Smallpox was a highly contagious, often fatal, disease caused by the variola virus. Over five hundred million people died from it during the twentieth century. Due to efforts of the World Health Organization, the disease was eradicated with no cases documented since 1977. The only known stocks of the organisms are at the CDC in Atlanta and the Ivanovsky Institute of Virology in Moscow. Antibiotics were not found to be effective, but vaccination resulted in reliable prevention. Vaccination against smallpox was routine in the United States until 1972. At this time, with few people having experienced exposure to the organism and few having received the vaccine, release of the variola virus could have catastrophic results.
Symptoms include high fever, backache, headache, malaise and prostration. A maculopapular rash spreads over the body with a predilection for the face and arms with involvement of the palms and soles.
All contacts require isolation and immediate vaccination. Contacts of contacts should also be vaccinated. Vaccination given within four days of exposure may decrease the severity of the disease or possibly prevent it. Any case of smallpox should be reported immediately to the CDC and to the FBI.

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