Smallpox is the infectious, contagious and deadly disease caused by the variola virus which is a DNA virus of the Orthopoxvirus family. Smallpox was certified as globally eradicated in 1980 by the World Health Organization, which means that there has been no naturally occurring cases since then. The Smallpox Eradication Progam used a vaccine containing another virus of the Orthopoxvirus family called vaccinia virus. Before smallpox was eradicated the death rate of smallpox was thought to be up to 30% and the survivors of smallpox had substantial skin scarring and a risk of blindness. Even though variola virus has been eradicated worldwide there is still stock of the virus in two WHO-designated reference laboratories for research purposes.
Incubation period
This is the time from when the patient becomes infected to when symptoms start and is usually between 10 to 14 days. The person is generally symptom free at this stage and are not contagious.
Symptoms
The first smallpox symptoms start with a high fever, body aches and sometimes vomiting, this usually lasts 2 to 4 days. Next small spots start appearing in the mouth and throat, which then becomes sores that start to breakdown. A rash then appears on the skin starting on the face and spreading to the arms, legs, then hands and feet. The rash goes through stages of first filling with fluid, these become pustules which then crust and form a scab that eventually falls off. The patient can be contagious from the first symptoms until the final scab falls off.
Transmission
The variola virus was spread from an infected patient coughing or sneezing, causing droplets infected with virus to be airborne and then these can be inhaled by healthy people who become infected. Fluid and scabs from the skin rash also contain variola virus so any contact with these directly or indirectly could also pass on the virus.
Treatment and Prevention
Although the variola virus has been eradicated in the natural environment public health authorities prepare and plan for the unlikely occurrence of an intentional or accidental release of the variola virus.
The smallpox vaccine is used to help prevent smallpox infection by developing the bodies immunity against the variola virus. The vaccination usually protects from smallpox for 3 to 5 years after which a booster vaccination may be required.
Treatment of smallpox infection is with antivirals that fight the viral infection and supportive care to treat the symptoms of the disease. If a patient develops smallpox it is important they are keep in isolation to control the spread of the disease.
Drugs used to treat Smallpox
The medications listed below are related to or used in the treatment of this condition.
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity
Activity is based on recent site visitor activity relative to other medications in the list.
Rx
Prescription only.
OTC
Over-the-counter.
Rx/OTC
Prescription or Over-the-counter.
Off-label
This medication may not be approved by the FDA for the treatment of this condition.
EUA
An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access
Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N
FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M
The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U
CSA Schedule is unknown.
N
Is not subject to the Controlled Substances Act.
1
Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2
Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3
Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4
Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5
Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X
Interacts with Alcohol.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
