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Smallpox is spread from one person to another by infected
saliva droplets that expose a susceptible person having
face-to-face contact with the ill person. Persons with smallpox
are most infectious during the first week of illness, because
that is when the largest amount of virus is present in saliva.
However, some risk of transmission lasts until all scabs
have fallen off. Routine vaccination against smallpox ended
in 1972. The level of immunity, if any, among persons who
were vaccinated before 1972 is uncertain; therefore, these
persons are assumed to be susceptible.
Vaccination against smallpox is not recommended to prevent
the disease in the general public and therefore is not available.
In people exposed to smallpox, the vaccine can lessen the
severity of or even prevent illness if given within 4 days
after exposure. Vaccine against smallpox contains another
live virus called vaccinia. The vaccine does not contain
smallpox virus.
The United States currently has an emergency supply of smallpox
vaccine.
There is no proven treatment for smallpox but research to
evaluate new antiviral agents is ongoing. Patients with
smallpox can benefit from supportive therapy (intravenous
fluids, medicine to control fever or pain, etc.) and antibiotics
for any secondary bacterial infections that occur.
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