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Smallpox is a serious infectious disease to have ever afflicted mankind. Smallpox is caused by variola virus, which belongs to a family of viruses known as poxviridae. Pox viruses are large DNA viruses which are 200-400 nm. The smallpox prodrome is characterized by the sudden on-set of high fever (38.5°C-40.5°C) and malaise 10 to 14 days after exposure. As populations grew and migrated, the disease spread across the globe, killing millions of people and shaping the course of history. Since 1978, no cases of smallpox have been reported to the World Health Organization from anywhere in the world, the last case had an onset of rash in 1977 in Somalia. However, a total of 2 years of effective surveillance must elapse before this last endemic area can be confirmed to be smallpox-free. The objective of this study was to describe a public-health response to smallpox as using for bioterrorism. In this study, we use Google Scholar, Med line, CDC, site of Ministry of Health and Medical Education and World Health Organization. Smallpox has a high mortality rate and can spread through aerosols and because the population is highly susceptible to the infection. The severity of variola, which includes variola major and variola minor, is related to the virulence of the infecting strains. The case fatality is about 1% for the minor form and up to 45% for the major that two less common clinical forms are the hemorrhagic and flat-type. Smallpox has a high mortality rate and can spread through aerosols, and immunity in the population is low. An outbreak of smallpox will be controlled through surveillance, containment, vaccination, and isolation of cases. Smallpox was eradicated before the development of modern antiviral drugs. Treatment is supportive as to the attention to treatment of bacterial super infection. Death from smallpox is usually the result of severe toxemia, septic shock or disseminated intravascular coagulation. There is great concern that smallpox is an excellent candidate for use as a terrorist weapon.

Keywords: Smallpox, Variola virus, Bioterrorism, Terrorist weapon

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