SMALLPOX

A highly contagious viral disease that causes high fever and a widespread pus-filled rash and can be fatal in up to 30% of cases.

Before widespread vaccination — early 1950s

• Cases: Approximately 50 million cases annually worldwide.

• Hospitalizations: No reliable global WHO estimate available.

• Deaths: Approximately 15 million deaths annually worldwide.

After widespread vaccination and eradication efforts

• Cases: 0 naturally occurring cases since 1977, when the last naturally occurring case was recorded in Somalia.

• Hospitalizations: No naturally occurring smallpox hospitalizations since 1977, because there have been no naturally occurring cases.

• Deaths: 0 deaths from naturally occurring smallpox since 1977. WHO states that smallpox was eradicated in 1980

Smallpox was officially declared eradicated in 1980, making it the only human infectious disease to have been eradicated worldwide.

• Who gets it: Routine vaccination is not recommended for the general public because smallpox has been eradicated. Vaccination is reserved for certain laboratory workers and people at high risk of exposure or may be used during a smallpox emergency.

• Doses: Vaccine schedules depend on the product. ACAM2000 is given as a single dose, while JYNNEOS is given as 2 doses, 4 weeks apart for people who have never been vaccinated.

• People exposed to the variola virus through laboratory work.

• Certain laboratory and healthcare personnel working with orthopoxviruses.

• People exposed during a confirmed smallpox emergency.

Smallpox spreads mainly through infectious respiratory droplets during prolonged, close face-to-face contact and can also spread through contaminated clothing or bedding.

Signs & Symptoms

• High fever

• Severe headache and fatigue

• Severe back pain

• Vomiting or abdominal pain

• Characteristic rash that begins on the face and hands and spreads across the body

• Pus-filled blisters that eventually crust and fall off

• Severe scarring

• Blindness

• Secondary bacterial infections

• Encephalitis

• Hemorrhagic smallpox

• Severe dehydration

• Multi-organ failure

• Death

• Mass vaccination, surveillance, contact tracing, isolation, and ring vaccination helped eradicate smallpox.

• Routine vaccination is no longer recommended because smallpox has been eradicated.

• If an outbreak occurs, rapid vaccination and containment measures would be used to stop transmission.

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