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Bioterrorism assessments from the CDC
Newsdesk
There have been no severe acute respiratory syndrome (SARS) cases since the end of the northern summer but worries are mounting of a recurrence in the winter season. “All the evidence points to a wild-animal source for the SARS coronavirus, but this source remains to be found. If the same set of circumstances occur this year in which the human population in southern China and north Vietnam is exposed again, we could certainly see more cases”, comments Meirion Evans (University of Wales College of Medicine, Cardiff, UK), a member of the SARS Expert Committee. Such fears are accelerating efforts to find a vaccine. In late November, the official Chinese news agency, Xinhua, reported an announcement by Yin Hongzhang, Head of the Biological Product Section of the Chinese State Food and Drug Administration, that clinical trials, in which healthy human volunteers will be given a “dead” strain of the SARS coronavirus, were close to being approved. Preclinical trials in monkeys have apparently shown the “dead” vaccine is effective without serious side-effects. The vaccine’s developer, Beijing Kexing, Bioproduct Co, produced more than 20 000 doses
in preparation for a 2-year study beginning at the Rights were not granted to end of 2003. In early include this image in electronic December, the Canadian SARS media. Please refer to the Accelerated Vaccine Initiative printed journal. also reported its intention to test a live vaccine and two recombinant vaccines within a year. Brett Finlay (University of British Columbia, Vancouver, Canada), director of the initiative, said that “human trials would be hurried to Could SARS and air pollution be linked? have a vaccine ready to go into production by spring 2005”. our study suggests that air pollution “Things seems to be moving very fast”, may increase the risk of dying from observes Evans, but warns against loss SARS, we were unable to investigate of last year’s international cooperation. confounding factors such as exposure “Establishment of an international to smoking, occupational exposure to laboratory network led to the early harmful substances, and the prevalence identification of the causative organism of pre-existing respiratory disease”, of SARS, and it would be a great shame comments Zhang. Detels adds that the to forget this precedent”, he says. next appropriate step to verify (or Research into why SARS caused so refute) this observed association would many deaths continues. In November, be to do studies that control for these Zuo-Feng Zhang and Roger Detels factors. Evans agrees, pointing out that (UCLA School of Public Health, Los most cases of SARS in China occurred Angeles, CA, USA) reported that in urban areas, where pollution would analysis of publicly available data on tend to be higher. “The greatest risk SARS suggested a positive relation factor for mortality did seem to be age between SARS fatality and air pollution and comorbidity”, he says. (Environ Health 2003; 2: 15). “Although Kathryn Senior
Bioterrorism assessments from the CDC The Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) are to start grading how prepared US states are for a bioterrorism attack, including how many could open massvaccination clinics to respond to a smallpox threat. Although the publichealth preparedness project is still in the initial stages, the CDC aims to have evaluations underway in 2004. Last year, more than US$1 billion was distributed among US states to enable them to develop bioterrorism preparedness plans, upgrade disease surveillance, enhance hospital systems to deal with large numbers of casualties, and expand public-health laboratory and communications capacities. The CDC advised state health officials to be prepared to vaccinate all residents within 10 days of a terrorist attack.
Joe Henderson, head of CDC’s bioterrorism preparedness effort, said that currently more than 190 000 doses of smallpox vaccine are available for states to inoculate emergency workers while they await supplies from national reserves. However, the voluntary smallpox vaccination programme for health-care workers implemented last year by the CDC has not had the predicted uptake, partly because of workers’ concerns over side-effects. The slow uptake might also have been due to the initial absence of a federal compensation programme for smallpox vaccination to cover medical expenses for adverse events, or, in extreme cases, disability or death resulting from vaccination. Government compensation has only been available since May 2003.
THE LANCET Infectious Diseases Vol 4 January 2004
According to the CDC, just one confirmed case of smallpox anywhere in the world would be considered a global emergency. This heightened state of preparedness is expensive to maintain, however, although federal funds continue to pour in to the US bioterrorism effort. Asked by TLID where the threat of bioterrorism is expected to come from, given that no biological weapons were uncovered in Iraq, a CDC spokesperson replied that “because it is difficult to anticipate the next public-health threat, CDC views preparedness for a biological or chemical attack as an ongoing process and we cannot become complacent”. Priya Shetty
http://infection.thelancet.com
For personal use. Only reproduce with permission from The Lancet.
3
AP Photo/Greg Baker
Spectre of SARS still looms
There have been no severe acute respiratory syndrome (SARS) cases since the end of the northern summer but worries are mounting of a recurrence in the winter season. “All the evidence points to a wild-animal source for the SARS coronavirus, but this source remains to be found. If the same set of circumstances occur this year in which the human population in southern China and north Vietnam is exposed again, we could certainly see more cases”, comments Meirion Evans (University of Wales College of Medicine, Cardiff, UK), a member of the SARS Expert Committee. Such fears are accelerating efforts to find a vaccine. In late November, the official Chinese news agency, Xinhua, reported an announcement by Yin Hongzhang, Head of the Biological Product Section of the Chinese State Food and Drug Administration, that clinical trials, in which healthy human volunteers will be given a “dead” strain of the SARS coronavirus, were close to being approved. Preclinical trials in monkeys have apparently shown the “dead” vaccine is effective without serious side-effects. The vaccine’s developer, Beijing Kexing, Bioproduct Co, produced more than 20 000 doses
in preparation for a 2-year study beginning at the Rights were not granted to end of 2003. In early include this image in electronic December, the Canadian SARS media. Please refer to the Accelerated Vaccine Initiative printed journal. also reported its intention to test a live vaccine and two recombinant vaccines within a year. Brett Finlay (University of British Columbia, Vancouver, Canada), director of the initiative, said that “human trials would be hurried to Could SARS and air pollution be linked? have a vaccine ready to go into production by spring 2005”. our study suggests that air pollution “Things seems to be moving very fast”, may increase the risk of dying from observes Evans, but warns against loss SARS, we were unable to investigate of last year’s international cooperation. confounding factors such as exposure “Establishment of an international to smoking, occupational exposure to laboratory network led to the early harmful substances, and the prevalence identification of the causative organism of pre-existing respiratory disease”, of SARS, and it would be a great shame comments Zhang. Detels adds that the to forget this precedent”, he says. next appropriate step to verify (or Research into why SARS caused so refute) this observed association would many deaths continues. In November, be to do studies that control for these Zuo-Feng Zhang and Roger Detels factors. Evans agrees, pointing out that (UCLA School of Public Health, Los most cases of SARS in China occurred Angeles, CA, USA) reported that in urban areas, where pollution would analysis of publicly available data on tend to be higher. “The greatest risk SARS suggested a positive relation factor for mortality did seem to be age between SARS fatality and air pollution and comorbidity”, he says. (Environ Health 2003; 2: 15). “Although Kathryn Senior
Bioterrorism assessments from the CDC The Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) are to start grading how prepared US states are for a bioterrorism attack, including how many could open massvaccination clinics to respond to a smallpox threat. Although the publichealth preparedness project is still in the initial stages, the CDC aims to have evaluations underway in 2004. Last year, more than US$1 billion was distributed among US states to enable them to develop bioterrorism preparedness plans, upgrade disease surveillance, enhance hospital systems to deal with large numbers of casualties, and expand public-health laboratory and communications capacities. The CDC advised state health officials to be prepared to vaccinate all residents within 10 days of a terrorist attack.
Joe Henderson, head of CDC’s bioterrorism preparedness effort, said that currently more than 190 000 doses of smallpox vaccine are available for states to inoculate emergency workers while they await supplies from national reserves. However, the voluntary smallpox vaccination programme for health-care workers implemented last year by the CDC has not had the predicted uptake, partly because of workers’ concerns over side-effects. The slow uptake might also have been due to the initial absence of a federal compensation programme for smallpox vaccination to cover medical expenses for adverse events, or, in extreme cases, disability or death resulting from vaccination. Government compensation has only been available since May 2003.
THE LANCET Infectious Diseases Vol 4 January 2004
According to the CDC, just one confirmed case of smallpox anywhere in the world would be considered a global emergency. This heightened state of preparedness is expensive to maintain, however, although federal funds continue to pour in to the US bioterrorism effort. Asked by TLID where the threat of bioterrorism is expected to come from, given that no biological weapons were uncovered in Iraq, a CDC spokesperson replied that “because it is difficult to anticipate the next public-health threat, CDC views preparedness for a biological or chemical attack as an ongoing process and we cannot become complacent”. Priya Shetty
http://infection.thelancet.com
For personal use. Only reproduce with permission from The Lancet.
3
AP Photo/Greg Baker
Spectre of SARS still looms