Preparedness for a smallpox pandemic in Japan: public health perspectives

Smallpox is an acute, febrile, contagious disease caused by the Variola virus, which is a member of the Poxviridae family. Until the 1970s, smallpox had been a pandemic disease for more than 3000 years, endemic in tropical and developing areas and periodically epidemic worldwide. The World Health Organization declared smallpox to be completely eradicated in 1980 as the result of global vaccination efforts. At that time, all routine vaccination programs were terminated, given the success of thismonumental eradication. Although smallpox remains fully eradicated, uncertainty exists regarding the possibility of recurrent smallpox outbreaks. At the end of the Cold War, concerns regarding unstable international security and the feasibility of terrorism with weapons of mass destruction have been highlighted. The potential threat of intentional release of smallpox has forced regional health authorities to reconsider their political landscape and create preparedness plans to protect the community in the event of biological attacks. Here we present current countermeasures to this biological threat in Japan and discuss methods for strengthening public health preparedness both domestically and internationally. These methods include infection control, vaccination policy, and international partnerships to help deter or contain a contagious smallpox pandemic.