ANN ARBOR—Targeted vaccination of people potentially exposed to smallpox during a bioterrorist episode, together with an appropriately low level of vaccination before an attack, provides the best protection against smallpox, according to an analysis by University of Michigan Professor Jim Koopman in the Nov. 15 issue of the journal Science.
But questions remain because of the lack of relevant data and because there is scientific modeling work left to be done, Koopman, professor of epidemiology at the U-M School of Public Health, writes in a Perspectives article in Science. In the absence of ongoing cases of smallpox to study, Koopman writes that scientists must use the best possible mathematical models to hypothesize what might happen if bioterrorists were to unleash the highly contagious disease, which the CIA suspects is held by four unauthorized countries including Iraq and North Korea.
Assessing the pros and cons of mass vaccinations, which administer the vaccine to anyone who comes in to get it, versus targeted vaccinations by health department personnel who go to those who must be vaccinated in order to stop spread, Koopman evaluates the infection transmission models used in two recent studies of how smallpox might move from person to person. A continuous population model treats people as being blended together—if any part of the population is infected, transmission to the susceptible part of the population will occur. A discrete individual model instead looks at who is infected and how they might pass along the disease to whom.
Jim Koopman faculty profiles: www.sph.umich.edu/~jkoopman/jkoopman.html
For more on U-M School of Public Health: www.sph.umich.edu
Centers for Disease Control and Prevention information on smallpox: http://www.bt.cdc.gov/agent/smallpox/index.asp