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CDC algorithm helps evaluate rash for smallpox

Infection Control Monitor, January 9, 2004

The fear of bioterrorism may have receded to the background a bit in light of emerging infectious diseases, but the threat is real. The Centers for Disease Control and Prevention's (CDC) Web site includes an online algorithm to help determine whether a patient with a rash has been exposed to smallpox.

The tool asks the health care provider six questions about the patient's rash illness, including the type of rash, how it developed, additional symptoms, and whether the lesions meet the minor criteria of smallpox.

After completing the algorithm, the provider clicks a button to "evaluate risk" and is taken to a page that indicates the level of risk and provides further instruction. If the risk of smallpox is high, the provider is asked to report the case immediately to the local and state health departments. No further testing for other diseases is necessary. In addition, the provider is asked to do the following:

  • Enforce proper airborne and contact precautions

  • Alert IC on admission to hospital

  • Arrange infectious disease or dermatology consultation

  • If after infectious disease or dermatology consultation, the patient is still classified as high-risk, seek advice on specimen collection from the CDC's smallpox response team

  • Arrange to test specimens at the CDC

  • If specimens test negative for smallpox, arrange further testing to determine the disease involved

    The CDC also provides access to a worksheet for evaluation of patients for smallpox. To access the algorithm, click here.

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