Which statement is true about fever and rash in smallpox?

• A. Fever typically precedes the rash.
• B. Rash precedes fever.
• C. There is no fever with smallpox.
• D. Fever and rash occur simultaneously.

Answer: (A)

Fever preceding the rash reflects the typical course of classic smallpox. The illness begins with a prodrome of systemic symptoms, especially high fever and malaise, that lasts about a couple of days. Only after this fever starts does the characteristic rash appear, usually starting on the face and spreading to the extremities as the lesions progress through macules, papules, vesicles, and pustules. This sequence—fever first, then rash—helps distinguish smallpox from illnesses like varicella, where the rash can accompany fever or even precede it and lesions appear in crops at different stages. So the statement that fever typically precedes the rash best matches the usual pattern.