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From the Centers for Disease Control and Prevention
October 16, 2002

Updated Post-Event Smallpox Response Plan and Guidelines

JAMA. 2002;288(15):1844. doi:10.1001/jama.288.15.1844-JWR1016-4-1

MMWR. 2002;51:864

CDC has released an updated version of the post-event Smallpox Response Plan and Guidelines. This is the second revision to these guidelines since they were released in November 2001.

Version 3 of the guidelines contains an important addition—the "Smallpox Vaccination Clinic Guide." This guide provides the operational and logistical considerations associated with implementing a large-scale, voluntary vaccination program as part of a multifaceted response to a confirmed smallpox outbreak. Following a confirmed smallpox outbreak within the United States, rapid, voluntary vaccination of a large segment of the population might be required to (1) supplement priority surveillance and containment control strategies in areas with smallpox cases, (2) reduce the at-risk population for additional intentional releases of smallpox virus if the probability of such occurrences is considered significant, and (3) address heightened public concerns about access to voluntary vaccination.

The most important component of smallpox containment is the rapid identification, isolation, and vaccination of close contacts of infected patients and contacts of their contacts (i.e., ring vaccination). This strategy involves identification of infected persons through intensive surveillance, isolation of infected persons, vaccination of household contacts and other close contacts of infected persons (i.e., primary contacts), and vaccination of household and other potential contacts of the primary contacts (i.e., secondary contacts).

The clinic guide will assist planning for larger-scale, post-event vaccination when exposure circumstances indicate the need to supplement the ring vaccination approach with broader protective measures. The clinic guide describes the activities and staffing needs associated with large-scale smallpox vaccination clinics, including suggested protocols for vaccine safety monitoring and treatment. The clinic guide provides an example of a model smallpox clinic and provides samples of pertinent clinic consent forms and patient information sheets that would be used at a clinic.

The clinic guide and the Smallpox Response Plan and Guidelines, Version 3 are available at http://www.cdc.gov/smallpox. CDC will take additional steps to increase preparedness to respond to a smallpox exposure of any magnitude, including updates to the Smallpox Response Plan and Guidelines. Updates on infection control, in-hospital isolation recommendations, post-event vaccination protocols, and outbreak response strategies are under way and will be posted on the CDC website.

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