Home > Exhibits > Biopreparedness in Nebraska > Smallpox
Following the terror attacks of September 2001, the U.S. government evaluated biothreats and determined the highest agent of concern would be use of the variola virus in another attack. In response, the CDC and Department of Homeland Security initiated the Smallpox Pre-Event Vaccination Program. Through this program thousands of key healthcare providers and public health workers across the country volunteered to be vaccinated against smallpox. The U.S. government also stockpiled enough doses of the smallpox vaccine to provide vaccination to every person in the country.
While this bioterrorism attack has never come to fruition, several public health workers at UNMC and Nebraska Medicine continue to volunteer for regular vaccination to maintain preparedness in the event of an outbreak. As a Biosafety Level 3 lab, select employees in the Nebraska Public Health Laboratory also stay updated on vaccinations so that they can handle testing for the region.
An Inquiry into the Effects of Variolae Vaccinae by Edward Jenner, 1798, from the McGoogan Health Sciences Library Rare Book Collection
Smallpox is a serious infectious disease caused by the variola virus that has been around for thousands of years. It is a part of the Orthopoxvirus family and is related to mpox, cowpox, and camelpox, among others. The virus has two forms, variola minor and variola major. The more common variola major has a mortality rate of 30%, making it a CDC Category A Bioterrorism Agent alongside Ebola.
An Inquiry into the Effects of Variolae Vaccinae by Edward Jenner, 1798, from the McGoogan Health Sciences Library Rare Book Collection
English physician and scientist Edward Jenner is credited with pioneering the concept of vaccines, having developed an effective inoculation for smallpox in the 1790s. Jenner noticed that milkmaids who had recovered from a milder disease, cowpox, appeared to have a natural immunity to smallpox. In 1796, Jenner tested the theory by inoculating an 8-year-old boy, James Phipps, with a live cowpox specimen. After he recovered, Jenner inoculated James with live smallpox and confirmed the boy was protected.
Courtesy of the UNMC Department of Strategic Communications
Dr. Hinrichs receives his smallpox vaccine during the program at Nebraska Medicine.
Because of smallpox eradication in the 1980s, most of the world no longer receives regular vaccinations against the disease, making a smallpox outbreak very dangerous. On February 14, 2003, Steven Hinrichs, then director of the Nebraska Public Health Laboratory, received his vaccination as a member of a 2,500-person bioterrorism response team for the state. This team would be the first responders in vaccinating all Nebraskans and treating patients in the event of a smallpox bioterrorism event.
Donated by Peter Iwen, PhD, director of the Nebraska Public Health Laboratory, from the McGoogan Health Sciences Library Robert S. Wigton Department of Special Collections and Archives
Peter Iwen, PhD, director of the Nebraska Public Health Laboratory (NPHL), continues to get regular vaccinations for smallpox as a part of his work in the biosafety level 3 lab. The NPHL is one of only a few laboratories in the country that has the capacity to test for the live smallpox virus in suspected specimens . Dr. Iwen’s immunity enables him to safely handle these specimens and provide the testing needed in the event of an outbreak.
Today’s most widely used vaccine for smallpox is a strain of the vaccinia virus, a poxvirus related to smallpox, but less harmful. The vaccine is administered using a two-pronged (bifurcated) needle that is dipped in the vaccine solution and then used to prick a small section of the skin multiple times in a few seconds. Thanks to the widespread vaccination starting in the 1850s, the WHO was able to declare smallpox eradicated in 1980.
After the terror attacks in 2001, the Centers for Disease Control and Prevention (CDC) prepared binders with information about possible biological and chemical agents that could be used in an attack. The UNMC Center for Preparedness Education duplicated binders like this to share with public health officials across Nebraska who were developing bioterrorism protocols for their districts. Smallpox was one of the biothreats identified in the binder.