Smallpox education now limited to staff

Patient education is in developmental stages

Although the United States is gearing up for the possible use of the smallpox virus by terrorists, educating the general public about smallpox is not a high priority at most health care facilities because vaccines are not available to this segment of the population yet. The current focus is on staff education with educational campaigns for consumers in the contemplation stage.

At Southwest Washington Medical Center in Vancouver, the emergency department recently completed a "skills day" for staff providing them with handouts and charts on the smallpox vaccine, vaccine side effects, and smallpox recognition. "We are not doing anything for patients at this point as recommendations aren’t really for them to be vaccinated. It is more just awareness," says Mary Paeth, MBA, RD, patient/family education coordinator at the medical center.

Plans are being set in place for a full-scale campaign to educate internal staff at Children’s Hospital and Regional Medical Center in Settle. A community education plan will follow but has yet to be defined.

Mercy Medical Center-Clinton (IA) is following the guidelines established by the Atlanta-based Centers for Disease Control and Prevention (CDC) and the Iowa Department of Public Health. A nationwide smallpox response plan to quickly vaccinate people to contain a smallpox outbreak has been initiated by the U.S. government.

"We are currently working with the state to set up regional disaster/bioterrorism plans," says Kelly Sterk, RN, BSN, an infection control practitioner at the medical facility.

Pressing educational needs in other areas also can make consumer education about smallpox and the vaccine a low priority. At Phoenix Children’s Hospital, the current focus is an educational campaign to prevent respiratory syncytial virus (RSV), an active infection that is a dangerous threat to premature babies and sick children. During RSV season, the hospital is in full alert and no one with RSV is allowed into the health care facility. Children younger than 12 are not allowed into Phoenix Children’s Hospital until RSV season is over.

"There is no smallpox in this country at this time and there are many other sources for smallpox information. I understand we will educate the public about it in the future, but it is not our immediate priority," says Fran London, MS, RN, a health education specialist at The Emily Center at Phoenix Children’s Hospital.

The information sheets available from the CDC are a great resource for education, says Sterk. She has used them to educate herself as well as staff about smallpox and the vaccine to prevent the virus.

The CDC information sheets include the facts that patients need to make an informed decision about the vaccine. These facts might include:

• People who should not get the vaccine

Those who should not receive the vaccine include women who are pregnant or breast-feeding; a child younger than 12 months of age; people who have or have had skin conditions; and those with weakened immune systems such as transplant patients.

• Possible side effects from the vaccine

Mild reactions to the vaccine include a sore arm, fever, and body aches. In the past, between one and two people out of every 1 million vaccinated died. Careful screening of vaccine recipients to identify those who are at increased risk is essential.

• Getting the vaccine after exposure to the virus

Smallpox can be prevented or a case significantly modified if a person who has been exposed is vaccinated within three days of exposure. Smallpox usually is spread from contact with infected persons.

The symptoms of smallpox are high fever, head and body aches, and sometimes vomiting in the early stages. Later, a rash appears that progresses to pus-filled blisters that crust, scab, and fall off after about three weeks.

After exposure, it takes between seven and 17 days for symptoms of smallpox to appear. A person is not contagious during the incubation period. People can be contagious at the onset of fever but are most contagious when the rash appears.

• Death rate for smallpox

Death occurs in up to 30% of smallpox cases. Although the majority survives, many smallpox survivors have permanent scars and some are left blind.

Uncovering resources on smallpox to use for staff and consumer education is helpful, says Sterk. "This is still very new to all of us and we are trying to get information together and share it in some concessive, organized manner," she says.


For additional information about educating the general public about smallpox, contact:

  • Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333. Telephone: (404) 639-3311. Web site:
  • Kelly Sterk, RN, BSN, Infection Control Practitioner, Mercy Medical Center-Clinton, 1410 N. Fourth St., Clinton, Iowa 52732. Telephone: (563) 244-5622. E-mail: