TV host takes on Small Pox?

I did a double take the other evening. I saw a commercial for an episode of Dr. Oz that was to focus on the next major bio-terrorism threat...smallpox. Just to be sure that I wasn't in some sort of scientific heaven, I checked the TV listings and, low and behold, there it was. Now, being a card carrying virologist, and having studied a BL-4 agent, I was quite curious as to what a daytime TV show doctor was going to do with such a sensitive topic...and thanks to my new best friend, my dvr, I was able to watch the segment.

As predicted, Dr. Oz pulled out all the stops...from misting the audience to simulate the spread of smallpox...to crazy lighting and seat arrangements...and of course, the obligate slide show of victims that died to small pox in the first half of the 20th century. It was a bit over the top, but all and all, I think he kept the fear of a smallpox outbreak in check with the facts. As many might remember, small pox was officially eliminated from the world back in the 1970's except for samples to be kept at two locations, one in the US and the other in Russia. There is concern amongst many scientists and security experts that smallpox may exist in other freezers throughout the world, but for now, all we have is speculation on that front. None the less, even if terrorists or rogue nations were to get hold of the virus (or make it), we have a very good vaccine that can be used up to four days post exposure to the actual virus. And, unlike the H1N1 vaccine, we have over 300 million doses of the virus already set to be distributed if needed.

The one major problem that I had with the show was that Dr. Oz and his experts failed to discuss one of the major problems with the vaccine. I realize that he might not want to detract from people taking the vaccine by scaring them with the potential side effects, but, I for one believe everyone has the right to know all the facts about what is going into their body. So here we go...The smallpox vaccine is a live virus vaccine. Its actually derived from another pox virus that was initially isolated from cows (aka cowpox). It was discovered a long time ago by Edward Jenner that milk maids were always spared during outbreaks of small pox. He realized that the milk maids were getting exposed to cowpox and that this exposure resulted in protection against the human version. This was the first, and to this day one of the most effective, vaccines to be made. Now, like many live virus vaccines, there are problems that can occur, most notably, death. While most people giving the vaccine will develop a small sore at the sight of inoculation, rarely the infection will become systemic, can leave to permanent neurological problems and cause complications during pregnancy. In addition, those vaccinated are infectious, and, if the virus is spread to some one with certain skin disorders, including eczema, severe complications can develop.

So, all that said, if smallpox breaks out in the US will I be standing in line for the vaccine? You betcha. Would I recommend everyone else get the vaccine? I'd say yes for almost everyone, though if you have a compromised immune system or a history of eczema or other skin disorders I would consult a physician first.

Image courtesy of the CDC.