Knowledge about the initial presentation of smallpox among emergency physicians in Washington, DC.
OBJECTIVE
To assess the current knowledge of full-time emergency physicians in Washington, DC, regarding the initial diagnosis of smallpox and the initial care of the patient with smallpox.


METHODS
A written true/false test was prepared based on information accessed from the current Centers for Disease Control and Prevention (CDC) Web site on smallpox. The 20-question test was administered to full-time emergency physicians practicing emergency medicine in all seven adult civilian hospitals in Washington, DC.


RESULTS
The overall response rate was 81% (52 of the 64 eligible full-time emergency physicians). The average score was 59% correct. The facts most likely to be known were 1) that the symptoms of smallpox begin with a two- to four-day prodrome of fever and myalgia (before the appearance of any rash), 2) that no antiviral treatment is of more proven value than vaccination of contacts, and 3) that a person with smallpox may be contagious before any rash appears (average, 90% correct). The facts least likely to be known were 1) that when dealing with a known case of smallpox, fit-tested N95 masks are not needed by treating personnel if they have been vaccinated; 2) that the rash of smallpox begins with 24-48 hours of flat, erythematous macules (not papules or vesicles); and 3) that very typically the rash of smallpox begins in the mouth (average, 22% correct).


CONCLUSIONS
Some facts from the current CDC Web site on smallpox are known by a large majority of full-time emergency physicians in Washington, DC, whereas questions based on other facts were answered incorrectly by a majority of the physicians tested.
Freed
Howard A
HA
Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA. chipfreed@aol.com
Milzman
David
D
Freed
Max
M
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D004219:District of Columbia; D004635:Emergency Medicine / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D012899:Smallpox / Q000175:diagnosis* / Q000628:therapy