The smallpox threat

Smallpox was eradicated in 1977, but concern has been recently expressed on the possible use of the variola virus may be reintroduced and used as a biological weapon. This has led to the preparation of new vaccination strategies against smallpox. Adverse events associated with smallpox vaccine include death, local reactions, dissemination, and generalized vaccinia. Immunosuppressed patients are particularly susceptible to adverse events of smallpox vaccine. In case of a bioterrorist attack, surveillance is crucial for a timely recognition of the disease. Immunization strategies include vaccination of individuals at risk or universal immunization. Despite the general perception of a severe threat associated with the reintroduction of smallpox, an accurate balance between risks and benefits of immunization should be performed, and proper information on safety of vaccine should be provided to the public.