Bio-terrorism > Information for the Public > Smallpox
	Printable Fact Sheets: California Department of Health Services - Smallpox Fact Sheet CDC Vaccine Information Links to useful websites CDC - Smallpox Webpage CDC Smallpox Vaccination Program Guidance. This document contains links to many different websites that contain information for the public on smallpox (English and Spanish). Information on Smallpox Smallpox is a serious, contagious and often fatal disease. There is no treatment for smallpox. The only prevention is vaccination. Smallpox outbreaks have occurred from time to time for thousands of years. In 1980, the disease was declared eradicated following worldwide vaccination programs. The last case of smallpox in the United States was in 1949. The last naturally occurring case in the world was in Somalia, Africa in 1977. So why is smallpox being talked about now? In the aftermath of September 2001, the U.S. government is taking precautions to be ready to deal with a bioterrorist attack using smallpox as a weapon. At this time we have no information that suggests an imminent smallpox threat. However, should there be a suspected case of smallpox, it would be immediately reported to the local health department, which is responsible for notifying the state health department, the FBI, and local law enforcement. The state department, in turn, would notify the federal Centers for Disease Control and Prevention (CDC). Frequently asked questions and answers on smallpox printable version What is smallpox? How can I differentiate smallpox from chickenpox? How is smallpox spread? If someone comes in contact with smallpox, how long does it take to show symptoms? Is smallpox fatal? Is there any treatment for smallpox? How can we stop the spread of smallpox after someone comes down with it? Does the Department of Health Services have a smallpox plan? Is a vaccine for smallpox currently available? If someone is exposed to smallpox, is it too late to get a vaccination? Should I get vaccinated against smallpox? What are the side effects of the smallpox vaccines? What are the risks of the smallpox vaccines? How much smallpox vaccine is available in case of a bioterrorism attack using smallpox? If people got the vaccination in the past when it was used routinely, will they be immune? Who will decide who should be vaccinated and when? Will vaccinations begin before a smallpox attack or after? Who should not get the smallpox vaccine? Will antibiotics like ciprofloxacin protect me against smallpox? Where can I get more information about smallpox?   What is smallpox? Smallpox is a contagious disease caused by the variola virus. Early symptoms include high fever and fatigue. The virus then produces a reddish rash, particularly on the face, arms and legs. The resulting spots become filled with clear fluid, and later, pus. A crust forms over the smallpox sores and then a scab that eventually dries up and falls off. Only after all scabs have fallen off is the person no longer contagious. More Information: Smallpox Overview Fact Sheet English Spanish Up How can I differentiate smallpox from chickenpox? Chickenpox is the most important disease likely to be confused with smallpox. Several particular points that help to differentiate smallpox from chickenpox include the following: In smallpox, fever is present for 2 to 4 days before the rash begins; while with chickenpox, fever and rash develop at the same time. All the pocks of the smallpox rash are in the same stage of development on any given part of the body and develop slowly. In chickenpox, the rash develops more rapidly, and vesicles, pustules, and scabs may be seen at the same time. The distribution of rash is also important in diagnosis. In smallpox, more pocks usually occur on the arms and legs than on the body. In chickenpox, more pocks occur on the body. In smallpox, lesions are commonly found on the palms and soles. In chickenpox, however, there are very few or no lesions on the palms and soles. Death following smallpox is not uncommon, while in chickenpox death is very rare. Up How is smallpox spread? In most cases, smallpox is spread from one person to another by face-to-face contact for several hours. During close contact, a "healthy" person can breathe in respiratory droplets from a sick person. Individuals with smallpox are most infectious during the first week of illness. Up If someone comes in contact with smallpox, how long does it take to show symptoms? Following exposure, the incubation period is about 12 days, but can range from 7 to 17 days. Up Is smallpox fatal? The majority of patients with smallpox recover, but death may occur in as many as three out of every 10 individuals who become sick with the disease. Up Is there any treatment for smallpox? There is currently no proven treatment for smallpox. Patients with smallpox may feel better from therapy such as intravenous fluids, medicine to control fever or pain, and antibiotics for any secondary infections that may occur. However, if the vaccine is given within four days after exposure to smallpox, it can prevent illness or lessen its severity. Up How can we stop the spread of smallpox after someone comes down with it? Patients with symptoms of smallpox are capable of spreading the virus. Patients should be isolated so that they will not continue to spread the virus. In addition, individuals who have come into close contact with smallpox patients should be vaccinated immediately and closely watched for symptoms of smallpox. Vaccination and isolation of contacts are the most effective strategies for stopping the spread of smallpox. Up Does the California Department of Health Services (DHS) have a smallpox plan? The Centers for Disease Control (CDC) has been preparing for the remote possibility of an outbreak of smallpox as an act of terror. As part of the ongoing effort to increase preparedness, the CDC has distributed a draft smallpox preparedness plan. The State of California DHS and local health departments have developed a comprehensive state plan. Federal, state, and local health officials, working with health care providers, will continue to improve this plan and our readiness to respond to the possible reintroduction of smallpox. In addition, doctors, health professionals and hospital personnel around the world have been trained to identify infectious diseases, verify their diagnosis and then respond accordingly. The same system would identify any possible outbreak of smallpox even if the virus were deliberately spread to cause harm. The public health system would then be mobilized to trace all known contacts of the infected person and vaccinate them to prevent more cases of smallpox from developing. If this is done rapidly and effectively, the number of cases could be kept to a minimum and the outbreak would be contained. This was the approach that successfully eradicated the disease. The key is a good disease detection system and a rapid response to infectious diseases, no matter what their cause. At this time, several governments have started to examine the potency and levels of their smallpox vaccine stocks, and to consider whether, and under what circumstances, to obtain additional supplies. Up Is a vaccine for smallpox currently available? There is a vaccine against smallpox and it was a key tool in the eradication of the disease. The vaccine does not contain the variola virus that causes smallpox, but a closely related virus called vaccinia. When this vaccine is given to humans, it protects them against smallpox. However, it can have very serious side effects, which in extreme cases can be fatal. It therefore has not been recommended for the general public since smallpox was eradicated. More Information: Vaccine Overview Fact Sheet English Spanish Up If someone is exposed to smallpox, is it too late to get a vaccination? A person exposed to smallpox has between 4-7 days to be vaccinated after exposure. Up Should I get vaccinated against smallpox? Vaccination is not recommended at this time and the vaccine is not available to the public. Routine smallpox vaccination was terminated in the U.S. in 1972 because the risk of complications outweighed the threat of the disease. In the absence of a confirmed case of smallpox anywhere in the world, there is no need for the general public to be vaccinated against smallpox. The CDC maintains an emergency supply of vaccine that can be released if necessary, since vaccination is still effective after exposure has occurred. More Information: Live Virus Vaccines and Vaccinia English | Spanish   Up     What are the side effects of the smallpox vaccines? Side effects from successful vaccination, particularly in those receiving their first dose of vaccine, include tenderness, redness, swelling, and a lesion at the vaccination site. In addition, the vaccination may cause fever for a few days and the lymph nodes in the vaccinated arm may become enlarged and tender. More Information: Reactions after Smallpox Vaccination Fact Sheet English | Spanish   Up What are the risks of the smallpox vaccines? The overall risks of serious complications of smallpox vaccination occur more frequently in those receiving their first dose of vaccine and among young children. An estimated one to two deaths occur for every million persons vaccinated. One of the most frequent serious complications is encephalitis (brain inflammation), which occurs in about one in 300,000 children who are vaccinated, and one in 200,000 vaccinated adults. Other vaccine-related adverse events include generalized rash due to the vaccine virus itself. Up How much smallpox vaccine is available in case of a bioterrorism attack using smallpox? The government currently has 15 million doses which can be diluted to 75 million doses and still retain its potency. The drug company Aventis Pasteur has donated an additional 80 million doses that could be used in an emergency. The government is also buying 220 million doses, which are being made by a new technique. Delivery of the new doses is expected at the end of 2003. Up If people got the vaccination in the past when it was used routinely, will they be immune? Not necessarily. Routine vaccination against smallpox ended in 1972. The level of immunity, if any, among persons who were vaccinated before 1972 is uncertain; therefore, these persons are assumed to be susceptible. For those who were vaccinated, it is not known how long immunity lasts. Most estimates suggest immunity from the vaccination lasts 3 to 5 years. This means that nearly the entire U.S. population has partial immunity at best. Immunity can be boosted effectively with a single revaccination. Prior infection with the disease grants lifelong immunity. Up Who will decide who should be vaccinated and when? Will vaccinations begin before a smallpox attack or after? The CDC and the U.S. Department of Health and Human Services are considering various options for smallpox vaccination. These possibilities include recommending that some or all Americans be vaccinated before a bioterrorist attack of smallpox occurs, or waiting until such an attack actually takes place. Getting the vaccine within four days of exposure to the virus can prevent illness or reduce its severity. Up Who should not get the smallpox vaccine? Smallpox vaccine should not be given to individuals with a history or presence of eczema or other skin conditions, pregnant women, or persons with immunodeficiency diseases and among those with suppressed immune systems as occurs with leukemia, lymphoma, generalized malignancy, or solid organ transplantation. More Information: Fact Sheet - Who should NOT receive the smallpox vaccine English| Spanish   Up Will antibiotics like ciprofloxacin protect me against smallpox? No. Smallpox is a virus; antibiotics such as ciprofloxacin will not fight the infection. Up Where can I get more information about smallpox? Additional information on smallpox can be obtained from the following websites: Centers for Disease Control and Prevention (CDC) World Health Organization (WHO) Up