

The decision to stockpile the available vaccine has raised concerns among state health officials who want the vaccine provided to "first responders," such as state police and public health workers. By late 2002, government health officials hope to have enough smallpox vaccine on hand to vaccinate the entire U.S. population.

The CDC draft plan also details tactics for containing a smallpox outbreak. These include the "ring vaccination" approach of isolating and vaccinating the index case and case contacts. This approach was used to eradicate the remaing global pockets of smallpox infection in the 1970s.

Health care workers are integral to finding these contacts and their subsequent contacts, expanding the those exposed and closing the epidemiologic circle or "cordon sanitaire." Given a major exposure, a whole city could potentially become the "ring" and be quarantined.