Acute Communicable Disease Control

County of Los Angeles
Department of Public Health
Acute Communicable Disease Control
313 N. Figueroa Street, #212
Los Angeles, CA 90012
Phone: (213) 240-7941
Fax: (213) 482-4856
Email:acdc2@ph.lacounty.gov

Have questions about things like where to go for vaccinations or other health care services?

Call 2-1-1.

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Smallpox

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NOTE TO ALL HEALTHCARE PROFESSIONALS:

If you suspect that a patient is infected with Smallpox, immediately call Acute Communicable Disease Control to assist with diagnosis and implementation of infection control.

(213) 240-7941 (7:30AM-5:00PM, Mon-Fri)
(213) 974-1234 (After Hours, Emergency Operator)

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Smallpox is a serious, contagious, and sometimes fatal infectious disease caused by the variola virus (an orthopoxvirus). There is no specific treatment for smallpox disease, and the only prevention is vaccination. The smallpox vaccine contains the “live” vaccinia virus—not dead virus like many other vaccines. The name smallpox is derived from the Latin word for “spotted” and refers to the raised bumps that appear on the face and body of an infected person.

There are two clinical forms of smallpox. Variola major is the severe and most common form of smallpox, with a more extensive rash and higher fever. There are four types of variola major smallpox: ordinary (the most frequent type, accounting for 90% or more of cases); modified (mild and occurring in previously vaccinated persons); flat; and hemorrhagic (both rare and very severe). Historically, variola major has an overall fatality rate of about 30%; however, flat and hemorrhagic smallpox usually are fatal. Variola minor is a less common presentation of smallpox, and a much less severe disease, with death rates historically of 1% or less.

Smallpox outbreaks have occurred from time to time for thousands of years, but the disease is now eradicated after a successful worldwide vaccination program. The last case of smallpox in the United States was in 1949. The last naturally occurring case in the world was in Somalia in 1977.

Vaccination against smallpox is no longer recommended for the general public due to erradication of natural disease. In the event of reintroduction of smallpox or any kind of smallpox emergency, vaccination against smallpox will be resumed as appropriate.


News and Updates

• CDC ─ Smallpox

Important Guidelines and Recommendations

• ACDC: A Manual of Departmental Rules, Regulations and Control Procedures (B-73)  
• LAC Report Form Smallpox 
• Smallpox Post-Event Surveillance Form 
• LAC: ACDC's Epidemiologic Case History Forms Web Page
• Bioterrorism Agents: Photos and Information for Clinicians
• Los Angeles County Terrorism Agent Information and Treatment Guidelines for Hospitals and Clinicians 
• JAMA article: Smallpox as a biological weapon (2012)
• Diagnostic Guidelines: Smallpox vs. Chickenpox (LAC DPH 2011) 
• Clinical Pathway: Vesicular or Pustular Rash Illness (2002) 
• CDC: Side Effects of Smallpox Vaccination
• MMWR: Smallpox Vaccination and Adverse Reactions (2/21/2003)
• Center for Infectious Disease Research and Policy (CIDRAP) Website, Smallpox Information

Reporting/Epidemiology Forms

• CDC: Evaluating Patients for Smallpox  Webpage  Poster (11x17)    Poster (8x11 1/2, 2 pages)  

Special Studies

• 2011: Testing Biological Team Response During a Full-Scale Multi-Agency Bioterrorism Exercise on Board a Cargo Ship
• 2006: Suspected Smallpox Case Investigation Training  
• 2004: Mass Smallpox Vaccination Center Exercise
• 2003: L.A. County Smallpox Vaccination Program  
• 2003: Summary of Adverse Events Following Civilian and Military Smallpox Vaccinations 

Press Releases

• Vaccinia Related Illness Reported in Person with Contact with Military Vaccinee (February 27, 2003)
  
• Smallpox Vaccinations Received by Los Angeles County Public Health Staff
  (January 29, 2003)
• Health Department Begins Smallpox Vaccinations for Public Health Staff
  (January 28, 2003)
• Smallpox Vaccine Arrives in Los Angeles County
  (January 22, 2003)
• NEWS ADVISORY: County Health Officials Prepare Plan to Vaccinate Public Health and Medical Response Teams for Smallpox (December 02, 2002)
• SMALLPOX REINSTATED AS REPORTABLE DISEASE
  (May 31, 2001)

For Healthcare Professionals

• Los Angeles County Terrorism Agent Information and Treatment Guidelines for Hospitals and Clinicians 
• Guide to Evaluating Patients with Fevers and Generalized Vesicular/Pustular Rash Illness: What to do if you suspect smallpox. Los Angeles County, The Public’s Health Newsletter (Oct 2006) 
• CDC: Smallpox Information for Clinicians
• CDC: Side Effects of Smallpox Vaccination
• CDC: Evaluating Patients for Smallpox  Webpage  Poster (11x17)    Poster (8x11 1/2, 2 pages)  

For the Public

• CDC: Smallpox Main Page
• CDC: What is smallpox?

Additional Resources

• CDC ─ Smallpox
• L.A. County Immunization Program
• CDPH: Smallpox

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