I hear you Tim but I have a concern and would appreciate your opinion
about this. it is my understanding from what I've read that patients in
the prodromal period, which can last 2-4 days and precedes appearance of
a rash, can sometimes be infectious. we do forensic cases here. I can
envision an individual who thinks he has the flu heading off to the
local Eckerd's for over the coutner medication and is killed in a fatal
car wreck. He ends up on my autopsy table as an MVA victim.
I don't believe this scenario is outside the realm of possibilities.

not wishing to cause anyone anxiety by bringing this up. I'm being told
that mortuary and autopsy personnel are not among those to be
vaccinated, at least initially, here. This may be based upon the belief
that the Feds will assume responsibility in the event of a smallpox
outbreak. I wonder if anyone has considered the scenario I've mentioned





Vinnie Della Speranza
Manager for Anatomic Pathology Services
Medical University of South Carolina
165 Ashley Avenue  Suite 309
Charleston, SC 29425
Ph: 843-792-6353
fax: 843-792-8974

>>> "Morken, Tim"  01/10/03 08:31AM >>>
Jude, and everyone else for that matter, PLEASE go to this website. It
has a
lot of info, including lab specimen collection. And PLEASE DO NOT EVEN
THINK
OF DOING FROZEN SECTIONS ON SMALLPOX!!! Frozens, or even an autopsy
would
have to be done in an air-isolatin room - which you most likely do not
have.
You would also need to wear isolation suits to do frozens. Even
specimen
collection is done in isolation with extreme precautions.

On this website look for "Laboratory Testing", then go to Specimen
Collection Guidelines, Guide-D, and also read the entire "Smallpox
Response
Plan & Guidelines"

http://www.bt.cdc.gov/agent/smallpox/index.asp 


Tim Morken EMT(MSA), HTL(ASCP)
Centers for Disease Control and Prevention
Infectious Disease Pathology
MS-G32 
1600 Clifton Road
Atlanta, GA 30333

PH 404-639-3964
FAX 404-639-3043
email tim9@cdc.gov 




-----Original Message-----
From: Carpenter, Judith A. [mailto:Jude.Carpenter@vtmednet.org] 
Sent: Friday, January 10, 2003 7:29 AM
To: 'NSH'
Subject: Smallpox protocols


Does anyone have an established or proposed protocol for how
they will deal with tissues from a "suspicious case" in which the
clinician might suspect smallpox and who at their facility will be
vaccinated up front ?
Our facility is working on a Bioterrorism matrix determining who needs
up
front
vaccinations should a smallpox threat present itself anywhere in
the world including the USA (our Level one).  We will be given limited
vaccine initially.
The plan goes from Level one ("Convincing Threat" up to Level six where
we
have multiple
cases at our facility.
We must determine who would get the limited number of vaccinations at
Level
one
(once we go beyond that the state will institute their plan).
We have chosen autopsy personnel and a few individuals in the Surgical
Dissection area
who might do frozen sections on suspicious cases.
Of course anytime a case is confirmed small pox we will cease to do
frozens
on any
suspicious cases and will not autopsy deceased small pox victims.
I was asked to throw this question out to you folks to see if anyone
else
has a protocol
we may learn from.
Appreciate your help and Happy Friday-
Jude 
Jude Carpenter, BS, HTL(ASCP)
Chief Technologist
FAHC Histopathology
111 Colchester Ave.
Burlington, VT  05401
(802)847-5116
FAX(802)847-3509
jude.carpenter@vtmednet.org