August 30, 2016 SPADA Meeting Book

Smallpox - Disease Elimination/Eradication

 Disease – viral exanthem  Major (“avg” 30% CFR) and minor disease (<1% CFR) Disease prevention  Childhood vaccination – variable rates; +/-variolation  Global Smallpox Eradication program - 1958  Intensification of Smallpox eradication program 1967 

• Surveillance -> contact tracing, vaccination of contacts (and contacts) • Isolation of cases, observation of contacts • Lyophilized vaccine, semi-standardized vaccine production o Vaccinia virus “Take” ~ protection o  No non-human animal reservoir

 Elimination in all countries by 1977  Commission to Certify Smallpox eradication activities • Certified as eradicated in 1979  WHA : Declaration of smallpox eradication 1980

* Smallpox and its EradicationWHO 1988

History- Variola virus Elimination/Eradication

Consolidation of laboratory-held virus materials*  1975 survey by WHO, post lab exposure in 1973 (LSTMH) • 74 labs report Variola virus materials  1976 voluntary consolidation • 1978 – Birmingham, England smallpox “lab”: 1 death, illness  1979 – WHO Committee of Experts recommends to preserve Variola virus stocks in a few collaborating center (CC) laboratories, review in 1982:->19 recommendations by the Global Commission • 1979 – 7 labs report Variola virus stocks • 1981 – 4 CC laboratories with Variola virus • Periodic inspections for safe and secure use virus  1984 – consolidation of stocks to 2 WHO CCs – BSL-4 facilities (WHA 33.4) * Smallpox and its Eradication1988