Seattle Sun Newspaper - Vol. 7, Issue 3, March 2003

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Local hospitals prepare for possible smallpox outbreak

By MATTHEW PREUSCH

The Bush administration wants hospitals to prepare for the possibility of terrorist-instigated smallpox outbreaks.

In North Seattle, two hospitals Swedish Medical Center/Ballard and the University of Washington Medical are forming "care teams" to address such a possibility.

A third acute-care hospital, Northwest Hospital, says while it is unable to recruit enough of its staff to form a care team, it would still be able to treat people exposed to the deadly disease.

Smallpox was eradicated worldwide in the 1970s, and routine vaccinations ceased at that time. But fears over the use of biological weapons in terrorist attacks have health officials planning for the prospect, some say remote, of another smallpox outbreak.

In Washington state, 91 acute-care hospitals, those with emergency rooms were scheduled to receive a portion of the 4,000 vaccines the state has ordered from the federal government. Those vaccinations are just the first part of the Center for Disease Control's multi-stage plan to brace the nation's health-care infrastructure for a smallpox outbreak.

But in recent months, several hospitals have declined to vaccinate any of their workers, thereby limiting the scope of the voluntary vaccinations. The hospitals cite the health risks the vaccine poses to health workers, their families and their patients. Other hospitals, like Northwest, have been unable to recruit sufficient staff for the program.

"Unlike some other hospitals across the country, we're not saying it's a bad plan," said Suzi Beerman, a spokeswoman for Northwest. "We're not saying it's good or bad we're just saying we can't participate with this."

There are real problems associated vaccinating health workers. About 500 out of every 1 million people who receive the vaccine, a live virus, become seriously ill; two per million could die. Particularly vulnerable are those with weakened immune systems or any form of cancer. For that reason, hospitals are carefully screening employees and their family members for any preexisting health conditions that could lead to complications after vaccination.

William Shelton, manager of Epidemiology and Infection Control for Swedish, said the hospital has gathered enough volunteers for a team of vaccinated workers at its two Seattle campuses that could respond in the event of an actual smallpox outbreak. Shelton said the hospital worked closely with public health officials to make sure their staff could make an educated decision about whether to be vaccinated.

"We're screening our employees very carefully, because this is a phase one, pre-event vaccination program," he said.

With an actual smallpox outbreak still the stuff of speculation, Shelton said hospital administrators at Swedish were not willing to take any chances with the health of their staff. "There are some people who clearly can not receive the vaccine; we don't want them to receive the vaccine," he said.

Pam Sowers, a spokeswoman for UW Medical Center, said recruitment for the vaccination at the hospital was going "really well."

"I was told we have sufficient volunteers for the first stage," she said. "We could provide adequate coverage without endangering anyone if a case [of smallpox] comes in."

At Northwest, administrators were hoping to recruit 100 nurses, physicians and technicians for an emergency response team, said Gayle Ward, vice president of Clinical Services. However, after a lengthy outreach campaign to staff, including letters, e-mails and six open forums, only 21 employees were deemed eligible to be vaccinated.

Lack of enthusiasm among the staff about vaccination was only part of the problem. Ward said a number of potential volunteers were screened out because of "contraindications" a medical term for red flags that signal a potential health risk associated with the vaccine.

Ward said the absence of a vaccinated team of "first responders" does not put Northwest at a disadvantage, and the community has no reason to be concerned.

In the off chance that someone is exposed to smallpox near Northwest, she said, they shouldn't hesitate to come to the hospital for treatment, where it would be treated like any other infectious disease.

"I'm confident that, in the event there is an exposure, we'll treat it appropriately," Ward said.

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For more information, contact Public Health-Seattle and King County, 205-5442.