title: Modeling potential responses to smallpox as a bioterrorist weapon.
abstract: We constructed a mathematical model to describe the spread of smallpox after a deliberate release of the virus. Assuming 100 persons initially infected and 3 persons infected per infectious person, quarantine alone could stop disease transmission but would require a minimum daily removal rate of 50% of those with overt symptoms. Vaccination would stop the outbreak within 365 days after release only if disease transmission were reduced to <0.85 persons infected per infectious person. A combined vaccination and quarantine campaign could stop an outbreak if a daily quarantine rate of 25% were achieved and vaccination reduced smallpox transmission by > or = 33%. In such a scenario, approximately 4,200 cases would occur and 365 days would be needed to stop the outbreak. Historical data indicate that a median of 2,155 smallpox vaccine doses per case were given to stop outbreaks, implying that a stockpile of 40 million doses should be adequate.
authors.affiliation: Centers for Disease Control and Prevention, Atalnta, Georgia 30333, USA.qzm4@cdc.gov
authors.forename: M I
authors.initials: MI
authors.lastname: Meltzer
authors.forename: I
authors.initials: I
authors.lastname: Damon
authors.forename: J W
authors.initials: JW
authors.lastname: LeDuc
authors.forename: J D
authors.initials: JD
authors.lastname: Millar
mesh_terms: D001694:Biological Warfare / Q000517:prevention & control*; D023482:Bioterrorism / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D016016:Proportional Hazards Models; D011790:Quarantine; D012680:Sensitivity and Specificity; D012899:Smallpox / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D012900:Smallpox Vaccine / Q000600:supply & distribution*; D014611:Vaccination; D012901:Variola virus
chemical_list: D012900:Smallpox Vaccine