Early Hemorrhagic Smallpox
(Rash on a patient's thigh)

Hemorrhagic Smallpox

Hemorrhagic smallpox was the rarest form of the disease. It was also the most lethal.

· Susceptibility to this form ran in families and may therefore be genetic

· For unknown reasons, pregnant women are also at high risk for hemorrhagic smallpox

Early Hemorrhagic Smallpox was 100% fatal.

· The rash presented as a thick, velvety reddish-purple layer, giving this form of the disease its old folk-name: the purples.

· Victims died on or about the sixth day after the onset of symptoms, before blisters ever broke out.

· The immediate cause of death was heart failure or pulmonary edema (fluid in the lungs).

Late Hemorrhagic or "Flat" Smallpox was about 97% fatal.

· The pustules sank deep into the skin, rather than rising, and were ringed by dark circles (from internal bleeding).

· Victims bled at nose, eyes, vagina, and anus. Old descriptions tell of victims weeping, peeing, and shitting blood.