Vaccineinfo

Vaccine and Antibiotic Information

Smallpox Vaccine Information

Anthrax Vaccine Information

Information about antibiotic use to prevent illness from bioterrorism events

What is smallpox?

Smallpox is an illness caused by variola virus. Infected persons usually first experience flu-like symptoms such as fever, fatigue, headache, and backache. Within 2-3 days a rash develops, starting on the face, arms and legs then spreading to the trunk. The rash changes during the course of illness, beginning as flat red lesions then becoming pus-filled, then crusting over. The lesions then develop scabs and finally separate and fall off 3-4 weeks after the rash first appeared.

Smallpox is a contagious disease that can spread from person-to-person through infective droplets during close contact. Smallpox is less commonly spread by indirect contact through the air or on inanimate objects, such as blankets. Smallpox is fatal in about 30% of those infected.

How common is smallpox?

Smallpox has been eradicated from the world, meaning transmission between people no longer occurs. The last naturally occurring case of smallpox was in Somalia in 1977. Samples of smallpox virus still exist in a few secure laboratories around the world, including at the Centers for Disease Control and Prevention (CDC) in Atlanta. There have been rumors of smallpox virus stocks in other locations, but these allegations have not been verified.

What is smallpox vaccine?

Smallpox vaccine protects against smallpox infection. The vaccine is composed of live vaccinia virus. Vaccinia virus is related to variola, the virus that causes smallpox. The vaccine does not contain variola virus and can not cause smallpox in a person who is immunized. The vaccine is effective in preventing illness in people before they are exposed to the virus, or up to 3-4 days following exposure.

Who gets smallpox vaccine?

In the U.S., routine vaccination of the general public ended in the 1970s. Vaccine production by U.S. manufacturers ceased in 1982. Currently, only people who are known to be exposed to smallpox virus, such as laboratory workers, are vaccinated.

Could I get vaccinated if smallpox was released?

The U.S. government has about 15 million doses of vaccine in storage. An additional 40 million doses are expected to be produced by next year. These vaccine doses are not available to the general public and will only be used in the event of a smallpox outbreak. The vaccine can still prevent disease after exposure to the virus.

Anthrax Vaccine Information

What is anthrax?

Anthrax is a serious disease that can affect both animals and humans. It is caused by bacteria called Bacillus anthracis. The bacteria form spores, or protective coverings, and can live in soil for many years. When the spores enter a human or animal (through breaks in the skin, through ingestion, or through inhalation) the spores produce bacteria that can grow and multiply.

People can get anthrax from contact with infected animals, wool, meat, or hides, or from contact with soil containing spores. In its most common form, anthrax is a skin disease that causes skin ulcers and usually fever and fatigue. Up to 20% of these cases are fatal if untreated. Anthrax may also cause gastrointestinal disease if it is ingested (swallowed).

When B. anthracis is inhaled, as when used as a biological weapon, it is much more serious. The first symptoms may include a sore throat, mild fever and muscle aches. Within several days these symptoms are followed by severe breathing problems, shocks, and often meningitis (inflammation of the brain and spinal cord covering). Once the severe symptoms appear, this form of anthrax is almost always fatal. None of these forms of anthrax has been shown to spread from person to person.

How common is anthrax?

Anthrax occurs in animals all over the world, most commonly in countries that have poor livestock public health programs, but also in the U.S. Occasionally cutaneous (skin) anthrax is reported in the U.S. in people who have contact with infected animals. Gastrointestinal and inhalational anthrax are extremely rare and result from ingestion or inhalation of anthrax spores.

What is anthrax vaccine?

Anthrax vaccine protects against anthrax disease. The vaccine used in the U.S. does not contain bacterial cells and can not cause anthrax disease. Information about the vaccine's effectiveness is limited, but it is believed to protect against the cutaneous and inhalational forms of the disease.

Who gets anthrax vaccine?

In the U.S., distribution of the vaccine is controlled by the Department of Defense. Vaccine is routinely given only to military personnel.

Could I get vaccinated if anthrax was released?

The availability of anthrax vaccine during an outbreak is a decision that would be made by federal officials. Factors to consider would be the number of persons potentially exposed and the availability of antibiotics for treatment or prevention of illness. The federal government has already prepared for bioterrorist events involving bacterial agents by stockpiling antibiotics for emergency use (more information below).

Using Antibiotics to Prevent Illness From Bioterrorism

I have heard that an antibiotic called ciprofloxacin may protect me from getting anthrax. Should I ask my doctor for antibiotics to protect me from bioterrorism?

No. The risk of being a victim of bioterrorism, while real, is extremely low. There are several reasons why people should not take antibiotics when they do not have bacterial infections. Preventive measures, such as prophylactic (before infection) treatment with antibiotics, are not without risk, and in the absence of any evidence of a release of a biologic agent, have no benefit. Inappropriate use of antibiotics may lead to increased antibiotic resistance among microorganisms that cause common bacterial infections and may result in serious adverse events.

Stockpiling antibiotics like ciprofloxacin is also not recommended because it may rapidly deplete existing pharmaceutical supplies and prevent access to drugs needed treat patients now under normal clinical circumstances.

If a bioterrorism event happens in a large city like Atlanta, how will I know there will be enough antibiotics to treat everyone, including me?

State and federal governments have been preparing for bioterrorism events. During the last year, the Georgia Division of Public Health has been working with representatives of the Georgia Pharmacy Association, the Georgia Society of Health System Pharmacists, and private sector pharmacists on the Georgia Pharmacy Disaster Planning Task Force, in which contingency plans are being developed to mobilize statewide pharmaceutical inventories during emergencies.

In addition, in the event that state and local pharmaceutical supplies are exhausted, a CDC-based National Pharmaceutical Stockpile (NPS) Program exists and would be deployed to a local community for mass treatment and prophylaxis in the event of a bioterrorist attack. The NPS is a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration and airway maintenance supplies, and medical/surgical items. The first shipment of medications from the NPS would arrive within 12 hours, ensuring that treatment would not be delayed. Information about this program is available on the CDC web site at http://www.cdc.gov/nceh/nps/default.htm.

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