Smallpox

Running Head: SMALLPOX

Smallpox

Causes, Symptoms, Effects and Treatment

Abstract

This paper will discuss the smallpox disease. It discuses how the disease originated and how Europeans brought the disease into the United States. It goes into detail about what the symptoms are, how this disease is treated, and what types of people should and should not receive this vaccination. The disease was more common about twenty-five years ago when the vaccination was still given to people. As compared to now, as the vaccination is not given to people. And since the vaccination only lasts three years no one in the country is vaccinated for it. If one case were to be brought into the Unites States, the whole country would be susceptible to it and since this disease is very contagious it would spread like wild fire. Finally, this paper discusses how the vaccination is given to people and what the symptoms are that people go through.

The disease smallpox started out in Northwestern Africa by Egyptian traders carrying this disease to India during the first millennium, where it became established as an endemic infection. Smallpox is now a disease of historical interest only. It is an exanthematous viral disease; it was once prevalent throughout the world, existing as an epidemic infection wherever concentrations of population were sufficient to sustain transmission. Outbreaks of variola major, the only known variety until the end of the 19th century, resulted in case-fertility rates of twenty percent or more. A second variety, variola minor, produced less severe illness and was associated with case-fatality rates of one percent or less. It was first described in South Africa, and then it moved to the United States. Then subsequently became the prevalent variety throughout United States, and parts of South Africa, and Europe as well as some areas of eastern and southern Africa.

Bishop Marius of Avenches of Switzerland first used the name variola during the 6th century. And the word itself was derived from the Latin varius (spotted) or varus (pimple). (http://www.ncbi.nlm.nih.org) Although Marius provides no clinical description of the disease concerned, there is little doubt that smallpox had already become endemic in some areas of Europe by this time. In the Anglo-Saxon world, by the 10th century, the word poc or pocca, a bag or pouch, described an exanthematous disease, possibly smallpox, and English accounts began to use the word pockes. (http://www.ncbi.nlm.nih.org)

The impact of smallpox on history and human affairs was profound. Deities to smallpox became a part of the cultures of India, China, and parts of Africa. In Europe, at the end of the 18th century, an estimated 400,000 people died annually from smallpox, and survivors accounted for one-third of all cases of blindness. (http://www.cryptome.org) A method for protection against the naturally acquired smallpox infection appears to have been discovered in India sometime before AD 1000. There it became the practice to deliberately inoculate, either into the skin or by nasal insufflations, scabs or pustule material from lesions of patients. This practice resulted in an infection that was usually less severe than an infection acquired naturally by inhalation of droplets. Case-Fertility rates associated with variolations, as it was called, were about one-tenth as great as when infection was naturally acquired, but those infected in this manner were capable of transmitting smallpox by droplet inhalation to others.

Smallpox, because of the high case-fatality rates transmissibility, now represents one of the most serious bioterrorist threats to the civilian population. Over the centuries, naturally occurring smallpox, with its case-fatality rate over thirty percent or more and its ability to spread in any climate and season, has been universally feared as the most devastating of all the infectious diseases. (http://www/hopkins-biodefense.gov) Smallpox was once worldwide in scope; before vaccination was practiced almost everyone eventually contracted the disease. In 1980, the World Health Assembly announced that smallpox had been eradicated and recommended that all countries cease vaccination (http://www.hopkins-biodefense.gov) An aerosol release of the smallpox virus would disseminate readily given its considerable stability in aerosol form and epidemiological evidence suggesting the infectious dose is very small. The disease has historically been feared as one of the most serious of all pestilential disease; it is physically disfiguring; it has a thirty percent case-fatality, and there is no treatment. This disease is communicable from person to person, and no one in the United States has been vaccinated within the past twenty- five years.

It spreads directly from person to person, primarily by droplet nuclei expelled from the oropharynx of the infected person or by aerosol. Natural infection occurs following the implantation of the virus or by the oropharyngeal or respiratory mucus. Contaminated clothing or bed linen could also spread the virus. Special precautions need to be taken to insure that all bedding and clothing of patients are autoclaved. Disinfectants such as hypochlorite and quaternary ammonia should be used for washing contaminated surfaces. A smallpox outbreak poses difficult problems because of the ability of the virus to continue to spread throughout the population unless checked by vaccination and isolation of patients and their close patients. After the incubation period, the patient experiences high fever, malaise, and prostration with headaches and backaches. Severe abdominal pain and delirium are sometimes present. A mascopapular rash then appears, first on the mucus of the mouth and pharynx, face and forearms, spreading to the trunk and legs. Within one or two days, the rash becomes vesicular and later pustule. The pustules are characteristically round, tense and deeply embedded in the dermis; crusts begin to form about the eight or ninth day. When the scabs separate, pigment-free skin remains, and eventually pitted scars form.

The smallpox vaccine helps to body develop immunity to this disease. The vaccine is made from a virus called the vaccinia which is a "pox"-type related to smallpox. The smallpox