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For informational purposes only — not medical advice
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How serious?
Risk of death
Yes
Vaccine available?
Time to symptoms
Countries affected
Active outbreaks
No natural travel risk — smallpox has been eradicated. No vaccination needed. Maintained awareness as a bioterrorism concern but risk is considered extremely low.
Devastating viral disease declared eradicated in 1980, caused by variola virus, with vaccine stockpiles maintained for bioterrorism preparedness.
Smallpox was a devastating viral disease caused by the variola virus. It was declared eradicated by WHO in 1980 following a successful global vaccination campaign — the first human disease to be eradicated. Vaccine stockpiles are maintained for emergency preparedness.
Smallpox was one of the most feared diseases in human history, killing an estimated 300 million people in the 20th century alone. The WHO declared global eradication in 1980, following an intensive vaccination and surveillance campaign.\n\nThe variola virus now exists only in two authorized research laboratories (CDC in Atlanta, USA and VECTOR in Novosibirsk, Russia). Routine vaccination ceased in the 1970s–1980s. Smallpox remains a concern as a potential bioterrorism agent, and vaccine stockpiles are maintained by multiple countries.
In the extremely unlikely event of a suspected case:\n- febrile illness with characteristic deep, firm vesicular rash (centrifugal distribution, all lesions at same stage)\n- history of potential exposure to variola virus\n- THIS IS A GLOBAL HEALTH EMERGENCY — immediately isolate the patient, notify local and national health authorities, and contact WHO\n- do not attempt to collect specimens without proper biosafety protocols
Most common signs and symptoms
Historical clinical presentation:\n\nProdrome (2–4 days): High fever (38.5–40.5°C), severe headache, intense backache, malaise, and prostration.\n\nRash phase: Macules (flat spots) → papules (raised bumps) → deep, firm vesicles (fluid-filled blisters) → pustules → crusts. The rash is centrifugal — more prominent on face and extremities than trunk. A key distinguishing feature: all lesions are at the same stage of development simultaneously, unlike chickenpox.
Knowing the symptoms is the first step to a quick response.
Historical course: incubation 7–19 days (typically 12–14 days). Prodromal phase lasted 2–4 days. Rash appeared and evolved over 2–3 weeks through distinct stages. Scabs separated in 3–4 weeks. The patient was infectious from rash onset until all scabs fell off. Total illness duration was approximately 4–6 weeks.
How this disease is identified
Diagnosis was based on characteristic clinical features: centrifugal rash distribution, deep firm lesions, all lesions at the same developmental stage. Laboratory confirmation by electron microscopy, PCR, and viral culture of lesion material. Any suspected case of smallpox is a global public health emergency — immediately contact local and national health authorities and WHO.
Available treatment methods
No specific antiviral was available historically. Tecovirimat (TPOXX) has been approved based on animal studies for treatment of smallpox. Supportive care includes fluids, pain management, and prevention of secondary bacterial infections. Vaccination within 3–4 days of exposure may prevent disease or reduce its severity. Any suspected case would trigger emergency public health response protocols.
Most cases are effectively treated with early diagnosis.
How to protect yourself
Preparation is the best protection.
Statistics and geographic data
ERADICATED worldwide since 1980. The last natural case occurred in Somalia in 1977. No natural transmission exists anywhere in the world. The only remaining risk is from a hypothetical laboratory accident or deliberate release (bioterrorism). The vast majority of the current world population (born after 1980) has no immunity to smallpox.
Who is most at risk
Potential complications
Historical complications included secondary bacterial skin infections, corneal ulceration leading to blindness (approximately 1% of cases), encephalitis (rare), and death (~30% for variola major). Hemorrhagic smallpox was nearly 100% fatal. Survivors typically had severe, permanent pock-mark scarring on the face and body. Arthritis could develop during convalescence.
Expected outcomes and recovery
Variola major (the more common and severe form) had approximately 30% mortality. Variola minor (alastrim) had approximately 1% mortality. Hemorrhagic and malignant (flat-type) forms were nearly always fatal. Survivors frequently had permanent deep pock-mark scarring and could develop blindness from corneal involvement.
This disease is vaccine-preventable. Effective protection is available through vaccination.
Talk to a travel health specialist about the recommended schedule before your trip.
Find a vaccination clinic →The content on this page is for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations. If you have health concerns, consult a qualified healthcare professional. Medova is not a medical service provider.
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