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An acute, highly contagious, often fatal infectious disease. Vaccination has succeeded in eradicating smallpox worldwide.

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Smallpox is an acute viral infection unique to humans. A worldwide smallpox campaign (including mass vaccination, patient isolation, and surveillance) contributed to the eradication of the disease by 1980. However, there is growing concern that the virus could now be used as a biological weapon. Smallpox spreads from one person to another by infected saliva droplets. The incubation period is 7 to 17 days. The symptoms begin with severe headache, backache, and fever up to 40 °C, all beginning abruptly. Then a rash appears on the face and spreads, the spots become watery blisters containing pus that form scabs and leave pitted scars when they fall off. The infected person is contagious until the last smallpox scab has fallen off, although most of the transmission occurs in the first week. Most people with smallpox recover, but some do die and the risk depends on the strain of virus. The early vaccines were effective, but they had a number of adverse effects, including headache, fever, and reaction at the infection site, and also the possibility of death. New vaccines continue to be developed. The review identified 10 trials that involved 2412 participants. Overall, the quality of the trials was not high but the review showed that stockpiles of the vaccines maintained their effectiveness even when diluted. New second‐generation vaccines seemed to be effective but still have adverse events. There were too few participants overall to be able to assess rare outcomes. Further research is needed, particularly on the third‐generation vaccines.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2007

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