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One of the first symptoms is a high fever. Then there’s a rash. As the variola virus spreads through a body, it’s heralded by rash after rash.

Soon, the body is essentially one big rash.

“It becomes unmistakable once the rash appears,” said Lt. Col. Loren Erickson, referring to smallpox — a deadly disease the World Health Organization declared conquered in May 1980.

So detecting someone infected with smallpox isn’t hard. Curing him or her is.

Historically, about three of every 10 people who get the disease will die.

“Once you’re sick with smallpox, there is no specific direct treatment,” said Erickson, chief of preventive medicine at Landstuhl Regional Medical Center in Germany.

Many who survive are left blind. Others carry the reminder of the disease on their skins for the rest of their lives.

“Frequently, they are left with permanent scars,” said Erickson, who is also a consultant for the Europe Regional Medical Command.

Smallpox is not a nice disease.

In the wake of the Sept. 11 attacks, military officials fear that some terrorist organizations or governments hostile to the United States may have access to the virus. President Bush ordered certain commands to start vaccinating their troops as soon as they could formulate a vaccination plan.

The Army, Navy and Air Force are doing that right now in Europe.

Those who would be the first to respond to a smallpox outbreak will get vaccinated “in the very near future,” according to Col. Allen Kraft, the director of force protection for U.S. Army Europe and the medical command.

President Bush recently received the vaccination, as did more than 100 military personnel at Walter Reed Medical Center in Maryland.

Before the first personnel get the vaccinations in Europe, officials in the medical command need to finish the fine details on their vaccination plan.

And each individual will be screened before getting the vaccine.

“We’re taking a very deliberate and careful approach,” Kraft said.

Careful because the vaccination itself holds some danger.

Erickson said the vaccine, called vaccinia, does not contain the smallpox virus. It contains a derivative of cowpox. But some people have severe reactions to it.

“If you immunize a million people, there will be a few who have trouble,” Erickson said.

Quoting from figures from the Centers for Disease Control, Erickson said about 40 of those million people will become severely sick.

Four will develop encephalitis. One or two will die.

Kraft and Erickson say part of the command’s plan is to identify those perceived to have greater risks of having problems with the vaccine. That includes those with severe skin conditions, people with lowered immunity levels and women who are pregnant. Others who live in the same homes as those in the categories mentioned above might also be exempt from getting the shots.

“Even though the risk is small, we don’t want to take that chance …,” Erickson said.

Cynthia Vaughan, a spokeswoman for the medical command, said there is some supply of the vaccine available in Europe. But she declined to quantify how much was available or say specifically who will be receiving the shots in the first wave, citing force protection measures.

According to a Dec. 13 Pentagon memorandum, the first wave will consist of mainly of medical personnel. A second stage would include “designated forces that constitute certain mission-critical capabilities.”

Other U.S. forces would be inoculated in a third stage, “depending on circumstances.”

Erickson said the potential problems of the vaccine might give some people pause. But balanced against getting the disease, he doesn’t think many will ultimately object.

“As we give them the facts, I think people will see this is the right thing to do,” he said. “We would be irresponsible if we were to do anything other than what we have planned.”

Shot’s small battle scar proves vaccine effective

Col. Philip La Kier received his second set of smallpox vaccinations when he joined the Air Force in 1976.

“It was a different kind of needle,” he said Monday, recalling his impression of the shots. “It’s sort of like a miniature shrimp fork.”

La Kier also remembers the aftereffects from the shot.

“It didn’t bother me that much right off,” he said. “But my arm got sore about a week later.”

Smallpox vaccinations are nothing new for those in the military, or even Americans in general. History says that George Washington gave an earlier, more dangerous variety of the vaccine to his soldiers in the Continental Army.

Those serving in World War I and World War II all got the shots.

But the military largely stopped giving the shots to troops in 1984. Some continued to get the shots until 1990, years after the last reported case — in Somalia in 1977 — was documented. Shots had been discontinued to the general U.S. population years earlier.

That means that about two-thirds of those currently in the military have never received the shots. When it comes time to baring arms, they may be the lucky ones. Those who received the shots more than 10 years ago are thought to have a small immunity left. So instead of getting three pricks with the two-pronged sticker, they’ll get 15 to make sure it takes.

La Kier, who is chief of aerospace medicine for U.S. Air Forces in Europe, is one of those who would get 15 sticks.

“It’s real fast,” he said. “It’s not like 15 separate needles.”

People can tell their inoculation has taken if they develop an itchy bump at the site of inoculation after a few days. That bump develops into a blister, which will eventually leave a small, permanent scar.

— Kent Harris

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Kent has filled numerous roles at Stars and Stripes including: copy editor, news editor, desk editor, reporter/photographer, web editor and overseas sports editor. Based at Aviano Air Base, Italy, he’s been TDY to countries such as Afghanistan Iraq, Kosovo and Bosnia. Born in California, he’s a 1988 graduate of Humboldt State University and has been a journalist for almost 38 years.
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