Which of the following symptoms is associated with smallpox?

Fatigue is indeed associated with smallpox, as it is a common symptom experienced during the early stages of infection. Smallpox typically presents with a range of systemic symptoms initially, including fever, fatigue, and malaise, which can precede the characteristic rash. This fatigue occurs due to the body's immune response working to fight the viral infection and can be quite debilitating.

In the context of smallpox, although muscle aches can also be present, they are less defining of the infection compared to fatigue. Similarly, while chest discomfort and severe dyspnea may occur in other respiratory illnesses or complications, they are not characteristic symptoms of smallpox. Understanding these distinctions helps in recognizing the clinical presentation of smallpox, particularly the systemic effects such as fatigue that impact the patient's overall condition during the infectious process.