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Smallpox

© Robert Moyer

Keep in mind the following article is to be used only as a guideline. I have about a years experience in the EMS field, so most of my information comes from my knowledge and experience in the hazardous materials and bio-terrorism fields.

Following the anthrax attacks against healthcare workers and the government, emergency medical personnel have had to shift their focus to a possible bioterrorismism attack involving the smallpox virus. The Center for Disease Control and Prevention is now working on a federal plan to approach such an incident. But nothing has been shown to be clear cut as of yet.

Federal advisory groups recommends vaccinations for healthcare workers and emergency personnel, but exactly when these vaccinations will be available and which group will include EMS providers is still up in the air. The vaccination available is Dryvax, others are still in production. The Food and Drug Administration has not licensed any smallpox vaccines. Some healthcare providers will not be able to take the vaccine because of their health status. In addition the vaccine isn't without side effects and possible complications.

So where does that leave emergency medical service providers? What can we do to reduce the risk of exposure?

First, let's take a long look at reality. As with the anthrax attack, we will probably not know about an exposure to the virus until after the fact. Bearing this in mind, it's essential to stress education and training about signs and symptoms of smallpox infection and proper use of personal protective equipment, (self-contained breathing apparatus and surgical masks may or may not be enough, but any level of protection will help.

The initial signs and symptoms of a smallpox infection may resemble many other illnesses. An individual may develop the disease seven to seventeen days after exposure, with an average time being about twelve days. This means that immediately following the exposure the patient is not communicable. This seven to seventeen day incubation period is when the patient poses a risk of transmitting the disease to others.

Signs & symptoms

Patient assessment is an essential part of exposure reduction. What signs and symptoms should emergency medical service providers look for? Symptoms may begin with two to four days of fever and muscle aches. Following this, a rash appearing on the face, arms and legs emerges. This rash is particularly notable on the palms of the hands and soles of the feet. A person with smallpox is considered contagious at the time the rash appears.

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