International Notes Orthopoxvirus Infections
The World Health Organization (WHO) Committee on Orthopoxvirus
Infections met in Geneva, Switzerland, March 24-26, 1986 (1). The
following is a summary of some of the major topics discussed and
several proposals for action drafted at that meeting.
Smallpox vaccination policy: All member states of WHO report
that
they have discontinued routine smallpox vaccination and that a
certificate of smallpox vaccination from international travelers is
no
longer required in any country in the world. However, some
countries
continue to vaccinate military personnel; the Committee recommends
that this practice be discontinued.
The original WHO recommendation for discontinuing smallpox
vaccination was formulated before the development of techniques
using
modified (recombinant) strains of vaccinia virus as vectors
(carriers)
for the expression of antigens to protect against diseases other
than
smallpox. The WHO recommendation against smallpox vaccination does
not apply to the use of vaccinia for immunization against diseases
other than smallpox.
Reserve stocks of smallpox vaccine: Because nearly a decade
has
passed since the last case of endemic smallpox, the Committee felt
that it is no longer necessary for WHO to maintain a global reserve
of
smallpox vaccine.
Investigation of suspected cases: Only 10 rumors of suspected
cases of smallpox were reported to WHO in 1985. The Committee
concluded that investigation of rumors in the future could be
carried
out by medical authorities of the member states of WHO.
Retention of variola virus stocks: Only two laboratories (the
Centers for Disease Control, in Atlanta, and the Research Institute
of
Viral Preparations, Moscow, U.S.S.R.), still maintain stocks of
variola (smallpox) virus. Neither laboratory plans to resume
experiments involving the culturing of variola virus. The variola
gene pool has been cloned into nonexpressing sites in bacterial
plasmids to allow future study of the variola virus. The
Committee's
opinion is that it will not be necessary to retain stocks of viable
variola virus after the cloning of DNA from variola has been
completed, and recommends that remaining stocks be destroyed at
that
time.
Monkeypox: In 1985, 55 cases of human monkeypox were reported;
all cases were from Zaire. WHO has sponsored intensive
surveillance
activities in a population of about five million people in Zaire.
The
incidence of human monkeypox is very low, and confidence is growing
that the virus cannot sustain itself in human-to-human spread. The
Committee recommended that WHO discontinue its direct involvement
in
monkeypox surveillance at the end of 1986.
Reported by International Health Program Office, Div of Viral
Diseases, Center for Infectious Diseases, CDC. Editorial Note
Editorial Note: The last endemic case of smallpox occurred in
October
1977 in Somalia. Two cases of smallpox occurred in the United
Kingdom
in 1978 associated with a smallpox research laboratory. The
Committee
on Orthopoxvirus Infections observed that in October 1987, 10 years
will have elapsed since the last case of endemic smallpox--a more
than
adequate period of time to provide full assurance that naturally
occurring smallpox will not recur.
Reference
World Health Organization. Committee on orthopoxvirus
infections. Report of the fourth meeting. Weekly
Epidemiological
Record 1986;61:289-93.
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