Smallpox Outbreak Control Activities and Strategies

Epidemiologic Investigation

During the initial phases of an outbreak, the goal of your investigations will be to establish the diagnosis, identify contacts, identify the source of exposure, and ascertain if there are any unusual features of the outbreak. As the outbreak progresses, we will also need to monitor the progress made in containing the outbreak and we will need to be prepared to change and adjust our outbreak control strategy. In both stages, public health agencies must be prepared to effectively communicate information about the outbreak and the control strategies to the public, the medical community, and the media.

Steps for the Epidemiologic Investigation

  1. Identify source of initial introduction(s)
  2. Identify contacts and other population(s) at risk
  3. Characterize and define outbreak. This includes identifying unusual/unexpected features and determining the scope of the outbreak.
  4. Monitor effectiveness of control measures.
  5. Communicate information and define public health recommendations

Contact Tracing

Contact Tracing will need to be one quickly and efficiently so that the surveillance and containment strategy works. We have 3 days in which to vaccinate people who have been exposed to the smallpox virus, in order to prevent disease or at least limit the severity of their disease. The goal of contact tracing is to find as many contacts as possible.

The first step of contact tracing is establishing contact with patient after onset of fever. Prioritize potential contacts based on closeness, length, and date of exposure. The highest priority contacts are people who live full-time in home and other face-to-face contacts after onset of fever. The next priority contacts are non face-to-face contacts exposed in a medical care facility or in home. The last priority contacts are people in same facility after onset of fever (other than home or hospital) but without face-to-face contact. If there are too many to find quickly, consider all people in same room (or possibly facility) with smallpox case after onset of fever as contacts. 

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