The response to the diagnosis of smallpox (variola) in South Carolina--what every practitioner should know.

The probability of a recurrence of smallpox from intentional release is high enough that all clinicians should be familiar with the clinical presentation and immediate response to a possible case. Our most powerful tool is vaccination, which is essentially 100% protective, provides protection even after exposure and is easy to give, but which requires careful screening of persons to be vaccinated because of the possibility of life-threatening complications. Front-line practitioners will have a vital role in initial detection, reporting and isolation of potential cases.