Smallpox

Small pox patient

Last Updated December 20th, 2021

Overview of smallpox

A few microbial diseases used to be a major threat in the past few decades, but have apparently disappeared in the recent years. But global health organizations are not yet sure whether those pathogens still exist in the environment in dormant form or not. In such cases, adequate measures need to be adopted before any unexpected epidemic outbreak occurs. A very common disease belonging to this category is “smallpox”. In the recent years, the occurrence of smallpox has not been observed. Still, proper knowledge of the disease is necessary in order to handle any unexpected occurrence at any point in time.

 

What is smallpox?

Small pox rashesSmallpox is a form of a communicable viral disease which is mediated by the Variola virus which exists in close association with the human population.  

This virus is a part of the Orthopoxvirus genus, which belongs to the Poxviridiae family Smallpox is usually manifested as elevated bumps all over the skin, which leave permanent scars after complete healing.

Smallpox can lead to serious epidemic outbreaks that may result in millions of fatalities all over the world. Adequate immunizations are necessary to eradicate smallpox completely.

 

What causes smallpox?

Smallpox is primarily mediated through two viral species, all belonging to the Poxviridiae family. The causative agents of smallpox are listed below-

  • Variola Major: It causes the more severe form of smallpox manifested through high fever and reddish, itchy skin rashes. Death cases due to Variola Major were reported as 20-40%. Variola Major has four distinct variants. These are-
  • Ordinary Variola Major: It has a mortality rate of 90% or more.
  • Mild Variola Major: It attacks previously vaccinated people as well. But the symptoms are mild and the mortality rates are not so high.
  • Flat Variola Major: It usually causes a lethal form of smallpox.
  • Haemorrhagic Variola Major: As the name implies, it causes internal bleeding and in many cases is fatal in nature.
  • Variola Minor: It is a relatively benign form of the Variola species and accounts for 1% or fewer fatalities.

 

Transmission route of smallpox

Smallpox is extremely contagious in nature and can spread through direct or indirect contact with the infected person. Following are the main transmission mediums of smallpox-

  • Direct contact with respiratory droplets of the infected person via coughing and sneezing
  • Sharing common items of use such as utensils, bed-sheets, towels or cosmetics
  • Direct contact with the smallpox blisters (and fluids discharged from the blisters) of the infected person while dressing them
  • Touching objects used by the infected person and putting the hand on the face or inside the mouth without washing hands

Humans are the primary hosts of smallpox. It has to be noted in this context that smallpox infections spread from human to human directly without the mediation of animals or other insects. The patients may spread infection even after 7-10 days of separation of the smallpox scabs.

 

Pathophysiology or stages of smallpox

Small pox patientSmallpox progresses within the human body through few consecutive stages, which can be discussed according to the stage of infection. The pathological phases of smallpox infections are described below-

  • The Variola virus is primarily acquired via inhalation. The incubation period of this virus ranges from 10-14 days. In the first stage, it invades the lungs. Gradually it invades the mucosal linings and progresses towards the lymph nodes, wherein it starts multiplying. After 2-3 days the virus enters the circulating blood and gets transferred to the spleen, bone marrow, and lymph nodes. The second phase of multiplication begins at this stage. At the end of this stage, the virus invades the leukocytes and later on spreads to the lungs, kidneys, and brain. Fever and toxemia are observed at this stage.
  • The second stage is called the pre-eruptive stage. It lasts for 2-6 days and is characterized by high fever, severe headache, back pain and pain in the limbs. Nausea and vomiting may result, accompanied by intermittent chills.
  • The third stage is called the eruptive stage, wherein macules (flattened red eruptions), vesicles (elevated lesions) and pustules (pus-filled blisters) appear on the skin (mainly on the face and trunk). This stage lasts for 4-6 days.
  • In the next phase, which is called the discharge phase, the vesicles, papules, and pustules burst and release the virus-containing fluid. Most of the smallpox infections spread in this stage.
  • In the final phase, the blisters become completely dried up and form crusty scales called scabs. These scabs finally peel off leaving deep scars on the skin.

 

Symptoms of smallpox

Smallpox is usually manifested through certain specific symptoms which are discussed according to the stages of infection-

  • Pre-eruptive symptoms: The pre-eruptive symptoms include fever, general body ache, nausea, and vomiting.
  • Early rashes: Small reddish spots appear on the tongue and inner linings of mouth. The rashes develop into contagious sores and fluid-filled blisters. The fluid is discharged at a later stage, releasing the virus into the body. Rashes also appear on the skin, which later on grows into fluid-filled blisters. Scabs are formed once these blisters get dried up.
  • Resolving scabs: The pustules and papules stay for a few days and release a purulent discharge. Crusty scabs are formed after this, which fall off within a few days. Pigmented or non-pigmented scars are formed after complete healing.

 

Diagnosis

Diagnosis of smallpox is usually done after collecting the fluids from the pustules and vesicles. Examination of the smallpox virus is usually done under an electron microscope, wherein clustered virus particles called Guarnieri bodies are found.

 

Treatment & Prevention

Small pox vaccinationAt present, no treatment modality had been devised for smallpox. The treatment aims to provide symptomatic relief and prevention of dehydration. In case, the infected individual develops an infection on the skin or the lungs, an antibiotic course can be prescribed to manage the infection.

The disease can be prevented by means of a vaccine. The response of the individual to the vaccine may vary based on the time of administration of the vaccine.

The vaccine protects an individual from getting sick if administered before the contact with the virus. If given within 3 days of exposure to the virus, there are possibilities of not getting the disease. However, even if the individual gets sick, the severity of the disease is quite less. If the vaccine is given within 4 to 7 days of exposure to the virus, the severity of the disease is less as compared to an unvaccinated individual. The smallpox vaccine cannot render protection after the development of the smallpox rash.

 

Facts

  • The smallpox vaccine cannot render protection after the development of the smallpox rash.
  • As per the World Health Organization, even one confirmed case of smallpox can be considered an international health emergency.
  • Smallpox is considered to be one of the world’s most devastating diseases known to the human race.

Facts

  • The last known case of smallpox was reported in Somalia in the year 1977.
  • Smallpox was declared eradicated by the World Health Assembly on the 8th of May 1980, after a global campaign of surveillance and vaccination.

Facts

  • Smallpox is the only infectious disease of humans that got eradicated by deliberate intervention.
  • On an average, death was observed in 3 out of 10 individuals who were infected by the smallpox virus.

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Dos and Don'ts

Dos
  • Consult your doctor if you observe symptoms such as fever, chills, skin rashes, breathing problems etc.
  • Get vaccinated if you are at high risk of getting exposed to the infection.
  • Infected individuals and those exposed to the virus should be kept in isolation.
  • Wear gloves and mask in case you are attending an infected patient.
Don'ts
  • Come in direct contact with the infected patient. Maintain standard hygiene protocols. Use anti-microbial soaps to wash hands after a physical contact with an infected individual.
  • Sneeze or cough with your face uncovered. Maintain personal hygiene.
  • Travel or move around a lot if you are infected with the virus. Avoid the spread of the virus.

 

 

 

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How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
CT-scan-machine
CT – Computed Tomography Scan CT scan or computed tomography scan is an diagnostic imaging technique where cross-sectional images of body are obtained…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Horny Goat Weed: Can it improve libido in human beings too? This plant got its name as Horny Goat Weed when one of the goats feeding on the plant…
Rick Simpson’s Oil: The truths and controversies of this cannabis product Rick Simpson's Oil is an extract from the much-controversial plant, Cannabis. What is the actual truth behind the…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
pilonidal sinus
Pilonidal sinus Pilonidal sinus is more common in young men than women. Learn about treatment options, surgical management, risks, and…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…