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Clinical experience, infection control practices and diagnostic algorithms for poxvirus infections - an Emerging Infections Network survey

Christine M Hughes1*, Edith R Lederman12, Mary G Reynolds1, Inger K Damon1, R Ryan Lash1, Susan E Beekmann3, Philip M Polgreen3 and the Infectious Diseases Society of America's Emerging Infections Network

Author Affiliations

1 Centers for Disease Control and Prevention, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Division of Viral and Rickettsial Diseases, 1600 Clifton Road, NE Atlanta, Georgia, 30333, USA

2 Centers for Disease Control and Prevention, Epidemic Intelligence Service, Office of Workforce and Career Development, 1600 Clifton Road, NE Atlanta, Georgia, 30333, USA

3 University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa, 52242, USA

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BMC Research Notes 2010, 3:46  doi:10.1186/1756-0500-3-46

Published: 25 February 2010



In order to determine how best to tailor outreach messages about poxvirus diagnosis and infection control for health practitioners, we surveyed infectious disease physicians in the Infectious Diseases Society of America's Emerging Infections Network.


Surveys consisting of two unknown case scenarios designed to raise suspicion for monkeypox and orf were distributed to the 1,080 members of the EIN. The surveys contained questions pertaining to which diagnostic tests, points of contact, and transmission precautions they would likely utilize during patient evaluation. Basic response rates and frequencies of responses were calculated. Comparisons of the survey responses were made using the chi-square test. Of the 212 members who responded (20% response rate), significantly more respondents indicated that they would request diagnostic testing in the context of the monkeypox case scenario as compared to the orf case scenario. A significantly higher number of respondents indicated they would institute droplet or airborne precautions for the monkeypox case as opposed to the orf case scenario.


This survey provided an opportunity for public health practitioners to gain insight into physician approaches to evaluation, diagnosis and reporting of suspected poxvirus-associated infections. This survey identified key areas in which public health practitioners can better serve physicians by focusing on education. As a result we were able to identify potential knowledge gaps and deficits in the availability of useful resources to facilitate accurate case identification and management.