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Smallpox containment updated: considerations for the 21st century
1Polio Eradication, World Health Organization, 1211 Geneva 27, Switzerland. heymannd@who.int
Summary
Global infectious disease surveillance, including HIV, impacts smallpox outbreak preparedness. Enhanced global networks improve response but require increased national investment in public health infrastructure.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Biosecurity
Background:
- The eradication of smallpox has not eliminated the threat of deliberate release or re-emergence.
- Emerging infectious diseases like HIV have complicated traditional smallpox response strategies.
- Global interconnectedness necessitates robust surveillance and response mechanisms for novel threats.
Observation:
- Human Immunodeficiency Virus (HIV) complicates smallpox vaccine use, increasing reliance on vaccinia immune globulin.
- Global Outbreak Alert and Response Network (GOARN) enhances international collaboration for infectious disease containment.
- GOARN's success in SARS containment offers a model for potential smallpox outbreak response.
Findings:
- Global investments in surveillance and response networks have indirectly improved preparedness for deliberate smallpox events.
- Existing global mechanisms like GOARN can facilitate international cooperation during a smallpox crisis.
- Despite global efforts, national public health capacity remains a critical determinant of effective smallpox outbreak management.
Implications:
- Strengthened national public health infrastructure, including surge capacity and communication, is essential for managing smallpox outbreaks.
- Continued investment in global and national public health systems is vital for biosecurity and pandemic preparedness.
- The interplay between emerging diseases and biothreat preparedness requires adaptive and integrated public health strategies.