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.

 

 

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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Biotin: One-stop-shop for shiny hair and an active body! What is common to bananas, eggs, sweet potatoes, and liver? These are delicious and rich in biotin ;…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
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…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
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…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
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…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Inhale oxygen, exhale worries: The top breathing exercises and how to perform them Performing the breathing exercise is like becoming mindful of how you breathe.  Here is a list of breathing…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
yoga health benefits
How to practice yoga for astounding health benefits Can a 5000-year-old system be the ultimate body healer? Did you know yoga can make you smarter and…
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…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
The complete “what to eat” guide for gluten intolerance Does eating breads and pastas often makes you nauseous? Gluten intolerance is a common reason why you might…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
The Shepherd's diet
Facts about the Shepherd’s diet Kristina Wilds promoted Shepherd's diet, a Christian-based diet that highlights Jesus Christ's diet as mentioned in the Bible.
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…

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