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Disease Name: Smallpox


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Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Idaho Department of Health and Welfare. (2016). Investigative Guidelines. Boise, ID:  Division of Public Health.


Overview / Case Definition

People who had smallpox had a fever and a distinctive, progressive skin rash.

Most people with smallpox recovered, but about 3 out of every 10 people with the disease died. Many smallpox survivors have permanent scars over large areas of their body, especially their faces. Some are left blind. Thanks to the success of vaccination, smallpox was eradicated, and no cases of naturally occurring smallpox have happened since 1977. The last natural outbreak of smallpox in the United States occurred in 1949.

Mainly spread by direct and fairly prolonged face-to-face contact between people. Smallpox patients became contagious once the first sores appeared in their mouth and throat (early rash stage). They spread the virus when they coughed or sneezed and droplets from their nose or mouth spread to other people. They remained contagious until their last smallpox scab fell off. These scabs and the fluid found in the patient’s sores also contained the variola virus. The virus can spread through these materials or through the objects contaminated by them, such as bedding or clothing. People who cared for smallpox patients and washed their bedding or clothing had to wear gloves and take care to not get infected. Rarely, smallpox has spread through the air in enclosed settings, such as a building (airborne route). Smallpox can be spread by humans only. Scientists have no evidence that smallpox can be spread by insects or animals.


Restrictions

Daycare Facility

A person diagnosed with smallpox must not attend a daycare facility as long as the disease is in a communicable form.

In the event of an outbreak, the Department or Health District may exclude susceptible children and employees from daycare facilities where a case has been identified until adequate immunization is obtained or the threat of further spread is contained.

Health Care Facility

A person diagnosed or suspected of having smallpox in a health care facility must be managed under the “Guideline for Isolation Precautions in Hospitals.”

Public Gatherings

A person diagnosed with smallpox must not attend public gatherings as long as the disease is in a communicable form.

Schools

A person diagnosed with smallpox, regardless of age, must not attend a private, parochial, charter or public school as long as the disease is in a communicable form.

In the event of an outbreak, the Department or Health District may exclude the susceptible children and employees from school where a case has been identified until adequate immunization is obtained or the threat of further spread is contained under Idaho code.


Reporting

Immediately, at time of identification

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable:

Reporting Timeframe: Immediately, at time of identification



Diagnosis / Testing

Can be detected in vesicular or pustular fluid by a number of different methods, including electron microscopy, immunohistochemistry, culture, or polymerase chain reaction assay. Only polymerase chain reaction can assay can diagnose infection with smallpox virus definitively.


Treatment

Military vaccine requirements: http://www.vaccines.mil/documents/2867_Clarifying_Guidance_for_SVP_and_AVIP.pdf


Additional Information

Idaho Department of Health and Welfare. (2016). Investigative Guidelines. Boise, ID:  Division of Public Health.


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