Smallpox continues to be a major national health concern as it poses the most serious bioterrorist threat to the US population at this time. Due to similarities in clinical presentation, smallpox may easily be confused with varicella (chickenpox) in young children. Management of a large-scale outbreak of smallpox in young children would require an intensive health care response. In addition, the current debate concerning potential revisions to the Centers for Disease Control and Prevention (CDC) interim guidelines for vaccination against smallpox has significant health implications for high-risk children and infants. As such, the diagnosis, management, and containment of smallpox in infants and children deserve special consideration.
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