CONTACT: DAVE PEDERSEN
Iowa City IA 52242
(319) 335-8032; fax (319) 384-4638
Release: Oct. 24, 2002
Photo: Patricia Winokur, left; Jack Stapleton
UI selected to participate in follow-up NIH smallpox study
University of Iowa is one of three institutions nationwide selected to participate
in a follow-up study aimed at increasing current stocks of the smallpox vaccine.
The study is sponsored by the National Institute of Allergy and Infectious
Diseases, part of the National Institutes of Health (NIH).
The UI portion of the investigation will take place at the UI General Clinical
Research Center and will be led by Patricia Winokur, M.D., and Jack Stapleton,
M.D., faculty members in the infectious diseases division of the UI department
of internal medicine, and members of the Helen C. Levitt Center for Viral
Pathogenesis. Winokur and Stapleton are also researchers and staff physicians
at the Veterans Affairs Medical Center in Iowa City.
A total of 148 participants, ages 18 to 32, will be invited to take part
in the trial. Most people in the United Sates in this age group have never
been vaccinated against smallpox because common use of the vaccine ended in
1971, Winokur said.
As a result, these individuals would be susceptible in the event of a biological
attack that used smallpox. Smallpox is thought to be one of the most dangerous
diseases that could be used in bioterrorism. Current estimates are that 120
million Americans are susceptible to smallpox, and given the 30 percent mortality
rate found with smallpox, the effect of a terrorist attack could be profound.
"This study follows our study completed this past summer. We will be
determining the effectiveness of different dilutions of a smallpox vaccine
that was stored for approximately 40 years. The previous study strongly suggests
that we can dilute this vaccine, and this new study will more precisely determine
the amount of vaccine available," Stapleton said.
"In addition to determining vaccine effectiveness, we plan to study
the effects of vaccination on human gene expression and inflammation as part
of the new study," he added.
A smallpox vaccine can reduce or prevent illness if given to a person within
four days after they have been exposed to the disease, according to the Centers
for Disease Control and Prevention
(CDC). Smallpox is spread among people by saliva and causes high fever,
fatigue, headaches, backaches and a rash that can eventually lead to scarring.
Although the majority of people recover from the disease, nearly 30 percent
of infected individuals die.
Winokur said the vaccine can have side effects that include soreness in
the arm, and approximately 10 to 15 percent of individuals who receive the
vaccine may feel ill enough to miss work for a day or two. The vaccine is
not smallpox, but a related virus called "vaccinia." Infection with
vaccinia results in a mild infection that gives a person protection against
After the last natural case of smallpox was documented in 1977, the World
Health Organization declared the disease eradicated in 1980 and urged that
people no longer be inoculated against it. People vaccinated for smallpox
before 1972, when routine vaccinations stopped, may no longer have immunity
against the disease. The U.S. military continued to routinely provide the
smallpox vaccine to its troops until a few years ago.
At the federal level, experts are discussing smallpox vaccination policies
that range from providing vaccinations after a biological attack or providing
them to people proactively, including as a requirement for health care workers.
"There is consideration of whether or not we should immunize everyone
now, or target specific groups likely to be needed for immunization, like
first-responders and health care workers," Stapleton said. "These
are important policy decisions that are currently under review."
For more information about National Institute of Allergy and Infectious
Diseases smallpox research, visit the institute online at www.niaid.nih.gov/publications/bioterrorism.htm.
For additional smallpox information, visit the CDC online at www.cdc.gov/nip/smallpox/default.htm
or the NIH at www.nlm.nih.gov/medlineplus/smallpox.html.
Smallpox-related images, some of which are in the public domain, are available
by clicking on "Smallpox images" at the CDC Web site www.bt.cdc.gov/Agent/Smallpox/Smallpox.asp.
University of Iowa Health Care describes the partnership between the
UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics
and the patient care, medical education and research programs and services