Smallpox drugs

Drugs The drugs available to treat smallpox victims include vaccines and an antiviral drug. 

Treatment — Vaccinia immune globulin must be used in conjunction with a vaccinia vaccine if exposure to a smallpox case occurred more than 4 days earlier. However, only the vaccinia vaccine is required less than 4 days after such contact. The vaccine starts to be protective in approximately 7 days. This vaccine does not provide life-long immunity. Revaccination is recommended at 5- to 10-year intervals. Certain antiviral drugs such as Cidofovir have demonstrated that they confer some protection against infection. Unfortunately, because smallpox has been eradicated, limited research on such drugs has been conducted.3... 

Although some efficacious drugs have been known for centuries, such as the antimalarial quinine first used in 1639, most important discoveries are of more recent origin. Smallpox vaccine was discovered around 1800, morphine in 1820, aspirin in 1894, and phenobarbital in 1912. But the discovery of the antibacterial activity of sulfur drugs in 1932 and penicillin in 1940 started the golden era of rapid expansion and discovery in the industry. Nearly all important drugs today have been discovered since 1940, some very recently. 

Systemic fungal infections hypersensitivity to the drug IM use in ITP administration of live virus vaccines (eg, smallpox) in patients receiving immunosuppressive corticosteroid doses (see Warnings). 

Revealing problems of safety in the drug industry, nine children in Camden, New Jersey, die from tetanus after receiving a commercially produced vaccine for smallpox. 

Every adult, whether traveling or not, should be immunized with tetanus toxoid and should also be fully immunized against poliomyelitis, measles (for those bom after 1956), and diphtheria. In addition, every traveler must fulfill the immunization requirements of the health authorities of the countries to be visited. These are listed in Health Information for International Travel, available from the Superintendent of Documents, United States Government Printing Office, Washington, DC 20402. A useful website is http //www.cdc. gov/travel/vaccinat.htm. The Medical Letter on Drugs and Therapeutics also offers periodically updated recommendations for international travelers (see issue of April 15, 2002). Immunizations received in preparation for travel should be recorded on the International Certificate of Immunization. Note Smallpox vaccination is not recommended or required for travel in any country. 

Until recently, smallpox vaccine was approved by the U.S. Food and Drug Administration for use only in persons in special-risk categories, including laboratory... 

Which antiviral drugs work or how the disease is dealt with in terms of public health measures, depends, in part, on the type of virus. The DNA viruses are relatively stable in form since mutations are internally corrected, and here it is often more effective to use vaccination than chemotherapy. By these means smallpox has been eradicated. For some RNA viruses, vaccination is also effective, including poliomyelitis, rubella, measles and mumps, and some rabies strains. Other viruses mutate so rapidly that vaccination is more difTicult, e.g. influenza, the common cold, HIV. 

There is, in fact, a finite number of drugs, vaccines, and antidotes available to support medical CW or BW defense. Vaccines could provide the most comprehensive defense against BW agents, but the Department of the Navy should be under no illusions that there will be a stream of effective approved vaccines (besides those for smallpox and anthrax) available in the near term to mid-term based on DOD priorities alone.5 In the absence of adequate supplies of effective vaccines, casualties must be anticipated, but observant sailors, corpsmen, clinicians, and commanders, in combination with modem diagnostic tools, will allow early medical interventions to save lives, minimize contamination and further... 

Currently, the Armed Services have only two FDA-licensed vaccines suitable for use in military populations—those for anthrax and smallpox.5 Other stocks of vaccine are held by the military and could be used widely in the military if needed, under an FDA-approved Investigational New Drug/Vaccinc (fND) research protocol. However, because of the current age of these stocks, these vaccines cannot be used under an IND protocol until they are retested and pass standard FDA quality-testing requirements. A hmited discussion of the current status of approved medical countermeasures is presented in Box 5.2. Table 5.1 demonstrates the status of most current DOD BW vaccines. 

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