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Interim Guidelines for Smallpox Response and Management in Scotland in the Post-Eradication era

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Interim Guidelines for Smallpox Response and Management in Scotland in the Post-Eradication era

Appendix 3: summary of Alert Levels and action required

Alert levels proceed in a stepwise fashion, except that level 0 may proceed directly to levels 1 or 2.

Alert Level

Circumstances

Vaccination strategy

Other Actions

0

Smallpox eradicated - no credible threat of a release

  • Vaccinate and maintain immunity of:

  • Small number of laboratory personnel in designated Scottish laboratory and UK Reference laboratories

  • Regional Smallpox Diagnosis and Response Teams

  • Network of ID physicians to act as Smallpox Diagnostic Experts

  • Identify essential personnel who should be vaccinated at Alert Levels 1 and 2

  • Establish RSDRGs

  • Establish and train RSDRTs and SDEs

  • Distribute Diagnostic Algorithm to all clinicians

  • Identify smallpox care centres

  • Identify smallpox vaccination centres

1

Heightened threat

  • Vaccinate:

    • Larger number of laboratory personnel

    • Additional Smallpox Diagnosis and Response Teams

    • Additional Smallpox Diagnostic experts

    • Identified essential personnel

  • Review list of essential personnel who should be vaccinated at Alert Level 2

  • Increase number of RSDRTs and SDEs

  • Inform all clinicians of the heightened threat and remind them of the features of smallpox and reporting systems

  • Prepare smallpox care centres

  • Prepare smallpox vaccination centres

2

First case confirmed in UK

  • Vaccinate:

    • Contacts of cases

    • Larger number of laboratory personnel

    • Additional Smallpox Diagnosis and Response Teams

    • Additional Smallpox Diagnostic experts

    • Identified healthcare and emergency

    • Identified key workers

  • Initiate Scottish and Regional Smallpox Outbreak Control Centres

  • Activate smallpox care centres

  • Activate smallpox vaccination centres

  • Begin contact identification, tracing and monitoring

  • Initiate enhanced surveillance

3

Outbreak occurring in the UK

  • Continue ring vaccination of contacts of cases

  • Review triggers for implementing wider vaccination

  • Continue contact identification, tracing and monitoring

  • Continue enhanced surveillance

  • Review capacity and need for additional smallpox care and vaccination centres

4

Large or multiple outbreak not controlled by ring vaccination

  • Consider mass vaccination

  • Activate additional smallpox care and vaccination centres as required

5

Outbreak controlled

- no further cases occurring

  • Maintain immunity of healthcare and emergency personnel and other key workers

  • Maintain increased number of RSDRTs and SDEs

  • Keep smallpox care and vaccination centres prepared in case they are required again

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Page updated: Friday, June 24, 2005