Smallpox FAQ:

Frequently Asked Questions about Smallpox

• What should I know about smallpox?
• What are the symptoms of smallpox?
• How is small pox spread?
• Is vaccination recommended?
• What's in the smallpox vaccine?
• Will vaccine help if I'm exposed to smallpox?
• Are their side effects to vaccination?
• What is the government doing?
• What can patients do who contract smallpox?

What should I know about smallpox?
Smallpox is caused by variola virus.  The incubation period is about 12 days (range: 7 to 17 days) following exposure.

What are the symptoms of smallpox?
Initial symptoms include high fever, fatigue, and head and back aches. A characteristic rash, most prominent on the face, arms, and legs, follows in 2-3 days. The rash starts with flat red lesions that evolve at the same rate. Lesions become pus-filled and begin to crust early in the second week. Scabs develop and then separate and fall off after about 3-4 weeks. The majority of patients with smallpox recover, but death occurs in up to 30% of cases.

How is small pox spread?
Smallpox is spread from one person to another by infected saliva droplets that expose a susceptible person having face-to-face contact with the ill person. Persons with smallpox are most infectious during the first week of illness, because that is when the largest amount of virus is present in saliva. However, some risk of transmission lasts until all scabs have fallen off.

Is vaccination recommended?
According to the CDC, vaccination is not recommended, and the vaccine is not available to health providers or the public. In the absence of a confirmed case of smallpox anywhere in the world, there is no need to be vaccinated against smallpox.

What's in the smallpox vaccine?
Vaccine against smallpox contains another live virus called vaccinia. The vaccine does not contain smallpox virus. The United States currently has an emergency supply of smallpox vaccine. Routine vaccination against smallpox ended in 1972. The level of immunity, if any, among persons who were vaccinated before 1972 is uncertain; therefore, these persons are assumed to be susceptible.

Will vaccine help if I'm exposed to smallpox?
According to the CDC, people exposed to smallpox, the vaccine can lessen the severity of or even prevent illness if given within four days after exposure.

Are their side effects to vaccination?
There can be severe side effects to the smallpox vaccine, which is another reason the CDC does not recommend vaccination. In the photo to the right, you see an example of accidental auto-inoculation of an eyelid with the vaccinia virus.

What is the government doing?
In the event of an outbreak, the CDC has clear guidelines to swiftly provide vaccine to people exposed to this disease. The vaccine is securely stored for use in the case of an outbreak. In addition, Secretary of Health and Human Services Tommy Thompson recently announced plans to accelerate production of a new smallpox vaccine.

What can people do who contract smallpox?
There is no proven treatment for smallpox but research to evaluate new antiviral agents is ongoing. Patients with smallpox can benefit from supportive therapy (intravenous fluids, medicine to control fever or pain, etc.) and antibiotics for any secondary bacterial infections that occur.