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Arundel health officials' plans for smallpox prevention begin

THE BALTIMORE SUN

Anne Arundel County Health Officer Frances B. Phillips remembers being vaccinated for smallpox as a child. A nurse pricked her arm with a forked needle, and days later the site blistered and scabbed.

A scared child no longer, Phillips again is dealing with smallpox. This time she is part of a nationwide effort to inoculate roughly 500,000 health care workers against the disease as a precaution against potential terrorist attack.

"It was a huge development in public health to eradicate the disease," said Phillips, who is overseeing the vaccination of 218 county health professionals, a process set to begin next month.

She finds it disturbing that authorities again might face combating the disease.

County health care workers selected to take part in the first wave of vaccinations - 100 volunteers each will be tapped among the ranks of doctors and nurses at North Arundel Hospital and Anne Arundel Medical Center - will travel to a central site in Maryland where state health officials will dole out the vaccine, Phillips said.

Phillips has grown used to receiving daily missives from the White House and the Centers for Disease Control and Prevention on the nation's smallpox battle plan, a cornerstone of President Bush's bioterrorism defense strategy.

The president recently announced that members of the military serving in high-risk areas would be vaccinated to protect against any terrorist-related outbreak of the disease, which was eradicated worldwide in 1980.

About 6,000 health workers in Maryland also are set to be inoculated, despite concerns by some medical researchers about the risks of the vaccine, which can lead to fatal complications for one or two of every million people inoculated.

Those at risk, said Phillips, include people with skin conditions such as eczema, those with immune systems weakened by cancer treatments, organ transplants or HIV and pregnant women.

Phillips has been diligently mapping her preoutbreak and worst-case scenario strategies - confidential plans she sent to federal authorities this month.

Anne Arundel's public and private health care workers who volunteer for the inoculation, including 18 employees from the county Health Department, will receive training about the risks and how to prevent spread of the virus used in the vaccine with the use of gauze and bandages.

Volunteers will have their dressings changed every day, Phillips said, either at the Health Department or at the hospital.

She said that studies by the military have shown that transfer of the virus in the vaccine, which is not the smallpox virus but a virus similar to it, is relatively rare and occurs only in cases of close contact.

Phillips said no one will be forced to participate in the vaccine campaign.

"If they choose to decline, they do so without having to state why," she said.

Officials at North Arundel Hospital also are looking for volunteers, said Kevin Murnane, hospital communications director.

"We've used our internal newsletter to get the word out that we are looking for volunteers," Murnane said.

He said that the employee heading the vaccination program has received many calls expressing interest.

Murnane said that many of the hospital's doctors, nurses and respiratory therapists see the inoculation as a way to further serve the community.

"A majority of our workers live in Anne Arundel County," Murnane said. "They view this as another way to help their neighbors and their families."

Phillips said the focus on smallpox - local police, emergency medical technicians, and firefighters are expected to receive inoculations next and residents could receive the vaccine in starting in 2004 - will tax the health system, said Phillips, whose staff also manages HIV and cancer prevention programs. Even so, she said, precautions must be a priority in Anne Arundel, a county so close to the nation's capital.

"Homeland security translates to local response," Phillips said. "And this is a county that must be in the forefront in terms of preparedness."

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