The incubation period for smallpox is 8 to 17 days, with people usually getting sick 10 to 12 days after infection. Symptoms start with malaise, fever, rigors, vomiting, headache, and backache. The trademark smallpox rash appears after two to four days, first on the face and arms and later on the legs, quickly progressing to red spots, called papules and eventually to large blisters, called pustular vesicles, which are more abundant on the arms and face. Although full-blown smallpox is unique and easy to identify, earlier stages of the rash could be mistaken for chickenpox. When fatal, death occurs within the first or second week of the illness.