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Medical Author:

Christopher J Hogan, MD

Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In the hospital's emergency department, a suspected smallpox victim is isolated. All emergency medical services and hospital personnel exposed to someone with smallpox require quarantine and vaccination if they have not been previously vaccinated.

• Quarantine: The infected person and anyone who has come into contact with the infected person for up to 17 days prior to illness (including the treating doctor and nursing staff) may be required to remain in isolation until a definite diagnosis is made. If the suspected case is indeed smallpox, these individuals will have to remain in isolation for at least 17 days to ensure that they are not also infected with the virus.
• The most likely scenario of a smallpox outbreak is from a terrorist attack or a laboratory accident. Given the highly infectious nature of the organism, researchers estimate that one infected person can infect up to 20 new contacts during the infectious stage of the illness. If one infected person appears at a hospital, it is assumed that more people have been infected.
• Because of the medical, legal, and social implications of quarantine and isolation, coordinated involvement at the federal, state, and local levels is mandatory. In reality, strict quarantine of a large segment of the population is probably not possible.
• Infectious disease specialists are consulted, along with state, federal, and local health authorities.
• Treatment: Medical treatment for smallpox eases its symptoms. This includes replacing fluid lost from fever and skin breakdown. Antibiotics may be needed for secondary skin infections. The infected person is kept in isolation for 17 days or until the scabs fall off.
• Experiments testing new antiviral medications are in progress, but it will be some time before they produce results. Vaccinations and postexposure interventions are the mainstays of treatment.

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