What would happen in the us if there was a smallpox outbreak?

Germ warfare: The primary means by which this would occur is by release of the two sites of containment of the virus. All unimmunized (most of population) would then be at risk of becoming infected.

It would be bad: A smallpox outbreak would be the result of bioterrorism, since natural smallpox has been eradicated from the globe. Smallpox vaccine is still available, but whether we would be able to produce it in large quantities and get people vaccinated in time to avert a lot of deaths is questionable. Underfunding of cdc and the public heatlh system only weakens our ability to respond.

Lots of cases: If appropriately placed in a population not immune to smallpox, there would likely be lots of cases and many deaths.