title: Smallpox containment updated: considerations for the 21st century.
abstract: The emergence and re-emergence of infectious diseases since the eradication of smallpox has had a direct impact on preparedness for a deliberately-caused smallpox outbreak, should one occur. The emergence of HIV has placed restrictions on the safe and effective use of smallpox vaccines and made the need for vaccinia immune globulin important for outbreak control. At the same time, the threat of international spread of emerging and re-emerging infections has prompted global investments in surveillance and response mechanisms such as the Global Outbreak Alert and Response Network (GOARN), a mechanism that would enhance the world's collaboration in smallpox containment as it did during the recent outbreak of SARS. Though global preparedness for a deliberately-caused smallpox outbreak has increased with the creation of GOARN, it does not replace the need for increased national public health investment to expand surge capacity for the management of patients and their contacts and to strengthen emergency communication networks to ensure effective response.
authors.affiliation: Polio Eradication, World Health Organization, 1211 Geneva 27, Switzerland. heymannd@who.int
authors.forename: David L
authors.initials: DL
authors.lastname: Heymann
mesh_terms: D023482:Bioterrorism; D021821:Communicable Diseases, Emerging; D004196:Disease Outbreaks / Q000517:prevention & control*; D014943:Global Health; D049671:History, 18th Century; D049673:History, 20th Century; D006801:Humans; D007391:International Cooperation; D011159:Population Surveillance; D012899:Smallpox / Q000266:history / Q000517:prevention & control*; D012900:Smallpox Vaccine / Q000009:adverse effects / Q000266:history / Q000276:immunology
chemical_list: D012900:Smallpox Vaccine