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The first symptoms of smallpox usually appear 12 to 14 days after you're infected. During the incubation period of seven to 17 days, you look and feel healthy and can't infect others.

Following the incubation period, a sudden onset of flu-like signs and symptoms occurs. These include:

  • Fever
  • Overall discomfort
  • Headache
  • Severe fatigue
  • Severe back pain
  • Sometimes vomiting, diarrhea or both

A few days later, flat, red spots appear first on your face, hands and forearms, and later on your trunk. Within a day or two, many of these lesions turn into small blisters filled with clear fluid, which then turns into pus. Scabs begin to form eight to nine days later and eventually fall off, leaving deep, pitted scars.

The rash is usually most noticeable on the palms of your hands and the soles of your feet. Lesions also develop in the mucous membranes of your nose and mouth and quickly turn into sores that break open, spreading the virus into your saliva.

Aug. 10, 2011

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