Monday, November 14, 2011

Smallpox Antiviral Pill?

Did you know that America has $1 billion worth of smallpox vaccine stored away?

The Obama administration has pushed through a contract for an additional $433 million of ST-246, an antiviral pill manufactured by Siga Technology. Each dose is over $200. This pill hasn't been tested thoroughly, but promises to combat smallpox when it's already been contracted, after the vaccine would be useful.

Issues are being raised as to whether or not we need more defense against bioterrorist threats, the safety and usefulness of Siga's pill (which is not yet FDA approved since it can't ethically be tested in humans), its short shelf life (3 years), and the manner in which Siga acquired the contract (apparently, they was little competition for the contract). The only known smallpox in existence is held by the U.S. and Russia.

LA Times Article

I didn't know we even had smallpox vaccine owned by the government, although it makes a lot of sense. At the same time, I'm not sure that stockpiling these drugs would be all that epidemiologically useful. Since smallpox is most contagious when symptoms are obvious and the patient is bed-ridden, dedicated wards where these patients and their contacts could be isolated/quarantined and cared for by vaccinated health workers might actually be more effective than mass-vaccinating everyone, especially given that the vaccine can be dangerous in immunocompromised people. But, in our extremely mobile world, it may be hard to stop the spread of a reemergent smallpox, and the populace may clamor for a drug. I also think it would be awesome to develop an antiviral that could combat smallpox, if ST-246 does what it promises, because so far the only treatment is vaccination.


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