How Do Doctors Make the Diagnosis?

Because smallpox was wiped out in the last quarter of the twentieth century, very few doctors practicing in the 21st century have ever seen a case. With the heightened awareness of the possibility that smallpox could be used as a weapon in biological warfare, doctors are trained to recognize the disease. To make a diagnosis of smallpox, tests would be done on blood and fluid from a patient's lesions to identify the virus. To prevent a widespread outbreak, the patient would be isolated, and those in close contact with the person would be vaccinated. In the early 2000s, one diagnosed case of smallpox could cause a public health emergency.

What Is the Treatment for Smallpox?

There is no known cure for smallpox. Receiving the smallpox vaccine within four days of being exposed to someone who has the disease may prevent infection or lessen symptoms. Scientists are looking for new medicines as possible treatments for the disease. Public health agencies recommend that patients who have symptoms of smallpox be isolated immediately - either in a special unit of a hospital or at home - so that the infection does not spread to others. Healthcare workers are advised to take careful precautions when treating these patients. In the absence of a cure, treatment focuses on easing symptoms and preventing further infections. Patients may receive intravenous fluids (fluids injected directly into a vein), pain relievers, and antibiotics (to combat bacterial infections that can develop in the open sores) while the disease runs its course.

What Should an Infected Person Expect?

Smallpox infection can last from three to four weeks or until the last scabs fall off. The lesions often leave behind deep, pitted scars. When smallpox is fatal, patients usually die during the second week of illness. Smallpox can lead to serious complications, including the following:

* Hemorrhagic (heh-muh-RAH-jik) smallpox, which is associated with bleeding in the skin and body membranes

* Malignant smallpox, in which the sores are flat and close together

* Blindness

* Bacterial infections

* Pneumonia

* Encephalitis

How Can Smallpox Be Prevented?

Widespread vaccination in the United States for smallpox ended in 1972. In 1980 the WHO declared the disease eradicated. It is unknown how long vaccine-generated immunity* lasts. Many experts believe that it prevents infection for at least 10 years, but scientists think that few people in the world as of 2009 were still immune to smallpox.

Two official facilities store samples of the virus: the CDC in Atlanta, Georgia, and the Russian State Research Center of Virologyand Biotechnology in Koltsovo. In the unlikely event that bioterrrorists were to get access to any of these stored samples, it is possible that they might try to use the virus to launch a biological attack. If this were to happen, vaccines would be in high demand. To prepare for such a potential emergency, mass production of the vaccine was under way in the United States in the early 2000s.

Owing to possible side effects of the smallpox vaccine, the CDC suggests that it be given only to those at greatest risk of being exposed to the virus, including military personnel and first responders, for example, medical care providers, law enforcement personnel, and laboratory workers. About one in a million people who are vaccinated die from the effects of the vaccine, and a small percentage experience scarring or serious infections.

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