Smallpox FAQ

Question: What is Smallpox?

Answer: Smallpox is a severe viral infection that was eliminated from the world in 1980. However, because some governments have preserved the smallpox virus, there is a remote risk that smallpox could be used as a weapon. Smallpox vaccinations for the general public were discontinued in the United States in 1972 because smallpox no longer occurred, and the vaccine was associated with a significant risk of severe side effects.

The U.S. Centers for Disease Control and Prevention (CDC) currently has a stockpile of approximately 100 million doses of smallpox vaccine for use in case of a smallpox outbreak. In the absence of a smallpox outbreak or a bioterrorism attack using smallpox, this smallpox vaccine is not available or recommended for public use. As a part of the federal bioterrorism response program, the U.S. government has ordered the production of another 100 million doses of new vaccine in 2002. Experts are currently reviewing smallpox vaccine recommendations for health care workers and other personnel who would likely come in contact with smallpox cases before they were diagnosed.

Question: What are the symptoms?

Answer: It takes approximately 12 days (the range is seven to seventeen days) after exposure to the smallpox virus for a person to begin having symptoms. Initial symptoms include high fever (>101¡ F), fatigue, headache and backache.One to four days after the first symptoms appear, the person develops a rash that is most prominent on the face, legs and arms. The rash starts as flat, red lesions, and over the next two days, these lesions fill with pus. The lesions begin to form a crust early in the second week of illness, then form scabs which fall off after about three to four weeks. The majority of persons with smallpox recover, but death occurs in up to 30 percent of cases.

Question: How is it spread?

Answer: Persons may get exposed to smallpox by coming into contact with droplets of saliva that are released when an infected person talks, coughs or sneezes. Direct contact with materials contaminated with the virus is another way that persons can get infected.

Persons with smallpox are most contagious during the first week of illness; however, there is some risk of transmission until all scabs have fallen off.

Question: How is smallpox diagnosed and what is the treatment?

Answer:There is no proven treatment for smallpox, but research to evaluate new treatments is ongoing. Patients with smallpox can benefit from supportive therapy, such as intravenous fluids, medicine to control fever or pain, etc. Antibiotics can be given for any secondary bacterial infections. In persons exposed to smallpox, vaccine given within four days of exposure can lessen the severity of illness or possibly prevent illness altogether. Vaccine against smallpox contains a live virus called vaccinia; it does not contain the smallpox virus.

Question: Can I be vaccinated for smallpox?

Answer: Smallpox vaccine is controlled by CDC and not available to any health care practice for administration to the general public. Smallpox vaccine will be made available by the CDC to any community to protect persons who are thought to be at-risk for smallpox infection in the unlikely event a smallpox case is diagnosed.

Question: Am I protected against smallpox if I was previously vaccinated?

Answer: Most people who were immunized against smallpox before 1972 are no longer protected. Although some persons who were vaccinated multiple times may have some protection against infection, this is not known with certainty, so therefore, all persons in the U.S. are considered susceptible to smallpox.

Question: What is Public Health doing about the possibility of a smallpox outbreak?

Answer: The Kitsap County Health District is actively working with local health care providers, hospitals, the Washington State Department of Health, the CDC, and others to prepare for large outbreaks and "biological disasters" of all types, including smallpox and other diseases resulting from bioterrorism. If a possible smallpox case is reported to the Health District, an immediate and intensive investigation will result. If a smallpox case is likely or confirmed, vaccine will be requested from the CDC to protect persons who may have been exposed.