42 CFR 102.54 - Documentation the representative of the estate of a deceased smallpox vaccine recipient or...

Science.gov (United States)

2010-10-01

... deceased smallpox vaccine recipient or vaccinia contact must submit to be deemed eligible by the Secretary... VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation To Be Deemed Eligible § 102.54 Documentation the representative of the estate of a deceased smallpox vaccine recipient or vaccinia contact must...

[The late media emergency of smallpox vaccine, news coverage of Spanish press (1999-2004)].

Science.gov (United States)

Martínez-Martínez, Pedro Javier; Tuells, José; Colmenar-Jarillo, Gema

2015-06-01

Discussions on the need for smallpox virus preservation in 1999 focused attention on an eradicated disease 20 years ago. Smallpox was replaced as a potential candidate to be used as a bioterrorist weapon because of the international alarm scenario produced after the 11/9 events in USA. The reactivation of a vaccine which remained forgotten was the direct consequence. The initial target groups were the security forces of America. Spain was also among the countries that were interested in acquiring the smallpox vaccine. The aim of this study is to analyze the considerable media coverage of smallpox obtained in our country. Systematic review of published news in the four largest national daily newspapers (ABC, El Mundo, El País and La Vanguardia) for the period 1999-2004 of the Dow Jones Factiva document database. "Smallpox" were used as a key word. From the obtained data, a qualitative and quantitative analysis was done. 416 reviews were analyzed; the newspaper El Mundo was the most interested in these news (158 citations, 37.98%). Most of the news were published in 2003 (152, 36.5%) The year with more news about smallpox (2003) coincides with the purchase of vaccines in Spain. The type of messages in the news was highly changeable over this six-year period. Those related to "politics and diplomacy", "epidemiological risk", "bioterrorism" and "vaccine" were predominant. The alarm raised around the smallpox vaccination was a media phenomenon due to political strategy issues rather than a real public health problem.

42 CFR 102.51 - Documentation a smallpox vaccine recipient must submit to be deemed eligible by the Secretary.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Documentation a smallpox vaccine recipient must..., DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation To Be Deemed Eligible § 102.51 Documentation a smallpox vaccine recipient must submit to be deemed eligible by...

What Is Smallpox?

Science.gov (United States)

... and don't need to — get a smallpox vaccine right now, there is a supply of the vaccine in ... become infected with the smallpox virus, getting the vaccine within a few days of becoming infected can lessen the disease's symptoms. ...

Introduction: simultaneously global and local: reassessing smallpox vaccination and its spread, 1789-1900.

Science.gov (United States)

Bhattacharya, Sanjoy; Brimnes, Niels

2009-01-01

The last two decades have seen a reawakening of scholarly interest in the history of smallpox prevention. Accounts of vaccination and others efforts at controlling smallpox have moved away from heroic narratives toward more nuanced and contextualized understandings. It is now accepted that several viruses traveled under the vaccine label from the outset, and it has been demonstrated that a variety of techniques were used to perform vaccination operations. The character of nineteenth century sea voyages that took the vaccine to distant territories has also been re-examined; sometimes the spread of the vaccine was caused by private networks and ad hoc decisions, while at other times it was the result of enterprises with close resemblances to contemporary centralized vaccination campaigns. Looking beyond Europe and North America we encounter a variety of state attitudes toward vaccination, ranging from concentrated efforts to spread the technique to efforts more uncertain and diluted. Although the reluctance to accept vaccination has been amply documented, recent studies emphasize this should not be attributed to simplistic dichotomies of modernity versus tradition or science versus culture; instead, instances of resistance are best studied as specific contextualized interactions. Indeed, factors like favorable geography, strong bureaucratic structures, and the absence of variolation seem to have helped the relatively smooth transfer of vaccination technologies. Perhaps most important, recent research encourages us to continue to study smallpox vaccination as a phenomenon that was simultaneously global and local.

[About smallpox and vaccination practices in Minas Gerais (Brazil) in the 19th century].

Science.gov (United States)

Silveira, Anny Jackeline Torres; Marques, Rita de Cássia

2011-02-01

This article discusses the impact of smallpox and vaccination practices used against the disease used in the province of Minas Gerais, in Brazil, during the Imperial Period (1822-1889). Despite the existence of services responsible for the organization and dissemination of the vaccine in the country since the early 19th century, some administrative and cultural factors, as identified in documents produced by the province's public health authorities at the time, had a negative impact upon the full implementation of both practice and organization of services aimed at the dissemination of smallpox vaccination. Based upon historiographic sources, it is argued that despite the trend towards centralization observed at different governmental spheres during the structuring of the Imperial State, in particular, in the provision of vaccination services, there was a prevailing disharmony between the different agencies responsible for the implementation and management of such services. A further contributor to the difficulties in the service implementation was the resistance of the population to submit to the vaccination, a phenomenon that can be best understood through examination of the social construction of perceptions about diseases and the vaccination method used against the smallpox.

Risk of lymphoma and leukaemia after bacille Calmette-Guérin and smallpox vaccination: a Danish case-cohort study

DEFF Research Database (Denmark)

Villumsen, Marie; Sørup, Signe; Jess, Tine

2009-01-01

Vaccines may have non-specific effects as suggested mainly in mortality studies from low-income countries. The objective was to examine the effects of BCG and smallpox vaccinations on subsequent risk of lymphoma and leukaemia in a Danish population experiencing rapid out-phasing of these vaccines...... cohort and analysed in a case-cohort design. BCG vaccination reduced the risk of lymphomas (HR=0.49 (95% CI: 0.26-0.93)), whereas smallpox vaccination did not (HR=1.32 (0.56-3.08)). With the small number of leukaemia cases, the analysis of leukaemia had limited power (BCG vaccination HR=0.81 (0.......31-2.16); smallpox vaccination HR=1.32 (0.49-3.53)). The present study with very reliable vaccine history information indicates a beneficial effect of BCG vaccination on the risk of lymphomas....

Analysis of variola and vaccinia virus neutralization assays for smallpox vaccines.

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Hughes, Christine M; Newman, Frances K; Davidson, Whitni B; Olson, Victoria A; Smith, Scott K; Holman, Robert C; Yan, Lihan; Frey, Sharon E; Belshe, Robert B; Karem, Kevin L; Damon, Inger K

2012-07-01

Possible smallpox reemergence drives research for third-generation vaccines that effectively neutralize variola virus. A comparison of neutralization assays using different substrates, variola and vaccinia (Dryvax and modified vaccinia Ankara [MVA]), showed significantly different 90% neutralization titers; Dryvax underestimated while MVA overestimated variola neutralization. Third-generation vaccines may rely upon neutralization as a correlate of protection.

The Spanish royal philanthropic expedition to bring smallpox vaccination to the New World and Asia in the 19th century.

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Franco-Paredes, Carlos; Lammoglia, Lorena; Santos-Preciado, José Ignacio

2005-11-01

The New World was ravaged by smallpox for several centuries after the Spanish conquest. Jenner's discovery of the smallpox vaccine made possible the prevention and control of smallpox epidemics. In response to a large outbreak of smallpox in the Spanish colonies, King Charles IV appointed Francisco Xavier de Balmis to lead an expedition that would introduce Jenner's vaccine to these colonies. During the journey, the vaccine was kept viable by passing it from arm to arm in orphaned children, who were brought along expressly for that purpose and remained under the care of the orphanage's director. This expedition was the first large scale mass vaccination of its kind. The historic legacy of this pioneering event in international health should be revisited in the current era of persistent inequalities in global health.

[The real philanthropic expedition of the smallpox vaccine: monarchy and modernity in 1803].

Science.gov (United States)

Rigau-Pérez, José G

2004-09-01

Smallpox resulted in the death of 30 % of those who acquired it, so the preventive method discovered by Edward Jenner (London, 1798) spread very quickly. At the request in 1803 of Carlos IV, king of Spain, his government evaluated offers to carry smallpox vaccine to the colonies. The selected proposal, by doctor Francisco Xavier de Balmis, sought to take the lymph to America and Asia in a chain of arm to arm vaccination of foundlings. The Expedition set sail from Corunna on November 30, 1803, stopped in the Canary Isles, Puerto Rico, and Venezuela and after Caracas (1804) split in two groups. Balmis led some members of the Expedition to Cuba and Mexico. For the trip to the Philippines, in 1805, parents lent their children in exchange for economic compensation and the promise that the boys would be returned home. The Expedition returned to Mexico in August, 1807, but Balmis separately took vaccine to China and returned to Spain. Another contingent of the Expedition, under vice-director José Salvany, took vaccine to what we know as Colombia, Ecuador, Peru and Bolivia. His assistant Manuel Grajales reached the Chilean Patagonia in 1811. This article also comments on three principal themes - the institutional management of the scientific project, the conflicts that characterized its course, and the children's experience. The Vaccine Expedition was a brave and humanitarian endeavor, but also an extraordinary sanitary and administrative success. It was not until the twentieth century that a global eradication campaign eliminated smallpox in the world.

Immune responses to the smallpox vaccine given in combination with ST-246, a small-molecule inhibitor of poxvirus dissemination

OpenAIRE

Grosenbach, Douglas W.; Jordan, Robert; King, David S.; Berhanu, Aklile; Warren, Travis K.; Kirkwood-Watts, Dana L.; Tyavanagimatt, Shanthakumar; Tan, Ying; Wilson, Rebecca L.; Jones, Kevin F.; Hruby, Dennis E.

2007-01-01

The re-emerging threat of smallpox and the emerging threat of monkeypox highlight the need for effective poxvirus countermeasures. Currently approved smallpox vaccines have unacceptable safety profiles and, consequently, the general populace is no longer vaccinated, leading to an increasingly susceptible population. ST-246, a small-molecule inhibitor of poxvirus dissemination, has been demonstrated in various animal models to be safe and effective in preventing poxviral disease. This suggests...

The Effect of Smallpox and Bacillus Calmette-Guérin Vaccination on the Risk of Human Immunodeficiency Virus-1 Infection in Guinea-Bissau and Denmark

DEFF Research Database (Denmark)

Rieckmann, Andreas; Villumsen, Marie; Jensen, Mette Lundsby

2017-01-01

: The studies from Guinea-Bissau and Denmark, 2 very different settings, both suggest that the BCG and smallpox vaccines could be associated with a decreased risk of sexually transmitted HIV-1. It might be informative to pursue this observation and explore possible protective mechanisms as part of the search......BACKGROUND: The live smallpox and Bacillus Calmette-Guérin (BCG) vaccinations have been associated with better adult survival in both Guinea-Bissau and Denmark. In Guinea-Bissau, human immunodeficiency virus (HIV)-1 became an important cause of death after smallpox vaccination was phased out...... globally in 1980. We hypothesised that smallpox and BCG vaccinations were associated with a lower prevalence of HIV-1 infection, and we tested this hypothesis in both Guinea-Bissau and Denmark. METHODS: We conducted 2 studies: (1) a cross-sectional study of HIV infection and vaccination scars in Guinea...

Antiviral immunity following smallpox virus infection: a case-control study.

Science.gov (United States)

Hammarlund, Erika; Lewis, Matthew W; Hanifin, Jon M; Mori, Motomi; Koudelka, Caroline W; Slifka, Mark K

2010-12-01

Outbreaks of smallpox (i.e., caused by variola virus) resulted in up to 30% mortality, but those who survived smallpox infection were regarded as immune for life. Early studies described the levels of neutralizing antibodies induced after infection, but smallpox was eradicated before contemporary methods for quantifying T-cell memory were developed. To better understand the levels and duration of immunity after smallpox infection, we performed a case-control study comparing antiviral CD4(+) and CD8(+) T-cell responses and neutralizing antibody levels of 24 smallpox survivors with the antiviral immunity observed in 60 smallpox-vaccinated (i.e., vaccinia virus-immune) control subjects. We found that the duration of immunity following smallpox infection was remarkably similar to that observed after smallpox vaccination, with antiviral T-cell responses that declined slowly over time and antiviral antibody responses that remained stable for decades after recovery from infection. These results indicate that severe, potentially life-threatening disease is not required for the development of sustainable long-term immunity. This study shows that the levels of immunity induced following smallpox vaccination are comparable in magnitude to that achieved through natural variola virus infection, and this may explain the notable success of vaccination in eradicating smallpox, one of the world's most lethal diseases.

Antiviral Immunity following Smallpox Virus Infection: a Case-Control Study▿

Science.gov (United States)

Hammarlund, Erika; Lewis, Matthew W.; Hanifin, Jon M.; Mori, Motomi; Koudelka, Caroline W.; Slifka, Mark K.

2010-01-01

Outbreaks of smallpox (i.e., caused by variola virus) resulted in up to 30% mortality, but those who survived smallpox infection were regarded as immune for life. Early studies described the levels of neutralizing antibodies induced after infection, but smallpox was eradicated before contemporary methods for quantifying T-cell memory were developed. To better understand the levels and duration of immunity after smallpox infection, we performed a case-control study comparing antiviral CD4+ and CD8+ T-cell responses and neutralizing antibody levels of 24 smallpox survivors with the antiviral immunity observed in 60 smallpox-vaccinated (i.e., vaccinia virus-immune) control subjects. We found that the duration of immunity following smallpox infection was remarkably similar to that observed after smallpox vaccination, with antiviral T-cell responses that declined slowly over time and antiviral antibody responses that remained stable for decades after recovery from infection. These results indicate that severe, potentially life-threatening disease is not required for the development of sustainable long-term immunity. This study shows that the levels of immunity induced following smallpox vaccination are comparable in magnitude to that achieved through natural variola virus infection, and this may explain the notable success of vaccination in eradicating smallpox, one of the world's most lethal diseases. PMID:20926574

Bichat guidelines for the clinical management of smallpox and bioterrorism-related smallpox.

Science.gov (United States)

Bossi, Philippe; Tegnell, Anders; Baka, Agoritsa; Van Loock, Frank; Hendriks, J; Werner, Albrecht; Maidhof, Heinrich; Gouvras, Georgios

2004-12-15

Smallpox is a viral infection caused by the variola virus. It was declared eradicated worldwide by the Word Health Organization in 1980 following a smallpox eradication campaign. Smallpox is seen as one of the viruses most likely to be used as a biological weapon. The variola virus exists legitimately in only two laboratories in the world. Any new case of smallpox would have to be the result of human accidental or deliberate release. The aerosol infectivity, high mortality, and stability of the variola virus make it a potential and dangerous threat in biological warfare. Early detection and diagnosis are important to limit the spread of the disease. Patients with smallpox must be isolated and managed, if possible, in a negative-pressure room until death or until all scabs have been shed. There is no established antiviral treatment for smallpox. The most effective prevention is vaccination before exposure.

Host range, growth property, and virulence of the smallpox vaccine: Vaccinia virus Tian Tan strain

International Nuclear Information System (INIS)

Fang Qing; Yang Lin; Zhu Weijun; Liu Li; Wang Haibo; Yu Wenbo; Xiao Genfu; Tien Po; Zhang Linqi; Chen Zhiwei

2005-01-01

Vaccinia Tian Tan (VTT) was used as a vaccine against smallpox in China for millions of people before 1980, yet the biological characteristics of the virus remain unclear. We have characterized VTT with respect to its host cell range, growth properties in vitro, and virulence in vivo. We found that 11 of the 12 mammalian cell lines studied are permissive to VTT infection whereas one, CHO-K1, is non-permissive. Using electron microscopy and sequence analysis, we found that the restriction of VTT replication in CHO-K1 is at a step before viral maturation probably due to the loss of the V025 gene. Moreover, VTT is significantly less virulent than vaccinia WR but remains neurovirulent in mice and causes significant body weight loss after intranasal inoculation. Our data demonstrate the need for further attenuation of VTT to serve either as a safer smallpox vaccine or as a live vaccine vector for other pathogens

[Smallpox virus as biological weapon].

Science.gov (United States)

Kondrusik, Maciej; Hermanowska-Szpakowicz, Teresa

2003-02-01

Smallpox, because of its high case-fatality rate, easy transmission from human to human, lack of specific treatment represents nowadays one of the main threats in bioterrorist attacks. Over the centuries, naturally occurring smallpox with its case-fatality over 30 percent and its ability to spread in any climate and season has been treated as the most dangerous infectious disease. But it is now, 25 years after the last documented case of smallpox and cessation of routine vaccination in present mobile and susceptible population, smallpox virus spread might be rapid and devastating.

A brief history of vaccines: smallpox to the present.

Science.gov (United States)

Hsu, Jennifer L

2013-01-01

Modern vaccine history began in the late 18th century with the discovery of smallpox immunization by Edward Jenner. This pivotal step led to substantial progress in prevention of infectious diseases with inactivated vaccines for multiple infectious diseases, including typhoid, plague and cholera. Each advance produced significant decreases in infection-associated morbidity and mortality, thus shaping our modem cultures. As knowledge of microbiology and immunology grew through the 20th century, techniques were developed for cell culture of viruses. This allowed for rapid advances in prevention of polio, varicella, influenza and others. Finally, recent research has led to development of alternative vaccine strategies through use of vectored antigens, pathogen subunits (purified proteins or polysaccharides) or genetically engineered antigens. As the science of vaccinology continues to rapidly evolve, knowledge of the past creates added emphasis on the importance of developing safe and effective strategies for infectious disease prevention in the 21st century.

Risk of Inflammatory Bowel Disease following Bacille Calmette-Guérin and Smallpox Vaccination

DEFF Research Database (Denmark)

Villumsen, Anne Marie; Jess, Tine; Sørup, Signe

2013-01-01

Childhood immunology has been suggested to play a role in development of inflammatory bowel disease (IBD) based on the studies of childhood vaccinations, infections, and treatment with antibiotics. Bacille Calmette-Guérin (BCG) and smallpox vaccinations were gradually phased-out in Denmark...... for children born between 1965 and 1976, hence allowing the study of subsequent risk of Crohn's disease and ulcerative colitis in a unique prospective design....

Immunomodulator-based enhancement of anti smallpox immune responses.

Directory of Open Access Journals (Sweden)

Osmarie Martínez

Full Text Available The current live vaccinia virus vaccine used in the prevention of smallpox is contraindicated for millions of immune-compromised individuals. Although vaccination with the current smallpox vaccine produces protective immunity, it might result in mild to serious health complications for some vaccinees. Thus, there is a critical need for the production of a safe virus-free vaccine against smallpox that is available to everyone. For that reason, we investigated the impact of imiquimod and resiquimod (Toll-like receptors agonists, and the codon-usage optimization of the vaccinia virus A27L gene in the enhancement of the immune response, with intent of producing a safe, virus-free DNA vaccine coding for the A27 vaccinia virus protein.We analyzed the cellular-immune response by measuring the IFN-γ production of splenocytes by ELISPOT, the humoral-immune responses measuring total IgG and IgG2a/IgG1 ratios by ELISA, and the TH1 and TH2 cytokine profiles by ELISA, in mice immunized with our vaccine formulation.The proposed vaccine formulation enhanced the A27L vaccine-mediated production of IFN-γ on mouse spleens, and increased the humoral immunity with a TH1-biased response. Also, our vaccine induced a TH1 cytokine milieu, which is important against viral infections.These results support the efforts to find a new mechanism to enhance an immune response against smallpox, through the implementation of a safe, virus-free DNA vaccination platform.

Immunomodulator-based enhancement of anti smallpox immune responses.

Science.gov (United States)

Martínez, Osmarie; Miranda, Eric; Ramírez, Maite; Santos, Saritza; Rivera, Carlos; Vázquez, Luis; Sánchez, Tomás; Tremblay, Raymond L; Ríos-Olivares, Eddy; Otero, Miguel

2015-01-01

The current live vaccinia virus vaccine used in the prevention of smallpox is contraindicated for millions of immune-compromised individuals. Although vaccination with the current smallpox vaccine produces protective immunity, it might result in mild to serious health complications for some vaccinees. Thus, there is a critical need for the production of a safe virus-free vaccine against smallpox that is available to everyone. For that reason, we investigated the impact of imiquimod and resiquimod (Toll-like receptors agonists), and the codon-usage optimization of the vaccinia virus A27L gene in the enhancement of the immune response, with intent of producing a safe, virus-free DNA vaccine coding for the A27 vaccinia virus protein. We analyzed the cellular-immune response by measuring the IFN-γ production of splenocytes by ELISPOT, the humoral-immune responses measuring total IgG and IgG2a/IgG1 ratios by ELISA, and the TH1 and TH2 cytokine profiles by ELISA, in mice immunized with our vaccine formulation. The proposed vaccine formulation enhanced the A27L vaccine-mediated production of IFN-γ on mouse spleens, and increased the humoral immunity with a TH1-biased response. Also, our vaccine induced a TH1 cytokine milieu, which is important against viral infections. These results support the efforts to find a new mechanism to enhance an immune response against smallpox, through the implementation of a safe, virus-free DNA vaccination platform.

The rediscovery of smallpox.

Science.gov (United States)

Thèves, C; Biagini, P; Crubézy, E

2014-03-01

Smallpox is an infectious disease that is unique to humans, caused by a poxvirus. It is one of the most lethal of diseases; the virus variant Variola major has a mortality rate of 30%. People surviving this disease have life-long consequences, but also assured immunity. Historically, smallpox was recognized early in human populations. This led to prevention attempts--variolation, quarantine, and the isolation of infected subjects--until Jenner's discovery of the first steps of vaccination in the 18th century. After vaccination campaigns throughout the 19th and 20th centuries, the WHO declared the eradication of smallpox in 1980. With the development of microscopy techniques, the structural characterization of the virus began in the early 20th century. In 1990, the genomes of different smallpox viruses were determined; viruses could be classified in order to investigate their origin, diffusion, and evolution. To study the evolution and possible re-emergence of this viral pathogen, however, researchers can only use viral genomes collected during the 20th century. Cases of smallpox in ancient periods are sometimes well documented, so palaeomicrobiology and, more precisely, the study of ancient smallpox viral strains could be an exceptional opportunity. The analysis of poxvirus fragmented genomes could give new insights into the genetic evolution of the poxvirus. Recently, small fragments of the poxvirus genome were detected. With the genetic information obtained, a new phylogeny of smallpox virus was described. The interest in conducting studies on ancient strains is discussed, in order to explore the natural history of this disease. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

Immunomodulator-Based Enhancement of Anti Smallpox Immune Responses

Science.gov (United States)

Martínez, Osmarie; Miranda, Eric; Ramírez, Maite; Santos, Saritza; Rivera, Carlos; Vázquez, Luis; Sánchez, Tomás; Tremblay, Raymond L.; Ríos-Olivares, Eddy; Otero, Miguel

2015-01-01

Background The current live vaccinia virus vaccine used in the prevention of smallpox is contraindicated for millions of immune-compromised individuals. Although vaccination with the current smallpox vaccine produces protective immunity, it might result in mild to serious health complications for some vaccinees. Thus, there is a critical need for the production of a safe virus-free vaccine against smallpox that is available to everyone. For that reason, we investigated the impact of imiquimod and resiquimod (Toll-like receptors agonists), and the codon-usage optimization of the vaccinia virus A27L gene in the enhancement of the immune response, with intent of producing a safe, virus-free DNA vaccine coding for the A27 vaccinia virus protein. Methods We analyzed the cellular-immune response by measuring the IFN-γ production of splenocytes by ELISPOT, the humoral-immune responses measuring total IgG and IgG2a/IgG1 ratios by ELISA, and the TH1 and TH2 cytokine profiles by ELISA, in mice immunized with our vaccine formulation. Results The proposed vaccine formulation enhanced the A27L vaccine-mediated production of IFN-γ on mouse spleens, and increased the humoral immunity with a TH1-biased response. Also, our vaccine induced a TH1 cytokine milieu, which is important against viral infections. Conclusion These results support the efforts to find a new mechanism to enhance an immune response against smallpox, through the implementation of a safe, virus-free DNA vaccination platform. PMID:25875833

The effects of post-exposure smallpox vaccination on clinical disease presentation: addressing the data gaps between historical epidemiology and modern surrogate model data.

Science.gov (United States)

Keckler, M Shannon; Reynolds, Mary G; Damon, Inger K; Karem, Kevin L

2013-10-25

Decades after public health interventions - including pre- and post-exposure vaccination - were used to eradicate smallpox, zoonotic orthopoxvirus outbreaks and the potential threat of a release of variola virus remain public health concerns. Routine prophylactic smallpox vaccination of the public ceased worldwide in 1980, and the adverse event rate associated with the currently licensed live vaccinia virus vaccine makes reinstatement of policies recommending routine pre-exposure vaccination unlikely in the absence of an orthopoxvirus outbreak. Consequently, licensing of safer vaccines and therapeutics that can be used post-orthopoxvirus exposure is necessary to protect the global population from these threats. Variola virus is a solely human pathogen that does not naturally infect any other known animal species. Therefore, the use of surrogate viruses in animal models of orthopoxvirus infection is important for the development of novel vaccines and therapeutics. Major complications involved with the use of surrogate models include both the absence of a model that accurately mimics all aspects of human smallpox disease and a lack of reproducibility across model species. These complications limit our ability to model post-exposure vaccination with newer vaccines for application to human orthopoxvirus outbreaks. This review seeks to (1) summarize conclusions about the efficacy of post-exposure smallpox vaccination from historic epidemiological reports and modern animal studies; (2) identify data gaps in these studies; and (3) summarize the clinical features of orthopoxvirus-associated infections in various animal models to identify those models that are most useful for post-exposure vaccination studies. The ultimate purpose of this review is to provide observations and comments regarding available model systems and data gaps for use in improving post-exposure medical countermeasures against orthopoxviruses. Copyright © 2013 Elsevier Ltd. All rights reserved.

High-dimensional gene expression profiling studies in high and low responders to primary smallpox vaccination.

Science.gov (United States)

Haralambieva, Iana H; Oberg, Ann L; Dhiman, Neelam; Ovsyannikova, Inna G; Kennedy, Richard B; Grill, Diane E; Jacobson, Robert M; Poland, Gregory A

2012-11-15

The mechanisms underlying smallpox vaccine-induced variations in immune responses are not well understood, but are of considerable interest to a deeper understanding of poxvirus immunity and correlates of protection. We assessed transcriptional messenger RNA expression changes in 197 recipients of primary smallpox vaccination representing the extremes of humoral and cellular immune responses. The 20 most significant differentially expressed genes include a tumor necrosis factor-receptor superfamily member, an interferon (IFN) gene, a chemokine gene, zinc finger protein genes, nuclear factors, and histones (P ≤ 1.06E(-20), q ≤ 2.64E(-17)). A pathway analysis identified 4 enriched pathways with cytokine production by the T-helper 17 subset of CD4+ T cells being the most significant pathway (P = 3.42E(-05)). Two pathways (antiviral actions of IFNs, P = 8.95E(-05); and IFN-α/β signaling pathway, P = 2.92E(-04)), integral to innate immunity, were enriched when comparing high with low antibody responders (false discovery rate, < 0.05). Genes related to immune function and transcription (TLR8, P = .0002; DAPP1, P = .0003; LAMP3, P = 9.96E(-05); NR4A2, P ≤ .0002; EGR3, P = 4.52E(-05)), and other genes with a possible impact on immunity (LNPEP, P = 3.72E(-05); CAPRIN1, P = .0001; XRN1, P = .0001), were found to be expressed differentially in high versus low antibody responders. We identified novel and known immunity-related genes and pathways that may account for differences in immune response to smallpox vaccination.

US Military Service Members Vaccinated Against Smallpox in 2003 and 2004 Experience a Slightly Higher Risk of Hospitalization Postvaccination

Science.gov (United States)

2008-01-01

vaccination on the health of young adults . Published by Elsevier Ltd. 1. Introduction Through extensive vaccination efforts [1], smallpoxwas globally...Disorders of lipoid metabolism 74 0.1 17 0.0 2.43 1.42, 4.18 250 Diabetes mellitus 23 0.0 2 0.0 244 Acquired hypothyroidism 19 0.0 2 0.0 278 Obesity and...and influenza elicited during primary versus recent or distant secondary smallpox vaccination of adults . Vaccine 2006;24:6913–23. REPORT DOCUMENTATION

The eradication of smallpox: organizational learning and innovation in international health administration.

Science.gov (United States)

Hopkins, J W

1988-04-01

The WHO smallpox eradication campaign represents perhaps the best example of a successful international health administration. In the 1st year of the campaign (1967), the guiding strategy was to vaccinate people en masse over a 2-3 year period in countries where smallpox was epidemic thereby conquering the disease. In Western Nigeria where 90% of the population had been vaccinated, a smallpox outbreak occurred in a religious sect resisting vaccinations and a delay in delivery of supplies forced a change in strategy. Campaign staff learned to rapidly isolate infected persons and swiftly vaccinate the uninfected in an outbreak area in order to break the transmission of smallpox, even where 1/2 the population had been vaccinated. Technological advancements also contributed to the campaign's success. For example, the jet injector vaccinated 1000 people/hour with efficient, reliable, mass produced potent, stable freeze dried vaccines (often produced in target countries) or the less costly and virtually maintenance free bifurcated needle was used. The most significant contribution to the success of the campaign, however, was the flexible mode of management adopted by the campaign staff at WHO which provided an appropriate environment for organizational learning and innovation. Although management was open and flexible, the campaign did depend on careful planning and setting of goals, continual assessment, and rapid response to field requests for assistance or advice. Trends in the incidence of smallpox was chosen as the indicator of success as opposed to the number of vaccinations. The campaign demonstrated the need for cultural adaptations as it operated in each country and region. This evaluation of the success of the smallpox campaign presents conclusions that serve as guidelines to the organization and administration of international programs designed to solve other health problems.

The Smallpox Threat: The School Nurse's Role

Science.gov (United States)

Martin, Mary E.; Didion, Judy

2003-01-01

Today, with the threat of bioterrorism and war, there is a new dimension to the traditional role of the school nurse. The smallpox threat to public health will invoke the school nurse's role as an educator, liaison, and consultant in the community. This article discusses smallpox, the vaccination process, adverse effects, and postvaccination care.…

Game theory of pre-emptive vaccination before bioterrorism or accidental release of smallpox.

Science.gov (United States)

Molina, Chai; Earn, David J D

2015-06-06

Smallpox was eradicated in the 1970s, but new outbreaks could be seeded by bioterrorism or accidental release. Substantial vaccine-induced morbidity and mortality make pre-emptive mass vaccination controversial, and if vaccination is voluntary, then there is a conflict between self- and group interests. This conflict can be framed as a tragedy of the commons, in which herd immunity plays the role of the commons, and free-riding (i.e. not vaccinating pre-emptively) is analogous to exploiting the commons. This game has been analysed previously for a particular post-outbreak vaccination scenario. We consider several post-outbreak vaccination scenarios and compare the expected increase in mortality that results from voluntary versus imposed vaccination. Below a threshold level of post-outbreak vaccination effort, expected mortality is independent of the level of response effort. A lag between an outbreak starting and a response being initiated increases the post-outbreak vaccination effort necessary to reduce mortality. For some post-outbreak vaccination scenarios, even modest response lags make it impractical to reduce mortality by increasing post-outbreak vaccination effort. In such situations, if decreasing the response lag is impossible, the only practical way to reduce mortality is to make the vaccine safer (greater post-outbreak vaccination effort leads only to fewer people vaccinating pre-emptively). © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Are We Prepared in Case of a Possible Smallpox-Like Disease Emergence?

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Olson, Victoria A.; Shchelkunov, Sergei N.

2017-01-01

Smallpox was the first human disease to be eradicated, through a concerted vaccination campaign led by the World Health Organization. Since its eradication, routine vaccination against smallpox has ceased, leaving the world population susceptible to disease caused by orthopoxviruses. In recent decades, reports of human disease from zoonotic orthopoxviruses have increased. Furthermore, multiple reports of newly identified poxviruses capable of causing human disease have occurred. These facts raise concerns regarding both the opportunity for these zoonotic orthopoxviruses to evolve and become a more severe public health issue, as well as the risk of Variola virus (the causative agent of smallpox) to be utilized as a bioterrorist weapon. The eradication of smallpox occurred prior to the development of the majority of modern virological and molecular biological techniques. Therefore, there is a considerable amount that is not understood regarding how this solely human pathogen interacts with its host. This paper briefly recounts the history and current status of diagnostic tools, vaccines, and anti-viral therapeutics for treatment of smallpox disease. The authors discuss the importance of further research to prepare the global community should a smallpox-like virus emerge.

RESPONSE OF VOLTA CHILDREN TO JET INOCULATION OF COMBINED LIVE MEASLES, SMALLPOX AND YELLOW FEVER VACCINES.

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MEYER, H M; HOSTETLER, D D; BERNHEIN, B C; ROGERS, N G; LAMBIN, P; CHASSARY, A; LABUSQUIERE, R; SMADEL, J E

1964-01-01

An earlier study established that Upper Volta children respond to vaccination with the Enders live attenuated measles strain in the same general fashion as do children in the USA. The present report describes a second pilot project carried out in Ouagadougou, Upper Volta. During this investigation various mixtures of live measles, smallpox and 17D yellow fever vaccines were introduced into susceptible infants by jet injection. Combining the attenuated virus vaccines did not alter or accentuate the characteristic clinical reactions elicited by the individual components, nor was there evidence of significant immunological interference. From this experience it is concluded that combined vaccination with these agents may be safely and effectively employed in larger programmes as the need dictates.

Tecovirimat, a p37 envelope protein inhibitor for the treatment of smallpox infection.

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Duraffour, Sophie; Andrei, Graciela; Snoeck, Robert

2010-03-01

Since the eradication of naturally occurring smallpox in 1980, the fear that variola virus could be used as a biological weapon has become real. Over the last 10 years, emergency preparedness programs have been launched to protect populations against a smallpox outbreak or the possible emergence in humans of other orthopoxvirus infections, such as monkeypox. Vaccination against smallpox was responsible for its eradication, but was linked with high rates of adverse events and contraindications. In this context, intensive research in the poxvirus field has led to the development of safer vaccines and to an increase in the number of anti-poxvirus agents in the pipeline. SIGA Technologies Inc, under license from ViroPharma Inc, is developing tecovirimat (ST-246). Tecovirimat is a novel antiviral that inhibits the egress of orthopoxviruses by targeting viral p37 protein orthologs. The development of tecovirimat during the last 5 years for the treatment of smallpox and for its potential use as adjunct to smallpox vaccine is reviewed here.

Challenges and Achievements in Prevention and Treatment of Smallpox

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Sharon Melamed

2018-01-01

Full Text Available Declaration of smallpox eradication by the WHO in 1980 led to discontinuation of the worldwide vaccination campaign. The increasing percentage of unvaccinated individuals, the existence of its causative infectious agent variola virus (VARV, and the recent synthetic achievements increase the threat of intentional or accidental release and reemergence of smallpox. Control of smallpox would require an emergency vaccination campaign, as no other protective measure has been approved to achieve eradication and ensure worldwide protection. Experimental data in surrogate animal models support the assumption, based on anecdotal, uncontrolled historical data, that vaccination up to 4 days postexposure confers effective protection. The long incubation period, and the uncertainty of the exposure status in the surrounding population, call for the development and evaluation of safe and effective methods enabling extension of the therapeutic window, and to reduce the disease manifestations and vaccine adverse reactions. To achieve these goals, we need to evaluate the efficacy of novel and already licensed vaccines as a sole treatment, or in conjunction with immune modulators and antiviral drugs. In this review, we address the available data, recent achievements, and open questions.

Smallpox-Related Knowledge and Beliefs among Recent College Graduates

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Bungum, Timothy; Day, Charlene

2006-01-01

Recent world events have increased concern and preparations for possible bioterror events. Despite worldwide efforts to limit access to bio-weapons, smallpox is still considered a potential bioterror threat. Americans' understanding of smallpox could prevent panic and enhance the willingness of citizens to receive vaccinations. Objective: The…

Safety and Immunogenicity of Modified Vaccinia Ankara-Bavarian Nordic Smallpox Vaccine in Vaccinia-Naive and Experienced Human Immunodeficiency Virus-Infected Individuals: An Open-Label, Controlled Clinical Phase II Trial

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Overton, Edgar Turner; Stapleton, Jack; Frank, Ian; Hassler, Shawn; Goepfert, Paul A.; Barker, David; Wagner, Eva; von Krempelhuber, Alfred; Virgin, Garth; Meyer, Thomas Peter; Müller, Jutta; Bädeker, Nicole; Grünert, Robert; Young, Philip; Rösch, Siegfried; Maclennan, Jane; Arndtz-Wiedemann, Nathaly; Chaplin, Paul

2015-01-01

Background. First- and second-generation smallpox vaccines are contraindicated in individuals infected with human immunodeficiency virus (HIV). A new smallpox vaccine is needed to protect this population in the context of biodefense preparedness. The focus of this study was to compare the safety and immunogenicity of a replication-deficient, highly attenuated smallpox vaccine modified vaccinia Ankara (MVA) in HIV-infected and healthy subjects. Methods. An open-label, controlled Phase II trial was conducted at 36 centers in the United States and Puerto Rico for HIV-infected and healthy subjects. Subjects received 2 doses of MVA administered 4 weeks apart. Safety was evaluated by assessment of adverse events, focused physical exams, electrocardiogram recordings, and safety laboratories. Immune responses were assessed using enzyme-linked immunosorbent assay (ELISA) and a plaque reduction neutralization test (PRNT). Results. Five hundred seventy-nine subjects were vaccinated at least once and had data available for analysis. Rates of ELISA seropositivity were comparably high in vaccinia-naive healthy and HIV-infected subjects, whereas PRNT seropositivity rates were higher in healthy compared with HIV-infected subjects. Modified vaccinia Ankara was safe and well tolerated with no adverse impact on viral load or CD4 counts. There were no cases of myo-/pericarditis reported. Conclusions. Modified vaccinia Ankara was safe and immunogenic in subjects infected with HIV and represents a promising smallpox vaccine candidate for use in immunocompromised populations. PMID:26380340

[Lessons learnt from the German smallpox outbreaks after World War II].

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Sasse, Julia; Gelderblom, Hans R

2015-07-01

Even though smallpox was declared eradicated by WHO in 1980, it cannot be ruled out that the etiological variola virus could be used as a biological weapon. Undestroyed viruses from biowarfare programmes, virus strains left undetected in a freezer or dangerous recombinant poxvirus constructs could cause dangerous outbreaks in a relatively unprotected population. Despite an abundance of studies performed during the eradication of smallpox, epidemiological data for preparedness planning and outbreak control in modern, industrialized countries are scarce. Full-text hand search for the period from 1945 to 1975 in the main German public health journals. After World War II 12 smallpox outbreaks occurred in Germany. They were studied with the focus on the period of contagiousness, the protective effect of vaccination, booster-effect of revaccination and the place of infection. A total of 95 individuals contracted smallpox, including 10 fatalities. Despite having been previously vaccinated, 81 vaccinated persons came down with smallpox, yet 91% of them developed only mild symptoms. These patients presented a high risk for spreading the infection to contact persons due to misinterpretation of symptoms and the continuing social contacts. Basically, the risk of transmission in the first 2 to 3 days after onset of symptoms was low, thus facilitating antiepidemic measures. The importance of hospital preparedness is emphasized by the fact that most infections occurred in hospitals. The data analyzed provide valuable information for today's outbreak response planning and counter bioterrorism preparedness.

In vitro efficacy of ST246 against smallpox and monkeypox.

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Smith, Scott K; Olson, Victoria A; Karem, Kevin L; Jordan, Robert; Hruby, Dennis E; Damon, Inger K

2009-03-01

Since the eradication of smallpox and the cessation of routine childhood vaccination for smallpox, the proportion of the world's population susceptible to infection with orthopoxviruses, such as variola virus (the causative agent of smallpox) and monkeypox virus, has grown substantially. In the United States, the only vaccines for smallpox licensed by the Food and Drug Administration (FDA) have been live virus vaccines. Unfortunately, a substantial number of people cannot receive live virus vaccines due to contraindications. Furthermore, no antiviral drugs have been fully approved by the FDA for the prevention or treatment of orthopoxvirus infection. Here, we show the inhibitory effect of one new antiviral compound, ST-246, on the in vitro growth properties of six variola virus strains and seven monkeypox virus strains. We performed multiple assays to monitor the cytopathic effect and to evaluate the reduction of viral progeny production and release in the presence of the compound. ST-246 had 50% effective concentrations of

A brief history of vaccines & vaccination in India

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Chandrakant Lahariya

2014-01-01

Full Text Available The challenges faced in delivering lifesaving vaccines to the targeted beneficiaries need to be addressed from the existing knowledge and learning from the past. This review documents the history of vaccines and vaccination in India with an objective to derive lessons for policy direction to expand the benefits of vaccination in the country. A brief historical perspective on smallpox disease and preventive efforts since antiquity is followed by an overview of 19 th century efforts to replace variolation by vaccination, setting up of a few vaccine institutes, cholera vaccine trial and the discovery of plague vaccine. The early twentieth century witnessed the challenges in expansion of smallpox vaccination, typhoid vaccine trial in Indian army personnel, and setting up of vaccine institutes in almost each of the then Indian States. In the post-independence period, the BCG vaccine laboratory and other national institutes were established; a number of private vaccine manufacturers came up, besides the continuation of smallpox eradication effort till the country became smallpox free in 1977. The Expanded Programme of Immunization (EPI (1978 and then Universal Immunization Programme (UIP (1985 were launched in India. The intervening events since UIP till India being declared non-endemic for poliomyelitis in 2012 have been described. Though the preventive efforts from diseases were practiced in India, the reluctance, opposition and a slow acceptance of vaccination have been the characteristic of vaccination history in the country. The operational challenges keep the coverage inequitable in the country. The lessons from the past events have been analysed and interpreted to guide immunization efforts.

A brief history of vaccines & vaccination in India.

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Lahariya, Chandrakant

2014-04-01

The challenges faced in delivering lifesaving vaccines to the targeted beneficiaries need to be addressed from the existing knowledge and learning from the past. This review documents the history of vaccines and vaccination in India with an objective to derive lessons for policy direction to expand the benefits of vaccination in the country. A brief historical perspective on smallpox disease and preventive efforts since antiquity is followed by an overview of 19 th century efforts to replace variolation by vaccination, setting up of a few vaccine institutes, cholera vaccine trial and the discovery of plague vaccine. The early twentieth century witnessed the challenges in expansion of smallpox vaccination, typhoid vaccine trial in Indian army personnel, and setting up of vaccine institutes in almost each of the then Indian States. In the post-independence period, the BCG vaccine laboratory and other national institutes were established; a number of private vaccine manufacturers came up, besides the continuation of smallpox eradication effort till the country became smallpox free in 1977. The Expanded Programme of Immunization (EPI) (1978) and then Universal Immunization Programme (UIP) (1985) were launched in India. The intervening events since UIP till India being declared non-endemic for poliomyelitis in 2012 have been described. Though the preventive efforts from diseases were practiced in India, the reluctance, opposition and a slow acceptance of vaccination have been the characteristic of vaccination history in the country. The operational challenges keep the coverage inequitable in the country. The lessons from the past events have been analysed and interpreted to guide immunization efforts.

SIMULTANEOUS BCG AND SMALLPOX VACCINATION ON NEWBORN INFANTS

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Abdul Rivai

2012-09-01

Full Text Available Telah dikemukakan anggapan-anggapan yang terdapat dewasa ini tentang vaksinasi BCG dan cacar secara simultan. Telah dilakukan vaksinasi BCG dan cacar secara simultan pada 729 neonati dengan freeze dried Smallpox vaccine buatan dari Bio Farma dan freeze dried BCG vaccine Tokyo. Pencacaran dilakukan secara multiple puncture dan bifurcated needle dengan suntikan BCG dengan jarum dan spuit khusus intracutan dengan dosis 0,1 ml. Tuberkulin test dilakukan dengan PPD dari Kopenhagen dengan kekuatan 2 TU 9 minggu setelah vaksinasi. Dari 741 bayi yang diikut sertakan dalam survey, 12 menolak, 3 bayi tidak dapat dilakukan pemeriksaan pertama, 35 bayi belum diperiksa, pemeriksaan pertama telah dilakukan pada 691 bayi. Dari 406 bayi yang seharusnya sudah diperiksa untuk pemeriksaan kedua, 23 dapat dilakukan karena tidak dapat dijumpai atau meninggal. Telah dikemukakan bahwa pencatatan alamat yang jelas dan lengkap serta kesungguhan dalam melakukan home visits sangat penting untuk berhasilnya penyelidikan semacam ini. Dari hasil-hasil yang didapatkan sampai sekarang telah dapat diambil kesimpulan sementara, bahwa vaksinasi BCG dan cacar secara simultan memberikan hasil yang memuaskan, juga bila dibandingkan dengan hasil-hasil penyelidikan diluar negeri take pada pencacaran 99.4 percent, test tuberkulin dengan PPD 2 TU 9 minggu setelah vaksinasi memberikan indurasi lebih dari 5 mm pada 99.75 percent dan tidak menimbulkan komplikasi-komplikasi. Pelaksanaan vaksinasi BCG dan cacar dapat dilakukan oleh tenaga paramedis yang telah mendapat latihan khusus dan diawasi oleh dokter yang kompeten. Dianjurkan untuk melakukan follow up pada bayi-bayi yang diikut sertakan dalam survey ini.

Navigation and history of science: The smallpox Royal Expedition (Balmis and Salvany

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Ignacio Jáuregui-Lobera

2018-02-01

Full Text Available By the end of 18th Century, smallpox killed about 400,000 citizens per year in Europe with a highest outbreak peak in 1796. This year, Edward Jenner discovered the smallpox vaccine and after being introduced in Spain, the King of Spain was asked to help American people against the disease. The transport of a fluid such delicate as the vaccine from a continent to another in extremely difficult sea voyages, which lasted several months, without electricity for keeping the cold chain, seemed impossible. Nevertheless Balmis and Salvany succeeded, by means of hundreds of orphans. Their bodies served as means of vaccine transport.

Adverse Events Post Smallpox-Vaccination: Insights from Tail Scarification Infection in Mice with Vaccinia virus

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Mota, Bruno E. F.; Gallardo-Romero, Nadia; Trindade, Giliane; Keckler, M. Shannon; Karem, Kevin; Carroll, Darin; Campos, Marco A.; Vieira, Leda Q.; da Fonseca, Flávio G.; Ferreira, Paulo C. P.; Bonjardim, Cláudio A.; Damon, Inger K.; Kroon, Erna G.

2011-01-01

Adverse events upon smallpox vaccination with fully-replicative strains of Vaccinia virus (VACV) comprise an array of clinical manifestations that occur primarily in immunocompromised patients leading to significant host morbidity/mortality. The expansion of immune-suppressed populations and the possible release of Variola virus as a bioterrorist act have given rise to concerns over vaccination complications should more widespread vaccination be reinitiated. Our goal was to evaluate the components of the host immune system that are sufficient to prevent morbidity/mortality in a murine model of tail scarification, which mimics immunological and clinical features of smallpox vaccination in humans. Infection of C57BL/6 wild-type mice led to a strictly localized infection, with complete viral clearance by day 28 p.i. On the other hand, infection of T and B-cell deficient mice (Rag1 −/−) produced a severe disease, with uncontrolled viral replication at the inoculation site and dissemination to internal organs. Infection of B-cell deficient animals (µMT) produced no mortality. However, viral clearance in µMT animals was delayed compared to WT animals, with detectable viral titers in tail and internal organs late in infection. Treatment of Rag1 −/− with rabbit hyperimmune anti-vaccinia serum had a subtle effect on the morbidity/mortality of this strain, but it was effective in reduce viral titers in ovaries. Finally, NUDE athymic mice showed a similar outcome of infection as Rag1 −/−, and passive transfer of WT T cells to Rag1 −/− animals proved fully effective in preventing morbidity/mortality. These results strongly suggest that both T and B cells are important in the immune response to primary VACV infection in mice, and that T-cells are required to control the infection at the inoculation site and providing help for B-cells to produce antibodies, which help to prevent viral dissemination. These insights might prove helpful to better identify

ACAM2000 clonal Vero cell culture vaccinia virus (New York City Board of Health strain)--a second-generation smallpox vaccine for biological defense.

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Monath, Thomas P; Caldwell, Joseph R; Mundt, Wolfgang; Fusco, Joan; Johnson, Casey S; Buller, Mark; Liu, Jian; Gardner, Bridget; Downing, Greg; Blum, Paul S; Kemp, Tracy; Nichols, Richard; Weltzin, Richard

2004-10-01

The threat of smallpox as a biological weapon has spurred efforts to create stockpiles of vaccine for emergency preparedness. In lieu of preparing vaccine in animal skin (the original method), we cloned vaccinia virus (New York City Board of Health strain, Dryvax by plaque purification and amplified the clone in cell culture. The overarching goal was to produce a modern vaccine that was equivalent to the currently licensed Dryvax in its preclinical and clinical properties, and could thus reliably protect humans against smallpox. A variety of clones were evaluated, and many were unacceptably virulent in animal models. One clonal virus (ACAM1000) was selected and produced at clinical grade in MRC-5 human diploid cells. ACAM1000 was comparable to Dryvax in immunogenicity and protective activity but was less neurovirulent for mice and nonhuman primates. To meet requirements for large quantities of vaccine after the events of September 11th 2001, the ACAM1000 master virus seed was used to prepare vaccine (designated ACAM2000) at large scale in Vero cells under serum-free conditions. The genomes of ACAM1000 and ACAM2000 had identical nucleotide sequences, and the vaccines had comparable biological phenotypes. ACAM1000 and ACAM2000 were evaluated in three Phase 1 clinical trials. The vaccines produced major cutaneous reactions and evoked neutralizing antibody and cell-mediated immune responses in the vast majority of subjects and had a reactogenicity profile similar to that of Dryvax.

SWOT analysis: strengths, weaknesses, opportunities and threats of the Israeli Smallpox Revaccination Program.

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Huerta, Michael; Balicer, Ran D; Leventhal, Alex

2003-01-01

During September 2002, Israel began its current revaccination program against smallpox, targeting previously vaccinated "first responders" among medical and emergency workers. In order to identify the potential strengths and weaknesses of this program and the conditions under which critical decisions were reached, we conducted a SWOT analysis of the current Israeli revaccination program, designed to identify its intrinsic strengths and weaknesses, as well as opportunities for its success and threats against it. SWOT analysis--a practical tool for the study of public health policy decisions and the social and political contexts in which they are reached--revealed clear and substantial strengths and weaknesses of the current smallpox revaccination program, intrinsic to the vaccine itself. A number of threats were identified that may jeopardize the success of the current program, chief among them the appearance of severe complications of vaccination. Our finding of a lack of a generation of knowledge on smallpox vaccination highlights the need for improved physician education and dissipation of misconceptions that are prevalent in the public today.

Genomic sequence and virulence of clonal isolates of vaccinia virus Tiantan, the Chinese smallpox vaccine strain.

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Qicheng Zhang

Full Text Available Despite the worldwide eradication of smallpox in 1979, the potential bioterrorism threat from variola virus and the ongoing use of vaccinia virus (VACV as a vector for vaccine development argue for continued research on VACV. In China, the VACV Tiantan strain (TT was used in the smallpox eradication campaign. Its progeny strain is currently being used to develop a human immunodeficiency virus (HIV vaccine. Here we sequenced the full genomes of five TT clones isolated by plaque purification from the TT (752-1 viral stock. Phylogenetic analysis with other commonly used VACV strains showed that TT (752-1 and its clones clustered and exhibited higher sequence diversity than that found in Dryvax clones. The ∼190 kbp genomes of TT appeared to encode 273 open reading frames (ORFs. ORFs located in the middle of the genome were more conserved than those located at the two termini, where many virulence and immunomodulation associated genes reside. Several patterns of nucleotide changes including point mutations, insertions and deletions were identified. The polymorphisms in seven virulence-associated proteins and six immunomodulation-related proteins were analyzed. We also investigated the neuro- and skin- virulence of TT clones in mice and rabbits, respectively. The TT clones exhibited significantly less virulence than the New York City Board of Health (NYCBH strain, as evidenced by less extensive weight loss and morbidity in mice as well as produced smaller skin lesions and lower incidence of putrescence in rabbits. The complete genome sequences, ORF annotations, and phenotypic diversity yielded from this study aid our understanding of the Chinese historic TT strain and are useful for HIV vaccine projects employing TT as a vector.

Genomic sequence and virulence of clonal isolates of vaccinia virus Tiantan, the Chinese smallpox vaccine strain.

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Zhang, Qicheng; Tian, Meijuan; Feng, Yi; Zhao, Kai; Xu, Jing; Liu, Ying; Shao, Yiming

2013-01-01

Despite the worldwide eradication of smallpox in 1979, the potential bioterrorism threat from variola virus and the ongoing use of vaccinia virus (VACV) as a vector for vaccine development argue for continued research on VACV. In China, the VACV Tiantan strain (TT) was used in the smallpox eradication campaign. Its progeny strain is currently being used to develop a human immunodeficiency virus (HIV) vaccine. Here we sequenced the full genomes of five TT clones isolated by plaque purification from the TT (752-1) viral stock. Phylogenetic analysis with other commonly used VACV strains showed that TT (752-1) and its clones clustered and exhibited higher sequence diversity than that found in Dryvax clones. The ∼190 kbp genomes of TT appeared to encode 273 open reading frames (ORFs). ORFs located in the middle of the genome were more conserved than those located at the two termini, where many virulence and immunomodulation associated genes reside. Several patterns of nucleotide changes including point mutations, insertions and deletions were identified. The polymorphisms in seven virulence-associated proteins and six immunomodulation-related proteins were analyzed. We also investigated the neuro- and skin- virulence of TT clones in mice and rabbits, respectively. The TT clones exhibited significantly less virulence than the New York City Board of Health (NYCBH) strain, as evidenced by less extensive weight loss and morbidity in mice as well as produced smaller skin lesions and lower incidence of putrescence in rabbits. The complete genome sequences, ORF annotations, and phenotypic diversity yielded from this study aid our understanding of the Chinese historic TT strain and are useful for HIV vaccine projects employing TT as a vector.

Experiences with smallpox eradication in Ethiopia.

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de Quadros, Ciro A

2011-12-30

The smallpox eradication campaign operated in Ethiopia from 1970 until 1977. During this time Ethiopia had only 84 hospitals, 64 health centres and fewer than 400 physicians in a country of 25 million people. In 1970 smallpox vaccination was relatively unknown in the country, and the government actually contested the fact that smallpox was present in the country. Most of the resources of the Ministry of Health were used for malaria eradication. Initial pessimism from the Ministry of Health and others was eventually overcome as the smallpox eradication campaign continued to pick up steam but many remained unenthusiastic. Ethiopia was the first country in the world to start its smallpox eradication campaign from day one with the strategy of "Surveillance and Containment". Establishing a surveillance system in a country with a limited health infrastructure was a daunting challenge. At the end of the first year of the programme in 1971, 26,000 cases of smallpox had been registered through the growing surveillance system. Throughout revolution of 1974 the smallpox campaign was the only UN program to operate in the country; in fact it expanded with the hire of many locals leading to a "nationalized" program. This development ushered in the most successful final phase of the program. As the program progressed cases were diminishing in most regions, however transmission continued in the Ogaden desert. Over the course of the campaign approximately 14.3 million US dollars was spent. Working conditions were extremely challenging and a variety of chiefs, guerrillas, landowners and governments had to be appeased. The programme was successful due to the dedicated national and international staff on the ground and by having the full support of the WHO HQ in Geneva. Copyright © 2011 Elsevier Ltd. All rights reserved.

Therapeutic Vaccines and Antibodies for Treatment of Orthopoxvirus Infections

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Stuart N. Isaacs

2010-10-01

Full Text Available Despite the eradication of smallpox several decades ago, variola and monkeypox viruses still have the potential to become significant threats to public health. The current licensed live vaccinia virus-based smallpox vaccine is extremely effective as a prophylactic vaccine to prevent orthopoxvirus infections, but because of safety issues, it is no longer given as a routine vaccine to the general population. In the event of serious human orthopoxvirus infections, it is important to have treatments available for individual patients as well as their close contacts. The smallpox vaccine and vaccinia immune globulin (VIG were used in the past as therapeutics for patients exposed to smallpox. VIG was also used in patients who were at high risk of developing complications from smallpox vaccination. Thus post-exposure vaccination and VIG treatments may again become important therapeutic modalities. This paper summarizes some of the historic use of the smallpox vaccine and immunoglobulins in the post-exposure setting in humans and reviews in detail the newer animal studies that address the use of therapeutic vaccines and immunoglobulins in orthopoxvirus infections as well as the development of new therapeutic monoclonal antibodies.

Frequency of adverse events after vaccination with different vaccinia strains.

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Mirjam Kretzschmar

2006-08-01

Full Text Available BACKGROUND: Large quantities of smallpox vaccine have been stockpiled to protect entire nations against a possible reintroduction of smallpox. Planning for an appropriate use of these stockpiled vaccines in response to a smallpox outbreak requires a rational assessment of the risks of vaccination-related adverse events, compared to the risk of contracting an infection. Although considerable effort has been made to understand the dynamics of smallpox transmission in modern societies, little attention has been paid to estimating the frequency of adverse events due to smallpox vaccination. Studies exploring the consequences of smallpox vaccination strategies have commonly used a frequency of approximately one death per million vaccinations, which is based on a study of vaccination with the New York City Board of Health (NYCBH strain of vaccinia virus. However, a multitude of historical studies of smallpox vaccination with other vaccinia strains suggest that there are strain-related differences in the frequency of adverse events after vaccination. Because many countries have stockpiled vaccine based on the Lister strain of vaccinia virus, a quantitative evaluation of the adverse effects of such vaccines is essential for emergency response planning. We conducted a systematic review and statistical analysis of historical data concerning vaccination against smallpox with different strains of vaccinia virus. METHODS AND FINDINGS: We analyzed historical vaccination data extracted from the literature. We extracted data on the frequency of postvaccinal encephalitis and death with respect to vaccinia strain and age of vaccinees. Using a hierarchical Bayesian approach for meta-analysis, we estimated the expected frequencies of postvaccinal encephalitis and death with respect to age at vaccination for smallpox vaccines based on the NYCBH and Lister vaccinia strains. We found large heterogeneity between findings from different studies and a time-period effect

Logistics in smallpox: the legacy.

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Wickett, John; Carrasco, Peter

2011-12-30

Logistics, defined as "the time-related positioning of resources" was critical to the implementation of the smallpox eradication strategy of surveillance and containment. Logistical challenges in the smallpox programme included vaccine delivery, supplies, staffing, vehicle maintenance, and financing. Ensuring mobility was essential as health workers had to travel to outbreaks to contain them. Three examples illustrate a range of logistic challenges which required imagination and innovation. Standard price lists were developed to expedite vehicle maintenance and repair in Bihar, India. Innovative staffing ensured an adequate infrastructure for vehicle maintenance in Bangladesh. The use of disaster relief mechanisms in Somalia provided airlifts, vehicles and funding within 27 days of their initiation. In contrast the Expanded Programme on Immunization (EPI) faces more complex logistical challenges. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Integration of Epistasis Network and Functional Interactions in a GWAS Implicates RXR Pathway Genes in the Immune Response to Smallpox Vaccine.

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Brett A McKinney

Full Text Available Although many diseases and traits show large heritability, few genetic variants have been found to strongly separate phenotype groups by genotype. Complex regulatory networks of variants and expression of multiple genes lead to small individual-variant effects and difficulty replicating the effect of any single variant in an affected pathway. Interaction network modeling of GWAS identifies effects ignored by univariate models, but population differences may still cause specific genes to not replicate. Integrative network models may help detect indirect effects of variants in the underlying biological pathway. In this study, we used gene-level functional interaction information from the Integrative Multi-species Prediction (IMP tool to reveal important genes associated with a complex phenotype through evidence from epistasis networks and pathway enrichment. We test this method for augmenting variant-based network analyses with functional interactions by applying it to a smallpox vaccine immune response GWAS. The integrative analysis spotlights the role of genes related to retinoid X receptor alpha (RXRA, which has been implicated in a previous epistasis network analysis of smallpox vaccine.

Frequency of Adverse Events after Vaccination with Different Vaccinia Strains.

NARCIS (Netherlands)

Kretzschmar, Mirjam; Wallinga, Jacco; Teunis, Peter F M; Xing, Shuqin; Mikolajczyk, Rafael

2006-01-01

BACKGROUND: Large quantities of smallpox vaccine have been stockpiled to protect entire nations against a possible reintroduction of smallpox. Planning for an appropriate use of these stockpiled vaccines in response to a smallpox outbreak requires a rational assessment of the risks of

Efficacy of tecovirimat (ST-246) in nonhuman primates infected with variola virus (Smallpox).

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Mucker, Eric M; Goff, Arthur J; Shamblin, Joshua D; Grosenbach, Douglas W; Damon, Inger K; Mehal, Jason M; Holman, Robert C; Carroll, Darin; Gallardo, Nadia; Olson, Victoria A; Clemmons, Cody J; Hudson, Paul; Hruby, Dennis E

2013-12-01

Naturally occurring smallpox has been eradicated but remains a considerable threat as a biowarfare/bioterrorist weapon (F. Fleck, Bull. World Health Organ. 81:917-918, 2003). While effective, the smallpox vaccine is currently not recommended for routine use in the general public due to safety concerns (http://www.bt.cdc.gov/agent/smallpox/vaccination). Safe and effective countermeasures, particularly those effective after exposure to smallpox, are needed. Currently, SIGA Technologies is developing the small-molecule oral drug, tecovirimat (previously known as ST-246), as a postexposure therapeutic treatment of orthopoxvirus disease, including smallpox. Tecovirimat has been shown to be efficacious in preventing lethal orthopoxviral disease in numerous animal models (G. Yang, D. C. Pevear, M. H. Davies, M. S. Collett, T. Bailey, et al., J. Virol. 79:13139-13149, 2005; D. C. Quenelle, R. M. Buller, S. Parker, K. A. Keith, D. E. Hruby, et al., Antimicrob. Agents Chemother., 51:689-695, 2007; E. Sbrana, R. Jordan, D. E. Hruby, R. I. Mateo, S. Y. Xiao, et al., Am. J. Trop. Med. Hyg. 76:768-773, 2007). Furthermore, in clinical trials thus far, the drug appears to be safe, with a good pharmacokinetic profile. In this study, the efficacy of tecovirimat was evaluated in both a prelesional and postlesional setting in nonhuman primates challenged intravenously with 1 × 10(8) PFU of Variola virus (VARV; the causative agent of smallpox), a model for smallpox disease in humans. Following challenge, 50% of placebo-treated controls succumbed to infection, while all tecovirimat-treated animals survived regardless of whether treatment was started at 2 or 4 days postinfection. In addition, tecovirimat treatment resulted in dramatic reductions in dermal lesion counts, oropharyngeal virus shedding, and viral DNA circulating in the blood. Although clinical disease was evident in tecovirimat-treated animals, it was generally very mild and appeared to resolve earlier than in placebo

Unraveling the structure of the variola topoisomerase IB-DNA complex: a possible new twist on smallpox therapy.

Science.gov (United States)

Osheroff, Neil

2006-10-01

Smallpox is a serious and highly contagious disease that is caused by the variola virus. It is one of the most severe infectious human diseases known, with mortality rates as high as 30%. A successful worldwide vaccination program led to the eradication of smallpox in 1980. However, the high transmission rate of variola virus, coupled with the deadly nature of smallpox, makes this virus a potentially devastating weapon for bioterrorism. Currently, there is no specific treatment for smallpox. However, a recent article on the structure of a variola topoisomerase IB-DNA complex provides an intriguing starting point for the rational design of drugs with potential activity against smallpox.

17th Century Variola Virus Reveals the Recent History of Smallpox.

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Duggan, Ana T; Perdomo, Maria F; Piombino-Mascali, Dario; Marciniak, Stephanie; Poinar, Debi; Emery, Matthew V; Buchmann, Jan P; Duchêne, Sebastian; Jankauskas, Rimantas; Humphreys, Margaret; Golding, G Brian; Southon, John; Devault, Alison; Rouillard, Jean-Marie; Sahl, Jason W; Dutour, Olivier; Hedman, Klaus; Sajantila, Antti; Smith, Geoffrey L; Holmes, Edward C; Poinar, Hendrik N

2016-12-19

Smallpox holds a unique position in the history of medicine. It was the first disease for which a vaccine was developed and remains the only human disease eradicated by vaccination. Although there have been claims of smallpox in Egypt, India, and China dating back millennia [1-4], the timescale of emergence of the causative agent, variola virus (VARV), and how it evolved in the context of increasingly widespread immunization, have proven controversial [4-9]. In particular, some molecular-clock-based studies have suggested that key events in VARV evolution only occurred during the last two centuries [4-6] and hence in apparent conflict with anecdotal historical reports, although it is difficult to distinguish smallpox from other pustular rashes by description alone. To address these issues, we captured, sequenced, and reconstructed a draft genome of an ancient strain of VARV, sampled from a Lithuanian child mummy dating between 1643 and 1665 and close to the time of several documented European epidemics [1, 2, 10]. When compared to vaccinia virus, this archival strain contained the same pattern of gene degradation as 20 th century VARVs, indicating that such loss of gene function had occurred before ca. 1650. Strikingly, the mummy sequence fell basal to all currently sequenced strains of VARV on phylogenetic trees. Molecular-clock analyses revealed a strong clock-like structure and that the timescale of smallpox evolution is more recent than often supposed, with the diversification of major viral lineages only occurring within the 18 th and 19 th centuries, concomitant with the development of modern vaccination. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Strategies, actors, promises and fears in the smallpox vaccinations campaigns in Mexico: from the Porfiriato to the Post-revolution (1880-1940)].

Science.gov (United States)

Agostoni, Claudia

2011-02-01

The article examines some of the strategies employed by the Mexican health authorities that led to the organization of massive and obligatory smallpox vaccination campaigns from the late 1880s to the 1940s, a period of Mexican history that corresponds to the Porfirio Díaz regime (1877-1911), to the armed phase of the Mexican Revolution (1910-1920), and to the first two decades of the Post-revolutionary governments (1920-1940). Attention will be placed of the vaccination programs in the main urban settings, notably in Mexico City, as well as the gradual but decisive organization and regulation of vaccination campaigns in the heterogeneous rural milieu. Furthermore, the importance that hygienic education acquired will be explored, as well as the divergent and contested responses that emerged due to the obligatory vaccination campaigns, responses that included resistance, fear, uncertainty and widespread acceptance.

Smallpox

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... smallpox could someday be used as a biological warfare agent. No cure or treatment for smallpox exists. ... logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2018 Mayo Foundation for Medical ...

[History of vaccination: from empiricism towards recombinant vaccines].

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Guérin, N

2007-01-01

Two hundreds years after the discovery of the smallpox vaccine, immunization remains one of the most powerful tools of preventive medicine. Immunization was born with Jenner, then Pasteur and expanded during the 19th and 20th century. It started with the empirical observation of cross-immunity between two diseases, cowpox and smallpox. It became a real science, with pathogen isolation, culture and attenuation or inactivation, to prepare a vaccine. Together with clinical and biological efficacy studies and adverse events assessments, it constructed the concept of "vaccinology". Protein conjugation of polyosidic vaccines has made possible early immunisation of infants. Nowadays, recombinant, reassortant, or virus-like particles technologies open the road for new vaccines. Ongoing research opens the way for the development of new vaccines that will help to control transmittable diseases for which we are lacking antimicrobial agents.

GM-CSF production allows the identification of immunoprevalent antigens recognized by human CD4+ T cells following smallpox vaccination.

Directory of Open Access Journals (Sweden)

Valeria Judkowski

Full Text Available The threat of bioterrorism with smallpox and the broad use of vaccinia vectors for other vaccines have led to the resurgence in the study of vaccinia immunological memory. The importance of the role of CD4+ T cells in the control of vaccinia infection is well known. However, more CD8+ than CD4+ T cell epitopes recognized by human subjects immunized with vaccinia virus have been reported. This could be, in part, due to the fact that most of the studies that have identified human CD4+ specific protein-derived fragments or peptides have used IFN-γ production to evaluate vaccinia specific T cell responses. Based on these findings, we reasoned that analyzing a large panel of cytokines would permit us to generate a more complete analysis of the CD4 T cell responses. The results presented provide clear evidence that TNF-α is an excellent readout of vaccinia specificity and that other cytokines such as GM-CSF can be used to evaluate the reactivity of CD4+ T cells in response to vaccinia antigens. Furthermore, using these cytokines as readout of vaccinia specificity, we present the identification of novel peptides from immunoprevalent vaccinia proteins recognized by CD4+ T cells derived from smallpox vaccinated human subjects. In conclusion, we describe a "T cell-driven" methodology that can be implemented to determine the specificity of the T cell response upon vaccination or infection. Together, the single pathogen in vitro stimulation, the selection of CD4+ T cells specific to the pathogen by limiting dilution, the evaluation of pathogen specificity by detecting multiple cytokines, and the screening of the clones with synthetic combinatorial libraries, constitutes a novel and valuable approach for the elucidation of human CD4+ T cell specificity in response to large pathogens.

Signs and Symptoms (Smallpox)

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... Search Form Controls Cancel Submit Search the CDC Smallpox Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Smallpox About Smallpox History of Smallpox Spread and Eradication ...

Extracting key information from historical data to quantify the transmission dynamics of smallpox

Directory of Open Access Journals (Sweden)

Brockmann Stefan O

2008-08-01

Full Text Available Abstract Background Quantification of the transmission dynamics of smallpox is crucial for optimizing intervention strategies in the event of a bioterrorist attack. This article reviews basic methods and findings in mathematical and statistical studies of smallpox which estimate key transmission parameters from historical data. Main findings First, critically important aspects in extracting key information from historical data are briefly summarized. We mention different sources of heterogeneity and potential pitfalls in utilizing historical records. Second, we discuss how smallpox spreads in the absence of interventions and how the optimal timing of quarantine and isolation measures can be determined. Case studies demonstrate the following. (1 The upper confidence limit of the 99th percentile of the incubation period is 22.2 days, suggesting that quarantine should last 23 days. (2 The highest frequency (61.8% of secondary transmissions occurs 3–5 days after onset of fever so that infected individuals should be isolated before the appearance of rash. (3 The U-shaped age-specific case fatality implies a vulnerability of infants and elderly among non-immune individuals. Estimates of the transmission potential are subsequently reviewed, followed by an assessment of vaccination effects and of the expected effectiveness of interventions. Conclusion Current debates on bio-terrorism preparedness indicate that public health decision making must account for the complex interplay and balance between vaccination strategies and other public health measures (e.g. case isolation and contact tracing taking into account the frequency of adverse events to vaccination. In this review, we summarize what has already been clarified and point out needs to analyze previous smallpox outbreaks systematically.

History of Smallpox and Its Spread in Human Populations.

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Thèves, Catherine; Crubézy, Eric; Biagini, Philippe

2016-08-01

Smallpox is considered among the most devastating of human diseases. Its spread in populations, initiated for thousands of years following a probable transmission from an animal host, was concomitant with movements of people across regions and continents, trade and wars. Literature permitted to retrace the occurrence of epidemics from ancient times to recent human history, smallpox having affected all levels of past society including famous monarchs. The disease was officially declared eradicated in 1979 following intensive vaccination campaigns.Paleomicrobiology dedicated to variola virus is restricted to few studies, most unsuccessful, involving ancient material. Only one recent approach allowed the identification of viral DNA fragments from lung tissue of a 300-year-old body excavated from permafrost in Eastern Siberia; phylogenetic analysis revealed that this ancient strain was distinct from those described during the 20th century.

42 CFR 102.3 - Definitions.

Science.gov (United States)

2010-10-01

...) Benefits means benefits and/or compensation. (e) Child means any natural, illegitimate, adopted, or... means the workers' compensation benefits program for civilian officers and employees of the Federal... Smallpox Vaccine Injury Compensation Program. (r) Public Safety Officers' Benefits Program (PSOB Program...

Comparative Pathology of Smallpox and Monkeypox in Man and Macaques

Science.gov (United States)

Cann, J. A.; Jahrling, P. B.; Hensley, L. E.; Wahl-Jensen, V.

2012-01-01

Summary In the three decades since the eradication of smallpox and cessation of routine vaccination, the collective memory of the devastating epidemics caused by this orthopoxvirus has waned, and the human population has become increasingly susceptible to a disease that remains high on the list of possible bioterrorism agents. Research using surrogate orthopoxviruses in their natural hosts, as well as limited variola virus research in animal models, continues worldwide; however, interpretation of findings is often limited by our relative lack of knowledge about the naturally occurring disease. For modern comparative pathologists, many of whom have no first-hand knowledge of naturally occurring smallpox, this work provides a contemporary review of this historical disease, as well as discussion of how it compares with human monkeypox and the corresponding diseases in macaques. PMID:22884034

Smallpox: can we still learn from the journey to eradication?

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Smith, Kendall A

2013-05-01

One of the most celebrated achievements of immunology and modern medicine is the eradication of the dreaded plague smallpox. From the introduction of smallpox vaccination by Edward Jenner, to its popularization by Louis Pasteur, to the eradication effort led by Donald Henderson, this story has many lessons for us today, including the characteristics of the disease and vaccine that permitted its eradication, and the obviousness of the vaccine as a vector for other intractable Infectious diseases. The disease itself, interpreted in the light of modern molecular immunology, is an obvious immunopathological disease, which occurs after a latent interval of 1-2 weeks, and manifests as a systemic cell-mediated delayed type hypersensitivity (DTH) syndrome. The vaccine that slayed this dragon was given the name vaccinia, and was thought to have evolved from cowpox virus, but is now known to be most closely related to a poxvirus isolated from a horse. Of interest is the fact that of the various isolates of orthopox viruses, only variola, vaccinia and monkeypox viruses can infect humans. In contrast to the systemic disease of variola, vaccinia only replicates locally at the site of inoculation, and causes a localized DTH response that usually peaks after 7-10 days. This difference in the pathogenicity of variola vs. vaccinia is thought to be due to the capacity of variola to circumvent innate immunity, which allows it to disseminate widely before the adaptive immune response occurs. Thus, the fact that vaccinia virus is attenuated compared to variola, but is still replication competent, makes for its remarkable efficacy as a vaccine, as the localized infection activates all of the cells and molecules of both innate and adaptive immunity. Accordingly vaccinia itself, and not modified replication incompetent vaccina, is the hope for use as a vector in the eradication of additional pathogenic microbes from the globe.

Mozart and smallpox

NARCIS (Netherlands)

Zegers, Richard H. C.

2007-01-01

In 1767 at 11 years of age, composer Wolfgang Amadeus Mozart contracted smallpox, allegedly causing him temporary blindness. Although now eradicated, smallpox in those days had a high mortality rate, and the history of classical music would have been very different if Mozart had become permanently

L1R, A27L, A33R and B5R vaccinia virus genes expressed by fowlpox recombinants as putative novel orthopoxvirus vaccines

OpenAIRE

Pacchioni, Sole Maria; Bissa, Massimiliano; Zanotto, Carlo; Morghen, Carlo De Giuli; Illiano, Elena; Radaelli, Antonia

2013-01-01

Background The traditional smallpox vaccine, administered by scarification, was discontinued in the general population from 1980, because of the absence of new smallpox cases. However, the development of an effective prophylactic vaccine against smallpox is still necessary, to protect from the threat of deliberate release of the variola virus for bioterrorism and from new zoonotic infections, and to improve the safety of the traditional vaccine. Preventive vaccination still remains the most e...

Ethical and legal challenges of vaccines and vaccination: Reflections.

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Jesani, Amar; Johari, Veena

2017-01-01

Vaccines and vaccination have emerged as key medical scientific tools for prevention of certain diseases. Documentation of the history of vaccination shows that the initial popular resistance to universal vaccination was based on false assumptions and eventually gave way to acceptance of vaccines and trust in their ability to save lives. The successes of the global eradication of smallpox, and now of polio, have only strengthened the premier position occupied by vaccines in disease prevention. However, the success of vaccines and public trust in their ability to eradicate disease are now under challenge, as increasing numbers of people refuse vaccination, questioning the effectiveness of vaccines and the need to vaccinate.

Frequently Asked Questions and Answers on Smallpox

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... with smallpox is still infectious until the last scabs fall off. How fast does smallpox spread? The ... Variola virus research Variola virus repository inspections Synthetic Biology Technology for smallpox Post-eradication of smallpox You ...

Mozart and smallpox.

Science.gov (United States)

Zegers, Richard H C

2007-01-01

In 1767 at 11 years of age, composer Wolfgang Amadeus Mozart contracted smallpox, allegedly causing him temporary blindness. Although now eradicated, smallpox in those days had a high mortality rate, and the history of classical music would have been very different if Mozart had become permanently blind, or died, as a result of the disease.

The Effect of Smallpox and Bacillus Calmette-Guérin Vaccination on the Risk of Human Immunodeficiency Virus-1 Infection in Guinea-Bissau and Denmark

DEFF Research Database (Denmark)

Rieckmann, Andreas; Villumsen, Marie; Jensen, Mette Lundsby

2017-01-01

-Bissau including 1751 individuals and (2) a case-base study with a background population of 46239 individuals in Denmark. In Guinea-Bissau, HIV-1 transmission was almost exclusively sexually transmitted. In Denmark, we excluded intravenous drug users. Data were analyzed using logistic regression. RESULTS: Bacillus......: The studies from Guinea-Bissau and Denmark, 2 very different settings, both suggest that the BCG and smallpox vaccines could be associated with a decreased risk of sexually transmitted HIV-1. It might be informative to pursue this observation and explore possible protective mechanisms as part of the search...

Smallpox: An eradicated infection with persistent sequels - Case report and a brief on smallpox

International Nuclear Information System (INIS)

Jastaneiah, Sabah

2009-01-01

Sequelae of smallpox infection on the ocular surface are still seen, including corneal scars adherent leukoma and phthisical globes. This paper will report another sequel of smallpox infection causing inadvertent bleb in a 62-year-old diabetic female with no history of ocular surgery or trauma in either eye. The patient had smallpox infection during her childhood. Her follow up extended from May 1997 until August 2007 with a constant eye examinations including controlled intraocular pressure, avascular cystic inadvertent bleb, and up drown peaked pupil. (author)

The prevention and eradication of smallpox: a commentary on Sloane (1755) ‘An account of inoculation’

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Weiss, Robin A.; Esparza, José

2015-01-01

Sir Hans Sloane's account of inoculation as a means to protect against smallpox followed several earlier articles published in Philosophical Transactions on this procedure. Inoculation (also called ‘variolation’) involved the introduction of small amounts of infectious material from smallpox vesicles into the skin of healthy subjects, with the goal of inducing mild symptoms that would result in protection against the more severe naturally acquired disease. It began to be practised in England in 1721 thanks to the efforts of Lady Mary Wortley Montagu who influenced Sloane to promote its use, including the inoculation of the royal family's children. When Edward Jenner's inoculation with the cow pox (‘vaccination’) followed 75 years later as a safer yet equally effective procedure, the scene was set for the eventual control of smallpox epidemics culminating in the worldwide eradication of smallpox in 1977, officially proclaimed by WHO in 1980. Here, we discuss the significance of variolation and vaccination with respect to scientific, public health and ethical controversies concerning these ‘weapons of mass protection’. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society. PMID:25750241

Planning for smallpox outbreaks

Science.gov (United States)

Ferguson, Neil M.; Keeling, Matt J.; John Edmunds, W.; Gani, Raymond; Grenfell, Bryan T.; Anderson, Roy M.; Leach, Steve

2003-10-01

Mathematical models of viral transmission and control are important tools for assessing the threat posed by deliberate release of the smallpox virus and the best means of containing an outbreak. Models must balance biological realism against limitations of knowledge, and uncertainties need to be accurately communicated to policy-makers. Smallpox poses the particular challenge that key biological, social and spatial factors affecting disease spread in contemporary populations must be elucidated largely from historical studies undertaken before disease eradication in 1979. We review the use of models in smallpox planning within the broader epidemiological context set by recent outbreaks of both novel and re-emerging pathogens.

Smallpox

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... two research laboratories in Atlanta, Georgia, and in Russia. Why Is the Study of Smallpox a Priority ... products; and establish platforms that can reduce the time and cost of creating new products. This is ...

Smallpox

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... infection caused by the variola virus. For centuries, epidemics affected people all over the globe, and the ... these stored virus samples with the aim of spreading smallpox infection. Despite talk about the possibility of ...

Percutaneous Vaccination as an Effective Method of Delivery of MVA and MVA-Vectored Vaccines.

Directory of Open Access Journals (Sweden)

Clement A Meseda

Full Text Available The robustness of immune responses to an antigen could be dictated by the route of vaccine inoculation. Traditional smallpox vaccines, essentially vaccinia virus strains, that were used in the eradication of smallpox were administered by percutaneous inoculation (skin scarification. The modified vaccinia virus Ankara is licensed as a smallpox vaccine in Europe and Canada and currently undergoing clinical development in the United States. MVA is also being investigated as a vector for the delivery of heterologous genes for prophylactic or therapeutic immunization. Since MVA is replication-deficient, MVA and MVA-vectored vaccines are often inoculated through the intramuscular, intradermal or subcutaneous routes. Vaccine inoculation via the intramuscular, intradermal or subcutaneous routes requires the use of injection needles, and an estimated 10 to 20% of the population of the United States has needle phobia. Following an observation in our laboratory that a replication-deficient recombinant vaccinia virus derived from the New York City Board of Health strain elicited protective immune responses in a mouse model upon inoculation by tail scarification, we investigated whether MVA and MVA recombinants can elicit protective responses following percutaneous administration in mouse models. Our data suggest that MVA administered by percutaneous inoculation, elicited vaccinia-specific antibody responses, and protected mice from lethal vaccinia virus challenge, at levels comparable to or better than subcutaneous or intramuscular inoculation. High titers of specific neutralizing antibodies were elicited in mice inoculated with a recombinant MVA expressing the herpes simplex type 2 glycoprotein D after scarification. Similarly, a recombinant MVA expressing the hemagglutinin of attenuated influenza virus rgA/Viet Nam/1203/2004 (H5N1 elicited protective immune responses when administered at low doses by scarification. Taken together, our data suggest that

Percutaneous Vaccination as an Effective Method of Delivery of MVA and MVA-Vectored Vaccines.

Science.gov (United States)

Meseda, Clement A; Atukorale, Vajini; Kuhn, Jordan; Schmeisser, Falko; Weir, Jerry P

2016-01-01

The robustness of immune responses to an antigen could be dictated by the route of vaccine inoculation. Traditional smallpox vaccines, essentially vaccinia virus strains, that were used in the eradication of smallpox were administered by percutaneous inoculation (skin scarification). The modified vaccinia virus Ankara is licensed as a smallpox vaccine in Europe and Canada and currently undergoing clinical development in the United States. MVA is also being investigated as a vector for the delivery of heterologous genes for prophylactic or therapeutic immunization. Since MVA is replication-deficient, MVA and MVA-vectored vaccines are often inoculated through the intramuscular, intradermal or subcutaneous routes. Vaccine inoculation via the intramuscular, intradermal or subcutaneous routes requires the use of injection needles, and an estimated 10 to 20% of the population of the United States has needle phobia. Following an observation in our laboratory that a replication-deficient recombinant vaccinia virus derived from the New York City Board of Health strain elicited protective immune responses in a mouse model upon inoculation by tail scarification, we investigated whether MVA and MVA recombinants can elicit protective responses following percutaneous administration in mouse models. Our data suggest that MVA administered by percutaneous inoculation, elicited vaccinia-specific antibody responses, and protected mice from lethal vaccinia virus challenge, at levels comparable to or better than subcutaneous or intramuscular inoculation. High titers of specific neutralizing antibodies were elicited in mice inoculated with a recombinant MVA expressing the herpes simplex type 2 glycoprotein D after scarification. Similarly, a recombinant MVA expressing the hemagglutinin of attenuated influenza virus rgA/Viet Nam/1203/2004 (H5N1) elicited protective immune responses when administered at low doses by scarification. Taken together, our data suggest that MVA and MVA

Small(pox) success?

Science.gov (United States)

Birn, Anne-Emanuelle

2011-02-01

The 30th anniversary of the World Health Organization's (WHO) official certification of smallpox eradication was marked by a slew of events hailing the campaign's dramatic tale of technological and organizational triumph against an ancient scourge. Yet commemorations also serve as moments of critical reflection. This article questions the acclaim showered upon smallpox eradication as the single greatest public health success in history. It examines how and why smallpox eradication and WHO's concurrent social justice-oriented primary health care approach (following from the Declaration of Alma-Ata) became competing paradigms. It synthesizes critiques of eradication's shortcomings and debunks some of the myths surrounding the global eradication campaign as a public health priority and necessity, and as a Cold War victory of cooperation. The article concludes with thoughts on integrating technical and social-political aspects of health within the context of welfare states as the means to achieving widespread and enduring global public health success.

Small(pox success?

Directory of Open Access Journals (Sweden)

Anne-Emanuelle Birn

Full Text Available The 30th anniversary of the World Health Organization's (WHO official certification of smallpox eradication was marked by a slew of events hailing the campaign's dramatic tale of technological and organizational triumph against an ancient scourge. Yet commemorations also serve as moments of critical reflection. This article questions the acclaim showered upon smallpox eradication as the single greatest public health success in history. It examines how and why smallpox eradication and WHO's concurrent social justice-oriented primary health care approach (following from the Declaration of Alma-Ata became competing paradigms. It synthesizes critiques of eradication's shortcomings and debunks some of the myths surrounding the global eradication campaign as a public health priority and necessity, and as a Cold War victory of cooperation. The article concludes with thoughts on integrating technical and social-political aspects of health within the context of welfare states as the means to achieving widespread and enduring global public health success.

Metabolites as Biomarkers of Adverse Reactions Following Vaccination: A Pilot Study using Nuclear Magnetic Resonance Metabolomics

Science.gov (United States)

McClenathan, Bruce M.; Stewart, Delisha A.; Spooner, Christina E.; Pathmasiri, Wimal W.; Burgess, Jason P.; McRitchie, Susan L.; Choi, Y. Sammy; Sumner, Susan C.J.

2017-01-01

An Adverse Event Following Immunization (AEFI) is an adverse reaction to a vaccination that goes above and beyond the usual side effects associated with vaccinations. One serious AEFI related to the smallpox vaccine is myopericarditis. Metabolomics involves the study of the low molecular weight metabolite profile of cells, tissues, and biological fluids, and provides a functional readout of the phenotype. Metabolomics may help identify a particular metabolic signature in serum of subjects who are predisposed to developing AEFIs. The goal of this study was to identify metabolic markers that may predict the development of adverse events following smallpox vaccination. Serum samples were collected from military personnel prior to and following receipt of smallpox vaccine. The study population included five subjects who were clinically diagnosed with myopericarditis, 30 subjects with asymptomatic elevation of troponins, and 31 subjects with systemic symptoms following immunization, and 34 subjects with no AEFI, serving as controls. Two-hundred pre- and post-smallpox vaccination sera were analyzed by untargeted metabolomics using 1H nuclear magnetic resonance (NMR) spectroscopy. Baseline (pre-) and post-vaccination samples from individuals who experienced clinically verified myocarditis or asymptomatic elevation of troponins were more metabolically distinguishable pre- and post-vaccination compared to individuals who only experienced systemic symptoms, or controls. Metabolomics profiles pre- and post-receipt of vaccine differed substantially when an AEFI resulted. This study is the first to describe pre- and post-vaccination metabolic profiles of subjects who developed an adverse event following immunization. The study demonstrates the promise of metabolites for determining mechanisms associated with subjects who develop AEFI and the potential to develop predictive biomarkers. PMID:28169076

Another vaccine, another story: BCG vaccination against tuberculosis in India, 1948 to 1960 Outra vacina, outra história: a vacinação de BCG contra tuberculose na Índia, 1948 a 1960

Directory of Open Access Journals (Sweden)

Niels Brimnes

2011-02-01

Full Text Available Through an examination of mass BCG vaccination against tuberculosis in India between 1948 and 1960 this article draws attention to the diversity of the history of vaccination. The features of vaccination campaigns often differed from those of the celebrated campaign to eradicate smallpox. Due to differences between smallpox and tuberculosis as well as between the vaccines developed against them, an analysis of BCG mass vaccination against tuberculosis seems particularly well suited for this purpose. Three points of difference are identified. First, in non-Western contexts BCG vaccination procedures were modified to a greater extent than vaccination against smallpox. Second, tuberculosis lacked the drama and urgency of smallpox and BCG vaccination campaigns suffered more from recruitment problems than did the more "heroic" smallpox eradication campaign. Third, the BCG vaccine was contested in medical circles and was much better suited than the vaccine against smallpox as a vehicle for the articulation of concerns about post-colonial modernization.Através da observação da vacinação em massa de BCG contra a tuberculose na Índia durante os anos de 1948 a 1960, este artigo chama a atenção para a diversidade da história da vacinação. As características das campanhas de vacinação geralmente diferem daquelas celebradas nas campanhas para erradicação da varíola. Devido às diferenças entre a varíola e a turberculose, assim como entre as vacinas desenvolvidas para combater essas doenças, uma análise da vacinação em massa de BCG contra a turberculose parece especialmente bem situada para essa proposta. Três pontos de diferença foram identificados. O primeiro é que em contextos não ocidentais os procedimentos da vacinação de BCG foram modificados em uma extensão maior do que a vacinação contra a varíola. Em segundo lugar, a tuberculose não tinha o drama e a urgência da varíola, e as campanhas de vacinação de BCG

The Royal Philanthropic Expedition of the Vaccine: a landmark in the history of public health.

Science.gov (United States)

Soto-Pérez-de-Celis, E

2008-11-01

In 1979, smallpox officially became the first disease ever to be eradicated by mankind. The global efforts to defeat this dreadful pandemic, however, started almost two centuries before. One of the most important, and sometimes forgotten, events in the fight against smallpox was the Royal Philanthropic Expedition of the Vaccine, commissioned by Charles IV of Spain to physicians Francisco Xavier Balmis y Berenguer and Jose Salvany in 1804. The aim of this expedition was to take the smallpox vaccine, discovered by Jenner, to Spain's territories in the Americas and in the Far East. After several years of vaccination in modern day Puerto Rico, Cuba, Venezuela, Ecuador, Peru, Bolivia, Chile, Mexico and the Philippines, the expedition returned to Europe. To this day, the Balmis and Salvany expedition remains a great example of international cooperation, and a landmark in the history of public health.

Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival

DEFF Research Database (Denmark)

Benn, Christine S; Fisker, Ane B; Whittle, Hilton C

2016-01-01

BACKGROUND: Live vaccines against measles (MV), tuberculosis (BCG), polio (OPV) and smallpox reduce mortality more than explained by target-disease prevention. The beneficial nonspecific effects (NSEs) of MV are strongest when MV is given in presence of maternal antibodies. We therefore hypothesi......BACKGROUND: Live vaccines against measles (MV), tuberculosis (BCG), polio (OPV) and smallpox reduce mortality more than explained by target-disease prevention. The beneficial nonspecific effects (NSEs) of MV are strongest when MV is given in presence of maternal antibodies. We therefore...

Vaccination and Clinical Severity: Is the Effectiveness of Contact Tracing and Case Isolation Hampered by Past Vaccination?

Directory of Open Access Journals (Sweden)

Hiroshi Nishiura

2013-02-01

Full Text Available While contact tracing and case isolation are considered as the first choice of interventions against a smallpox bioterrorist event, their effectiveness under vaccination is questioned, because not only susceptibility of host and infectiousness of case but also the risk of severe clinical manifestations among cases is known to be reduced by vaccine-induced immunity, thereby potentially delaying the diagnosis and increasing mobility among vaccinated cases. We employed a multi-type stochastic epidemic model, aiming to assess the feasibility of contact tracing and case isolation in a partially vaccinated population and identify data gaps. We computed four epidemiological outcome measures, i.e., (i the threshold of a major epidemic under the interventions; (ii the expected total number of cases; (iii the probability of extinction, and (iv the expected duration of an outbreak, demonstrating that all of these outcomes critically depend on the clinical impact of past vaccination on the diagnosis and movement of vaccinated cases. We discuss that, even in the absence of smallpox in the present day, one should consider the way to empirically quantify the delay in case detection and an increase in the frequency of contacts among previously vaccinated cases compared to unvaccinated during the early stage of an epidemic so that the feasibility of contact tracing and case isolation in a vaccinated population can be explicitly assessed.

A Randomized, Double-Blind, Placebo-Controlled Phase II Trial Investigating the Safety and Immunogenicity of Modified Vaccinia Ankara Smallpox Vaccine (MVA-BN®) in 56-80-Year-Old Subjects.

Science.gov (United States)

Greenberg, Richard N; Hay, Christine M; Stapleton, Jack T; Marbury, Thomas C; Wagner, Eva; Kreitmeir, Eva; Röesch, Siegfried; von Krempelhuber, Alfred; Young, Philip; Nichols, Richard; Meyer, Thomas P; Schmidt, Darja; Weigl, Josef; Virgin, Garth; Arndtz-Wiedemann, Nathaly; Chaplin, Paul

2016-01-01

Modified Vaccinia Ankara MVA-BN® is a live, highly attenuated, viral vaccine under advanced development as a non-replicating smallpox vaccine. In this Phase II trial, the safety and immunogenicity of Modified Vaccinia Ankara MVA-BN® (MVA) was assessed in a 56-80 years old population. MVA with a virus titer of 1 x 108 TCID50/dose was administered via subcutaneous injection to 56-80 year old vaccinia-experienced subjects (N = 120). Subjects received either two injections of MVA (MM group) or one injection of Placebo and one injection of MVA (PM group) four weeks apart. Safety was evaluated by assessment of adverse events (AE), focused physical exams, electrocardiogram recordings and safety laboratories. Solicited AEs consisted of a set of pre-defined expected local reactions (erythema, swelling, pain, pruritus, and induration) and systemic symptoms (body temperature, headache, myalgia, nausea and fatigue) and were recorded on a memory aid for an 8-day period following each injection. The immunogenicity of the vaccine was evaluated in terms of humoral immune responses measured with a vaccinia-specific enzyme-linked immunosorbent assay (ELISA) and a plaque reduction neutralization test (PRNT) before and at different time points after vaccination. Vaccinations were well tolerated by all subjects. No serious adverse event related to MVA and no case of myopericarditis was reported. The overall incidence of unsolicited AEs was similar in both groups. For both groups immunogenicity responses two weeks after the final vaccination (i.e. Visit 4) were as follows: Seroconversion (SC) rates (doubling of titers from baseline) in vaccine specific antibody titers measured by ELISA were 83.3% in Group MM and 82.8% in Group PM (difference 0.6% with 95% exact CI [-13.8%, 15.0%]), and 90.0% for Group MM and 77.6% for Group PM measured by PRNT (difference 12.4% with 95% CI of [-1.1%, 27.0%]). Geometric mean titers (GMT) measured by ELISA two weeks after the final vaccination for Group

A Multicenter, Open-Label, Controlled Phase II Study to Evaluate Safety and Immunogenicity of MVA Smallpox Vaccine (IMVAMUNE in 18-40 Year Old Subjects with Diagnosed Atopic Dermatitis.

Directory of Open Access Journals (Sweden)

Richard N Greenberg

Full Text Available Replicating smallpox vaccines can cause severe complications in individuals with atopic dermatitis (AD. Prior studies evaluating Modified Vaccinia Ankara virus (MVA, a non-replicating vaccine in humans, showed a favorable safety and immunogenicity profile in healthy volunteers.This Phase II study compared the safety and immunogenicity of MVA enrolling groups of 350 subjects with AD (SCORAD ≤ 30 and 282 healthy subjects.Subjects were vaccinated twice with MVA, each dose given subcutaneously 4 weeks apart. Adverse events, cardiac parameters, and the development of vaccinia virus humoral immune responses were monitored.The overall safety of the vaccine was similar in both groups. Adverse events affecting skin were experienced significantly more often in subjects with AD, but the majority of these events were mild to moderate in intensity. Seroconversion rates and geometric mean titers for total and neutralizing vaccinia-specific antibodies in the AD group were non-inferior compared to the healthy subjects.The size of the study population limited the detection of serious adverse events occurring at a frequency less than 1%.MVA has a favorable safety profile and the ability to elicit vaccinia-specific immune responses in subjects with AD.ClinicalTrials.gov NCT00316602.

[Should the human smallpox virus (variola) be destroyed?].

Science.gov (United States)

Tryland, Morten

2004-10-21

Smallpox, caused by variola virus, was a terror for civilizations around the world for more than 3000 years. Although the disease is eradicated, hundreds of variola virus isolates are kept in two WHO-collaborating facilities, one in USA and one in Russia. In spite of several agreements on destruction, it is now doubtful that these virus isolates will be destroyed. Variola virus may exist in other places and may be used as a biological weapon in war or for terror. Further research on variola virus is thus essential in order to achieve a better understanding of the pathogenicity of the virus and to develop new anti-variola virus vaccines and antiviral drugs.

LIVE ATTENUATED VACCINES FOR THE IMMUNOPROPHYLAXIS

Directory of Open Access Journals (Sweden)

O. A. Shamsutdinova

2017-01-01

Full Text Available The review focuses on the history of the production of live antiviral vaccines and their use for the prevention of infectious diseases. It was noted that before the beginning of the 20th century, only three live vaccines were developed and put into practice — against smallpox, rabies, plague. The discovery of D. Enders, T.H. Weller and F.Ch. Robins of the ability of the polio virus, and then of a number of other viruses, to reproduce in vitro in cell cultures of various types, greatly expanded the studies on the production of attenuated strains of viruses for live vaccines. The historical stages of obtaining and introducing live vaccines for the prevention of smallpox, poliomyelitis, measles, rubella, and mumps are highlighted. Arguments in favor of the use of associated vaccine preparations for the prevention of viral infections are presented. Various variants of the strategy and tactics of using live vaccines, which are used for specific prevention of viral infections in different countries, are described. The review provides information on technological methods for obtaining antiviral vaccines. The publications testifying to the development of specific reactions in immunized vaccine strains of measles, mumps, poliomyelitis and rubella viruses, such as aseptic meningitis (vaccine strains of mumps virus, acute arthritis (vaccine rubella virus strains, temperature reactions, rash (vaccine strains of the virus Measles, vaccine-associated paralytic poliomyelitis (VAPP vaccine vaccine poliovirus. It is particularly noted that the long experience of vaccine prevention both in Russia and abroad convincingly shows that the risk of developing post-vaccination complications is incommensurably lower than the risk of causing harm to health from the corresponding infections. It is concluded that despite introduction of new third and fourth generation vaccines into practice, live attenuated vaccines do not lose their significance and are used in vaccine

The Emergency campaign for smallpox eradication from Somalia (1977-1979)--revisited.

Science.gov (United States)

Deria, Abdullahi

2011-12-30

The historical significance of smallpox eradication from Somalia lies in the fact that the country was the last to record the last endemic smallpox case in the world. Before 1977 the programme was mismanaged. In the mid-1970s, the programme was plagued with concealment. Confirmation of smallpox outbreak in Mogadishu in September 1976 delayed global smallpox eradication. The Government maintained that there was no ongoing smallpox transmission in the country after the Mogadishu outbreak and frustrated independent attempts to verify its claim. In February 1977 the Government allowed World Health Organization (WHO) epidemiologists to search, unhindered, for smallpox outside Mogadishu. Soon widespread smallpox transmission was detected. The Government appealed for international support. The strategy to stop the smallpox transmission was based on surveillance and containment. The WHO took the leading role of the campaign which, in spite of the Somalia/Ethiopia war of 1977/78, culminated in the eradication of smallpox from the country. Somalia was certified smallpox-free on 19 October 1979. Copyright © 2011 Elsevier Ltd. All rights reserved.

The De Novo Synthesis of Horsepox Virus: Implications for Biosecurity and Recommendations for Preventing the Reemergence of Smallpox.

Science.gov (United States)

Koblentz, Gregory D

In March 2017, the American biotech company Tonix announced that a Canadian scientist had synthesized horsepox virus as part of a project to develop a safer vaccine against smallpox. The first de novo synthesis of an orthopoxvirus, a closely related group of viruses that includes horsepox and the variola virus that causes smallpox, crosses an important Rubicon in the field of biosecurity. The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security. That threat has been held at bay for the past 40 years by the extreme difficulty of obtaining variola virus and the availability of effective medical countermeasures. The techniques demonstrated by the synthesis of horsepox have the potential to erase both of these barriers. The primary risk posed by this research is that it will open the door to the routine and widespread synthesis of other orthopoxviruses, such as vaccinia, for use in research, public health, and medicine. The normalization and globalization of orthopoxvirus synthesis for these beneficial applications will create a cadre of laboratories and scientists that will also have the capability and expertise to create infectious variola virus from synthetic DNA. Unless the safeguards against the synthesis of variola virus are strengthened, the capability to reintroduce smallpox into the human population will be globally distributed and either loosely or completely unregulated, providing the foundation for a disgruntled or radicalized scientist, sophisticated terrorist group, unscrupulous company, or rogue state to recreate one of humanity's most feared microbial enemies. The reemergence of smallpox-because of a laboratory accident or an intentional release-would be a global health disaster. International organizations, national governments, the DNA synthesis industry, and the synthetic biology community all have a role to play in devising new approaches to preventing the reemergence of

MHC-I-restricted epitopes conserved among variola and other related orthopoxviruses are recognized by T cells 30 years after vaccination

DEFF Research Database (Denmark)

Tang, Sheila Tuyet; Wang, M.; Lamberth, K.

2008-01-01

It is many years since the general population has been vaccinated against smallpox virus. Here, we report that human leukocyte antigen (HLA) class I restricted T cell epitopes can be recognized more than 30 years after vaccination. Using bioinformatic methods, we predicted 177 potential cytotoxic T...... lymphocyte epitopes. Eight epitopes were confirmed to stimulate IFN-gamma release by T cells in smallpox-vaccinated subjects. The epitopes were restricted by five supertypes (HLA-A1, -A2, -A24 -A26 and -B44). Significant T cell responses were detected against 8 of 45 peptides with an HLA class I affinity...... of K(D) less than or equal to 5 nM, whereas no T cell responses were detected against 60 peptides with an HLA affinity of K(D) more than 5 nM. All epitopes were fully conserved in seven variola, vaccinia and cowpox strains. Knowledge of the long-term response to smallpox vaccination may lead...

Live attenuated vaccines: Historical successes and current challenges

Energy Technology Data Exchange (ETDEWEB)

Minor, Philip D., E-mail: Philip.Minor@nibsc.org

2015-05-15

Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up in clinical use; the identification of the candidates is reviewed. - Highlights: • Live vaccines against human diseases caused by viruses have been very successful. • They have been developed by empirical clinical studies and problems identified in later use. • It can be difficult to balance ability to cause disease and ability to immunise for a strain. • There is currently no reliable basis for predicting success from pure virological studies. • Vaccinia, which eradicated smallpox, is the paradigm for all successes and issues.

Live attenuated vaccines: Historical successes and current challenges

International Nuclear Information System (INIS)

Minor, Philip D.

2015-01-01

Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up in clinical use; the identification of the candidates is reviewed. - Highlights: • Live vaccines against human diseases caused by viruses have been very successful. • They have been developed by empirical clinical studies and problems identified in later use. • It can be difficult to balance ability to cause disease and ability to immunise for a strain. • There is currently no reliable basis for predicting success from pure virological studies. • Vaccinia, which eradicated smallpox, is the paradigm for all successes and issues

Vaccine-preventable diseases and vaccination rates in South Dakota.

Science.gov (United States)

Kightlinger, Lon

2013-01-01

Vaccine-preventable diseases have historically caused much illness and death in South Dakota. Sixty-seven diphtheria deaths were reported in 1892 and 1,017 polio cases were reported at the peak of the polio epidemic in 1952. As vaccines have been developed, licensed and put into wide use, the rates of diphtheria, polio, measles, smallpox and other diseases have successfully decreased leading to control, statewide elimination or eradication. Other diseases, such as pertussis, have been more difficult to control by vaccination alone. Although current vaccination coverage rates for South Dakota's kindergarten children surpass the Healthy People 2020 targets of 95 percent, the coverage rates for 2-year-old children and teenagers are below the target rates. Until vaccine-preventable diseases are eradicated globally, we must vigilantly maintain high vaccination coverage rates and aggressively apply control measures to limit transmission when diseases do occur in South Dakota.

[History of Smallpox Vaccination and of the Vaccine Supply in Hungary, up to 1890].

Science.gov (United States)

Kiss, László

2015-01-01

One of the preconditions for the spread of vaccination against pox diseases was making vaccination available. The first vaccinations were carried out using original cowpox lymph sent by Jenner. For further vaccinations the vaccine was extracted from the blisters of those who had been successfully inoculated. In order to provide vaccine continuously six vaccine centres were set up in 1804 in the following cities: Pest, Buda, Kassa, Gyula, Pozsony and Zágráb (Croatia). Detailed information is available only about the centre in Pest which operated in Rókus Hospital under the leadership of the hospital director András Bossányi. Besides regular vaccination they also provided vaccine for the countryside. From 1824 the vaccine was relocated to the medical faculty of the university in Pest and Ferenc Gebhardt, an instructor of surgeons, became its head. The centre operated in the building of the medical faculty and vaccinations were given on Thursdays and Sundays. After the retirement of Gebhardt in 1860, the centre was taken over by the dermatologist Ferenc Poor for a short time, then by Ignác Semmelweis. From 1863 Gergely Patrubány was responsible for managing the centre. In 1874 the central vaccine institution moved to the Hospital for Poor Children in Pest where it was led first by Lázár Wittman, then by Géza Hainiss. In the 1880s private institutions appeared, the best known were Dani Pécsi's centre in Pest and Béla Intze's one in Tirgu Lapus (Romania). Between 1873 an 1889 András Kreichel ran a vaccine centre in Nálepkovo (Slovakia).

Smallpox: A Review for Health Educators

Science.gov (United States)

Bungum, Timothy J.

2003-01-01

Since the declaration of the eradication of smallpox in May of 1980 concern about this virus has ebbed. However, recent world events, including the destabilization of governments, have raised concerns that smallpox could fall into the hands of nefarious individuals or groups who might attempt to use the virus as a weapon. In Centers for Disease…

From smallpox eradication to contemporary global health initiatives: enhancing human capacity towards a global public health goal.

Science.gov (United States)

Tarantola, Daniel; Foster, Stanley O

2011-12-30

The eradication of smallpox owes its success first and foremost to the thousands of lay health workers and community members who, throughout the campaign and across continents, took on the roles of advocates, educators, vaccinators, care providers and contributors to epidemic surveillance and containment. Bangladesh provides a good example where smallpox eradication and the capacity enhancement needed to achieve this goal resulted in a two-way mutually beneficial process. Smallpox-dedicated staff provided community members with information guidance, support and tools. In turn, communities not only created the enabling environment for smallpox program staff to perform their work but acquired the capacity to perform essential eradication tasks. Contemporary global health programmes can learn much from these core lessons including: the pivotal importance of supporting community aspirations, capacity and resilience; the critical need to enhance commitment, capacity and accountability across the workforce; and the high value of attentive human resources management and support. We owe to subsequent global disease control, elimination and eradication ventures recognition of the need for social and behavioural science to inform public health strategies; the essential roles that civil society organizations and public-private partnerships can play in public health discourse and action; the overall necessity of investing in broad-based health system strengthening; and the utility of applying human rights principles, norms and standards to public health policy and practice. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

A Global Perspective on Vaccine Safety and Public Health: The Global Advisory Committee on Vaccine Safety

Science.gov (United States)

Folb, Peter I.; Bernatowska, Ewa; Chen, Robert; Clemens, John; Dodoo, Alex N. O.; Ellenberg, Susan S.; Farrington, C. Patrick; John, T. Jacob; Lambert, Paul-Henri; MacDonald, Noni E.; Miller, Elizabeth; Salisbury, David; Schmitt, Heinz-J.; Siegrist, Claire-Anne; Wimalaratne, Omala

2004-01-01

Established in 1999, the Global Advisory Committee on Vaccine Safety advises the World Health Organization (WHO) on vaccine-related safety issues and enables WHO to respond promptly, efficiently, and with scientific rigor to issues of vaccine safety with potential global importance. The committee also assesses the implications of vaccine safety for practice worldwide and for WHO policies. We describe the principles on which the committee was established, its modus operandi, and the scope of the work undertaken, both present and future. We highlight its recent recommendations on major issues, including the purported link between the measles–mumps–rubella vaccine and autism and the safety of the mumps, influenza, yellow fever, BCG, and smallpox vaccines as well as that of thiomersal-containing vaccines. PMID:15514229

On the origin of smallpox: correlating variola phylogenics with historical smallpox records.

Science.gov (United States)

Li, Yu; Carroll, Darin S; Gardner, Shea N; Walsh, Matthew C; Vitalis, Elizabeth A; Damon, Inger K

2007-10-02

Human disease likely attributable to variola virus (VARV), the etiologic agent of smallpox, has been reported in human populations for >2,000 years. VARV is unique among orthopoxviruses in that it is an exclusively human pathogen. Because VARV has a large, slowly evolving DNA genome, we were able to construct a robust phylogeny of VARV by analyzing concatenated single nucleotide polymorphisms (SNPs) from genome sequences of 47 VARV isolates with broad geographic distributions. Our results show two primary VARV clades, which likely diverged from an ancestral African rodent-borne variola-like virus either approximately 16,000 or approximately 68,000 years before present (YBP), depending on which historical records (East Asian or African) are used to calibrate the molecular clock. One primary clade was represented by the Asian VARV major strains, the more clinically severe form of smallpox, which spread from Asia either 400 or 1,600 YBP. Another primary clade included both alastrim minor, a phenotypically mild smallpox described from the American continents, and isolates from West Africa. This clade diverged from an ancestral VARV either 1,400 or 6,300 YBP, and then further diverged into two subclades at least 800 YBP. All of these analyses indicate that the divergence of alastrim and variola major occurred earlier than previously believed.

Spinocellulært karcinom opstået ved cikatrice efter Calmette-vaccination

DEFF Research Database (Denmark)

Nielsen, Rikke Maria; Andersen, F.; Salskov-Iversen, Maria Luise

2014-01-01

Marjolin's ulcer is an aggressive squamous cell carcinoma (SCC) found in chronically inflamed skin. SCC has been reported in smallpox vaccination sites, whereas basal cell carcinomas are more common in scar after bacille Calmette-Guerin (BCG) vaccination. A 72-year-old man presented with a chronic...

Biopower, Normalization, and HPV: A Foucauldian Analysis of the HPV Vaccine Controversy.

Science.gov (United States)

Engels, Kimberly S

2016-09-01

This article utilizes the Foucauldian concepts of biopower and normalization to give an analysis of the debate surrounding the controversial administration of the HPV vaccine to adolescents. My intention is not to solve the problem, rather to utilize a Foucauldian framework to bring various facets of the issue to light, specifically the way the vaccine contributes to strategies of power in reference to how young adults develop within relationships of power. To begin, the article provides an overview of the Foucauldian concepts of biopower and normalization, including how these two strategies of power were present in the administration of the smallpox vaccine in the 19th century. Next, information about HPV and the history of the current controversy in the United States is presented. Lastly, the article presents an analysis of the strategies of biopower and normalization present in the debate on HPV, including an emphasis on how the vaccination is similar to, and different from, 19th century smallpox vaccination. It also explores the way that mechanisms of disease control affect and are affected by individual subjects, in this case, adolescents.

Vaccines today, vaccines tomorrow: a perspective.

Science.gov (United States)

Loucq, Christian

2013-01-01

Vaccines are considered as one of the major contributions of the 20th century and one of the most cost effective public health interventions. The International Vaccine Institute has as a mission to discover, develop and deliver new and improved vaccines against infectious diseases that affects developing nations. If Louis Pasteur is known across the globe, vaccinologists like Maurice Hilleman, Jonas Salk and Charles Mérieux are known among experts only despite their contribution to global health. Thanks to a vaccine, smallpox has been eradicated, polio has nearly disappeared, Haemophilus influenzae B, measles and more recently meningitis A are controlled in many countries. While a malaria vaccine is undergoing phase 3, International Vaccine Institute, in collaboration with an Indian manufacturer has brought an oral inactivated cholera vaccine to pre-qualification. The field of vaccinology has undergone major changes thanks to philanthropists such as Bill and Melinda Gates, initiatives like the Decade of Vaccines and public private partnerships. Current researches on vaccines have more challenging targets like the dengue viruses, malaria, human immunodeficiency virus, the respiratory syncytial virus and nosocomial diseases. Exciting research is taking place on new adjuvants, nanoparticles, virus like particles and new route of administration. An overcrowded infant immunization program, anti-vaccine groups, immunizing a growing number of elderlies and delivering vaccines to difficult places are among challenges faced by vaccinologists and global health experts.

Should remaining stockpiles of smallpox virus (variola) be destroyed?

Science.gov (United States)

Weinstein, Raymond S

2011-04-01

In 2011, the World Health Organization will recommend the fate of existing smallpox stockpiles, but circumstances have changed since the complete destruction of these cultures was first proposed. Recent studies suggest that variola and its experimental surrogate, vaccinia, have a remarkable ability to modify the human immune response through complex mechanisms that scientists are only just beginning to unravel. Further study that might require intact virus is essential. Moreover, modern science now has the capability to recreate smallpox or a smallpox-like organism in the laboratory in addition to the risk of nature re-creating it as it did once before. These factors strongly suggest that relegating smallpox to the autoclave of extinction would be ill advised.

[A short history of infectious diseases since the fifties of the last century and the importance of vaccination].

Science.gov (United States)

Marešová, Vilma

2015-01-01

Vaccination in the Czech lands has a long history; it begun during the Austro-Hungarian Empire in 1803 by vaccination against smallpox, and in the late 19th century by vaccination against rabies. In the second half of the 20th century, the basic vaccination included also other vaccines. Thanks to paediatricians, vaccination coverage of children was so high that in addition to the immunity of individuals the collective immunity was also significant. The incidence of infectious diseases has dropped significantly. Today the population, both medical and lay, almost does not know the classic childrens infectious diseases or their risk of complications. This creates a feeling in recent years that vaccination is unnecessary and that it is a source of complication and, therefore, better not to vaccinate. However, diseases, except for smallpox, have not disappeared, and for the susceptible unvaccinated individuals they represent a great risk. There are now occurring at atypical age groups where their diagnosis is even not considered. Therefore, it is important to return to the course of disease as well as to the potentially serious complications in unvaccinated people.

Sobre a varíola e as práticas da vacinação em Minas Gerais (Brasil no século XIX About smallpox and vaccination practices in Minas Gerais (Brazil in the 19th century

Directory of Open Access Journals (Sweden)

Anny Jackeline Torres Silveira

2011-02-01

Full Text Available Este artigo analisa o impacto da varíola e da prática da vacinação antivariólica em Minas Gerais durante o período imperial brasileiro (1822-1889. Apesar da presença de órgãos que visavam à organização e à propagação da vacina no país desde o início do século XIX, identifica-se, pela documentação relativa à saúde pública produzida pelas autoridades provinciais, uma série de fatores de natureza administrativa e cultural que influenciaram negativamente na plena implementação quer da vacina quer da estrutura organizada no período visando à sua difusão. Seguindo as proposições da historiografia dedicada ao tema, discute-se que, apesar da tendência à centralização observada em diferentes esferas da administração no processo de estruturação do Estado Imperial, no âmbito da saúde e, particularmente, no âmbito do serviço de vacinação antivariólica, prevaleceu uma desarticulação entre os diferentes agentes responsáveis pela implementação e o controle desse serviço. Outro aspecto que contribuiu para as dificuldades relativas à implementação desse serviço foi a grande resistência da população em submeter-se à vacina e que pode ser entendida pela análise das percepções sociais construídas sobre a doença e o método da vacinação.This article discusses the impact of smallpox and vaccination practices used against the disease used in the province of Minas Gerais, in Brazil, during the Imperial Period (1822-1889. Despite the existence of services responsible for the organization and dissemination of the vaccine in the country since the early 19th century, some administrative and cultural factors, as identified in documents produced by the province's public health authorities at the time, had a negative impact upon the full implementation of both practice and organization of services aimed at the dissemination of smallpox vaccination. Based upon historiographic sources, it is argued that despite

Vaccines for the 21st century: a tool for decisionmaking

National Research Council Canada - National Science Library

Stratton, Kathleen R; Durch, Jane; Lawrence, Robert S

Vaccines have made it possible to eradicate the scourge of smallpox, promise the same for polio, and have profoundly reduced the threat posed by other diseases such as whooping cough, measles, and meningitis. What is next...

In Vitro Characterization of a Nineteenth-Century Therapy for Smallpox

OpenAIRE

Arndt, William; Mitnik, Chandra; Denzler, Karen L.; White, Stacy; Waters, Robert; Jacobs, Bertram L.; Rochon, Yvan; Olson, Victoria A.; Damon, Inger K.; Langland, Jeffrey O.

2012-01-01

In the nineteenth century, smallpox ravaged through the United States and Canada. At this time, a botanical preparation, derived from the carnivorous plant Sarracenia purpurea, was proclaimed as being a successful therapy for smallpox infections. The work described characterizes the antipoxvirus activity associated with this botanical extract against vaccinia virus, monkeypox virus and variola virus, the causative agent of smallpox. Our work demonstrates the in vitro characterization of Sarra...

The history of vaccines and immunization: familiar patterns, new challenges.

Science.gov (United States)

Stern, Alexandra Minna; Markel, Howard

2005-01-01

Human beings have benefited from vaccines for more than two centuries. Yet the pathway to effective vaccines has been neither neat nor direct. This paper explores the history of vaccines and immunization, beginning with Edward Jenner's creation of the world's first vaccine for smallpox in the 1790s. We then demonstrate that many of the issues salient in Jenner's era-such as the need for secure funding mechanisms, streamlined manufacturing and safety concerns, and deep-seated public fears of inoculating agents-have frequently reappeared and have often dominated vaccine policies. We suggest that historical awareness can help inform viable long-term solutions to contemporary problems with vaccine research, production, and supply.

The Florey lecture, 1983. Biological control, as exemplified by smallpox eradication and myxomatosis.

Science.gov (United States)

Fenner, F

1983-06-22

Biological control is an important method of dealing with plant and insect pests. The control of rabbits by myxomatosis and the eradication of smallpox by vaccination are unusual examples of biological control, in that they involve a vertebrate and a viral pest respectively. Myxomatosis is a benign disease in Sylvilagus rabbits in South America which is transmitted mechanically by mosquitoes. In the European rabbit, Oryctolagus, which is a pest in Australia and England, the virus from Sylvilagus produces a generalized disease that is almost always lethal. Myxomatosis was deliberately introduced into Australia in 1950 and into Europe in 1952. It was at first spectacularly successful in controlling the rabbit pest, but biological adjustments occurred in the virulence of the virus and the genetic resistances of rabbits. After 30 years of interaction, natural selection has resulted in a balance at a fairly high level of viral virulence. Smallpox has been a major scourge of mankind for over 1500 years. It spread from Asia to Europe in the Middle ages and from Europe to Africa and the Americas in the 15th and 16th centuries. Jenner's cowpox vaccine provided a method of control that reduced the severity of the disease during the 19th century but failed to eliminate the disease from many countries before the 1930s. Thereafter it was eradicated from Europe and North America, but remained endemic in South America, Africa and Asia. In 1967 it was still endemic in 33 countries and W.H.O. established a programme for global eradication within 10 years. The goal was achieved in 1977. Problems of the eradication programme and reasons for its success will be described.

A New Document on Smallpox Vaccination.

Science.gov (United States)

Tayarani-Najaran, Zahra; Tayarani-Najaran, Nilufar; Sahebkar, Amirhossein; Emami, Seyed Ahmad

2016-12-01

Modern medicine owes much to the invaluable heritage of the practices of past generations and their achievements that have now become medical rules. In the case of vaccination, there is evidence that the nomads of Baluchistan (Southeast Iran) demonstrated natural immunization against cowpox, a practice that was later introduced to the medical community by Edward Jenner. Although the discoveries of scientists cannot be ignored, they are certainly based on the traditional and indigenous experiences that have been transferred from generation to generation until reaching us. Copyright © 2016. Published by Elsevier B.V.

A New Document on Smallpox Vaccination

Directory of Open Access Journals (Sweden)

Zahra Tayarani-Najaran

2016-12-01

Full Text Available Modern medicine owes much to the invaluable heritage of the practices of past generations and their achievements that have now become medical rules. In the case of vaccination, there is evidence that the nomads of Baluchistan (Southeast Iran demonstrated natural immunization against cowpox, a practice that was later introduced to the medical community by Edward Jenner. Although the discoveries of scientists cannot be ignored, they are certainly based on the traditional and indigenous experiences that have been transferred from generation to generation until reaching us.

L1R, A27L, A33R and B5R vaccinia virus genes expressed by fowlpox recombinants as putative novel orthopoxvirus vaccines.

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Pacchioni, Sole Maria; Bissa, Massimiliano; Zanotto, Carlo; Morghen, Carlo De Giuli; Illiano, Elena; Radaelli, Antonia

2013-04-11

The traditional smallpox vaccine, administered by scarification, was discontinued in the general population from 1980, because of the absence of new smallpox cases. However, the development of an effective prophylactic vaccine against smallpox is still necessary, to protect from the threat of deliberate release of the variola virus for bioterrorism and from new zoonotic infections, and to improve the safety of the traditional vaccine. Preventive vaccination still remains the most effective control and new vectors have been developed to generate recombinant vaccines against smallpox that induce the same immunogenicity as the traditional one. As protective antibodies are mainly directed against the surface proteins of the two infectious forms of vaccinia, the intracellular mature virions and the extracellular virions, combined proteins from these viral forms can be used to better elicit a complete and protective immunity. Four novel viral recombinants were constructed based on the fowlpox genetic background, which independently express the vaccinia virus L1 and A27 proteins present on the mature virions, and the A33 and B5 proteins present on the extracellular virions. The correct expression of the transgenes was determined by RT-PCR, Western blotting, and immunofluorescence. Using immunoprecipitation and Western blotting, the ability of the proteins expressed by the four novel FPL1R, FPA27L, FPA33R and FPB5R recombinants to be recognized by VV-specific hyperimmune mouse sera was demonstrated. By neutralisation assays, recombinant virus particles released by infected chick embryo fibroblasts were shown not be recognised by hyperimmune sera. This thus demonstrates that the L1R, A27L, A33R and B5R gene products are not inserted into the new viral progeny. Fowlpox virus replicates only in avian species, but it is permissive for entry and transgene expression in mammalian cells, while being immunologically non-cross-reactive with vaccinia virus. These recombinants might

Diagnosing smallpox: would you know it if you saw it?

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Woods, Ryan; McCarthy, Tara; Barry, M Anita; Mahon, Barbara

2004-01-01

The intentional release of anthrax in the United States in 2001 and other recent acts of terrorism have highlighted the possibility of intentional release of smallpox by terrorists. Little is known about physicians' ability to diagnose smallpox, especially in the critical first days, when the potential for rapid control of transmission is greatest. During December 2002 and January 2003, primary care and emergency physicians at a large urban academic medical center were surveyed regarding the diagnosis and management of patients who present with vesicular rash illness. In addition to demographic and training-related questions, the questionnaire included items about perceived comfort in diagnosing and evaluating rashes, knowledge of the key differential diagnostic characteristics of chickenpox and smallpox, and the diagnostic interpretation of color photographs of patients with smallpox or chickenpox. Responses were summarized as a perceived comfort score, a differential diagnosis score, and a picture score. Of 266 eligible physicians, 178 (67%) responded. Of these, 95% thought clinicians need more education about bioterrorism; only 17% reported comfort in diagnosing smallpox. Although most physicians recognized pictures of smallpox and chickenpox, only 36% correctly answered 3 of 4 questions regarding differential diagnosis, an important aspect of identifying cases early. Those who were comfortable diagnosing rash illnesses had higher differential diagnosis scores. Strategies for bioterrorism-related training could take advantage of physicians' awareness of their own knowledge deficits.

Immunity to Diphtheria and Tetanus in Army Personnel and Adult Civilians in Mashhad, Iran.

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Hosseini Shokouh, Seyyed Javad; Mohammadi, Babak; Rajabi, Jalil; Mohammadian Roshan, Ghasem

2017-03-24

This study aimed to investigate serologic immunity to diphtheria and tetanus in army personnel and a sample population of adult civilians in Mashhad, Iran. Army personnel (n = 180) and civilians (n = 83) who presented at Mashhad army hospital participated in this study. Diphtheria and tetanus antitoxin levels were determined by enzyme-linked immunosorbent assay. Approximately 77% and 94% of army personnel aged 18-34 years had at least basic protection against diphtheria (antitoxin level ≥0.1 IU/mL) and tetanus (antitoxin level >0.1 IU/mL), respectively. For civilians in this age group, the proportions were 76% for both diseases. Antitoxin levels waned with age. Thus, participants older than 50 years had lower immunity; this decrease in immunity was more pronounced for tetanus than for diphtheria in both army personnel and civilians. For both diseases, geometric mean antitoxin titers and the proportion of participants with at least basic protection were higher in subjects with a history of vaccination in the last 10 years (P diphtheria and tetanus. However, the large number of susceptible older adults (>50 years old) calls for improved booster vaccination protocols.

Development of the small-molecule antiviral ST-246® as a smallpox therapeutic

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Grosenbach, Douglas W; Jordan, Robert; Hruby, Dennis E

2011-01-01

Naturally occurring smallpox has been eradicated, yet it remains as one of the highest priority pathogens due to its potential as a biological weapon. The majority of the US population would be vulnerable in a smallpox outbreak. SIGA Technologies, Inc. has responded to the call of the US government to develop and supply to the Strategic National Stockpile a smallpox antiviral to be deployed in the event of a smallpox outbreak. ST-246® (tecovirimat) was initially identified via a high-throughput screen in 2002, and in the ensuing years, our drug-development activities have spanned in vitro analysis, preclinical safety, pharmacokinetics and efficacy testing (all according to the ‘animal rule’). Additionally, SIGA has conducted Phase I and II clinical trials to evaluate the safety, tolerability and pharmacokinetics of ST-246, bringing us to our current late stage of clinical development. This article reviews the need for a smallpox therapeutic and our experience in developing ST-246, and provides perspective on the role of a smallpox antiviral during a smallpox public health emergency. PMID:21837250

Smallpox as a Bioweapon: Should We Be Concerned?

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2012-03-01

73  A.  DOES THIS TYPE OF ATTACK MATCH A PARTICULAR IDEOLOGY ...apply to smallpox. Smallpox is a virus of the Orthopox genus and the Poxviridae family, also known by the scientific name of Variola. It is easy to...they claim to possess, but it is evident that nothing in their stated ideology indicates they would abstain from using those that they could attain

75 FR 3244 - Prospective Grant of Exclusive License: Monoclonal Antibodies Against Smallpox/Orthopoxviruses

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2010-01-20

... Exclusive License: Monoclonal Antibodies Against Smallpox/Orthopoxviruses AGENCY: National Institutes of.... SUPPLEMENTARY INFORMATION: Concerns that variola (smallpox) virus might be used as a biological weapon have led... safe and effective for prevention of smallpox, it is well documented that various adverse reactions in...

Public fear of vaccination: separating fact from fiction.

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Amanna, Ian; Slifka, Mark K

2005-01-01

During the last two centuries, the world has seen a substantial increase in the number and availability of vaccines for the prevention of infectious disease. Smallpox vaccine remains the most celebrated vaccine-related achievement in human history, but worldwide reductions in many other diseases including measles, mumps, rubella, polio, diphtheria, and whooping cough (Bordetella pertussis) also illustrate the power of vaccination in controlling outbreaks of contagious diseases. Ironically, as advances in vaccination successfully limit disease outbreaks, the impact that these infectious agents once had on society becomes marginalized. Public confidence in vaccination may erode because of real or perceived risks associated with immunization, and this in turn may lead to lower vaccination coverage and loss of herd immunity. Here, we will discuss some of the elements associated with public perceptions and fear of vaccination and place these into the context of how deadly several vaccine-preventable childhood diseases can be if vaccination coverage is insufficient.

Vaccines for the 21st century

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Delany, Isabel; Rappuoli, Rino; De Gregorio, Ennio

2014-01-01

In the last century, vaccination has been the most effective medical intervention to reduce death and morbidity caused by infectious diseases. It is believed that vaccines save at least 2–3 million lives per year worldwide. Smallpox has been eradicated and polio has almost disappeared worldwide through global vaccine campaigns. Most of the viral and bacterial infections that traditionally affected children have been drastically reduced thanks to national immunization programs in developed countries. However, many diseases are not yet preventable by vaccination, and vaccines have not been fully exploited for target populations such as elderly and pregnant women. This review focuses on the state of the art of recent clinical trials of vaccines for major unmet medical needs such as HIV, malaria, TB, and cancer. In addition, we describe the innovative technologies currently used in vaccine research and development including adjuvants, vectors, nucleic acid vaccines, and structure-based antigen design. The hope is that thanks to these technologies, more diseases will be addressed in the 21st century by novel preventative and therapeutic vaccines. PMID:24803000

O sentido da vacina ou quando o prever é um dever The meaning of vaccine or when predicting is a duty

Directory of Open Access Journals (Sweden)

Myriam Bahia Lopes

1996-06-01

Full Text Available Partindo da historiografia, analisamos a construção do monumento da medicina científica: a vacina antivariólica. Ao criar e difundir a vacina, a medicina demonstra como a técnica controla a vicia em escala planetária. A grande vitória da medicina científica se funda no seguinte resultado: hoje, a existência do vírus cia varíola depende da vida em laboratório. O movimento antivacinista surge na década de 1870, na Inglaterra, e questiona a adoção universal e obrigatória da vacina antivariólica. Estudamos algumas metáforas e analogias empregadas por médicos e historiadores. Elas nos revelam o processo de construção do fato vacina.From the perspective of historiography, the article analyzes the construction of scientific medicine's major landmark: the small-pox vaccine. When this vaccine was created and widely distributed, the medical field demonstrated how technology controls life on a planetary scale. The great victory of scientific medicine rests on the fact that today the life of the small-pox virus depends upon laboratory conditions. Born in England during the 1870's, the anti-vaccine movement questioned universal, mandatory small-pox vaccination. The article examines some metaphors and analogies used by physicians and historians, revealing the process by which the vaccine, as a phenomenon, was constructed.

In vitro characterization of a nineteenth-century therapy for smallpox.

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William Arndt

Full Text Available In the nineteenth century, smallpox ravaged through the United States and Canada. At this time, a botanical preparation, derived from the carnivorous plant Sarracenia purpurea, was proclaimed as being a successful therapy for smallpox infections. The work described characterizes the antipoxvirus activity associated with this botanical extract against vaccinia virus, monkeypox virus and variola virus, the causative agent of smallpox. Our work demonstrates the in vitro characterization of Sarracenia purpurea as the first effective inhibitor of poxvirus replication at the level of early viral transcription. With the renewed threat of poxvirus-related infections, our results indicate Sarracenia purpurea may act as another defensive measure against Orthopoxvirus infections.

In vitro characterization of a nineteenth-century therapy for smallpox.

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Arndt, William; Mitnik, Chandra; Denzler, Karen L; White, Stacy; Waters, Robert; Jacobs, Bertram L; Rochon, Yvan; Olson, Victoria A; Damon, Inger K; Langland, Jeffrey O

2012-01-01

In the nineteenth century, smallpox ravaged through the United States and Canada. At this time, a botanical preparation, derived from the carnivorous plant Sarracenia purpurea, was proclaimed as being a successful therapy for smallpox infections. The work described characterizes the antipoxvirus activity associated with this botanical extract against vaccinia virus, monkeypox virus and variola virus, the causative agent of smallpox. Our work demonstrates the in vitro characterization of Sarracenia purpurea as the first effective inhibitor of poxvirus replication at the level of early viral transcription. With the renewed threat of poxvirus-related infections, our results indicate Sarracenia purpurea may act as another defensive measure against Orthopoxvirus infections.

Assessing the Importance of Domestic Vaccine Manufacturing Centers: An Overview of Immunization Programs, Vaccine Manufacture, and Distribution

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Emma Rey-Jurado

2018-01-01

Full Text Available Vaccines have significantly reduced the detrimental effects of numerous human infectious diseases worldwide, helped to reduce drastically child mortality rates and even achieved eradication of major pathogens, such as smallpox. These achievements have been possible due to a dedicated effort for vaccine research and development, as well as an effective transfer of these vaccines to public health care systems globally. Either public or private institutions have committed to developing and manufacturing vaccines for local or international population supply. However, current vaccine manufacturers worldwide might not be able to guarantee sufficient vaccine supplies for all nations when epidemics or pandemics events could take place. Currently, different countries produce their own vaccine supplies under Good Manufacturing Practices, which include the USA, Canada, China, India, some nations in Europe and South America, such as Germany, the Netherlands, Italy, France, Argentina, and Brazil, respectively. Here, we discuss some of the vaccine programs and manufacturing capacities, comparing the current models of vaccine management between industrialized and developing countries. Because local vaccine production undoubtedly provides significant benefits for the respective population, the manufacture capacity of these prophylactic products should be included in every country as a matter of national safety.

Assessing the Importance of Domestic Vaccine Manufacturing Centers: An Overview of Immunization Programs, Vaccine Manufacture, and Distribution.

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Rey-Jurado, Emma; Tapia, Felipe; Muñoz-Durango, Natalia; Lay, Margarita K; Carreño, Leandro J; Riedel, Claudia A; Bueno, Susan M; Genzel, Yvonne; Kalergis, Alexis M

2018-01-01

Vaccines have significantly reduced the detrimental effects of numerous human infectious diseases worldwide, helped to reduce drastically child mortality rates and even achieved eradication of major pathogens, such as smallpox. These achievements have been possible due to a dedicated effort for vaccine research and development, as well as an effective transfer of these vaccines to public health care systems globally. Either public or private institutions have committed to developing and manufacturing vaccines for local or international population supply. However, current vaccine manufacturers worldwide might not be able to guarantee sufficient vaccine supplies for all nations when epidemics or pandemics events could take place. Currently, different countries produce their own vaccine supplies under Good Manufacturing Practices, which include the USA, Canada, China, India, some nations in Europe and South America, such as Germany, the Netherlands, Italy, France, Argentina, and Brazil, respectively. Here, we discuss some of the vaccine programs and manufacturing capacities, comparing the current models of vaccine management between industrialized and developing countries. Because local vaccine production undoubtedly provides significant benefits for the respective population, the manufacture capacity of these prophylactic products should be included in every country as a matter of national safety.

The eradication of smallpox--an overview of the past, present, and future.

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Henderson, Donald A

2011-12-30

The 30th anniversary of the declaration of smallpox eradication is a propitious time to look back on the evolutionary history of the program, its execution, and its legacy for the future. The eradication of history's most feared disease culminated a decade-long World Health Organization campaign which began despite skepticism and doubt and succeeded despite a never ending array of obstacles occasioned by floods, civil war, famine, and bureaucratic inertia. New concepts in public health management, surveillance, and the application of large-scale programs for vaccination were fostered and matured. A new generation of young health workers emerged who applied new approaches and experienced the gratification of public health achievement. A definitive legacy for the future was the extension of the program into an "Expanded Program on Immunization", now functioning world-wide and resulting in dramatic improvements in health through control of vaccine-preventable diseases. No less important are the growing number of multi-national programs whose foundations rest on the development of active case surveillance to measure achievement and to guide progress - poliomyelitis, measles, guinea worm, and rubella. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Migration of Smallpox and Its Indelible Footprint on Latin American History. Junior Division Winner.

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Thomson, Mark

1998-01-01

Addresses the migration of smallpox into the New World where it caused the extinction of entire indigenous civilizations and altered the survivors' cultures. Discusses the historical origins of smallpox and highlights the migration and consequences of smallpox in Central and South America. Includes an annotated bibliography, research description,…

Variola minor in coalfield areas of England and Wales, 1921-34: Geographical determinants of a national smallpox epidemic that spread out of effective control.

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Smallman-Raynor, Matthew R; Rafferty, Sarah; Cliff, Andrew D

2017-05-01

This paper uses techniques of binary logistic regression to identify the spatial determinants of the last national epidemic of smallpox to spread in England and Wales, the variola minor epidemic of 1921-34. Adjusting for age and county-level variations in vaccination coverage in infancy, the analysis identifies a dose-response gradient with increasing odds of elevated smallpox rates in local government areas with (i) medium (odds ratio [OR] = 5.32, 95% Confidence Interval [95% CI] 1.96-14.41) and high (OR = 11.32, 95% CI 4.20-31.59) coal mining occupation rates and (ii) medium (OR = 16.74, 95% CI 2.24-125.21) and high (OR = 63.43, 95% CI 7.82-497.21) levels of residential density. The results imply that the spatial transmission of variola virus was facilitated by the close spatial packing of individuals, with a heightened transmission risk in coal mining areas of the country. A syndemic interaction between common respiratory conditions arising from exposure to coal dust and smallpox virus transmission is postulated to have contributed to the findings. We suggest that further studies of the geographical intersection of coal mining and acute infections that are transmitted via respiratory secretions are warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

How long ago did smallpox virus emerge?

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Shchelkunov, Sergei N

2009-01-01

Unlike vertebrates, for which paleontological data are available, and RNA viruses, which display a high rate of genetic variation, an objective estimate of time parameters for the molecular evolution of DNA viruses, which display a low rate of accumulation of mutations, is a complex problem. Genomic studies of a set of smallpox (variola) virus (VARV) isolates demonstrated the patterns of phylogenetic relationships between geographic variants of this virus. Using archival data on smallpox outbreaks and the results of phylogenetic analyses of poxvirus genomes, different research teams have obtained contradictory data on the possible time point of VARV origin. I discuss the approaches used for dating of VARV evolution and adduce the arguments favoring its historically recent origin.

Modified Vaccinia Virus Ankara: History, Value in Basic Research, and Current Perspectives for Vaccine Development.

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Volz, A; Sutter, G

2017-01-01

Safety tested Modified Vaccinia virus Ankara (MVA) is licensed as third-generation vaccine against smallpox and serves as a potent vector system for development of new candidate vaccines against infectious diseases and cancer. Historically, MVA was developed by serial tissue culture passage in primary chicken cells of vaccinia virus strain Ankara, and clinically used to avoid the undesirable side effects of conventional smallpox vaccination. Adapted to growth in avian cells MVA lost the ability to replicate in mammalian hosts and lacks many of the genes orthopoxviruses use to conquer their host (cell) environment. As a biologically well-characterized mutant virus, MVA facilitates fundamental research to elucidate the functions of poxvirus host-interaction factors. As extremely safe viral vectors MVA vaccines have been found immunogenic and protective in various preclinical infection models. Multiple recombinant MVA currently undergo clinical testing for vaccination against human immunodeficiency viruses, Mycobacterium tuberculosis or Plasmodium falciparum. The versatility of the MVA vector vaccine platform is readily demonstrated by the swift development of experimental vaccines for immunization against emerging infections such as the Middle East Respiratory Syndrome. Recent advances include promising results from the clinical testing of recombinant MVA-producing antigens of highly pathogenic avian influenza virus H5N1 or Ebola virus. This review summarizes our current knowledge about MVA as a unique strain of vaccinia virus, and discusses the prospects of exploiting this virus as research tool in poxvirus biology or as safe viral vector vaccine to challenge existing and future bottlenecks in vaccinology. © 2017 Elsevier Inc. All rights reserved.

Side-by-side comparison of gene-based smallpox vaccine with MVA in nonhuman primates.

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Golden, Joseph W; Josleyn, Matthew; Mucker, Eric M; Hung, Chien-Fu; Loudon, Peter T; Wu, T C; Hooper, Jay W

2012-01-01

Orthopoxviruses remain a threat as biological weapons and zoonoses. The licensed live-virus vaccine is associated with serious health risks, making its general usage unacceptable. Attenuated vaccines are being developed as alternatives, the most advanced of which is modified-vaccinia virus Ankara (MVA). We previously developed a gene-based vaccine, termed 4pox, which targets four orthopoxvirus antigens, A33, B5, A27 and L1. This vaccine protects mice and non-human primates from lethal orthopoxvirus disease. Here, we investigated the capacity of the molecular adjuvants GM-CSF and Escherichia coli heat-labile enterotoxin (LT) to enhance the efficacy of the 4pox gene-based vaccine. Both adjuvants significantly increased protective antibody responses in mice. We directly compared the 4pox plus LT vaccine against MVA in a monkeypox virus (MPXV) nonhuman primate (NHP) challenge model. NHPs were vaccinated twice with MVA by intramuscular injection or the 4pox/LT vaccine delivered using a disposable gene gun device. As a positive control, one NHP was vaccinated with ACAM2000. NHPs vaccinated with each vaccine developed anti-orthopoxvirus antibody responses, including those against the 4pox antigens. After MPXV intravenous challenge, all control NHPs developed severe disease, while the ACAM2000 vaccinated animal was well protected. All NHPs vaccinated with MVA were protected from lethality, but three of five developed severe disease and all animals shed virus. All five NHPs vaccinated with 4pox/LT survived and only one developed severe disease. None of the 4pox/LT-vaccinated animals shed virus. Our findings show, for the first time, that a subunit orthopoxvirus vaccine delivered by the same schedule can provide a degree of protection at least as high as that of MVA.

Side-by-side comparison of gene-based smallpox vaccine with MVA in nonhuman primates.

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Joseph W Golden

Full Text Available Orthopoxviruses remain a threat as biological weapons and zoonoses. The licensed live-virus vaccine is associated with serious health risks, making its general usage unacceptable. Attenuated vaccines are being developed as alternatives, the most advanced of which is modified-vaccinia virus Ankara (MVA. We previously developed a gene-based vaccine, termed 4pox, which targets four orthopoxvirus antigens, A33, B5, A27 and L1. This vaccine protects mice and non-human primates from lethal orthopoxvirus disease. Here, we investigated the capacity of the molecular adjuvants GM-CSF and Escherichia coli heat-labile enterotoxin (LT to enhance the efficacy of the 4pox gene-based vaccine. Both adjuvants significantly increased protective antibody responses in mice. We directly compared the 4pox plus LT vaccine against MVA in a monkeypox virus (MPXV nonhuman primate (NHP challenge model. NHPs were vaccinated twice with MVA by intramuscular injection or the 4pox/LT vaccine delivered using a disposable gene gun device. As a positive control, one NHP was vaccinated with ACAM2000. NHPs vaccinated with each vaccine developed anti-orthopoxvirus antibody responses, including those against the 4pox antigens. After MPXV intravenous challenge, all control NHPs developed severe disease, while the ACAM2000 vaccinated animal was well protected. All NHPs vaccinated with MVA were protected from lethality, but three of five developed severe disease and all animals shed virus. All five NHPs vaccinated with 4pox/LT survived and only one developed severe disease. None of the 4pox/LT-vaccinated animals shed virus. Our findings show, for the first time, that a subunit orthopoxvirus vaccine delivered by the same schedule can provide a degree of protection at least as high as that of MVA.

[EVALUATION OF THE HUMAN SENSITIVITY TO SMALLPOX VIRUS BY THE PRIMARY CULTURES OF THE MONOCYTE-MACROPHAGES].

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Zamedyanskaya, A S; Titova, K A; Sergeev, Al A; Kabanov, A S; Bulychev, L E; Sergeev, Ar A; Galakhova, D O; Nesterov, A E; Nosareva, O V; Shishkina, L N; Taranov, O S; Omigov, V V; Agafonov, A P; Sergeev, A N

2016-01-01

Studies of the primary cultures of granulocytes, mononuclear, and monocyte-macrophage cells derived from human blood were performed using variola virus (VARV) in the doses of 0.001-0.021 PFU/cell (plaques-forming units per cell). Positive dynamics of the virus accumulation was observed only in the monocyte-macrophages with maximum values of virus concentration (5.0-5.5 Ig PFU/ml) mainly within six days after the infection. The fact of VARV replication in the monocyte-macrophages was confirmed by the data of electron microscopy. At the same time, virus vaccines when tested in doses 3.3 and 4.2 Ig PFU/ml did not show the ability to reproduce in these human cells. The people sensitivity to VARV as assessed from the data obtained on human monocyte-macrophages corresponded to -1 PFU (taking into account the smooth interaction of the virus in the body to the cells of this type), which is consistent to previously found theoretical data on the virus sensitivity. The human susceptibility to VARV assessed experimentally can be used to predict the adequacy of developed smallpox models (in vivo) based on susceptible animals. This is necessary for reliable assessment of the efficiency of development of drugs for treatment and prophylaxis of the smallpox.

Live attenuated vaccines: Historical successes and current challenges.

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Minor, Philip D

2015-05-01

Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up in clinical use; the identification of the candidates is reviewed. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

Interwoven support: an historical survey of US federal programs enabling immunization.

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Dalrymple, Dack W; Grabenstein, John D

2014-11-28

The US Government (USG) can date its involvement with immunization to military and civilian efforts in 1777 and 1813 to prevent smallpox. USG involvement began accelerating with federal licensing of vaccine and antibody manufacturers in 1903. In addition to ongoing regulation of manufacturing and product quality, military and civilian arms of the USG have led research efforts into new or improved vaccines. These efforts have included diseases endemic in the United States, as well as medical countermeasures targeted against biological weapons, influenza pandemics, and emerging infectious diseases. Especially since the 1950s, the USG has provided increasing levels of funding to purchase vaccines and conduct vaccination programs. These programs have focused largely on children, although vaccination programs for adults have been expanded somewhat in recent years. Multiple agencies of the USG have convened various panels of accomplished external experts who have generated widely regarded recommendations on vaccine safety and efficacy and optimal immunization practices. USG programs for safety assessment, injury compensation, liability protection, and disease surveillance have been developed to assess needs, evaluate safety questions, ensure vaccine supply, and foster confidence in vaccination efforts. Debates on the extent of government involvement date back to the 1890 s and continue today. Several pivotal expansions of government involvement followed disease outbreaks or manufacturing accidents. This historical survey describes each of the major US federal programs in these categories, including references to applicable law. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Evolution of Poxvirus Vaccines

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Sánchez-Sampedro, Lucas; Perdiguero, Beatriz; Mejías-Pérez, Ernesto; García-Arriaza, Juan; Di Pilato, Mauro; Esteban, Mariano

2015-01-01

After Edward Jenner established human vaccination over 200 years ago, attenuated poxviruses became key players to contain the deadliest virus of its own family: Variola virus (VARV), the causative agent of smallpox. Cowpox virus (CPXV) and horsepox virus (HSPV) were extensively used to this end, passaged in cattle and humans until the appearance of vaccinia virus (VACV), which was used in the final campaigns aimed to eradicate the disease, an endeavor that was accomplished by the World Health Organization (WHO) in 1980. Ever since, naturally evolved strains used for vaccination were introduced into research laboratories where VACV and other poxviruses with improved safety profiles were generated. Recombinant DNA technology along with the DNA genome features of this virus family allowed the generation of vaccines against heterologous diseases, and the specific insertion and deletion of poxvirus genes generated an even broader spectrum of modified viruses with new properties that increase their immunogenicity and safety profile as vaccine vectors. In this review, we highlight the evolution of poxvirus vaccines, from first generation to the current status, pointing out how different vaccines have emerged and approaches that are being followed up in the development of more rational vaccines against a wide range of diseases. PMID:25853483

Oral vaccination: where we are?

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Silin, Dmytro S; Lyubomska, Oksana V; Jirathitikal, Vichai; Bourinbaiar, Aldar S

2007-07-01

As early as 900 years ago, the Bedouins of the Negev desert were reported to kill a rabid dog, roast its liver and feed it to a dog-bitten person for three to five days according to the size and number of bites [1] . In sixteenth century China, physicians routinely prescribed pills made from the fleas collected from sick cows, which purportedly prevented smallpox. One may dismiss the wisdom of the Bedouins or Chinese but the Nobel laureate, Charles Richet, demonstrated in 1900 that feeding raw meat can cure tuberculous dogs - an approach he termed zomotherapy. Despite historical clues indicating the feasibility of oral vaccination, this particular field is notoriously infamous for the abundance of dead-end leads. Today, most commercial vaccines are delivered by injection, which has the principal limitation that recipients do not like needles. In the last few years, there has been a sharp increase in interest in needle-free vaccine delivery; new data emerges almost daily in the literature. So far, there are very few licensed oral vaccines, but many more vaccine candidates are in development. Vaccines delivered orally have the potential to take immunization to a fundamentally new level. In this review, the authors summarize the recent progress in the area of oral vaccines.

The Evolution of Poxvirus Vaccines

Directory of Open Access Journals (Sweden)

Lucas Sánchez-Sampedro

2015-04-01

Full Text Available After Edward Jenner established human vaccination over 200 years ago, attenuated poxviruses became key players to contain the deadliest virus of its own family: Variola virus (VARV, the causative agent of smallpox. Cowpox virus (CPXV and horsepox virus (HSPV were extensively used to this end, passaged in cattle and humans until the appearance of vaccinia virus (VACV, which was used in the final campaigns aimed to eradicate the disease, an endeavor that was accomplished by the World Health Organization (WHO in 1980. Ever since, naturally evolved strains used for vaccination were introduced into research laboratories where VACV and other poxviruses with improved safety profiles were generated. Recombinant DNA technology along with the DNA genome features of this virus family allowed the generation of vaccines against heterologous diseases, and the specific insertion and deletion of poxvirus genes generated an even broader spectrum of modified viruses with new properties that increase their immunogenicity and safety profile as vaccine vectors. In this review, we highlight the evolution of poxvirus vaccines, from first generation to the current status, pointing out how different vaccines have emerged and approaches that are being followed up in the development of more rational vaccines against a wide range of diseases.

42 CFR 102.21 - Smallpox (Vaccinia) Vaccine Injury Table.

Science.gov (United States)

2010-10-01

... inflammatory cells in the dermis of the skin at the vaccination or inoculation site. The diagnosis of PV may be... the mother that results from the placental transmission of the vaccinia virus during any time in the... membrane lesion containing an accumulation of white blood cells. (8) Recipient means a person to whom the...

Political epidemiology: strengthening socio-political analysis for mass immunisation - lessons from the smallpox and polio programmes.

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Taylor, S

2009-01-01

Control and reduction of infectious diseases is a key to attaining the Millennium Development Goals. An important element of this work is the successful immunisation, especially in resource-poor countries. Mass immunisation, most intensively in the case of eradication, depends on a combination of reliable demand (e.g. public willingness to comply with the vaccine protocol) and effective supply (e.g. robust, generally state-led, vaccine delivery). This balance of compliance and enforceability is, quintessentially, socio-political in nature - conditioned by popular perceptions of disease and risk, wider conditions of economic development and poverty, technical aspects of vaccine delivery, and the prevailing international norms regarding power relations between states and peoples. In the past 100 years, three out of six disease eradication programmes have failed. The explanations for failure have focused on biotechnical and managerial or financial issues. Less attention is paid to socio-political aspects. Yet socio-political explanations are key. Eradication is neither inherently prone to failure, nor necessarily doomed in the case of polio. However, eradication, and similar mass immunisation initiatives, which fail to address social and political realities of intervention may be. A comparison of the smallpox and polio eradication programmes illustrates the importance of disease-specific socio-political analysis in programme conceptualisation, design, and management.

Smallpox: What the dermatologist should know

NARCIS (Netherlands)

Spuls, Phyllis I.; Bos, Jan D.; Rudikoff, Donald

2004-01-01

Despite the eradication of naturally occurring smallpox in 1977, stores of the virus have been maintained in laboratories in the United States and Russia. It is feared that certain rogue states and terrorist organizations may have illicitly acquired the virus with the intent of unleashing it as an

[Role of vaccination in animal health].

Science.gov (United States)

Pastoret, Paul-Pierre

2012-03-01

According to the IFAH, veterinary vaccines currently account for 26% of the global market in veterinary medicines, reflecting the importance of vaccines in animal health, as well as the number of wild and domesticated target species, and the monospecific nature of most vaccines. Multispecies vaccines include tetanus and rabies. In 2010, the number of food-producing animals was estimated to be roughly 20 billion and is rising gradually. Fowl currently represent the main food species. Veterinary vaccination has allowed the eradication of rinderpest, as officially declared last year (2011), jointly by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation of the United Nations (FAO). Rinderpest was a real scourge, and was only the second viral disease to be totally eradicated (after human smallpox). One characteristic of veterinary vaccination is the DIVA approach, "differentiating infected from vaccinated animals". The DIVA strategy is especially interesting for regulated control of diseases like foot-and-mouth disease, infectious bovine rhinotracheitis, pseudorabies, and classical swine fever. DIVA vaccination requires prior serological testing. Vaccination is also used for wild animals such as foxes (rabies) and wild boars (classical swine fever). "In ovo" vaccination of fowl on day 18 of the incubation period is used to prevent Marek's disease for instance, and double vaccination (vector and insert) to prevent both Marek's disease and Gumboro's disease in fowl. Animal vaccination can also help to protect human health, as illustrated by fowl vaccination against salmonellosis.

Translational mini-review series on vaccines: The Edward Jenner Museum and the history of vaccination.

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Morgan, A J; Parker, S

2007-03-01

Edward Jenner's discovery of vaccination must rank as one of the most important medical advances of all time and is a prominent example of the power of rational enquiry being brought to bear during the Age of Enlightenment in 18th century Europe. In the modern era many millions of lives are saved each year by vaccines that work essentially on the same principles that were established by Edward Jenner more than 200 years ago. His country home in Berkeley, Gloucestershire, is where he carried out his work and where he spent most of his life. The building is now a museum in which the life and times of Jenner are commemorated including not only the discovery of smallpox vaccination but also his other important scientific contributions to natural history and medicine. The trustees of the Edward Jenner museum are committed to promoting the museum as a real and "virtual" educational centre that is both entertaining and informative.

Dismantling the Taboo against Vaccines in Pregnancy

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Maurizio de Martino

2016-06-01

Full Text Available Vaccinating pregnant women in order to protect them, the fetus, and the child has become universal in no way at all. Prejudice in health professionals add to fears of women and their families. Both these feelings are not supported by even the smallest scientific data. Harmlessness for the mother and the child has been observed for seasonal, pandemic, or quadrivalent influenza, mono, combined polysaccharide or conjugated meningococcal or pneumococcal, tetanus toxoid, acellular pertussis, human papillomavirus, cholera, hepatitis A, Japanese encephalitis, rabies, anthrax, smallpox, yellow fever, mumps, measles and rubella combined, typhoid fever, inactivated or attenuated polio vaccines, and Bacillus Calmétte Guerin vaccines. Instead, the beneficial effects of influenza vaccine for the mother and the child as well as of pertussis vaccine for the child have been demonstrated. Obstetrician-gynecologists, general practitioners, and midwives must incorporate vaccination into their standard clinical care. Strong communication strategies effective at reducing parental vaccine hesitancy and approval of regulatory agencies for use of vaccines during pregnancy are needed. It must be clear that the lack of pre-licensure studies in pregnant women and, consequently, the lack of a statement about the use of the vaccine in pregnant women does not preclude its use in pregnancy.

Varíola e vacina no Brasil no século XX: institucionalização da educação sanitária Smallpox and vaccine in Brazil at 20th century: institutionalization of health education

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Tania Maria Dias Fernandes

2011-02-01

Full Text Available O objetivo deste texto é discutir algumas ações que possibilitaram a erradicação da varíola no Brasil, considerando os principais contextos e as políticas adotadas para as doenças entre 1920 e 1970, assumindo como destaque as medidas educativas no campo da saúde e estabelecendo uma discussão acerca do conteúdo educacional dos programas adotados. Observam-se, ao longo deste período, a configuração de políticas de saúde e a criação de organismos estatais direcionados a doenças e ações específicas, o que no caso da varíola somente ocorreu na década de 1960, quando foram criadas a Campanha Nacional contra a Varíola e a Campanha Nacional de Erradicação da Varíola. A educação sanitária e as relações com estas instituições foram de fundamental importância para a divulgação e implementação de ações estatais que possibilitaram ampliação da cobertura vacinal com a aceitação de seu uso pela população, o alcance do controle e a erradicação da doença.The aim of this paper is to discuss some actions that made possible the eradication of smallpox in Brazil, considering the main contexts and policies adopted for the disease between 1920 and 1970, assuming as contrast educational measures in the field of health and establishing a discussion on the educational content of the programs adopted. It can be observed that, during this period, the setting of the health policies and the creation of state agencies that target specific diseases and actions, which in the case of the smallpox, only occurred in the 1960s, when the National Campaign against the Smallpox and the National Campaign for Eradication of Smallpox were created. Health education and the relations with these institutions were of fundamental importance to the dissemination and implementation of state actions that allowed the expansion of the vaccinal coverage with acceptance of its use by the population and the range of control and eradication of the

Ontology-Based Vaccine Adverse Event Representation and Analysis.

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Xie, Jiangan; He, Yongqun

2017-01-01

Vaccine is the one of the greatest inventions of modern medicine that has contributed most to the relief of human misery and the exciting increase in life expectancy. In 1796, an English country physician, Edward Jenner, discovered that inoculating mankind with cowpox can protect them from smallpox (Riedel S, Edward Jenner and the history of smallpox and vaccination. Proceedings (Baylor University. Medical Center) 18(1):21, 2005). Based on the vaccination worldwide, we finally succeeded in the eradication of smallpox in 1977 (Henderson, Vaccine 29:D7-D9, 2011). Other disabling and lethal diseases, like poliomyelitis and measles, are targeted for eradication (Bonanni, Vaccine 17:S120-S125, 1999).Although vaccine development and administration are tremendously successful and cost-effective practices to human health, no vaccine is 100% safe for everyone because each person reacts to vaccinations differently given different genetic background and health conditions. Although all licensed vaccines are generally safe for the majority of people, vaccinees may still suffer adverse events (AEs) in reaction to various vaccines, some of which can be serious or even fatal (Haber et al., Drug Saf 32(4):309-323, 2009). Hence, the double-edged sword of vaccination remains a concern.To support integrative AE data collection and analysis, it is critical to adopt an AE normalization strategy. In the past decades, different controlled terminologies, including the Medical Dictionary for Regulatory Activities (MedDRA) (Brown EG, Wood L, Wood S, et al., Drug Saf 20(2):109-117, 1999), the Common Terminology Criteria for Adverse Events (CTCAE) (NCI, The Common Terminology Criteria for Adverse Events (CTCAE). Available from: http://evs.nci.nih.gov/ftp1/CTCAE/About.html . Access on 7 Oct 2015), and the World Health Organization (WHO) Adverse Reactions Terminology (WHO-ART) (WHO, The WHO Adverse Reaction Terminology - WHO-ART. Available from: https://www.umc-products.com/graphics/28010.pdf

Lessons for Implementation from the World's Most Successful Programme: The Global Eradication of Smallpox.

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Pratt, David

1999-01-01

Focuses on lessons educators might learn from the Intensified Campaign for the Global Eradication of Smallpox. Outlines the history of smallpox eradication. Discusses the eradication effort's obstacles, campaign, and costs and benefits. Considers five factors relevant to the successful implementation of educational programs. (CMK)

A chemokine-binding domain in the tumor necrosis factor receptor from variola (smallpox) virus.

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Alejo, Alí; Ruiz-Argüello, M Begoña; Ho, Yin; Smith, Vincent P; Saraiva, Margarida; Alcami, Antonio

2006-04-11

Variola virus (VaV) is the causative agent of smallpox, one of the most devastating diseases encountered by man, that was eradicated in 1980. The deliberate release of VaV would have catastrophic consequences on global public health. However, the mechanisms that contribute to smallpox pathogenesis are poorly understood at the molecular level. The ability of viruses to evade the host defense mechanisms is an important determinant of viral pathogenesis. Here we show that the tumor necrosis factor receptor (TNFR) homologue CrmB encoded by VaV functions not only as a soluble decoy TNFR but also as a highly specific binding protein for several chemokines that mediate recruitment of immune cells to mucosal surfaces and the skin, sites of virus entry and viral replication at late stages of smallpox. CrmB binds chemokines through its C-terminal domain, which is unrelated to TNFRs, was named smallpox virus-encoded chemokine receptor (SECRET) domain and uncovers a family of poxvirus chemokine inhibitors. An active SECRET domain was found in another viral TNFR (CrmD) and three secreted proteins encoded by orthopoxviruses. These findings identify a previously undescribed chemokine-binding and inhibitory domain unrelated to host chemokine receptors and a mechanism of immune modulation in VaV that may influence smallpox pathogenesis.

A chemokine-binding domain in the tumor necrosis factor receptor from variola (smallpox) virus

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Alejo, Alí; Ruiz-Argüello, M. Begoña; Ho, Yin; Smith, Vincent P.; Saraiva, Margarida; Alcami, Antonio

2006-01-01

Variola virus (VaV) is the causative agent of smallpox, one of the most devastating diseases encountered by man, that was eradicated in 1980. The deliberate release of VaV would have catastrophic consequences on global public health. However, the mechanisms that contribute to smallpox pathogenesis are poorly understood at the molecular level. The ability of viruses to evade the host defense mechanisms is an important determinant of viral pathogenesis. Here we show that the tumor necrosis factor receptor (TNFR) homologue CrmB encoded by VaV functions not only as a soluble decoy TNFR but also as a highly specific binding protein for several chemokines that mediate recruitment of immune cells to mucosal surfaces and the skin, sites of virus entry and viral replication at late stages of smallpox. CrmB binds chemokines through its C-terminal domain, which is unrelated to TNFRs, was named smallpox virus-encoded chemokine receptor (SECRET) domain and uncovers a family of poxvirus chemokine inhibitors. An active SECRET domain was found in another viral TNFR (CrmD) and three secreted proteins encoded by orthopoxviruses. These findings identify a previously undescribed chemokine-binding and inhibitory domain unrelated to host chemokine receptors and a mechanism of immune modulation in VaV that may influence smallpox pathogenesis. PMID:16581912

Challenges and solutions for a rational vaccine design for TB-endemic regions.

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Gowthaman, Uthaman; Mushtaq, Khurram; Tan, Amabel C; Rai, Pradeep K; Jackson, David C; Agrewala, Javed N

2015-01-01

Vaccines have been successful for global eradication or control of dreaded diseases such as smallpox, diphtheria, tetanus, yellow fever, whooping cough, polio, and measles. Unfortunately, this success has not been achieved for controlling tuberculosis (TB) worldwide. Bacillus Calmette Guérin (BCG) is the only available vaccine against TB. Paradoxically, BCG has deciphered success in the Western world but has failed in TB-endemic areas. In this article, we highlight and discuss the aspects of immunity responsible for controlling Mycobacterium tuberculosis infection and factors responsible for the failure of BCG in TB-endemic countries. In addition, we also suggest strategies that contribute toward the development of successful vaccine in protecting populations where BCG has failed.

New insights about host response to smallpox using microarray data

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Dias Rodrigo A

2007-08-01

Full Text Available Abstract Background Smallpox is a lethal disease that was endemic in many parts of the world until eradicated by massive immunization. Due to its lethality, there are serious concerns about its use as a bioweapon. Here we analyze publicly available microarray data to further understand survival of smallpox infected macaques, using systems biology approaches. Our goal is to improve the knowledge about the progression of this disease. Results We used KEGG pathways annotations to define groups of genes (or modules, and subsequently compared them to macaque survival times. This technique provided additional insights about the host response to this disease, such as increased expression of the cytokines and ECM receptors in the individuals with higher survival times. These results could indicate that these gene groups could influence an effective response from the host to smallpox. Conclusion Macaques with higher survival times clearly express some specific pathways previously unidentified using regular gene-by-gene approaches. Our work also shows how third party analysis of public datasets can be important to support new hypotheses to relevant biological problems.

The efficacy and pharmacokinetics of brincidofovir for the treatment of lethal rabbitpox virus infection: a model of smallpox disease.

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Trost, Lawrence C; Rose, Michelle L; Khouri, Jody; Keilholz, Laurie; Long, James; Godin, Stephen J; Foster, Scott A

2015-05-01

Brincidofovir (BCV) has broad-spectrum in vitro activity against dsDNA viruses, including smallpox, and is being developed as a treatment for smallpox as well as infections caused by other dsDNA viruses. BCV has previously been shown to be active in multiple animal models of smallpox. Here we present the results of a randomized, blinded, placebo-controlled study of the efficacy and pharmacokinetics of a novel, "humanized" regimen of BCV for treatment of New Zealand White rabbits infected with a highly lethal inoculum of rabbitpox virus, a well characterized model of smallpox. Compared with placebo, a dose-dependent increase in survival was observed in all BCV-treatment groups. Concentrations of cidofovir diphosphate (CDV-PP), the active antiviral, in rabbit peripheral blood mononuclear cells (PBMCs) were determined for comparison to those produced in humans at the dose proposed for treatment of smallpox. CDV-PP exposure in PBMCs from rabbits given BCV scaled to human exposures at the dose proposed for treatment of smallpox, which is also currently under evaluation for other indications. The results of this study demonstrate the activity of BCV in the rabbitpox model of smallpox and the feasibility of scaling doses efficacious in the model to a proposed human dose and regimen for treatment of smallpox. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Resister's logic: the anti-vaccination arguments of Alfred Russel Wallace and their role in the debates over compulsory vaccination in England, 1870-1907.

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Fichman, Martin; Keelan, Jennifer E

2007-09-01

In the 1880s, Alfred Russel Wallace, the celebrated co-discoverer of natural selection, launched himself into the centre of a politicised and polarised debate over the unpopular compulsory vaccination laws in England. Wallace never wavered in his belief that smallpox vaccination was useless and likely dangerous. Six years before his death, the anti-vaccinationists successfully secured a conscience clause that effectively dismantled the compulsory vaccination laws. Several other important Victorian scientists joined Wallace in the fight to repeal compulsory vaccination arguing that widely held views on the effectiveness of vaccination and evidence for immunity were inconclusive in the light of (then) contemporary standards of evidence. This article situates Wallace's anti-vaccination logic within the broader matrix of sociopolitical and cultural reform movements of the late Victorian era. Additionally it provides the first detailed analysis of his critique of vaccination science, in particular the role statistics played in his arguments. In this period, both pro-vaccinationists and anti-vaccinationists invested great efforts in collating and analysing statistical data sets that either supported or refuted the claims of vaccination's effectiveness. While each side presented 'controlled' case studies to support their assertions, without an unambiguous test to measure or demonstrate vaccination's effectiveness, the anti-vaccinationists continued to mount credible statistical critiques of vaccination science.

Vaccines in historic evolution and perspective: a narrative of vaccine discoveries.

Science.gov (United States)

Hilleman, M R

2000-01-01

The sciences of vaccinology and immunology were created only two centuries ago by Jenner's scientific studies of prevention of smallpox through inoculation with cowpox virus. This rudimentary beginning was expanded greatly by the giants of late 19th- and early 20th-century biomedical sciences. The period from 1930 to 1950 was a transitional era, with the introduction of chick embryos and minced tissues for propagating viruses and rickettsiae in vitro for vaccines. Modern vaccinology began about 1950 as a continuum following notable advances made during the 1940s and World War II. Its pursuit has been based largely on breakthroughs in cell culture, bacterial polysaccharide chemistry, molecular biology, and immunology which have yielded many live and killed viral and bacterial vaccines plus the recombinant-expressed hepatitis B vaccine. The present paper was presented as a lecture given at a Meeting of the Institute of Human Virology entitled A Symposium on HIV-AIDS and Cancer Biology, Baltimore, Maryland, on August 30, 1999 and recounts, by invitation, more than 55 years of vaccine research from the venue of personal experience and attainment by the author. The paper is intentionally brief and truncated with focus only on highlights and limited referencing. Detailed recounting and referencing are given elsewhere in text references 1 and 2. This narration will have achieved its purpose if it provides a background of understanding and guidelines that will assist others who seek to engage in creation of new vaccines.

76 FR 41063 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Inclusion of...

Science.gov (United States)

2011-07-13

... DEPARTMENT OF DEFENSE Office of the Secretary 32 CFR Part 199 [DoD-2009-HA-0151; 0720-AB37] Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Inclusion of Retail... 74 FR 65436. Inclusion of vaccines under the pharmacy benefit when provided by a TRICARE retail...

Ebola hemorrhagic Fever and the current state of vaccine development.

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Hong, Joo Eun; Hong, Kee-Jong; Choi, Woo Young; Lee, Won-Ja; Choi, Yeon Hwa; Jeong, Chung-Hyeon; Cho, Kwang-Il

2014-12-01

Current Ebola virus outbreak in West Africa already reached the total number of 1,323 including 729 deaths by July 31st. the fatality is around 55% in the southeastern area of Guinea, Sierra Leone, Liberia, and Nigeria. The number of patients with Ebola Hemorrhagic Fever (EHF) was continuously increasing even though the any effective therapeutics or vaccines has not been developed yet. The Ebola virus in Guinea showed 98% homology with Zaire Ebola Virus. Study of the pathogenesis of Ebola virus infection and assess of the various candidates of vaccine have been tried for a long time, especially in United States and some European countries. Even though the attenuated live vaccine and DNA vaccine containing Ebola viral genes were tested and showed efficacy in chimpanzees, those candidates still need clinical tests requiring much longer time than the preclinical development to be approved for the practical treatment. It can be expected to eradicate Ebola virus by a safe and efficient vaccine development similar to the case of smallpox virus which was extinguished from the world by the variola vaccine.

[The world is free of pox - Implementation and success of a grandiose program].

Science.gov (United States)

Dittmann, S

1980-12-15

At the beginning of this century the compulsory vaccination and revaccination which was legally founded after the introduction of the vaccination by Jenner (1796) led to the removal of the smallpox in Europe and Northern America. However, up to the sixties in the developing countries of Asia, Africa as well as of Southern America and Middle America still fell ill and died of small-pox millions of people. Between 1953 and 1973 importations into countries of Europe and Northern America took place in 51 cases. In 1959 on the motion of the USSR the WHO decided performance of a world-wide eradication programme of small-pox which could be led to success with comprehensive personal, material and financial support of many countries. Flanking scientific, technological and methodical measures were of essential importance. In May 1980 the World Health Assembly in Geneva announced in solemn form the world-wide eradication of the small-pox and gave recommendations to the member countries for concluding measures concerning the small-pox vaccination, the foundation of vaccine reserves and the control of the epidemiological situation in the world. Also in the GDR the small-pox vaccination in childhood could be abolished.

Serological studies on an outbreak of smallpox in the State of Bahia - Brazil in 1969

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Eduardo de Azeredo Costa

1972-01-01

Full Text Available Four weeks after Containment Vaccination undertaken against the largest outbreak of smallpox occured in Brazil in 1969, that of the municipality of Utinga, Bahia, 99 samples of serum were collected from the local population. These samples were classified in four groups: a - Individuals with a history of variola prior to the beginning of present outbreak in town (15 sera; "Previous smallpox group"; b - Individuals with primary vaccination, with no record variola, at the time of containment measures (15 sera. "Primary vaccinated group"; c - Individuals with no previous record of variola revaccinated with "take" at the time of containment (15 sera0, "Revaccinated group"; d - Individuals who contracted variola in present outbreak (54 sera these were subdivided in four sub-groups, according to dates on which cases ocurred, "Variola in outbreak group". Serological study of samples was done by tests of hemagglutination inhibition, neutralization, and complement fixation. It was observed that HI titers were significantly lower in cases of previous smallpox than in other groups. Although they were slightly higher on revaccinated individuals than on primary vaccinated group and than in the group of variola in outbreak, this difference was not significant. Those same antibodies were present in all cases of variola in outbreak, and it was found that titers decreased in direct proportion to time elapsed from occurrence of cases. Neutralizing antibodies proved to be significantly higher on the revaccinated group than on variola in outbreak group, and higher on these than on primary vaccinated and on the previous smallpox groups. In cases from the variola in outbreak it was verified that neutralizing antibodies remained stable, although with great variation in titers. Tests of complement fixation could not be undertaken on all samples, because many of them proved to have anticomplementarity. However, it was found that complement fixing antibodies diminished

Infection prevention and mass vaccination training for U.S. point of dispensing staff and volunteers: a national study.

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Rebmann, Terri; Loux, Travis M; Zink, Thomas K; Swick, Zachary; Wakefield, Mary

2015-03-01

Points of dispensing (PODs) are deployed for medical countermeasure mass dispensing. However, infection prevention and vaccine administration pre-event training offered and just-in-time (JIT) education planned for POD workers have not been assessed. Disaster planners were sent an online questionnaire in 2013. McNemar tests compared training offered to staff versus volunteers and pre-event training versus JIT training. In total, 301 disaster planners participated. The most frequent pre-event training included hand hygiene (59.1% and 28.0%) and personal protective equipment (PPE) selection (52.1% and 24.1%) for staff and volunteers, respectively. Few provided pre-event training on the cold chain technique (14.8% and 5.1%) or smallpox vaccine administration (4.7% and 2.3%) for staff or volunteers. For all topics except smallpox vaccine administration, more staff than volunteers received pre-event training (P training includes hand hygiene (79.8% and 73.5%) and PPE selection (79.4% and 70.0%) to staff and volunteers. For all topics, more JIT education is planned for staff than volunteers (P training is planned than has been given pre-event for all topics (P training is needed on infection prevention and vaccine administration to ensure safe and successful POD deployment. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

The US Military Commitment to Vaccine Development: A Century of Successes and Challenges

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Silvia Ratto-Kim

2018-06-01

Full Text Available The US military has been a leading proponent of vaccine development since its founding. General George Washington ordered the entire American army to be variolated against smallpox after recognizing the serious threat that it posed to military operations. He did this on the recommendation from Dr. John Morgan, the physician-in-chief of the American army, who wrote a treatise on variolation in 1776. Although cases of smallpox still occurred, they were far fewer than expected, and it is believed that the vaccination program contributed to victory in the War of Independence. Effective military force requires personnel who are healthy and combat ready for worldwide deployment. Given the geography of US military operations, military personnel should also be protected against diseases that are endemic in potential areas of conflict. For this reason, and unknown to many, the US military has strongly supported vaccine research and development. Four categories of communicable infectious diseases threaten military personnel: (1 diseases that spread easily in densely populated areas (respiratory and dysenteric diseases; (2 vector-borne diseases (disease carried by mosquitoes and other insects; (3 sexually transmitted diseases (hepatitis, HIV, and gonorrhea; and (4 diseases associated with biological warfare. For each category, the US military has supported research that has provided the basis for many of the vaccines available today. Although preventive measures and the development of drugs have provided some relief from the burden of malaria, dengue, and HIV, the US military continues to fund research and development of prophylactic vaccines that will contribute to force health protection and global health. In the past few years, newly recognized infections with Zika, severe acute respiratory syndrome, Middle East respiratory syndrome viruses have pushed the US military to fund research and fast track clinical trials to quickly and effectively develop

Vaccine refusal - what we need to know.

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Succi, Regina Célia de Menezes

2018-04-12

Opposition to vaccines is not a new event, and appeared soon after the introduction of the smallpox vaccine in the late 18th century. The purpose of this review is to educate healthcare professionals about vaccine hesitancy and refusal, its causes and consequences, and make suggestions to address this challenge. A comprehensive and non-systematic search was carried out in the PubMed, LILACS, and ScieLo databases from 1980 to the present day, using the terms "vaccine refusal," "vaccine hesitancy," and "vaccine confidence." The publications considered as the most relevant by the author were critically selected. The beliefs and arguments of the anti-vaccine movements have remained unchanged in the past two centuries, but new social media has facilitated the dissemination of information against vaccines. Studies on the subject have intensified after 2010, but the author did not retrieve any published studies to quantify this behavior in Brazil. The nomenclature on the subject (vaccine hesitancy) was standardized by the World Health Organization in 2012. Discussions have been carried out on the possible causes of vaccine hesitancy and refusal, as well as on the behavior of families and health professionals. Proposals for interventions to decrease public doubts, clarify myths, and improve confidence in vaccines have been made. Guides for the health care professional to face the problem are emerging. The healthcare professional is a key element to transmit information, resolve doubts and increase confidence in vaccines. They must be prepared to face this new challenge. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Mistrust in Medicine: The Rise and Fall of America's First Vaccine Institute.

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Lanzarotta, Tess; Ramos, Marco A

2018-06-01

In 1813, the American government passed An Act to Encourage Vaccination, the first federal endorsement of a medical practice in American history. The law tasked a federal agent with maintaining a supply of the smallpox vaccine and distributing it nationwide. James Smith, a well-respected physician and proponent of vaccination, was appointed as vaccine agent. Smith was skeptical of claims that only well-trained physicians should be allowed to perform vaccination; he felt it was a simple procedure that should be available to all American citizens. In 1822, he made a tragic error that caused several deaths and left him vulnerable to criticism from political opponents and his medical peers. This ended Smith's professional career and led to the repeal of the act itself. In this article, we use the rise and fall of James Smith to provide a historical perspective on contemporary debates surrounding delayed vaccination schedules. We explain how physicians-in the 19th century and today-have worked to build public trust in vaccination in an American culture suspicious of medical expertise.

E3L and F1L Gene Functions Modulate the Protective Capacity of Modified Vaccinia Virus Ankara Immunization in Murine Model of Human Smallpox

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Asisa Volz

2018-01-01

Full Text Available The highly attenuated Modified Vaccinia virus Ankara (MVA lacks most of the known vaccinia virus (VACV virulence and immune evasion genes. Today MVA can serve as a safety-tested next-generation smallpox vaccine. Yet, we still need to learn about regulatory gene functions preserved in the MVA genome, such as the apoptosis inhibitor genes F1L and E3L. Here, we tested MVA vaccine preparations on the basis of the deletion mutant viruses MVA-ΔF1L and MVA-ΔE3L for efficacy against ectromelia virus (ECTV challenge infections in mice. In non-permissive human tissue culture the MVA deletion mutant viruses produced reduced levels of the VACV envelope antigen B5. Upon mousepox challenge at three weeks after vaccination, MVA-ΔF1L and MVA-ΔE3L exhibited reduced protective capacity in comparison to wildtype MVA. Surprisingly, however, all vaccines proved equally protective against a lethal ECTV infection at two days after vaccination. Accordingly, the deletion mutant MVA vaccines induced high levels of virus-specific CD8+ T cells previously shown to be essential for rapidly protective MVA vaccination. These results suggest that inactivation of the anti-apoptotic genes F1L or E3L modulates the protective capacity of MVA vaccination most likely through the induction of distinct orthopoxvirus specific immunity in the absence of these viral regulatory proteins.

Protection of mice against the highly pathogenic VVIHD-J by DNA and fowlpox recombinant vaccines, administered by electroporation and intranasal routes, correlates with serum neutralizing activity.

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Bissa, Massimiliano; Quaglino, Elena; Zanotto, Carlo; Illiano, Elena; Rolih, Valeria; Pacchioni, Sole; Cavallo, Federica; De Giuli Morghen, Carlo; Radaelli, Antonia

2016-10-01

The control of smallpox was achieved using live vaccinia virus (VV) vaccine, which successfully eradicated the disease worldwide. As the variola virus no longer exists as a natural infection agent, mass vaccination was discontinued after 1980. However, emergence of smallpox outbreaks caused by accidental or deliberate release of variola virus has stimulated new research for second-generation vaccine development based on attenuated VV strains. Considering the closely related animal poxviruses that also arise as zoonoses, and the increasing number of unvaccinated or immunocompromised people, a safer and more effective vaccine is still required. With this aim, new vectors based on avian poxviruses that cannot replicate in mammals should improve the safety of conventional vaccines, and protect from zoonotic orthopoxvirus diseases, such as cowpox and monkeypox. In this study, DNA and fowlpox (FP) recombinants that expressed the VV L1R, A27L, A33R, and B5R genes were generated (4DNAmix, 4FPmix, respectively) and tested in mice using novel administration routes. Mice were primed with 4DNAmix by electroporation, and boosted with 4FPmix applied intranasally. The lethal VV IHD-J strain was then administered by intranasal challenge. All of the mice receiving 4DNAmix followed by 4FPmix, and 20% of the mice immunized only with 4FPmix, were protected. The induction of specific humoral and cellular immune responses directly correlated with this protection. In particular, higher anti-A27 antibodies and IFNγ-producing T lymphocytes were measured in the blood and spleen of the protected mice, as compared to controls. VV IHD-J neutralizing antibodies in sera from the protected mice suggest that the prime/boost vaccination regimen with 4DNAmix plus 4FPmix may be an effective and safe mode to induce protection against smallpox and poxvirus zoonotic infections. The electroporation/intranasal administration routes contributed to effective immune responses and mouse survival. Copyright �

Characterization of Two Historic Smallpox Specimens from a Czech Museum.

Science.gov (United States)

Pajer, Petr; Dresler, Jiri; Kabíckova, Hana; Písa, Libor; Aganov, Pavel; Fucik, Karel; Elleder, Daniel; Hron, Tomas; Kuzelka, Vitezslav; Velemínsky, Petr; Klimentova, Jana; Fucikova, Alena; Pejchal, Jaroslav; Hrabakova, Rita; Benes, Vladimir; Rausch, Tobias; Dundr, Pavel; Pilin, Alexander; Cabala, Radomir; Hubalek, Martin; Stríbrny, Jan; Antwerpen, Markus H; Meyer, Hermann

2017-07-27

Although smallpox has been known for centuries, the oldest available variola virus strains were isolated in the early 1940s. At that time, large regions of the world were already smallpox-free. Therefore, genetic information of these strains can represent only the very last fraction of a long evolutionary process. Based on the genomes of 48 strains, two clades are differentiated: Clade 1 includes variants of variola major, and clade 2 includes West African and variola minor (Alastrim) strains. Recently, the genome of an almost 400-year-old Lithuanian mummy was determined, which fell basal to all currently sequenced strains of variola virus on phylogenetic trees. Here, we determined two complete variola virus genomes from human tissues kept in a museum in Prague dating back 60 and 160 years, respectively. Moreover, mass spectrometry-based proteomic, chemical, and microscopic examinations were performed. The 60-year-old specimen was most likely an importation from India, a country with endemic smallpox at that time. The genome of the 160-year-old specimen is related to clade 2 West African and variola minor strains. This sequence likely represents a new endemic European variant of variola virus circulating in the midst of the 19th century in Europe.

Operationalizing Civilian Protection in Mali: The Case for a Civilian Casualty Tracking, Analysis, and Response Cell

Directory of Open Access Journals (Sweden)

Marla B. Keenan

2013-06-01

Full Text Available This practice note details an emerging best practice of civilian harm mitigation in armed conflict: namely, the creation of civilian casualty tracking, analysis and response processes by a warring party or peace operation force. It asserts that in Iraq, Afghanistan and soon Somalia, these processes to better understand civilian harm and address consequences have positively shaped mission tactics, training, and overall operations. In both Iraq and Afghanistan, tracking and analysis has lead to a marked decrease in civilian casualties and facilitated the making of amends for any civilian losses. The paper argues that for warring parties to achieve their mission—particularly one with a protection of civilians mandate as with the United Nations Multidimensional Integrated Stabilization Mission in Mali (MINUSMA—they must fully understand the impact of their actions on the civilian population, positive or negative. For this reason, a Civilian Casualty Tracking, Analysis, and Response Cell should be created for MINUSMA to improve its ability mitigate risk to civilians as required by its Security Council mandate.

Impact of imitation processes on the effectiveness of ring vaccination.

Science.gov (United States)

Wells, Chad R; Tchuenche, Jean M; Meyers, Lauren Ancel; Galvani, Alison P; Bauch, Chris T

2011-11-01

Ring vaccination can be a highly effective control strategy for an emerging disease or in the final phase of disease eradication, as witnessed in the eradication of smallpox. However, the impact of behavioural dynamics on the effectiveness of ring vaccination has not been explored in mathematical models. Here, we analyze a series of stochastic models of voluntary ring vaccination. Contacts of an index case base vaccinating decisions on their own individual payoffs to vaccinate or not vaccinate, and they can also imitate the behaviour of other contacts of the index case. We find that including imitation changes the probability of containment through ring vaccination considerably. Imitation can cause a strong majority of contacts to choose vaccination in some cases, or to choose non-vaccination in other cases-even when the equivalent solution under perfectly rational (non-imitative) behaviour yields mixed choices. Moreover, imitation processes can result in very different outcomes in different stochastic realizations sampled from the same parameter distributions, by magnifying moderate tendencies toward one behaviour or the other: in some realizations, imitation causes a strong majority of contacts not to vaccinate, while in others, imitation promotes vaccination and reduces the number of secondary infections. Hence, the effectiveness of ring vaccination can depend significantly and unpredictably on imitation processes. Therefore, our results suggest that risk communication efforts should be initiated early in an outbreak when ring vaccination is to be applied, especially among subpopulations that are heavily influenced by peer opinions.

Differential antigen requirements for protection against systemic and intranasal vaccinia virus challenges in mice

NARCIS (Netherlands)

Kaufman, David R.; Goudsmit, Jaap; Holterman, Lennart; Ewald, Bonnie A.; Denholtz, Matthew; Devoy, Colleen; Giri, Ayush; Grandpre, Lauren E.; Heraud, Jean-Michel; Franchini, Genoveffa; Seaman, Michael S.; Havenga, Menzo J. E.; Barouch, Dan H.

2008-01-01

The development of a subunit vaccine for smallpox represents a potential strategy to avoid the safety concerns associated with replication-competent vaccinia virus. Preclinical studies to date with subunit smallpox vaccine candidates, however, have been limited by incomplete information regarding

42 CFR 102.50 - Medical records necessary to establish that a covered injury was sustained.

Science.gov (United States)

2010-10-01

... HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation To Be Deemed... to establish that a smallpox vaccine recipient or vaccinia contact sustained a covered injury, a... records, including the admission history and physical examination, the discharge summary, all physician...

What is Wrong in Killing Civilians?

OpenAIRE

Majima, Shunzo

2009-01-01

In this article, we examine the status of civilians in the ethical context. For this purpose, we explore the ethical sources that address their status; specifically, we consider the ethical reasons that civilians should be protected in armed conflict by examining ethical concepts that could differentiate civilians from combatants and justify the protection of civilians. In order to assess how the status of civilians can be characterised and their protection justified by ethical concepts, we e...

Transmission patterns of smallpox: systematic review of natural outbreaks in Europe and North America since World War II

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Boer Rob

2006-05-01

Full Text Available Abstract Background Because smallpox (variola major may be used as a biological weapon, we reviewed outbreaks in post-World War II Europe and North America in order to understand smallpox transmission patterns. Methods A systematic review was used to identify papers from the National Library of Medicine, Embase, Biosis, Cochrane Library, Defense Technical Information Center, WorldCat, and reference lists of included publications. Two authors reviewed selected papers for smallpox outbreaks. Results 51 relevant outbreaks were identified from 1,389 publications. The median for the effective first generation reproduction rate (initial R was 2 (range 0–38. The majority outbreaks were small (less than 5 cases and contained within one generation. Outbreaks with few hospitalized patients had low initial R values (median of 1 and were prolonged if not initially recognized (median of 3 generations; outbreaks with mostly hospitalized patients had higher initial R values (median 12 and were shorter (median of 3 generations. Index cases with an atypical presentation of smallpox were less likely to have been diagnosed with smallpox; outbreaks in which the index case was not correctly diagnosed were larger (median of 27.5 cases and longer (median of 3 generations compared to outbreaks in which the index case was correctly diagnosed (median of 3 cases and 1 generation. Conclusion Patterns of spread during Smallpox outbreaks varied with circumstances, but early detection and implementation of control measures is a most important influence on the magnitude of outbreaks. The majority of outbreaks studied in Europe and North America were controlled within a few generations if detected early.

Transmission patterns of smallpox: Systematic review of natural outbreaks in Europe and North America since World War II

NARCIS (Netherlands)

V. Bhatnagar (Vibha); M.A. Stoto (Michael); S.C. Morton (Sally); R. Boer (Rob); S.A. Bozzette (Samuel)

2006-01-01

textabstractBackground: Because smallpox (variola major) may be used as a biological weapon, we reviewed outbreaks in post-World War II Europe and North America in order to understand smallpox transmission patterns. Methods: A systematic review was used to identify papers from the National Library

Study of adverse events following immunisation with universal and newer vaccines in the Serampore IMA Child Clinic over a period of 7 years.

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Das, Pradip Kumar

2013-04-01

Immunisation is an important part of childcare practice. It is one of the most beneficial and cost effective measures for the prevention of diseases. From the previous retrospective studies, it was evident that smallpox has been completely eradicated throughout now-a-days with the wholehearted and sincere efforts of healthcare providers by applying efficient and safe vaccine against smallpox, same is true also to polio which is now close to worldwide eradication and measles and rubella are no longer endemic in certain parts of the world. Not only has that with the introduction of safer and more efficient newer vaccines, the incidence of most other vaccine preventable disease of childhood also reduced considerably. The aim of the present study is to estimate the incidence and clinical presentation of adverse events following immunisation with universal and newer vaccines for a period of seven years using prospective active surveillance. Children under the age of 7 years were taken for universal and newer scheduled vaccinations given in the Serampore IMA Child Clinic under the supervision of the clinicians maintaining strictly the guidelines of Expanded Programme of Immunisation (Government of India). This study of adverse events following immunisation in the Serampore IMA Child Clinic confirms that the adverse events such as fever (0.37%), pain and swelling at the site of injection (0.32%0, urticarial rash (0.02%), anaphylactic shock (0.003%) are negligible. There were only two reports of anaphylaxis following preschool and infant schedule vaccines, including measles, mumps and rubella (MMR), Haemophilus influenzae type B vaccines and typhoid vaccines in approximately 52,000 infants received over a period of 7 years starting from 1st April, 2005 to 31st March, 2012 and there were no deaths or longterm effects reported during the post follow-up period in the Serampore IMA Child Clinic.

[Small pox--infection, therapy and anaesthesiological management (part 1)].

Science.gov (United States)

Langefeld, T W; Engel, J; Menges, T; Hempelmann, G

2003-07-01

Smallpox is an acute contagious and sometimes fatal infectious disease. It is caused by the variola-virus. Smallpox is characterized by a typical disease form with a progressive distinctive skin rash, especially at face, arms and legs. Smallpox has a fatality rate of about 30 % and the therapy of infected patients is only symptomatically. As prevention the WHO initiated worldwide vaccination programs in the year 1967. The last naturally occurring case of smallpox in the world was in Somalia in 1977. Since then the only known cases of smallpox happened from an outbreak in Birmingham, England caused by a laboratory accident in the year of 1979. On May the 8 th 1980 the disease was declared as eliminated from the world by the WHO (WHO-Resolution 33.33). A natural occurrence of the variola-virus seems to be not given. Nevertheless the virus exists for research in two laboratories, the American Centers of Disease Control and Prevention in Atlanta, Georgia and in the Russian Research Center for Virology and Biotechnics in Kolzowo, Sibiria. Threatening infections with smallpox or other microorganisms, used as bioweapons, get a new dimension through global terrorism. The variola-virus represents an optimal candidate for bioweapons. It is easy to replicate, it is highly contagious and the transmission over aerosol or direct contact from man to man is easy to handle. After the disease was eliminated from the world, routine vaccination among general public was stopped. Therefore younger people don't possess any vaccination protection. Older formerly vaccinated people probably have only a non-sufficient protection. Because of the smallpox elimination a lot of physicians have no experience with this disease. An outbreak of this smallpox isn't only controlled by new vaccination. In our times we need adapted prevention-standards, pox-alarm plans and quarantine standards.

Comparing Civilian Support for Terrorism

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Srobana Bhattacharya

2017-06-01

Full Text Available Terrorism is an extreme form of political violence, that is inherently abhorrent in nature. Yet, it continues to attain enough support to continue and survive. The recent proliferation of Islamic State and its ever increasing domestic and international civilian support base urges immediate attention to this question. While most research holds that provision of public goods by terrorist groups is the primary cause for high levels of civilian support, I argue that, terrorist groups are more interested in resource extraction rather than resource provision. Additionally, these studies pay scant attention to existing resource structure, especially territorial and political control to explain terrorist-civilian interaction. This paper emphasizes the bi-directional nature of this interaction – a. perception of civilians by the terrorist group and b. terrorist group’s perception of the civilians. To analyze levels of civilian support for terrorism, I compare fifteen terrorist groups using qualitative comparative analysis and show how territory, political competition, ethnicity, target selection and organizational structure combine to explain conditions that lead terrorist groups to include or exclude civilian population for support. Based on the variance in support networks of terrorist groups, counter-terrorism policies should also differ. High civilian support indicates the need to use non-military methods to decrease the appeal of terrorist groups. However, terrorist groups with more diffused and multiple support structures need more collaborative and coercive measures to intercept all the possible links to the main group.

Viral vaccines and their manufacturing cell substrates: New trends and designs in modern vaccinology.

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Rodrigues, Ana F; Soares, Hugo R; Guerreiro, Miguel R; Alves, Paula M; Coroadinha, Ana S

2015-09-01

Vaccination is one of the most effective interventions in global health. The worldwide vaccination programs significantly reduced the number of deaths caused by infectious agents. A successful example was the eradication of smallpox in 1979 after two centuries of vaccination campaigns. Since the first variolation administrations until today, the knowledge on immunology has increased substantially. This knowledge combined with the introduction of cell culture and DNA recombinant technologies revolutionized vaccine design. This review will focus on vaccines against human viral pathogens, recent developments on vaccine design and cell substrates used for their manufacture. While the production of attenuated and inactivated vaccines requires the use of the respective permissible cell substrates, the production of recombinant antigens, virus-like particles, vectored vaccines and chimeric vaccines requires the use - and often the development - of specific cell lines. Indeed, the development of novel modern viral vaccine designs combined with, the stringent safety requirements for manufacture, and the better understanding on animal cell metabolism and physiology are increasing the awareness on the importance of cell line development and engineering areas. A new era of modern vaccinology is arriving, offering an extensive toolbox to materialize novel and creative ideas in vaccine design and its manufacture. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Susceptibility of Marmosets (Callithrix jacchus) to Monkeypox Virus: A Low Dose Prospective Model for Monkeypox and Smallpox Disease.

Science.gov (United States)

Mucker, Eric M; Chapman, Jennifer; Huzella, Louis M; Huggins, John W; Shamblin, Joshua; Robinson, Camenzind G; Hensley, Lisa E

2015-01-01

Although current nonhuman primate models of monkeypox and smallpox diseases provide some insight into disease pathogenesis, they require a high titer inoculum, use an unnatural route of infection, and/or do not accurately represent the entire disease course. This is a concern when developing smallpox and/or monkeypox countermeasures or trying to understand host pathogen relationships. In our studies, we altered half of the test system by using a New World nonhuman primate host, the common marmoset. Based on dose finding studies, we found that marmosets are susceptible to monkeypox virus infection, produce a high viremia, and have pathological features consistent with smallpox and monkeypox in humans. The low dose (48 plaque forming units) required to elicit a uniformly lethal disease and the extended incubation (preclinical signs) are unique features among nonhuman primate models utilizing monkeypox virus. The uniform lethality, hemorrhagic rash, high viremia, decrease in platelets, pathology, and abbreviated acute phase are reflective of early-type hemorrhagic smallpox.

Disease: H00372 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H00372 Smallpox; Variola Smallpox is a contagious disease caused by the variola vi...al varieties of smallpox: variola major with a case fatality rate of 30% and variola minor with milder severity. Smallpox... millions of people. Infectious disease ... Variola virus [GN:T40082] ... Smallpox vaccine [DR:D05295] ... ICD-10: ...URNAL ... Dev Biol Stand 100:31-7 (1999) ... PMID:9795781 (description, env_factor) ... AUTHORS ... Ellner PD ... TITLE ... Smallpox

[The royal philanthropic expedition of the vaccine (Xavier de Balmis/Josep Salvany). 1803-1806].

Science.gov (United States)

Botet, Francesc Asensi

2009-12-01

Six years after Jenner discovered the anti-smallpox vaccine, King Charles IV mandated the initiation of vaccination campaigns throughout his kingdom. The overseas campaign was coordinated by the Valencian military doctor Xavier de Balmis with the aid of the Catalan Josep Salvany. The vaccine was transported to America "in vivo" in 22 children. The expedition departed from La Coruña on November 1806 and arrived to the Venezuelan port of La Guayra where it was split in two: One sub expedition under the order of Josep Salvany, continued by land to Colombia, Ecuador, Peru and Bolivia. Salvany died in the Bolivian city of Cochabamba. The other sub expedition, leaded by Balmis himself, continued by sea to Cuba and Mexico. From Acapulco it arrived to Manila and from there to Macau followed by inland penetration into China.

Disease, religion and medicine: smallpox in nineteenth-century Benin Doenças, religião e medicina: a varíola no Benim, século XIX

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Elisée Soumonni

2012-12-01

Full Text Available The essay examines, with special reference to smallpox, the perception and interpretation of disease in pre-colonial Dahomey, present-day Republic of Benin. Because disease is seen primarily as a punishment from the gods and not just as a medical problem or a bodily disorder, traditional cult priests play a leading role in making diagnoses and prescribing remedies, mostly based on medicinal plants. The prominence of Sakpata, god of smallpox, coupled with the influence of its priests is evaluated within the context of Dahomey's political history and the spread of the disease. This pivotal position was to constitute a challenge to the French colonial campaign to vaccinate against smallpox.O ensaio examina - com especial atenção à varíola - as percepções e interpretações das doenças no Daomé pré-colonial, atual República do Benim. Uma vez que as doenças eram vistas antes de tudo como punição divina, e não como problema ou distúrbio do corpo, os sacerdotes tradicionais exerciam papel central no seu diagnóstico e na prescrição de remédios, com base principalmente em plantas medicinais. A importância do culto a Sakpata, deus da varíola, juntamente com a influência dos sacerdotes é avaliada dentro do contexto da história política do Daomé e da disseminação das doenças. A posição crucial desse culto constituiu-se como um desafio para a campanha colonial francesa de vacinação contra a varíola.

Vaccinations against smallpox and tuberculosis are associated with better long-term survival

DEFF Research Database (Denmark)

Rieckmann, Andreas; Villumsen, Marie; Sørup, Signe

2017-01-01

to natural causes of death; those who only received BCG had an aHR of 0.58 (95% CI: 0.39-0.85). Vaccinia and BCG were not associated with any protection against deaths by accidents, suicide or murder, the combined aHR being 0.94 (95% CI: 0.62-1.42). CONCLUSIONS: Vaccinia and BCG vaccinations were associated...

Jennerian vaccination and the creation of a national public health agenda in Japan, 1850-1900.

Science.gov (United States)

Jannetta, Ann

2009-01-01

Vaccination played a leading role in transforming the social and political status of medicine in Japanese society in the second half of the nineteenth century. The process began well before the Meiji Restoration of 1868 created a centralized government under the Japanese emperor. At the beginning of the century, medicine was a private business. There was no oversight from an interested government, and there were no medical societies or journals in which to debate and formulate opinion about medical practice. Medical knowledge was transmitted privately through personal lineage structures whose members jealously guarded their medical techniques. For almost a half century before live vaccine could be imported, knowledge of vaccination was limited to a small group of Japanese physicians who could read Dutch. This special knowledge created a medical elite whose members managed the transmission of vaccination after the vaccine arrived, and dominated the new medical and public health bureaucracies created by the Meiji state. By the end of the century, a rigorous vaccination program was in place, smallpox mortality had fallen, and Japan's Western-oriented physicians were in control of a national public health bureaucracy that could monitor the vaccination status of individuals in households throughout Japan.

Antiviral treatment is more effective than smallpox vaccination upon lethal monkeypox virus infection

Czech Academy of Sciences Publication Activity Database

Stittelaar, K. J.; Neyts, J.; Naesens, L.; Amerongen van, G.; Lavieren van, R. F.; Holý, Antonín; De Clercq, E.; Niesters, H. G. M.; Fries, E.; Maas, Ch.; Mulder, P. G. H.; Zeijst van der, B. A. M.; Osterhaus, D. M. E.

2006-01-01

Roč. 439, č. 7077 (2006), s. 745-748 ISSN 0028-0836 Institutional research plan: CEZ:AV0Z40550506 Keywords : monkeypox virus * vaccination * HPMPC * HPMPO-DAPy Subject RIV: CC - Organic Chemistry Impact factor: 26.681, year: 2006

Vaccination and the TAP-independent antigen processing pathways.

Science.gov (United States)

López, Daniel; Lorente, Elena; Barriga, Alejandro; Johnstone, Carolina; Mir, Carmen

2013-09-01

The cytotoxic CD8(+) T lymphocyte-mediated cellular response is important for the elimination of virus-infected cells and requires the prior recognition of short viral peptide antigens previously translocated to the endoplasmic reticulum by the transporter associated with antigen processing (TAP). However, individuals with nonfunctional TAP complexes or infected cells with TAP molecules blocked by specific viral proteins, such as the cowpoxvirus, a component of the first source of early empirical vaccination against smallpox, are still able to present several HLA class I ligands generated by the TAP-independent antigen processing pathways to specific cytotoxic CD8(+) T lymphocytes. Currently, bioterrorism and emerging infectious diseases have renewed interest in poxviruses. Recent works that have identified HLA class I ligands and epitopes in virus-infected TAP-deficient cells have implications for the study of both the effectiveness of early empirical vaccination and the analysis of HLA class I antigen processing in TAP-deficient subjects.

Military Versus Civilian Murder-Suicide.

Science.gov (United States)

Patton, Christina L; McNally, Matthew R; Fremouw, William J

2015-07-03

Previous studies have implicated significant differences between military members and civilians with regard to violent behavior, including suicide, domestic violence, and harm to others, but none have examined military murder-suicide. This study sought to determine whether there were meaningful differences between military and civilian murder-suicide perpetrators. Using data from the Center for Disease Control's (CDC) National Violent Death Reporting System (NVDRS), military (n = 259) and civilian (n = 259) murder-suicide perpetrators were compared on a number of demographic, psychological, and contextual factors using chi-square analyses. Logistic regression was used to determine which variables predicted membership to the military or civilian perpetrator groups. Military murder-suicide perpetrators were more likely to be older, have physical health problems, be currently or formerly married, less likely to abuse substances, and to exhibit significantly different motives than civilian perpetrators. Logistic regression revealed that membership to the military, rather than the civilian, perpetrator group was predicted by age, physical health problems, and declining heath motive-reflecting the significance of a more than 15-year difference in mean age between the two groups. Findings point to the need to tailor suicide risk assessments to include questions specific to murder-suicide, to assess attitudes toward murder-suicide, and to the importance of assessing suicide and violence risk in older adult military populations. © The Author(s) 2015.

Vaccines Through Centuries: Major Cornerstones of Global Health

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Inaya eHajj Hussein

2015-11-01

Full Text Available Multiple cornerstones have shaped the history of vaccines, which may contain live attenuated viruses, inactivated organisms/viruses, inactivated toxins, or merely segments of the pathogen that could elicit an immune response.The story began with Hippocrates 400 B.C. with his description of mumps and diphtheria. No further discoveries were recorded until 1100 A.D. when the smallpox vaccine was described. During the 18th century, vaccines for cholera and yellow fever were reported and Edward Jenner, the father of vaccination and immunology, published his work on small pox.The 19th century was a major landmark, with the Germ Theory of disease of Louis Pasteur, the discovery of the germ tubercle bacillus for tuberculosis by Robert Koch, and the isolation of pneumococcus organism by George Miller Sternberg. Another landmark was the discovery of diphtheria toxin by Emile Roux and its serological treatment by Emil Von Behring and Paul Ehrlih. In addition, Pasteur was able to generate the first live attenuated viral vaccine against rabies. Typhoid vaccines were then developed, followed by the plague vaccine of Yersin. At the beginning of World War I, the tetanus toxoid was introduced, followed in 1915 by the pertussis vaccine. In 1974, The Expanded Program of Immunization was established within the WHO for BCG, Polio, DTP, measles, yellow fever and hepatitis B. The year 1996 witnessed the launching of the International AIDS Vaccine Initiative. In 1988, the WHO passed a resolution to eradicate polio by the year 2000 and in 2006; the first vaccine to prevent cervical cancer was developed. In 2010 The Decade of vaccines was launched, and on April 1st 2012, the United Nations launched the shot@Life campaign. In brief, the armamentarium of vaccines continues to grow with more emphasis on safety, availability and accessibility. This mini review highlights the major historical events and pioneers in the course of development of vaccines, which have eradicated

Smallpox in the modern scientific and colonial contexts 1721–1840

Indian Academy of Sciences (India)

2011-09-23

Sep 23, 2011 ... Home; Journals; Journal of Biosciences; Volume 36; Issue 5. Smallpox in the modern scientific and colonial contexts 1721–1840. Rajesh Kochhar. Perspectives Volume 36 Issue 5 December 2011 pp 761-768. Fulltext. Click here to view fulltext PDF. Permanent link:

Characterization of Two Historic Smallpox Specimens from a Czech Museum

Czech Academy of Sciences Publication Activity Database

Pajer, P.; Dresler, J.; Kabickova, H.; Píša, L.; Aganov, P.; Fucik, K.; Elleder, Daniel; Hron, Tomáš; Kuželka, V.; Velemínský, P.; Klimentová, J.; Fučíková, A.; Pejchal, J.; Hrabáková, Rita; Beneš, V.; Rausch, T.; Dundr, P.; Pilin, A.; Čabala, R.; Hubálek, Martin; Stříbrný, J.; Antwerpen, M.H.; Meyer, H.

2017-01-01

Roč. 9, č. 8 (2017), č. článku 200. ISSN 1999-4915 Institutional support: RVO:68378050 ; RVO:67985904 ; RVO:61388963 Keywords : smallpox * variola virus * evolution * next generation suquencing * historic specimen * phylogeny Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Virology; Virology (UZFG-Y); Virology (UOCHB-X) Impact factor: 3.465, year: 2016

46 CFR 168.10-5 - Civilian nautical school.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Civilian nautical school. 168.10-5 Section 168.10-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS CIVILIAN NAUTICAL SCHOOL VESSELS Definitions of Terms Used in This Part § 168.10-5 Civilian nautical school. The term civilian...

Bioterrorism and Smallpox: Policies, Practices, and Implications for Social Work

Science.gov (United States)

Mackelprang, Romel W.; Mackelprang, Romel D.; Thirkill, Ashley D.

2005-01-01

Terrorist acts and the fear of terrorism have become a part of everyday life in the early 21st century. Among the threats most feared is bioterrorism, including the intentional release of smallpox. With the invasion of Iraq and toppling of the Saddam Hussein regime, acute bioterrorism fears have abated; however, an ongoing threat remains. This…

The dichotomy of pathogens and allergens in vaccination approaches

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Fiona J. Baird

2014-07-01

Full Text Available Traditional prophylactic vaccination to prevent illness is the primary objective of many research activities worldwide. The golden age of vaccination began with an approach called variolation in ancient China and the evolution of vaccines still continues today with modern developments such as the production of Gardasil™ against HPV and cervical cancer. The historical aspect of how different forms of vaccination have changed the face of medicine and communities is important as it dictates our future approaches on both a local and global scale. From the eradication of smallpox to the use of an experimental vaccine to save a species, this review will explore these successes in infectious disease vaccination and also discuss a few significant failures which have hampered our efforts to eradicate certain diseases. The second part of the review will explore designing a prophylactic vaccine for the growing global health concern that is allergy. Allergies are an emerging global health burden. Of particular concern is the rise of food allergies in developed countries where 1 in 10 children is currently affected. The formation of an allergic response results from the recognition of a foreign component by our immune system that is usually encountered on a regular basis. This may be a dust-mite or a prawn but this inappropriate immune response can result in a life-time of food avoidance and lifestyle restrictions. These foreign components are very similar to antigens derived from infectious pathogens. The question arises: should the allergy community be focussing on protective measures rather than ongoing therapeutic interventions to deal with these chronic inflammatory conditions? We will explore the difficulties and benefits of prophylactic vaccination against various allergens by means of genetic technology that will dictate how vaccination against allergens could be utilised in the near future.

Acute Disseminated Encephalomyelitis following Vaccination against Hepatitis B in a Child: A Case Report and Literature Review

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Jun-liang Yuan

2016-01-01

Full Text Available Acute disseminated encephalomyelitis (ADEM is an inflammatory demyelinating disease of the central nervous system, which has been associated with several vaccines such as rabies, diphtheria-tetanus-polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, and the Hog vaccine. Here, we presented a case of 12-year-old child who suffered from ADEM three weeks after hepatitis B vaccination. He was admitted to our hospital with symptoms of weakness of limbs, high fever, and alteration of consciousness. Some abnormalities were also found in CSF. Treatment with high-dose corticosteroids and intravenous immunoglobulin had significant effect, with marked improvement of the clinical symptoms and the results of CSF. The findings of MRI also detected some abnormal lesions located in both brain and spinal cord. The clinical features, the findings of CSF and MRI, and therapeutic effect may contribute to such diagnosis of ADEM.

Management of civilian ballistic fractures.

Science.gov (United States)

Seng, V S; Masquelet, A C

2013-12-01

The management of ballistic fractures, which are open fractures, has often been studied in wartime and has benefited from the principles of military surgery with debridement and lavage, and the use of external fixation for bone stabilization. In civilian practice, bone stabilization of these fractures is different and is not performed by external fixation. Fifteen civilian ballistic fractures, Gustilo II or IIIa, two associated with nerve damage and none with vascular damage, were reviewed. After debridement and lavage, ten internal fixations and five conservative treatments were used. No superficial or deep surgical site infection was noted. Fourteen of the 15 fractures (93%) healed without reoperation. Eleven of the 15 patients (73%) regained normal function. Ballistic fractures have a bad reputation due to their many complications, including infections. In civilian practice, the use of internal fixation is not responsible for excessive morbidity, provided debridement and lavage are performed. Civilian ballistic fractures, when they are caused by low-velocity firearms, differ from military ballistic fractures. Although the principle of surgical debridement and lavage remains the same, bone stabilization is different and is similar to conventional open fractures. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

32 CFR 700.320 - The Civilian Executive Assistants.

Science.gov (United States)

2010-07-01

... the Navy. (b) Each Civilian Executive Assistants, within his or her assigned area of responsibility... 32 National Defense 5 2010-07-01 2010-07-01 false The Civilian Executive Assistants. 700.320... of the Navy The Office of the Secretary of the Navy/the Civilian Executive Assistants § 700.320 The...

32 CFR 191.7 - Civilian EEO program staff.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...

Air Force Civilian Senior Leadership Development Challenges

National Research Council Canada - National Science Library

Webb, Billy P

2008-01-01

.... While Gen Jumper's sight picture recognizes the need to grow civilians for leadership positions, there is a more compelling reason for the Air Force to focus on civilian leadership development...

Using ICR and SCID mice as animal models for smallpox to assess antiviral drug efficacy.

Science.gov (United States)

Titova, Ksenya A; Sergeev, Alexander A; Zamedyanskaya, Alena S; Galahova, Darya O; Kabanov, Alexey S; Morozova, Anastasia A; Bulychev, Leonid E; Sergeev, Artemiy A; Glotova, Tanyana I; Shishkina, Larisa N; Taranov, Oleg S; Omigov, Vladimir V; Zavjalov, Evgenii L; Agafonov, Alexander P; Sergeev, Alexander N

2015-09-01

The possibility of using immunocompetent ICR mice and immunodeficient SCID mice as model animals for smallpox to assess antiviral drug efficacy was investigated. Clinical signs of the disease did not appear following intranasal (i.n.) challenge of mice with strain Ind-3a of variola virus (VARV), even when using the highest possible dose of the virus (5.2 log10 p.f.u.). The 50 % infective doses (ID50) of VARV, estimated by the virus presence or absence in the lungs 3 and 4 days post-infection, were 2.7 ± 0.4 log10 p.f.u. for ICR mice and 3.5 ± 0.7 log10 p.f.u. for SCID mice. After i.n. challenge of ICR and SCID mice with VARV 30 and 50 ID50, respectively, steady reproduction of the virus occurred only in the respiratory tract (lungs and nose). Pathological inflammatory destructive changes were revealed in the respiratory tract and the primary target cells for VARV (macrophages and epithelial cells) in mice, similar to those in humans and cynomolgus macaques. The use of mice to assess antiviral efficacies of NIOCH-14 and ST-246 demonstrated the compliance of results with those described in scientific literature, which opens up the prospect of their use as an animal model for smallpox to develop anti-smallpox drugs intended for humans.

Protection of Mice from Lethal Vaccinia Virus Infection by Vaccinia Virus Protein Subunits with a CpG Adjuvant

Directory of Open Access Journals (Sweden)

Sarah Reeman

2017-12-01

Full Text Available Smallpox vaccination carries a high risk of adverse events in recipients with a variety of contra-indications for live vaccines. Although alternative non-replicating vaccines have been described in the form of replication-deficient vaccine viruses, DNA vaccines, and subunit vaccines, these are less efficacious than replicating vaccines in animal models. DNA and subunit vaccines in particular have not been shown to give equivalent protection to the traditional replicating smallpox vaccine. We show here that combinations of the orthopoxvirus A27, A33, B5 and L1 proteins give differing levels of protection when administered in different combinations with different adjuvants. In particular, the combination of B5 and A27 proteins adjuvanted with CpG oligodeoxynucleotides (ODN gives a level of protection in mice that is equivalent to the Lister traditional vaccine in a lethal vaccinia virus challenge model.

The origins of the vaccine cold chain and a glimpse of the future.

Science.gov (United States)

Lloyd, John; Cheyne, James

2017-04-19

International efforts to eradicate smallpox in the 1960s and 1970s provided the foundation for efforts to expand immunization programmes, including work to develop immunization supply chains. The need to create a reliable system to keep vaccines cold during the lengthy journey from the manufacturer to the point of use, even in remote areas, was a crucial concern during the early days of the Expanded Programme on Immunization. The vaccine cold chain was deliberately separated from other medical distribution systems to assure timely access to and control of vaccines and injection materials. The story of the early development of the vaccine cold chain shows how a number of challenges were overcome with technological and human resource solutions. For example, the lack of methods to monitor exposure of vaccines to heat during transport and storage led to many innovations, including temperature-sensitive vaccine vial monitors and better methods to record and communicate temperatures in vaccine stores. The need for appropriate equipment to store and transport vaccines in tropical developing countries led to innovations in refrigeration equipment as well as the introduction and widespread adoption of novel high performance vaccine cold-boxes and carriers. New technologies also helped to make injection safer. Underlying this work on technologies and equipment was a major effort to develop the human resources required to manage and implement the immunization supply chain. This included creating foundational policies and a management infrastructure; providing training for managers, health workers, technicians, and others. The vaccine cold chain has contributed to one of the world's public health success stories and provides three priority lessons for future: the vaccine supply chain needs to be integrated with other public health supplies, re-designed for efficiency and effectiveness and work is needed in the longer term to eliminate the need for refrigeration in the supply

Progression of pathogenic events in cynomolgus macaques infected with variola virus.

Directory of Open Access Journals (Sweden)

Victoria Wahl-Jensen

Full Text Available Smallpox, caused by variola virus (VARV, is a devastating human disease that affected millions worldwide until the virus was eradicated in the 1970 s. Subsequent cessation of vaccination has resulted in an immunologically naive human population that would be at risk should VARV be used as an agent of bioterrorism. The development of antivirals and improved vaccines to counter this threat would be facilitated by the development of animal models using authentic VARV. Towards this end, cynomolgus macaques were identified as adequate hosts for VARV, developing ordinary or hemorrhagic smallpox in a dose-dependent fashion. To further refine this model, we performed a serial sampling study on macaques exposed to doses of VARV strain Harper calibrated to induce ordinary or hemorrhagic disease. Several key differences were noted between these models. In the ordinary smallpox model, lymphoid and myeloid hyperplasias were consistently found whereas lymphocytolysis and hematopoietic necrosis developed in hemorrhagic smallpox. Viral antigen accumulation, as assessed immunohistochemically, was mild and transient in the ordinary smallpox model. In contrast, in the hemorrhagic model antigen distribution was widespread and included tissues and cells not involved in the ordinary model. Hemorrhagic smallpox developed only in the presence of secondary bacterial infections - an observation also commonly noted in historical reports of human smallpox. Together, our results support the macaque model as an excellent surrogate for human smallpox in terms of disease onset, acute disease course, and gross and histopathological lesions.

20 CFR 609.20 - Information to Federal civilian employees.

Science.gov (United States)

2010-04-01

... UNEMPLOYMENT COMPENSATION FOR FEDERAL CIVILIAN EMPLOYEES Responsibilities of Federal Agencies § 609.20 Information to Federal civilian employees. Each Federal agency shall: (a) Furnish information to its employees... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Information to Federal civilian employees...

Preventing the return of smallpox: molecular modeling studies on thymidylate kinase from Variola virus.

Science.gov (United States)

Guimarães, Ana Paula; Ramalho, Teodorico Castro; França, Tanos Celmar Costa

2014-01-01

Smallpox was one of the most devastating diseases in the human history and still represents a serious menace today due to its potential use by bioterrorists. Considering this threat and the non-existence of effective chemotherapy, we propose the enzyme thymidylate kinase from Variola virus (VarTMPK) as a potential target to the drug design against smallpox. We first built a homology model for VarTMPK and performed molecular docking studies on it in order to investigate the interactions with inhibitors of Vaccinia virus TMPK (VacTMPK). Subsequently, molecular dynamics (MD) simulations of these compounds inside VarTMPK and human TMPK (HssTMPK) were carried out in order to select the most promising and selective compounds as leads for the design of potential VarTMPK inhibitors. Results of the docking and MD simulations corroborated to each other, suggesting selectivity towards VarTMPK and, also, a good correlation with the experimental data.

LGBT health and vaccinations: Findings from a community health survey of Lexington-Fayette County, Kentucky, USA.

Science.gov (United States)

Jones, Jeff; Poole, Asheley; Lasley-Bibbs, Vivian; Johnson, Mark

2016-04-07

Data on adult immunization coverage at the state level and for LGBT Americans in particular are sparse. This study reports the results of a 2012 Lexington-Fayette County, Kentucky, community health assessment's results asking about eight adult vaccinations among 218 lesbian, gay, bisexual, and transgendered (LGBT) respondents. Researchers collected data using an online survey distributed through LGBT social media, posters, and LGBT print media. The LGBT sample largely matches the demographics of the county as a whole except this group reports higher level of education and fewer uninsured individuals. Among LGBT respondents, immunization prevalence reaches 68.0% (annual Influenza), 65.7% (Hepatitis B), 58.8% (Chickenpox/Varicella), 55.9% (Hepatitis A), 41.2% (Smallpox), and 25.8% (Pneumonia). Among respondents who are currently within the recommended 19-26 years age range for the Human Papillomavirus (HPV) vaccine, the LGBT females are less likely to report receiving the vaccine (15.4%) compared to the national coverage percentage of 34.5%. Males, however, are more likely to have received the vaccine (10.3%) than the national percentage of 2.3%. The small number of LGBT seniors in the study report a much higher prevalence of the Shingles (Herpes Zoster) vaccines than for U.S. seniors 60 and older (71.4% compared to 20.1% nationally). LGBT respondents report higher percentages of adult vaccination. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mass psychogenic illness after vaccination.

Science.gov (United States)

Clements, C John

2003-01-01

surveillance/reporting systems for reporting adverse events be improved before such campaigns. A mass campaign using a smallpox vaccine should be accompanied by a surveillance system capable of distinguishing between multiple cases of conventionally understood vaccine reactions and outbreaks of mass psychogenic illness.

Reacting to Conflict: Civilian Capabilities in the EU, UN and OSCE

NARCIS (Netherlands)

Dijkstra, Hylke; Petrov, Petar; Mahr, Ewa

2016-01-01

This report analyses how the EU, UN and OSCE make resources available for civilian missions. It starts with an overview of civilian missions around the world before comparing civilian planning and conduct procedures in these international organisations. The report zooms in on EU civilian

Genital Autoinoculation with Vaccinia: A Look at Two Cases.

Science.gov (United States)

Whittington, Julie R; Rollene, Nanette L; Gist, Richard S

2018-05-01

Smallpox, or vaccinia, has been eradicated worldwide as a disease; however, it may be weaponized and is thus a required immunization when military members deploy to certain parts of the world. We report two unusual cases of genital autoinoculation following smallpox vaccination. Both patients' lesions resolved without sequelae within 20 d. We advocate for thorough education on this potential vaccination adverse event. These cases highlight the importance of a broad differential diagnosis when dealing with vulvar lesions, particularly in our military population.

De vreselijkste aller harpijen : pokkenepidemieen en pokkenbestrijding in Nederland in de achttiende en negentiende eeuw : een sociaal-historische en historisch-demografische studie

NARCIS (Netherlands)

Rutten, W.

1997-01-01

This study examines the fight against smallpox in the Netherlands in the 18th and 19th centuries. Smallpox mortality dropped in an unprecedented way from about 1810, generating a substantial reduction in the urban child mortality rate. The impact of vaccination on the acceleration of the Dutch

Integrated Analysis of Genetic and Proteomic Data Identifies Biomarkers Associated with Adverse Events Following Smallpox Vaccination

Science.gov (United States)

Complex clinical outcomes, such as adverse reaction to vaccination, arise from the concerted interactions among the myriad components of a biological system. Therefore, comprehensive etiological models can be developed only through the integrated study of multiple types of experi...

Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines?

Science.gov (United States)

Michel, R; Berger, F; Ravelonarivo, J; Dussart, P; Dia, M; Nacher, M; Rogier, S; Moua, D; Sarr, F D; Diop, O M; Sall, A A; Baril, L

2015-05-11

The use of 2 live attenuated vaccines (LAV) is recommended to be simultaneous or after an interval of at least four weeks between injections. The primary objective of this study was to compare the humoral response to yellow fever (YF) and measles vaccines among children vaccinated against these two diseases, either simultaneously or separated by an interval of 7-28 days. A prospective, multicenter observational study was conducted among children aged 9-15 months. The primary endpoint was the occurrence of positive yellow fever antibodies after YF vaccine by estimating the titers of neutralizing antibodies from venous blood samples. Children vaccinated against YF 7-28 days after receiving the vaccine against measles (test group) were compared with children vaccinated the same day against these two diseases (referent group). Analysis was performed on 284 children. Of them, fifty-four belonged to the test group. Measles serology was positive in 91.7% of children. Neutralizing antibodies against YF were detected in 90.7% of the test group and 92.9 of the referent group (p=0.6). In addition, quantitative analysis of the immune response did not show a lower response to YF vaccination when it took place 1-28 days after measles vaccination. In 1965, Petralli showed a lower response to the smallpox vaccine when injected 4-20 days after measles vaccination. Since then, recommendations are to observe an interval of four weeks between LAV not injected on the same day. Other published studies failed to show a significant difference in the immune response to a LAV injected 1-28 days after another LAV. These results suggest that the usual recommendations for immunization with two LAV may not be correct. In low income countries, the current policy should be re-evaluated. This re-evaluation should also be applied to travelers to yellow fever endemic countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

A New Wave of Vaccines for Non-Communicable Diseases: What Are the Regulatory Challenges?

Science.gov (United States)

Darrow, Jonathan J; Kesselheim, Aaron S

2015-01-01

Vaccines represent one of the greatest achievements of medicine, dramatically reducing the incidence of serious or life-threatening infectious diseases and allowing people to live longer, healthier lives. As life expectancy has increased, however, the burden of non-communicable diseases (NCDs) such as cancer, hypertension, atherosclerosis, and diabetes has increased. This shifting burden of disease has heightened the already urgent need for therapies that treat or prevent NCDs, a need that is now being met with increased efforts to develop NCD vaccines. Like traditional vaccines, NCD vaccines work by modulating the human immune system, but target cells, proteins or other molecules that are associated with the NCD in question rather than pathogens or pathogen-infected cells. Efforts are underway to develop NCD vaccines to address not only cancer and hypertension, but also addiction, obesity, asthma, arthritis, psoriasis, multiple sclerosis, and Crohn's disease, among others. NCD vaccines present an interesting challenge for the U.S. Food and Drug Administration (FDA), which is tasked with approving new treatments on the basis of efficacy and safety. Should NCD vaccines be evaluated under the same analytic frame as traditional vaccines, or that of biologic drugs? Despite the borrowed nomenclature, NCD vaccines differ in important ways from infectious disease vaccines. Because infectious disease vaccines are generally administered to healthy individuals, often children, tolerance for adverse events is low and willingness to pay is limited. It is important to have infectious disease vaccines even for rare or eradicated disease (e.g., smallpox), in the event of an outbreak. The efficacy of infectious disease vaccines is generally high, and the vaccines convey population level benefits associated with herd immunity and potential eradication. The combination of substantial population-level benefits, low willingness to pay, and low tolerance for adverse events explains the

Civilian Personnel: Career Management

National Research Council Canada - National Science Library

2001-01-01

This revision; (1) Contains changes required by the establishment of a consolidated and realigned management structure for civilian personnel, manpower, and related functions in the Office of the Assistant Secretary of the Army...

Comment: Characterization of Two Historic Smallpox Specimens from a Czech Museum

OpenAIRE

Porter, Ashleigh F.; Duggan, Ana T.; Poinar, Hendrik N.; Holmes, Edward C.

2017-01-01

The complete genome sequences of two strains of variola virus (VARV) sampled from human smallpox specimens present in the Czech National Museum, Prague, were recently determined, with one of the sequences estimated to date to the mid-19th century. Using molecular clock methods, the authors of this study go on to infer that the currently available strains of VARV share an older common ancestor, at around 1350 AD, than some recent estimates based on other archival human samples. Herein, we show...

Improving the Care and Treatment of Monkeypox Patients in Low-Resource Settings: Applying Evidence from Contemporary Biomedical and Smallpox Biodefense Research

Directory of Open Access Journals (Sweden)

Mary G. Reynolds

2017-12-01

Full Text Available Monkeypox is a smallpox-like illness that can be accompanied by a range of significant medical complications. To date there are no standard or optimized guidelines for the clinical management of monkeypox (MPX patients, particularly in low-resource settings. Consequently, patients can experience protracted illness and poor outcomes. Improving care necessitates developing a better understanding of the range of clinical manifestations—including complications and sequelae—as well as of features of illness that may be predictive of illness severity and poor outcomes. Experimental and natural infection of non-human primates with monkeypox virus can inform the approach to improving patient care, and may suggest options for pharmaceutical intervention. These studies have traditionally been performed to address the threat of smallpox bioterrorism and were designed with the intent of using MPX as a disease surrogate for smallpox. In many cases this necessitated employing high-dose, inhalational or intravenous challenge to recapitulate the severe manifestations of illness seen with smallpox. Overall, these data—and data from biomedical research involving burns, superficial wounds, herpes, eczema vaccinatum, and so forth—suggest that MPX patients could benefit from clinical support to mitigate the consequences of compromised skin and mucosa. This should include prevention and treatment of secondary bacterial infections (and other complications, ensuring adequate hydration and nutrition, and protecting vulnerable anatomical locations such as the eyes and genitals. A standard of care that considers these factors should be developed and assessed in different settings, using clinical metrics specific for MPX alongside consideration of antiviral therapies.

Nudging Armed Groups: How Civilians Transmit Norms of Protection

Directory of Open Access Journals (Sweden)

Oliver Kaplan

2013-12-01

Full Text Available What are the varying roles that norms play to either enable or constrain violence in armed conflict settings? The article examines this question by drawing on experiences from communities and armed groups in Colombia and Syria. It begins by presenting an explanation of how norms of violence and nonviolence may arise within communities and influence the behavior of civilian residents, reducing the chances of them becoming involved with armed groups. It then considers how civilian communities can transmit those same norms, shared understandings, and patterns of interaction to the ranks of illegal armed groups and subsequently shape their decisions about the use of violence against civilians. The author argues that civilians may be better positioned to promote the principles codified in International Humanitarian Law than international humanitarian organizations because they have closer contact with irregular armed actors and are viewed with greater legitimacy. The analysis illustrates that to better understand civilian protection mechanisms it is essential to study the interactions between communities and armed actors.

Military to civilian nurse: Personal and professional reconstruction.

Science.gov (United States)

Elliott, Brenda; Chargualaf, Katie A; Patterson, Barbara

2017-05-01

To examine and describe the transition process of military nurses from military nursing practice to civilian nursing practice. A second aim was to identify challenges and facilitators to this transition. Serving in the military, and embodying its values, can have a major impact on a person's worldview. These individuals serve not only as nurses but also as part of a larger military culture with a mission to protect. The decision to separate from the military and transition into the civilian workforce carries many challenges capable of influencing nurses' personal and professional identities. Qualitative descriptive. Semi-structured interviews of 10 nurse veterans were conducted in 2015-2016. Data were collected until saturation was reached. The transition includes four major phases from military to civilian nurse: Separating from Military Life, Conflict and Chaos, Shifting Sands and Personal and Professional Reconstruction. Duration and progress through each phase varied slightly for individual nurses. Both work-role and personal identity transition occur when a nurse leaves the military and enters civilian practice. Military and civilian organisations, in both the USA and other countries, can implement supports to aid these nurses during this personal and professional change. Recommendations from the study group are provided. The global nursing profession, as well as healthcare organisations that employ nurse veterans, has a commitment and obligation to understand the transition process of nurses who practise within the scope of military nursing and later in civilian nursing environments so that they may be supported and used to the extent of their prior experience. Lessons learned and advice from this group of nurses may positively aid others in their transition experience. © 2016 John Wiley & Sons Ltd.

Hysteresis of targeting civilians in armed conflicts

OpenAIRE

Uih Ran Lee

2015-01-01

This article explores warring groups’ intentional targeting behavior against civilians, a strictly prohibited war strategy by international norms. Using dynamic panel regressions run on a comprehensive dataset of contemporary warfare which covers 22 years (1989-2010), I find that warring actors, both sovereign states and formally organized armed groups, behave systematically in terms of civilian targeting when they are involved in prolonged armed conflict (15-22 years). Warring actors’ lethal...

Military and civilian media coverage of suicide.

Science.gov (United States)

Edwards-Stewart, Amanda; Kinn, Julie T; June, Jennifer D; Fullerton, Nicole R

2011-01-01

Military suicide has increased over the past decade and reports of Service Member and Veteran suicides receive media attention. Some methods of reporting suicide appear to cause a "media contagion" effect, potentially increasing suicide. This effect is explored in relation to media reports of both military and civilian suicides. To reduce possible contagion, recommendations for media reporting of suicides were adapted by the Suicide Prevention Resource Center (SPRC). We assessed 240 military and civilian newspaper reports of suicide from 15 different sources for compliance with the SPRC guidelines. Nearly all reviewed articles violated at least one guideline. Results highlighted military news articles regarding Service Members included more pejorative language and discussion of failed psychological treatment. Conversely, civilian articles romanticized the victim and provided more details regarding the suicide. Further exploration of military suicide reporting bias is discussed as a need in future research.

Guarding the guardians: Civilian control of nuclear weapons in the United States

International Nuclear Information System (INIS)

Feaver, P.D.

1992-01-01

This book has three separate complementary goals. First, it develops a model to explain how the command and control of nuclear weapons evolves over time. Second, it tells the story of the evolution of one critical aspect of the nuclear command system, the custody of nuclear weapons. Finally, it assesses the general problem of ensuring civilian control over nuclear operations. The focus is on the formation of operational policy. Where to deploy a weapon and at what state of alertness is an operational decision. Part I, The Theory of Civilian Control is divided into three chapters: Civilian control: Principles and problems; Civilian Control: From alerts to war termination; and Explaining changes in civilian control. Part II, The Evolution of Custody Policy has seven chapters: The Atomic Energy Act and the origin of assertive control, 1945-1947; The first test of assertive civilian control, 1948-1949; The breach in assertive control, 1950-1952; Assertive control becomes delegative control, 1953-1958; The resurgence of assertive control, 1959-1962; The cycle continues, 1963-1990; and Conclusion: The future of civilian control

"A wild and wondrous ride": CDC field epidemiologists in the east Pakistan smallpox and cholera epidemics of 1958 "Uma louca e maravilhosa jornada": epidemiologistas de campo do CDC nas epidemias de varíola e cólera do Paquistão Oriental em 1958

Directory of Open Access Journals (Sweden)

Paul Greenough

2011-02-01

Full Text Available In mid-April of 1958 the Government of Pakistan summoned the press to announce a grave need for international aid to cope with smallpox and cholera epidemics in East Pakistan. In response, and with the backing of the US State Department, Dr. Alexander D. Langmuir, chief epidemiologist of the CDC, led a team of epidemiologists to assist authorities in Dacca strengthen their immunization programs. Langmuir's superiors hoped for a Cold War advantage, but he saw an opportunity for trainees in the Epidemic Intelligence Service to learn about public health in a developing country. Langmuir later described the episode as a "wild and wondrous ride," but it had been more like a nightmare: the East Pakistan health department had collapsed; a popular movement had taken over vaccination and squandered vaccine supplies; hostile journalists had questioned the Americans' deeper motives; and a professional rivalry opened between the Americans and a British epidemiologist named Aidan Cockburn. By the time the epidemic subsided in July 1958, 30 million Bengalis had been vaccinated for smallpox but another 20,000 had succumbed to the disease. This episode was CDC's first sustained foreign intervention, a precursor to its extensive role in the 1970s helping WHO eradicate smallpox from Bangladesh.Em meados de abril de 1958, o Governo do Paquistão convocou a imprensa para anunciar a urgente necessidade de auxílio internacional para lidar com epidemias de varíola e cólera no Paquistão Oriental. Em resposta, e com o apoio do Departamento de Estado dos Estados Unidos, Dr. Alexander D. Langmuir, chefe de epidemiologia do CDC em Atlanta, liderou um time de epidemiologistas para auxiliar as autoridades em Dacca a reforçar seus programas de imunização. Os superiores de Langmuir ansiavam por demonstrações de capacidade dos EUA na Guerra Fria, mas ele vislumbrou uma chance para o Serviço de Inteligência Epidemiológica aprender sobre saúde pública em países em

An Argument for Documenting Casualties: Violence Against Iraqi Civilians 2006

National Research Council Canada - National Science Library

Hall, Katharine; Stahl, Dale

2008-01-01

The problem of measuring the number of civilian fatalities in Iraq gained widespread media coverage when the Lancet published a study in October 2004 claiming that more than 100,000 Iraqi civilians...

The First Smallpox Epidemic on the Canadian Plains: In the Fur-traders' Words

Directory of Open Access Journals (Sweden)

C Stuart Houston

2000-01-01

Full Text Available William Tomison, in charge of the Hudson's Bay Company's Cumberland House on the Saskatchewan River, described the devastating smallpox epidemic of 1781 and 1782. He understood contagion, practised isolation and disinfection, and provided mortality statistics during a 'virgin soil' epidemic. Above all, he showed remarkable compassion. He and his men took dying Indians into their already crowded quarters, and provided them with food, shelter and 24 h care. This article describes the epidemic and its aftermath.

Estrategias, actores, promesas y temores en las campañas de vacunación antivariolosa en México: del Porfiriato a la Posrevolución (1880-1940 Strategies, actors, promises and fears in the smallpox vaccinations campaigns in Mexico: from the Porfiriato to the Post-revolution (1880-1940

Directory of Open Access Journals (Sweden)

Claudia Agostoni

2011-02-01

Full Text Available El artículo estudia algunas de las estrategias a las que recurrieron las autoridades de salud durante la puesta en marcha de programas vacunación antivariolosa durante los años de 1880 a 1940, periodo que corresponde al gobierno encabezado por Porfirio Díaz (1877-1911, a la fase armada de la Revolución Mexicana (1910-1920, y a las dos primeras décadas del estado posrevolucionario (1920-1940. Por una parte se prestará atención a la preeminencia que tuvo la vacunación en los centros urbanos, notablemente en la ciudad de México; y por la otra, se destacará la gradual, pero decisiva, organización y reglamentación de la vacunación antivariolosa en los programas destinados para el heterogéneo y desigual ámbito rural. Asimismo, se analizará la importancia que adquirió la educación higiénica, y se prestará atención a las divergentes respuestas que la aplicación masiva y cotidiana de la vacuna suscitó en las ciudades principales y en pequeños pueblos y municipios rurales, respuestas que incluyeron la resistencia, el temor, la incredulidad y la franca aceptación.The article examines some of the strategies employed by the Mexican health authorities that led to the organization of massive and obligatory smallpox vaccination campaigns from the late 1880s to the 1940s, a period of Mexican history that corresponds to the Porfirio Díaz regime (1877-1911, to the armed phase of the Mexican Revolution (1910-1920, and to the first two decades of the Post-revolutionary governments (1920-1940. Attention will be placed of the vaccination programs in the main urban settings, notably in Mexico City, as well as the gradual but decisive organization and regulation of vaccination campaigns in the heterogeneous rural milieu. Furthermore, the importance that hygienic education acquired will be explored, as well as the divergent and contested responses that emerged due to the obligatory vaccination campaigns, responses that included resistance, fear

Global comparison of warring groups in 2002-2007: fatalities from targeting civilians vs. fighting battles.

Science.gov (United States)

Hicks, Madelyn Hsiao-Rei; Lee, Uih Ran; Sundberg, Ralph; Spagat, Michael

2011-01-01

Warring groups that compete to dominate a civilian population confront contending behavioral options: target civilians or battle the enemy. We aimed to describe degrees to which combatant groups concentrated lethal behavior into intentionally targeting civilians as opposed to engaging in battle with opponents in contemporary armed conflict. We identified all 226 formally organized state and non-state groups (i.e. actors) that engaged in lethal armed conflict during 2002-2007: 43 state and 183 non-state. We summed civilians killed by an actor's intentional targeting with civilians and combatants killed in battles in which the actor was involved for total fatalities associated with each actor, indicating overall scale of armed conflict. We used a Civilian Targeting Index (CTI), defined as the proportion of total fatalities caused by intentional targeting of civilians, to measure the concentration of lethal behavior into civilian targeting. We report actor-specific findings and four significant trends: 1.) 61% of all 226 actors (95% CI 55% to 67%) refrained from targeting civilians. 2.) Logistic regression showed actors were more likely to have targeted civilians if conflict duration was three or more years rather than one year. 3.) In the 88 actors that targeted civilians, multiple regressions showed an inverse correlation between CTI values and the total number of fatalities. Conflict duration of three or more years was associated with lower CTI values than conflict duration of one year. 4.) When conflict scale and duration were accounted for, state and non-state actors did not differ. We describe civilian targeting by actors in prolonged conflict. We discuss comparable patterns found in nature and interdisciplinary research. Most warring groups in 2002-2007 did not target civilians. Warring groups that targeted civilians in small-scale, brief conflict concentrated more lethal behavior into targeting civilians, and less into battles, than groups in larger

Prospective surveillance for cardiac adverse events in healthy adults receiving modified vaccinia Ankara vaccines: a systematic review.

Science.gov (United States)

Elizaga, Marnie L; Vasan, Sandhya; Marovich, Mary A; Sato, Alicia H; Lawrence, Dale N; Chaitman, Bernard R; Frey, Sharon E; Keefer, Michael C

2013-01-01

Vaccinia-associated myo/pericarditis was observed during the US smallpox vaccination (DryVax) campaign initiated in 2002. A highly-attenuated vaccinia strain, modified vaccinia Ankara (MVA) has been evaluated in clinical trials as a safer alternative to DryVax and as a vector for recombinant vaccines. Due to the lack of prospectively collected cardiac safety data, the US Food and Drug Administration required cardiac screening and surveillance in all clinical trials of MVA since 2004. Here, we report cardiac safety surveillance from 6 phase I trials of MVA vaccines. Four clinical research organizations contributed cardiac safety data using common surveillance methods in trials administering MVA or recombinant MVA vaccines to healthy participants. 'Routine cardiac investigations' (ECGs and cardiac enzymes obtained 2 weeks after injections of MVA or MVA-HIV recombinants, or placebo-controls), and 'Symptom-driven cardiac investigations' are reported. The outcome measure is the number of participants who met the CDC-case definition for vaccinia-related myo/pericarditis or who experienced cardiac adverse events from an MVA vaccine. Four hundred twenty-five study participants had post-vaccination safety data analyzed, 382 received at least one MVA-containing vaccine and 43 received placebo; 717 routine ECGs and 930 cardiac troponin assays were performed. Forty-five MVA recipients (12%) had additional cardiac testing performed; 22 for cardiac symptoms, 19 for ECG/laboratory changes, and 4 for cardiac symptoms with an ECG/laboratory change. No participant had evidence of symptomatic or asymptomatic myo/pericarditis meeting the CDC-case definition and judged to be related to an MVA vaccine. Prospective surveillance of MVA recipients for myo/pericarditis did not detect cardiac adverse reactions in 382 study participants. ClinicalTrials.gov NCT00082446 NCT003766090 NCT00252148 NCT00083603 NCT00301184 NCT00428337.

Prospective surveillance for cardiac adverse events in healthy adults receiving modified vaccinia Ankara vaccines: a systematic review.

Directory of Open Access Journals (Sweden)

Marnie L Elizaga

Full Text Available Vaccinia-associated myo/pericarditis was observed during the US smallpox vaccination (DryVax campaign initiated in 2002. A highly-attenuated vaccinia strain, modified vaccinia Ankara (MVA has been evaluated in clinical trials as a safer alternative to DryVax and as a vector for recombinant vaccines. Due to the lack of prospectively collected cardiac safety data, the US Food and Drug Administration required cardiac screening and surveillance in all clinical trials of MVA since 2004. Here, we report cardiac safety surveillance from 6 phase I trials of MVA vaccines.Four clinical research organizations contributed cardiac safety data using common surveillance methods in trials administering MVA or recombinant MVA vaccines to healthy participants. 'Routine cardiac investigations' (ECGs and cardiac enzymes obtained 2 weeks after injections of MVA or MVA-HIV recombinants, or placebo-controls, and 'Symptom-driven cardiac investigations' are reported. The outcome measure is the number of participants who met the CDC-case definition for vaccinia-related myo/pericarditis or who experienced cardiac adverse events from an MVA vaccine.Four hundred twenty-five study participants had post-vaccination safety data analyzed, 382 received at least one MVA-containing vaccine and 43 received placebo; 717 routine ECGs and 930 cardiac troponin assays were performed. Forty-five MVA recipients (12% had additional cardiac testing performed; 22 for cardiac symptoms, 19 for ECG/laboratory changes, and 4 for cardiac symptoms with an ECG/laboratory change. No participant had evidence of symptomatic or asymptomatic myo/pericarditis meeting the CDC-case definition and judged to be related to an MVA vaccine.Prospective surveillance of MVA recipients for myo/pericarditis did not detect cardiac adverse reactions in 382 study participants.ClinicalTrials.gov NCT00082446 NCT003766090 NCT00252148 NCT00083603 NCT00301184 NCT00428337.

The Protestant medical missions to China: the introduction of Western medicine with vaccination.

Science.gov (United States)

Fu, Louis

2013-05-01

Modern medicine in China began with the arrival of Anglo-American Protestant missionaries in the early 19th century. Conditions were vastly different from the times of the Jesuits in Peking during the 17th and 18th centuries, when the priests enjoyed the endorsement of the Court and high officials. Faced with hostile and xenophobic officialdom and populace, surgeons of the British East India Company in collaboration with missionaries took the initiative. In 1805 Dr Alexander Pearson (1780-1874) introduced smallpox vaccination in Macao and Canton. Reverend Dr Robert Morrison (1782-1834) of the London Missionary Society with another East India Company Surgeon, Dr John Livingstone (1829) opened a dispensary for the poor in Macao in 1820. These pioneers paved the way for later Anglo-American medical missionaries who revolutionized medical practice in China.

Department of Defense Civilian Personnel Manual

National Research Council Canada - National Science Library

1996-01-01

.... It implements policy, establishes uniform DoD-wide procedures, provides guidelines and model programs, delegates authority, and assigns responsibilities regarding civilian personnel management within...

Fulltext PDF

Indian Academy of Sciences (India)

They also knew that vaccines could boost the ability of the body to fight infections, since some infections, such as smallpox, were already being controlled with the help of vaccines. Infectious diseases were. [then as now] the bane of the developing world, and vaccines seemed [then as now] the ideal solutions for the future.

Reporting Iraqi civilian fatalities in a time of war

Directory of Open Access Journals (Sweden)

Olander William E

2009-11-01

Full Text Available Abstract Background In February, 2007, the Associated Press (AP conducted a poll of 1,002 adults in the United States about their attitudes towards the war in Iraq. Respondents were remarkably accurate estimating the current death toll of US soldiers, yet were grossly inaccurate in estimating the current death toll of Iraqi civilians. We conducted a search of newspapers reports to determine the extent of the discrepancy between reporting Coalition and Iraqi civilian deaths, hypothesizing that there would be an over-representation of Coalition deaths compared to Iraqi civilian deaths. Methods We examined 11 U.S. newspapers and 5 non-U.S. newspapers using electronic databases or newspaper web-archives, to record any reports between March 2003 and March 2008 of Coalition and Iraqi deaths that included a numeric indicator. Reports were described as "events" where they described a specific occurrence involving fatalities and "tallies" when they mentioned the number of deaths over a period of time. We recorded the number of events and tallies related to Coalition deaths, Iraqi civilian deaths, and Iraqi combatant deaths Results U.S. newspapers report more events and tallies related to Coalition deaths than Iraqi civilian deaths, although there are substantially different proportions amongst the different U.S. newspapers. In four of the five non-US newspapers, the pattern was reversed. Conclusion This difference in reporting trends may partly explain the discrepancy in how well people are informed about U.S. and Iraqi civilian fatalities in Iraq. Furthermore, this calls into question the role of the media in reporting and sustaining armed conflict, and the extent to which newspaper and other media reports can be used as data to assess fatalities or trends in the time of war.

Real-Time PCR Assay To Detect Smallpox Virus

Science.gov (United States)

Sofi Ibrahim, M.; Kulesh, David A.; Saleh, Sharron S.; Damon, Inger K.; Esposito, Joseph J.; Schmaljohn, Alan L.; Jahrling, Peter B.

2003-01-01

We developed a highly sensitive and specific assay for the rapid detection of smallpox virus DNA on both the Smart Cycler and LightCycler platforms. The assay is based on TaqMan chemistry with the orthopoxvirus hemagglutinin gene used as the target sequence. With genomic DNA purified from variola virus Bangladesh 1975, the limit of detection was estimated to be approximately 25 copies on both machines. The assay was evaluated in a blinded study with 322 coded samples that included genomic DNA from 48 different isolates of variola virus; 25 different strains and isolates of camelpox, cowpox, ectromelia, gerbilpox, herpes, monkeypox, myxoma, rabbitpox, raccoonpox, skunkpox, vaccinia, and varicella-zoster viruses; and two rickettsial species at concentrations mostly ranging from 100 fg/μl to 1 ng/μl. Contained within those 322 samples were variola virus DNA, obtained from purified viral preparations, at concentrations of 1 fg/μl to 1 ng/μl. On the Smart Cycler platform, 2 samples with false-positive results were detected among the 116 samples not containing variola virus tested; i.e., the overall specificity of the assay was 98.3%. On the LightCycler platform, five samples with false-positive results were detected (overall specificity, 95.7%). Of the 206 samples that contained variola virus DNA ranging in concentrations from 100 fg/μl to 1 ng/μl, 8 samples were considered negative on the Smart Cycler platform and 1 sample was considered negative on the LightCycler platform. Thus, the clinical sensitivities were 96.1% for the Smart Cycler instrument and 99.5% for the LightCycler instrument. The vast majority of these samples were derived from virus-infected cell cultures and variola virus-infected tissues; thus, the DNA material contained both viral DNA and cellular DNA. Of the 43 samples that contained purified variola virus DNA ranging in concentration from 1 fg/μl to 1 ng/μl, the assay correctly detected the virus in all 43 samples on both the Smart Cycler

A Study of Waste Management within the COL Florence A. Blanchfield Army Community Hospital, Fort Campbell, Kentucky.

Science.gov (United States)

1981-08-01

besnoiti Borna disease virus Bovine infectious petechial fever virus Camel pox virus Ephemeral fever virus Fowl plague virus Goat pox virus Hog...Varicella virus Vole rickettsia Yellow fever virus, 17D vaccine strain 69 Class 3 Alastrun, smallpox, monkeypox, and whitepox, when used in vitro Arbovirus...animal inoculation experiments Vesicular stomatitis virus Yellow fever virus - wild when used in vitro Class 4 Alastrun, smallpox, monkeypox, and

Global comparison of warring groups in 2002-2007: fatalities from targeting civilians vs. fighting battles.

Directory of Open Access Journals (Sweden)

Madelyn Hsiao-Rei Hicks

Full Text Available BACKGROUND: Warring groups that compete to dominate a civilian population confront contending behavioral options: target civilians or battle the enemy. We aimed to describe degrees to which combatant groups concentrated lethal behavior into intentionally targeting civilians as opposed to engaging in battle with opponents in contemporary armed conflict. METHODOLOGY/PRINCIPAL FINDINGS: We identified all 226 formally organized state and non-state groups (i.e. actors that engaged in lethal armed conflict during 2002-2007: 43 state and 183 non-state. We summed civilians killed by an actor's intentional targeting with civilians and combatants killed in battles in which the actor was involved for total fatalities associated with each actor, indicating overall scale of armed conflict. We used a Civilian Targeting Index (CTI, defined as the proportion of total fatalities caused by intentional targeting of civilians, to measure the concentration of lethal behavior into civilian targeting. We report actor-specific findings and four significant trends: 1. 61% of all 226 actors (95% CI 55% to 67% refrained from targeting civilians. 2. Logistic regression showed actors were more likely to have targeted civilians if conflict duration was three or more years rather than one year. 3. In the 88 actors that targeted civilians, multiple regressions showed an inverse correlation between CTI values and the total number of fatalities. Conflict duration of three or more years was associated with lower CTI values than conflict duration of one year. 4. When conflict scale and duration were accounted for, state and non-state actors did not differ. We describe civilian targeting by actors in prolonged conflict. We discuss comparable patterns found in nature and interdisciplinary research. CONCLUSIONS/SIGNIFICANCE: Most warring groups in 2002-2007 did not target civilians. Warring groups that targeted civilians in small-scale, brief conflict concentrated more lethal

Mathematical modeling provides kinetic details of the human immune response to vaccination

Directory of Open Access Journals (Sweden)

Dustin eLe

2015-01-01

Full Text Available With major advances in experimental techniques to track antigen-specific immune responses many basic questions on the kinetics of virus-specific immunity in humans remain unanswered. To gain insights into kinetics of T and B cell responses in human volunteers we combine mathematical models and experimental data from recent studies employing vaccines against yellow fever and smallpox. Yellow fever virus-specific CD8 T cell population expanded slowly with the average doubling time of 2 days peaking 2.5 weeks post immunization. Interestingly, we found that the peak of the yellow fever-specific CD8 T cell response is determined by the rate of T cell proliferation and not by the precursor frequency of antigen-specific cells as has been suggested in several studies in mice. We also found that while the frequency of virus-specific T cells increases slowly, the slow increase can still accurately explain clearance of yellow fever virus in the blood. Our additional mathematical model describes well the kinetics of virus-specific antibody-secreting cell and antibody response to vaccinia virus in vaccinated individuals suggesting that most of antibodies in 3 months post immunization are derived from the population of circulating antibody-secreting cells. Taken together, our analysis provides novel insights into mechanisms by which live vaccines induce immunity to viral infections and highlight challenges of applying methods of mathematical modeling to the current, state-of-the-art yet limited immunological data.

Mathematical modeling provides kinetic details of the human immune response to vaccination.

Science.gov (United States)

Le, Dustin; Miller, Joseph D; Ganusov, Vitaly V

2014-01-01

With major advances in experimental techniques to track antigen-specific immune responses many basic questions on the kinetics of virus-specific immunity in humans remain unanswered. To gain insights into kinetics of T and B cell responses in human volunteers we combined mathematical models and experimental data from recent studies employing vaccines against yellow fever and smallpox. Yellow fever virus-specific CD8 T cell population expanded slowly with the average doubling time of 2 days peaking 2.5 weeks post immunization. Interestingly, we found that the peak of the yellow fever-specific CD8 T cell response was determined by the rate of T cell proliferation and not by the precursor frequency of antigen-specific cells as has been suggested in several studies in mice. We also found that while the frequency of virus-specific T cells increased slowly, the slow increase could still accurately explain clearance of yellow fever virus in the blood. Our additional mathematical model described well the kinetics of virus-specific antibody-secreting cell and antibody response to vaccinia virus in vaccinated individuals suggesting that most of antibodies in 3 months post immunization were derived from the population of circulating antibody-secreting cells. Taken together, our analysis provided novel insights into mechanisms by which live vaccines induce immunity to viral infections and highlighted challenges of applying methods of mathematical modeling to the current, state-of-the-art yet limited immunological data.

Senior Service College: A Pillar of Civilian Senior Leader Development

Science.gov (United States)

2011-02-16

other burgeoning global issues mandate the existence of capable senior civilian leaders who can effectively participate within the whole-of-government...experience that provides the opportunity to discuss and debate current global issues with the members of the world’s finest military. Civilians not only

32 CFR 720.23 - Naval prisoners as witnesses or parties in civilian courts.

Science.gov (United States)

2010-07-01

... assume responsibility for the prisoner while he is in its custody; and (3) that the civilian authority... civilian courts. 720.23 Section 720.23 National Defense Department of Defense (Continued) DEPARTMENT OF THE... civilian courts. (a) Criminal actions. When Federal or State authorities desire the attendance of a naval...

Civilian casualties of Iraqi ballistic missile attack to

Directory of Open Access Journals (Sweden)

Khaji Ali

2012-06-01

Full Text Available 【Abstract】Objective: To determine the pattern of causalities of Iraqi ballistic missile attacks on Tehran, the capital of Iran, during Iraq-Iran war. Methods: Data were extracted from the Army Staff Headquarters based on daily reports of Iranian army units during the war. Results: During 52 days, Tehran was stroked by 118 Al-Hussein missiles (a modified version of Scud missile. Eighty-six missiles landed in populated areas. During Iraqi missile attacks, 422 civilians died and 1 579 injured (4.9 deaths and 18.3 injuries per missile. During 52 days, 8.1 of the civilians died and 30.4 injured daily. Of the cases that died, 101 persons (24% were excluded due to the lack of information. Among the remainders, 179 (55.8% were male and 142 (44.2% were female. The mean age of the victims was 25.3 years±19.9 years. Our results show that the high accuracy of modified Scud missiles landed in crowded ar-eas is the major cause of high mortality in Tehran. The pres-ence of suitable warning system and shelters could reduce civilian casualties. Conclusion: The awareness and readiness of civilian defense forces, rescue services and all medical facilities for dealing with mass casualties caused by ballistic missile at-tacks are necessary. Key words: Mortality; War; Mass casualty incidents; Wounds and injuries

Genome sequence diversity and clues to the evolution of variola (smallpox) virus.

Science.gov (United States)

Esposito, Joseph J; Sammons, Scott A; Frace, A Michael; Osborne, John D; Olsen-Rasmussen, Melissa; Zhang, Ming; Govil, Dhwani; Damon, Inger K; Kline, Richard; Laker, Miriam; Li, Yu; Smith, Geoffrey L; Meyer, Hermann; Leduc, James W; Wohlhueter, Robert M

2006-08-11

Comparative genomics of 45 epidemiologically varied variola virus isolates from the past 30 years of the smallpox era indicate low sequence diversity, suggesting that there is probably little difference in the isolates' functional gene content. Phylogenetic clustering inferred three clades coincident with their geographical origin and case-fatality rate; the latter implicated putative proteins that mediate viral virulence differences. Analysis of the viral linear DNA genome suggests that its evolution involved direct descent and DNA end-region recombination events. Knowing the sequences will help understand the viral proteome and improve diagnostic test precision, therapeutics, and systems for their assessment.

The World Health Organization and global smallpox eradication.

Science.gov (United States)

Bhattacharya, S

2008-10-01

This article examines the multifaceted structures and complex operations of the World Health Organization and its regional offices; it also reassesses the form and the workings of the global smallpox eradication programme with which these bodies were closely linked in the 1960s and 1970s. Using the case study of South Asia, it seeks to highlight the importance of writing nuanced histories of international health campaigns through an assessment of differences between official rhetoric and practice. The article argues that the detailed examination of the implementation of policy in a variety of localities, within and across national borders, allows us to recognise the importance of the agency of field managers and workers. This analytical approach also helps us acknowledge that communities were able to influence the shape and the timing of completion of public health campaigns in myriad ways. This, in turn, can provide useful pointers for the design and management of health programmes in the contemporary world.

Global Comparison of Warring Groups in 2002–2007: Fatalities from Targeting Civilians vs. Fighting Battles

Science.gov (United States)

Hicks, Madelyn Hsiao-Rei; Lee, Uih Ran; Sundberg, Ralph; Spagat, Michael

2011-01-01

Background Warring groups that compete to dominate a civilian population confront contending behavioral options: target civilians or battle the enemy. We aimed to describe degrees to which combatant groups concentrated lethal behavior into intentionally targeting civilians as opposed to engaging in battle with opponents in contemporary armed conflict. Methodology/Principal Findings We identified all 226 formally organized state and non-state groups (i.e. actors) that engaged in lethal armed conflict during 2002–2007: 43 state and 183 non-state. We summed civilians killed by an actor's intentional targeting with civilians and combatants killed in battles in which the actor was involved for total fatalities associated with each actor, indicating overall scale of armed conflict. We used a Civilian Targeting Index (CTI), defined as the proportion of total fatalities caused by intentional targeting of civilians, to measure the concentration of lethal behavior into civilian targeting. We report actor-specific findings and four significant trends: 1.) 61% of all 226 actors (95% CI 55% to 67%) refrained from targeting civilians. 2.) Logistic regression showed actors were more likely to have targeted civilians if conflict duration was three or more years rather than one year. 3.) In the 88 actors that targeted civilians, multiple regressions showed an inverse correlation between CTI values and the total number of fatalities. Conflict duration of three or more years was associated with lower CTI values than conflict duration of one year. 4.) When conflict scale and duration were accounted for, state and non-state actors did not differ. We describe civilian targeting by actors in prolonged conflict. We discuss comparable patterns found in nature and interdisciplinary research. Conclusions/Significance Most warring groups in 2002–2007 did not target civilians. Warring groups that targeted civilians in small-scale, brief conflict concentrated more lethal behavior into

Civilian Agency Industry Working Group EVM World Update

Science.gov (United States)

Kerby, Jerald

2013-01-01

Objectives include: Promote the use of standards ]based, objective, and quantitative systems for managing projects and programs in the federal government. Understand how civilian agencies in general, manage their projects and programs. Project management survey expected to go out soon to civilian agencies. Describe how EVM and other best practices can be applied by the government to better manage its project and programs irrespective of whether work is contracted out or the types of contracts employed. Develop model policies aimed at project and program managers that are transportable across the government.

DoD Civilian Training: Source, Content, Frequency and Cost

Science.gov (United States)

1994-03-01

statistics. This especially includes Mr. Mike Dove, Ms. Kris Hoffman, Ms. Ninfa Camargo , Mr. Edward Christie, Ms. Rebecca Tag, Ms. Elizabeth Kundift Ms...Center, San Francisco , CA, will close. DoD Civilian Training Study Page 10 Chapter 2: Source There were 1,507 civilians trained We learned that 166...San Diego, CA Service School Command 13 60 San Diego, CA Submarine Training Facility 4 61 San Francisco , CA Naval Technical Training Center 13 62

Antibodies to the A27 protein of vaccinia virus neutralize and protect against infection but represent a minor component of Dryvax vaccine--induced immunity.

Science.gov (United States)

He, Yong; Manischewitz, Jody; Meseda, Clement A; Merchlinsky, Michael; Vassell, Russell A; Sirota, Lev; Berkower, Ira; Golding, Hana; Weiss, Carol D

2007-10-01

The smallpox vaccine Dryvax, which consists of replication-competent vaccinia virus, elicits antibodies that play a major role in protection. Several vaccinia proteins generate neutralizing antibodies, but their importance for protection is unknown. We investigated the potency of antibodies to the A27 protein of the mature virion in neutralization and protection experiments and the contributions of A27 antibodies to Dryvax-induced immunity. Using a recombinant A27 protein (rA27), we confirmed that A27 contains neutralizing determinants and that vaccinia immune globulin (VIG) derived from Dryvax recipients contains reactivity to A27. However, VIG neutralization was not significantly reduced when A27 antibodies were removed, and antibodies elicited by an rA27 enhanced the protection conferred by VIG in passive transfer experiments. These findings demonstrate that A27 antibodies do not represent the major fraction of neutralizing activity in VIG and suggest that immunity may be augmented by vaccines and immune globulins that include strong antibody responses to A27.

Office of Civilian Response Deployment Tracking System

Data.gov (United States)

US Agency for International Development — The purpose of OCR DTS is to establish, manage and track relevant Civilian Response Corps teams for deployment by sector experience, training, education etc.

A Survey of Civilian Employee Attitudes

Science.gov (United States)

1989-06-01

U.S. Army Troop Support Command. The survey was conducted as part of an organizational diagnosis in preparation for the implementation of a civilian...survey as part of the program evaluation is recommended. Keywords: Surveys; Questionnaires; Employee attitudes; Attitude measurement; Organizational diagnosis .

2013 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Civilian Leaders

Science.gov (United States)

2014-05-30

Army civilian workforce with regard to gender and ethnic origin (Office of the Assistant G-1 for Civilian Personnel, 2013). The reported education...climates of perceived inequality . Civilian leader comments frequently referenced favoritism as reflecting cronyism, unfair personnel actions, and...interests of others, unequal enforcement of standards and discipline, and use of discretion in workplace justice. As demonstrated in previous CASAL

Civilian social work: serving the military and veteran populations.

Science.gov (United States)

Savitsky, Laura; Illingworth, Maria; DuLaney, Megan

2009-10-01

This article discusses social work practice areas for civilian social workers who provide services to military service members,veterans, and their families. These practice areas include education, child welfare, domestic violence, mental health, health care, substance abuse, and criminal justice. The authors examine the impact of the contemporary military lifestyle and current military operations on service members and their families in the context of these practice areas, with the goal of compelling civilian social workers to acknowledge their responsibility to competently serve military and veteran clients.

32 CFR 705.36 - Government transportation of civilians for public affairs purposes.

Science.gov (United States)

2010-07-01

....36 Government transportation of civilians for public affairs purposes. (a) General policy. (1... Assistant Secretary of Defense (Public Affairs), as appropriate. (8) Point to point transportation within... 32 National Defense 5 2010-07-01 2010-07-01 false Government transportation of civilians for...

Medical experimentation concerning chemical and biological weapons for mass destruction.

Science.gov (United States)

Deutsch, Erwin

2003-04-01

This article is the text of a speech originally presented at the Second World Conference on Medical Ethics at Gijon, Spain, on 2 October 2002 under the title "Medical Experimentation Concerning Chemical and Biological Weapons for Mass Destruction: Clinical Design for New Smallpox Vaccines: Ethical and Legal Aspects." Experimentation on vaccines such as smallpox is subject to the usual ethical rules such as the need for informed consent. However, the participants will not often be at risk of catching the disease but expose themselves by taking part in the experimentation. Professor Deutsch explores the implications of this, including the position of vulnerable groups such as children, those with mental handicaps, and those acting under orders such as the miliary, the policy and fire officers.

Heterotopic ossification in civilians with lower limb amputations.

Science.gov (United States)

Matsumoto, Mary E; Khan, Mohammed; Jayabalan, Prakash; Ziebarth, Jessica; Munin, Michael C

2014-09-01

To report the incidence of symptomatic heterotopic ossification (HO) in a defined civilian amputee population, describe its characteristics, and compare these findings to published data in military amputees. Retrospective chart analysis from July 1998 to July 2009. Ambulatory amputee clinic within a large university medical center. Adults with lower limb amputation (N=158). Not applicable. Patients with symptomatic HO confirmed by radiographs. A total of 261 patients were evaluated; 158 met inclusion criteria, with 59% having traumatic etiology, 18% vascular etiology, 22% infection, and 1% tumor. Symptomatic HO was diagnosed in 36 (22.8%) patients, and 94% patients had mild HO on radiographic scoring. Rate of HO in amputations related to trauma was not increased compared with those of other etiologies. Surgical resection of the ectopic bone was required in 4 (11%) patients. HO is seen commonly after civilian lower limb amputation regardless of etiology. The prevalence was less than that observed in previous reports from military populations. This is the first report estimating the prevalence of HO in adult civilian amputees. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Protection of Civilians: An Evolving Paradigm?

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Stuart Gordon

2013-08-01

Full Text Available Whilst the protection of civilians (POC in conflict has been a recurring feature of the humanitarian discourse the same has not been true in military doctrines, where the protection of civilians has long been cast in terms of arms bearers upholding their responsibilities under international humanitarian law (IHL. However, opportunities for and pressures on military actors to develop more specific capacities and approaches in this field have grown: partly as a response to the changing nature, location and scope of conflict, particularly the increasing proportion of internal conflicts fought by irregular armed groups in urban environments. It is also a response to the scale and complexity of protection challenges in the Balkans, Rwanda, Darfur and Libya - each of which has clearly demonstrated that threats to civilians are complex and dynamic and that no single international actor is capable of mitigating them without significant support from other institutions (O’Callaghan and Pantuliano, 2007. Despite the enormous growth in opportunities for interaction between militaries and humanitarians there is only a very limited literature on their interaction over protection issues and evaluations of the emerging doctrines. Consequently this article charts the growth in military policies towards POC in the UN, UK, NATO and a range of other states as well as drawing attention to the challenges that still remain in operationalising responses.

Hepatitis A and hepatitis B vaccination coverage among adults with chronic liver disease.

Science.gov (United States)

Yue, Xin; Black, Carla L; O'Halloran, Alissa; Lu, Peng-Jun; Williams, Walter W; Nelson, Noele P

2018-02-21

Infection with hepatitis A and hepatitis B virus can increase the risk of morbidity and mortality in persons with chronic liver disease (CLD). The Advisory Committee on Immunization Practices recommends hepatitis A (HepA) and hepatitis B (HepB) vaccination for persons with CLD. Data from the 2014 and 2015 National Health Interview Surveys (NHIS), nationally representative, in-person interview surveys of the non-institutionalized US civilian population, were used to assess self-reported HepA (≥1 and ≥2 doses) and HepB vaccination (≥1 and ≥3 doses) coverage among adults who reported a chronic or long-term liver condition. Multivariable logistic regression was used to identify factors independently associated with HepA and HepB vaccination among adults with CLD. Overall, 19.4% and 11.5% of adults aged ≥ 18 years with CLD reported receiving ≥1 dose and ≥2 doses of HepA vaccine, respectively, compared with 14.7% and 9.1% of adults without CLD (p CLD, ≥1dose). Age, education, geographic region, and international travel were associated with receipt of ≥2 doses HepA vaccine among adults with CLD. Overall, 35.7% and 29.1% of adults with CLD reported receiving ≥1 dose and ≥3 doses of HepB vaccine, respectively, compared with 30.2% and 24.7% of adults without CLD (p CLD, ≥1 dose). Age, education, and receipt of influenza vaccination in the past 12 months were associated with receipt of ≥3 doses HepB vaccine among adults with CLD. Among adults with CLD and ≥10 provider visits, only 13.8% and 35.3% had received ≥2 doses HepA and ≥3 doses HepB vaccine, respectively. HepA and HepB vaccination among adults with CLD is suboptimal and missed opportunities to vaccinate occurred. Providers should adhere to recommendations to vaccinate persons with CLD to increase vaccination among this population. Copyright © 2018 Elsevier Ltd. All rights reserved.

Complex sequelae of psychological trauma among Kosovar civilian war victims.

Science.gov (United States)

Morina, Nexhmedin; Ford, Julian D

2008-09-01

The impact of war trauma on civilians may include, but also extend beyond, post-traumatic stress disorder (PTSD) to include complex sequelae such as those described by the syndrome of Disorders of Extreme Stress Not Otherwise Specified (DESNOS). In the present study, 102 civilian war victims were interviewed in Kosovo, assessing traumatic life events, PTSD, DESNOS, and depression. Full DESNOS rarely occurred (2% prevalence), however, clinically significant DESNOS symptoms of somatization, altered relationships, and altered systems of meaning were reported by between 24-42% of respondents. Although DESNOS symptoms were correlated with PTSD symptoms, DESNOS symptoms were associated with poorer overall psychological functioning, self-evaluations, satisfaction with life, and social support independent of the effects of PTSD. The findings suggest that DESNOS warrants attention in addition to PTSD in the assessment and treatment of civilians who have been exposed to war and genocide.

Gel-eletroforese no diagnóstico da varíola Gel-electrophoresis in the smallpox diagnosis

Directory of Open Access Journals (Sweden)

Julio A. Mesquita

1972-01-01

Full Text Available O emprego de gel-eletroforese no diagnóstico da varíola, demonstrou ser ao menos trinta vezes (30X mais sensível que o teste de agar-gel, nas condições descritas (tabela I. Doze (12 espécimes, cujos testes convencionais de inoculação em ovos embrionados e de agar-gel resultaram positivos, foram testados em suas diluições originais congeladas por mais de um ano, sendo seis deles revelados por gel-eletroforese enquanto nenhum o foi por agar-gel (tabela II. Trinta e três (33 amostras isoladas no laboratório, foram testadas com material colhido de membrana cório-alantóica da primeira inoculação para o diagnóstico, conservado em glicerina 50%, resultando 15 positivas em gel-eletroforese e apenas 3 em agar-gel (tabela II. Os últimos 60 espécimes recebidos para diagnóstico, através a Campanha de Erradicação da Varíola, também resultaram negativos em gel-eletroforese, que não mostrou falsos-positivos nas condições descritas.The test of gel-electrophoresis applied to the pox virus group showed to be at least thirth times (30X more sensitive than agar-gel test on the described conditions (Table I. Twelve specimens, which were positives form Smallpox in the conventional tests of egg inoculation and agar-gel difusion test, have been screened in their original dilutions frozen for more than 1 year and six of them were still detectable by gel-eletrophoresis, while by agar-gel test any of them was positive (Table II. Thirty three Smallpox isolates have been tested with material from first egg inoculation (chorioallantoic membranes which have been stored in glycerin 50%, at - 15ºC. Fifteen of them were still positive by gel-electrophoresis and only 3 by agar-gel (Table II. The last 60 specimens received for diagnosis from Smallpox Erradication Campaign (CEV, were negatives by both tests. The gel-electrophoresis, did not show false-positives on described conditions.

A novel highly reproducible and lethal nonhuman primate model for orthopox virus infection.

Directory of Open Access Journals (Sweden)

Marit Kramski

Full Text Available The intentional re-introduction of Variola virus (VARV, the agent of smallpox, into the human population is of great concern due its bio-terroristic potential. Moreover, zoonotic infections with Cowpox (CPXV and Monkeypox virus (MPXV cause severe diseases in humans. Smallpox vaccines presently available can have severe adverse effects that are no longer acceptable. The efficacy and safety of new vaccines and antiviral drugs for use in humans can only be demonstrated in animal models. The existing nonhuman primate models, using VARV and MPXV, need very high viral doses that have to be applied intravenously or intratracheally to induce a lethal infection in macaques. To overcome these drawbacks, the infectivity and pathogenicity of a particular CPXV was evaluated in the common marmoset (Callithrix jacchus.A CPXV named calpox virus was isolated from a lethal orthopox virus (OPV outbreak in New World monkeys. We demonstrated that marmosets infected with calpox virus, not only via the intravenous but also the intranasal route, reproducibly develop symptoms resembling smallpox in humans. Infected animals died within 1-3 days after onset of symptoms, even when very low infectious viral doses of 5x10(2 pfu were applied intranasally. Infectious virus was demonstrated in blood, saliva and all organs analyzed.We present the first characterization of a new OPV infection model inducing a disease in common marmosets comparable to smallpox in humans. Intranasal virus inoculation mimicking the natural route of smallpox infection led to reproducible infection. In vivo titration resulted in an MID(50 (minimal monkey infectious dose 50% of 8.3x10(2 pfu of calpox virus which is approximately 10,000-fold lower than MPXV and VARV doses applied in the macaque models. Therefore, the calpox virus/marmoset model is a suitable nonhuman primate model for the validation of vaccines and antiviral drugs. Furthermore, this model can help study mechanisms of OPV pathogenesis.

The importance of civilian nursing organizations: integrative literature review.

Science.gov (United States)

Santos, James Farley Estevam Dos; Santos, Regina Maria Dos; Costa, Laís de Miranda Crispim; Almeida, Lenira Maria Wanderley Santos de; Macêdo, Amanda Cavalcante de; Santos, Tânia Cristina Franco

2016-06-01

to identify and analyze evidence from studies about the importance of civilian nursing organizations. an integrative literature review, for which searches were conducted in the databases LILACS, PubMed/MEDLINE, SciELO, BDENF, and Scopus. sixteen articles published between the years 2004-2013 were selected, 68.75% of which were sourced from Brazilian journals and 31.25% from American journals. civilian nursing organizations are important and necessary, because they have collaborated decisively in nursing struggles in favor of the working class and society in general, and these contributions influence different axes of professional performance.

Emerging Options and Opportunities in Civilian Aeronautics

Science.gov (United States)

Bushnell, Dennis M.

2012-01-01

This paper addresses the major problems/issues with civilian aeronautics going forward, the contextual ongoing technology revolutions, the several emerging civilian aeronautical "Big Ideas" and associated enabling technological approaches. The ongoing IT Revolution is increasingly providing, as 5 senses virtual presence/reality becomes available, along with Nano/Molecular Manufacturing, virtual alternatives to Physical transportation for both people and goods. Paper examines the potential options available to aeronautics to maintain and perhaps grow "market share" in the context of this evolving competition. Many of these concepts are not new, but the emerging technology landscape is enhancing their viability and marketability. The concepts vary from the "interesting" to the truly revolutionary and all require considerable research. Paper considers the speed range from personal/general aviation to supersonic transports and technologies from energetics to fabrication.

Characteristics and Pay of Federal Civilian Employees

National Research Council Canada - National Science Library

2007-01-01

...) examined the attributes of a subset of the government's civilian workforce: the roughly 1.4 million salaried workers not including employees of the Postal Service who fill full-time permanent positions in the executive branch...

Implications of Posttraumatic Stress Among Military-Affiliated and Civilian Students

Science.gov (United States)

Barry, Adam E.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.

2012-01-01

Objectives Determine whether posttraumatic stress symptoms (PTS) are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants Final sample (n = 248) included 78 combat exposed student service members/veterans, 53 non-combat exposed student service members/veterans, 38 ROTC students, and 79 civilian students. Method Self-report data was collected spring 2011 via a web-based survey measuring PTS, problem drinking, alcohol-related consequences, GPA, educational self-efficacy, academic amotivation and persistence. Results Military students exposed to combat-related trauma reported significantly greater PTS symptoms than other military and civilian groups. PTS symptoms were associated with problem drinking and alcohol-related consequences for all groups, yet unrelated to academic correlates among those exposed to combat-related trauma. Conclusions This study adds to the scant literature base exploring the unique characteristics of student service members/veterans in higher education. PMID:23157198

Small(pox success? Erradicação da varíola: medida do sucesso?

Directory of Open Access Journals (Sweden)

Anne-Emanuelle Birn

2011-02-01

Full Text Available The 30th anniversary of the World Health Organization's (WHO official certification of smallpox eradication was marked by a slew of events hailing the campaign's dramatic tale of technological and organizational triumph against an ancient scourge. Yet commemorations also serve as moments of critical reflection. This article questions the acclaim showered upon smallpox eradication as the single greatest public health success in history. It examines how and why smallpox eradication and WHO's concurrent social justice-oriented primary health care approach (following from the Declaration of Alma-Ata became competing paradigms. It synthesizes critiques of eradication's shortcomings and debunks some of the myths surrounding the global eradication campaign as a public health priority and necessity, and as a Cold War victory of cooperation. The article concludes with thoughts on integrating technical and social-political aspects of health within the context of welfare states as the means to achieving widespread and enduring global public health success.O 30º aniversário da certificação oficial da Organização Mundial da Saúde (OMS da erradicação da varíola foi marcado por uma série de eventos que saudaram a dramática história do triunfo tecnológico e organizacional contra este antigo flagelo. Todavia, as comemorações também servem como momentos para uma reflexão crítica. Este artigo questiona os aplausos excessivos para a erradicação da varíola como o único e absoluto sucesso na história da saúde pública. Examina como e por que a erradicação da varíola e a abordagem da atenção básica de saúde orientada para a justiça social (de acordo com a Declaração de Alma-Ata se tornaram paradigmas concorrentes. Sintetiza críticas sobre as deficiências da erradicação e busca desvelar alguns dos mitos que envolvem a campanha de erradicação global como uma prioridade e necessidade da saúde pública, e como uma vitória da

Update on Key Studies - The Millennium Cohort Study, The STAMPEDE Study, The Million Veteran Program, and The National Health Study for a New Generation of US Veterans

Science.gov (United States)

2015-01-01

Deployment scientific; ethical ; and legal experts in the field of genetics and veteran representatives, and partners, including but not limited to veterans...Smith TC, et al. Anthrax vaccination in the Millennium Cohort: validation and measures of health. Am J Prev Med. 2007;32:347–353. 20. Smith B, Smith...LeardMann CA, Smith B, Smith TC, Wells TS, Ryan MAK. Smallpox vaccination : comparison of self-reported and electronic vaccine records in the millennium

How Drone Strikes and a Fake Vaccination Program Have Inhibited Polio Eradication in Pakistan: An Analysis of National Level Data.

Science.gov (United States)

Kennedy, Jonathan

2017-10-01

This article investigates whether the United States' counterinsurgency operations have inhibited polio eradication efforts in northwestern Pakistan, the world's last major reservoir of polio. Anecdotal evidence suggests that militants disrupt polio vaccination programs because of suspicions that campaigns are a cover for gathering intelligence on Central Intelligence Agency (CIA) drone targets. This paper analyzes national-level quantitative data to test this argument. Between 2004 and 2012, the number of polio cases in Pakistan closely mirrored the number of drone strikes. But from 2013 onward, polio cases increased while drone strikes fell. This can be explained by the CIA's use of a fake immunization campaign in a failed attempt to obtain the DNA of Osama bin Laden's relatives prior to his assassination in 2011. This seemingly vindicated militants' suspicions that vaccination programs were a cover for espionage. Militants consequently intensified their disruption of immunization campaigns, resulting in an increase in polio cases in Pakistan, as well as in Afghanistan, Syria, and Iraq. For politicians and military planners, drones are attractive because they are said to harm fewer civilians than conventional methods of warfare. However, this paper demonstrates that drone strikes had negative effects on the well-being of civilians in Pakistan and further afield because they undermined global efforts to eradicate polio.

Caring for Active Duty Military Personnel in the Civilian Sector

Science.gov (United States)

Waitzkin, Howard; Noble, Marylou

2011-01-01

Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians), and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers. PMID:21339846

Caring for Active Duty Military Personnel in the Civilian Sector

Directory of Open Access Journals (Sweden)

Marylou Noble

2009-03-01

Full Text Available Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians, and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers.

Civilian Training in High-Altitude Flight Physiology

Science.gov (United States)

1991-08-01

A survey was conducted to determine if training in high-altitude physiology should : be required for civilian pilots; what the current status of such training was; and, : if required, what should be included in an ideal curriculum. The survey include...

Report on the Audit of the Joint Civilian Orientation Conference Fund

Science.gov (United States)

1991-01-31

This is our final report on the audit of the Joint Civilian Orientation Conference (JCOC) Fund (the Fund). We performed the audit from June to July...1990. The Director, Budget and Finance, Washington Headquarters Services, requested the audit because a new Treasurer had been appointed. The overall...Instruction No. 48, Joint Civilian Orientation Conference Fund, May 31, 1983, and with DoD policy and guidelines. In addition, the audit evaluated

Systems analysis of decontamination options for civilian vehicles.

Energy Technology Data Exchange (ETDEWEB)

Foltz, Greg W.; Hoette, Trisha Marie

2010-11-01

The objective of this project, which was supported by the Department of Homeland Security (DHS) Science and Technology Directorate (S&T) Chemical and Biological Division (CBD), was to investigate options for the decontamination of the exteriors and interiors of vehicles in the civilian setting in order to restore those vehicles to normal use following the release of a highly toxic chemical. The decontamination of vehicles is especially challenging because they often contain sensitive electronic equipment, multiple materials some of which strongly adsorb chemical agents, and in the case of aircraft, have very rigid material compatibility requirements (i.e., they cannot be exposed to reagents that may cause even minor corrosion). A systems analysis approach was taken examine existing and future civilian vehicle decontamination capabilities.

Multifaceted contributions: health workers and smallpox eradication in India.

Science.gov (United States)

Bhattacharya, Sanjoy

2008-01-01

Smallpox eradication in South Asia was a result of the efforts of many grades of health-workers. Working from within the confines of international organisations and government structures, the role of the field officials, who were of various nationalities and also drawn from the cities and rural enclaves of the countries in these regions, was crucial to the development and deployment of policies. However, the role of these personnel is often downplayed in official histories and academic histories, which highlight instead the roles played by a handful of senior officials within the World Health Organization and the federal governments in the sub-continent. This article attempts to provide a more rounded assessment of the complex situation in the field. In this regard, an effort is made to underline the great usefulness of the operational flexibility displayed by field officers, wherein lessons learnt in the field were made an integral part of deploying local campaigns; careful engagement with the communities being targeted, as well as the employment of short term workers from amongst them, was an important feature of this work.

Fulltext PDF

Indian Academy of Sciences (India)

Unknown

items produced by the international media also tend to annoy me: most of them refer to the disease ... Smallpox Eradication Archives of the World Health Organization. ... governmental standpoints and, sometimes, oppose vaccination, and the ...

Smallpox virus plaque phenotypes: genetic, geographical and case fatality relationships.

Science.gov (United States)

Olson, Victoria A; Karem, Kevin L; Smith, Scott K; Hughes, Christine M; Damon, Inger K

2009-04-01

Smallpox (infection with Orthopoxvirus variola) remains a feared illness more than 25 years after its eradication. Historically, case-fatality rates (CFRs) varied between outbreaks (<1 to approximately 40 %), the reasons for which are incompletely understood. The extracellular enveloped virus (EEV) form of orthopoxvirus progeny is hypothesized to disseminate infection. Investigations with the closely related Orthopoxvirus vaccinia have associated increased comet formation (EEV production) with increased mouse mortality (pathogenicity). Other vaccinia virus genetic manipulations which affect EEV production inconsistently support this association. However, antisera against vaccinia virus envelope protect mice from lethal challenge, further supporting a critical role for EEV in pathogenicity. Here, we show that the increased comet formation phenotypes of a diverse collection of variola viruses associate with strain phylogeny and geographical origin, but not with increased outbreak-related CFRs; within clades, there may be an association of plaque size with CFR. The mechanisms for variola virus pathogenicity probably involves multiple host and pathogen factors.

Civilian applications for superconducting magnet technology developed for defense

International Nuclear Information System (INIS)

Johnson, R.A.; Klein, S.W.; Gurol, H.

1986-01-01

Seventy years after its discovery, superconducting technology is beginning to play an important role in the civilian sector. Strategic defense initiative (SDI)-related research in space- and ground-based strategic defense weapons, particularly research efforts utilizing superconducting magnet energy storage, magnetohydrodynamics (MHD), and superconducting pulsed-power devices, have direct applications in the civilian sector as well and are discussed in the paper. Other applications of superconducting magnets, which will be indirectly enhanced by the overall advancement in superconducting technology, include high-energy physics accelerators, magnetic resonance imaging, materials purifying, water purifying, superconducting generators, electric power transmission, magnetically levitated trains, magnetic-fusion power plants, and superconducting computers

The Department of Defense's Civilian Human Capital Strategic Plan Does Not Meet Most Statutory Requirements

National Research Council Canada - National Science Library

Farrell, Brenda S

2008-01-01

To examine the extent to which DOD's civilian human capital strategic plan addresses congressional reporting requirements, we obtained and analyzed the "Department of Defense Civilian Human Capital...

Transmission of vaccinia virus, possibly through sexual contact, to a woman at high risk for adverse complications.

Science.gov (United States)

Said, Maria A; Haile, Charles; Palabindala, Venkataraman; Barker, Naomi; Myers, Robert; Thompson, Ruth; Wilson, Lucy; Allan-Martinez, Frances; Montgomery, Jay; Monroe, Benjamin; Tack, Danielle; Reynolds, Mary; Damon, Inger; Blythe, David

2013-12-01

Severe adverse events, including eczema vaccinatum (EV), can result after smallpox vaccination. Persons at risk for EV include those with underlying dermatologic conditions, such as atopic dermatitis. We investigated a case of vaccinia infection, possibly acquired during sexual contact with a recently vaccinated military service member, in a female Maryland resident with atopic dermatitis. The U.S. Department of Defense's Vaccine Healthcare Centers Network (VHCN) and the Centers for Disease Control and Prevention (CDC) worked in conjunction with the patient's physician and the Maryland Department of Health and Mental Hygiene (DHMH) to confirm the diagnosis, ensure treatment, and prevent further transmission. Specimens collected from the patient were tested at the DHMH laboratories and were positive by real-time polymerase chain reaction for nonvariola orthopoxvirus. Testing at the CDC verified the presence of vaccinia-specific DNA signatures. Continuing spread of the patient's lesions led to the administration of vaccinia immune globulin and strict infection control measures to prevent tertiary transmission to vulnerable family members, also with atopic dermatitis. VHCN contacted the service member to reinforce vaccination site care and hygiene. This case underscores the importance of prevaccination education for those receiving the smallpox vaccine to protect contacts at risk for developing severe adverse reactions. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

US military primary care: problems, solutions, and implications for civilian medicine.

Science.gov (United States)

Mundell, Benjamin F; Friedberg, Mark W; Eibner, Christine; Mundell, William C

2013-11-01

The US Military Health System (MHS), which is responsible for providing care to active and retired members of the military and their dependents, faces challenges in delivering cost-effective, high-quality primary care while maintaining a provider workforce capable of meeting both peacetime and wartime needs. The MHS has implemented workforce management strategies to address these challenges, including "medical home" teams for primary care and other strategies that expand the roles of nonphysician providers such as physician assistants, nurse practitioners, and medical technicians. Because these workforce strategies have been implemented relatively recently, there is limited evidence of their effectiveness. If they prove successful, they could serve as a model for the civilian sector. However, because the MHS model features a broad mix of provider types, changes to civilian scope-of-practice regulations for nonphysician providers would be necessary before the civilian provider mix could replicate that of the MHS.

cost-benefit analysis of anti-retroviral therapy (art) for hiv/aids

African Journals Online (AJOL)

user

HIV/AIDS is high and that is why most patients cannot access HIV/AIDS treatment even though these drugs are supposed to .... Laboratory in New Mexico, Dr. Gerald Myers, and ... tuberculosis, and vaccinations against smallpox represented ...

32 CFR 719.138 - Fees of civilian witnesses.

Science.gov (United States)

2010-07-01

...) Method of Payment. The fees and mileage of a civilian witness shall be paid by the disbursing officer of... whose testimony is determined not to meet the standards of relevancy and materiality set forth in...

Epidemiological patterns of suicide terrorism in the civilian Pakistani population.

Science.gov (United States)

Bhatti, Junaid Ahmad; Mehmood, Amber; Shahid, Muhammad; Bhatti, Sajjad Akbar; Akhtar, Umbreen; Razzak, Junaid Abdul

2011-09-01

In this study, we assessed the epidemiological patterns of suicide terrorism in the civilian population of Pakistan. Information about suicide terrorism-related events, deaths and injuries was extracted from the South-Asian Terrorism Portal (SATP) for the period from 2002 to October 2009. Of 198 events, civilians were involved in 194 events. Civilians accounted for 74.1% (N = 2017) of those who died and 93.8% (N = 6129) of those who were injured. In nine districts, mortality rates were more than one death per 100,000 inhabitants per year. The yearly trend showed a shift of attack targets from foreigners and sectarian targets in 2002-2005 to security forces or general public in 2006-2009. Attacks on public installations (mosques) or political gatherings resulted in a significantly greater (P ≤ 0.02) number of deaths (22 vs. 8) and injuries (59 vs. 24) per event compared with security installations. These results show that prevention might focus on political negotiation with armed groups and that appropriate measures should be taken to protect mosques and political gatherings.

Factors associated with civilian drivers involved in crashes with emergency vehicles.

Science.gov (United States)

Drucker, Christopher; Gerberich, Susan G; Manser, Michael P; Alexander, Bruce H; Church, Timothy R; Ryan, Andrew D; Becic, Ensar

2013-06-01

Motor vehicle crashes involving civilian and emergency vehicles (EVs) have been a known problem that contributes to fatal and nonfatal injuries; however, characteristics associated with civilian drivers have not been examined adequately. This study used data from The National Highway Traffic Safety Administration's Fatality Analysis Reporting System and the National Automotive Sampling System General Estimates System to identify driver, roadway, environmental, and crash factors, and consequences for civilian drivers involved in fatal and nonfatal crashes with in-use and in-transport EVs. In general, drivers involved in emergency-civilian crashes (ECCs) were more often driving: straight through intersections (vs. same direction) of four-points or more (vs. not at intersection); where traffic signals were present (vs. no traffic control device); and at night (vs. midday). For nonfatal ECCs, drivers were more often driving: distracted (vs. not distracted); with vision obstructed by external objects (vs. no obstruction); on dark but lighted roads (vs. daylight); and in opposite directions (vs. same directions) of the EVs. Consequences included increased risk of injury (vs. no injury) and receiving traffic violations (vs. no violation). Fatal ECCs were associated with driving on urban roads (vs. rural), although these types of crashes were less likely to occur on dark roads (vs. daylight). The findings of this study suggest drivers may have difficulties in visually detecting EVs in different environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

The U.S. Army Person-Event Data Environment: A Military-Civilian Big Data Enterprise.

Science.gov (United States)

Vie, Loryana L; Scheier, Lawrence M; Lester, Paul B; Ho, Tiffany E; Labarthe, Darwin R; Seligman, Martin E P

2015-06-01

This report describes a groundbreaking military-civilian collaboration that benefits from an Army and Department of Defense (DoD) big data business intelligence platform called the Person-Event Data Environment (PDE). The PDE is a consolidated data repository that contains unclassified but sensitive manpower, training, financial, health, and medical records covering U.S. Army personnel (Active Duty, Reserve, and National Guard), civilian contractors, and military dependents. These unique data assets provide a veridical timeline capturing each soldier's military experience from entry to separation from the armed forces. The PDE was designed to afford unprecedented cost-efficiencies by bringing researchers and military scientists to a single computerized repository rather than porting vast data resources to individual laboratories. With funding from the Robert Wood Johnson Foundation, researchers from the University of Pennsylvania Positive Psychology Center joined forces with the U.S. Army Research Facilitation Laboratory, forming the scientific backbone of the military-civilian collaboration. This unparalleled opportunity was necessitated by a growing need to learn more about relations between psychological and health assets and health outcomes, including healthcare utilization and costs-issues of major importance for both military and civilian population health. The PDE represents more than 100 times the population size and many times the number of linked variables covered by the nation's leading sources of population health data (e.g., the National Health and Nutrition Examination Survey). Following extensive Army vetting procedures, civilian researchers can mine the PDE's trove of information using a suite of statistical packages made available in a Citrix Virtual Desktop. A SharePoint collaboration and governance management environment ensures user compliance with federal and DoD regulations concerning human subjects' protections and also provides a secure

The highly virulent variola and monkeypox viruses express secreted inhibitors of type I interferon

Science.gov (United States)

Fernández de Marco, María del Mar; Alejo, Alí; Hudson, Paul; Damon, Inger K.; Alcami, Antonio

2010-01-01

Variola virus (VARV) caused smallpox, one of the most devastating human diseases and the first to be eradicated, but its deliberate release represents a dangerous threat. Virulent orthopoxviruses infecting humans, such as monkeypox virus (MPXV), could fill the niche left by smallpox eradication and the cessation of vaccination. However, immunomodulatory activities and virulence determinants of VARV and MPXV remain largely unexplored. We report the molecular characterization of the VARV- and MPXV-secreted type I interferon-binding proteins, which interact with the cell surface after secretion and prevent type I interferon responses. The proteins expressed in the baculovirus system have been purified, and their interferon-binding properties characterized by surface plasmon resonance. The ability of these proteins to inhibit a broad range of interferons was investigated to identify potential adaptation to the human immune system. Furthermore, we demonstrate by Western blot and activity assays the expression of the type I interferon inhibitor during VARV and MPXV infections. These findings are relevant for the design of new vaccines and therapeutics to smallpox and emergent virulent orthopoxviruses because the type I interferon-binding protein is a major virulence factor in animal models, vaccination with this protein induces protective immunity, and its neutralization prevents disease progression.—Fernández de Marco, M. M., Alejo, A., Hudson, P., Damon, I. K., Alcami, A. The highly virulent variola and monkeypox viruses express secreted inhibitors of type I interferon. PMID:20019241

Systemically administered DNA and fowlpox recombinants expressing four vaccinia virus genes although immunogenic do not protect mice against the highly pathogenic IHD-J vaccinia strain.

Science.gov (United States)

Bissa, Massimiliano; Pacchioni, Sole Maria; Zanotto, Carlo; De Giuli Morghen, Carlo; Illiano, Elena; Granucci, Francesca; Zanoni, Ivan; Broggi, Achille; Radaelli, Antonia

2013-12-26

The first-generation smallpox vaccine was based on live vaccinia virus (VV) and it successfully eradicated the disease worldwide. Therefore, it was not administered any more after 1980, as smallpox no longer existed as a natural infection. However, emerging threats by terrorist organisations has prompted new programmes for second-generation vaccine development based on attenuated VV strains, which have been shown to cause rare but serious adverse events in immunocompromised patients. Considering the closely related animal poxviruses that might also be used as bioweapons, and the increasing number of unvaccinated young people and AIDS-affected immunocompromised subjects, a safer and more effective smallpox vaccine is still required. New avipoxvirus-based vectors should improve the safety of conventional vaccines, and protect from newly emerging zoonotic orthopoxvirus diseases and from the threat of deliberate release of variola or monkeypox virus in a bioterrorist attack. In this study, DNA and fowlpox recombinants expressing the L1R, A27L, A33R and B5R genes were constructed and evaluated in a pre-clinical trial in mouse, following six prime/boost immunisation regimens, to compare their immunogenicity and protective efficacy against a challenge with the lethal VV IHD-J strain. Although higher numbers of VV-specific IFNγ-producing T lymphocytes were observed in the protected mice, the cytotoxic T-lymphocyte response and the presence of neutralising antibodies did not always correlate with protection. In spite of previous successful results in mice, rabbits and monkeys, where SIV/HIV transgenes were expressed by the fowlpox vector, the immune response elicited by these recombinants was low, and most of the mice were not protected. Copyright © 2013 Elsevier B.V. All rights reserved.

[Comparison of protective properties of the smallpox DNA-vaccine based on the variola virus A30L gene and its variant with modified codon usage].

Science.gov (United States)

Maksiutov, R A; Shchelkunov, S N

2011-01-01

Efficacy of candidate DNA-vaccines based on the variola virus natural gene A30L and artificial gene A30Lopt with modified codon usage, optimized for expression in mammalian cells, was tested. The groups of mice were intracutaneously immunized three times with three-week intervals with candidate DNA-vaccines: pcDNA_A30L or pcDNA_A30Lopt, and in three weeks after the last immunization all mice in the groups were intraperitoneally infected by the ectromelia virus K1 strain in 10 LD50 dose for the estimation of protection. It was shown that the DNA-vaccines based on natural gene A30L and codon-optimized gene A30Lopt elicited virus, thereby neutralizing the antibody response and protected mice from lethal intraperitoneal challenge with the ectromelia virus with lack of statistically significant difference.

32 CFR 705.15 - Employment of Navy personnel as correspondents or staff members of civilian news media.

Science.gov (United States)

2010-07-01

... or staff members of civilian news media. 705.15 Section 705.15 National Defense Department of Defense... REGULATIONS § 705.15 Employment of Navy personnel as correspondents or staff members of civilian news media. (a) A member of the naval service on active duty or Navy civilian may act as correspondent for a news...

Non-Human Primate Models of Orthopoxvirus Infections

Directory of Open Access Journals (Sweden)

Anne Schmitt

2014-06-01

Full Text Available Smallpox, one of the most destructive diseases, has been successfully eradicated through a worldwide vaccination campaign. Since immunization programs have been stopped, the number of people with vaccinia virus induced immunity is declining. This leads to an increase in orthopoxvirus (OPXV infections in humans, as well as in animals. Additionally, potential abuse of Variola virus (VARV, the causative agent of smallpox, or monkeypox virus, as agents of bioterrorism, has renewed interest in development of antiviral therapeutics and of safer vaccines. Due to its high risk potential, research with VARV is restricted to two laboratories worldwide. Therefore, numerous animal models of other OPXV infections have been developed in the last decades. Non-human primates are especially suitable due to their close relationship to humans. This article provides a review about on non-human primate models of orthopoxvirus infections.

Civilian duodenal gunshot wounds: surgical management made simpler.

Science.gov (United States)

Talving, Peep; Nicol, Andrew J; Navsaria, Pradeep H

2006-04-01

Low-velocity gunshot wounds cause most civilian duodenal injuries. The objective of this study was to describe a simplified surgical algorithm currently in use in a South African civilian trauma center and to verify its validity by measuring morbidity and mortality. A retrospective chart review of patients with duodenal gunshot injuries during the study period January 1999 to December 2003 was performed. Data points accrued included patient demographics, admission hemodynamic status and resuscitative measures, laparotomy damage control procedures, methods of surgical repair of the duodenal injury, associated injuries, length of intensive care and hospital stays, complications, and mortality. A total of 75 consecutive patients with gunshot injuries to the duodenum were reviewed. Primary repair was performed in 54 patients (87%), resection and reanastomosis in 7 (11%), and pancreatoduodenectomy in 1 (2%) during the initial phases. The overall morbidity and mortality were 58% and 28%, respectively. Duodenum-related complications were recorded in nine (15%) patients: two duodenal fistulas, one duodenal obstruction, and six cases of suture-line dehiscence. Overall and duodenum-related morbidity rates in patients with combined pancreatoduodenal injuries were 83% and 17%, respectively. Duodenum-related mortality occurred in three (4.8%) patients. Most civilian low-velocity duodenal gunshot injuries treated with simple primary repair result in overall morbidity, mortality, and duodenum-related complication rates comparable to those in reports where more complex surgical procedures were employed. Primary repair is also applicable for most combined pancreatic and duodenal gunshot injuries.

Investigating the Relationship Between Drone Warfare and Civilian Casualties in Gaza

Directory of Open Access Journals (Sweden)

Dr. Ann Rogers

2014-12-01

Full Text Available Unmanned aerial vehicles (UAVs, better known as drones, are increasingly touted as ‘humanitarian’ weapons that contribute positively to fighting just wars and saving innocent lives. At the same time, civilian casualties have become the most visible and criticized aspect of drone warfare. It is argued here that drones contribute to civilian casualties not in spite of, but because of, their unique attributes. They greatly extend war across time and space, pulling more potential threats and targets into play over long periods, and because they are low-risk and highly accurate, they are more likely to be used. The assumption that drones save lives obscures a new turn in strategic thinking that sees states such as Israel and the US rely on large numbers of small, highly discriminating attacks applied over time to achieve their objectives. This examination of Israel’s 2014 war in Gaza argues that civilian casualties are not an unexpected or unintended consequence of drone warfare, but an entirely predictable outcome.

Comparison of elective lumbar discectomy outcomes between civilians and military personnel

International Nuclear Information System (INIS)

Farzanegan, G.; Mohebbi, H.A.; Moharamzad, Y.

2007-01-01

To determine the results of discectomy surgery for lumbar disc herniation in military personnel and compare it with civilians. One-hundred and seventeen military patients (54 subjects as combat forces and 63 as office personnel) and 115 civilians, who underwent discectomy surgery were included. In a mean duration of 50.8 months, the ability to return to full duty and resolution of complaints were assessed and satisfaction was measured using a Visual Analog Scale. Inability to return to previous duty was significantly higher in military personnel compared to civilians (p = 0.002); and in combat forces compared to office personnel (p 0.05). Surgical intervention had relatively poor outcomes in military personnel, specifically in combat forces. Prevention of injury to back region should be considered in military training programs and in case of presence of disc herniation related symptoms, efforts should be made to save patients effective function by conservation and medical therapies. (author)

Pre-hospital management of mass casualty civilian shootings: a systematic literature review

OpenAIRE

Turner, Conor D. A.; Lockey, David J.; Rehn, Marius

2016-01-01

Background Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future p...

Peacekeeping/Stabilization and Conflict Transitions: Background and Congressional Action on the Civilian Response/Reserve Corps and Other Civilian Stabilization and Reconstruction Capabilities

National Research Council Canada - National Science Library

Serafino, Nina M

2009-01-01

.... In September 2008, Congress passed the Reconstruction and Stabilization Civilian Management Act, 2008, as Title XVI of the Duncan Hunter National Defense Authorization Act for Fiscal Year 2009 (S. 3001, P.L...

Military and Civilian L2 Instructors: Decoding Perceptions of U.S. Service Academy Cadets

Science.gov (United States)

Miller, Zachary F.

2016-01-01

This study examined whether cadets at a U.S. service academy perceived attitudinal differences toward their military and civilian L2 instructors along three variables: foreign language expertise, communicative anxiety, and relatability. Cadets' proficiency levels (divided by beginning and intermediate classes) and current instructor (civilian or…

Survey of Retired Military Pharmacist's Transition to a Civilian Pharmacy Career Path.

Science.gov (United States)

Bennett, David; Wellman, Greg; Mahmood, Maysaa; Freye, Ryan; Remund, Daniel; Samples, Phil L

2015-12-01

To explore variables relevant to transition to civilian pharmacy career path for retiring military pharmacists. A cross-sectional survey was designed to collect information from retired military pharmacists including demographics, military service information, postretirement employment and perceptions of transition, satisfaction, level of responsibility, work environment, rewards (level of financial compensation, opportunities for professional development and career advancement, health benefits), and level of supervisory support. The questionnaire also included additional items asking about their perception of their military experience, transition to civilian work and the impact the military career had on their personal and family life. Respondents included 140 retired pharmacists from the U.S. Army, Navy, Air Force, or Coast Guard. Factors found to be significant predictors of transition to civilian career included: bureaucracy in current job, time elapsed since retirement, extent to which an individual misses military structure and chain of command, access to military facilities and Veterans Administration benefits, and reporting little or no stress in committed long-term personal relationship while in the military. Findings suggest that the majority of retired military pharmacists perceived the transition to civilian professional sector was about what they expected or easier than expected. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Civilian Protection in the Eastern DRC: Evaluation of the MONUSCO Peacekeeping Operation

Science.gov (United States)

2012-03-01

Richard Shelly Hartigan, Civilian Victims in War: A Political History (Chicago: Precedent Publishers, 2010), 5–6. 32 Ibid., 7. 33 Martha Finnemore...in the DRC, and also because it casts light on the convoluted reality of violence in the eastern Congo. That is, it presents a visceral example of how...be Anonymous,’” National Public Radio World News, 6 April 2011. Hartigan, Richard Shelly . Civilian Victims in War: A Political History. Chicago

Educating nurses to care for military veterans in civilian hospitals: An integrated literature review.

Science.gov (United States)

Cooper, Linda; Andrew, Sharon; Fossey, Matt

2016-12-01

In the UK, military veterans will receive care by civilian nurses in civilian hospitals. We propose that the nurses providing this care require an understanding of the unique experiences and specific health needs of veterans to deliver evidence-based care. To conduct an integrative review of published literature to explore how nursing programmes prepare nurses to care for the military veteran population in civilian hospitals. A systematic search was undertaken of a range of electronic databases, Google Scholar and hand searching of Military and Veteran health journals. Papers that focused on education of civilian nurses about veteran health and included primary research or description of practice-based innovations were included in the review. The search generated sixteen papers that were focused on nurse education in higher education institutions. Several papers focused on simulation as a teaching method for veteran-specific health issues or curriculum developments with educational innovations such as online courses. Six papers focusing in continuing professional education of nurses in the clinical setting were included as supplementary information. All papers reviewed were US focused and dated between January 2011 and September 2015. Our search concluded that there is a gap in knowledge in this subject area within a UK context, therefore our review includes UK background information to support the US findings. Civilian nurses need educational preparation to understand the specific needs of veterans. Educational institutions in the US have responded to nationwide initiatives to undertake that preparation. More empirical studies need to be undertaken to develop, test and evaluate educational innovations for preparing students and nurses delivering care to military veteran in civilian healthcare settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

[The court physician, the clergyman, a learned society and smallpox].

Science.gov (United States)

Hillen, H F P

2017-01-01

Variolation was introduced in England in the first half of the 18th century. The positive effects of this new method for preventing smallpox were already known in the Netherlands around 1720, one of whom was the Dutch physician Boerhaave. In spite of this, it took another 30 years before variolation was used in the Netherlands. Despite receiving positive advice and information from his learned English friends Sloane and Sherard, Boerhaave did not apply nor advise the use of variolation. There were various arguments for this restrained approach. In 1754 Thomas Schwencke found that conditions were favourable for the introduction of variolation in The Hague. There was support from the House of Orange-Nassau (the current royal family in the Netherlands) and from a learned society; a highly motivated clergyman acted as ambassador for the new technique and the court physician Schwencke was willing to take the lead. A similar combination had previously been effective in England, though the ambassador there was not a clergyman but an influential noble lady.

Is Soviet Defense Policy Becoming Civilianized?

Science.gov (United States)

1990-08-01

Larionov, a consultant to the institute, both at RAND and in Moscow; and Drs. Alexei Arbatov and Aleksandr Savelyev and several of their colleagues during...Soviet defense industry resources to civilian use is presented in Arthur J. Alexander , Perestroika and Change in Soviet Weapons Acquisition, The RAND...1986, especially pp. 101-102. 17 18 the more prominent younger specialists like Alexei Arbatov, Andrei Kokoshin, and Aleksandr Savelyev have long been

Comment: Characterization of Two Historic Smallpox Specimens from a Czech Museum.

Science.gov (United States)

Porter, Ashleigh F; Duggan, Ana T; Poinar, Hendrik N; Holmes, Edward C

2017-09-28

The complete genome sequences of two strains of variola virus (VARV) sampled from human smallpox specimens present in the Czech National Museum, Prague, were recently determined, with one of the sequences estimated to date to the mid-19th century. Using molecular clock methods, the authors of this study go on to infer that the currently available strains of VARV share an older common ancestor, at around 1350 AD, than some recent estimates based on other archival human samples. Herein, we show that the two Czech strains exhibit anomalous branch lengths given their proposed age, and by assuming a constant rate of evolutionary change across the rest of the VARV phylogeny estimate that their true age in fact lies between 1918 and 1937. We therefore suggest that the age of the common ancestor of currently available VARV genomes most likely dates to late 16th and early 17th centuries and not ~1350 AD.

Comment: Characterization of Two Historic Smallpox Specimens from a Czech Museum

Directory of Open Access Journals (Sweden)

Ashleigh F. Porter

2017-09-01

Full Text Available The complete genome sequences of two strains of variola virus (VARV sampled from human smallpox specimens present in the Czech National Museum, Prague, were recently determined, with one of the sequences estimated to date to the mid-19th century. Using molecular clock methods, the authors of this study go on to infer that the currently available strains of VARV share an older common ancestor, at around 1350 AD, than some recent estimates based on other archival human samples. Herein, we show that the two Czech strains exhibit anomalous branch lengths given their proposed age, and by assuming a constant rate of evolutionary change across the rest of the VARV phylogeny estimate that their true age in fact lies between 1918 and 1937. We therefore suggest that the age of the common ancestor of currently available VARV genomes most likely dates to late 16th and early 17th centuries and not ~1350 AD.

Civilian Penetrating Gunshot Injury to the Neurocranium in Enugu

African Journals Online (AJOL)

This is an open access article distributed under the terms of the Creative Commons ... Table 1: Clinicodemographic profile of civilian penetrating gunshot neurocranial injuries ... (*Armed robbery, cultists, terrorism). [Downloaded free from ...

From civilians to soldiers and from soldiers to civilians: a micro-approach to disarmament, demobilization, and reintegration (DDR) in Sudan

NARCIS (Netherlands)

Baas, S.

2011-01-01

This dissertation investigates the processes of mobilization and demobilization of fighters during civil war. Why do civilians, at some point during a conflict, decide to participate in the violence of the war? What are the consequences of becoming part of a guerilla movement? And, once a civil war

State of the Art in Research on Medical Countermeasures Against Biological Agents (Etat de la recherch sur les contre-mesures medicales de lutte contre les agents biologiques)

Science.gov (United States)

2016-08-01

immunity to varicella -zoster virus in healthy adults. Vaccine 24, 5913-5918, doi:10.1016/j.vaccine.2006.04.060 (2006). [124] Kee SJ, et al. Age- and...Australia, Mexico , and South Korea). As the LRN-B continues programmatic maturation, they will not only continue to address biological terrorism...exanthematous illnesses [23]. For example, the severe chickenpox rash caused by varicella zoster virus was often misdiagnosed as that of smallpox. Other

76 FR 36019 - Amendments to Sterility Test Requirements for Biological Products

Science.gov (United States)

2011-06-21

... the biologics regulations. DATES: Submit either electronic or written comments on this proposed rule... No. FDA-2011- N-0080, by any of the following methods: Electronic Submissions Submit electronic... Factor (AHF), Platelets, Red Blood Cells, Plasma, Source Plasma, Smallpox Vaccine, Reagent Red Blood...

Against the Odds

Science.gov (United States)

... was eliminated in 1977 thanks to an extensive vaccination program. Photo: Ethiopia, ca. 1972, courtesy WHO Smallpox and ... living conditions and health services. PAHO worked with government leaders, combatants, and local organizations to create ... Immunization As part of a campaign to prevent the ...

20 CFR 1002.306 - Is a National Guard civilian technician considered a State or Federal employee for purposes of...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Is a National Guard civilian technician... a National Guard civilian technician considered a State or Federal employee for purposes of USERRA? A National Guard civilian technician is considered a State employee for USERRA purposes, although he...

Potential nuclear material safeguards applied to the Department of Energy's Civilian Radioactive Waste Management System

International Nuclear Information System (INIS)

Danker, W.J.; Floyd, W.

1993-01-01

The Office of Civilian Radioactive Waste Management (OCRWM) within the U.S. Department of Energy is charged with the responsibility of safe and efficient disposal of this Nation's civilian high-level radioactive waste and spent fuel. Part of this responsibility includes providing for the application of both domestic and international safeguards on nuclear material at facilities of the Civilian Waste Management System. While detailed safeguards requirements for these disposal facilities have yet to be established, once established, they could impact facility design. Accordingly, OCRWM has participated in efforts to develop safeguards approaches for geologic repositories and will continue to participate actively with the Nuclear Regulatory Commission (NRC), International Atomic Energy Agency (IAEA), as well as other Department of Energy (DOE) Offices in efforts to resolve safeguards issues related to spent fuel disposal, to minimize any potential design impacts and to support effective nuclear material safeguards. The following paper discusses current plants and issues related to the application of safeguards to the Civilian Radioactive Waste Management System (CRWMS)

DOE reassesses civilian radioactive waste management program

International Nuclear Information System (INIS)

Yates, M.

1990-01-01

This article reports on the announcement by the Department of Energy (DOE) that the opening of a high-level radioactive nuclear waste repository site will be delayed for seven years. The article discusses DOE's reassessment plan, the restructuring of the Office of Civilian Radioactive Waste Management, site access and evaluation, the Monitored Retrievable Storage Commission proposal, and the industry's response

[Combined burn trauma in the array of modern civilian and combat burns].

Science.gov (United States)

Ivchenko, E V; Borisov, D N; Golota, A S; Krassiĭ, A B; Rusev, I T

2015-02-01

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

Modified vaccinia virus Ankara protects macaques against respiratory challenge with monkeypox virus.

NARCIS (Netherlands)

K.J. Stittelaar (Koert); G. van Amerongen (Geert); I. Kondova (Ivanela); R.F. van Lavieren (Rob); F.H. Pistoor (Frank); H.G.M. Niesters (Bert); G.J.J. van Doornum (Gerard); B.A.M. van der Zeijst (Ben); L. Mateo (Luis); P.J. Chaplin (Paul); A.D.M.E. Osterhaus (Albert); T. Kuiken (Thijs)

2005-01-01

textabstractThe use of classical smallpox vaccines based on vaccinia virus (VV) is associated with severe complications in both naive and immune individuals. Modified vaccinia virus Ankara (MVA), a highly attenuated replication-deficient strain of VV, has been proven to be safe in humans and

Resident involvement in civilian tactical emergency medicine.

Science.gov (United States)

Ramirez, Mario Luis; Slovis, Corey M

2010-07-01

Tactical emergency medicine services (TEMS) has emerged as a specialized niche within the field of emergency medicine. With increasing demand for physician participation in civilian tactical teams, there will be efforts by residents to become involved at earlier points in their clinical training. This article discusses resident involvement with a civilian TEMS unit and provides five maxims for emergency physicians to better understand the difference between working in the emergency department or with emergency medical services vs. in a TEMS environment. Differences between TEMS and other trauma life support models, institutional and political barriers likely to be encountered by the resident, the value of preventive medicine and the role of the physician in long-term tactical operations, opportunities for subspecialty growth, and the role of operational security are all discussed in detail. Tactical emergency medicine is a specialty that utilizes the full array of the emergency physician's skill set. It is also a field that is ripe for continued expansion, but the resident looking to become involved with a team should be aware of the requirements necessary to do so and the obstacles likely to be encountered along the way. Copyright 2010 Elsevier Inc. All rights reserved.

Situação vacinal da população discente da Universidade de São Paulo Vaccinal condition of the student population of the S. Paulo University

Directory of Open Access Journals (Sweden)

Ernesto Lima Gonçalves

1977-06-01

pupils from upcountry and 75%. from São Paulo said they were vaccinated about 5 years ago and 35% of all of them said that the last vaccination was efficient. About 2/3 of all USP students were not vaccinated against tetanus or did not receive a recognized scheme of immunization. In reference to antimeningococcus immunization, the inquest was done in an upcountry "campi" before the wide official programme of May 1975; in the São Paulo "campus" , the inquest was applied after this event. Because of this, only 17% of hinterland people were said to be already immunized, as against 80% from São Paulo university students. The chosen patterns were absence of smallpox-vaccination scar and utilization of a non-recognized scheme of anti-tetanic vaccination. From 3.113 people examined, 405 received smallpox-vaccine, with 87.3% positive results. As regards antitetanic immunization, 67% of all examined people received the previously approved anatox dose.

Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls: A National Survey.

Science.gov (United States)

Agénor, Madina; Peitzmeier, Sarah; Gordon, Allegra R; Haneuse, Sebastien; Potter, Jennifer E; Austin, S Bryn

2015-07-21

Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners. To examine the association between sexual orientation identity and HPV vaccination among U.S. women and girls. Cross-sectional, using 2006-2010 National Survey of Family Growth data. U.S. civilian noninstitutionalized population. The 2006-2010 National Survey of Family Growth used stratified cluster sampling to establish a national probability sample of 12,279 U.S. women and girls aged 15 to 44 years. Analyses were restricted to 3253 women and girls aged 15 to 25 years who were asked about HPV vaccination. Multivariable logistic regression was used to obtain prevalence estimates of HPV vaccine awareness and initiation adjusted for sociodemographic and health care factors for each sexual orientation identity group. Among U.S. women and girls aged 15 to 25 years, 84.4% reported having heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. After adjustment for covariates, 8.5% (P = 0.007) of lesbians and 33.2% (P = 0.33) of bisexual women and girls who had heard of the vaccine had initiated vaccination compared with 28.4% of their heterosexual counterparts. Self-reported, cross-sectional data, and findings may not be generalizable to periods after 2006 to 2010 or all U.S. lesbians aged 15 to 25 years (because of the small sample size for this group). Adolescent and young adult lesbians may be less likely to initiate HPV vaccination than their heterosexual counterparts. Programs should facilitate access to HPV vaccination services among young lesbians. National Cancer Institute.

Civil-Military Relations in Thailand: Military Autonomy or Civilian Control?

National Research Council Canada - National Science Library

Matthews, Warren E

2005-01-01

...: economic development, political parties, and the Monarchy. Next, the thesis analyzes three different periods in Thailand's political development to determine trends in the level of military autonomy and civilian control...

Salvadoran Civilian-Military Relations: Strategic Need for a National Plan

National Research Council Canada - National Science Library

Lopez, Cesar

1997-01-01

.... Particularly in El Salvador, which has only just recently resolved a decade-long insurgency, there exists an absolute need for the civilian and military leadership to work efficiently and effectively...

A Global Civilian Power? The Future Role of the European Union in International Politics

Directory of Open Access Journals (Sweden)

Bedrudin Brljavac

2011-06-01

Full Text Available Questions about the future of the European Union as an international actor continue to puzzle students of international relations and particularly students of EU foreign policy. What kind of predictions can we make about the future role of the EU in international politics? While the question is often framed in terms of military versus normative and/or global civilian power Europe, there are indications that ambitions in both directions may very well coincide. However, despite the EU’s development towards deepened defense integration since the 1990s, such developments are by far outweighed by developments pointing in the direction of the EU consolidating its role as a global civilian power. In this article, we analyze the union’s civilian policies and contrast the findings of our analysis with developments in the field of Common Security and Defence Policy (CSDP. Based on our analysis of EU enlargement policy, external aid, global environmental policy and the union’s commitment to multilateralism, our conclusion is that the EU’s international role in the next decades will continue to be best described in terms of a global civilian power.

77 FR 47690 - 30-Day Notice of Proposed Information Collection: Civilian Response Corps Database In-Processing...

Science.gov (United States)

2012-08-09

.... Title of Information Collection: Civilian Response Corps Database In-Processing Electronic Form. OMB... DEPARTMENT OF STATE [Public Notice 7976] 30-Day Notice of Proposed Information Collection: Civilian Response Corps Database In-Processing Electronic Form, OMB Control Number 1405-0168, Form DS-4096...

Civilian nuclear ships

International Nuclear Information System (INIS)

Oelgaard, P.L.

1993-03-01

This report contains a review of the information available on nuclear powered ships, built for civilian purposes. In the introduction a short discussion is given of the reasons for the limited use of nuclear ships for these purposes. In the second section a brief review is presented of data for the three experimental/merchant ships build by the United States, Germany and Japan, i.e. NS Savannah, NS Otto Hahn and NS Mutsu. In the third section the Soviet/Russian icebreaker NS Lenin is considered. Its design, operational experience and the introduction of a new nuclear propulsion plant is reviewed. In the fourth section the newer Soviet/Russian icebreakers with nuclear propulsion are considered. Finally design of the Soviet/Russian icebreaker transport/container ship NS Sevmorput is reviewed in the fifth section. The future Russian plans for nuclear vessels for the arctic waters are briefly discussed. (au)

Military/Civilian Mixed-Mode Global Positioning System (GPS) Receiver (MMGR)

National Research Council Canada - National Science Library

Peczalski, Andy; Kriz, Jeff; Carlson, Stephen G; Sampson, Steven J

2004-01-01

... AND T) MMGR objective of meeting pervasive defense system requirements and civilian needs for ultra-small GPS receiver technology is dependent in part upon the creation of multi- L-band reconfigurable...

The European Union in International Politics: Acting as a Global Civilian Power (GCP

Directory of Open Access Journals (Sweden)

Bedrudin Brljavac

2011-01-01

Full Text Available During the Cold War the European Community lacking common military instruments was perceived as the example of a civilian power. However, in the early 1990s, under the framework of CFSP, the first concrete defence initiatives have been launched. By the end of the 1990s and after the agreement on the Common Security and Defence Policy (CSDP the first Rapid Reaction Forces were on the European military agenda. Such defence and military capabilities challenged the idea of the EU as a civil or civilian power. Thus, a main concern in the paper has been to assess the character and identity of the EU`s activities in the context of international relations. For this purpose, this study has explored the EU policy instruments such as the enlargement policy, external aid, environmental policy at the global level, multilateralism, and the EU armed forces. The study concludes that the enlargement policy accounts for an important EU strategy to shape the international environment through civilian means. Furthermore, the international aid policy of the EU states has primarily been based on the sense of duty to other countries as constructivists point out. The EU has also been vocal and has used environmental foreign policy as an instrument to demonstrate its global leadership role which is a clear indication of its commitment to global welfare. Thanks to its presence in the major multilateral interventions of the last decade, the EU has qualified itself as great supporter of multilateralism. Lastly, the EU military capabilities are not achieved by creating permanent European armed forces but are still based on the voluntary contributions of its member states. Therefore, the EU still can be portrayed as a global civilian power (GCP or civilian power Europe (CPE.

32 CFR 644.560 - Inspections of civilian component training facilities and other properties conveyed subject to...

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Inspections of civilian component training... Disposal Inspections to Insure Compliance with Disposal Conditions § 644.560 Inspections of civilian... responsibility of the Secretary of Transportation; for property conveyed for purposes of health and education...

The Strategic Effect of Army Civilian Workplace Injuries and Illnesses

National Research Council Canada - National Science Library

Koucheravy, Richard J

2008-01-01

.... Lately, the Army has improved safety and embedded a more effective safety culture, but it has not improved its program for reducing civilian accident costs or returning injured workers to the workplace...

Green revolution vaccines, edible vaccines

African Journals Online (AJOL)

Admin

of development. Food vaccines may also help to suppress autoimmunity disorders such as Type-1. Diabetes. Key words: Edible vaccines, oral vaccines, antigen expression, food vaccines. INTRODUCTION. Vaccination involves the stimulation of the immune system to prepare it for the event of an invasion from a particular ...

Nigerian Journal of Biotechnology (Vol. 33)

African Journals Online (AJOL)

Ladaf 2

Malaria continues to be a major global health accounting for about 29% of the total malaria cases problem with .... malaria. Given the role of pro-inflammatory cytokines ... in early immunity against Plasmodium by enhancing .... Thick and thin blood smears were prepared .... smallpox vaccination in Caucasians and African.

42 CFR 102.74 - Disapproval of benefits.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Disapproval of benefits. 102.74 Section 102.74 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Secretarial Determinations § 102.74 Disapproval of benefits. (a) If the Secretary...

Civilian Penetrating Gunshot Injury to the Neurocranium in Enugu.

Science.gov (United States)

Onyia, Ephraim Eziechina; Chikani, Mark C; Mezue, Wilfred C; Uche, Enoch O; Iloabachie, Izuchukwu; Mesi, Matthew; Ejembi, Sunday; Agunwa, Chuka

2017-01-01

Civilian penetrating gunshot injuries to the neurocranium are no longer uncommon in Nigeria. Such injuries are however poorly reported. They are associated with poor outcome and, at close range, are frequently fatal, especially when inflicted by high-velocity weapons. Prompt transfer to neurosurgical service and urgent intervention may improve outcome in those that are not mortally wounded. Fifty-two patients with civilian penetrating gunshot wounds seen over a 10-year period (2004-2014) at the University of Nigeria Teaching Hospital and Memfys Hospital for Neurosurgery Enugu were reviewed retrospectively, and their data were analyzed to evaluate factors that impacted on outcome. Only patients with clinical and imaging evidence of cranial gunshot injuries who reached hospital alive were included in the study. The overall mortality and Glasgow outcome score were analyzed. Fifty-two patients with isolated civilian penetrating gunshot wounds were identified (M:F = 7.7:1); mean (standard deviation) age was 32.8 (11.9) years. There was a high correlation (0.983) between the sex of the patients and the outcome. The overall mortality was 30.8%, whereas the mortality for patients with postresuscitation Glasgow coma scale (GCS) score ≤8 was 57%, as against 12.9% in those in whom postresuscitation GCS was >8; meaning that 87.1% of patients in whom postresuscitation GCS was >8 survived. Thirty-one patients (59.6%) had papillary abnormalities. Majority of patients with monohemispheric lesions survived while all those with diencephalic, transventricular, and posterior fossa involvement had 100% mortality. Admitting GCS and bullet trajectory were predictive of outcome.

Mental Illness-Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data.

Science.gov (United States)

Weeks, Murray; Zamorski, Mark A; Rusu, Corneliu; Colman, Ian

2017-07-01

This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians. Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care. Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25). Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.

Civilian End Strength Study. Study Sponsor ODCSLOG.

Science.gov (United States)

1985-12-30

Chief of Staff deferred action on the recommendations and requested a subsequent briefing with the following guidance. (1) Need to do more to take...Term Actions ... ..................... 38-39 ix CIVILIAN END STRENGTH STUDY Abstract This study examined the methodology by which the Army determines...DAPE-MBC) and COA ( DACA -OMP) has facilitated this process; an updated LOI, in draft, will clear up some of the problems identified in the test

Expeditionary Civilians: Creating a Viable Practice of Civilian Deployment Within the U.S. Interagency Community and Among Foreign Defense Organizations

Science.gov (United States)

2016-01-01

reflect the opinions of its research clients and sponsors. Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving... Organisation [now the Defence Science and Technology Group] EEAS European External Action Service FEMA Federal Emergency Management Agency HR human resources... Organisation (DSTO); and the European Union’s European External Action Service (EEAS) Civilian Planning and Conduct Capability (CPCC), including a

CIVILIAN-MILITARY INTERACTION ON THE MATIE CAMPUS: THE ...

African Journals Online (AJOL)

hennie

would have nothing to do with it after the Second World War.4. The National ... 113–115. 4. Visser, British influence on military training and education in South Africa, p. 73. ..... residence, but agreed that they could be dispersed among the civilian students within .... Memories of the Second World War were still very strong …

Radiological protection of service and civilian personnel

International Nuclear Information System (INIS)

1990-01-01

Since the United Kingdom's defence nuclear industry was founded in the late 1940s, Service and civilian personnel have been exposed to ionising radiation. During the last forty years, as knowledge about the effects of radiation exposure has grown, concern to ensure adequate protection against exposure has also increased,. As part of our continuing scrutiny of the Ministry of Defence (MoD), we have undertaken a short inquiry to examine MoD's current and future policy and practice on radiological protection. The principal work involving exposure of Service and civilian personnel to significant levels of radiation falls into two discrete areas: the nuclear weapons programme and the nuclear propulsion programme. The nuclear weapons programme involves research, the production of nuclear warheads and their deployment with Her Majesty's Forces. The nuclear propulsion programme involves research, production, operation, refitting and decommissioning of pressurised water reactors as a source of propulsion power in Royal Navy submarines. These two nuclear programmes are not the only sources of ionising radiation within MoD's responsibility: it also arises from research, non-destructive testing and medical applications, most notably conventional radiography. In this Report we have concentrated upon ionising radiation arising from the two defence nuclear programmes. (author)

The influence of psychosocial factors in veteran adjustment to civilian life.

Science.gov (United States)

Bowes, Margaret A; Ferreira, Nuno; Henderson, Mike

2018-03-25

Although most veterans have a successful transition to civilian life when they leave the military, some struggle to cope and adjust to the demands and challenges of civilian life. This study explores how a variety of psychosocial factors influence veteran adjustment to civilian life in Scotland, UK, and which of these factors predict a poor adjustment. One hundred and fifty-four veterans across Scotland completed a set of questionnaires that measured veteran adjustment difficulty, quality of life, mental health, stigma, self-stigma, attitude towards help-seeking, likelihood of help-seeking, experiential avoidance, reappraisal and suppression. Veteran adjustment difficulty and quality of life were significantly correlated to a number of psychosocial factors. Mental health, experiential avoidance and cognitive reappraisal were found to be predictors of veteran adjustment difficulty, and experiential avoidance and cognitive reappraisal partially mediated the relationship between mental health and veteran adjustment, with experiential avoidance being the stronger mediator. Our findings suggest that early assessment of experiential avoidance and cognitive reappraisal and the provision of relevant emotion regulation skills training could potentially reduce the veteran's need for more complex (and costly) psychological interventions in the future. Implications for veterans, as well as the services and professionals involved with veteran transition and health care are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

Ideology in science and technology: the case of civilian nuclear power

International Nuclear Information System (INIS)

Harrod, A.N.

1987-01-01

This dissertation traces the complicated interrelationships between ideology and interest within the civilian nuclear power controversy. The first chapter introduces the topic. The second chapter provides a social-political-economic overview of the context in which the conflicting ideologies arose. Factors looked at are the ascendancy of the physical sciences, the development of nuclear energy, the disenchantment with science and technology and the consequent rise of an anti-nuclear ideology. Chapter III uses the theories of Alvin Gouldner to understand the structure of ideology. The chapter defines ideology's similarities to and differences from scientific discourse. Chapter IV examines the ideological discourse of a selected sample of scientists who have spoken for and against civilian nuclear power. In parallel to chapter IV, chapter V examines a scientific controversy among the sample of experts. It shows how scientific disagreement can be produced and how ideology is most closely linked to science. Chapter VI examines the social interests of the scientists and experts to discover ways that interests have shaped the ideological and scientific positions for and against civilian nuclear energy. Based on the foregoing, chapter VII concludes that the introduction of science and experts into a controversy cannot be expected to end disagreement over policy because of the link between science and ideology

civilian vascular injuries in an urban african referral institution

African Journals Online (AJOL)

2013-12-12

Dec 12, 2013 ... thoracic and cardiovascular surgery care. Road traffic, occupational and industrial accidents account for a large proportion of cases while stab wounds and gunshot injuries are emerging as common causes in civilian practice (1). The incidence of vascular injuries is increasing in the developing countries.

42 CFR 102.32 - Benefits for lost employment income.

Science.gov (United States)

2010-10-01

... 102.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX... pay for lost employment income or to provide disability or retirement benefits to the requester. As provided in § 102.84, the Secretary retains the right to recover benefits for lost employment income paid...

42 CFR 102.2 - Summary of available benefits.

Science.gov (United States)

2010-10-01

... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX... benefits paid under § 102.82(c) are secondary to death and disability benefits under the PSOB Program. The... potential third-party payor makes a determination on the availability of similar benefits and has the right...

42 CFR 102.33 - Death benefits.

Science.gov (United States)

2010-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM... are described in § 102.82. As provided in § 102.84, the Secretary retains the right to recover death... secondary to disability benefits under the PSOB Program. Any death benefit paid under the standard...

Structural basis for the binding of the neutralizing antibody, 7D11, to the poxvirus L1 protein

International Nuclear Information System (INIS)

Su, Hua-Poo; Golden, Joseph W.; Gittis, Apostolos G.; Hooper, Jay W.; Garboczi, David N.

2007-01-01

Medical countermeasures to prevent or treat smallpox are needed due to the potential use of poxviruses as biological weapons. Safety concerns with the currently available smallpox vaccine indicate a need for research on alternative poxvirus vaccine strategies. Molecular vaccines involving the use of proteins and/or genes and recombinant antibodies are among the strategies under current investigation. The poxvirus L1 protein, encoded by the L1R open reading frame, is the target of neutralizing antibodies and has been successfully used as a component of both protein subunit and DNA vaccines. L1-specific monoclonal antibodies (e.g., mouse monoclonal antibody mAb-7D11, mAb-10F5) with potent neutralizing activity bind L1 in a conformation-specific manner. This suggests that proper folding of the L1 protein used in molecular vaccines will affect the production of neutralizing antibodies and protection. Here, we co-crystallized the Fab fragment of mAb-7D11 with the L1 protein. The crystal structure of the complex between Fab-7D11 and L1 reveals the basis for the conformation-specific binding as recognition of a discontinuous epitope containing two loops that are held together by a disulfide bond. The structure of this important conformational epitope of L1 will contribute to the development of molecular poxvirus vaccines and also provides a novel target for anti-poxvirus drugs. In addition, the sequence and structure of Fab-7D11 will contribute to the development of L1-targeted immunotherapeutics

EU Civilian Crisis Management : Law and Practice of Accountability

NARCIS (Netherlands)

Moser, C.

2018-01-01

In the growing collection of literature on the EU’s governance credentials, security and defence activities of the Union remain under-represented. This thesis attempts to fill that void by shedding light on the law and practice of accountability in EU civilian crisis management. Unknown to many, the

Defining Criteria for Handover to Civilian Officials in Relief Operations

National Research Council Canada - National Science Library

Bessler, John

2008-01-01

.... Department of Defense Directive (DoDD) 3000.05 directs that the military shall be prepared to accomplish 'all tasks necessary to establish or maintain order when civilians are unable to do so,' but the metrics which define success...

Integration of Training Civilian and Military Disaster Responders

Science.gov (United States)

2011-09-01

Personal hygiene including foot care, hydration, and nutrition will be covered. The appropriate clothing and footwear will be discussed, including how...policy proposals , for review by civilian health system leaders, National Guard command staff, and both the Departments of Homeland Security and...for healthcare emergency response planning. Journal of Business Continuity and Emergency Preparedness, 1(4). Center for Disease Control and

Civilian penetrating gunshot injury to the neurocranium in Enugu

Directory of Open Access Journals (Sweden)

Ephraim Eziechina Onyia

2017-01-01

Full Text Available Introduction: Civilian penetrating gunshot injuries to the neurocranium are no longer uncommon in Nigeria. Such injuries are however poorly reported. They are associated with poor outcome and, at close range, are frequently fatal, especially when inflicted by high-velocity weapons. Prompt transfer to neurosurgical service and urgent intervention may improve outcome in those that are not mortally wounded. Materials and Methods: Fifty-two patients with civilian penetrating gunshot wounds seen over a 10-year period (2004–2014 at the University of Nigeria Teaching Hospital and Memfys Hospital for Neurosurgery Enugu were reviewed retrospectively, and their data were analyzed to evaluate factors that impacted on outcome. Only patients with clinical and imaging evidence of cranial gunshot injuries who reached hospital alive were included in the study. The overall mortality and Glasgow outcome score were analyzed. Results: Fifty-two patients with isolated civilian penetrating gunshot wounds were identified (M:F = 7.7:1; mean (standard deviation age was 32.8 (11.9 years. There was a high correlation (0.983 between the sex of the patients and the outcome. The overall mortality was 30.8%, whereas the mortality for patients with postresuscitation Glasgow coma scale (GCS score ≤8 was 57%, as against 12.9% in those in whom postresuscitation GCS was> 8; meaning that 87.1% of patients in whom postresuscitation GCS was> 8 survived. Thirty-one patients (59.6% had papillary abnormalities. Majority of patients with monohemispheric lesions survived while all those with diencephalic, transventricular, and posterior fossa involvement had 100% mortality. Conclusions: Admitting GCS and bullet trajectory were predictive of outcome.

A civilian perspective on ballistic trauma and gunshot injuries

Directory of Open Access Journals (Sweden)

Pape Hans-Christoph

2010-06-01

Full Text Available Abstract Background Gun violence is on the rise in some European countries, however most of the literature on gunshot injuries pertains to military weaponry and is difficult to apply to civilians, due to dissimilarities in wound contamination and wounding potential of firearms and ammunition. Gunshot injuries in civilians have more focal injury patterns and should be considered distinct entities. Methods A search of the National Library of Medicine and the National Institutes of Health MEDLINE database was performed using PubMed. Results Craniocerebral gunshot injuries are often lethal, especially after suicide attempts. The treatment of non space consuming haematomas and the indications for invasive pressure measurement are controversial. Civilian gunshot injuries to the torso mostly intend to kill; however for those patients who do not die at the scene and are hemodynamically stable, insertion of a chest tube is usually the only required procedure for the majority of penetrating chest injuries. In penetrating abdominal injuries there is a trend towards non-operative care, provided that the patient is hemodynamically stable. Spinal gunshots can also often be treated without operation. Gunshot injuries of the extremities are rarely life-threatening but can be associated with severe morbidity. With the exception of craniocerebral, bowel, articular, or severe soft tissue injury, the use of antibiotics is controversial and may depend on the surgeon's preference. Conclusion The treatment strategy for patients with gunshot injuries to the torso mostly depends on the hemodynamic status of the patient. Whereas hemodynamically unstable patients require immediate operative measures like thoracotomy or laparotomy, hemodynamically stable patients might be treated with minor surgical procedures (e.g. chest tube or even conservatively.

A civilian perspective on ballistic trauma and gunshot injuries

Science.gov (United States)

2010-01-01

Background Gun violence is on the rise in some European countries, however most of the literature on gunshot injuries pertains to military weaponry and is difficult to apply to civilians, due to dissimilarities in wound contamination and wounding potential of firearms and ammunition. Gunshot injuries in civilians have more focal injury patterns and should be considered distinct entities. Methods A search of the National Library of Medicine and the National Institutes of Health MEDLINE database was performed using PubMed. Results Craniocerebral gunshot injuries are often lethal, especially after suicide attempts. The treatment of non space consuming haematomas and the indications for invasive pressure measurement are controversial. Civilian gunshot injuries to the torso mostly intend to kill; however for those patients who do not die at the scene and are hemodynamically stable, insertion of a chest tube is usually the only required procedure for the majority of penetrating chest injuries. In penetrating abdominal injuries there is a trend towards non-operative care, provided that the patient is hemodynamically stable. Spinal gunshots can also often be treated without operation. Gunshot injuries of the extremities are rarely life-threatening but can be associated with severe morbidity. With the exception of craniocerebral, bowel, articular, or severe soft tissue injury, the use of antibiotics is controversial and may depend on the surgeon's preference. Conclusion The treatment strategy for patients with gunshot injuries to the torso mostly depends on the hemodynamic status of the patient. Whereas hemodynamically unstable patients require immediate operative measures like thoracotomy or laparotomy, hemodynamically stable patients might be treated with minor surgical procedures (e.g. chest tube) or even conservatively. PMID:20565804

How will military/civilian coordination work for reception of mass casualties from overseas?

Science.gov (United States)

Mackenzie, Colin; Donohue, John; Wasylina, Philip; Cullum, Woodrow; Hu, Peter; Lam, David M

2009-01-01

In Maryland, there have been no military/civilian training exercises of the Medical Mutual Aid Agreement for >20 years. The aims of this paper are to describe the National Disaster Medical System (NDMS), to coordinate military and civilian medical mutual aid in response to arrival of overseas mass casualties, and to evaluate the mass-casualty reception and bed "surge" capacity of Maryland NDMS Hospitals. Three tabletop exercises and a functional exercise were performed using a simulated, overseas, military mass-casualty event. The first tabletop exercise was with military and civilian NMDS partners. The second tested the revised NDMS activation plan. The third exercised the Authorities of State Emergency Medical System and Walter Reed Army Medical Center Directors of Emergency Medicine over Maryland NDMS hospitals, and their Medical Mutual Aid Agreement. The functional exercise used Homeland Security Exercise Evaluation Program tools to evaluate reception, triage, staging, and transportation of 160 notional patients (including 20 live, moulaged "patients") and one canine. The first tabletop exercise identified deficiencies in operational protocols for military/civilian mass-casualty reception, triage, treatment, and problems with sharing a Unified Command. The second found improvements in the revised NDMS activation plan. The third informed expectations for NDMS hospitals. In the functional exercise, all notional patients were received, triaged, dispatched, and accounted in military and five civilian hospitals within two hours. The canine revealed deficiencies in companion/military animal reception, holding, treatment, and evacuation. Three working groups were suggested: (1) to ensure 100% compliance with triage tags, patient accountability, and return of equipment used in mass casualty events and exercises; (2) to investigate making information technology and imaging networks available for Emergency Operation Centers and Incident Command; and (3) to establish NDMS

Buccal viral DNA as a trigger for brincidofovir therapy in the mousepox model of smallpox.

Science.gov (United States)

Crump, Ryan; Korom, Maria; Buller, R Mark; Parker, Scott

2017-03-01

Orthopoxviruses continue to pose a significant threat to the population as potential agents of bioterrorism. An intentional release of natural or engineered variola virus (VARV) or monkeypox viruses would cause mortality and morbidity in the target population. To address this, antivirals have been developed and evaluated in animal models of smallpox and monkeypox. One such antiviral, brincidofovir (BCV, previously CMX001), has demonstrated high levels of efficacy against orthopoxviruses in animal models and is currently under clinical evaluation for prevention and treatment of diseases caused by cytomegaloviruses and adenoviruses. In this study we use the mousepox model of smallpox to evaluate the relationship between the magnitude of the infectious virus dose and an efficacious BCV therapy outcome when treatment is initiated concomitant with detection of ectromelia virus viral DNA (vDNA) in mouse buccal swabs. We found that vDNA could be detected in buccal swabs of some, but not all infected mice over a range of challenge doses by day 3 or 4 postexposure, when initiation of BCV treatment was efficacious, suggesting that detection of vDNA in buccal swabs could be used as a trigger to initiate BCV treatment of an entire potentially exposed population. However, buccal swabs of some mice did not become positive until 5 days postexposure, when initiation of BCV therapy failed to protect mice that received high doses of virus. And finally, the data suggest that the therapeutic window for efficacious BCV treatment decreases as the virus infectious dose increases. Extrapolating these findings to VARV, the data suggest that treatment should be initiated as soon as possible after exposure and not rely on a diagnostic tool such as the measurement of vDNA in buccal cavity swabs; however, consideration should be given to the fact that the behavior/disease-course of VARV in humans is different from that of ectromelia virus in the mouse. Copyright © 2016 Elsevier B.V. All

Mortality and Morbidity Among Military Personnel and Civilians During the 1930s and World War II From Transmission of Hepatitis During Yellow Fever Vaccination: Systematic Review

Science.gov (United States)

Lorenzetti, Diane L.; Spragins, Wendy

2013-01-01

During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced. PMID:23327242

Mortality and morbidity among military personnel and civilians during the 1930s and World War II from transmission of hepatitis during yellow fever vaccination: systematic review.

Science.gov (United States)

Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy

2013-03-01

During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced.

42 CFR 102.31 - Medical benefits.

Science.gov (United States)

2010-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION... covered injury, or to give relief, reduce the degree or the period of disability, or aid in lessening the... provided in § 102.84, the Secretary retains the right to recover medical benefits paid to requesters by...

Brazilian Vaccinia Viruses and Their Origins

Centers for Disease Control (CDC) Podcasts

Smallpox was eradicated more than 25 years ago, but live viruses used in vaccines may have survived to cause animal and human illness today. Dr. Inger Damon, Acting Branch Chief of the Poxvirus and Rabies Branch at CDC, discusses efforts to determine origins and spread of vaccinia viruses in Brazil.

How Might Civilian Technology Firms Play A Role In The Defense Industrial Base Going Forward

Science.gov (United States)

2017-12-01

CIVILIAN TECHNOLOGY FIRMS PLAY A ROLE IN THE DEFENSE INDUSTRIAL BASE GOING FORWARD? by Daniel J. Shipman December 2017 Thesis Advisor: Mie...2017 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE HOW MIGHT CIVILIAN TECHNOLOGY FIRMS PLAY A ROLE IN THE DEFENSE INDUSTRIAL...the competitive business environment of Department of Defense (DOD) vendors and whether the market is favorable for non-traditional, technology

CBO Testimony: The Effects of Reserve Call-Ups on Civilian Employers

National Research Council Canada - National Science Library

2005-01-01

...) recent analysis of the effects of reserve call-ups on civilian employers. The military reserves provide trained service members and units that are available for active military duty during peacetime and war...

Integration of Military and Civilians Space Assets: Legal and National Security Implications

National Research Council Canada - National Science Library

Waldrop, Elizabeth

2003-01-01

.... From a military perspective, intentional reliance on civilian systems must address, inter alia, national security concerns, contractual obligations, licensing restrictions, liability, and long-term...

DefenseLink Special: Joint Civilian Orientation Conference(JCOC), 2005

Science.gov (United States)

updated and may no longer be applicable as a result of changes in law, regulation and/or administration civilian business and civic leaders Oct. 19, providing an introduction to the U.S. Army in Europe. Story Business Leaders Meet Unique Navy Crew ABOARD THE USS MOUNT WHITNEY, Oct. 21, 2005 - Business leaders

EU Civilian Crisis Management: The Record So Far

Science.gov (United States)

2010-01-01

significant contribution to the construction of an Afghan police force. 1 See for example, Dempsey, 2006; DiManno, 2008; and Graw , 2007. 18 EU Civilian...Giegerich, Bastian, European Military Crisis Management: Connecting Ambition and Reality, Adelphi Paper No. 397, London: Routledge, 2008. Graw , Ansgar...4. Gros-Verheyde, Nicolas, “Interview with Stephen White, Head of EUJUST Lex Mission for Iraq,” Europolitics, January 21, 2009. References 51

Vaccine decision-making begins in pregnancy: Correlation between vaccine concerns, intentions and maternal vaccination with subsequent childhood vaccine uptake.

Science.gov (United States)

Danchin, M H; Costa-Pinto, J; Attwell, K; Willaby, H; Wiley, K; Hoq, M; Leask, J; Perrett, K P; O'Keefe, Jacinta; Giles, M L; Marshall, H

2017-08-12

Maternal and childhood vaccine decision-making begins prenatally. Amongst pregnant Australian women we aimed to ascertain vaccine information received, maternal immunisation uptake and attitudes and concerns regarding childhood vaccination. We also aimed to determine any correlation between a) intentions and concerns regarding childhood vaccination, (b) concerns about pregnancy vaccination, (c) socioeconomic status (SES) and (d) uptake of influenza and pertussis vaccines during pregnancy and routine vaccines during childhood. Women attending public antenatal clinics were recruited in three Australian states. Surveys were completed on iPads. Follow-up phone surveys were done three to six months post delivery, and infant vaccination status obtained via the Australian Childhood Immunisation Register (ACIR). Between October 2015 and March 2016, 975 (82%) of 1184 mothers consented and 406 (42%) agreed to a follow up survey, post delivery. First-time mothers (445; 49%) had significantly more vaccine concerns in pregnancy and only 73% had made a decision about childhood vaccination compared to 89% of mothers with existing children (p-valuepost delivery survey, 46% and 82% of mothers reported receiving pregnancy influenza and pertussis vaccines respectively. The mother's degree of vaccine hesitancy and two attitudinal factors were correlated with vaccine uptake post delivery. There was no association between reported maternal vaccine uptake or SES and childhood vaccine uptake. First time mothers are more vaccine hesitant and undecided about childhood vaccination, and only two thirds of all mothers believed they received enough information during pregnancy. New interventions to improve both education and communication on childhood and maternal vaccines, delivered by midwives and obstetricians in the Australian public hospital system, may reduce vaccine hesitancy for all mothers in pregnancy and post delivery, particularly first-time mothers. Copyright © 2017 Elsevier Ltd

Factors predicting health behaviors among Army Reserve, active duty Army, and civilian hospital employees.

Science.gov (United States)

Wynd, Christine A; Ryan-Wenger, Nancy A

2004-12-01

This study identified health-risk and health-promoting behaviors in military and civilian personnel employed in hospitals. Intrinsic self-motivation and extrinsic organizational workplace factors were examined as predictors of health behaviors. Because reservists represent a blend of military and civilian lifestyles, descriptive analyses focused on comparing Army Reserve personnel (n = 199) with active duty Army (n = 218) and civilian employees (n = 193), for a total sample of 610. Self-motivation and social support were significant factors contributing to the adoption of health-promoting behaviors; however, organizational workplace cultures were inconsistent predictors of health among the three groups. Only the active Army subgroup identified a hierarchical culture as having an influence on health promotion, possibly because of the Army's mandatory physical fitness and weight control standards. Social support and self-motivation are essential to promoting health among employees, thus hospital commanders and chief executive officers should encourage strategies that enhance and reward these behaviors.

[Civilian-military coordination].

Science.gov (United States)

de Montravel, G

2002-01-01

Current humanitarian emergencies create complex, mutidimensional situations that stimulate simultaneous responses from a wide variety of sources including governments, non-governmental organizations (NGO), United Nations agencies, and private individuals. As a result, it has become essential to establish a coherent framework in which each actor can contribute promptly and effectively to the overall effort. This is the role of the United Nations Office for the Coordination of Humanitarian Affairs. Regardless of the circumstances and level of coordination, cooperation and collaboration between humanitarian and military personnel, it is necessary to bear in mind their objectives. The purpose of humanitarian action is to reduce human suffering. The purpose of military intervention is to stop warfare. The author of this article will discuss the three major obstacles to civilian-military coordination (strategic, tactical, and operational). Operations cannot be conducted smoothly and differences cannot be ironed out without mutual respect between the two parties, an explicit definition of their respective duties and responsibilities, a clear understanding of their cultural differences, and the presence of an organization and facilities for coordination and arbitrage by a neutral referee.

Civilian Power Program. Part 1, Summary, Current status of reactor concepts

Energy Technology Data Exchange (ETDEWEB)

Author, Not Given

1959-09-01

This study group covered the following: delineation of the specific objectives of the overall US AEC civilian power reactor program, technical objectives of each reactor concept, preparation of a chronological development program for each reactor concept, evaluation of the economic potential of each reactor type, a program to encourage the the development, and yardsticks for measuring the development. Results were used for policy review by AEC, program direction, authorization and appropriation requests, etc. This evaluation encompassed civilian power reactors rated at 25 MW(e) or larger and related experimental facilities and R&D. This Part I summarizes the significant results of the comprehensive effort to determine the current technical and economic status for each reactor concept; it is based on the 8 individual technical status reports (Part III).

Evaluating anti-Orthopoxvirus antibodies in individuals from Brazilian rural areas prior to the bovine vaccinia era

Directory of Open Access Journals (Sweden)

Poliana de Oliveira Figueiredo

2015-09-01

Full Text Available Vaccinia virus naturally circulates in Brazil and is the causative agent of a zoonotic disease known as bovine vaccinia (BV. We retrospectively evaluated two populations from the Amazon and Southeast Regions. BV outbreaks had not been reported in these regions before sample collection. Neutralising antibodies were found in 13 individuals (n = 132 with titres ranging from 100 ≥ 6,400 neutralising units/mL. Univariate analysis identified age and vaccination as statistically significant risk factors in individuals from the Southeast Region. The absence of detectable antibodies in vaccinated individuals raises questions about the protection of smallpox vaccine years after vaccination and reinforces the need for surveillance of Orthopoxvirus in Brazilian populations without evidence of previous outbreaks.

Security for whom? Stabilisation and civilian protection in Colombia.

Science.gov (United States)

Elhawary, Samir

2010-10-01

This paper focuses on three periods of stabilisation in Colombia: the Alliance for Progress (1961-73) that sought to stem the threat of communist revolution in Latin America; Plan Colombia and President Alvaro Uribe's 'democratic security' policy (2000-07) aimed at defeating the guerrillas and negotiating a settlement with the paramilitaries; and the current 'integrated approach', adopted from 2007, to consolidate more effectively the state's control of its territory.(1) The paper assesses the extent to which these stabilisation efforts have enhanced the protection of civilians and ultimately finds that in all three periods there has been a disconnect between the discourse and the practice of stabilisation. While they have all sought to enhance security, in actual fact, they have privileged the security of the state and its allies at the expense of the effective protection of the civilian population. This has not only led to widespread human rights abuses but also has undermined the long-term stability being pursued. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

Identification of Abuse and Health Consequences for Military and Civilian Women

National Research Council Canada - National Science Library

Campbell, Jacquelyn

2001-01-01

The objective of the study was to compare the prevalence of intimate partner violence and health consequences in civilian and active duty military women in the same geographic area using telephone survey and a case...

Civilian Joint Task Force’ (CJTF – A Community Security Option: A Comprehensive and Proactive Approach of Reducing Terrorism

Directory of Open Access Journals (Sweden)

Oluwaseun Bamidele

2016-06-01

Full Text Available Since the Boko Haram uprising in 2009, the Nigerian government has employed various strategies as counter-terrorism measures to stem the atrocities of the group. These strategies include amnesty negotiations, implementation of emergency law in the northeast, increase in security spending to the deployment of military force. In the midst of these security measures, the civilian Joint Task Force (JTF emerged, first as a community effort, and later as a joint effort with the security forces to help fight Boko Haram. The civilian JTF has helped recover towns and villages from Boko Haram, rescued women in the northeast and helped identify Boko Haram members shielded by some local people. Although doubts have been expressed in some quatres that the civilian JTF could transform into ethnic militias, the Boko Haram security threat neutralized by the group indicates an untapped security potential in Nigerian communities. However, one approach that has yet to be pursued is community security option. Community security option is a model built around proactive citizen-driven communal response. This article explains the role of civilian JTF and how civilian JTF can be used to investigate terrorism in Nigeria. This article will contribute to the discourse on the imperative of African-inspired mechanisms to solving African security problems.

Military exceptionalism or tobacco exceptionalism: How civilian health leaders' beliefs may impede military tobacco control efforts

OpenAIRE

Smith, EA; Malone, RE

2013-01-01

Smoking impairs the readiness and performance of military personnel, yet congressional opposition has thwarted military tobacco control initiatives. Involvement of civilian organizations might alter this political dynamic. We interviewed 13 leaders of national civilian public health and tobacco control organizations to explore their perspectives on military tobacco control, inductively analyzing data for themes. Leaders believed that military tobacco use was problematic but lacked specific kn...

Treatment of Social Competence in Military Veterans, Service Members, and Civilians with Traumatic Brain Injury

Science.gov (United States)

2015-08-01

External Relation, Clarity of Expression, Social Style, Subject Matter, and Aesthetics ). Each of these 10 subscales are rated on a scale of 0 to 5 where 0...Award Number: W81XWH-11-1-0635 TITLE: Treatment of Social Competence in Military Veterans, Service Members, and Civilians with Traumatic Brain...1Aug2014 - 31Jul2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Treatment of Social Competence in Military Veterans, Service Members, and Civilians with

Implications of Posttraumatic Stress among Military-Affiliated and Civilian Students

Science.gov (United States)

Barry, Adam E.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.

2012-01-01

Objectives: To determine whether posttraumatic stress (PTS) symptoms are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants: The final sample (n = 248) included 78 combat-exposed student service members/veterans, 53 non-combat-exposed…

Design of inhibitors of thymidylate kinase from Variola virus as new selective drugs against smallpox.

Science.gov (United States)

Guimarães, Ana P; de Souza, Felipe R; Oliveira, Aline A; Gonçalves, Arlan S; de Alencastro, Ricardo B; Ramalho, Teodorico C; França, Tanos C C

2015-02-16

Recently we constructed a homology model of the enzyme thymidylate kinase from Variola virus (VarTMPK) and proposed it as a new target to the drug design against smallpox. In the present work, we used the antivirals cidofovir and acyclovir as reference compounds to choose eleven compounds as leads to the drug design of inhibitors for VarTMPK. Docking and molecular dynamics (MD) studies of the interactions of these compounds inside VarTMPK and human TMPK (HssTMPK) suggest that they compete for the binding region of the substrate and were used to propose the structures of ten new inhibitors for VarTMPK. Further docking and MD simulations of these compounds, inside VarTMPK and HssTMPK, suggest that nine among ten are potential selective inhibitors of VarTMPK. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Tranexamic acid use in severely injured civilian patients and the effects on outcomes: a prospective cohort study.

Science.gov (United States)

Cole, Elaine; Davenport, Ross; Willett, Keith; Brohi, Karim

2015-02-01

To characterize the relationship between tranexamic acid (TXA) use and patient outcomes in a severely injured civilian cohort, and to determine any differential effect between patients who presented with and without shock. TXA has demonstrated survival benefits in trauma patients in an international randomized control trial and the military setting. The uptake of TXA into civilian major hemorrhage protocols (MHPs) has been variable. The evidence gap in mature civilian trauma systems is limiting the widespread use of TXA and its potential benefits on survival. Prospective cohort study of severely injured adult patients (Injury severity score > 15) admitted to a civilian trauma system during the adoption phase of TXA into the hospital's MHP. Outcomes measured were mortality, multiple organ failure (MOF), venous thromboembolism, infection, stroke, ventilator-free days (VFD), and length of stay. Patients receiving TXA (n = 160, 42%) were more severely injured, shocked, and coagulopathic on arrival. TXA was not independently associated with any change in outcome for either the overall or nonshocked cohorts. In multivariate analysis, TXA was independently associated with a reduction in MOF [odds ratio (OR) = 0.27, confidence interval (CI): 0.10-0.73, P = 0.01] and was protective for adjusted all-cause mortality (OR = 0.16 CI: 0.03-0.86, P = 0.03) in shocked patients. TXA as part of a major hemorrhage protocol within a mature civilian trauma system provides outcome benefits specifically for severely injured shocked patients.

A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

Science.gov (United States)

1983-12-01

In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

Retaining a Resilient and Enduring Workforce: Examination of Duty/Position Rotational Assignments for Civilian Acquisition Positions

Science.gov (United States)

2015-04-12

civilian employees are composed primarily of “ Generation X” (people born roughly between 1965 and 1979) and Baby Boomers (people born roughly between...1946 and 1964). The employees replacing “ Generation X” and Baby Boomers are Millennials; “ninety-one percent of Millennials (born 1977–1997) expect to...distribution of the survey. Approximately 15% of the sample (including all General Schedule (GS) 14/15 government civilian employees assigned to Aberdeen

The Symbiosis of Combat Casualty Care and Civilian Trauma Care: 1914-2007

National Research Council Canada - National Science Library

Pruitt, Jr, Basil A

2008-01-01

.... Treatment refinements developed during wartime and research findings generated during conflict and the interbellum periods have been transferred to the civilian community to improve the care of all trauma patients...

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Data.gov (United States)

Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

Patent landscape of countermeasures against smallpox and estimation of grant attraction capability through patent landscape data.

Science.gov (United States)

Mayburd, Anatoly L; Kedia, Govind; Evans, Haydn W; Kaslival, Pritesh C

2010-11-01

The study was concerned with countermeasures against a possible smallpox outbreak. In the process of assessment 18 landscaping sectors were defined and described, the advantages and drawbacks of the corresponding countermeasures being reviewed. The data of the previously published influenza landscape were revisited. The current economic climate of deficit cutting (austerity) also puts emphasis on the optimization of capital investment. We used the materials of the landscape to define and analyze metrics of capital placement optimization. Value score was obtained by fitting patent landscape internals to the sale price of individual patents. Success score was obtained as a product of a-priori parameters that measure likelihood of emergence of a marketable product in a technological sector. Both scores were combined in a qualitative metric. Our methodology defined weight as a product of the sector size by the success score. We hypothesized - based on the material of two landscapes- that a life cycle of a technology begins in IP space with a high patent quality low volume "bud" of low weight, reaches maximum weight and then weight falls again when the technology becomes outdated. The weight and the annual dynamic of weight can serve a measure of investment risk and return. In this report we modeled investment by issue of government grants or purchase of patents by government. In the smallpox landscape the number of patents purchased by government agencies was the highest in the sectors with the highest weight and the trend was confirmed by the count of NIH grants issued in support of the technological sectors. In the influenza landscape only grant issue count was statistically meaningful and the trend was also confirmed. To better fit the grant support levels, the weight expression was optimized by using training coefficients. We propose to use value scores for evaluation of individual patent publications/company portfolios and to use weights for assessment of

How influenza vaccination policy may affect vaccine logistics.

Science.gov (United States)

Assi, Tina-Marie; Rookkapan, Korngamon; Rajgopal, Jayant; Sornsrivichai, Vorasith; Brown, Shawn T; Welling, Joel S; Norman, Bryan A; Connor, Diana L; Chen, Sheng-I; Slayton, Rachel B; Laosiritaworn, Yongjua; Wateska, Angela R; Wisniewski, Stephen R; Lee, Bruce Y

2012-06-22

When policymakers make decision about the target populations and timing of influenza vaccination, they may not consider the impact on the vaccine supply chains, which may in turn affect vaccine availability. Our goal is to explore the effects on the Thailand vaccine supply chain of introducing influenza vaccines and varying the target populations and immunization time-frames. We Utilized our custom-designed software HERMES (Highly Extensible Resource for Modeling Supply Chains), we developed a detailed, computational discrete-event simulation model of the Thailand's National Immunization Program (NIP) supply chain in Trang Province, Thailand. A suite of experiments simulated introducing influenza vaccines for different target populations and over different time-frames prior to and during the annual influenza season. Introducing influenza vaccines creates bottlenecks that reduce the availability of both influenza vaccines as well as the other NIP vaccines, with provincial to district transport capacity being the primary constraint. Even covering only 25% of the Advisory Committee on Immunization Practice-recommended population while administering the vaccine over six months hinders overall vaccine availability so that only 62% of arriving patients can receive vaccines. Increasing the target population from 25% to 100% progressively worsens these bottlenecks, while increasing influenza vaccination time-frame from 1 to 6 months decreases these bottlenecks. Since the choice of target populations for influenza vaccination and the time-frame to deliver this vaccine can substantially affect the flow of all vaccines, policy-makers may want to consider supply chain effects when choosing target populations for a vaccine. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Changing World of Childhood Immunizations

Science.gov (United States)

Graville, Iris

2010-01-01

Theories and practices in early childhood education continually evolve, and the same is true in the health field. Such change is especially apparent in the area of childhood immunizations. Since vaccination to prevent smallpox was first started in the late 1700s, recommendations for which immunizations to give and when to give them have been…

Nonproliferation norms in civilian nuclear fuel cycle

International Nuclear Information System (INIS)

Kawata, Tomio

2005-01-01

For sustainable use of nuclear energy in large scale, it seems inevitable to choose a closed cycle option. One of the important questions is, then, whether we can really achieve the compatibility between civilian nuclear fuel cycle and nonproliferation norms. In this aspect, Japan is very unique because she is now only one country with full-scope nuclear fuel cycle program as a non-nuclear weapon state in NPT regime. In June 2004 in the midst of heightened proliferation concerns in NPT regime, the IAEA Board of Governors concluded that, for Japanese nuclear energy program, non-diversion of declared nuclear material and the absence of undeclared nuclear material and activities were verified through the inspections and examinations under Comprehensive Safeguards and the Additional Protocol. Based on this conclusion, the IAEA announced the implementation of Integrated Safeguards in Japan in September 2004. This paper reviews how Japan has succeeded in becoming the first country with full-scope nuclear fuel cycle program to qualify for integrated Safeguards, and identifies five key elements that have made this achievement happen: (1) Obvious need of nuclear fuel cycle program, (2) Country's clear intention for renunciation of nuclear armament, (3) Transparency of national nuclear energy program, (4) Record of excellent compliance with nonproliferation obligations for many decades, and (5) Numerous proactive efforts. These five key elements will constitute a kind of an acceptance model for civilian nuclear fuel cycle in NNWS, and may become the basis for building 'Nonproliferation Culture'. (author)

Decline of Civilian power in Japan's Defense Policy

OpenAIRE

SEBATA, TAKAO; 瀬端, 孝夫

2006-01-01

Over the last thirty years, military official of Japan's Self-Defense Forces (SDF) have begun voicing their opinions more aggressively, exerting influence and power in such areas as: the right of personnel management, budget formulation, organization, and defense policy decision-making. Due to the enhanced status of military officials, change of power balance between civilians and military is taking place. This paper examines civil-military relations in the above areas and discusses how this ...

Army Civilian Leadership Development: Self-Efficacy, Choice, and Learning Transfer

Science.gov (United States)

Godinez, Eileen; Leslie, Barry B.

2015-01-01

The mission of the Army Management Staff College (AMSC) is to provide leader development educational experiences for Army civilians. To develop as leaders, students must recognize they have a choice to take action that influences their work environment. The authors suggest the learning environment at AMSC is intentionally designed to be…

Integration of Military and Civilians Space Assets: Legal and National Security Implications

National Research Council Canada - National Science Library

Waldrop, Elizabeth

2003-01-01

.... While international space law is very permissive with regard to military uses of space, there are considerable legal and security implications resulting from military and civilian dependence on the same space services...

Major alternatives for government policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States

International Nuclear Information System (INIS)

1980-01-01

The purpose of this report is to identify and assess major alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States. The National Academy of Public Administration agreed to identify and evaluate alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management. It agreed to review present policies and practices in civilian nuclear reactor emergency management, to review selected experiences and practices of governmental agencies other than the Nuclear Regulatory Commission, and industries other than the nuclear power industry, and to identify alternatives to the present nuclear emergency system

Vaccines.gov

Science.gov (United States)

... Vaccine Safety Vaccines Work Vaccine Types Vaccine Ingredients Vaccines by Disease Chickenpox ... Typhoid Fever Whooping Cough (Pertussis) Yellow Fever Who and When Infants, Children, and Teens ...

Tactic-operational problems of soldiers, civilians and environmental protection against contamination

International Nuclear Information System (INIS)

Krauze, M.

1994-01-01

The military problems connected with the probable use in warfare the chemical and nuclear weapon have been discussed. The concept of soldiers, civilians and environmental protection against the chemical and radiological contamination has been presented from the view point of military tactics

Program summary for the Civilian Reactor Development Program

International Nuclear Information System (INIS)

1982-07-01

This Civilian Reactor Development Program document has the prime purpose of summarizing the technical programs supported by the FY 1983 budget request. This section provides a statement of the overall program objectives and a general program overview. Section II presents the technical programs in a format intended to show logical technical interrelationships, and does not necessarily follow the structure of the formal budget presentation. Section III presents the technical organization and management structure of the program

Ensuring Biologics Advanced Development and Manufacturing Capability for the United States Government: A Summary of Key Findings and Conclusions

Science.gov (United States)

2009-10-06

CRISP Computer Retrieval Information on Scientific Projects DARPA Defense Advanced Research Projects Agency DCA Demand Capacity Assessment DHS...2007. 8. BARDA, HHS. Personal interview. 20 September 2007. 9. Bravata DM . Reducing mortality from anthrax bioterrorism: strategies for stockpiling...Projects ( CRISP ). Novel smallpox vaccine derived from VV/VAR Immunome. EPIVAX, INC. 17. Congressional Research Services (CRS) RL32917: Bioterrorism

Vaccine Hesitancy.

Science.gov (United States)

Jacobson, Robert M; St Sauver, Jennifer L; Finney Rutten, Lila J

2015-11-01

Vaccine refusal received a lot of press with the 2015 Disneyland measles outbreak, but vaccine refusal is only a fraction of a much larger problem of vaccine delay and hesitancy. Opposition to vaccination dates back to the 1800 s, Edward Jenner, and the first vaccine ever. It has never gone away despite the public's growing scientific sophistication. A variety of factors contribute to modern vaccine hesitancy, including the layperson's heuristic thinking when it comes to balancing risks and benefits as well as a number of other features of vaccination, including falling victim to its own success. Vaccine hesitancy is pervasive, affecting a quarter to a third of US parents. Clinicians report that they routinely receive requests to delay vaccines and that they routinely acquiesce. Vaccine rates vary by state and locale and by specific vaccine, and vaccine hesitancy results in personal risk and in the failure to achieve or sustain herd immunity to protect others who have contraindications to the vaccine or fail to generate immunity to the vaccine. Clinicians should adopt a variety of practices to combat vaccine hesitancy, including a variety of population health management approaches that go beyond the usual call to educate patients, clinicians, and the public. Strategies include using every visit to vaccinate, the creation of standing orders or nursing protocols to provide vaccination without clinical encounters, and adopting the practice of stating clear recommendations. Up-to-date, trusted resources exist to support clinicians' efforts in adopting these approaches to reduce vaccine hesitancy and its impact. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Patterns of civilian and child deaths due to war-related violence in Syria: a comparative analysis from the Violation Documentation Center dataset, 2011-16.

Science.gov (United States)

Guha-Sapir, Debarati; Schlüter, Benjamin; Rodriguez-Llanes, Jose Manuel; Lillywhite, Louis; Hicks, Madelyn Hsiao-Rei

2018-01-01

Since March, 2011, the Syrian civil war has lowered life expectancy by as much as 20 years. We describe demographic, spatial, and temporal patterns of direct deaths of civilians and opposition combatants from conflict-related violence in 6 years of war. We analysed conflict-related violent deaths with complete information on date, place, and cause of death and demographic group occurring from March 18, 2011, to Dec 31, 2016, recorded by the Violation Documentation Center (VDC). We included civilian and combatant deaths in all Syrian governorates, excluding government-controlled areas. We did not include detainees and missing persons, nor deaths from siege conditions or insufficient medical care. We categorised deaths based on VDC weapon type. We used χ 2 testing to compare deaths from different weapons in civilian men, women, boys, and girls and adult and child combatants. We analysed deaths by governorate and over time. The VDC recorded 143 630 conflict-related violent deaths with complete information between March 18, 2011, and Dec 31, 2016. Syrian civilians constituted 101 453 (70·6%) of the deaths compared with 42 177 (29·4%) opposition combatants. Direct deaths were caused by wide-area weapons of shelling and air bombardments in 58 099 (57·3%) civilians, including 8285 (74·6%) civilian women and 13 810 (79·4%) civilian children, and in 4058 (9·6%) opposition combatants. Proportions of children among civilian deaths increased from 8·9% (388 of 4254 civilian deaths) in 2011 to 19·0% (4927 of 25 972) in 2013 and to 23·3% (2662 of 11 444) in 2016. Of 7566 deaths from barrel bombs, 7351 (97·2%) were civilians, of whom 2007 (27·3%) were children. Of 20 281 deaths by execution, 18 747 (92·4%) were civilians and 1534 (7·6%) were opposition combatants. Compared with opposition child soldiers who were male (n=333), deaths of civilian male children (n=11 730) were caused more often by air bombardments (39·2% vs 5·4%, pwar crime. None

Comparative analysis of prevalence of intimate partner violence against women in military and civilian communities in Abuja, Nigeria.

Science.gov (United States)

Chimah, Carol Uzoamaka; Adogu, Prosper Obunikem Uche; Odeyemi, Kofoworola; Ilika, Amobi Linus

2015-01-01

Intimate partner violence (IPV) occurs across the world, in various cultures, and affects people across societies irrespective of economic status or gender. Most data on IPV before World Health Organization multicountry study (WHOMCS) usually came from sources other than the military. Result of this study will contribute to the existing body of knowledge and may serve as a baseline for future studies in military populations. This study compares the prevalence of the different types of IPV against women in military and civilian communities in Abuja, Nigeria. Using a multistage sampling technique, 260 women who had intimate male partners were selected from military and civilian communities of Abuja. Collected data on personal characteristics and different types of IPV experienced were analyzed to demonstrate comparison of the association between the different forms of IPV and the respondents' sociodemographic and partner characteristics in the two study populations using percentages and χ-square statistics, and P-value was assumed to be significant at ≤0.05. The prevalence of the four major types of IPV was higher among the military respondents than among civilians: controlling behavior, 37.1% versus 29.1%; emotional/psychological abuse, 42.4% versus 13.4%; physical abuse, 19.7% versus 5.9%, and sexual abuse, 9.2% versus 8.8%. Significantly more respondents from the military population (59 [45.4%]) compared to civilians (21 [19.4%]) were prevented by their partners from seeing their friends (P=0.000). The situation is reversed with regard to permission to seek health care for self, with civilians reporting a significantly higher prevalence (35 [32.4%]) than did military respondents (20 [15.4%]) (P=0.002). The military respondents were clearly at a higher risk of experiencing all the variants of emotional violence than the civilians (P=0.00). The commonest form of physical violence against women was "being slapped or having something thrown at them, that could hurt

HIV Infection among Civilian Applicants for Nigeria Military Service

Directory of Open Access Journals (Sweden)

Joshua A. Itsifinus

2010-06-01

Full Text Available AIM: HIV/AIDS is a serious social pathology in public health, developmental and security problem since the productive and reproductive age group is mostly affected. This study was to determine the sero-prevalence of HIV among civilian applicants enrolling into military services of Nigeria army where youth’s vulnerability to HIV infection is very high. METHOD: A periodic cross sectional study was carried out amongst the civilian applicants undergoing recruitment into the Nigeria Army between January-February and July-August 2005, to determine their HIV status. Samples were collected from the applicants after interview to collect their socio-demographic characteristics. Data were analyzed with the aid of SPSS Version 12 and Chi square statistics was used to test for significance of association at P< 0.05. RESULTS: Out of the 9260 samples collected, 204 (2.2% tested positive for HIV with the highest proportion (73.5% occurring in the 22-25yrs bracket. Infection was detected in both sexes. The mean age of the applicants was 22yrs, with age range of 18-30 yrs and sex ratio of 1:7 (M: F. Age sex-specificity shows aged between 21-24 years have the highest number of HIV-antibody positivity. CONCLUSION: Antibody-positive applicants were identified in all the regions of Nigeria and the prevalence suggests that the epidemiology of transmission is changing both quantitatively and qualitatively because HIV now occurs commonly among young adults in their teens and late 20s and the impact of HIV on the military has grave consequences on the stability of Nigeria. The adoption of routine screening of applicants at point of recruitment, serving and retiring from the military can also be a source of data for understanding the epidemiology of this disease among the civilian and the military but in as HIV counseling and testing is an important continuum of the disease prevention and treatment, there is need to review Nigerian Army HIV and AIDS policy. [TAF Prev Med

Bioinformatics analysis of Brucella vaccines and vaccine targets using VIOLIN.

Science.gov (United States)

He, Yongqun; Xiang, Zuoshuang

2010-09-27

Brucella spp. are Gram-negative, facultative intracellular bacteria that cause brucellosis, one of the commonest zoonotic diseases found worldwide in humans and a variety of animal species. While several animal vaccines are available, there is no effective and safe vaccine for prevention of brucellosis in humans. VIOLIN (http://www.violinet.org) is a web-based vaccine database and analysis system that curates, stores, and analyzes published data of commercialized vaccines, and vaccines in clinical trials or in research. VIOLIN contains information for 454 vaccines or vaccine candidates for 73 pathogens. VIOLIN also contains many bioinformatics tools for vaccine data analysis, data integration, and vaccine target prediction. To demonstrate the applicability of VIOLIN for vaccine research, VIOLIN was used for bioinformatics analysis of existing Brucella vaccines and prediction of new Brucella vaccine targets. VIOLIN contains many literature mining programs (e.g., Vaxmesh) that provide in-depth analysis of Brucella vaccine literature. As a result of manual literature curation, VIOLIN contains information for 38 Brucella vaccines or vaccine candidates, 14 protective Brucella antigens, and 68 host response studies to Brucella vaccines from 97 peer-reviewed articles. These Brucella vaccines are classified in the Vaccine Ontology (VO) system and used for different ontological applications. The web-based VIOLIN vaccine target prediction program Vaxign was used to predict new Brucella vaccine targets. Vaxign identified 14 outer membrane proteins that are conserved in six virulent strains from B. abortus, B. melitensis, and B. suis that are pathogenic in humans. Of the 14 membrane proteins, two proteins (Omp2b and Omp31-1) are not present in B. ovis, a Brucella species that is not pathogenic in humans. Brucella vaccine data stored in VIOLIN were compared and analyzed using the VIOLIN query system. Bioinformatics curation and ontological representation of Brucella vaccines

Green revolution vaccines, edible vaccines | Tripurani | African ...

African Journals Online (AJOL)

Edible vaccines are sub-unit vaccines where the selected genes are introduced into the plants and the transgenic plant is then induced to manufacture the encoded protein. Edible vaccines are mucosal-targeted vaccines where stimulation of both systematic and mucosal immune network takes place. Foods under study ...

Effect of the deletion of genes encoding proteins of the extracellular virion form of vaccinia virus on vaccine immunogenicity and protective effectiveness in the mouse model.

Directory of Open Access Journals (Sweden)

Clement A Meseda

Full Text Available Antibodies to both infectious forms of vaccinia virus, the mature virion (MV and the enveloped virion (EV, as well as cell-mediated immune response appear to be important for protection against smallpox. EV virus particles, although more labile and less numerous than MV, are important for dissemination and spread of virus in infected hosts and thus important in virus pathogenesis. The importance of the EV A33 and B5 proteins for vaccine induced immunity and protection in a murine intranasal challenge model was evaluated by deletion of both the A33R and B5R genes in a vaccine-derived strain of vaccinia virus. Deletion of either A33R or B5R resulted in viruses with a small plaque phenotype and reduced virus yields, as reported previously, whereas deletion of both EV protein-encoding genes resulted in a virus that formed small infection foci that were detectable and quantifiable only by immunostaining and an even more dramatic decrease in total virus yield in cell culture. Deletion of B5R, either as a single gene knockout or in the double EV gene knockout virus, resulted in a loss of EV neutralizing activity, but all EV gene knockout viruses still induced a robust neutralizing activity against the vaccinia MV form of the virus. The effect of elimination of A33 and/or B5 on the protection afforded by vaccination was evaluated by intranasal challenge with a lethal dose of either vaccinia virus WR or IHD-J, a strain of vaccinia virus that produces relatively higher amounts of EV virus. The results from multiple experiments, using a range of vaccination doses and virus challenge doses, and using mortality, morbidity, and virus dissemination as endpoints, indicate that the absence of A33 and B5 have little effect on the ability of a vaccinia vaccine virus to provide protection against a lethal intranasal challenge in a mouse model.

Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

Directory of Open Access Journals (Sweden)

Melissa B Gilkey

Full Text Available To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents.We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR, varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status.A substantial minority of parents reported a history of vaccine refusal (15% or delay (27%. Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63 as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86. Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68, varicella (OR = 1.54, 95% CI, 1.42-1.66, and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42.Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

Comparative analysis of prevalence of intimate partner violence against women in military and civilian communities in Abuja, Nigeria

Directory of Open Access Journals (Sweden)

Chimah CU

2015-03-01

Full Text Available Carol Uzoamaka Chimah,1 Prosper Obunikem Uche Adogu,2 Kofoworola Odeyemi,3 Amobi Linus Ilika4 1Medical Department, Ministry of Defence Headquarters, Abuja, Nigeria; 2Department of Community Medicine and PHC, Nnamdi Azikiwe University/Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria; 3Department of Community Health, University of Lagos, Lagos, Nigeria Introduction: Intimate partner violence (IPV occurs across the world, in various cultures, and affects people across societies irrespective of economic status or gender. Most data on IPV before World Health Organization multicountry study (WHOMCS usually came from sources other than the military. Result of this study will contribute to the existing body of knowledge and may serve as a baseline for future studies in military populations. This study compares the prevalence of the different types of IPV against women in military and civilian communities in Abuja, Nigeria.Methods: Using a multistage sampling technique, 260 women who had intimate male partners were selected from military and civilian communities of Abuja. Collected data on personal characteristics and different types of IPV experienced were analyzed to demonstrate comparison of the association between the different forms of IPV and the respondents’ sociodemographic and partner characteristics in the two study populations using percentages and Χ-square statistics, and P-value was assumed to be significant at ≤0.05.Results: The prevalence of the four major types of IPV was higher among the military respondents than among civilians: controlling behavior, 37.1% versus 29.1%; emotional/psychological abuse, 42.4% versus 13.4%; physical abuse, 19.7% versus 5.9%, and sexual abuse, 9.2% versus 8.8%. Significantly more respondents from the military population (59 [45.4%] compared to civilians (21 [19.4%] were prevented by their partners from seeing their friends (P=0.000. The situation is reversed with regard to permission to seek

Mental Health Treatment Seeking Among Veteran and Civilian Community College Students.

Science.gov (United States)

Fortney, John C; Curran, Geoffrey M; Hunt, Justin B; Lu, Liya; Eisenberg, Daniel; Valenstein, Marcia

2017-08-01

A Web-based survey examined treatment seeking among community college students to inform the design of engagement interventions. Veteran and civilian community college students (N=765) were screened for mental disorders and reported perceptions of treatment need, effectiveness, and stigma, as well as service use. Regression analysis identified predictors of pharmacotherapy and psychotherapy use. Of the 511 students who screened positive for a current mental disorder or reported a perceived need for treatment (149 veterans and 362 civilians), 30% reported past-year use of psychotropic medications. Predictors were perceived treatment need (odds ratio [OR]=7.81, p<.001) and the perception that psychotropic medications are effective (OR=3.38, p=.012). Eleven percent of participants reported past-year psychotherapy use, and predictors were a positive screen for posttraumatic stress disorder (OR=2.78, p=.04) and poorer financial status. Modifiable barriers, including perceived need for and effectiveness of treatment, were correlated with pharmacotherapy use and should be targeted by engagement interventions.

The development and implications of peer emotional support for student service members/veterans and civilian college students.

Science.gov (United States)

Whiteman, Shawn D; Barry, Adam E; Mroczek, Daniel K; Macdermid Wadsworth, Shelley

2013-04-01

Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college.

The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws.

Science.gov (United States)

Barraza, Leila; Schmit, Cason; Hoss, Aila

2017-03-01

This paper discusses recent changes to state legal frameworks for mandatory vaccination in the context of school and healthcare worker vaccination. It then discusses state laws that allow pharmacists the authority to vaccinate.

A Content Analysis of Army Newspapers Based in the Continental United States (CONUS) to Determine Editorial Differences Between Military and Civilian Editors

National Research Council Canada - National Science Library

Swiergosz, Paul

1998-01-01

A content analysis of four civilian enterprise Army newspapers published in the United States was conducted to determine if editorial differences in content and tone existed between military and civilian editors...

Rotavirus vaccines

Directory of Open Access Journals (Sweden)

Kang G

2006-01-01

Full Text Available Rotavirus, the most common cause of severe diarrhea and a leading cause of mortality in children, has been a priority target for vaccine development for the past several years. The first rotavirus vaccine licensed in the United States was withdrawn because of an association of the vaccine with intussusception. However, the need for a vaccine is greatest in the developing world, because the benefits of preventing deaths due to rotavirus disease are substantially greater than the risk of intussusception. Early vaccines were based on animal strains. More recently developed and licenced vaccines are either animal-human reassortants or are based on human strains. In India, two candidate vaccines are in the development process, but have not yet reached efficacy trials. Many challenges regarding vaccine efficacy and safety remain. In addition to completing clinical evaluations of vaccines in development in settings with the highest disease burden and virus diversity, there is also a need to consider alternative vaccine development strategies.

Informing vaccine decision-making: A strategic multi-attribute ranking tool for vaccines-SMART Vaccines 2.0.

Science.gov (United States)

Knobler, Stacey; Bok, Karin; Gellin, Bruce

2017-01-20

SMART Vaccines 2.0 software is being developed to support decision-making among multiple stakeholders in the process of prioritizing investments to optimize the outcomes of vaccine development and deployment. Vaccines and associated vaccination programs are one of the most successful and effective public health interventions to prevent communicable diseases and vaccine researchers are continually working towards expanding targets for communicable and non-communicable diseases through preventive and therapeutic modes. A growing body of evidence on emerging vaccine technologies, trends in disease burden, costs associated with vaccine development and deployment, and benefits derived from disease prevention through vaccination and a range of other factors can inform decision-making and investment in new and improved vaccines and targeted utilization of already existing vaccines. Recognizing that an array of inputs influences these decisions, the strategic multi-attribute ranking method for vaccines (SMART Vaccines 2.0) is in development as a web-based tool-modified from a U.S. Institute of Medicine Committee effort (IOM, 2015)-to highlight data needs and create transparency to facilitate dialogue and information-sharing among decision-makers and to optimize the investment of resources leading to improved health outcomes. Current development efforts of the SMART Vaccines 2.0 framework seek to generate a weighted recommendation on vaccine development or vaccination priorities based on population, disease, economic, and vaccine-specific data in combination with individual preference and weights of user-selected attributes incorporating valuations of health, economics, demographics, public concern, scientific and business, programmatic, and political considerations. Further development of the design and utility of the tool is being carried out by the National Vaccine Program Office of the Department of Health and Human Services and the Fogarty International Center of the

The impact of making vaccines thermostable in Niger's vaccine supply chain.

Science.gov (United States)

Lee, Bruce Y; Cakouros, Brigid E; Assi, Tina-Marie; Connor, Diana L; Welling, Joel; Kone, Souleymane; Djibo, Ali; Wateska, Angela R; Pierre, Lionel; Brown, Shawn T

2012-08-17

Determine the effects on the vaccine cold chain of making different types of World Health Organization (WHO) Expanded Program on Immunizations (EPI) vaccines thermostable. Utilizing a detailed computational, discrete-event simulation model of the Niger vaccine supply chain, we simulated the impact of making different combinations of the six current EPI vaccines thermostable. Making any EPI vaccine thermostable relieved existing supply chain bottlenecks (especially at the lowest levels), increased vaccine availability of all EPI vaccines, and decreased cold storage and transport capacity utilization. By far, the most substantial impact came from making the pentavalent vaccine thermostable, increasing its own vaccine availability from 87% to 97% and the vaccine availabilities of all other remaining non-thermostable EPI vaccines to over 93%. By contrast, making each of the other vaccines thermostable had considerably less effect on the remaining vaccines, failing to increase the vaccine availabilities of other vaccines to more than 89%. Making tetanus toxoid vaccine along with the pentavalent thermostable further increased the vaccine availability of all EPI vaccines by at least 1-2%. Our study shows the potential benefits of making any of Niger's EPI vaccines thermostable and therefore supports further development of thermostable vaccines. Eliminating the need for refrigerators and freezers should not necessarily be the only benefit and goal of vaccine thermostability. Rather, making even a single vaccine (or some subset of the vaccines) thermostable could free up significant cold storage space for other vaccines, and thereby help alleviate supply chain bottlenecks that occur throughout the world. Copyright © 2012 Elsevier Ltd. All rights reserved.

Differences by Veteran/civilian status and gender in associations between childhood adversity and alcohol and drug use disorders.

Science.gov (United States)

Evans, Elizabeth A; Upchurch, Dawn M; Simpson, Tracy; Hamilton, Alison B; Hoggatt, Katherine J

2018-04-01

To examine differences by US military Veteran status and gender in associations between childhood adversity and DSM-5 lifetime alcohol and drug use disorders (AUD/DUD). We analyzed nationally representative data from 3119 Veterans (n = 379 women; n = 2740 men) and 33,182 civilians (n = 20,066 women; n = 13,116 men) as provided by the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). We used weighted multinomial logistic regression, tested interaction terms, and calculated predicted probabilities by Veteran status and gender, controlling for covariates. To test which specific moderation contrasts were statistically significant, we conducted pairwise comparisons. Among civilians, women had lower AUD and DUD prevalence than men; however, with more childhood adversity, this gender gap narrowed for AUD and widened for DUD. Among Veterans, in contrast, similar proportions of women and men had AUD and DUD; with more childhood adversity, AUD-predicted probability among men surpassed that of women. Childhood adversity elevated AUD probability among civilian women to levels exhibited by Veteran women. Among men, Veterans with more childhood adversity were more likely than civilians to have AUD, and less likely to have DUD. Childhood adversity alters the gender gap in AUD and DUD risk, and in ways that are different for Veterans compared with civilians. Department of Defense, Veterans Affairs, and community health centers can prevent and ameliorate the harmful effects of childhood adversity by adapting existing behavioral health efforts to be trauma informed, Veteran sensitive, and gender tailored.

Incidence and severity of ocular and adnexal injuries during the Second Lebanon War among Israeli soldiers and civilians.

Science.gov (United States)

Barak, Adiel; Elhalel, Amir; Pikkel, Joseph; Krauss, Eli; Miller, Benjamin

2011-12-01

To analyze the incidence and severity of ocular and adnexal injuries in the Second Lebanon War among Israeli soldiers and civilians. Retrospective cohort study. All patients recorded in the Israeli National Trauma Registry during the Second Lebanon War (July-August, 2006). Retrieval of all data relevant to ocular and adnexal injuries sustained during the study period, and differentiation between those associated with combat/terrorist and other events. Analysis of data according to the severity of trauma , anatomical location of the injury, and whether the patients were military personnel or civilians. A total of 69 war-related ocular trauma patients (58 military personnel and 11 civilians) were registered during the 34 days of war. The injuries involved the anterior segment injury (n = 25), posterior segment (n = 29) and the periocular region (n = 15, all severe). Twenty-seven of the patients had open-globe injuries, of which 18 involved intraocular foreign bodies, and 27 patients had closed-globe injuries. The rate of ocular injuries was 7% among all registered wounded military personnel and 1.2% among all injured civilians. The incidence and severity of ocular and adnexal injuries among military personnel during the Second Lebanon War were consistent with previous reports from American sources of ocular injuries sustained in Iraq and Afghanistan. The rates of ocular injury associated with wartime events sustained by civilians has not been investigated before, and it was relatively low, probably as a result of stringent government-mandated building regulations for passive defense that are discussed.

Beacon of Hope? Lessons Learned from Efforts to Reduce Civilian Deaths from Police Shootings in an Australian State.

Science.gov (United States)

Saligari, Jessica; Evans, Richard

2016-04-01

In the 1990s, the police service in Victoria, Australia, faced a crisis of community confidence due to a spate of civilian deaths from police shootings. In that decade, twice as many civilians died at the hands of the police in Victoria than in every other Australian state combined. Most of those killed were mentally ill and affected by drugs and alcohol, and were rarely a serious threat except to themselves. The problem was also almost entirely an urban phenomenon. Shootings in rural communities, where mentally ill people were more likely to be personally known to local police, were (and remain) almost unknown. The large number of fatalities was recognised as a serious threat to public confidence, and Victoria Police introduced a ground-breaking training programme, Operation Beacon. Operating procedures and weapons training were fundamentally changed, to focus on de-escalation of conflict and avoiding or minimising police use of force. In the short term, Operation Beacon was successful. Shooting incidents were dramatically reduced. However, during the first decade of the new century, the number of civilians being killed again increased. This article examines Operation Beacon, both as a successful model for reducing civilian deaths at the hand of police and as a cautionary tale for police reform. We argue that the lessons of Operation Beacon have been gradually forgotten and that old habits and attitudes resurfaced. Fatal shootings of mentally ill civilians can be prevented, but if success is to be other than temporary, the Beacon philosophy must be continually reemphasised by police management.

Vaccines (immunizations) - overview

Science.gov (United States)

Vaccinations; Immunizations; Immunize; Vaccine shots; Prevention - vaccine ... of the vaccine. VACCINE SCHEDULE The recommended vaccination (immunization) schedule is updated every 12 months by the ...

Defense IRM: Alternatives Should Be Considered in Developing the New Civilian Personnel System

National Research Council Canada - National Science Library

1999-01-01

... regional centers, and attempting to improve personnel management business processes. A key part of this initiative is Defense's development of a new information management system-the Defense Civilian Personnel Data System (DCPDs...

Rotavirus vaccines

Science.gov (United States)

Yen, Catherine; Tate, Jacqueline E; Hyde, Terri B; Cortese, Margaret M; Lopman, Benjamin A; Jiang, Baoming; Glass, Roger I; Parashar, Umesh D

2014-01-01

Rotavirus is the leading cause of severe diarrhea among children rotavirus vaccines have been efficacious and effective, with many countries reporting substantial declines in diarrheal and rotavirus-specific morbidity and mortality. However, the full public health impact of these vaccines has not been realized. Most countries, including those with the highest disease burden, have not yet introduced rotavirus vaccines into their national immunization programs. Research activities that may help inform vaccine introduction decisions include (1) establishing effectiveness, impact, and safety for rotavirus vaccines in low-income settings; (2) identifying potential strategies to improve performance of oral rotavirus vaccines in developing countries, such as zinc supplementation; and (3) pursuing alternate approaches to oral vaccines, such as parenteral immunization. Policy- and program-level barriers, such as financial implications of new vaccine introductions, should be addressed to ensure that countries are able to make informed decisions regarding rotavirus vaccine introduction. PMID:24755452

Hepatitis Vaccines

Directory of Open Access Journals (Sweden)

Sina Ogholikhan

2016-03-01

Full Text Available Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver.

Hepatitis Vaccines

Science.gov (United States)

Ogholikhan, Sina; Schwarz, Kathleen B.

2016-01-01

Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver. PMID:26978406

Imperfect Vaccine Aggravates the Long-Standing Dilemma of Voluntary Vaccination

Science.gov (United States)

Wu, Bin; Fu, Feng; Wang, Long

2011-01-01

Achieving widespread population immunity by voluntary vaccination poses a major challenge for public health administration and practice. The situation is complicated even more by imperfect vaccines. How the vaccine efficacy affects individuals' vaccination behavior has yet to be fully answered. To address this issue, we combine a simple yet effective game theoretic model of vaccination behavior with an epidemiological process. Our analysis shows that, in a population of self-interested individuals, there exists an overshooting of vaccine uptake levels as the effectiveness of vaccination increases. Moreover, when the basic reproductive number, , exceeds a certain threshold, all individuals opt for vaccination for an intermediate region of vaccine efficacy. We further show that increasing effectiveness of vaccination always increases the number of effectively vaccinated individuals and therefore attenuates the epidemic strain. The results suggest that ‘number is traded for efficiency’: although increases in vaccination effectiveness lead to uptake drops due to free-riding effects, the impact of the epidemic can be better mitigated. PMID:21687680

Imperfect vaccine aggravates the long-standing dilemma of voluntary vaccination.

Directory of Open Access Journals (Sweden)

Bin Wu

Full Text Available Achieving widespread population immunity by voluntary vaccination poses a major challenge for public health administration and practice. The situation is complicated even more by imperfect vaccines. How the vaccine efficacy affects individuals' vaccination behavior has yet to be fully answered. To address this issue, we combine a simple yet effective game theoretic model of vaccination behavior with an epidemiological process. Our analysis shows that, in a population of self-interested individuals, there exists an overshooting of vaccine uptake levels as the effectiveness of vaccination increases. Moreover, when the basic reproductive number, R0, exceeds a certain threshold, all individuals opt for vaccination for an intermediate region of vaccine efficacy. We further show that increasing effectiveness of vaccination always increases the number of effectively vaccinated individuals and therefore attenuates the epidemic strain. The results suggest that 'number is traded for efficiency': although increases in vaccination effectiveness lead to uptake drops due to free-riding effects, the impact of the epidemic can be better mitigated.

Replacing Military Personnel in Support Positions With Civilian Employees

Science.gov (United States)

2015-12-01

burdened costs , as they are known, would include the per-person share of costs for recruit -processing centers, schools, and training bases and would...sector so that, in principle, those same positions could be filled by civilian employees. To cut costs , DoD could transfer some of those positions to...functions more cost -effectively. DoD competed and outsourced many positions outlined in those plans. However, CBO does not have information showing

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Pneumococcal vaccine and flu vaccine. 410.57 Section 410.57 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its...

New effective chemically synthesized anti-smallpox compound NIOCH-14.

Science.gov (United States)

Mazurkov, Oleg Yu; Kabanov, Alexey S; Shishkina, Larisa N; Sergeev, Alexander A; Skarnovich, Maksim O; Bormotov, Nikolay I; Skarnovich, Maria A; Ovchinnikova, Alena S; Titova, Ksenya A; Galahova, Darya O; Bulychev, Leonid E; Sergeev, Artemiy A; Taranov, Oleg S; Selivanov, Boris A; Tikhonov, Alexey Ya; Zavjalov, Evgenii L; Agafonov, Alexander P; Sergeev, Alexander N

2016-05-01

Antiviral activity of the new chemically synthesized compound NIOCH-14 (a derivative of tricyclodicarboxylic acid) in comparison with ST-246 (the condensed derivative of pyrroledione) was observed in experiments in vitro and in vivo using orthopoxviruses including highly pathogenic ones. After oral administration of NIOCH-14 to outbred ICR mice infected intranasally with 100 % lethal dose of ectromelia virus, it was shown that 50 % effective doses of NIOCH-14 and ST-246 did not significantly differ. The 'therapeutic window' varied from 1 day before infection to 6 days post-infection (p.i.) to achieve 100-60 % survival rate. The administration of NIOCH-14 and ST-246 to mice resulted in a significant reduction of ectromelia virus titres in organs examined as compared with the control and also reduced pathological changes in the lungs 6 days p.i. Oral administration of NIOCH-14 and ST-246 to ICR mice and marmots challenged with monkeypox virus as compared with the control resulted in a significant reduction of virus production in the lungs and the proportion of infected mice 7 days p.i. as well as the absence of disease in marmots. Significantly lower proportions of infected mice and virus production levels in the lungs as compared with the control were demonstrated in experiments after oral administration of NIOCH-14 and ST-246 to ICR mice and immunodeficient SCID mice challenged with variola virus 3 and 4 days p.i., respectively. The results obtained suggest good prospects for further study of the chemical compound NIOCH-14 to create a new smallpox drug on its basis.

Vaccination Perceptions of College Students: With and without Vaccination Waiver.

Science.gov (United States)

Jadhav, Emmanuel D; Winkler, Danielle L; Anderson, Billie S

2018-01-01

The resurgence of vaccine preventable diseases occurs more often among intentionally unvaccinated individuals, placing at direct risk young adults not caught up on vaccinations. The objectives of this study were to characterize the sociodemographic characteristics of young adults with and without vaccination waivers and identify their perceived benefits, barriers, and influencers of vaccination. Young adults ( n  = 964) from a Midwestern rural university responded to a survey (fall 2015-spring 2016) designed to identify their perception toward vaccination. Instrument consistency was measured using the Cronbach α-scores. The Chi-square test was used to test any sociodemographic differences and Mann-Whitney U -tests results for differences between exempt and non-exempt students. Analysis occurred in spring 2017. A little over one-third of young adults with a vaccination waiver were not up to date on their vaccinations, and think that vaccinations can cause autism. The biggest identifiable benefit was effective control against disease. The surveyed young adults ranked the out of pocket cost associated with vaccination as the most important barrier and safe and easy to use vaccines as the most important influencer of vaccination. Young adults who have had a vaccination waiver appear to not be up to date on their vaccinations. Vaccine administration programs, such as university campus clinics, would benefit from addressing perceptions unique to young adults with and without a vaccine waiver. This would subsequently better provide young adults a second shot for getting appropriately caught up on vaccinations.

Review of Canine Deaths While in Service in US Civilian Law Enforcement (2002-2012).

Science.gov (United States)

Stojsih, Sarah E; Baker, Janice L; Les, Clifford M; Bir, Cynthia A

2014-01-01

Working dogs have been proven effective in multiple military and law enforcement applications. Similar to their human counterparts, understanding mortality while still in service can help improve treatment of injuries, and improve equipment and training, to potentially reduce deaths. This is a retrospective study to characterize mortality of working dogs used in civilian law enforcement. Reported causes of death were gathered from two working dog and law enforcement officer memorial websites. Of the 867 civilian law enforcement dogs reported to these memorial websites from 2002 to 2012 with reported causes of death while in service, the deaths of 318 were categorized as traumatic. The leading reported causes of traumatic death or euthanasia include trauma as a result of a vehicle strike, 25.8% (n=82); heatstroke, 24.8% (n=79); and penetrating ballistic trauma, 23.0% (n=73). Although the information gathered was from online sources, this study casts some light on the risks that civilian law enforcement dogs undergo as part of the tasks to which they are assigned. These data underscore the need for a comprehensive database for this specialized population of working dogs to provide the robust, reliable data needed to develop prevention and treatment strategies for this valuable resource. 2014.

[From new vaccine to new target: revisiting influenza vaccination].

Science.gov (United States)

Gérard, M

2011-09-01

Annual vaccination is since many years the corner stone of Influenza control strategy. Because conventional vaccine are needle-based, are less immunogenic in old people and induce only systemic IgG production, intranasal and intradermal vaccines that are recently or will be soon available in Belgium will offer distinct advantages. Intradermal vaccination is on the Belgian market since 2010. A stronger immune response that allows an antigen sparing strategy is elicited because antigens are delivered near the dermal dendritic cells. Local side effects are more pronounced than after intramuscular injection. The needle-free intranasal vaccine that has been approved for use in people less than 18 years old by the EMEA in October 2010 induces also a mucosal IgA response. Improved clinical results than with intramuscular vaccine has been documented in several studies in children. Several conditions are contraindication to nasal vaccination because of patterns of side effects and because the vaccine is an live-attenuated vaccine. Pregnant women has become a top priority for Influenza vaccination in the recommendations of the High Council of Health in Belgium since the 2009 H1N1 pandemic. Several studies has since then documented the increased risk for Influenza-related morbidity in pregnant women especially during the third trimester and independently of the presence of other comorbidities. Reduced incidence of documented Influenza and of Influenza-related hospitalizations are observed in the new born of vaccinated women until 6 months of age. Availability of new vaccines for Influenza and better knowledge of the benefit of vaccination in target populations are important tools to optimize vaccine coverage of the population.

The effects of anti-vaccine conspiracy theories on vaccination intentions.

Directory of Open Access Journals (Sweden)

Daniel Jolley

Full Text Available The current studies investigated the potential impact of anti-vaccine conspiracy beliefs, and exposure to anti-vaccine conspiracy theories, on vaccination intentions. In Study 1, British parents completed a questionnaire measuring beliefs in anti-vaccine conspiracy theories and the likelihood that they would have a fictitious child vaccinated. Results revealed a significant negative relationship between anti-vaccine conspiracy beliefs and vaccination intentions. This effect was mediated by the perceived dangers of vaccines, and feelings of powerlessness, disillusionment and mistrust in authorities. In Study 2, participants were exposed to information that either supported or refuted anti-vaccine conspiracy theories, or a control condition. Results revealed that participants who had been exposed to material supporting anti-vaccine conspiracy theories showed less intention to vaccinate than those in the anti-conspiracy condition or controls. This effect was mediated by the same variables as in Study 1. These findings point to the potentially detrimental consequences of anti-vaccine conspiracy theories, and highlight their potential role in shaping health-related behaviors.

[VACCINES].

Science.gov (United States)

Bellver Capella, Vincente

2015-10-01

Vaccines are an extraordinary instrument of immunization of the population against infectious diseases. Around them there are many ethical issues. One of the most debated is what to do with certain groups opposition to vaccination of their children. States have managed in different ways the conflict between the duty of vaccination and the refusal to use vaccines: some impose the vaccination and others simply promote it. In this article we deal with which of these two approaches is the most suitable from an ethical and legal point of view. We stand up for the second option, which is the current one in Spain, and we propose some measures which should be kept in mind to improve immunization programs.

Pre-hospital management of mass casualty civilian shootings: a systematic literature review.

Science.gov (United States)

Turner, Conor D A; Lockey, David J; Rehn, Marius

2016-11-08

Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice. Systematic literature searches of PubMed, Cochrane Database of Systematic Reviews and Scopus were conducted in conjunction with simple searches of non-indexed databases; Web of Science, OpenDOAR and Evidence Search. The searches were last carried out on 20 April 2016 and only identified those papers published after the 1 January 1980. Included documents had to contain descriptions, discussions or experiences of the pre-hospital management of civilian mass shootings. From the 494 identified manuscripts, 73 were selected on abstract and title and after full text reading 47 were selected for inclusion in analysis. The search yielded reports of 17 mass shooting events, the majority from the USA with additions from France, Norway, the UK and Kenya. Between 1994 and 2015 the shooting of 1649 people with 578 deaths at 17 separate events are described. Quality appraisal demonstrated considerable heterogeneity in reporting and revealed limited data on mass shootings globally. Key themes were identified to improve future practice: tactical emergency medical support may harmonise inner cordon interventions, a need for inter-service education on effective haemorrhage control, the value of senior triage operators and the need for regular mass casualty incident simulation.

Vaccination in Fish

DEFF Research Database (Denmark)

Chettri, Jiwan Kumar

vaccines have reduced the need for usage of antibiotics with more than 99 % since the 1980s. Fish can be vaccinated by three different administration routes: injection, immersion and oral vaccination. Injection vaccination (intraperitoneal injection of vaccine) is the most time consuming and labor...... intensive method, which however, provides the best protection of the fish. Immersion vaccination is used for immunization of a high number of small fish is cost-efficient and fast (30 sec immersion into vaccine). Oral vaccination (vaccine in feed) is the least efficient. As in higher vertebrates fish...... respond to vaccination by increasing the specific antibody titer and by activating the cellular responses. My talk will cover vaccination methods in fish, immune responses and some adverse effect of oil-adjuvanted vaccines in fish with reference to our work in rainbow trout, Oncorhynchus mykiss....

Vaccination Perceptions of College Students: With and without Vaccination Waiver

Directory of Open Access Journals (Sweden)

Emmanuel D. Jadhav

2018-02-01

Full Text Available IntroductionThe resurgence of vaccine preventable diseases occurs more often among intentionally unvaccinated individuals, placing at direct risk young adults not caught up on vaccinations. The objectives of this study were to characterize the sociodemographic characteristics of young adults with and without vaccination waivers and identify their perceived benefits, barriers, and influencers of vaccination.MethodsYoung adults (n = 964 from a Midwestern rural university responded to a survey (fall 2015—spring 2016 designed to identify their perception toward vaccination. Instrument consistency was measured using the Cronbach α-scores. The Chi-square test was used to test any sociodemographic differences and Mann–Whitney U-tests results for differences between exempt and non-exempt students. Analysis occurred in spring 2017.ResultsA little over one-third of young adults with a vaccination waiver were not up to date on their vaccinations, and think that vaccinations can cause autism. The biggest identifiable benefit was effective control against disease. The surveyed young adults ranked the out of pocket cost associated with vaccination as the most important barrier and safe and easy to use vaccines as the most important influencer of vaccination.ConclusionYoung adults who have had a vaccination waiver appear to not be up to date on their vaccinations. Vaccine administration programs, such as university campus clinics, would benefit from addressing perceptions unique to young adults with and without a vaccine waiver. This would subsequently better provide young adults a second shot for getting appropriately caught up on vaccinations.

Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England.

Science.gov (United States)

Paterson, Pauline; Chantler, Tracey; Larson, Heidi J

2017-08-14

In 2013, the annual influenza immunisation programme in England was extended to children to reduce the burden of influenza, but uptake was sub-optimal at 53.2%. To explore the reasons some parents decided not to vaccinate their child against influenza as part of the pilot programme offered in schools. Cross-sectional qualitative study conducted between February and July 2015. 913 parents whose children were not vaccinated against influenza in the school pilots in West Yorkshire and Greater Manchester, England, were asked to comment on their reasons for non-vaccination and invited to take part in a semi-structured interview. 138 parents returned response forms, of which 38 were eligible and interested in participating and 25 were interviewed. Interview transcripts were coded by theme in NVivo. A third of parents who returned response forms had either vaccinated their child elsewhere, intended to have them vaccinated, or had not vaccinated them due to medical reasons (valid or perceived). Most interviewees were not convinced of the need to vaccinate their child against influenza. Parents expressed concerns about influenza vaccine effectiveness and vaccine side effects. Several parents interviewed declined the vaccine for faith reasons due to the presence of porcine gelatine in the vaccine. To significantly decrease the burden of influenza in England, influenza vaccination coverage in children needs to be >60%. Hence, it is important to understand the reasons why parents are not vaccinating their children, and to tailor the communication and immunisation programme accordingly. Our finding that a third of parents, who did not consent to their child being vaccinated as part of the school programme, had actually vaccinated their child elsewhere, intended to have their child vaccinated, or had not vaccinated them due to medical reasons, illustrates the importance of including additional questions or data sources when investigating under-vaccination. Copyright © 2017 The

Smallpox still haunts scientists: results of a questionnaire-based inquiry on the views of health care and life science experts and students on preserving the remaining variola virus stocks.

Science.gov (United States)

Srinivasan, Thangavelu; Dedeepiya, Vidyasagar Devaprasad; John, Sudhakar; Senthilkumar, Rajappa; Reena, Helen C; Rajendran, Paramasivam; Balamurugan, Madasamy; Kurosawa, Gene; Iwasaki, Masaru; Preethy, Senthilkumar; Abraham, Samuel J K

2013-01-01

The World Health Organization (WHO) declared eradication of the dreadful disease "smallpox" in 1980. Though the disease has died down, the causative virus "variola" has not, as it has been well preserved in two high security laboratories-one in USA and another in Russia. The debate on whether the remaining stocks of the smallpox virus should be destroyed or not is ongoing, and the World Health Assembly (WHA) in 2011 has decided to postpone the review on this debate to the 67th WHA in 2014. A short questionnaire-based inquiry was organized during a one-day stem cell meeting to explore the views of various health care and life science specialists especially students on this aspect. Among the 200 participants of the meeting, only 66 had answered the questionnaire. 60.6% of participants who responded to the questionnaire were for preserving the virus for future reference, while 36.4% of the participants were for destroying the virus considering the magnitude with which it killed millions. However, 3% of the respondents were not able to decide on any verdict. Therefore, this inquiry expresses the view that "what we cannot create, we do not have the right to destroy."

An integrated approach to strategic planning in the civilian high-level radioactive waste management program

International Nuclear Information System (INIS)

Sprecher, W.M.; Katz, J.; Redmond, R.J.

1992-01-01

This paper describes the approach that the Office of Civilian Radioactive Waste Management (OCRWM) of the Department of Energy (DOE) is taking to the task of strategic planning for the civilian high-level radioactive waste management program. It highlights selected planning products and activities that have emerged over the past year. It demonstrates that this approach is an integrated one, both in the sense of being systematic on the program level but also as a component of DOE strategic planning efforts. Lastly, it indicates that OCRWM strategic planning takes place in a dynamic environment and consequently is a process that is still evolving in response to the demands placed upon it

The Impact of Making Vaccines Thermostable in Niger’s Vaccine Supply Chain

Science.gov (United States)

Lee, Bruce Y.; Cakouros, Brigid E.; Assi, Tina-Marie; Connor, Diana L.; Welling, Joel; Kone, Souleymane; Djibo, Ali; Wateska, Angela R.; Pierre, Lionel; Brown, Shawn T.

2012-01-01

Objective Determine the effects on the vaccine cold chain of making different types of World Health Organization (WHO) Expanded Program on Immunizations (EPI) vaccines thermostable. Methods Utilizing a detailed computational, discrete-event simulation model of the Niger vaccine supply chain, we simulated the impact of making different combinations of the six current EPI vaccines thermostable. Findings Making any EPI vaccine thermostable relieved existing supply chain bottlenecks (especially at the lowest levels), increased vaccine availability of all EPI vaccines, and decreased cold storage and transport capacity utilization. By far, the most substantial impact came from making the pentavalent vaccine thermostable, increasing its own vaccine availability from 87% to 97% and the vaccine availabilities of all other remaining non-thermostable EPI vaccines to over 93%. By contrast, making each of the other vaccines thermostable had considerably less effect on the remaining vaccines, failing to increase the vaccine availabilities of other vaccines to more than 89%. Making tetanus toxoid vaccine along with the pentavalent thermostable further increased the vaccine availability of all EPI vaccines by at least 1–2%. Conclusion Our study shows the potential benefits of making any of Niger’s EPI vaccines thermostable and therefore supports further development of thermostable vaccines. Eliminating the need for refrigerators and freezers should not necessarily be the only benefit and goal of vaccine thermostability. Rather, making even a single vaccine (or some subset of the vaccines) thermostable could free up significant cold storage space for other vaccines, and thereby help alleviate supply chain bottlenecks that occur throughout the world. PMID:22789507

A Comparative Analysis of Guilty Plea Inquiries in Federal Civilian and Military Practice

National Research Council Canada - National Science Library

Elling, Terry L

1991-01-01

.... The thesis examines the advice to accused persons concerning the nature of the charge to which they pleaded guilty and the manner in which military and civilian judges develop the factual basis to support a guilty plea...

Vaccines against poverty

Science.gov (United States)

MacLennan, Calman A.; Saul, Allan

2014-01-01

With the 2010s declared the Decade of Vaccines, and Millennium Development Goals 4 and 5 focused on reducing diseases that are potentially vaccine preventable, now is an exciting time for vaccines against poverty, that is, vaccines against diseases that disproportionately affect low- and middle-income countries (LMICs). The Global Burden of Disease Study 2010 has helped better understand which vaccines are most needed. In 2012, US$1.3 billion was spent on research and development for new vaccines for neglected infectious diseases. However, the majority of this went to three diseases: HIV/AIDS, malaria, and tuberculosis, and not neglected diseases. Much of it went to basic research rather than development, with an ongoing decline in funding for product development partnerships. Further investment in vaccines against diarrheal diseases, hepatitis C, and group A Streptococcus could lead to a major health impact in LMICs, along with vaccines to prevent sepsis, particularly among mothers and neonates. The Advanced Market Commitment strategy of the Global Alliance for Vaccines and Immunisation (GAVI) Alliance is helping to implement vaccines against rotavirus and pneumococcus in LMICs, and the roll out of the MenAfriVac meningococcal A vaccine in the African Meningitis Belt represents a paradigm shift in vaccines against poverty: the development of a vaccine primarily targeted at LMICs. Global health vaccine institutes and increasing capacity of vaccine manufacturers in emerging economies are helping drive forward new vaccines for LMICs. Above all, partnership is needed between those developing and manufacturing LMIC vaccines and the scientists, health care professionals, and policy makers in LMICs where such vaccines will be implemented. PMID:25136089

Dried influenza vaccines : Over the counter vaccines

NARCIS (Netherlands)

Saluja, Vinay; Hinrichs, Wouter L. J.; Frijlink, Henderik W.

2010-01-01

Since last year influenza pandemic has struck again after 40 years, this is the right moment to discuss the different available formulation options for influenza vaccine. Looking back to the last 4 decades, most vaccines are still formulated as liquid solution. These vaccines have shown a poor

Egg-Independent Influenza Vaccines and Vaccine Candidates

Directory of Open Access Journals (Sweden)

Ilaria Manini

2017-07-01

Full Text Available Vaccination remains the principal way to control seasonal infections and is the most effective method of reducing influenza-associated morbidity and mortality. Since the 1940s, the main method of producing influenza vaccines has been an egg-based production process. However, in the event of a pandemic, this method has a significant limitation, as the time lag from strain isolation to final dose formulation and validation is six months. Indeed, production in eggs is a relatively slow process and production yields are both unpredictable and highly variable from strain to strain. In particular, if the next influenza pandemic were to arise from an avian influenza virus, and thus reduce the egg-laying hen population, there would be a shortage of embryonated eggs available for vaccine manufacturing. Although the production of egg-derived vaccines will continue, new technological developments have generated a cell-culture-based influenza vaccine and other more recent platforms, such as synthetic influenza vaccines.

Rotavirus vaccines and vaccination in Latin America

Directory of Open Access Journals (Sweden)

Linhares Alexandre C.

2000-01-01

Full Text Available Worldwide, rotaviruses account for more than 125 million cases of infantile gastroenteritis and nearly 1 million deaths per year, mainly in developing countries. Rather than other control measures, vaccination is most likely to have a major impact on rotavirus disease incidence. The peak incidence of rotavirus diarrhea occurs between 6 and 24 months of age. In developing countries, however, cases are not uncommon among children younger than 6 months. G serotypes 1 to 4 are responsible for most disease, but there are indications that in Brazil that G type 5 is of emerging epidemiological importance. Both homotypic and heterotypic responses are elicited during natural rotavirus infection, and the immunological response at the intestinal mucosal surface is probably the more consistent predictor of clinical immunity. With the primary objective of protecting children against life-threatening dehydrating diarrhea, many approaches to rotavirus vaccine development have been attempted. One vaccine, the tetravalent rhesus-human reassortant rotavirus vaccine (RRV-TV, was given licensing approval in the United States of America, introduced to the market, and later withdrawn. A number of studies have found better efficacy of RRV-TV in developed countries than in developing ones. Field trials with a 4 X 10(4 plaque-forming units (PFU preparation of RRV-TV have been carried out in two countries in Latin America, Brazil and Peru. Those trials yielded protective efficacy rates against all rotavirus diarrhea ranging from 18% to 35%. Data from a large catchment trial in Venezuela with a higher RRV-TV dose, of 4 X 10(5 PFU/dose, indicated an efficacy rate of 48% against all rotavirus diarrhea and 88% against severe rotavirus diarrhea. It appears that breast-feeding does not compromise the efficacy of RRV-TV if three doses of the vaccine are administered. Similarly, possible interference of oral poliovirus vaccine with the "take" of the rotavirus vaccine can be

Rotavirus vaccines and vaccination in Latin America

Directory of Open Access Journals (Sweden)

Alexandre C. Linhares

2000-11-01

Full Text Available Worldwide, rotaviruses account for more than 125 million cases of infantile gastroenteritis and nearly 1 million deaths per year, mainly in developing countries. Rather than other control measures, vaccination is most likely to have a major impact on rotavirus disease incidence. The peak incidence of rotavirus diarrhea occurs between 6 and 24 months of age. In developing countries, however, cases are not uncommon among children younger than 6 months. G serotypes 1 to 4 are responsible for most disease, but there are indications that in Brazil that G type 5 is of emerging epidemiological importance. Both homotypic and heterotypic responses are elicited during natural rotavirus infection, and the immunological response at the intestinal mucosal surface is probably the more consistent predictor of clinical immunity. With the primary objective of protecting children against life-threatening dehydrating diarrhea, many approaches to rotavirus vaccine development have been attempted. One vaccine, the tetravalent rhesus-human reassortant rotavirus vaccine (RRV-TV, was given licensing approval in the United States of America, introduced to the market, and later withdrawn. A number of studies have found better efficacy of RRV-TV in developed countries than in developing ones. Field trials with a 4 X 10(4 plaque-forming units (PFU preparation of RRV-TV have been carried out in two countries in Latin America, Brazil and Peru. Those trials yielded protective efficacy rates against all rotavirus diarrhea ranging from 18% to 35%. Data from a large catchment trial in Venezuela with a higher RRV-TV dose, of 4 X 10(5 PFU/dose, indicated an efficacy rate of 48% against all rotavirus diarrhea and 88% against severe rotavirus diarrhea. It appears that breast-feeding does not compromise the efficacy of RRV-TV if three doses of the vaccine are administered. Similarly, possible interference of oral poliovirus vaccine with the "take" of the rotavirus vaccine can be