To: dreamer who wrote (93630 ) 10/14/2001 6:46:24 PM From: Jim Bishop Respond to of 150070 ACAM in Fortune.com story for Monday Oct 15, ACAM on page 2 of the article on Bioterror, although they blew it in the last paragraph as it has already been announced that the program has been accelerated.fortune.com As bioterror priorities are sorted out, smallpox and anthrax are likely to get the most attention--they appear to pose the greatest risk. The bad news on smallpox: The virus may have fallen into terrorists' hands as the former Soviet Union's biowarfare program disintegrated. It is hardy, highly infectious, and fatal in about 30% of untreated cases. Routine vaccination for it ended worldwide after 1980--perhaps 20% of Americans have residual immunity from childhood inoculations. In its first few days, a smallpox infection mimics flu; telltale skin lesions typically don't appear for a week or more--plenty of time for an unsuspecting carrier to infect many others. The somewhat good news: Smallpox vaccinations before exposure confer immunity, and they can attenuate illness in susceptible people if given within four days of infection. Thus, an outbreak might be contained by rapidly vaccinating people in and around the affected area and quarantining those already infected. Currently the CDC has a stockpile of about 12 million usable doses of vaccine--not nearly enough. Last year the CDC contracted with a British firm, Acambis, to add 40 million doses of a new smallpox vaccine to the U.S. stockpile beginning in 2004. Acambis and the CDC declined to comment on whether the project would be accelerated. "I'd be very surprised if it isn't," says George Washington University microbiologist Peter Hotez, who last year co-authored an article in the Washington Post arguing that at least 100 million doses would be needed to cope with a multi-city outbreak. Lance Gordon, a former Acambis executive who is now CEO at VaxGen, a Brisbane, Calif., vaccine developer, says that as soon as initial clinical tests are completed--they're needed to show whether Acambis' manufacturing process yields a consistent product--the project could be speeded up.