Variola major virus infection is a more severe type of smallpox, characterized by a higher fever and severe rash. It was infectious, which means it spread from individual to individual.

Most individuals with variola major virus infection survived, but roughly one out of every ten died. Many people who survive this infection have lasting scars on vast portions of their bodies, particularly their faces. Some people have gone blind.


Variola major virus infection symptoms often appear twelve to fourteen days after infection. The virus, however, may be present in your body for seven to nineteen days before you get unwell. This is referred to as the initial stage.

Flu-like symptoms appear suddenly after the initial stage. These include:

  • Muscle aches
  • Severe fatigue
  • Vomiting, sometimes
  • Fever
  • Headache
  • Severe back pain

These patches develop into little blisters filled with fluid, which fill with pus and become known as pustules. Scabs appear 8 to 9 days later and peel off, leaving sharp, pitted scars.

When the rash forms and the scabs break off, smallpox may be transmitted from one person to another.


If a smallpox outbreak occurred today, most doctors would probably not detect the virus in its initial phases. This would facilitate the transmission of the variola major virus infection.

A single incidence of smallpox would constitute a public health disaster. Centers have tested tissue samples for smallpox in specialized facilities. This test can identify if an individual is infected with the virus or not.


New antiviral drugs may be taken if someone is diagnosed with variola major virus infection.

  • Brincidofovir (Tembexa). The FDA has authorized this medication. Brincidofovir was studied in laboratories and on animals, like tecovirimat. It has been administered safely to both healthy and virus-infected individuals.
  • Tecovirimat (Tpoxx). The FDA has authorized this medication. It was discovered that it functioned in both animal and laboratory experiments. However, it has not been tried on persons who have smallpox. Consequently, it is still being determined if it is an effective medication option. It was determined to be safe in a study of healthy persons.

It is uncertain if these medications work in people who have smallpox. Other antiviral drugs for treating smallpox are also being researched.

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