Smallpox Q and A (cont.)

What should I know about Smallpox?

Vaccination is not recommended, and the vaccine is not available to health providers or the public. In the absence of a confirmed case of smallpox anywhere in the world, there is no need to be vaccinated against smallpox. There also can be severe side effects to the smallpox vaccine, which is another reason we do not recommend vaccination. In the event of an outbreak, the CDC has clear guidelines to swiftly provide vaccine to people exposed to this disease. The vaccine is securely stored for use in the case of an outbreak. In addition, Secretary of Health and Human Services Tommy Thompson recently announced plans to accelerate production of a new smallpox vaccine.

Are we expecting a smallpox attack?

We are not expecting a smallpox attack, but the recent events that include the use of biological agents as weapons have heightened our awareness of the possibility of such an attack.

Is there an immediate smallpox threat?

At this time we have no information that suggests an imminent smallpox threat.

If I am concerned about a smallpox attack, can I go to my doctor and request the smallpox vaccine?

The last naturally acquired case of smallpox occurred in 1977. The last cases of smallpox, from laboratory exposure, occurred in 1978. In the United States, routine vaccination against smallpox ended in 1972. Since the vaccine is no longer recommended, the vaccine is not available. The CDC maintains an emergency supply of vaccine that can be released if necessary, since post-exposure vaccination is effective.

Are there plans to manufacture more vaccine in case of a bioterrorism attack using smallpox?

Yes. In 2000, CDC awarded a contract to a vaccine manufacturer to produce additional doses of smallpox vaccine.

If someone comes in contact with smallpox, how long does it take to show symptoms?

The incubation period is about 12 days (range: 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. The rash starts with flat red lesions that evolve at the same rate. Lesions become pus-filled after a few days and then begin to crust early in the second week. Scabs develop and then separate and fall off after about 3-4 weeks.

Is smallpox fatal?

The majority of patients with smallpox recover, but death may occur in up to 30% of cases.

How is smallpox spread?

In the majority of cases, smallpox is spread from one person to another by infected saliva droplets that expose a susceptible person having face-to-face contact with the ill person. People with smallpox are most infectious during the first week of illness, because that is when the largest amount of virus is present in saliva. However, some risk of transmission lasts until all scabs have fallen off.

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