SMALLPOX

Smallpox was once a worldwide disease. By 1980, it was eliminated as a disease following worldwide vaccination programs so vaccination programs were stopped. Now there is concern that it can be used as a biological weapon by terrorists. The threat of a smallpox outbreak is of concern because the virus can be spread from person to person. It is difficult to identify right away since the first symptoms are very similar to many viral illnesses. Scientists are, however, developing and testing antiviral drugs that may be used to treat smallpox. In addition, drug companies have made new supplies of the smallpox vaccine.

Smallpox is a contagious and sometimes fatal disease. It is usually spread by direct face-to-face contact with infected persons. Coming in contact with infected body fluids or contaminated clothing or bedding can also spread it. Rarely, smallpox may be spread by air in enclosed places like buildings, buses, and trains. The smallpox virus is very fragile and can only live in the air for 24 hours or less.

Symptoms of smallpox begin 7 to 17 days after exposure, the average being 12 to 14 days. Some of the first symptoms are high fever, tired feeling, head, and body aches. In a few days, a flat, red rash appears, first on the face and forearms, then spreading to the trunk and legs. The spots become filled with fluid and pus, breaking open and then forming crusty scabs. The scabs fall off after about 3 weeks, leaving pitted scars. A person is infectious from the time of the fever until the last scab falls off. People who survive a smallpox illness, usually have severe scars and sometimes blindness.

There is no current treatment for smallpox. Antibiotics and other forms of therapy may be used to prevent or treat complications, but will have no effect on the smallpox virus itself. Persons with smallpox need to be isolated to prevent spreading it to others.

There is a vaccine available that protects people from smallpox. It is recommended that people in the military and laboratory workers who handle cultures or animals infected with vaccinia or related viruses receive the vaccine. Public health, hospital, and other personnel, 18 to 65 years of age, who may have to respond to a smallpox outbreak, should be vaccinated also. At this time there is no recommendation to vaccinate the public. Emergency vaccination is recommended for anyone directly exposed to smallpox, or anyone at risk of exposure to the smallpox virus.

Most people who receive the smallpox vaccine before exposure are usually protected from smallpox. Anyone who gets the vaccine within 3 days of being exposed to smallpox will not usually get smallpox, or if they do, it will be mild. Even getting the vaccine within 7 days after exposure can still make the illness less severe.

After being vaccinated, a person is protected from getting smallpox for 3 to 5 years, and protected from severe illness and death for 10 years or more. After a second vaccination, protection lasts for an even longer period of time.

There are certain situations when people should not be vaccinated. They include individuals who have ever been diagnosed with eczema or atopic dermatitis, other skin conditions, conditions or treatments causing immunodeficiency or immunosuppression, pregnant or breastfeeding women, or individuals with known heart disease or having 3 or more risk factors for heart disease. These restrictions may not apply in case of an emergency. People who need to be vaccinated should check with a healthcare provider before getting the vaccination.

National, state, and local agencies have emergency response plans in place for dealing with possible bioterrorist attacks. For more information, contact the United States Department of Homeland Security at 1-800-BE-READY or the Centers for Disease Control and Prevention at (888) 246-2675 or the World Health Organization. Their website addresses are www.ready.gov, www.cdc.gov, and www.who.int.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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