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Smallpox, if used as a weapon, would be a serious threat because: it is spread through the air when an infected person breathes, talks, laughs, or coughs it can also be spread by infected clothing or bed linens it can spread in any climate or season there is no treatment or cure few doctors would know smallpox if they saw it people who survive it are left with ugly scars on their bodies or face, and some become blind 30% or more of people who contract smallpox die Smallpox devastated the American population in the 1700s (see Elizabeth Fenn's book, Pox Americana, for the details). Anyone who knows about it fears it. Once a few cases were reported in the media there would be widespread concern, even pan

What is being done about a possible outbreak Since the last case of smallpox occurred in 1977 in Somalia, scientists have had to rely on research that was done before then, plus their best educated guesses, when trying to plan for an outbreak. Here's what we know, and what is being done:

1. People vaccinated many years ago may not be immune. Vaccination gives immunity to a disease, but not forever; scientists generally agree that full immunity only lasts 3-5 years. After that, it begins to fade. A study published in 1972 showed a death rate of 11% for people vaccinated more than 20 years prior to exposure to smallpox. Scientists do know that if someone is exposed to smallpox, giving the person the vaccine within 4 days reduces the severity of the disease or even prevents him/her from getting it.

Smallpox does not occur in nature. People cannot get smallpox by traveling to a foreign country, nor can they get it from people visiting this country. The only known stocks of the virus exist in high-security labs in Atlanta and Russia.

Vaccine given within 4 days of exposure can prevent the disease or lessen symptoms.

Smallpox is spread from one person to another by infected saliva droplets that expose a susceptible person who has face-to-face contact with the ill person. Persons with smallpox are most infectious after the onset of rash. Vaccine given within 4 days of exposure can prevent the disease or lessen symptoms. The vaccine does not contain smallpox virus. The incubation range for smallpox is 7 to 17 days following exposure. Initial symptoms include high fever, fatigue, and head and back aches. A characteristic rash, most prominent on the face, arms, and legs, follows in 2-3 days. 70% of patients with smallpox recover. Further, to help the media provide accurate information to the public through articles, interviews, or other venues, the Association of State and Territorial Health Officials and ASTHO Affiliated Organizations are making the following experts available to answer questions about smallpox and related public health issues.

A few days later, flat, red spots appear first on your face, hands and forearms, and later on your trunk. Within a day or two, many of these lesions turn into small blisters filled with clear fluid, which then turns into pus. Scabs begin to form eight to nine days later and eventually fall off, leaving deep, pitted scars. The rash is usually most noticeable on the palms of your hands and the soles of your feet. Lesions also develop in the mucous membranes of your nose and mouth and quickly turn into sores that break open, spreading the virus into your saliva.

Indirect contact is less efficient at spreading the virus, but can still occur via fine-particle aerosols or inanimate objects carrying the virus. Spread by contact with inanimate objects (e.g., clothing, towels, linens) would be less common, but possible. Special precautions need to be taken to thoroughly clean all bedding and clothing of smallpox patients with bleach and hot water. Disinfectants such as household bleach or hospital-approved quaternary ammonia disinfectants can be used for cleaning contaminated surfaces.

Smallpox is an acute contagious disease caused by Variola virus, a member of the orthopoxvirus family.

Smallpox was officially declared eradicated in 1979.

Smallpox vaccination provides full immunity for 3 to 5 years and decreasing immunity thereafter. If a person is vaccinated again later, immunity lasts even longer. Historically, the vaccine has been effective in preventing smallpox infection in 95% of those vaccinated. In addition, the vaccine was proven to prevent or substantially lessen infection when given within a few days of exposure. It is important to note, however, that at the time when the smallpox vaccine was used to eradicate the disease, testing was not as advanced or precise as it is today, so there may still be things to learn about the vaccine and its effectiveness and length of protection.

After the vaccine is given, it is very important to follow instructions follow to care for the site of the vaccine.