SMALLPOX: Frequently Asked Questions

Recent international events, including the use of anthrax as a biological weapon, have raised awareness of the possibility of other biological attacks, including the use of smallpox for this purpose. Many health organizations—including the American Academy of Pediatrics—have issued public health recommendations regarding smallpox vaccination.

What are the AAP smallpox vaccine recommendations?
The AAP supports ring vaccination, a strategy in which contacts of people with smallpox, and contacts of these contacts, would be vaccinated immediately. This, along with isolation of infectious individuals, would reduce the chance of transmission to susceptible people.

How much vaccine is available?
There are enough vaccine stores to immunize the entire population of the United States, though experts are not recommending that strategy unless there is an outbreak.

Is there an immediate threat?
At this time, we have no information that suggests an immediate threat. The last naturally occurring case of smallpox in the world occurred in 1977. There are reports that laboratory samples of smallpox virus may have been obtained by unauthorized individuals, giving rise to concern about a possible threat.

If I want to be vaccinated, is vaccine available?
While vaccine is not currently available to the general public, the government has recently recommended vaccinating some physicians as well as other health care and emergency personnel.

If I am exposed to smallpox, is it too late for a vaccination?
If vaccine is received within 4 days of exposure, it may prevent infection or reduce the severity of illness.

How long does it take to show symptoms after exposure?
The incubation period ranges from 7 to 17 days, with an average of 12 days.

What are the symptoms of smallpox and how is it spread?
The early symptoms include high fever, fatigue, headache and back pain. The rash usually follows in 2-3 days, starting with flat, red sores that fill with pus, become crusted over and form scabs that eventually fall off. Most often, smallpox is spread from one person to another by face-to-face contact. Contaminated clothing or bed linens can also spread the virus.

What are the possible complications of vaccination?
It is not possible to get smallpox from vaccination, but the vaccine uses another live virus called vaccinia. Complications of smallpox vaccine range from mild skin rashes to very rare, but potentially fatal viral infections due to vaccinia.

Is there any treatment for smallpox?
There is no proven treatment for smallpox. Infected individuals may benefit from fluids, skin care and medications to control fever and pain.

How can I learn more?
For more information about smallpox, or about smallpox vaccine, you can visit the following websites:

American Academy of Pediatrics
Centers for Disease Control and Prevention