In 1999, The Centers for Disease Control and Prevention (CDC), along with the Working Group for Civilian Biodefense, assessed various bioterrorist threats using an expert panel. The general criteria used in evaluating the biological hazards included the impact on public health; distribution, transmission, and virulence of the diseases; the effects on the public awareness; possible treatments and hospitalization; and the requirements for US preparedness against biological attack.

From the biological threats assessed, the panel concluded that smallpox (Variola major) posed the greatest public danger in way of transmission and required the most efforts in order to prepare for a possible outbreak. Immediately subsequent threats included anthrax and plague, along with eleven other agents that were termed "emerging but unidentifiable" threats. Nevertheless, the biological preparedness program calls for US preparedness against smallpox by utilizing the smallpox vaccine [1].

The evaluation of these threats, however, did not take into account the availability of the biological agent or the feasibility of putting into effect a preparedness factor. Smallpox was eradicated officially in 1980, and the only samples left are in two high security laboratories in the United States and in Russia [1].

In addition, the only method for preparing against a smallpox outbreak is the smallpox vaccine, which presents both financial and health-related hazards on its own. Government funding for about 45,000 health care workers estimates to cost around $13 per person, according to Judy Gerberding, the director of the CDC, while Patrick Libbey of the National Association of County and City Health Officials estimates costs between $142 to $220 per person [1]. The smallpox vaccine has a probability of many side effects as well as death, so workers' compensation is another financial consideration and the Health and Human Services Treasury offers just "two-thirds of wages after the fifth day from work" and a maximum amount of $50,000 for death coverage [1].

According to the National Academy of Engineering, which is part of a private research organization known as the National Academies, the likelihood of a smallpox attack is extremely low. This research cadre feels that the attention geared toward smallpox preparedness detracts from the overall biological threat preparedness program, for the smallpox vaccine does not protect against other agents. The National Academy feels that by focusing so centrally upon smallpox, other more likely agents may be neglected [2].

Public awareness, including that of health care professionals, is crucial when public health may be threatened. People must also be informed regarding the legal issues, which may involve the material well being of themselves and their close relations. Just as importantly, reasons Dr. Louis Bell of the Children's Hospital of Philadelphia, physicians must know certain dangers posed with this vaccine and be ready to prevent any unnecessary risks placed upon themselves and their patients [3]. Using these general guidelines, there is a possibility of maintaining the welfare of the individuals and of the entire population.

Krystyna is first-year student majoring in Biology. She aspires to enter the field of medicine.