Symptoms of smallpox

Smallpox had a typical course. Symptoms usually began about 7 to 17 days after exposure, with no signs during the incubation period, when the person was not contagious.

Early symptoms (prodrome, 2 to 4 days)

• Sudden high fever
• Severe headache and backache
• Body aches and extreme tiredness
• Vomiting and, sometimes, abdominal pain
• Occasional confusion

Rash stage

• Small red spots first appeared in the mouth and throat, then on the face and quickly spread to the arms, legs, palms and soles.
• The spots turned into raised bumps, then fluid-filled blisters, then pus-filled pustules with a central dent.
• The rash was usually at the same stage across any one body area, which helps distinguish it from chickenpox, where spots appear in crops at different stages.
• Pustules crusted over by about the second week, and scabs fell off by the third or fourth week, often leaving pitted scars.

Severe signs

• Bleeding into the skin or from the mucous membranes in the hemorrhagic form
• Very high fever, breathing difficulty or shock
• Eye pain and loss of vision

Smallpox versus other rashes Chickenpox, mpox, measles and some drug reactions can cause rashes. A doctor uses the pattern, history and laboratory tests to tell them apart.

Ayurvedic view (interpretive) Old texts describe fever followed by eruptions as signs of Masurika. They are of historical interest only and cannot be used to diagnose illness today.

When to get urgent help Fever with a spreading blistering rash, trouble breathing, bleeding or confusion needs urgent medical care (112).

Remember Smallpox is eradicated. Any blistering rash with fever should be assessed by a doctor.