Voluntary Smallpox vaccination begins at Clinical Center
An electron micrograph of Vaccinia virions; a virion is a single complete
and infectious virus particle. Vaccinia virus is normally confined
to cattle, but is conveyed to humans through vaccination, thereby
imparting immunity to the smallpox Variola virus.
In response to the President's request for voluntary smallpox vaccination
of healthcare workers, the Clinical Center is initiating a voluntary smallpox
vaccination program for specified Clinical Center healthcare workers.
This cadre of healthcare workers will provide care for individuals who
are referred to the Clinical Center for participation in a protocol that
is designed to study the complications of vaccination. In addition, the
program will respond to the U.S. Surgeon General's call for commissioned
officers to be vaccinated and to agree to plasmapheresis in order to increase
the availability of vaccinia immune globulin (i.e., specific antibody
directed against vaccinia, which can be used to treat complications of
vaccination). The program begins March 17 and is open to specified healthcare
providers who are federal employees.
"We are encouraging those who are eligible to consider voluntary
vaccination to reduce the already small risk of acquiring vaccinia infection
from patients who have complications of vaccination," said Dr. David
Henderson, deputy director for Clinical Care.
The vaccine will be provided in sequence to those whose skills will
be needed to provide comprehensive care to patients who develop complications
of the vaccine. The first people to be offered the vaccine will be individuals
who are likely to have direct, bedside patient or specimen contact. Staff
who have limited patient contact will receive the vaccine last (see
sidebar for a priority staff listing).
The following staff members are encouraged to volunteer for the vaccine:
• Those who work on units housing immune competent patients;
• Those who have previously been vaccinated without serious complications;
• Those who have the expertise required to care for patients who
develop serious complications; and
• Those who want to increase the supply of vaccinia immune globulin.
The following staff members should not volunteer for the program (see
sidebar for a list of risk factors):
• Those who are immune compromised;
• Those who are or may be pregnant;
• Those who have histories of, or who have active skin disorders,
such as eczema, psoriasis or atopic dermatitis.
Confidential HIV testing will be made available through the Occupational
Medical Service (OMS). HIV testing is strongly advised for all vaccination
Confidential pregnancy testing will be available through OMS for female
program participants and will be required for program entry.
Most employees will be able to assume their routine duties after vaccination.
OMS staff will monitor the progress of vaccination and will work with
CC Administration to determine job assignments as the vaccination evolves.
In the unusual event of systemic side effects administrative leave will
be granted to vaccinated employees. Complications resulting from the vaccine
will be covered by the federal government; civilian employees will be
covered by the Federal Employees Compensation Act, and commissioned officers'
complications will be managed through their own compensation plans. Direct
inspection of vaccination sites will be required, even if employees received
the vaccine through a community program rather than the Clinical Center.
The vaccination program timeline will be designed to provide the least
possible disruption to ongoing clinical research programs.
Program staff members will counsel vaccinated employees about risks and
potential routes of transmission of the vaccine to others, including patients'
families or associates. They will also explain strategies to reduce this
The program was presented to healthcare staff at the March 5 Clinical
Center Grand Rounds program presented by CC Director Dr. John Gallin,
Henderson, and NIAID Clinical Director Clifford Lane. The Grand Rounds
program can be accessed on the NIH Videocast at http://videocast.nih.gov.
Additional questions may be directed to Dr. Henderson at 496-3515 or emailed
-by Colleen Henrichsen
Do you qualify to volunteer for the Smallpox Vaccination?
Do You Qualify to Volunteer for the Smallpox Vaccination? The following
NIH federal employees will have priority for volunteering to receive the
• Occupational Medical Service Staff
• Nurses (those needed to care for patients who develop complications
of vaccination, focusing first on those who care for immune competent
patients and those previously vaccinated)
• Nurse Practitioners
• Physician Assistants
• Physicians (beginning with ICU staff and first-line consultants
needed to provide comprehensive care for patients who develop complications
• Hospital Epidemiology Staff
• Respiratory Therapists
• Anesthesia and Surgical Services Staff
• Selected Radiology, Nuclear Medicine, and PET Technologists/Technicians
The following NIH federal employees may be offered vaccination in order
to provide comprehensive care for those who develop complications of vaccination:
• Clinical Pharmacists
• Physical, Occupational and Recreational Therapists
• Social Workers
• Spiritual Ministry Staff
Check to see if you are at risk before volunteering
The following situations increase the risk of complications of the smallpox
vaccination and are considered contraindications to participation in the
voluntary vaccination program:
Those with immune compromised conditions such as the following:
• HIV infection
• Organ transplantation
• Chemotherapy for cancer or immunological disease
• Uncontrolled cancer, leukemia or lymphoma
• Chronic corticosteriod use
• Autoimmune diseases
• Drugs or agents that cause immune suppression Pregnancy Immunologically
mediated skin disorders (either active or past history) such as:
• Atopic dermatitis
• Psoriasis Other skin disorders such as the following:
• Cystic acne
• Active staphylococcal or streptococcal skin infections
• Active viral skin infections (such as HSV-II, zoster)
• Contact dermatitis Documented allergy to antimicrobial agents present
in the vaccine such as the following:
• Polymyxin B
Those living with children less than one year old or with anyone who
has any of the conditions listed above.
Gerber receives two awards for helping to improve lives through rehabilitation
Dr. Lynn Gerber
Dr. Lynn Gerber, chief, Rehabilitation Medicine Department,
will be presented with two awards this month for her outstanding accomplishments
as a physician and researcher.
Gerber will receive the Distinguished Academician award
from the Association of Academic Physiatrists–making her the seventh
person in the world to receive such an honor. "It is very unexpected,
but extremely nice," said Gerber. "These are my peers. These
are the people who do the same things that I do and yet they felt I should
be given an award."
The award is given to a member of the association who has
achieved distinction and peer recognition regionally or nationally by
virtue of excellence as a teacher, researcher and/or administrator. Gerber
will receive the award this month during the AAP Annual Meeting in Florida.
To add to her credits, Gerber will also receive the Isabelle
and Leonard Goldenson Technology and Rehabilitation Award from the United
Cerebral Palsy Research and Educational Foundation.
This award is presented to a clinician-investigator for
advances in the development and utilization of technology and the rehabilitation
sciences to improve the quality of life for persons with cerebral palsy,
The award comes as a surprise to Gerber, because she didn't
apply for the award, nor did she know that anyone had nominated her. Although
her work in rehabilitation medicine is not directly related to cerebral
palsy, rehabilitation medicine plays a major role in every medical discipline.
"We don't treat cerebral palsy, but we are involved
in the gate or motion abnormalities that effect people with cerebral palsy,"
said Gerber. "If a person has a disability or problems walking, we
want to know what are the abnormalities and how are they compensating.
Then we can find ways to restore function."
The Rehabilitation Medicine Department works with every
institute within NIH and numerous patients with different disabilities.
This requires knowledge and understanding of multiple diseases and disorders.
"Ask me how many journals I read?" Gerber said
jokingly. But in reality, she immerses herself in almost 10 to 20 journals
a month, and throughout her medical career she has either been editor,
reviewer or has sat on the editorial board of seven of those journals.
"This is a specialty that is not on everyone's tongue," said
Gerber. "But as the population ages and more chronic illnesses arise,
the focus is on rehabilitation needs–making the best of what we have
and maximizing the potential for function."
Gerber has been a pioneer in establishing the subspecialty
of rehabilitative rheumatology. Much of her efforts have centered around
writing educational materials, and she has conducted research in the evaluation
of the mechanics of foot function in patients with rheumatoid arthritis,
functional assessments of patients with inflammatory arthritis and the
use of joint protection and energy conservation.
She is board certified in Internal Medicine, Rheumatology
and Physical Medicine, and Rehabilitation Medicine. She has served as
chief of the Rehabilitation Medicine department for nearly 27 years. Dr.
Gerber has also been the recipient of more than 20 awards, including the
GEICO Public Service Award, The Surgeon General's Award, The NIH Director's
Award and the Public Health Service Award for Exceptional Achievement.
Although her schedule is demanding, Dr. Gerber finds time
to exercise, entertain friends and cook. In fact, despite working long
hours each day, Dr. Gerber goes home each night and cooks a full dinner.
"I love to cook. It's my outlet," she said. Additionally, she
is a member of the United States Tennis Association and regularly plays
"I believe in fitness and exercise as part of rehabilitation,"
she said. "Exercise adds life to your years and years to your lifeÉso
I must practice what I preach."
-by Tanya Brown
Teamwork and dedicated employees keeps CC operational during snow storm
The 26-inches of snow that covered the Metropolitan area, didnÕt stop
the Clinical Center from operating.
The big storm of 2003 that dumped nearly 26 inches of snow on the Washington
area and closed federal agencies and local airports, also brought with
it a mix of stranded employees, double shifts and days away from families.
But it couldn't have worked out better.
"It was a lot of hard work and many hours were put in," said
Karen Kaczorowski, chief, Ambulatory Care Services. "However, we
had tremendous teamwork, and it was rewarding to be in a position to help
Close to one hundred employees made the Clinical Center their home for
two and three consecutive days during the winter blast Feb. 15-17. Some
worked double shifts, while others worked one shift, slept for five or
six hours and then began another.
"It was a wonderful thing to see human nature rise to the occasion,"
said Clare Hastings, chief, Nursing Department. Hastings worked Sunday
through Tuesday and slept on a bed in the EKG room. "The staff was
just fabulous, despite their exhaustion and being separated from their
The nutrition department provided meals for patients and employees,
even though they worked with less than half of their regular staff.
"We had no cooks for two days," said Judy Bowman, food service
supervisor. "The supervisors cooked and the others filled the orders
and delivered the food."
The menu was adjusted to make cooking and delivering a lot easier on
the staff. "We cut the room service program and just went with the
tray line service," said Bowman. "It was difficult, but we worked
Preparation for the storm began that Friday night with simple weather
predictions from local newscasts. Kaczorowski said she consulted with
Clare Hastings chief, Nursing and Patient Care Services, Laura Chisholm,
Critical and Acute Care Services, and Tannia Cartledge, Adult, Pediatric,
and Behavioral Health Services, to determine what units should be used
as sleeping quarters for the employees.
By early Sunday morning, the larger part of the storm covered the area
with 22 inches of snow, which prompted Kaczorowski to ask permission to
activate the snow emergency plan, which allows for volunteers of 4-wheel
drive vehicles to pick up and drop off employees.
At the Admissions desk, systems were put into place for employees to
sign up and have a room reserved where they could sleep for the night.
Once assigned to a bed, employees were given instructions, and were required
to strip the linen from the bed so that housekeeping could remake the
bed for the next shift of employees.
Admissions staff, along with a few nursing staff members, manned the
phones, kept logs of incoming calls from employees and connected employees
with four-wheel drive volunteers to get them to work, or to get them home.
Nearly 98 volunteers within the community volunteered to pick up and
drop off employees, along with NIH Police and a campus shuttle that was
on-call. Overall, nearly 150 trips were made and beds were provided for
employees in the Nursing Department; Nutrition Department; Pharmacy; Messenger
Escort Service; NIH Police; Security; Housekeeping, and Lab and Hospital
In one case, the snow didn't even stop a patient from arriving at the
Clinical Center. "Most of the airports were shut down, but we contacted
Omega Travel and they changed her flight and made reservations for her
to travel by train. Once she got to Union Station, there weren't any taxis
or shuttle buses running," said Kaczorowski.
Admissions staff gave directions on how to catch the Metro to the campus.
Once the patient made it to campus, a campus shuttle that was on call
went to the Metro and picked her up. "The patient just didn't want
to miss her first visit to the Clinical Center, so we made a way for her
to get here," said Kaczorowski.
New website provides more resources for pediatric
Pediatric health care professionals at the Clinical Center now have one
on-line resource for their research-based information needs.
The new web site,
will simplify the process of obtaining clinical information regarding
pediatric protocols carried out at the Clinical Center. It will serve
as a common point of contact for Institute and Clinical Center staff caring
for children on a daily basis.
"This website highlights the interdisciplinary nature of care that
is provided for children at the Clinical Center," says Madeline Michael,
M.P.H., R.D., chief, Nutrition Department's Clinical Nutrition Services.
"I think this site will be especially useful for practitioners who
are rotating here for a short period of time," she adds.
The website's goal is to provide caregivers with essential pediatric
guidelines�?–from general information on how to admit a child to the
Clinical Center to exacting clinical values, including separate links
for intravenous fluid management and age-appropriate measurements. Pediatric
care guidelines and policies relating to pediatric patients are also accessible
on the site. Protocol and research-specific information may be added.
The Pediatric Care Committee, an interdisciplinary team chaired by Deborah
Merke, M.D., chief, Pediatric Services, developed the web site.
More than 32 health professionals in a multitude of disciplines make
up the group. Members include Clinical Directors or their designees, Institute
senior investigators, physician and nonphysician representatives of Clinical
Center departments involved in pediatric care (i.e., Critical Care, Anesthesia,
Radiology, Nutrition, Pharmacy, Social Work, Spiritual Ministry, Nursing),
and a representative from the Children's Inn. The "direct resource"
for pediatric information.
Dr. Merke sees the website improving both communication of pediatric
care guidelines and coordination of services for pediatric patients and
their families. "This website is a powerful tool. It will be a reference
guide for established pediatric clinical investigators and a resource
for new investigators learning how to coordinate the care of their pediatric
patients," she said.
David Lang, M.D., Clinical Center staff pediatrician, who helped develop
the site with Dr. Merke and her committee members, agrees. "We hope
people will use this site as a resource when caring for pediatric patients."
Physicians who take care of children in the Clinical Center are doing
just that. "This site provides convenient and up-to-date resources
for me so that I don't need to consult multiple textbooks. My comfort
level with pediatric patients is a lot higher than it was even a week
ago," said Dr. Khalid Shumburo, a third year internal medicine resident
visiting NIH from George Washington University.
Nurses will reap similar benefits. "It is so helpful to have a
web page with links to all the resources," said Donna Gwyer, R.N.,
M.S., a clinical research nurse on 9 West, one of the two pediatric inpatient
units. "The nursing staff gets many questions about pediatric policies
and care. To be able to refer someone to the direct resource is a plus."
The efficiency of the web as a communications medium makes "direct
resource" the watchword for this website. It enables Clinical Center
staff to count on changes in policies or procedures to be updated quickly,
so that they can continue their commitment to providing excellence in
-by Wendy Schubert, Sc.M.
Quality of Worklife Initiative and Diversity Council
Want more energy at work? Snack wisely
Snacks can help optimize your energy and mental power, control your weight,
reduce the load on your heart and prevent heartburn. In celebration of
National Nutrition Month¨, food and nutrition experts at the American
Dietetic Association say your snacking habits should help balance your
diet, not add unneeded calories or fat.
"To get all the essential nutrients your body needs in a day, snacking
can be very beneficial to your overall health and well being," said
Katherine Tallmadge, registered dietitian and spokesperson for the American
"As long as snacks are planned, small and balanced, they can really
help fuel your body for activities throughout your day," Tallmadge
said. "I often tell my clients to snack up to three times a day,
but limit the snack calories to 100 to 200 calories. It helps keep them
satisfied throughout the day and they are less likely to binge late at
night while watching television or working on the computer. I like to
recommend snacks that provide a little carbohydrate, protein and small
amount of fat, if any. Mix and match with whatever your taste preference
may be and you can be energized throughout your day,Ó she said.
Here are some suggestions:
•medium banana and one tablespoon of peanut butter: 200 calories,
8.5 grams of fat, 3 grams of fiber
• medium apple with skin and one-ounce string cheese: 190 calories,
6.5 grams of fat, 3 grams of fiber
• one-quarter cup of raisins and one half cup plain yogurt: 170 calories,
0 grams of fat, 1.5 grams of fiber
• two-cups of popcorn, unbuttered sprinkled with cayenne pepper:
80 calories, 1 gram of fat, 2 grams of fiber
• one-half cup of pretzels and mustard: 93 calories, 1 gram of fat,
0.5 grams of fiber
• ten regular tortilla chips and one-quarter cup salsa: 188 calories,
10 grams of fat, 2 grams of fiber
• one-cup of dry cereal and one cup of one percent milk: 200 calories,
3 grams of fat, 3.5 grams of fiber
• six-ounces of skim milk, one-half tablespoon cocoa, one half tablespoon
sugar, dash cinnamon and vanilla extract: 102 calories, 5 grams of fat,
0 grams of fiber.
• one small corn tortilla, one-half ounce grated reduced fat cheddar
cheese, 1 chopped tomato, 1 tablespoon jalapeno pepper slices: 109 calories,
2 grams of fat, 2.7 grams of fiber
• one whole-wheat pita pocket, three ounces of tuna fish packed in
water with tomato slices: 185 calories, 1 gram of fat, 4.7 grams of fiber.
Source: American Dietetic Association
A sweet doughnation
Ed Auld, Store Manager, Krispy Kreme Doughnut Corporation; Son Q.
Che, General Manager, Krispy Kreme Doughnut Corp., Alexandria, Va.;
Therese Clemens, Executive Director, FOCC; Michael Daniel, FOCC board
member; Dominica Roth, President, FOCC; Benny Angle, Divisional Operations
Director, Krispy Kreme Doughnut Corp.
When the new Krispy Kreme doughnut store opened in Alexandria, Va., last
month, the Friends of the Clinical Center received more than just a warm,
sweet, treat. They received 20 percent of the sales from that day.
"We had a terrific opening and are delighted by the warm welcome
we received from the community," said Ed Auld, manager of the Alexandria
store. "We are thrilled to be able to give something back by supporting
The Friends of the Clinical Center."
The FOCC received a check totaling $4,200. "This contribution will
help us assist patients who are participating in medical research at NIH,
and who are faced with financial mergencies," said Therese Clemens,
executive director, FOCC. ÒThe generosity of Krispy Kreme is greatly appreciated."
FOCC is a private, nonprofit charity that provides emergency financial
aid to NIH patients and their families while they are participating in
clinical research studies at the Clinical Center. The patients, who come
from around the world, play a vital role in the study of human health
and disease. FOCCÕs goal is to enhance the lives of Clinical Center patients
and their family members by relieving them of emergency financial burdens
related to their participation in these clinical trials.
Founded in 1937 in Winston-Salem, North Carolina, Krispy Kreme is a leading
branded specialty retailer of premium quality doughnuts, including the
company's signature Hot Original Glazed. Krispy Kreme currently operates
more than 275 stores in 37 states, Australia and Canada. An estimated
7.5 million Krispy Kreme doughnuts are made every day and more than 2.7
billion are produced each year. Krispy Kreme can be found on the internet
Healthy volunteers needed for host of studies
The Mood & Anxiety Disorders Program, NIMH, is looking for healthy
volunteers, not on medication, with no current or history of psychiatric
illness, between the ages of 18 and 65, for a multitude of studies. Studies
may include PET Scans, MRI, psychological interview, neuropsychological
testing, and other procedures depending on which project you choose to
participate in. A stipend is available. Call 1-866-627-6464 (TTY1-866-411-1010).
Healthy volunteers for hearing study
NIDCD is seeking healthy persons with normal hearing, ages 30-50,
for a listening study. English must be first language. Study involves
a single 3 hr. visit to Univ. of MD. for a hearing test, written language
test, and a series of listening tests. Compensation is provided. Call:
1-800-892-3276 (TTY-1-866-411-1010). email: firstname.lastname@example.org.
Healthy African American needed
NIDDK is seeking healthy African-American males and females to participate
in a study to understand the formation of white blood cells.Ê Procedures
include a blood draw and limited physical and medical history.Ê You may
be eligible if you are between 18-50 yrs. old. Compensation is provided.
Call: 1-800-892-3276 (TTY-1-866-411-1010) email: email@example.com.
Children needed for weight-loss study
Overweight children, ages 6-17, are needed for two new weight loss
studies. Call: 1-800-411-1222. (TTY-1-866-411-1010).
The Artificial Lung: Bench to Bedside via Bethesda
Robert Bartlett, M.D., Professor of Surgery, University of Michigan
3 p.m. Masur Auditorium
Telomeres and Telomerase: Their Functional Interplay and its Cellular
Elizabeth H. Blackburn, Ph.D., University of California, San Francisco
noon-1 p.m. Masur Auditorium
New Insights about Management of Obstructive and Non-Obstructive
Hypertrophic Cardiomyopathy from Recent Therapeutic Studies
Lameh Fananapazir, M.D., NHLBI
Sorcin Gene as a Non-Sarcomeric Cause of Hypertensive-Hypertrophic
Saidi Mohiddin, M.D., C.H.B., NHLBI.
Wednesday Afternoon Lecture
3 p.m. Masur Auditorium
Regulating T Cell Antigen Receptor Signaling
Arthur Weiss, M.D., Ph.D., University of California, SanFrancisco
noon-1 p.m. Masur Auditorium
Glutamate and Alchol Dependence from Neurobiology to Treatment
John H. Krystal, M.D., Yale University of Medicine
Wednesday Afternoon Lecture
3 p.m. Masur Auditorium
Tinkering and Modeling of Genetic Networks
Stanislas Leibler, Ph.D., The Rockefeller University, New York, NY
Tanya C. Brown
writers: Colleen Henrichsen, John Iler, Wendy Schubert
Clinical Center News, 6100 Executive Blvd., Suite 3C01, MSC 7511,
National Institutes of Health, Bethesda, MD 20892-7511. Tel: 301-496-2563.
Fax: 301-402-2984. Published monthly for CC employees by the Office
of Clinical Center Communications, Colleen Henrichsen, chief. News,
article ideas, calendar events, letters, and photographs are welcome.
Deadline for submissions is the second Monday of each month