21st Century Smallpox Digest: Government Information on Biological Warfare and Bioterrorism, Symptoms, Vaccines, and Treatment

This is a unique compendium of the best available U.S. government and military information on smallpox (also known as variola), compiled from fifteen documents. Topics covered include: overview; history and significance; description of agent; clinical features; signs and symptoms; diagnosis; treatment; prophylaxis; decontamination and isolation; outbreak control; and laboratory identification. It also includes information on government public health plans to handle a bioterrorism attack using smallpox.

Smallpox is an infection cause by Variola virus, a member of the chordopoxvirus family. Naturally occurring smallpox has been eradicated from the globe, with the last case occurring in Somalia in 1977. Repositories of virus are known to exist in only two laboratories worldwide. Monkeypox, Cowpox, and accinia are closely -related viruses which might lend themselves to genetic manipulation and the subsequent production of smallpox-like disease.

The United States cannot, with complete certainty, verify that the virus is not being held in places other than the two WHO reference laboratories; therefore, the deliberate reintroduction of smallpox is regarded as a possibility. Because this virus is relatively stable (not easily destroyed in the environment) and the infectious dose is small, an aerosol release of variola virus could disseminate widely. A single suspected case of smallpox would be treated as a health emergency.