Disease Control Center Won't Test Woman With Rash
Toxicologists say risk low, buy why take chance?

October 25, 2002
By CHARLES RUNNELLS, crunnells@news-press.com

Doctors still don't know what's wrong with a sick North Fort Myers woman taken to Cape Coral Hospital on Tuesday, and they're urging state and federal health experts to test her and officially rule out smallpox.

So far, the state health department and the U.S. Centers for Disease Control have said no.

They haven't discounted smallpox completely, but they say it's close enough.

"This is a low risk for being a smallpox case," said Dr. Bill Tynan, deputy state epidemiologist for the Florida Department of Health. "It was pretty clear to us Tuesday that this just wasn't smallpox.

"The public was safe."

Ann Hawkins, 59, of North Fort Myers arrived at the Cape emergency room Tuesday afternoon in critical condition. She had a fever and a spray of crusted sores on her face, arms and upper trunk.

Fear of smallpox led Lee Memorial Health System to close the emergency rooms there and at Lee Memorial Hospital on Tuesday for about four hours. They worried paramedics who dropped Hawkins off at the Cape Coral emergency room had then gone to Lee Memorial.

Later Tuesday night, CDC and state smallpox experts looked at e-mailed digital photos of Hawkins' symptoms, Tynan said. That's when they decided not to send a CDC team to take scrapings from her sores.

"It just wasn't worth it," Tynan said. "Believe me, if we thought there was anything above a zero percent chance, we would have sent a team."

Dr. Judith Hartner, director of Lee County's health department, said Hawkins' improving condition supports their belief that it wasn't smallpox.

"As each day passes, and her condition changes, the chances are less and less likely," Hartner said.

Hawkins was listed in good condition Thursday at Cape Coral Hospital. She was being kept in isolation in the intensive care unit.

Still, the toxicologists treating Hawkins don't understand why health officials haven't tested Hawkins and ruled out smallpox once and for all.

"It's a one-in-a-million shot," said Dr. Tucker Greene. "But I can't understand why they would risk it."

Dr. Timothy Dougherty said he'd feel better if a CDC expert had looked at Hawkins in person, rather than from Atlanta.

Still, Hawkins is recuperating and that points to her sickness being something other than smallpox, Dougherty said. The need to test her now is less than it was Tuesday, when Dougherty feared Hawkins could be the first of an outbreak.

"But the CDC are the experts in this, not myself," Dougherty said. "That's why they make the ultimate call."

Greene and Tynan say the possible causes for Hawkins' symptoms include a reaction to medication, shingles, chicken pox and a staph infection. Smallpox is at the very bottom of the list.

The CDC has the only civilian lab in the country for testing smallpox, Greene said.

Greene wouldn't talk specifically about Hawkins' treatment - citing patient confidentiality - but he said such symptoms would be treated with antibiotics, bed rest and possibly steroids.

Doctors are awaiting several blood tests to determine what's making Hawkins sick. Those will take a week or two to come back, Dougherty said.

Llelwyn Grant, spokesman for the CDC, said the agency generally awaits results of local investigations before it gets involved.

"It's really not uncommon to have scares like this," Grant said. "So we let them look at things first."

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