Smallpox

In the past centuries, smallpox has been at the origin of numerous epidemics. The elaboration of a vaccine at the end of the 18^th century allowed reducing little by little its impact. At the beginning of the second half of the 20^th century, use of lyophilization allowed vaccine transport to the most remote corners of the world.

As smallpox directly transmits from one infected person to another sane and unprotected person without any intervention of external vector or of another intermediate agent, the idea was conceived to attempt eradicating the disease thanks to a vaccination campaign at world level. The eradication world campaign was piloted by the WHO and executed by the Member States. The last smallpox case was recorded in Somalia in 1977. On the 26^th October 1979, after a 2-year observation period, the WHO declared the world free of smallpox. Vaccination against smallpox was legally compulsory in Belgium. It is since 1976 that that vaccination obligation is suspended.

A new smallpox epidemic is rather unlikely. The WHO has approved two highly secured laboratories in which smallpox virus samples are officially kept. Would a smallpox epidemic now occur, it could be concluded that the origin of it would probably be an ill-intentioned act. Risks linked to anti-smallpox vaccination are not to be neglected. Given the fact that for the time being the disease does not exist, the Belgian government, following in that way the notice of the “Conseil Supérieur d’Hygiène” (Health Council), is not in favour of preventive vaccination.

In the eventuality of a confirmed smallpox epidemic, concentric vaccination (in rings) would be applied. Anyone having been in contact with a person infected by smallpox would be vaccinated. In order to apply that counter-attack measure, it is necessary that a first-aid polyvalent team be itself vaccinated before getting into action. The “Smallpox Rapid Intervention Team” (RIT) counts about 600 persons. That team is composed of doctors, nurses, ambulance drivers, laboratory personnel (some of them highly qualified), civil protection drivers (to insure samples transport), police staff, administrative personnel (to cover for vaccination centres needs), logistic support personnel, judicial personnel, and still many more other staff types. The government has to be prepared in case such an eventuality occurs in Belgium or elsewhere in the world.

Selection of candidates for the “Smallpox Rapid Intervention Team” (RIT) has started. Besides, in 2002 already, the government has constituted a strategic stock of anti-smallpox vaccine.