With introduction of world wide campaign to eradicate Smallpox by WHO in 1967,the disease was totally eradicated in 1977, and in 1980 the world health authorities declared the world is free from Smallpox in 1980..Smallpox is caused by a DNA type virus with Variola major producing classical Smallpox and Variola minor producing Alastrim, a less serious disease.The spread is by man to man contact, and respiratory route is main source of entry of virus to non infected persons.There is no known vector or animal harboring the virus.All the health efforts were successful as the humans developing herd immunity.

The clinical manifestations present with characteristic rash which progress from Macules - Papules -pustules leaving on many occasions with permanent pocks and dis figuration of face. Stray cases of Varicella ( not Variola which causes Smallpox ) Monkey pox,Parapoxviruses and aggressive forms of drug reaction can be mistaken and informed to health authorities.An experienced clinical approach in observing the pattern of rash can make a definite diagnosis, as the rashes are all in the similar stage at any given time in the progress of diseases unlike Chickenpox where the rashes are different at given time..The key to specific diagnosis remains with Virological laboratories and serves in times of Clinical confusion.

The present question Smallpox can it reemerge after more than three decades of silence, the hypothetical answer is very, very, remote as there is no known animal harboring the virus or vector gone into hibernation. Even in crisis of reemerging/or surfacing of mutated virus can be easily controlled, as we learnt lot of lessons with SARS/INFLUENZA,And Small pox is less contagious in spread, as it requires close contact between face to face, and patients with rash are infectious, and easily Diagnosed with growing awareness in the better communicated world and increasing awareness on reemering infectious diseases. Millions of doses of Vaccine for Smallpox in stock and are available at the click of mouse, We identified for good the world in one in controlling communicable diseases in the era of fast travel.

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