GATEWAY MUN Crisis—February 16, 2002

Situation:

An international flight originating in Hungary has landed in Rome, Italy.  A passenger on that flight has been diagnosed with Smallpox, and been quarantined in a hospital in Rome.  Unfortunately, the other passengers on the same flight have since gone on their respective ways.  The airline is currently working to contact each passenger, pilot, and flight attendant to inform them that they have been exposed.  The incubation time for the virus is 12-14 days, and it has been 24-hours since the flight landed in Rome and the infected passenger was diagnosed.

• At this time, the World Health Organization has declared a contagious disease emergency and airlines in Europe have been grounded.  In addition, the WHO has estimated the global stockpile of smallpox vaccine to be 60 million doses worldwide; however, the dilutant used to rehydrate the vaccine has deteriorated and does not pass quality control.  To further complicate the situation, the vaccine must be administered with a bifurcated needle, and fewer than 5 million bifurcated needles are held as a part of the global stockpile.

• We know that smallpox can spread in any climate, and in any part of the world.  The only weapons against the disease are vaccination and patient isolation.  Vaccination before exposure or within 2-3 days after exposure affords almost complete protection against the disease; vaccination as late as 4-5 days after exposure may protect against death.  Smallpox can only be transmitted from the time of the earliest appearance of rash, and the virus must pass from person to person in a continuing chain of infection through inhalation.

·        The need for vaccine will overwhelm the supply, and the cost of new vaccine development is prohibitive.  Containment of infected and exposed persons is key to preventing secondary infection.  International, state and local leadership is critical to managing this major public health emergency.

• The traditional method of producing the smallpox vaccine is now obsolete; the facilities, expertise and infrastructure that produced the stockpiled vaccine no longer exist.  In addition, those who have already contracted the disease require antiviral drugs that need to be distributed with the vaccine.  Experts have suggested that an emergency measure to stretch the vaccine supply include arm-to-arm vaccination as the rash forms on the arms of vaccinated people; however, there is serious concern about the spread of additional infectious diseases like HIV if this emergency measure is utilized.

• The United States, China, Russia, and United Kingdom have identified strains of the smallpox virus that have proven effective in eliminating the disease.  These strains could be appropriate for a new vaccine, but money needs to be made immediately available to manufacture additional vaccines.  This is an incredibly time sensitive problem; previous experience has proven that quantities of vaccine are absolutely necessary to stop the spread of the disease.  For example, in 1972 a single case of smallpox in Yugoslavia required 18 million doses of the vaccine to prevent the spread of the disease.

The Basic Facts:

• Flight left Hungary in the afternoon of January 1^st, and landed in Rome at 7:00pm.
• The flight had four flight attendants, two pilots, and 86 passengers from six countries.
• The infected passenger was diagnosed with the rash typical of a smallpox infection around 10:00 January 1^st—he was immediately quarantined.
• Twenty-three passengers, two-flight attendants and one pilot boarded other flights in Rome that went on to other destinations—those flights left the evening of January 1^st. 
• It’s now 7:00pm January 2^nd—a full 24-hours since the infected passenger was identified.

Some Questions to Consider:

1. How will the existing stockpile of vaccine be distributed?
2. How will the production of the vaccine be increased in those countries that possess the strains identified as appropriate to produce new vaccine?
3. Who is going to mobilize the media to disseminate information to the public and hospitals regarding preventative measures that must be taken immediately?
4. Who is going to pay for the production of more vaccine?

Return to Crisis Index Page

Return to Civitas Home Page