David Penn has a formidable task confronting him as the new bioterrorism coordinator for the Mohave County Department of Health and Social Services.
He must develop and write an emergency response plan that deals with use of chemical and biologic agents against the population of Mohave County.
Some of the questions he must concern himself with are: is the target of such an attack people or infrastructure?; where may it occur in the county?; is the attack localized or widespread?; what are the ages and total numbers of people affected?
"It will have to be a pretty elaborate plan in preparing to vaccinate the population of the whole county," Penn said.
"Smallpox is just one aspect of what the plan will include."
Penn said he must submit quarterly reports on the plan under development to the Department of Emergency Planning at the state Health Department.
The possibility of war with Iraq and future terrorist acts has placed national emphasis on smallpox as a weapon likely to be used against America.
The Bush administration is moving to ensure enough smallpox vaccine is available for all 280 million Americans.
A consensus of administration officials agree that people at greatest risk of encountering a smallpox patient, such as hospital emergency room workers, should be the first group to receive the vaccine, which is not yet fully licensed by the Food and Drug Administration.
Primary care doctors, police, firefighters and other emergency workers would comprise the second line of people to get the vaccine, according to an Associated Press story.
The mortality rate from smallpox is about one-third.
However, the vaccine carries some risk, especially for people with certain skins diseases and weakened immune systems.
Studies suggest one or two people per million vaccinated could die and roughly one in 1,000 will face complications that could include severe skin rash or encephalitis.
Penn said there is a national pharmaceutical stockpile from which smallpox vaccine may be drawn if the need arose.
He has recently seen news reports indicating smallpox could affect Arizona through an outbreak as far away as New Jersey or Delaware.
"Last week, I was in Phoenix to attend a Department of Justice seminar that covered across the board response to weapons of mass destruction," Penn said.
"It led to a better understanding of the roles of the media, fire and police in any emergency.
"There also will be a weeklong workshop (Nov.
18-21) on bioterrorism in Las Vegas that I'll attend along with Patty Mead and Jennifer McNally."
Mead is director and McNally is assistant director of the Mohave County Department of Health and Social Services.
Mead said her department had been working on a bioterrorism plan even before the terrorist attacks of Sept.
"We'll need a computer surveillance system, but we can't get ours going until the state has theirs up and running," Mead said.
"The system would monitor symptoms diagnosed at hospitals and care clinics.
"We also must recruit volunteers in the community in case of emergency.
We don't have enough staff to do mass vaccinations."
Mead said her department would eventually be prepared to vaccinate all 155,000 county residents, plus any winter visitors.
The vaccine is highly effective, but protects the recipient just three to five years, she said.
"State health officials want a selected number of people from each county to be vaccinated against smallpox so they could respond to any report of someone with smallpox," Mead said.
"If you're vaccinated within two days of exposure the vaccine will prevent you from getting smallpox.
If you get the vaccination within four days of exposure it will lessen the severity of the disease."
Information updates are available on the county health department website at www.healthelinks.com.