What is smallpox? Smallpox is a serious infectious disease that no longer occurs anywhere in the world. It is caused by a virus called variola. The last naturally acquired case in the world occurred in 1977. Since smallpox has been eliminated from all countries, a single case would be considered a national public health emergency.

How is smallpox spread? Smallpox is most often spread by close contact with the respiratory discharges of a person with the disease or contact with objects contaminated by an ill individual.

What are the symptoms of smallpox? The symptoms of smallpox include chills, high fever, headache, joint and muscle pains (especially backache), nausea and vomiting. Lesions in the mouth and throat that appear early in the illness ulcerate and release large amounts of virus into the saliva. The classic smallpox skin rash appears several days after the other symptoms. The skin rash becomes raised and then pus-filled. The pustules rupture, then dry and crust over approximately on the eighth or ninth day. The rash with lesions is most dense on the face, arms and legs and cause severe itching and burning.

How soon after exposure do symptoms appear? The symptoms of smallpox appear about 12 days after the exposure, with a range of of 7-17 days.

How long can an infected person spread the virus? Infected persons spread the disease until all of the scabs have fallen off the skin. This usually happens about two weeks after the rash began. Virus is also present in the scabs that separate from the skin.

What is the treatment for smallpox? At this time, no medications have proven effective for treating smallpox. Patients with this disease would be given supportive therapy including treatment to keep the patient as comfortable as possible by keeping the skin clean, trying to control the itching, relieving the pain and other symptoms as much as possible. Antibiotics would be used only if bacterial infection developed as a complication.

How can smallpox be prevented? Smallpox has been eradicated because the vaccine was effective and used widely to prevent cases. Isolation of persons with the disease, appropriate disinfection of articles that came in contact with patients and vaccination of contacts helped prevent the spread to others.


As a result of the successful eradication program smallpox vaccine was removed from the commercial market in 1983, and is no longer a licensed product in the United States. The United States Public Health Service maintains an emergency stockpile of approximately 15 million doses. At the present time, smallpox vaccine is supplied only to certain laboratory workers who are at risk of infection with smallpox-like viruses because of their occupation. The U.S. Food and Drug Administration does not allow the release of smallpox vaccine to any other person for any reason.

Prepared by the Virginia Department of Health, September 2001


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