SPADA

Post-event

• Need to assess what needs for testing will be:

– One scenario: greatest needs in beginning, and

near end of smallpox re-eradication

• May need to test more “low suspicion

samples”

Sensitivity vs specificity

–

Issues Relevant to Implementation

of Smallpox Diagnostics

• Biosafety:

– containment;

– Standard vs. Universal vs. Airborne precautions;

– Vaccination

• Biosecurity

• Reagents

– WHO, CDC, select agent recommendations on use of

Variola virus

DNA

• Centralized/regionalized testing

– Transportation of specimens

• QA/QC, Proficiency testing: implementation

• Communication between clinician/epidemiologists/laboratory

– Clinical history, case patient photos

• Development of a disease confirmatory algorithm

– Screening tests, confirmatory tests: regional vs. centralized

– Presumed positive, Confirmed Positive

– Communication of results, and public health response

– Role of viral isolation by culture