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Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on December 31st, 2023.
Smallpox is a serious infectious disease caused by the variola virus. Although it has been eradicated since 1980, it is important to understand its history, symptoms, causes, and prevention methods.
Smallpox is a highly contagious viral disease that once claimed the lives of millions of people worldwide. It is characterized by flu-like symptoms and a distinctive rash that spreads across the body. The World Health Organization (WHO) declared smallpox eradicated in 1980, thanks to global vaccination efforts.
Smallpox symptoms typically appear 10-12 days after exposure to the virus. Early symptoms include:
High fever
Fatigue
Headache
Body aches
Vomiting
About 2 days after the initial symptoms, a flat red rash develops, which quickly turns into raised bumps filled with clear liquid. These bumps eventually become pus-filled blisters that crust over and form scabs, which fall off over the next 3-4 weeks, often leaving permanent scars.
Smallpox is caused by the variola virus, which has two main forms: variola major and variola minor. Variola major is the more dangerous form, with a mortality rate of about 30%, while variola minor is less deadly, with a mortality rate of around 1%.
Smallpox is spread from person to person through close contact, such as:
Breathing in the virus during face-to-face contact with an infected person
Handling the clothes or bedding of an infected person
Coming into contact with an infected person's body fluids
The best way to prevent smallpox is through vaccination. The smallpox vaccine, developed by English doctor Edward Jenner in 1796, uses the vaccinia virus to help the body build immunity against the variola virus. Routine smallpox vaccinations stopped in most countries by 1972, but governments maintain emergency stockpiles in case of an outbreak.
If a smallpox case is diagnosed, antiviral drugs such as tecovirimat (TPOXX) and brincidofovir (Tembexa) can be used to treat the disease. Supportive care, such as managing fever and preventing secondary infections, is also crucial.
Although smallpox has been eradicated, it is essential to maintain awareness of the disease and its potential as a public health threat. Factors such as weakened immune systems and uncertain long-term vaccine effectiveness could impact the severity of a potential outbreak. The eradication of smallpox is an important example of the power of an effective vaccine on a disease with clear symptoms and no animal reservoir, augmented by unprecedented global cooperation to facilitate mass immunization. By understanding the history, symptoms, causes, and prevention methods of smallpox, we can be better prepared to respond to any future threats.
For more information on smallpox, visit the Centers for Disease Control and Prevention (CDC) website.
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