What is Smallpox?
Smallpox is a highly contagious disease which stems from the variola virus. It causes a disfiguring rash that can cause blindness and permanent scarring.
People with smallpox have a high mortality risk, in fact three out of 10 infected die from the disease. Fortunately a vaccine was invented and curbed its epidemic progression. (1)
In fact, in 1980 smallpox was officially eliminated and now the vaccine is no longer necessary unless the person is at high risk. (2)
Symptoms
Smallpox is classified a category A pathogen, this means the disease is a serious threat to public health. (3)
The disease is very contagious with a high mortality risk. This means it could result in detrimental impact on the population, causing panic and major social disruption.
Because of these risks a small amount of the virus is kept in both the United States and Russia just in case smallpox should start spreading again and a vaccine is needed.
Smallpox transmits through face-to-face contact. When an infected person sneezes or coughs the virus can spread through the droplets. In rare cases it has even shown to spread through the air in enclosed environments, for example inside a room or office. (4)
Symptoms are flu-like, although signs don’t present until around seven to 19 days once the sores start to show. Before this point the virus is not contagious.
The virus can only spread through humans, there isn’t any evidence to suggest it can spread from infected animals or insects. (5)
The symptoms include:
High Fever
When the body temperature reaches above 40 degrees celcius it’s considered a high fever, this is a sign in the earlier stages of smallpox. (6, 7)
A fever is the body’s way of trying to eradicate an infection or virus and can be followed by chills, sweating or at times nausea.
Head and Body Aches
This can also be described as fatigue. When the virus has taken hold it can give the person a feeling of overwhelming tiredness in the body.
Muscles will ache and headaches can start as sores begin to develop in the mouth and throat. Some people might also feel excessive backache.
At this point the person may feel too sick and tired to continue normal activities. (8)
Vomiting
Vomiting is an unpleasant reaction of the body, sometimes due to a virus or bacteria.
People affected with the smallpox virus can sometimes experience vomiting. (9)
Although this is a common symptom of many causes if it appears alongside a high fever it should be checked out.
Rash
A skin rash is a signature sign of smallpox. It’s best described as small blister like bumps or pimples.
It will typically begin in the mouth and on the tongue. Although it will spread to other parts of the body, like the face and even the palms of your hands and the soles of your feet. (10)
Stages
There are six stages of smallpox. These start from the incubation period to the final phase where the scabs fall off. (11)
Stage #1
This is the incubation period.
It starts when the person comes into contact with an infected person and therefore catches the virus.
During this stage the virus takes a hold in the body and starts to develop symptoms towards the end of this phase.
This period can last from seven to 19 days, although the average time before a person starts to show signs is generally 10 to 14 days. (12)
At this point the virus is not yet deemed contagious.
Stage #2
This stage is known as when the initial symptoms make an appearance.
It starts after the incubation period and will last around two to four days. During this time the virus can spread, although not as rapidly as in the next two stages.
The infected person will have symptoms such as high fever, body aches and headaches followed by fatigue and sometimes vomiting.
This point of the virus can make the person feel very ill to the extent where everyday tasks and life becomes near on impossible. (13)
Stage #3
At this stage the rash will start to develop. It usually begins in the mouth where small red spots become visible on the tongue.
These will transform into sores which later rupture and thereby the virus spreads further into the body.
The rash spreads rather quickly, starting off on the face followed by arms and legs, before continuing down to the hands and feet. Typically the rash engulfs the body within 24 hours. (14)
However, as the rash advances the person usually starts to feel better and the fever tends to decline.
This stage can last about four days and is very contagious. On the fourth day the sores will start to fill with a opaque fluid causing the fever to return. (15)
Stage #4
At this stage the sores starts to become pustules, these can best be described as firm sharply raised bumps. It can be explained like a feeling of garden peas underneath the skin. (16)
This stage can last up to 10 days and during this time the virus is still extremely contagious. However, around the halfway point the sores can start to scab over and near the end of this stage most of the sores have dried up.
Stage #5
Now that the sores have scabbed over they will start to fall off, this stage can last about six days.
As the scabs naturally remove themselves the person will be left with visible marks. During this stage the person is still contagious.
Stage #6
Most people reach this stage generally four weeks from when the first rash took place.
By this time all the scabs should have dropped off. Once this happens it means the person is no longer contagious and marks the end of the smallpox infection.
Treatment
Smallpox doesn’t have a specific treatment. However, there are methods to treat the symptoms such as fluids and medication.
The smallpox vaccine can alleviate and reduce the severity of the virus, yet this needs to be administered very early on for it to have the desired effect.
If a pregnant woman is infected with smallpox it can have serious complications such as early miscarriage and a high infant fatality risk. This is because the virus has shown to be more aggressive during pregnancy. (17)
Smallpox Vaccine
After the smallpox vaccine was invented, less people became infected therefore assisting to eliminate the virus worldwide.
The vaccine has also shown to help people in the early stages of the disease.
People who received the smallpox vaccine within three days after exposure were highly likely to stop further development of the illness. (18)
If the vaccine was received within four to seven days after exposure it could still potentially protect from the disease. Nevertheless, either way it would protect from severe symptoms and complications.
However if the rash has already developed the vaccine won’t be effective. (19)
Antiviral Drugs
Some antiviral drugs such as tecovirimat, cidofovir and brincidofovir have shown to either be effective against the variola virus or the smallpox itself.
However, this is still in laboratory testing stages and has not been tested on anyone directly with smallpox. (20)
These drugs are being tested in case an outbreak should happen again.
FAQ
What is smallpox? Smallpox is a dangerous disease which is highly contagious and characterized with a a rash consistent of dense fluid filled blisters.
What are the signs of smallpox? Initially there’s no symptoms or signs until about 10 days after exposure to the virus. At this point, flu-like symptoms will occur such as: high fever, vomiting, aches and pain, and fatigue. However, the most obvious sign of smallpox is a blistering rash which spreads all over the body.
How do you develop smallpox? Smallpox can easily be transmitted by coughing or sneezing. (21)
How are you diagnosed for smallpox? If a doctor suspects smallpox, the person will most likely be put in isolation to avoid an outbreak. Strict protocol will also have to be followed. (22)
What is the best treatment for smallpox? Because there isn’t a specific treatment as of yet for smallpox, it’s usually treated in the early stages with the vaccine. Other treatments can include medicines to reduce fever.
What are the long term complications of smallpox? Long term complications can be permanent scars from the rash, but it could also lead to blindness.
Is smallpox considered a disability? Smallpox was eliminated decades ago, however those who developed serious complications such as blindness would be considered disabled. (23)
Is there any cure for smallpox? There is no known cure, but the vaccine can help protect the person in the initial stages from worsening. The vaccine can also help prevent the virus.
Is smallpox life threatening? Yes it can be. It has shown that every three people in 10 infected would die from the disease.
Summary
Smallpox was a highly contagious disease caused by the variola virus. It displayed the potentials of being deadly to the infected person.
It could easily transmit through droplets from coughing and sneezing. This would result in flu-like symptoms followed by a rash which would spread rapidly across the body.
Thankfully a successful vaccine was developed and eventually the disease was eliminated worldwide. Today the inoculation is no longer offered except for people who are at high risk.