Smallpox (patient information)

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 * Assistant Editor(s)-in-Chief: Samuel A. Hom

Overview
Smallpox is a serious, contagious, and sometimes fatal infectious disease characterized by a raised pink rash.

What are the symptoms of Smallpox?

 * Delirium
 * Diarrhea
 * Excessive bleeding
 * Fatigue
 * Severe Headaches
 * High Fever (102-104 Fahrenheit)
 * Malaise
 * Aches
 * Raised pink rash -- turns into sores that become crusty on day 8 or 9 (develop into pustules)
 * Vomiting

What causes Smallpox?
Smallpox is caused by the variola virus that emerged in human populations thousands of years ago. Except for laboratory stockpiles, the variola virus has been eliminated.

Who is at highest risk?
Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing. Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains. Humans are the only natural hosts of variola. Smallpox is not known to be transmitted by insects or animals. A person with smallpox is sometimes contagious with onset of fever (prodrome phase), but the person becomes most contagious with the onset of rash. At this stage the infected person is usually very sick and not able to move around in the community. The infected person is contagious until the last smallpox scab falls off.

Diagnosis
If the patient has a fever, malaise, head and body aches, and sometimes vomiting. The fever is usually high, in the range of 101 to 104 degrees Fahrenheit. Around 4 days after exposure a rash will emerge, first as small red dots on the mouth and tongue.

When to seek urgent medical care?
If you think you may have been exposed to smallpox, contact your health care provider immediately. Because smallpox has been wiped out this would be very unlikely, unless you have worked with the virus in a laboratory or there has been an act of bioterrorism.

Treatment options
There is no proven treatment for smallpox. Scientists are currently researching new treatments. Patients with smallpox may be helped by intravenous fluids, medicine to control fever or pain, and antibiotics for any secondary bacterial infections that may occur.

Diseases with similar symptoms

 * Influenza
 * Chickenpox

Where to find medical care for Smallpox?
Directions to Hospitals Treating Smallpox

Prevention of Smallpox
One of the best ways to prevent smallpox is through vaccination. If given to a person before exposure to smallpox, the vaccine can completely protect them. Vaccination within 3 days after exposure will prevent or greatly lessen the severity of smallpox in most people. Vaccination 4 to 7 days after exposure likely offers some protection from disease or may decrease the severity of disease. Vaccination will not protect smallpox patients who already have a rash. Currently, the smallpox vaccine is not widely available to the general public. However, there is enough smallpox vaccine to vaccinate every person in the United States in the event of a smallpox emergency.

What to expect (Outlook/Prognosis)?

 * 30% exposed may become infected
 * 30% of those infected may die
 * Arthritis and bone infections
 * Brain swelling (encephalitis)
 * Death
 * Eye infections
 * Pneumonia
 * Scarring
 * Severe bleeding
 * Skin infections (from the sores)