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Below is a cache of http://www.health.state.nd.us/WebcastHTML/20021205/smallpoxmaster.pdf. It's a snapshot of the page taken as our search engine crawled the Web.
The web site itself may have changed. You can check the current page or check for previous versions at the Internet Archive. Yahoo! is not affiliated with the authors of this page or responsible for its content. Benchmark One-Designate a Senior Public Health Official within the State/local health department to serve as Executive Director. Media Smallpox Seminar North Dakota Department of Health North Dakota Department of Health Smallpox Overview Terry L. Dwelle, MD, MPHTM Terry L. Dwelle, MD, MPHTM State Health Officer State Health Officer North Dakota Department of North Dakota Department of Health Health History 1977 1977 Last naturally acquired Last naturally acquired case in Somalia case in Somalia 1978 1978 Laboratory Laboratory - - related death related death at the University of Birmingham, at the University of Birmingham, England England 1980 1980 Global eradication Global eradication certified by the World Health certified by the World Health Organization Organization Method of eradication Method of eradication Ring Ring vaccination, not mass vaccination, not mass vaccination vaccination Ring Vaccination Concept Isolation of confirmed and suspected cases Isolation of confirmed and suspected cases Identification, vaccination and surveillance of Identification, vaccination and surveillance of significant contacts of proven cases significant contacts of proven cases Vaccination of household contacts of contacts Vaccination of household contacts of contacts Contacts Case Contacts Household Contacts of Contacts Smallpox Basic Facts Cause Cause Variola Variola Virus Virus Can infect only humans Can infect only humans Transmission Transmission Close face to face (generally Close face to face (generally within 6 feet) via respiratory droplets of a within 6 feet) via respiratory droplets of a person who has the disease person who has the disease Smallpox - Disease Onset is 12 to 14 days after exposure Onset is 12 to 14 days after exposure Days 2 to 3 Days 2 to 3 High fever, bed High fever, bed - - ridden, ridden, headache and backache headache and backache Days 4 to 5 Days 4 to 5 Onset of the rash (small bump Onset of the rash (small bump blister blister pustule pustule scab) scab) Most infectious during the first week of the Most infectious during the first week of the rash. No longer infectious once the scabs fall rash. No longer infectious once the scabs fall off ( 3 to 4 weeks) off ( 3 to 4 weeks) Death rate is about 30 percent Death rate is about 30 percent Smallpox Smallpox Vaccination Live virus vaccine Live virus vaccine Vaccinia Vaccinia (this is not the (this is not the smallpox virus) smallpox virus) Highly effective in preventing illness or severe Highly effective in preventing illness or severe disease if given within 3 to 4 days of definite disease if given within 3 to 4 days of definite exposure to smallpox exposure to smallpox Smallpox Vaccination Skin reactions are an indicator that the Skin reactions are an indicator that the vaccine was effective (vaccine take) vaccine was effective (vaccine take) 3 to 4 days 3 to 4 days Redness and itching Redness and itching 7 to 11 days 7 to 11 days Vesicle (blister) Vesicle (blister) develops into a pustule, redness develops into a pustule, redness increases increases 14 to 21 days 14 to 21 days Pustule dries, Pustule dries, scab forms scab forms 21 days 21 days Scabs falls off, Scabs falls off, leaving a permanent scar leaving a permanent scar Commonly see fever and tender, Commonly see fever and tender, enlarged lymph nodes enlarged lymph nodes Vaccination Adverse Reactions Death Death 1 / million 1 / million Accidental infection of other Accidental infection of other body part (i.e. eye) body part (i.e. eye) 1 / 2000 1 / 2000 Generalized Generalized vaccinia vaccinia 1 / 5000 1 / 5000 Eczema Eczema vaccinatum vaccinatum 1 / 1 / 26,000 26,000 Post vaccination encephalitis Post vaccination encephalitis 1 / 300,000 1 / 300,000 Progressive Progressive vaccinia vaccinia 0.83 / 0.83 / million million Vaccination Site Progression Vaccination Site Progression Vaccination Site Progression Vaccination Site Progression Surveillance for Smallpox Larry A. Shireley, MS,MPH Larry A. Shireley, MS,MPH State Epidemiologist State Epidemiologist North Dakota Department of Health North Dakota Department of Health Early Detection Atypical Rash Illnesses Atypical Rash Illnesses Rule Out Chickenpox (Varicella) Rule Out Chickenpox (Varicella) Reporting of hospitalized patients Reporting of hospitalized patients Consult with Infectious Disease Consult with Infectious Disease Physicians/Dermatologists Physicians/Dermatologists ND Public Health Laboratory ND Public Health Laboratory Free testing Free testing Consultation/Confirmation Consultation/Confirmation Centers for Disease Control and Centers for Disease Control and Prevention Prevention Syndromic Surveillance Regional Ask Regional Ask - - A A - - Nurse Nurse Emergency Room Emergency Room Others Others Ambulance Runs Ambulance Runs Pharmaceutical Sales Pharmaceutical Sales Case Investigation Ring Vaccination Ring Vaccination Case Contact to Case Contact to Contact Contact to Contact Smallpox Plan Overview Tim Wiedrich, Director Tim Wiedrich, Director Bioterrorism Bioterrorism Preparedness and Response Preparedness and Response North Dakota Department of Health North Dakota Department of Health Smallpox Plan Categories Pre Pre - - event event Phase I Phase I Initial Initial Responders Responders Public Health Public Health Hospital Hospital About 2,000 About 2,000 Smallpox Plan Categories Pre Pre - - event event Phase II Phase II All Responders All Responders Public Health Public Health Hospital Hospital Clinic/Physician Clinic/Physician Public Safety Public Safety Law enforcement Law enforcement Fire Fire EMS EMS Smallpox Plan Categories Pre Pre - - event event Phase III Phase III Public Public Smallpox Plan Categories Post Post - - event event Ring vaccination Ring vaccination Mass vaccination Mass vaccination Bioterrorism Regional Planning Areas North East North East Central North West Central North West South West South West Central South East Central South East Public Health
Regional Resources Lead Public Health Lead Public Health Units Units Bioterrorism Bioterrorism Directors Directors Field Epidemiologists Field Epidemiologists Medical Consultants Medical Consultants Public Information Public Information Officers Officers Phase I Pre-event Vaccination
Clinics State Responsibilities State Responsibilities Receipt and delivery of vaccine Receipt and delivery of vaccine Establishment of regional consultants Establishment of regional consultants Data registration Data registration Training Training Public education Public education Regional and Local Responsibilities Regional and Local Responsibilities Identification of public & hospital response Identification of public & hospital response teams teams Clinic Planning Clinic Planning Site selections Site selections Supply acquisitions Supply acquisitions Staffing Staffing Schedule planning Schedule planning Supervision and evaluation Supervision and evaluation Smallpox Communications Loreeta Leer Frank Loreeta Leer Frank Public Information Officer Public Information Officer North Dakota Department of Health North Dakota Department of Health Emergency Communication
Response The NDDoH Office of Public Information The NDDoH Office of Public Information supports state and local public health supports state and local public health officials in their efforts to protect the public officials in their efforts to protect the public in the event of a public health emergency in the event of a public health emergency Objectives To provide the public and the media To provide the public and the media access to accurate, consistent, access to accurate, consistent, comprehensive and timely information comprehensive and timely information To minimize, as much as possible, To minimize, as much as possible, public panic and fears public panic and fears To coordinate public information To coordinate public information response with other local, state and response with other local, state and federal partners federal partners Guiding Principle The public will need information that will The public will need information that will help them minimize their risk help them minimize their risk Not Business as Usual A public health emergency: A public health emergency: Triggers a level of public interest and Triggers a level of public interest and media inquiry that requires a media inquiry that requires a response beyond normal operations response beyond normal operations and resources. and resources. Requires a significant diversion of Requires a significant diversion of department staff from regular duties. department staff from regular duties. Recent Events Anthrax concerns ~ 2001 Anthrax concerns ~ 2001 West Nile virus ~ 2002 West Nile virus ~ 2002 Smallpox Communication Plan Within 30 minutes of notification of a Within 30 minutes of notification of a smallpox case: smallpox case: All media calls to NDDoH routed to All media calls to NDDoH routed to Office of Public Information Office of Public Information Smallpox Communication Plan State health officer or designee will act State health officer or designee will act as official spokesperson for the as official spokesperson for the department department News conference held as soon as News conference held as soon as possible possible Any subsequent news conferences held Any subsequent news conferences held at consistent, central location at consistent, central location Smallpox Communication Plan Regular briefings held as warranted Regular briefings held as warranted If few new details, then news releases If few new details, then news releases and news conferences as necessary and news conferences as necessary Updates posted to NDDoH website at Updates posted to NDDoH website at least daily least daily Public health experts will be available Public health experts will be available for interviews with media for interviews with media Confidentiality Issues By law, NDDoH cannot release patient By law, NDDoH cannot release patient - - identifying information identifying information Ex. Ex. West Nile virus West Nile virus Confidentiality Issues During smallpox event, confidentiality During smallpox event, confidentiality issues will be balanced with public issues will be balanced with public safety safety Smallpox cases will be identified by Smallpox cases will be identified by county county Condition of cases will be described Condition of cases will be described Name, age and gender not released Name, age and gender not released Emergencies Are Media Events Emergency response would be Emergency response would be hampered if media not involved hampered if media not involved People rely on media for up People rely on media for up - - to to - - date date information during an emergency information during an emergency Media relay important protective Media relay important protective actions for the public actions for the public Media know how to reach their Media know how to reach their audiences and what their audiences audiences and what their audiences need need Pledge to Media The NDDoH will: The NDDoH will: Respond to your requests for Respond to your requests for information information Arrange access to public health Arrange access to public health experts experts Know your deadlines and work to Know your deadlines and work to accommodate them accommodate them Provide accurate facts and Provide accurate facts and information information Public Healths Goal in
Emergency Response To efficiently and effectively reduce To efficiently and effectively reduce and prevent illness, injury and death and prevent illness, injury and death and to return individuals and and to return individuals and communities to normal communities to normal Contact Information Loreeta Leer Frank, public information officer Loreeta Leer Frank, public information officer 701.328.1665 701.328.1665 rfrank@state.nd.us rfrank@state.nd.us Patience Hurley, public information coordinator Patience Hurley, public information coordinator 701.328.4619 701.328.4619 phurley@state.nd.us phurley@state.nd.us
The web site itself may have changed. You can check the current page or check for previous versions at the Internet Archive. Yahoo! is not affiliated with the authors of this page or responsible for its content. Benchmark One-Designate a Senior Public Health Official within the State/local health department to serve as Executive Director. Media Smallpox Seminar North Dakota Department of Health North Dakota Department of Health Smallpox Overview Terry L. Dwelle, MD, MPHTM Terry L. Dwelle, MD, MPHTM State Health Officer State Health Officer North Dakota Department of North Dakota Department of Health Health History 1977 1977 Last naturally acquired Last naturally acquired case in Somalia case in Somalia 1978 1978 Laboratory Laboratory - - related death related death at the University of Birmingham, at the University of Birmingham, England England 1980 1980 Global eradication Global eradication certified by the World Health certified by the World Health Organization Organization Method of eradication Method of eradication Ring Ring vaccination, not mass vaccination, not mass vaccination vaccination Ring Vaccination Concept Isolation of confirmed and suspected cases Isolation of confirmed and suspected cases Identification, vaccination and surveillance of Identification, vaccination and surveillance of significant contacts of proven cases significant contacts of proven cases Vaccination of household contacts of contacts Vaccination of household contacts of contacts Contacts Case Contacts Household Contacts of Contacts Smallpox Basic Facts Cause Cause Variola Variola Virus Virus Can infect only humans Can infect only humans Transmission Transmission Close face to face (generally Close face to face (generally within 6 feet) via respiratory droplets of a within 6 feet) via respiratory droplets of a person who has the disease person who has the disease Smallpox - Disease Onset is 12 to 14 days after exposure Onset is 12 to 14 days after exposure Days 2 to 3 Days 2 to 3 High fever, bed High fever, bed - - ridden, ridden, headache and backache headache and backache Days 4 to 5 Days 4 to 5 Onset of the rash (small bump Onset of the rash (small bump blister blister pustule pustule scab) scab) Most infectious during the first week of the Most infectious during the first week of the rash. No longer infectious once the scabs fall rash. No longer infectious once the scabs fall off ( 3 to 4 weeks) off ( 3 to 4 weeks) Death rate is about 30 percent Death rate is about 30 percent Smallpox Smallpox Vaccination Live virus vaccine Live virus vaccine Vaccinia Vaccinia (this is not the (this is not the smallpox virus) smallpox virus) Highly effective in preventing illness or severe Highly effective in preventing illness or severe disease if given within 3 to 4 days of definite disease if given within 3 to 4 days of definite exposure to smallpox exposure to smallpox Smallpox Vaccination Skin reactions are an indicator that the Skin reactions are an indicator that the vaccine was effective (vaccine take) vaccine was effective (vaccine take) 3 to 4 days 3 to 4 days Redness and itching Redness and itching 7 to 11 days 7 to 11 days Vesicle (blister) Vesicle (blister) develops into a pustule, redness develops into a pustule, redness increases increases 14 to 21 days 14 to 21 days Pustule dries, Pustule dries, scab forms scab forms 21 days 21 days Scabs falls off, Scabs falls off, leaving a permanent scar leaving a permanent scar Commonly see fever and tender, Commonly see fever and tender, enlarged lymph nodes enlarged lymph nodes Vaccination Adverse Reactions Death Death 1 / million 1 / million Accidental infection of other Accidental infection of other body part (i.e. eye) body part (i.e. eye) 1 / 2000 1 / 2000 Generalized Generalized vaccinia vaccinia 1 / 5000 1 / 5000 Eczema Eczema vaccinatum vaccinatum 1 / 1 / 26,000 26,000 Post vaccination encephalitis Post vaccination encephalitis 1 / 300,000 1 / 300,000 Progressive Progressive vaccinia vaccinia 0.83 / 0.83 / million million Vaccination Site Progression Vaccination Site Progression Vaccination Site Progression Vaccination Site Progression Surveillance for Smallpox Larry A. Shireley, MS,MPH Larry A. Shireley, MS,MPH State Epidemiologist State Epidemiologist North Dakota Department of Health North Dakota Department of Health Early Detection Atypical Rash Illnesses Atypical Rash Illnesses Rule Out Chickenpox (Varicella) Rule Out Chickenpox (Varicella) Reporting of hospitalized patients Reporting of hospitalized patients Consult with Infectious Disease Consult with Infectious Disease Physicians/Dermatologists Physicians/Dermatologists ND Public Health Laboratory ND Public Health Laboratory Free testing Free testing Consultation/Confirmation Consultation/Confirmation Centers for Disease Control and Centers for Disease Control and Prevention Prevention Syndromic Surveillance Regional Ask Regional Ask - - A A - - Nurse Nurse Emergency Room Emergency Room Others Others Ambulance Runs Ambulance Runs Pharmaceutical Sales Pharmaceutical Sales Case Investigation Ring Vaccination Ring Vaccination Case Contact to Case Contact to Contact Contact to Contact Smallpox Plan Overview Tim Wiedrich, Director Tim Wiedrich, Director Bioterrorism Bioterrorism Preparedness and Response Preparedness and Response North Dakota Department of Health North Dakota Department of Health Smallpox Plan Categories Pre Pre - - event event Phase I Phase I Initial Initial Responders Responders Public Health Public Health Hospital Hospital About 2,000 About 2,000 Smallpox Plan Categories Pre Pre - - event event Phase II Phase II All Responders All Responders Public Health Public Health Hospital Hospital Clinic/Physician Clinic/Physician Public Safety Public Safety Law enforcement Law enforcement Fire Fire EMS EMS Smallpox Plan Categories Pre Pre - - event event Phase III Phase III Public Public Smallpox Plan Categories Post Post - - event event Ring vaccination Ring vaccination Mass vaccination Mass vaccination Bioterrorism Regional Planning Areas North East North East Central North West Central North West South West South West Central South East Central South East Public Health
Regional Resources Lead Public Health Lead Public Health Units Units Bioterrorism Bioterrorism Directors Directors Field Epidemiologists Field Epidemiologists Medical Consultants Medical Consultants Public Information Public Information Officers Officers Phase I Pre-event Vaccination
Clinics State Responsibilities State Responsibilities Receipt and delivery of vaccine Receipt and delivery of vaccine Establishment of regional consultants Establishment of regional consultants Data registration Data registration Training Training Public education Public education Regional and Local Responsibilities Regional and Local Responsibilities Identification of public & hospital response Identification of public & hospital response teams teams Clinic Planning Clinic Planning Site selections Site selections Supply acquisitions Supply acquisitions Staffing Staffing Schedule planning Schedule planning Supervision and evaluation Supervision and evaluation Smallpox Communications Loreeta Leer Frank Loreeta Leer Frank Public Information Officer Public Information Officer North Dakota Department of Health North Dakota Department of Health Emergency Communication
Response The NDDoH Office of Public Information The NDDoH Office of Public Information supports state and local public health supports state and local public health officials in their efforts to protect the public officials in their efforts to protect the public in the event of a public health emergency in the event of a public health emergency Objectives To provide the public and the media To provide the public and the media access to accurate, consistent, access to accurate, consistent, comprehensive and timely information comprehensive and timely information To minimize, as much as possible, To minimize, as much as possible, public panic and fears public panic and fears To coordinate public information To coordinate public information response with other local, state and response with other local, state and federal partners federal partners Guiding Principle The public will need information that will The public will need information that will help them minimize their risk help them minimize their risk Not Business as Usual A public health emergency: A public health emergency: Triggers a level of public interest and Triggers a level of public interest and media inquiry that requires a media inquiry that requires a response beyond normal operations response beyond normal operations and resources. and resources. Requires a significant diversion of Requires a significant diversion of department staff from regular duties. department staff from regular duties. Recent Events Anthrax concerns ~ 2001 Anthrax concerns ~ 2001 West Nile virus ~ 2002 West Nile virus ~ 2002 Smallpox Communication Plan Within 30 minutes of notification of a Within 30 minutes of notification of a smallpox case: smallpox case: All media calls to NDDoH routed to All media calls to NDDoH routed to Office of Public Information Office of Public Information Smallpox Communication Plan State health officer or designee will act State health officer or designee will act as official spokesperson for the as official spokesperson for the department department News conference held as soon as News conference held as soon as possible possible Any subsequent news conferences held Any subsequent news conferences held at consistent, central location at consistent, central location Smallpox Communication Plan Regular briefings held as warranted Regular briefings held as warranted If few new details, then news releases If few new details, then news releases and news conferences as necessary and news conferences as necessary Updates posted to NDDoH website at Updates posted to NDDoH website at least daily least daily Public health experts will be available Public health experts will be available for interviews with media for interviews with media Confidentiality Issues By law, NDDoH cannot release patient By law, NDDoH cannot release patient - - identifying information identifying information Ex. Ex. West Nile virus West Nile virus Confidentiality Issues During smallpox event, confidentiality During smallpox event, confidentiality issues will be balanced with public issues will be balanced with public safety safety Smallpox cases will be identified by Smallpox cases will be identified by county county Condition of cases will be described Condition of cases will be described Name, age and gender not released Name, age and gender not released Emergencies Are Media Events Emergency response would be Emergency response would be hampered if media not involved hampered if media not involved People rely on media for up People rely on media for up - - to to - - date date information during an emergency information during an emergency Media relay important protective Media relay important protective actions for the public actions for the public Media know how to reach their Media know how to reach their audiences and what their audiences audiences and what their audiences need need Pledge to Media The NDDoH will: The NDDoH will: Respond to your requests for Respond to your requests for information information Arrange access to public health Arrange access to public health experts experts Know your deadlines and work to Know your deadlines and work to accommodate them accommodate them Provide accurate facts and Provide accurate facts and information information Public Healths Goal in
Emergency Response To efficiently and effectively reduce To efficiently and effectively reduce and prevent illness, injury and death and prevent illness, injury and death and to return individuals and and to return individuals and communities to normal communities to normal Contact Information Loreeta Leer Frank, public information officer Loreeta Leer Frank, public information officer 701.328.1665 701.328.1665 rfrank@state.nd.us rfrank@state.nd.us Patience Hurley, public information coordinator Patience Hurley, public information coordinator 701.328.4619 701.328.4619 phurley@state.nd.us phurley@state.nd.us
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