Smallpox:  GAO Says Floundering Smallpox Program Lacks Guidance

By David McGlinchey
Global Security Newswire

WASHINGTON — The U.S. General Accounting Office today said the struggling national smallpox immunization program lacks direction and leadership (see GSN, April 22).

In its report, Smallpox Vaccination:  Implementation of National Program Faces Challenges, the GAO said the program is “unprecedented and complex,” and called on the Centers for Disease Control and Prevention to provide more guidance to state and local health officials.

When U.S. President George W. Bush announced the program in December, U.S. health officials said they hoped to immunize 500,000 medical personnel by the end of February and 10 million emergency workers immediately after.  To date, fewer than 34,000 health workers have received the vaccination.

CDC Director Julie Gerberding said the earlier goals could be unnecessary, and only 50,000 immunized health workers might be needed to prepare the country for a biological terrorism attack, according to the GAO report.

“She has indicated that as few as 50,000 would suffice but has not explained how CDC arrived at that number.  CDC has not said how these workers should be organized and distributed within the smallpox response teams and across the nation.  As of late April, CDC had yet to set new targets,” the report said.

A lack of leadership from top U.S. health officials has resulted in a disjointed national immunization effort, according to the report.

“Some jurisdictions have indicated that they are attempting to follow their original plans … others have said that they have begun to revise their targets downward for the first stage without waiting for a request from CDC,” the GAO said.

As the immunization program unfolded — and the turnout of volunteer health workers proved underwhelming — the CDC sought to lower expectations.  Health officials denied they were attempting to reach targets of 500,000 or 10 million immunized workers.  Officials also said the ultimate goal is not a number, but a level of readiness.  Public health experts have agreed with the CDC that the United States can be ready for a smallpox terrorist attack with fewer than 10 million immunized personnel, but they said a comprehensive response plan is needed in lieu of massive, widespread pre-attack vaccinations.

The GAO agreed that a plan is necessary, and missing.

“If estimates are reduced for the numbers and types of vaccinated health workers in smallpox response teams, CDC would need to provide guidance to ensure that smaller or fewer teams are organized and distributed in a manner that will provide adequate response capacity,” the GAO said.

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Smallpox II:  Bush Signs Smallpox Compensation Bill

U.S. President George W. Bush signed a smallpox vaccine compensation bill into law yesterday to reinforce public confidence in the stalled smallpox immunization program, Reuters reported (see GSN, April 14).

Fears of the vaccine’s side affects and the lack of compensation for those sickened or killed have crippled the national program.

Bush signed the bill without publicity, Reuters reported (Reuters/New York Times, April 30).

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Anthrax:  Scientists Decipher Anthrax Strain Genetic Code

Scientists at the Institute for Genomic Research in Maryland have deciphered the genetic code for a strain of Bacillus anthracis, which causes anthrax, the Associated Press reported today (see GSN, April 8).

Institute scientists have mapped out the genetic code of the Ames strain of the anthrax bacterium, according to AP.  The new research, published today in Nature, could help the development of new vaccines and treatments against the disease.

The research provides a “much-expanded list of potential virulence genes,” said institute President Claire Fraser.  In addition, scientists discovered more than 600 genes with no known function, which might also play a role in the disease’s virulence, according to Fraser (Associated Press/Baltimore Sun, May 1). 

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Anthrax:  Canada Releases Ship From Quarantine

Canadian officials yesterday released a Brazilian ship from quarantine off the coast of Halifax after tests determined that anthrax was not responsible for the death of an Egyptian crewman onboard (see GSN, April 29).  Brazilian officials said the cause of Ibrahim Saved Soliman Ibrahim’s death remains unknown (Shannon McCaffrey, Philadelphia Inquirer, April 30).

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Anthrax:  Dead Crewman Might Have Been Smuggling Anthrax

A Egyptian man who died on a ship bound for Canada might have been poisoned by anthrax in a suitcase he was carrying, the Philadelphia Inquirer reported today (see GSN, April 28).

Ibrahim Saved Soliman Ibrahim boarded a bauxite carrier in Brazil April 11.  He told shipmates that he was to deliver a suitcase to someone in Canada, but that he had opened the suitcase.  He said he felt sick, and he died that night while vomiting blood, according to the Inquirer.

Authorities are waiting for blood tests to determine the cause of Ibrahim’s death, but an aide to Brazilian Justice Minister Marcio Thomaz Bastos yesterday said there was a “strong suspicion” Ibrahim was carrying anthrax.

An autopsy in Brazil discovered that bacteria destroyed Ibrahim’s internal organs.

“The bacteria colonies were similar to anthrax,” said Luiz Malcher, head of the Renato Chavez Forensic Sciences Center in Belem, Brazil.  “If it isn’t anthrax, it is an extremely virulent bacteria,” he added (McCaffrey/Hall, Philadelphia Inquirer, April 29).

A Canadian official, however, cautioned against jumping to any conclusions before test results are known.

“I can assure you we’ve discovered no threat to Canada, criminally or terrorism-wise,” Royal Canadian Mounted Police Inspector Dan Tanner said yesterday.  “Right now, it’s just a story,” he said.

The ship, the Wadi al-Arab, remained in quarantine eight kilometers offshore of Halifax (Barry Dorey, Halifax Herald, April 29).

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Anthrax:  Canadian Officials Waiting for Test Results

Canadian authorities are searching for traces of anthrax in samples from a ship held in quarantine off the coast of Nova Scotia, the Globe and Mail reported Saturday (see GSN, April 25).

Results are expected late today or tomorrow, according to Tracey Taweel, a Health Canada spokeswoman.

A team of six investigators, dressed in protective suits, spent five hours taking swabs from the living quarters on the Wadi al-Arab.  The team also interviewed the 30 members of the crew.

“It’s just what we expected.  Everyone is in extremely good health,” Taweel said.

The ship was quarantined and placed under 1000-meter exclusion zone after it was discovered that the death of the ship’s chief officer might have been caused by anthrax.

“We’re in a bit of a holding pattern at this point,” she said.  “We just have to wait until we hear back from the lab about the results,” she added (Globe and Mail, April 26).

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Anthrax:  Suspicious Death Spurs Canada to Quarantine Brazilian Ship

Canadian public health officials yesterday quarantined a cargo ship from Brazil off the port of Halifax because of concerns that a crewmember onboard may have died from exposure to anthrax.

Brazilian public health officials had warned Canadian officials that a crewmember onboard the ship had died and that the possible cause of death was anthrax.  Canadian officials said the cause of death is still unknown (Agence France-Presse, April 24).

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