The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62117

Ellen J. Stein, MD, MA, MPH¹, Shabbir Ahmad, DVM, MS, PhD¹, Leslie A. Jones, PhD², Karen P. Menendez, MPH¹, and Tilahun D. Yilma, DVM, PhD². (1) Epidemiology, Evaluation & Surveillance Section, Maternal & Child Health Branch, California Department of Health Services, 714 P Street, Room 499, Sacramento, CA 95814, (2) International Laboratory of Molecular Biology, University of California at Davis, 1 Hutchison Drive, Haring Hall, Davis, CA 95616

New approaches in vaccine development and public policy are emerging in response to anticipated bioterrorism threats. Smallpox virus is the most probable among many choices because of the ease in delivery, relative viral resistance to environmental factors, virus spread by contact, and high morbidity and mortality. Smallpox is a contagious disease caused by the highly pathogenic variola virus; case mortality may approach up to 30 percent in humans. The disease, in susceptible populations, can be prevented by using prophylactic vaccinia virus vaccine which was extensively used in the global eradication of smallpox by WHO. However, vaccine complications occur after vaccinia virus vaccination in a small number of normal individuals. Vaccinia virus is contraindicated in pregnant women and subpopulations with congenital and acquired immunodeficiencies (e.g. individuals with HIV-infection, cancer radiotherapy/chemotherapy, tissue/organ transplant, or corticosteroids use). We will present alternate vaccine approaches that are emerging through the use of molecular techniques, including: 1) Highly attenuated vaccinia virus, 2) Recombinant vaccinia virus expressing lymphokines, 3) Viral DNA vaccines, and 4) Passive vaccines (vIg).

Conclusions: Renewed interest in vaccine use against smallpox reinforces the need to develop safer vaccines. Highly attenuated and molecularly modified vaccinia virus vaccines are emerging as the safer vaccine strategy for pregnant women and for individuals with immunodeficiencies.

Implications: Health care providers will have safer vaccine choices with which to respond to bioterrorist threats.

Learning Objectives:

From this session, participants will:
• Learn the basic biology of the smallpox virus and its pathogenesis in humans.
• Recognize the public health significance of smallpox in infants, children and pregnant women.
• Develop preparedness programs to safeguard maternal and child health populations. 4) Learn about safer prophylactic and therapeutic vaccine regimens for pregnant women.

Keywords: Bioterrorism, Pregnancy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.