The Smallpox Conundrum .

Public health officials in Tulsa, Okla. recently ran a smallpox preparedness drill--practicing what they would do to stop the spread of this deadly disease in the case of a bioterrorist event. The drill is just one part of a plan that Tulsa's health department, like many others around the nation, submitted last week to the federal Centers for Disease Control and Prevention, just days before President George W. Bush announced that the United States would resume smallpox vaccinations for the first time in three decades. He has ordered that key military units be inoculated, and Bush himself will receive the vaccine with them. Then "first responders" such as ER doctors, nurses, and other emergency personnel will be vaccinated. The president has not recommended vaccinations for the general public. However, if people demand it, Bush says health officials should vaccinate them. Until now, smallpox preparedness has relied on so-called ring vaccination-- containing an outbreak by rapidly isolating and vaccinating people who had close, face-to-face contact with the victim. The United States and Russia are the only two countries that officially have the virus, but scientists and intelligence agencies fear other nations, such as North Korea and Iraq, may have secret smallpox stores that could be used as biological weapons.