Since smallpox eradication, the science of eradication has changed and with it, our definitions of what diseases are possible to eradicate. However, eradication must not beget complacency. As has been learned from past control or eradication attempts with a variety of viral diseases, from yellow fever to influenza, accidental or intentional reintroduction is a real threat-one that could strike anywhere and for which we need to be fully prepared. The criteria for assessing eradicability of polio, measles, and other viral infections have been debated extensively. With the elimination and eradication of several viral diseases on the horizon, issues surrounding the cessation of immunization activities become exceedingly important. In an effort to better understand the dynamics of disease eradication and post-immunization policies, the Institute of Medicine Forum on Emerging Infections hosted a two-day workshop (February 1-2, 2001) on The Consequences of Viral Disease Eradication. This book explores the principles underlying the biological challenges, medical interventions, the continuing research agenda, and operational considerations for post-immunization strategies for vaccine-preventable viral diseases, and highlights important efforts that may facilitate wise decision making.

At the World Health Assembly in May 1980, the World Health Organization declared the world free of smallpox. Smallpox vaccination of civilians is now indicated only for laboratory workers directly involved with smallpox or closely related orthopox viruses. However recent questions raised by the terrorist attacks in fall 2001 have renewed concerns about possible outbreaks of smallpox resulting from its use as a biological weapon. In June 2002, the Institute of Medicine convened a public conference to discuss the scientific, clinical, procedural, and administrative aspects of various immunization strategies. Scientific and Policy Considerations in Developing Smallpox Vaccination Options summarizes the presentations and discussions from this workshop.

Experts explore the biological, social, and economic complexities of eradicating disease. Disease eradication represents the ultimate in global equity and the definitive outcome of good public health practice. Thirty years ago, the elimination of smallpox defined disease eradication as a monumental global achievement with lasting benefits for society. Today, the global commitment to eradicate polio and guinea worm and heightened interest in the potential eradication of other infectious diseases, including measles/rubella, lymphatic filariasis, onchocerciasis, and malaria, dominate public health concerns. But what does it take to eradicate a disease? This book takes a fresh look at the evolving concepts of disease eradication, influenced by scientific advances, field experience, societal issues, and economic realities. A diverse group of experts from around the world, representing a range of disciplines, examines the biological, social, political, and economic complexities of eradicating a disease. The book details lessons learned from the initiatives against polio, measles/rubella, and onchocerciasis. Further chapters examine ethical issues, the investment case, governance models, organizational and institutional arrangements, political and social factors, feasibility of eradication goals, priority setting, and the integration of disease eradication programs with existing health systems. Contributors Stephen L. Cochi, Walter R. Dowdle, Claudia I. Emerson, Kimberly M. Thompson, Radboud J. Duintjer Tebbens, Regina Rabinovich, Lesong Conteh, B. Fenton Hall, Peter A. Singer, Maya Vijayaraghavan, Damian G. Walker, Kari Stoever, Julie Jacobson, Andy Wright, Chris Maher, Bruce Aylward, Ali Jaffer Mohamed, T. Jacob John, Robert S. Scott, Robert Hall, Jeffrey Bates, Sherine Guirguis, Thomas Moran, Peter Strebel, Eric A. Ottesen, Ciro de Quadros, Linda Muller, Jai Prakash Narain, Ole Wichmann, Alan R. Hinman, Stewart Tyson, Robin Biellik, Piya Hanvoravongchai, Sandra Mounier-Jack, Valeria Oliveira Cruz, Dina Balabanova, Yayehyirad Kitaw, Tracey Koehlmoos, Sebastião Loureiro, Mitike Molla, Ha Trong Nguyen, Pierre Ongolo-Zogo, Umeda Sadykova, Harbandhu Sarma, Maria Gloria Teixeira M, Jasim Uddin, Alya Dabbagh, Ulla Kou Griffiths, Muhammad Ali Pate, John O. Gyapong, Adrian Hopkins, Dairiku Hozumi, Mwelecele Malecela

African swine fever (ASF) is a disease with a mortality rate close to 100 percent. There is no vaccine and no conventional treatment against the disease. To reduce the effects caused by ASF outbreaks, optimal response mechanisms against probable ASF emergency disease situations need to be planned and rehearsed so that the disease can be controlled and eradicated in the most rapid and cost-effective way. These plans should be refined from time to time through simulation exercises and personnel should be trained in their individual roles and responsibilities. This manual provides information on the nature of ASF, and on the principles of, and strategic options for its prevention, control and elimination. Guidelines are given for individual countries threatened by ASF to formulate their own national policy on control and eradication of a possible incursion of the disease. The manual identifies both personnel and equipment and other facilities that are needed in a national ASF contingency plan. An outline of the suggested format and contents of a national contingency plan is also provided as a guide, which can be modified to suit the needs and circumstances of individual countries.

In 1980, the World Health Organization (WHO) officially declared that smallpox had been eradicated. In 1986, WHO's international Ad Hoc Committee on Orthopox Virus Infections unanimously recommended destruction of the two remaining official stocks of variola virus, one at the Centers for Disease Control and Prevention and the other at the VECTOR laboratory in Siberia. In June 1999, WHO decided to delay the destruction of these stocks. Informing that decision was Assessment of Future Scientific Needs for Variola Virus, which examines: -- Whether the sequenced variola genome, vaccinia, and monkey pox virus are adequate for future research or whether the live variola virus itself is needed to assist in the development of antiviral therapies. -- What further benefits, if any, would likely be gained through the use of variola in research and development efforts related to agent detection, diagnosis, prevention, and treatment. -- What unique potential benefits, if any, the study of variola would have in increasing our fundamental understanding of the biology, host-agent interactions, pathogenesis, and immune mechanisms of viral diseases.

In the past half century, deadly disease outbreaks caused by novel viruses of animal origin - Nipah virus in Malaysia, Hendra virus in Australia, Hantavirus in the United States, Ebola virus in Africa, along with HIV (human immunodeficiency virus), several influenza subtypes, and the SARS (sudden acute respiratory syndrome) and MERS (Middle East respiratory syndrome) coronaviruses - have underscored the urgency of understanding factors influencing viral disease emergence and spread. Emerging Viral Diseases is the summary of a public workshop hosted in March 2014 to examine factors driving the appearance, establishment, and spread of emerging, re-emerging and novel viral diseases; the global health and economic impacts of recently emerging and novel viral diseases in humans; and the scientific and policy approaches to improving domestic and international capacity to detect and respond to global outbreaks of infectious disease. This report is a record of the presentations and discussion of the event.