Smallpox (Human)
Primary reference(s)
WHO, 2019. Smallpox. World Health Organization (WHO). Accessed 17 December 2019.
Additional scientific description
Smallpox was still endemic in Africa and Asia at the end of the 1960s. Vaccination campaigns, and surveillance and prevention measures were undertaken to contain epidemic hotspots and to better inform affected populations. Smallpox was officially declared eradicated in 1980 and is the first disease to have been fought on a global scale. This extraordinary achievement was accomplished through the collaboration of countries around the world (WHO, 2010).
Before its eradication, smallpox was one of the world’s most devastating diseases known and was fatal in up to 30% of cases (WHO, 2019).
Smallpox is transmitted from person to person via infective droplets during close contact with infected symptomatic people (WHO, 2019).
Early symptoms include high fever and fatigue. The virus then produces a characteristic rash, particularly on the face, arms and legs (WHO, 2019).
The disease can be definitively diagnosed by polymerase chain reaction (PCR), genetic sequencing or isolation of the virus from the blood or skin lesions (WHO, 2019).
The World Health Organization (WHO) has published guidance on case classification and surveillance standards (WHO, 2019).
Metrics and numeric limits
Not applicable.
Key relevant UN convention / multilateral treaty
Convention on the prohibition of the development, production and stockpiling of bacteriological (biological) and toxin weapons and on their destruction: Article I (UNODA, 1972).
International Health Regulations (2005), 3rd ed. (WHO, 2016).
Examples of drivers, outcomes and risk management
Post-eradication, there are concerns about accidental or deliberate release or reconstruction of variola virus that could be deployed as a biological weapon (UNODA, 1972; Thompson, 2016).
Vaccination against smallpox can be used very effectively to prevent infection and disease (WHO, 2019). A global smallpox vaccine stockpile is maintained by the WHO to complement stocks held by a number of countries (WHO, 2017).
A specific treatment for smallpox was licensed in 2018 (WHO, 2019).
Preparedness for smallpox also entails education of health personnel in the differential diagnosis of smallpox, strengthening laboratory capacities for diagnostics, expansion of expertise in the area of laboratory biosafety and biosecurity, and strengthening of national-level biosafety regulations in all countries (WHO, 2019).
References
Thompson, K., 2016. Airborne assassin: why the official stockpiles of the smallpox virus must be destroyed. Emory International Law Review, 31:167-195.
UNODA, 1972. Convention on the prohibition of the development, production and stockpiling of bacteriological (biological) and toxin weapons and on their destruction: Article I. United Nations Offices for Disarmament Affairs (UNODA). Accessed 1 December 2019.
WHO, 2010. The Smallpox Eradication Programme - SEP (1966-1980). World Health Organization (WHO). Accessed 19 September 2020.
WHO, 2016. International Health Regulations (2005), 3rd ed. World Health Organization (WHO). Accessed 26 September 2020.
WHO, 2017. Operational framework for the deployment of the WHO Smallpox Vaccine Emergency Stockpile in response to a smallpox event. World Health Organization (WHO). Accessed 31 August 2020.
WHO, 2019. Smallpox. World Health Organization (WHO). Accessed 19 December 2019