Medical Protocol

[Refer to CDC’s Smallpox Response Plan for current protocol. http://www.bt.cdc.gov/agent/smallpox/prep/index.asp]

Immediate Action for Patients with Generalized Vesicular or Pustular Rash Illness. (22:V4:47)

All patients that present to a hospital with a fever and an acute, generalized vesicular or pustular rash illness should be placed under airborne and contact precautions. This is standard practice for a case of varicella or measles.

The hospital infection control team should be alerted if the patient is admitted. In a doctor’s office, these patients should be isolated in a room with the door closed. Review the clinical presentation of the patient and assess if the illness is high, moderate, or low risk for smallpox according to the major and minor criteria.

Use appropriate safety precautions to prevent transmission to yourself and others. (22:V4:48) Whether or not you think the person you are evaluating has smallpox, i t is important to institute appropriate precautions to prevent the spread of an infectious agent. Always wear gloves when touching a patient with a rash illness, and institute respiratory precautions if there is any concern about an infectious agent that can have airborne spread, as occurs with both varicella and smallpox.

Use the Diagnostic Algorithm to determine the patient’s case risk. Any patient presenting with all 3 major criteria is classified as high risk for smallpox and should be reported to public health officials and hospital officials immediately. (22:V4:49) Immediate action should be taken to make sure that contact precautions and respiratory isolation are in place. (22:V4:49) 

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