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This is the VOA Special English Health Report.

American medical groups are urging the government to limit the use of the vaccine medicine to prevent the disease smallpox. Smallpox is caused by the variola virus. It spreads when an infected person coughs or sneezes.

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Smallpox can damage the brain and other body organs. Smallpox kills about thirty percent of the people who get it. There is no treatment. The vaccine ended the threat of smallpox around the world in nineteen-seventy-seven. But now, American officials fear that terrorists may have the virus and could use it in a biological attack.

The Bush administration's top bioterrorism advisors have developed a plan to protect the American people. They would begin by giving the vaccine to five-hundred-thousand health care workers and ten-million emergency workers. The plan would also provide the vaccine to all Americans in two years. The experts say each person would decide if he or she wants the vaccine.

The smallpox vaccine can be dangerous. It can even kill. The vaccine is a live virus that is related to the one that causes smallpox. The vaccine can spread throughout a person's body and cause infection. Records from the nineteen-sixties show that one or two people died for every one-million people who received the vaccine. Nine other people suffered brain infections and more than one-hundred people developed severe skin infections. Hundreds of other people developed other health problems.

Medical professionals expect that even more people would suffer such reactions today. This is because many more people have weakened body defense systems against disease. These include cancer patients who have been treated with chemotherapy drugs, people who are infected with the AIDS virus and people with skin diseases like eczema. Doctors also say the current smallpox vaccine has not been tested on children and may not be safe for them.

The smallpox vaccine is effective against the disease four days after it is given. Doctors say that everyone should get the vaccine if smallpox was used in a biological attack. But many experts say it is too dangerous to give to the general public unless that happens.

This VOA Special English Health Report was written by Nancy Steinbach.