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Smallpox Rash, Blisters, and Other Symptoms

Smallpox gets its name from its most common symptom: small blisters erupting on the face, arms, and body that become pustules (filled with pus).

Symptoms of smallpox include:

  • Flu-like fatigue, headache, body ache, and occasionally vomiting
  • High fever
  • Mouth sores and blisters that spread the virus into the throat
  • A progressive skin rash that follows a predictable pattern:
    • The rash starts with flat red sores that a few days later become raised bumps.
    • The bumps turn into fluid-filled blisters.
    • The blisters become pustules.
    • The pustules crust over, usually in the second week of smallpox.
    • Scabs form over the blisters and then fall off, usually in the third week of the disease, resulting in scars that are often disfiguring.
  • Blindness commonly resulted when blisters formed near the eyes.

Treatment for Smallpox

Smallpox has no known treatment. Using the smallpox vaccine within three to four days of exposure may help reduce the severity of smallpox disease, and possibly help prevent it.

Beyond that, medical care aims to ease symptoms such as fever and body aches, as well as to control any other illnesses that can develop when the immune system has been weakened by smallpox. Antibiotics can be used if a secondary bacterial infection occurs.

Research efforts continue to explore antiviral drugs as possible treatment for smallpox. the antiviral drug cidofovir has shown promise in early studies.

Prevention: The Smallpox Vaccine

The smallpox vaccine uses the cousin virus to variola -- the vaccinia virus -- because it poses fewer health risks. The vaccine stimulates the body's immune system to create antibodies that protect against the variola virus and help prevent smallpox disease.

No data exists proving how long the smallpox vaccine protects against smallpox. Some experts believe the vaccine lasts for up to 5 years, with less protection as the years pass. Since the vaccine has not been proven to provide lifelong protection, anyone vaccinated years ago as a child could theoretically be at risk of future infection by the variola virus. The only people known to be immune for life are those who have had smallpox and survived.

The WHO and its member countries keep an emergency stockpile of the smallpox vaccine. The vaccine is rarely used today, except for those few people at risk of being exposed to the variola virus, such as laboratory researchers working with variola and similar viruses. No countries today give routine smallpox vaccinations to the public.

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