Abstract
OBJECTIVESThe aim of this study was to estimate the medical surge capacity required for mass prophylaxis based on a hypothetical outbreak of smallpox.METHODSWe performed a simulation using the Bioterrorism and Epidemic Outbreak Response Model and varied some important parameters, such as the number of core medical personnel and the number of dispensing clinics.RESULTSGaps were identified in the medical surge capacity of the Korean government, especially in the number of medical personnel who could respond to the need for mass prophylaxis against smallpox.CONCLUSIONSThe Korean government will need to train 1,000 or more medical personnel for such an event, and will need to prepare many more dispensing centers than are currently available.
Highlights
Smallpox used to be a major scourge of humankind, with high infection and mortality rates
There is no one-size-fits-all plan for a smallpox outbreak with respect to vaccination, it has been demonstrated that achieving high vaccination coverage was key to eradicating the virus during outbreaks in the past [4]
From our crude but conservative simulation using a well-established tool, we found that there is expected to be a gap in medical surge capacity if, for any reason, an immediate response to a smallpox outbreak is needed
Summary
Smallpox used to be a major scourge of humankind, with high infection and mortality rates. History shows that 1 smallpox-contagious individual can infect, on average, 3.5-7.0 people naive to the virus [1]. This high infectiousness prompted communities to require at least 70% vaccination coverage for effective herd immunity. As almost one-third of infected people died of severe hemorrhage and dehydration, smallpox posed a uniquely severe threat to public health until its eradication (World Health Organization [WHO], 2014). Ring vaccination was performed to prevent further exposure to the virus among those who were at risk of exposure and ranged from 1 to 70,000 vaccinations per case [5]. Mass vaccination is a strategy to vaccinate all eligible people who have no immunity and are vulnerable to the disease. If for any reason smallpox reemerges, regardless of the nature of the reemergence (either intentional or accidental release), mass vaccination
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