eMedicine Specialties > Infectious Diseases > Viral Infections

Smallpox: Multimedia

Author: Aneela Naureen Hussain, MD, FAAFM, Assistant Professor, Department of Family Medicine, State University of New York Downstate Medical Center; Consulting Staff, Department of Family Medicine, University Hospital of Brooklyn
Coauthor(s): Fazal Hussain, MD, MBBS, Director, Clinical Research, King Faisal Cancer Centre; Maqsood Alam, MD, Fellow, Department of Infectious Diseases, State University of New York Downstate Medical Center; Dennis J Cleri, MD, FACP, FAAM, FIDSA, Chairman, Graduate Medical Education Committee, Professor of Medicine, Associate Professor of Infection Disease, Seton Hall University; Director, Internal Medicine Residency Program, St Francis Medical Center
Contributor Information and Disclosures

Updated: Oct 20, 2008

Multimedia

Smallpox virion. Courtesy of US Centers for Disea...Media file 1: Smallpox virion. Courtesy of US Centers for Disease Control and Prevention.
Smallpox virion. Courtesy of US Centers for Disea...

Smallpox virion. Courtesy of US Centers for Disease Control and Prevention.

After exposure to the smallpox virus, a symptom-f...Media file 2: After exposure to the smallpox virus, a symptom-free incubation period follows. It normally lasts 10-12 days but may vary from 7-17 days. Smallpox begins with fever, headache, and severe backache. A rash appears after 2-4 days and progresses through characteristic stages of papules, vesicles, pustules, and, finally, scabs. The scabs desquamate at the end of the third or fourth week. Courtesy of the World Health Organization.
After exposure to the smallpox virus, a symptom-f...

After exposure to the smallpox virus, a symptom-free incubation period follows. It normally lasts 10-12 days but may vary from 7-17 days. Smallpox begins with fever, headache, and severe backache. A rash appears after 2-4 days and progresses through characteristic stages of papules, vesicles, pustules, and, finally, scabs. The scabs desquamate at the end of the third or fourth week. Courtesy of the World Health Organization.

Smallpox rash at days 3, 5, and 7 of evolution. L...Media file 3: Smallpox rash at days 3, 5, and 7 of evolution. Lesions are denser on the face and extremities than on the trunk. They also appear on the palms of the hand and have a similar appearance. Courtesy of the World Health Organization.
Smallpox rash at days 3, 5, and 7 of evolution. L...

Smallpox rash at days 3, 5, and 7 of evolution. Lesions are denser on the face and extremities than on the trunk. They also appear on the palms of the hand and have a similar appearance. Courtesy of the World Health Organization.

Flat-type smallpox on day 6 of the rash. Courtesy...Media file 4: Flat-type smallpox on day 6 of the rash. Courtesy of the US Centers for Disease Control and Prevention.
Flat-type smallpox on day 6 of the rash. Courtesy...

Flat-type smallpox on day 6 of the rash. Courtesy of the US Centers for Disease Control and Prevention.

This patient with smallpox survived toxemia to su...Media file 5: This patient with smallpox survived toxemia to succumb to secondary tissue damage days after this photo was taken. Courtesy of the US Centers for Disease Control and Prevention.
This patient with smallpox survived toxemia to su...

This patient with smallpox survived toxemia to succumb to secondary tissue damage days after this photo was taken. Courtesy of the US Centers for Disease Control and Prevention.

Smallpox vaccination with bifurcated needle. Reco...Media file 6: Smallpox vaccination with bifurcated needle. Reconstituted vaccine is held between the prongs of the needle and injected subcutaneously by multiple punctures; 15 rapid strokes, at right angles to the skin over the deltoid muscle, are made within a 5-mm area. Courtesy of the World Health Organization.
Smallpox vaccination with bifurcated needle. Reco...

Smallpox vaccination with bifurcated needle. Reconstituted vaccine is held between the prongs of the needle and injected subcutaneously by multiple punctures; 15 rapid strokes, at right angles to the skin over the deltoid muscle, are made within a 5-mm area. Courtesy of the World Health Organization.

Smallpox vaccination. Evolving primary vaccinatio...Media file 7: Smallpox vaccination. Evolving primary vaccination appearance. Courtesy of the US Centers for Disease Control and Prevention.
Smallpox vaccination. Evolving primary vaccinatio...

Smallpox vaccination. Evolving primary vaccination appearance. Courtesy of the US Centers for Disease Control and Prevention.

Typical temperature chart of a patient with small...Media file 8: Typical temperature chart of a patient with smallpox infection (from Henderson, 1999).
Typical temperature chart of a patient with small...

Typical temperature chart of a patient with smallpox infection (from Henderson, 1999).

US Centers for Disease Control and Prevention Poc...Media file 9: US Centers for Disease Control and Prevention Pocket Reference Guide for smallpox vaccine adverse events. Available at: http://www.bt.cdc.gov/training/smallpoxvaccine/reactions/SmallpoxVaccinationGuide.pdf. Courtesy of the US Centers for Disease Control and Prevention.
US Centers for Disease Control and Prevention Poc...

US Centers for Disease Control and Prevention Pocket Reference Guide for smallpox vaccine adverse events. Available at: http://www.bt.cdc.gov/training/smallpoxvaccine/reactions/SmallpoxVaccinationGuide.pdf. Courtesy of the US Centers for Disease Control and Prevention.

Characteristic skin lesion of variola viral infec...Media file 10: Characteristic skin lesion of variola viral infection on the arms and the legs of an adolescent. Photo used with the permission of the World Health Organization (WHO).
Characteristic skin lesion of variola viral infec...

Characteristic skin lesion of variola viral infection on the arms and the legs of an adolescent. Photo used with the permission of the World Health Organization (WHO).

Small child with pustular lesions due to variola ...Media file 11: Small child with pustular lesions due to variola viral infection. Photo used with the permission of the World Health Organization (WHO).
Small child with pustular lesions due to variola ...

Small child with pustular lesions due to variola viral infection. Photo used with the permission of the World Health Organization (WHO).

Infant with advanced lesions due to variola viral...Media file 12: Infant with advanced lesions due to variola viral infection. Photo used with the permission of the World Health Organization (WHO).
Infant with advanced lesions due to variola viral...

Infant with advanced lesions due to variola viral infection. Photo used with the permission of the World Health Organization (WHO).

Unvaccinated infant with the ordinary form of the...Media file 13: Unvaccinated infant with the ordinary form of the variola major strain of smallpox has centrifugally distributed umbilicated pustules on day 3 in the course of the disease. Reprinted with permission from the World Health Organization (WHO).
Unvaccinated infant with the ordinary form of the...

Unvaccinated infant with the ordinary form of the variola major strain of smallpox has centrifugally distributed umbilicated pustules on day 3 in the course of the disease. Reprinted with permission from the World Health Organization (WHO).

Unvaccinated infant with the ordinary form of the...Media file 14: Unvaccinated infant with the ordinary form of the variola major strain of smallpox has centrifugally distributed umbilicated pustules on day 5 in the course of the disease. Reprinted with permission from the World Health Organization (WHO).
Unvaccinated infant with the ordinary form of the...

Unvaccinated infant with the ordinary form of the variola major strain of smallpox has centrifugally distributed umbilicated pustules on day 5 in the course of the disease. Reprinted with permission from the World Health Organization (WHO).

Unvaccinated infant with the ordinary form of the...Media file 15: Unvaccinated infant with the ordinary form of the variola major strain of smallpox has centrifugally distributed umbilicated pustules on day 7 in the course of the disease. Reprinted with permission from the World Health Organization (WHO).
Unvaccinated infant with the ordinary form of the...

Unvaccinated infant with the ordinary form of the variola major strain of smallpox has centrifugally distributed umbilicated pustules on day 7 in the course of the disease. Reprinted with permission from the World Health Organization (WHO).

The ordinary form of the variola minor strain of ...Media file 16: The ordinary form of the variola minor strain of smallpox (alastrim) in an unvaccinated woman 12 days after the onset of skin lesions. The facial lesions are sparser and evolved more rapidly than the extremity lesions. Reprinted with permission from the World Health Organization (WHO).
The ordinary form of the variola minor strain of ...

The ordinary form of the variola minor strain of smallpox (alastrim) in an unvaccinated woman 12 days after the onset of skin lesions. The facial lesions are sparser and evolved more rapidly than the extremity lesions. Reprinted with permission from the World Health Organization (WHO).

The ordinary form of the variola minor strain of ...Media file 17: The ordinary form of the variola minor strain of smallpox (alastrim) in an unvaccinated woman 12 days after the onset of skin lesions. The facial lesions are sparser and evolved more rapidly than the extremity lesions. Reprinted with permission from the World Health Organization (WHO).
The ordinary form of the variola minor strain of ...

The ordinary form of the variola minor strain of smallpox (alastrim) in an unvaccinated woman 12 days after the onset of skin lesions. The facial lesions are sparser and evolved more rapidly than the extremity lesions. Reprinted with permission from the World Health Organization (WHO).

The ordinary form of the variola minor strain of ...Media file 18: The ordinary form of the variola minor strain of smallpox (alastrim) in an unvaccinated woman 12 days after the onset of skin lesions. The facial lesions are sparser and evolved more rapidly than the extremity lesions. Reprinted with permission from the World Health Organization (WHO).
The ordinary form of the variola minor strain of ...

The ordinary form of the variola minor strain of smallpox (alastrim) in an unvaccinated woman 12 days after the onset of skin lesions. The facial lesions are sparser and evolved more rapidly than the extremity lesions. Reprinted with permission from the World Health Organization (WHO).

Adult with variola major with hundreds of pustula...Media file 19: Adult with variola major with hundreds of pustular lesions centrifugally distributed. Photo from Fitzsimmons Army Medical Center slide file.
Adult with variola major with hundreds of pustula...

Adult with variola major with hundreds of pustular lesions centrifugally distributed. Photo from Fitzsimmons Army Medical Center slide file.

Hemorrhagic-type variola major lesions. Death usu...Media file 20: Hemorrhagic-type variola major lesions. Death usually ensued before typical pustules developed. Reprinted with permission from the World Health Organization (WHO). 1988; 10-14, 35-36.
Hemorrhagic-type variola major lesions. Death usu...

Hemorrhagic-type variola major lesions. Death usually ensued before typical pustules developed. Reprinted with permission from the World Health Organization (WHO). 1988; 10-14, 35-36.

More on Smallpox

Overview: Smallpox
Differential Diagnoses & Workup: Smallpox
Treatment & Medication: Smallpox
Follow-up: Smallpox
Multimedia: Smallpox
References

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Further Reading

Keywords

smallpox, Poxvirus variolae, variola virus, variola, variola vera, variola major, variola minor, orthopoxvirus, poxvirus, hemorrhagic smallpox, ordinary smallpox, flat smallpox, modified smallpox, alastrim, amass, cottonpox, milkpox, whitepox, Cuban itch, Kaffir, biological agent, bioterrorism, bio-terrorism, biological attack, pox virus, malignant smallpox, fulminant smallpox, variola sine eruptione, variola sine exanthemata, smallpox vaccination, vaccinia immune globulin, vaccinia immunoglobulin, VIG, VIGIV, osteomyelitis variolosa, variola residua, fetal vaccinia

Contributor Information and Disclosures

Author

Aneela Naureen Hussain, MD, FAAFM, Assistant Professor, Department of Family Medicine, State University of New York Downstate Medical Center; Consulting Staff, Department of Family Medicine, University Hospital of Brooklyn
Aneela Naureen Hussain, MD, FAAFM is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, American Medical Women's Association, Medical Society of the State of New York, and Society of Teachers of Family Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Fazal Hussain, MD, MBBS, Director, Clinical Research, King Faisal Cancer Centre
Fazal Hussain, MD, MBBS is a member of the following medical societies: American College of Radiology
Disclosure: Nothing to disclose.

Maqsood Alam, MD, Fellow, Department of Infectious Diseases, State University of New York Downstate Medical Center
Maqsood Alam, MD is a member of the following medical societies: American Medical Association and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Dennis J Cleri, MD, FACP, FAAM, FIDSA, Chairman, Graduate Medical Education Committee, Professor of Medicine, Associate Professor of Infection Disease, Seton Hall University; Director, Internal Medicine Residency Program, St Francis Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Duane R Hospenthal, MD, PhD, Chief, Infectious Disease Service, San Antonio Military Medical Center, Brooke Army Medical Center; Professor of Medicine, Uniformed Services University of the Health Sciences
Duane R Hospenthal, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Armed Forces Infectious Diseases Society, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Society for Infectious Diseases, International Society of Travel Medicine, and Medical Mycology Society of the Americas
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

John L Brusch, MD, FACP, Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance
John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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