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Caused by Variola virus Characterized by sudden onset of fever, headache, backache, vomiting & sometimes convulsions Rash on 3 rd day of fever, centrifugal in distribution & passes through stages of macule, papule, vesicle, pustule, & scab with scarring

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Last known case of small pox in India 24 May 1975 India declared small pox free 5 th July 1975 Global eradication of small pox May 1980 Discontinuation of routine vaccination against small pox by all countries Reserve stock of smallpox vaccine & vaccinations needles by WHO

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Case definition for notification of small pox under IHR, 2005 An individual of any age presenting with acute onset of fever ( 38.3C), malaise & severe prostration with head ache & back ache occuring 2-4 days before onset of rash AND Subsequent development of maculopapular rash starting on the face & forearms then spreading to trunks & legs, & with in 48 hours firm round vesicles, pustules, which may become umbilicated

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AND Lesions that appear at the same stage of development (i.e all are vesicles or all are pustules) on any given part of the body AND No alternative diagnosis explaining the illness AND Laboratory confirmation

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Primary prophylaxis Vaccine EDWARD JENNER first vaccine