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EMS AND DISASTER MEDICINE^908

TREATMENT

■ Isolate patients.

■ Donotincise and drain fluctuant lymph nodes (aspiration ok).

■ Antibiotics: Multiple choices available

■ Mild bubonic may be treated at home.

■ Prophylaxis: Same drugs for 7-day course

Smallpox

Organism:V. major, a large DNA virus

Was successfully eradicated in 1980 with small pox vaccine, but United States

and Russia have viral repositories for research purposes

There are several clinical forms of disease:

■ Variola major and minor—90% of cases

■ The classic form of disease

■ Hemorrhagic smallpox

■ Malignant smallpox

SYMPTOMS/EXAM

Variola Major and Minor

■ Incubation period of 2 weeks, followed by:

■ Constitutional symptoms

■ Maculopapular rash (see Figure 20.8)

FIGURE 20.8. Smallpox: Variola major. Mutiple pustules on the trunk, all in the same

stage of development.

(Reproduced, with permission, from Wolff K, Johnson RA, Surrmond D.Fitzpatrick’s Color

Atlas & Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005:771.)