Materiały źródłowe

• #1 Smallpox – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470418/

  Smallpox is the first human infectious disease to be successfully eradicated worldwide. […] It remains of clinical concern because of the potential for release and weaponization. […] This activity illustrates the evaluation and treatment of smallpox and describes the role of the interprofessional team in managing those with this condition. […] The Centers for Disease Control and Prevention (CDC) has developed an evaluation tool for clinicians caring for patients presenting with a rash illness that resembles smallpox based upon major and minor criteria. Major criteria for smallpox include febrile prodrome, classic lesion appearance, and lesions in the same stage of development. […] Based on these criteria patients are described as having a low, moderate, or high risk for smallpox with recommendations for diagnostic testing based upon classification.

• #1 Smallpox – Wikipedia

  https://en.wikipedia.org/wiki/Smallpox

  The clinical definition of ordinary smallpox is an illness with acute onset of fever equal to or greater than 38.3 °C (101 °F) followed by a rash characterized by firm, deep-seated vesicles or pustules in the same stage of development without other apparent cause. When a clinical case was observed, smallpox was confirmed using laboratory tests. […] Definitive laboratory identification of variola virus involved growing the virus on chorioallantoic membrane (part of a chicken embryo) and examining the resulting pock lesions under defined temperature conditions. Strains were characterized by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. Serologic tests and enzyme linked immunosorbent assays (ELISA), which measured variola virus-specific immunoglobulin and antigen were also developed to assist in the diagnosis of infection.

• #1 Diagnosis & Evaluation | Smallpox | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/smallpox/clinicians/diagnosis-evaluation.html

  An illness with acute onset of fever 101F (38.3C) followed by a rash characterized by firm, deep-seated vesicles or pustules in the same stage of development without other apparent cause. […] The algorithm, Evaluating Patients for Smallpox: Acute, Generalized Vesicular or Pustular Rash Illness Protocol provides a standard method for evaluating patients with acute, severe vesicular or pustular rash illness by giving clinical clues for differentiating smallpox from varicella and other rash illnesses. […] Use the major and minor diagnostic criteria for smallpox to categorize the patients risk of smallpox. […] Major Diagnostic Criteria for Smallpox: Febrile prodrome occurring 1 to 4 days before rash onset: Fever 101F (38.3C) AND at least one of the following: prostration, headache, backache, chills, vomiting, severe abdominal pain.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Smallpox.aspx

  According to United States Centers for Disease Control and Prevention (CDC), the primary diagnostic criteria for smallpox include febrile prodrome one to four days before rash onset, with a fever exceeding 38.3 C. In addition, headache, backache, chills, vomiting, and severe abdominal pain are also often present in infected patients. […] Classic smallpox lesions are deep-seated, firm/hard, round, well-circumscribed vesicles or pustules. As they evolve, lesions may become umbilicated or confluent. […] Minor diagnostic criteria for smallpox include centrifugal distribution of the rash. The patient appears moribund or toxic, with slow rash evolution from macules to papules to pustules over days, as well as lesions on the palms and/or soles. […] CDC laboratory criteria for confirming the diagnosis of smallpox include the identification of variola deoxyribonucleic acid (DNA) in clinical specimens through the polymerase chain reaction (PCR) assay. Variola virus may be isolated from clinical specimens and cultured in a biosafety level 4 (BSL4) laboratory. Electron microscopy may also be utilized.

• #1

  https://www.who.int/publications/m/item/smallpox-clinical-diagnosis

  Smallpox is a disease which can be easily diagnosed by trained health workers without the need for laboratory support. […] The centrifugal distribution of lesions, more prominent on the face and extremities than on the trunk, is a distinctive diagnostic feature of smallpox and gives the trained eye cause to suspect the disease. […] In the past, smallpox was sometimes confused with chickenpox, a worldwide infection of children that is seldom lethal.

• #1 Evaluating Patients for Smallpox: Acute, Generalized Vesicular or Pustular Rash Illness Protocol | Smallpox | CDC

  https://www.cdc.gov/smallpox/hcp/diagnosis-testing/evaluating-patients-rash-illness-protocol.html

  Medical providers should know the steps to take in evaluating patients with an acute, generalized vesicular or pustular rash illness. […] The flow chart describes the steps medical providers should take to evaluate a patient with an acute, generalized vesicular or pustular rash illness. […] When a patient presents with an acute, generalized vesicular or pustular rash illness, institute airborne and contact precautions. Alert infection control on admission. […] Determine the patients risk of smallpox using the MAJOR and MINOR criteria. […] If the patient has a febrile prodrome AND classic smallpox lesions AND lesions in the same stage of development, the patients risk of smallpox is HIGH. […] Report all HIGH-RISK CASES immediately (without waiting for lab results) to hospital infection control and applicable public health department. […] Images of patients with smallpox show that on any one part of the body, all lesions are in the same stage of development. […] Chickenpox (varicella) is the most likely condition to be confused with smallpox.

• #1 Diagnosis and Evaluation | Smallpox | CDC

  https://www.cdc.gov/smallpox/hcp/diagnosis-testing/index.html

  Smallpox presents with an acute onset of fever 101F (38.3C) followed by a rash characterized by firm, deep-seated vesicles or pustules. […] Determine the patient’s risk category using the major and minor diagnostic criteria for smallpox. […] Use the major and minor diagnostic criteria for smallpox to categorize the patient’s risk of smallpox. […] The laboratory criteria for diagnosis are: Polymerase chain reaction (PCR) identification of variola DNA in a clinical specimen, OR Isolation of smallpox (variola) virus from a clinical specimen (WHO Smallpox Reference Laboratory or laboratory with appropriate reference capabilities) with variola PCR confirmation. […] Note: Generic orthopoxvirus PCR and negative stain electron microscopy (EM) identification of a poxvirus in a clinical specimen are suggestive of an orthopoxvirus infection but not diagnostic for smallpox.

• #1 Smallpox Preparedness and Response | FDA

  https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/smallpox-preparedness-and-response

  Diagnosis of initial cases of smallpox in a smallpox emergency would likely be based on clinical diagnosis confirmed by follow-up laboratory testing. Laboratory diagnostic testing for Variola virus would occur in a CDC Laboratory Response Network (LRN) laboratory using specialized diagnostic tests and protocols for Variola virus. […] Cleared Variola virus diagnostic tests: Variola Virus Real-time PCR Assay, cleared for the qualitative detection of Variola virus DNA.

• #1 Smallpox – Wikipedia

  https://en.wikipedia.org/wiki/Smallpox

  The diagnosis of an orthopoxvirus infection can also be made rapidly by electron microscopic examination of pustular fluid or scabs. All orthopoxviruses exhibit identical brick-shaped virions by electron microscopy. If particles with the characteristic morphology of herpesviruses are seen this will eliminate smallpox and other orthopoxvirus infections.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2482932/

  Between July 1966 and May 1972 the Vesicular Disease Laboratory, Center for Disease Control, Atlanta, Ga., USA, tested specimens from 849 suspected smallpox cases by at least 2 methods, electron microscopy and chick embryo chorioallantoic membrane (CAM) cultures. […] For specimens handled in the field the CAM culture method was less sensitive than electron microscopy because the adverse conditions often inactivated the virus. […] The agar gel precipitation test was the least sensitive but was of value in confirming the results of electron microscopy. […] The latter was highly effective for the diagnosis of varicella, but dependably identified only about half of the vaccinia infections; for vaccinia, the CAM technique was essential. […] The occurrence of human monkeypox cases in West Africa emphasized that the usual smallpox diagnostic methods were inadequate. […] More sophisticated tests, such as the rabbit dermal sensitivity test, are necessary for accurate diagnosis of these cases as monkeypox.

• #1

  https://link.springer.com/article/10.1007/BF02538617

  The Nicolau stain deserves to replace the Gutstein stain as a routine method for smallpox diagnosis; it is simple, effective and fool proof. […] Stains for smallpox diagnosis: C. E. van Rooyen and A. Rhodes, Virus diseases of Man 1948, p. 296.

• #1

  https://www.who.int/publications/m/item/smallpox-diagnostics-laboratory-network

  A case of smallpox detected by a member state requires notification as soon as possible to WHO under the International Health Regulations (2005), and any confirmed smallpox case would generate an immediate global public health response. […] WHO needs to rely on fast and reliable laboratory diagnostic capacity worldwide to be able to identify a re-emergence of smallpox, particularly in countries where systemic Orthopoxvirus infections such as monkeypox, vaccinia virus infection or cowpox, and other non-pox viral rash illnesses such as chickenpox (varicella) may cause clinical diagnostic confusion. […] Early detection and confirmation of smallpox rely on the two WHO Collaborating Centres for smallpox and other poxvirus infections at CDC (USA) and VECTOR (Russian Federation). These two Centres are supported by a worldwide network of reliable laboratories able to perform PCR and real-time PCR diagnostics to enable detection and first identification of smallpox events through the Emerging and Dangerous Pathogens Laboratory Network.

• #1 Smallpox: Vaccine, Causes, Symptoms, Treatment & Pictures

  https://www.emedicinehealth.com/smallpox/article_em.htm

  What Tests Do Physicians Use to Diagnose Smallpox? Initial diagnosis of smallpox is most likely based on history and physical examination findings; any person suspected of having the disease needs to be isolated, and people caring for the patient should use strict isolation-barrier techniques to protect themselves and others from exposure and local, state and national health authorities should be informed immediately. Other procedures (quarantine and vaccinations of people who contacted the patient) will be done if smallpox is diagnosed. […] The doctor may take a throat swab to make the diagnosis of smallpox. Tests include taking a sample from a freshly opened pustule, which may be useful in diagnosis. For suspected cases of hemorrhagic smallpox, the doctor may sample fluid from a spinal tap (lumbar puncture). Under certain conditions, cytoplasmic inclusion bodies (also known as Guarnieri bodies) may be visible within the cells. This is also evidence of smallpox infection.

• #1 2 State of Smallpox Medical Countermeasures Readiness | Future State of Smallpox Medical Countermeasures | The National Academies Press

  https://nap.nationalacademies.org/read/27652/chapter/4

  The ability to rapidly detect and diagnose a potential case of smallpox is central to all containment strategies. […] In the United States, testing would be conducted by a U.S. Centers for Disease Control and Prevention (CDC) Laboratory Response Network (LRN) laboratory, with CDC conducting confirmatory testing on any positive samples with further confirmatory testing at CDC for any initially variola virus-positive results. […] U.S. diagnostic testing options to confirm smallpox rely on a variola-specific assay approved by the U.S. Food and Drug Administration (FDA) in 2017. […] The FDA-approved Variola Virus Nucleic Acid-Based Detection Assay is indicated for individuals presenting with pustular or vesicular rash illness or other signs and symptoms of Variola virus infection. […] The identification of smallpox cases requires clinical recognition.

• #1 Smallpox Differential Diagnoses

  https://emedicine.medscape.com/article/237229-differential

  The rash of chickenpox was frequently mistaken for that of smallpox during the days of natural infection. Both conditions can result in pustular scarring lesions that involve the face. […] The fever and vesicular rash of herpes zoster and erythema multiforme also were often confused with those of variola major. […] Hemorrhagic smallpox, seen in the image below, develops fulminantly and was most often confused with meningococcemia or severe acute leukemia. […] Contact dermatitis, although often vesicular, is distinguishable from smallpox lesions because contact dermatitis is pruritic and is not accompanied by fever or constitutional symptoms. […] Conditions to consider in the differential diagnosis of smallpox include the following: Rocky Mountain spotted fever, Syphilis, Varicella-zoster virus, Drug eruptions, Insect bites, Kawasaki disease, Measles, rubeola, Monkeypox, Rubella, Generalized vaccinia and eczema vaccinatum, Insect bites, Viral hemorrhagic fevers (may be confused with hemorrhagic smallpox), Varicella virus, Acne, Atypical measles, Coxsackievirus, Acute leukemia, Secondary syphilis, Rat-bite fever, Infectious mononucleosis, Toxic erythemas, Parvovirus B19, Cytomegalovirus, Erythema multiforme (Stevens-Johnson syndrome), Molluscum contagiosum, Scarlet fever. […] Hemorrhagic-type variola major lesions. Death usually ensued before typical pustules developed.

• #1 Diagnosis: Smallpox? – ViroLIEgy

  https://viroliegy.com/2022/05/29/diagnosis-smallpox/

  Smallpox was confused with chickenpox more frequently than with any other illness. […] The similarities between the diseases and the importance of making the correct diagnosis led an infectious disease expert to declare that there was no more important diagnosis in clinical medicine than the differentiation of these two diseases. […] In the absence of smallpox, the main clinical diagnostic problem is the differentiation of human monkeypox from chickenpox. […] Laboratory methods played a crucial role in the global smallpox eradication programme; indeed, eradication could not have been confidently certified to have been achieved without their use. […] Laboratory confirmation or refutation of suspected smallpox was a valuable procedure in non-endemic countries and in smallpox-free regions of the endemic countries as eradication approached.

• #1 Smallpox – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470418/

  Laboratory testing is not recommended for low or moderate risk patients in the absence of known smallpox circulation. […] For patients in whom testing is recommended, PCR from serum or whole blood as well as tissue samples may be recommended after public health consultation. […] In the post-eradication era, development of anti-orthopoxvirus medical therapies remains an active area of research. […] In 2018, the United States approved tecovirimat as the first antiviral therapy indicated for treatment of smallpox. […] Although the antiviral has only been evaluated fully in animal models, it has been administered to human volunteers in a safety trial, and as an emergency investigational drug to patients who developed post-vaccination complications.

• #1 Action Needed to Improve U.S. Smallpox Readiness and Diagnostics, Vaccines, and Therapeutics, Says New Report | National Academies

  https://www.nationalacademies.org/news/2024/03/action-needed-to-improve-u-s-smallpox-readiness-and-diagnostics-vaccines-and-therapeutics-says-new-report

  Action Needed to Improve U.S. Smallpox Readiness and Diagnostics, Vaccines, and Therapeutics, Says New Report […] The development of better diagnostics, vaccines, and therapeutics — also called medical countermeasures — would improve the nation’s ability to respond to a smallpox outbreak or attack using the virus, the report says. […] Diagnostic tests are needed that can more accurately detect smallpox and related viruses, identify potential cases at earlier stages of disease, assess prior exposure or immunity to smallpox, be used across biosafety levels and in field settings, support disease surveillance, and enhance equitable access to testing than those available today. […] It is vital to prioritize research into the development of safer and more effective smallpox diagnostics, vaccines, and therapeutics, make judicious choices in stockpiling, and have modern, well-practiced, and adaptable plans for responding in the event of a smallpox outbreak. […] Research using live variola and related viruses is essential for creating and improving medical countermeasures for smallpox and other related diseases, and to ensuring the U.S. is ready to respond to an outbreak, says the report.

• #1 Smallpox – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/smallpox/diagnosis-treatment/drc-20353032

  If a smallpox outbreak happened today, most health care providers probably wouldn’t recognize the virus in its early stages. This would allow the smallpox virus to spread. […] The Centers for Disease Control and Prevention uses special labs to test tissue samples for smallpox. This test can tell for sure if a person has the virus.

• #1 2 State of Smallpox Medical Countermeasures Readiness | Future State of Smallpox Medical Countermeasures | The National Academies Press

  https://nap.nationalacademies.org/read/27652/chapter/4

  The current algorithm was designed for the detection of initial cases in the absence of endemic disease, but planning for laboratory capacity should include strategies for both immediate response and long-term scenarios where greater demand for testing arises. […] Diagnostic assays for variola are available only at select LRN laboratories, largely due to biosafety considerations, and only as part of a clinical testing algorithm. […] FDA-cleared serological assays for smallpox have not been developed, and protein-based tests are still being explored. […] Tests that can more accurately detect smallpox and other orthopoxviruses than those available today are needed; efforts should focus on adapting multiplex nucleic acid assays for new platforms and field settings.

• #1 Diagnosis: Smallpox? – ViroLIEgy

  https://viroliegy.com/2022/05/29/diagnosis-smallpox/

  In the absence of known smallpox disease, the predictive value of a positive smallpox test diagnosis is low, so only cases that meet the clinical definition of the disease should be tested. […] Definitive diagnosis depended on the isolation of the causative virus on the chorioallantoic membrane of the developing chick embryo and its further characterization, if necessary, by biological tests. […] The laboratory criteria for diagnosis are polymerase chain reaction (PCR) identification of variola DNA in a clinical specimen, OR isolation of smallpox (variola) virus from a clinical specimen with variola PCR confirmation.

• #1 Diagnosis and Management of Smallpox | Journal of Ethics | American Medical Association

  https://journalofethics.ama-assn.org/article/diagnosis-and-management-smallpox/2003-02

  In 1980, the World Health Organization announced that smallpox had been eradicated. Accurate diagnosis and proper management is critical to treating those already infected and limiting the spread of the disease in the community. Smallpox can appear in 4 different forms: ordinary, modified, flat, or hemorrhagic. The latter 2 forms occur in patients with compromised immune systems, and the modified form occurs in previously vaccinated patients (those who are now roughly 30 years of age or older). Patients with confirmed or suspected smallpox should be isolated. Vaccination administered within 3-4 days post-exposure can prevent disease or severe illness. […] Skin lesions in smallpox begin as macules and over the next couple of weeks progress to firm papules, then vesicles which soon become opaque and pustular. […] Medical care is generally supportive and treatment of complications such as: hypovolemia and electrolyte imbalance (eg, hyponatremia, hypokalemia) due to fluid loss from skin lesions.

• #1 Smallpox – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/smallpox/smallpox+-+including+symptoms+treatment+and+prevention

  Smallpox is a notifiable condition. […] Diagnosis is by laboratory testing of blister fluid or skin scrapings, or blood taken during the fever stage.

• #1 Smallpox Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/smallpox/

  If a doctor suspected a case of smallpox, blood and skin tests would be needed to confirm the diagnosis. A confirmed case of smallpox would be considered a worldwide health emergency. In the U.S., state and federal health officials would quickly take action. They would keep anyone who might have been exposed away from others. […] If a smallpox outbreak had been confirmed, a doctor in the outbreak area could diagnose smallpox without a lab test. The doctor would look at the rash and ask about symptoms and possible exposure to the disease.

• #1 Smallpox: Symptoms, Diagnosis, Treatment, And Prevention | ER of Mesquite

  https://erofmesquite.com/blog/smallpox-symptoms-diagnosis-treatment-and-prevention/

  A rash where the face and extremities have the highest concentration of lesions […] Lesions that start as mouth, facial, or forearm lesions […] Severe sickness […] Rash that gradually transforms into many forms […] Ailments on the hands palms or the feets soles […] Laboratory testing can confirm a smallpox diagnosis and rule out other possible diseases, like chicken pox. […] […] […] Treatment for smallpox in the past involved isolating the patient until all the scabs fell off to relieve symptoms and stop the illness from spreading. However, researchers have created antiviral drugs to treat smallpox in recent years. […] The medication tecovirimat (TPOXX) was licensed by the U.S. Food and Drug Administration (FDA) in 2018 to treat smallpox. The medication prevents the action of a protein known as p37, which stops virus particles from escaping an infected cell and infecting other cells.

• #1 Smallpox: Symptoms, Diagnosis, Treatment, And Prevention | ER of Mesquite

  https://erofmesquite.com/blog/smallpox-symptoms-diagnosis-treatment-and-prevention/

  […] […] According to research, tecovirimat can treat illnesses akin to smallpox in animals and is effective against the variola virus in lab conditions (in cell cultures). Additionally, studies demonstrate the safety of tecovirimat, with headache, nausea, and abdominal pain being the most common side effects. […] However, because the medication was created after smallpox was eradicated, human testing has not been conducted on it, raising questions about how well it would function in the extremely improbable case of an outbreak. […] […] […] Further research has demonstrated that the antiviral medications brincidofovir, an experimental medication also used to treat adenovirus and cytomegalovirus retinitis in patients with AIDS, and cidofovir (Vistide), which is occasionally used to treat cytomegalovirus retinitis in eye infections in AIDS patients, are both effective against smallpox in laboratory settings and can treat diseases related to smallpox in animals. […] Patients who have smallpox have not been tested for cidofovir or brincidofovir. Researchers are still looking at the toxicity and efficacy of the medications.

• #1 Smallpox – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/pox-viruses/smallpox

  No cases of smallpox have occurred since 1977, but concerns about possible use for bioterrorism remain. […] Diagnosis is made by PCR. […] Treatment is mainly supportive, but tecovirimat and brincidofovir have been approved for use; cidofovir may be considered. […] Vaccination is highly protective, but rare complications from replication-competent virus vaccine (about 1:10,000) can be serious. […] Immunity fades over decades.

• #2

  https://www.who.int/publications/m/item/smallpox-clinical-diagnosis

  Smallpox is a disease which can be easily diagnosed by trained health workers without the need for laboratory support. […] The centrifugal distribution of lesions, more prominent on the face and extremities than on the trunk, is a distinctive diagnostic feature of smallpox and gives the trained eye cause to suspect the disease. […] In the past, smallpox was sometimes confused with chickenpox, a worldwide infection of children that is seldom lethal.

• #2 Diagnosis and Evaluation | Smallpox | CDC

  https://www.cdc.gov/smallpox/hcp/diagnosis-testing/index.html

  Smallpox presents with an acute onset of fever 101F (38.3C) followed by a rash characterized by firm, deep-seated vesicles or pustules. […] Determine the patient’s risk category using the major and minor diagnostic criteria for smallpox. […] Use the major and minor diagnostic criteria for smallpox to categorize the patient’s risk of smallpox. […] The laboratory criteria for diagnosis are: Polymerase chain reaction (PCR) identification of variola DNA in a clinical specimen, OR Isolation of smallpox (variola) virus from a clinical specimen (WHO Smallpox Reference Laboratory or laboratory with appropriate reference capabilities) with variola PCR confirmation. […] Note: Generic orthopoxvirus PCR and negative stain electron microscopy (EM) identification of a poxvirus in a clinical specimen are suggestive of an orthopoxvirus infection but not diagnostic for smallpox.

• #2 Smallpox – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470418/

  Smallpox is the first human infectious disease to be successfully eradicated worldwide. […] It remains of clinical concern because of the potential for release and weaponization. […] This activity illustrates the evaluation and treatment of smallpox and describes the role of the interprofessional team in managing those with this condition. […] The Centers for Disease Control and Prevention (CDC) has developed an evaluation tool for clinicians caring for patients presenting with a rash illness that resembles smallpox based upon major and minor criteria. Major criteria for smallpox include febrile prodrome, classic lesion appearance, and lesions in the same stage of development. […] Based on these criteria patients are described as having a low, moderate, or high risk for smallpox with recommendations for diagnostic testing based upon classification.

• #2 Diagnosis & Evaluation | Smallpox | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/smallpox/clinicians/diagnosis-evaluation.html

  Classic smallpox lesions: deep-seated, firm/hard, round, well-circumscribed vesicles or pustules. […] Laboratory diagnostic testing for variola virus will occur in a CDC Laboratory Response Network (LRN) laboratory using LRN-approved PCR tests and protocols for variola virus. […] The laboratory criteria for diagnosis are: Polymerase chain reaction (PCR) identification of variola DNA in a clinical specimen, OR Isolation of smallpox (variola) virus from a clinical specimen (WHO Smallpox Reference Laboratory or laboratory with appropriate reference capabilities) with variola PCR confirmation.

• #2 Smallpox: Symptoms, Diagnosis, Treatment, And Prevention | ER of Mesquite

  https://erofmesquite.com/blog/smallpox-symptoms-diagnosis-treatment-and-prevention/

  How Is Smallpox Diagnosed? […] Rashes can be a symptom of several disorders. However, it is highly improbable that a rash is caused by smallpox. […] The following are the main smallpox diagnostic criteria: […] A fever with a minimum temperature of 101 degrees Fahrenheit (38.3 degrees Celsius), occurring one to four days before the appearance of a rash, and at least one additional symptom such as excessive weakness, headache, backache, chills, vomiting, or intense abdominal pain […] Traditional smallpox lesions as previously mentioned […] Lesions on a single body part that are at the same stage of development (for example, having only bumps on the arms as opposed to blisters and pustules mixed) […] someone likely has smallpox if they fit the description as mentioned above. The following are minor diagnostic criteria (lower likelihood):

• #2 What Is Smallpox? Symptoms, Diagnosis, Treatment, And Prevention – ER of Dallas TX

  https://erofdallastx.com/blog/what-is-smallpox-symptoms-diagnosis-treatment-and-prevention/

  How Is Smallpox Diagnosed […] Rashes can be a symptom of several disorders. However, it is extremely improbable that a rash is caused by smallpox. […] The following are the main smallpox diagnostic criteria: […] A fever with a minimum temperature of 101 degrees Fahrenheit (38.3 degrees Celsius), occurring one to four days before the appearance of a rash, and at least one additional symptom such as excessive weakness, headache, backache, chills, vomiting, or intense abdominal pain […] Traditional smallpox lesions as previously mentioned […] Lesions on a single body part that are at the same stage of development (for example, having only pustules on the arms as opposed to blisters and pustules mixed) […] Its very likely that someone has smallpox if they fit the aforementioned description. The following are minor diagnostic criteria (lower likelihood):

• #2 Smallpox – Wikipedia

  https://en.wikipedia.org/wiki/Smallpox

  The diagnosis of an orthopoxvirus infection can also be made rapidly by electron microscopic examination of pustular fluid or scabs. All orthopoxviruses exhibit identical brick-shaped virions by electron microscopy. If particles with the characteristic morphology of herpesviruses are seen this will eliminate smallpox and other orthopoxvirus infections.

• #2 Evaluating Patients for Smallpox: Acute, Generalized Vesicular or Pustular Rash Illness Protocol | Smallpox | CDC

  https://www.cdc.gov/smallpox/hcp/diagnosis-testing/evaluating-patients-rash-illness-protocol.html

  Medical providers should know the steps to take in evaluating patients with an acute, generalized vesicular or pustular rash illness. […] The flow chart describes the steps medical providers should take to evaluate a patient with an acute, generalized vesicular or pustular rash illness. […] When a patient presents with an acute, generalized vesicular or pustular rash illness, institute airborne and contact precautions. Alert infection control on admission. […] Determine the patients risk of smallpox using the MAJOR and MINOR criteria. […] If the patient has a febrile prodrome AND classic smallpox lesions AND lesions in the same stage of development, the patients risk of smallpox is HIGH. […] Report all HIGH-RISK CASES immediately (without waiting for lab results) to hospital infection control and applicable public health department. […] Images of patients with smallpox show that on any one part of the body, all lesions are in the same stage of development. […] Chickenpox (varicella) is the most likely condition to be confused with smallpox.

• #2 2 State of Smallpox Medical Countermeasures Readiness | Future State of Smallpox Medical Countermeasures | The National Academies Press

  https://nap.nationalacademies.org/read/27652/chapter/4

  The ability to rapidly detect and diagnose a potential case of smallpox is central to all containment strategies. […] In the United States, testing would be conducted by a U.S. Centers for Disease Control and Prevention (CDC) Laboratory Response Network (LRN) laboratory, with CDC conducting confirmatory testing on any positive samples with further confirmatory testing at CDC for any initially variola virus-positive results. […] U.S. diagnostic testing options to confirm smallpox rely on a variola-specific assay approved by the U.S. Food and Drug Administration (FDA) in 2017. […] The FDA-approved Variola Virus Nucleic Acid-Based Detection Assay is indicated for individuals presenting with pustular or vesicular rash illness or other signs and symptoms of Variola virus infection. […] The identification of smallpox cases requires clinical recognition.

• #2 2 State of Smallpox Medical Countermeasures Readiness | Future State of Smallpox Medical Countermeasures | The National Academies Press

  https://nap.nationalacademies.org/read/27652/chapter/4

  The current algorithm was designed for the detection of initial cases in the absence of endemic disease, but planning for laboratory capacity should include strategies for both immediate response and long-term scenarios where greater demand for testing arises. […] Diagnostic assays for variola are available only at select LRN laboratories, largely due to biosafety considerations, and only as part of a clinical testing algorithm. […] FDA-cleared serological assays for smallpox have not been developed, and protein-based tests are still being explored. […] Tests that can more accurately detect smallpox and other orthopoxviruses than those available today are needed; efforts should focus on adapting multiplex nucleic acid assays for new platforms and field settings.

• #2 Action Needed to Improve U.S. Smallpox Readiness and Diagnostics, Vaccines, and Therapeutics, Says New Report | National Academies

  https://www.nationalacademies.org/news/2024/03/action-needed-to-improve-u-s-smallpox-readiness-and-diagnostics-vaccines-and-therapeutics-says-new-report

  Action Needed to Improve U.S. Smallpox Readiness and Diagnostics, Vaccines, and Therapeutics, Says New Report […] The development of better diagnostics, vaccines, and therapeutics — also called medical countermeasures — would improve the nation’s ability to respond to a smallpox outbreak or attack using the virus, the report says. […] Diagnostic tests are needed that can more accurately detect smallpox and related viruses, identify potential cases at earlier stages of disease, assess prior exposure or immunity to smallpox, be used across biosafety levels and in field settings, support disease surveillance, and enhance equitable access to testing than those available today. […] It is vital to prioritize research into the development of safer and more effective smallpox diagnostics, vaccines, and therapeutics, make judicious choices in stockpiling, and have modern, well-practiced, and adaptable plans for responding in the event of a smallpox outbreak. […] Research using live variola and related viruses is essential for creating and improving medical countermeasures for smallpox and other related diseases, and to ensuring the U.S. is ready to respond to an outbreak, says the report.

• #2 Smallpox: Symptoms, Diagnosis, Treatment, And Prevention | ER of Mesquite

  https://erofmesquite.com/blog/smallpox-symptoms-diagnosis-treatment-and-prevention/

  A rash where the face and extremities have the highest concentration of lesions […] Lesions that start as mouth, facial, or forearm lesions […] Severe sickness […] Rash that gradually transforms into many forms […] Ailments on the hands palms or the feets soles […] Laboratory testing can confirm a smallpox diagnosis and rule out other possible diseases, like chicken pox. […] […] […] Treatment for smallpox in the past involved isolating the patient until all the scabs fell off to relieve symptoms and stop the illness from spreading. However, researchers have created antiviral drugs to treat smallpox in recent years. […] The medication tecovirimat (TPOXX) was licensed by the U.S. Food and Drug Administration (FDA) in 2018 to treat smallpox. The medication prevents the action of a protein known as p37, which stops virus particles from escaping an infected cell and infecting other cells.

• #2 Smallpox: Symptoms, Diagnosis, Treatment, And Prevention | ER of Mesquite

  https://erofmesquite.com/blog/smallpox-symptoms-diagnosis-treatment-and-prevention/

  […] […] According to research, tecovirimat can treat illnesses akin to smallpox in animals and is effective against the variola virus in lab conditions (in cell cultures). Additionally, studies demonstrate the safety of tecovirimat, with headache, nausea, and abdominal pain being the most common side effects. […] However, because the medication was created after smallpox was eradicated, human testing has not been conducted on it, raising questions about how well it would function in the extremely improbable case of an outbreak. […] […] […] Further research has demonstrated that the antiviral medications brincidofovir, an experimental medication also used to treat adenovirus and cytomegalovirus retinitis in patients with AIDS, and cidofovir (Vistide), which is occasionally used to treat cytomegalovirus retinitis in eye infections in AIDS patients, are both effective against smallpox in laboratory settings and can treat diseases related to smallpox in animals. […] Patients who have smallpox have not been tested for cidofovir or brincidofovir. Researchers are still looking at the toxicity and efficacy of the medications.

• #3 Evaluating Patients for Smallpox: Acute, Generalized Vesicular or Pustular Rash Illness Protocol | Smallpox | CDC

  https://www.cdc.gov/smallpox/hcp/diagnosis-testing/evaluating-patients-rash-illness-protocol.html

  Medical providers should know the steps to take in evaluating patients with an acute, generalized vesicular or pustular rash illness. […] The flow chart describes the steps medical providers should take to evaluate a patient with an acute, generalized vesicular or pustular rash illness. […] When a patient presents with an acute, generalized vesicular or pustular rash illness, institute airborne and contact precautions. Alert infection control on admission. […] Determine the patients risk of smallpox using the MAJOR and MINOR criteria. […] If the patient has a febrile prodrome AND classic smallpox lesions AND lesions in the same stage of development, the patients risk of smallpox is HIGH. […] Report all HIGH-RISK CASES immediately (without waiting for lab results) to hospital infection control and applicable public health department. […] Images of patients with smallpox show that on any one part of the body, all lesions are in the same stage of development. […] Chickenpox (varicella) is the most likely condition to be confused with smallpox.

• #3 What Is Smallpox? Symptoms, Diagnosis, Treatment, And Prevention – ER of Dallas TX

  https://erofdallastx.com/blog/what-is-smallpox-symptoms-diagnosis-treatment-and-prevention/

  A rash where the face and extremities have the highest concentration of lesions […] Lesions that start out as mouth, facial, or forearm lesions […] Severe sickness […] Rash that gradually transforms into many forms […] Ailments on the hands palms or the feets soles […] Laboratory testing can confirm a smallpox diagnosis and rule out other possible diseases, like chicken pox. […] […] […] Treatment of Smallpox […] Treatment for smallpox in the past involved isolating the patient until all of the scabs fell off in order to relieve symptoms and stop the illness from spreading. However, researchers have created antiviral drugs to treat smallpox in recent years. […] The medication tecovirimat (TPOXX) was licensed by the U.S. Food and Drug Administration (FDA) in 2018 for the treatment of smallpox. The medication functions by preventing the action of a protein known as p37, which in turn stops virus particles from escaping an infected cell and infecting other cells.

• #3 Smallpox: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/smallpox

  Diagnostic tests commonly used to detect smallpox include polymerase chain reaction (PCR) testing, immunofluorescence assays, virus isolation through cell cultures, electron microscopy, and serological testing. […] Smallpox diagnosis can take anywhere from a few hours to a few days, depending on the method of testing used and the availability of laboratory facilities. […] Physical examination alone is not enough to diagnose smallpox, as the symptoms can be similar to those of other viral illnesses. Laboratory testing is necessary for accurate diagnosis. […] Serological testing can be a useful tool for smallpox diagnosis, but it should not be relied upon as the sole diagnostic method. False positives and negatives are possible, and other methods such as PCR testing and virus isolation are more reliable.

• #3 Action Needed to Improve U.S. Smallpox Readiness and Diagnostics, Vaccines, and Therapeutics, Says New Report | National Academies

  https://www.nationalacademies.org/news/2024/03/action-needed-to-improve-u-s-smallpox-readiness-and-diagnostics-vaccines-and-therapeutics-says-new-report

  Action Needed to Improve U.S. Smallpox Readiness and Diagnostics, Vaccines, and Therapeutics, Says New Report […] The development of better diagnostics, vaccines, and therapeutics — also called medical countermeasures — would improve the nation’s ability to respond to a smallpox outbreak or attack using the virus, the report says. […] Diagnostic tests are needed that can more accurately detect smallpox and related viruses, identify potential cases at earlier stages of disease, assess prior exposure or immunity to smallpox, be used across biosafety levels and in field settings, support disease surveillance, and enhance equitable access to testing than those available today. […] It is vital to prioritize research into the development of safer and more effective smallpox diagnostics, vaccines, and therapeutics, make judicious choices in stockpiling, and have modern, well-practiced, and adaptable plans for responding in the event of a smallpox outbreak. […] Research using live variola and related viruses is essential for creating and improving medical countermeasures for smallpox and other related diseases, and to ensuring the U.S. is ready to respond to an outbreak, says the report.

• #3 Smallpox – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470418/

  Laboratory testing is not recommended for low or moderate risk patients in the absence of known smallpox circulation. […] For patients in whom testing is recommended, PCR from serum or whole blood as well as tissue samples may be recommended after public health consultation. […] In the post-eradication era, development of anti-orthopoxvirus medical therapies remains an active area of research. […] In 2018, the United States approved tecovirimat as the first antiviral therapy indicated for treatment of smallpox. […] Although the antiviral has only been evaluated fully in animal models, it has been administered to human volunteers in a safety trial, and as an emergency investigational drug to patients who developed post-vaccination complications.

• #4 What Is Smallpox? Symptoms, Diagnosis, Treatment, And Prevention – ER of Dallas TX

  https://erofdallastx.com/blog/what-is-smallpox-symptoms-diagnosis-treatment-and-prevention/

  A rash where the face and extremities have the highest concentration of lesions […] Lesions that start out as mouth, facial, or forearm lesions […] Severe sickness […] Rash that gradually transforms into many forms […] Ailments on the hands palms or the feets soles […] Laboratory testing can confirm a smallpox diagnosis and rule out other possible diseases, like chicken pox. […] […] […] Treatment of Smallpox […] Treatment for smallpox in the past involved isolating the patient until all of the scabs fell off in order to relieve symptoms and stop the illness from spreading. However, researchers have created antiviral drugs to treat smallpox in recent years. […] The medication tecovirimat (TPOXX) was licensed by the U.S. Food and Drug Administration (FDA) in 2018 for the treatment of smallpox. The medication functions by preventing the action of a protein known as p37, which in turn stops virus particles from escaping an infected cell and infecting other cells.

• #5 What Is Smallpox? Symptoms, Diagnosis, Treatment, And Prevention – ER of Dallas TX

  https://erofdallastx.com/blog/what-is-smallpox-symptoms-diagnosis-treatment-and-prevention/

  A rash where the face and extremities have the highest concentration of lesions […] Lesions that start out as mouth, facial, or forearm lesions […] Severe sickness […] Rash that gradually transforms into many forms […] Ailments on the hands palms or the feets soles […] Laboratory testing can confirm a smallpox diagnosis and rule out other possible diseases, like chicken pox. […] […] […] Treatment of Smallpox […] Treatment for smallpox in the past involved isolating the patient until all of the scabs fell off in order to relieve symptoms and stop the illness from spreading. However, researchers have created antiviral drugs to treat smallpox in recent years. […] The medication tecovirimat (TPOXX) was licensed by the U.S. Food and Drug Administration (FDA) in 2018 for the treatment of smallpox. The medication functions by preventing the action of a protein known as p37, which in turn stops virus particles from escaping an infected cell and infecting other cells.

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