Early signs and symptoms of smallpox include all of the following, EXCEPT:

• A. Fever
• B. Headache
• C. Malaise
• D. Skin blisters

Answer: (D)

The key idea is distinguishing the prodromal phase from the rash phase of smallpox. Early signs reflect the body's response to infection before the skin eruptions appear. In this phase, fever, headache, and malaise are common and signal systemic illness starting to take hold. These symptoms arise as the body fights the infection and can come with fatigue and general discomfort; they tell you something is off but you don’t yet see skin changes.

Skin blisters, on the other hand, appear with the characteristic rash that follows the prodrome. The rash develops through stages—from macules to papules to vesicles (blisters) and pustules, then crusts. So blisters are not part of the early prodromal signs; they are a later manifestation tied to the rash phase.

Recognizing the prodrome of fever, headache, and malaise helps with early suspicion and isolation before the rash develops, which is critical for containment.