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15 March 2008 Supplement

Volume 46, Number S3
Clinical Infectious Diseases 2008;46:S195–S203
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4606S3-0006$15.00
DOI: 10.1086/524383
SUPPLEMENT ARTICLE

Performance of an Algorithm for Assessing Smallpox Risk among Patients with Rashes That May Be Confused with Smallpox

Sonja S. Hutchins,1

Iddrisu Sulemana,1

Katherine L. Heilpern,3

William Schaffner,4

Gary Wax,8

E. Brooke Lerner,9

Barbara Watson,10

Robert Baltimore,13

Rachel A. Waltenburg,3

Dominik Aronsky,5,6

Susan Coffin,11

Gladys Ng,13

Allen S. Craig,7

Amy Behrman,12

James Meek,13

Eileen Sherman,10

Sandra S. Chavez,1

Rafael Harpaz,1 and

Scott Schmid2

1National Immunization Program and 2National Center for Infectious Diseases, Centers for Disease Control and Prevention, and 3Emory University, Atlanta, Georgia; Departments of 4Preventive Medicine, 5Biomedical Informatics, and 6Emergency Medicine, Vanderbilt University School of Medicine, and 7Tennessee Department of Health, Nashville, Tennessee; 8Minnesota Department of Health, St. Paul; 9Department of Emergency Medicine, University of Rochester, Rochester, New York; 10Division for Disease Control, City of Philadelphia Department of Health, 11Division of Infectious Diseases, Children’s Hospital of Philadelphia, and 12Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; and 13Connecticut Emerging Infections Program, Yale University School of Medicine, New Haven

After the 2001 anthrax bioterror attacks, the Centers for Disease Control and Prevention developed an algorithm to evaluate patients rapidly for suspected smallpox. A prospective, multicenter study examined the performance of this algorithm in assessing patients with an acute, generalized vesicular or pustular rash (AGVPR) admitted to emergency departments and inpatient units of 12 acute‐care hospitals in 6 states. Of 26,747 patients (3.5% of all admissions) with rashlike conditions screened, 89 (1.2 patients per 10,000 admissions) had an AGVPR. Physicians or study staff classified none of 73 enrolled patients as being at high risk for having smallpox; 72 (99%) were classified as being at low risk, and 1 was classified as being at moderate risk. The discharge diagnosis for 55 (75%) of these 73 participants was varicella illness. Use of the algorithm did not result in misclassification of AGVPR as high risk for smallpox. The algorithm is a highly specific tool for clinical evaluation of suspected smallpox disease.

Reprints or correspondence: Dr. Sonja S. Hutchins, Office of Minority Health and Health Disparities, Centers for Disease Control and Prevention, MS E‐67, 1600 Clifton Rd. NE, Atlanta, GA 30333 ().

Cited by

Raymond A. Strikas, Linda J. Neff, Lisa Rotz, Joanne Cono, Donna Knutson, Joseph Henderson, and Walter A. Orenstein. (2008) US Civilian Smallpox Preparedness and Response Program, 2003. Clinical Infectious Diseases 46:s3, S157-S167
Online publication date: 15-Mar-2008.
Abstract-Full Text-PDF Version (250 kB)
Louisa E. Chapman, Gina T. Mootrey, and Linda J. Neff. (2008) Introduction: Vaccination against Smallpox in the Posteradication Era. Clinical Infectious Diseases 46:s3, S153-S156
Online publication date: 15-Mar-2008.
Abstract-Full Text-PDF Version (149 kB)
Sonja S. Hutchins, Guthrie S. Birkhead, Kristin Kenyan, John Abellera, Jennifer Lemmings, and the Council of State and Territorial Epidemiologists Smallpox Working Group. (2008) Public Health Surveillance for Suspected Smallpox in the United States, 2003–2005: Results of a National Survey. Clinical Infectious Diseases 46:s3, S204-S211
Online publication date: 15-Mar-2008.
Abstract-Full Text-PDF Version (289 kB)

  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agency.

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