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Are you prepared? — Bioterrorism Attacks Involving Pediatric Patients December 7, 2018

Posted by Andy Jagoda, MD in : What's Your Diagnosis , trackback

Your next patient is a 2-year-old girl with a 3-day history of high fevers, body aches, fatigue, and a rash. Her vital signs are; temperature, 40.5°C (104.9°F); heart rate, 105 beats/min; and blood pressure, 100/60 mm Hg. The physical examination reveals pustular vesicles with central umbilication in the same stage of development on her face, torso, and extremities. The mother says the lesions started in the girl’s mouth 3 to 4 days ago. The patient’s past medical history is notable only for severe eczema.

What features of this suggests a potential bioterrorism threat? Does the patient require isolation? What public health notifications are needed?

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Comments»

1. Ryan - December 7, 2018

Smallpox would be a concern given the appearance and distribution of the lesions. but differential would also include chickenpox. isolation would be needed for either until PCR results returned. Notifying state public health officials for both infections are needed. I would assume state officials would notify CDC once confirmatory testing finalized.

2. Debe - December 7, 2018

Smallpox; pts become contagious once the first sores appear in mouth/throat. Virus can spread through bedding or clothing. It is recommended that pts with smallpox stay at home away from people up to 18 days so yes isolate

3. Eva Soos-Kapusy - December 7, 2018

Pustular umbilicals lesions, same stage, preceded by oral lesions, high fever. Suggestive of Smallpox, eradicated, last case in 1977, no naturally occurring case since then.
Patients need to be isolated.
Immediately to be contacted the local public health than state and federal public health.CDC.

4. Ahmed Morsy - December 7, 2018

May it is small pox , should be isolated ( contat & airborne precautions & droplets) . Public health must be notified

5. William - December 7, 2018

Smallpox- definite isolation and health department/CDC notification

6. William - December 8, 2018

Smallpox; isolate patient with negative pressure room; notify health department and CDC

7. Suman - December 9, 2018

Pustules in the same stage

All comments are held for approval.



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Last Modified: 12-12-2018
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