Steamboat Springs Routt County is not immune to smallpox.
Law enforcement, emergency service and public health officials in the county recognize an outbreak could occur anywhere in the country and are crafting a plan to locally handle such an event.
The Northwest Colorado Emergency Preparedness Advisory Committee began meeting in the wake of the Sept. 11 terrorist attacks to develop strategies for dealing with homeland security issues.
"Since Sept. 11, we've had to think about all kinds of things," said Susan Bowler, public health nurse manager for the Northwest Colorado Visiting Nurse Association.
One of those things is immunizing the 20,000 people who call Routt County home against smallpox.
Routine smallpox vaccinations in the United States stopped in 1972, eight years before the disease was eradicated.
But the threat of new outbreaks looms on the nation's horizon.
President Bush will respond today to extended debate about the threat of terrorists or other governments using the virus as a biological weapon against the United States. Bush plans to present a plan to vaccinate military personnel, health-care and emergency workers against smallpox around the first of the year, followed by vaccinations for the public in 2004.
The advisory committee is gearing up to implement Bush's plan.
Counties in every state are required to put together a plan to respond to smallpox outbreaks, Bowler said.
The high volume of visitors to Northwest Colorado increases the possibility of smallpox originating from an outside source.
"Routt County is a destination resort," said Steve Hilley, county trauma coordinator and director of the flight nurse program at Yampa Valley Medical Center. "We have people flying in from all around the world."
The county must know beforehand how it will respond to the discovery of smallpox, he said.
"We have to be prepared for this," Hilley said.
Bush's plan calls for several phases of inoculation. Those most likely to be exposed to someone with smallpox are first in line for the vaccine.
Military personnel are expected to receive the immunization within weeks. States have submitted their plans for vaccinating health-care and emergency workers to the Centers for Disease Control and Prevention and will begin implementing those plans in January.
The CDC will ship smallpox vaccinations to every state. The Colorado Department of Public Health and Environment would distribute its shipment to four locations in the state.
About 20 local health-care workers will travel to Mesa County to receive the first round of vaccinations and training on how to administer the vaccine to other health-care workers in the county.
The group consists of physicians, nurses, medical technicians, admissions and maintenance workers who have volunteered to be in position to treat people with smallpox and vaccinate people exposed to the disease, Hilley said.
All health-care workers in the county, including those at the VNA and Yampa Valley Medical Center, will receive vaccinations. Inoculations for police, fire and ambulance personnel will follow.
Immunizations are expected to become available to the public in late 2003 or early 2004. All shots are voluntary.
Immunizing everyone in Routt County is not an overnight process, said Pam Nettleton, VNA public health nurse for Steamboat Springs.
Medical staff must screen patients to determine if any medical conditions prevent them from getting the vaccination.
Vaccine recipients with immune systems weakened by AIDS, cancer or other diseases invite complications. People with the skin conditions eczema or psoriasis are at risk if they get a smallpox shot.
Fever, swollen lymph nodes and sore arms often follow smallpox vaccinations.
"It's not a vaccine like a lot of the other vaccines we vaccinate our children with," Nettleton said. "There are some side effects that aren't really pleasant."
People who received smallpox shots as children are not exempt from a second vaccination. They might require a booster shot, Nettleton said.
But those who experienced no negative side effects the first time around are unlikely to experience any discomfort the second time around, she added.
Health-care and public safety officials in the county are careful not to raise alarm about the disease.
They stress education and awareness of smallpox, not anxiety.
"It's really important for people to understand there's no smallpox out there," Nettleton said.
She hopes the interim between immunizations for health-care and emergency workers and the public gives residents time to digest information about smallpox.
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