Emergency Preparedness

Kern Medical Bioterrorism Response Guide Section 2-C-1 – Smallpox

SMALLPOX – QUICK REFERENCE

Bioterrorism Epidemiology: Transmission: highly contagious; person-to-person contact with respiratory secretions; coughing patients most contagious; contact with lesions and fomites (clothes and bed linens). Persons vaccinated prior to 1972 do not have immunity. Persons vaccinated multiple times (military prior to 1990 and foreign travelers prior to 1972) may have some residual immunity. Incubation Period: Average 12 – 14 days; range 7-17 days. Clinical Disease: Acute onset of malaise, rigors, vomiting, headache, backache, possible delirium ; high fever (up to 40.5 degrees C) prior to onset of rash, rash predominate on face and mucous membranes of mouth and pharynx migrating to forearms, legs, palms and soles then to trunk. Diagnosis: Presumptive diagnosis based on signs and symptoms. Differential Diagnosis: Chicken pox, allergic contact dermatitis, erythema multiforme with bullae, secondary syphilis, atypical measles (Chickenpox eruptions are more numerous on trunk than on face and extremities. Lesions occur in crops in different stages of development and are superficial with rare scar formation). Treatment: Provide supportive care, pain and fever control, sedation for delirium; maintain hydration; antibiotics for secondary infection. Prophylaxis: See Smallpox Vaccination Recommendations Isolation: See Smallpox Isolation Recommendations. Any suspected or confirmed case of smallpox MUST BE TREATED AS A PUBLIC HEALTH EMERGENCY and reported to the infection control practitioner [ insert telephone number ] and the local health department [insert telephone number] immediately.

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