Leave a comment

Smallpox

Smallpox

Diagnosis

1.
Malaise, F, rigors, N/V, HA, backache

2.
2-3 days later:

Macules to papules, to vesicles to pustules to scabs

Start on face & hands to arms, legs, trunk

All lesions are in same phase of development

3.
Electron and light microscopy can’t discriminate variola from vaccinia, monkeypox or cowpox

4.
PCR diagnostic techniques accurate to discriminate between variola and other orthopox viruses
History

1.
Declared eradicated in 1980 by WHO

2.
Considered by Japan in WWII

3.
In 1996 WHO recommended all stockpiles be eliminated by 1999
Pathophysiology

1.
Variola virus: orthopox virus

2.
Aerosol infectivity; high human to human transmission

3.
Infective dose: 10-100 organisms

4.
Incubation: 7-17 d

5.
Duration of illness: 4 wks

6.
Mortality:

3% vacinnated

30% if unvacinnated

50% if develop secondary bact. pneumonia
Prevention

1.
Vaccinia immune globulin 0.6 ml/kg IM within 3 d

2.
Vaccine: Wyeth calf lymph vaccinia: 1 dose by scarification

3.
Vaccine not used in immunosuppression, HIV, hx of eczema, pregnancy
Isolation/Decontamination

1.
Quarantine with respiratory isolation

2.
Droplet and airborne precautions for min of 16-17 d

3.
Pts infectious until all scabs separate
Treatment

1.
No effective chemotherapy

2.
Cidofovir effective in vitro; adefovir, ribavirin may also be tried
Disposition

1.
Admit; quarantine, respiratory isolation; droplet & airborne precautions

2.
Notify CDC & local health dept

* Material is taken from the PEPID database
* Copyrighted material – All Rights Reserved
* For more information visit http://www.pepid.com

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: