Smallpox

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Why is smallpox a concern?
For centuries, smallpox was a worldwide cause of death, killing about 30% of people infected.2 However, after a decade-long vaccination effort, the last natural case of smallpox occurred in 1977. In 1980, the World Health Organization (WHO) declared the disease fully eradicated. The smallpox (vaccinia) vaccine poses a slight risk of serious reactions, including death. Therefore, once smallpox was nearly eliminated, routine vaccinia vaccination was ended in the United States in 1972.
Live variola virus is known to exist in laboratories at the U.S. Centers for Disease Control and Prevention (CDC) and at the Institute of Virus Preparations in Moscow and may also exist in poorly secured laboratories elsewhere. Since the recent increase in global terrorist activities, there has been renewed concern that smallpox could be used as a bioterrorist weapon.
What are typical symptoms of smallpox?
The first symptoms develop about 12 days after smallpox exposure; high fever, fatigue, and severe headache and backache are sometimes accompanied by severe stomach pain and vomiting or delirium. After 2 to 3 days of severe illness, a flat, red rash first appears in the throat, mouth, face, or forearms, then spreads to the rest of the body. Over the next 2 to 3 weeks, the flat, red spots become firm, dome-shaped, and pus-filled, then scab over. Scabs fall off 3 to 4 weeks after rash onset, leaving pitted scars.
A severe chickenpox rash can be mistaken for a smallpox rash. These illnesses are caused by two different viruses.
How is smallpox spread?
The variola virus spreads from person to person, usually transported through the air in tiny saliva droplets by coughing, sneezing, or breathing. An infected person's urine and eye secretions also carry the virus, as can personal items and linens.
The variola virus is most communicable during the first week of the rash. As scabs form, the virus is less contagious, though it c...