Signs and Symptoms

Infection with orthopoxviruses can lead to localized or generalized skin lesions, progressing from papules, to vesicles and scabs. Depending on the species and strain of orthopoxvirus involved, other signs and symptoms can include fever, swollen lymph nodes, malaise, and body aches. For information, see specific signs and symptoms for various orthopoxviruses.

Infection with Vaccinia virus generally results in a localized cutaneous lesion characterized by serous and/or purulent discharge, ulceration, and necrosis. This can be accompanied by fever and lymphadenopathy.

Persons with immunocompromising conditions or other contraindications to vaccination are at increased risk for severe disease (e.g., progressive vaccinia, generalized vaccinia, eczema vaccinatum). The following medical conditions may increase the risk of serious complications:

  • Active skin conditions (e.g., eczema, atopic dermatitis, acne, or psoriasis)
  • Immunosuppressive conditions (e.g., HIV/AIDS, steroid medication)
  • Pregnancy or nursing

The clinical course of Vaccinia virus or other Orthopoxvirus infection will vary depending on the route and dose of exposure, strain, and vaccination history.