Health Issues: USA Preparing for Smallpox Vaccinations

by R.A. Clappison, DDS, FRCD(C)

The concern that smallpox could be used as a weapon of biological terror has caused the U.S. government to plan a response to the threat. The plan calls for rapidly vaccinating millions of people in the case of an outbreak.

The project calls for 280 million doses being sent out from the National Pharmaceutical Stockpile within 5-7 days. In a single day it is expected that 75 million doses could be shipped.

The U.S. agency has purchased 90 million doses of the vaccine from Aventis-Pasteur in France. In order to augment the inventory of Wyeth’s DryVax vaccine, Acambis Plc and Baxter International have been engaged to supply more vaccine.

Monitoring some patients for side effects is considered essential. Patients with some types of excema and cancer and those with HIV infection particularly fall into that category.


The American Heart Association (AHA) has released guidelines to request physicians to routinely evaluate the risk factors in patients. There is a decline in the number of deaths from heart disease but an increase in the number of cases.

Adoption of a healthy lifestyle is the key to the reduction of heart attacks and stroke in patients void of cardiovascular disease. Eating a healthy diet; keeping weight under control; avoiding smoking and second-hand smoke and incorporating at least 30 minutes of exercise on most days is the crux.

If you believe there is not a lot of credence to exercise and diet think of the Okinawans. Suzuki, Willcox and associates think that the long life of the Okinawans is their life long involvement in exercise. They are the population with the highest number of centenarians in the world. They are involved in karate and tai chi and in addition this group of centenarians has one of the healthiest diets in the world.

Prevention of the first heart attack is the goal. When patients reach 40, physicians are encouraged to be involved in a plan of evaluation in order to calculate the patient’s estimated risk of developing cardiovascular disease within the next 10 years. This should be repeated every five years after age 40. Special emphasis should be placed on the determination of each individual’s risk of cardiovascular disease followed by recommendations to reduce them. Patients should know what their risk is and what can be done to reduce it. A partnership needs to be structured between the physician and the patient with the aim of preventing the status of being classified as a heart disease patient.

The panel recommends that most persons keep blood pressure below 140/90 (mmHg) and that people with no more than one cardiovascular risk factor should keep the levels of the “bad cholesterol” under 160 milligrams (mg/dl) per deciliter of blood. More risks require lower levels.

The original recommendation of aspirin for those who have already had a heart attack or stroke is now updated to the advice that those with a higher risk of cardiovascular disease should take a low dose — 75 to 160 mgm each day. This is the equivalent of one or two baby aspirins per day. The concerns about gastrointestinal bleeding and bleeding in the brain are somewhat balanced, in patients with increased risk of heart attack or stroke, by the fact that the benefits outweigh the risks.

The panel, in another change, recommends that patients with atrial fibrillation take blood thinners to reduce the risk of stroke.