Emergency Preparedness

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

Vaccinated Health Care Workers Newly vaccinated health care workers may continue to have patient contact, including contact with immunosuppressed patients, as long as the vaccination site is covered with a water-tight seal at all times. Cover the vaccination site with a gauze dressing reinforced with a semi-permeable dressing such as Opsite (R) or Tegaderm (R) during the work shift. Remove the semi-permeable dressing at the end of the work shift. Practice meticulous handwashing before contact with all patients. Hands should be thoroughly washed after contact with fluid or pus that may accumulate under the semi-permeable dressing. Complications : Fever Low-grade (100F – 102F) fever and enlarged lymph nodes; occurs most commonly in children. ? Autoinoculation Vaccinia virus is transferred from the site of vaccination by contaminated hands or articles such as clothes, sheets or towels. The most common sites involve the face, eyelid, nose, mouth genitalia and rectum. ? Encephalitis Occurs 8 - 15 days after the vaccination; symptoms include fever, headache, vomiting, drowsiness, spastic paralysis, coma, and convulsions. ? Progressive vaccinia Pustules fail to heal and spreads to surrounding tissue that becomes black and necrotic. ? Eczema vaccinatum Lesions spread to areas of skin afflicted by eczema or other chronic or exfoliative skin conditions; symptoms may be mild to severe but may be fatal. ? Generalized vaccinia Lesions spread to cover part or all of the body 6-9 days after vaccination. ?

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