The World Health Organization

(WHO) declared the eradication of smallpox in 1980; three years after the last endemic case of smallpox had been identified in Somalia. There is no current natural transmission of this disease in the world, and the only source of smallpox infection will be an accident or the result of a bioterrorism event (1). Smallpox is a viral disease unique to humans. To sustain itself, the virus must pass from person to person in a continuing chain of infection and is spread by inhalation of air droplets or aerosols. Twelve to 14 days after in-fection, the patient typically becomes febrile and has severe aching pains and prostration. Some 2 to 3 days later, a papular rash develops over the face and spreads to the extremities (2). The disease most commonly confused with smallpox is chickenpox, and dur-ing the first 2 to 3 days of rash, it may be all but impossible to distinguish be-tween the two (2)