Figure 4.8a. Febrile Rash Illness Algorithm for Evaluating Patients Suspected of Having Smallpox

Figure 4.8b. Classification of Risk—Febrile Rash Illness Algorithm

High Risk (All three major criteria)

• Febrile prodrome (1.4 days pre-rash, >101° F), and
• Classic smallpox lesions, and
• Same stage of development.

Moderate Risk

• Febrile prodrome, and
• 1 other major or >4 minor criteria.

Low Risk

• No fever or
• Febrile prodrome and <4 minor criteria.

Minor Criteria

• Greatest concentration of lesions on face and distal extremities.
• Lesions first appeared on oral mucosa/palate, face, forearms.
• Patient appears toxic or moribund.
• Lesions evolve slowly from macules to papules to pustules over days.
• Lesions on palms and soles.

Source: Centers for Disease Control and Prevention. Emergency Preparedness and Response. Poster: Evaluating patients for smallpox.

Note: Full protocol available at http://www.bt.cdc.gov/agent/smallpox/diagnosis/evalposter.asp.

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