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Pediatric Terrorism and Disaster Preparedness

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

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Figure 4.8a. Febrile Rash Illness Algorithm for Evaluating Patients Suspected of Having Smallpox

Chart depicts algorithm. At the top of the chart, a large blue box is labeled 'Patient with Acute, Generalized Vesicular or Pustular Rash Illness'.

Figure 4.8b. Classification of Risk—Febrile Rash Illness Algorithm

High Risk (All three major criteria)

  • Febrile prodrome (1.4 days pre-rash, >101° F), and
  • Classic smallpox lesions, and
  • Same stage of development.

Moderate Risk

  • Febrile prodrome, and
  • 1 other major or >4 minor criteria.

Low Risk

  • No fever or
  • Febrile prodrome and <4 minor criteria.

Minor Criteria

  • Greatest concentration of lesions on face and distal extremities.
  • Lesions first appeared on oral mucosa/palate, face, forearms.
  • Patient appears toxic or moribund.
  • Lesions evolve slowly from macules to papules to pustules over days.
  • Lesions on palms and soles.

Source: Centers for Disease Control and Prevention. Emergency Preparedness and Response. Poster: Evaluating patients for smallpox.

Note: Full protocol available at

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