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LETTERS: Cathy E Roth, Patrick Drury, Roberta Andraghetti, Ray R Arthur, Michael J Ryan, and Guenael Rodier WHO advocates investment in global infrastructure for outbreaks such as smallpox BMJ 2003; 326: 447 [Full text]

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Clarifications

Cathy Roth, Pat Drury, Roberta Andraghetti, Ray R. Arthur, Michael J. Ryan, Guenael Rodier, David L. Heymann   (6 March 2003)

Clarifications 6 March 2003
Cathy Roth, Medical Officer, Department of Communicable Disease Surveillance and Response/CDS World Health Organization, 20 Av.Appia, 1211 Geneva, Switzerland, Pat Drury, Roberta Andraghetti, Ray R. Arthur, Michael J. Ryan, Guenael Rodier, David L. Heymann Send response to journal: Re: Clarifications	Editorial changes to our letter (BMJ 2003;326:447) have altered the sense of two of our comments. The first concerns the WHO smallpox vaccine stockpile. WHO activities to build an adequate global reserve, as a critical element of smallpox preparedness, include engaging with the G7+Mexico countries in the Global Health Security Initiative. The Health Ministers of these countries recently have undertaken "to support and increase the existing WHO global vaccine reserve and encourage others to do the same." Current concerns suggest that a vaccine reserve much larger than the current WHO stockpile is desirable. WHO's policy on immunisation has not changed, and our advice remains that in the absence of a real risk of exposure to smallpox, the risk of serious adverse events is sufficiently high that mass vaccination is not warranted. However, WHO recognises that countries may wish to identify key workers and immunise them to allow a rapid response to a smallpox outbreak. It is in keeping with WHO policy for countries to devise and implement such a plan in line with their own assessment of national infrastructure and needs. Another glitch has deleted the name of one of the authors from the published version. The full list of authors is given below, and with a fuller discussion may be found in the original rapid response in the electronic edition of the BMJ at http://bmj.com/cgi/eletters/325/7377/1371 Cathy Roth, Medical Officer, Global Alert and Response Department of Communicable Diseases Surveillance and Response, ; Patrick Drury, Project Manager, Global Alert and Response Network, Global Alert and Response, Department of Communicable Diseases Surveillance and Response ; Ray R.Arthur, Project Leader, Viral Haemorrhagic Fevers, Arbovirus and Orthopox Infections, Global Alert and Response, Department of Communicable Diseases Surveillance and Response; Michael J.Ryan, Team Coordinator; Global Alert and Response G.Rodier, Director, Department of Communicable Diseases Surveillance and Response; David L.Heymann, Executive Director, Communicable Diseases Cluster, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland Competing interests:   None declared