Smallpox Virus

Origin

Variola Virus
Genus Orthopoxvirus
Poxviridae family & Chordopoxvirinae subfamily: Eight genera

Classified in single genus Orthopoxvirus

Rodents African Hunters
Africa Arab Armies
China through Silk Road
Caused Athens defeat by Spartans 430 B.C.
History (Cont.)

Shrunk Aztec pop. 25 million to three million in 50 yrs.

Native Americans
Somalia 1977
Eradicated 1949 US
Eradicated 1980 World wide (WHO)
Clinical Features

Incubation period 12-14 days (range of 7-19)

Second Day- Lesions macular then popular
Fourth-Fifth Day- Vesicular
End of First Week- Pustular
Differential Diagnoses

Confused with many skin illnesses

Vesicular/Pustular rashes confused with chickenpox, acne,
herpes, impetigo, scabies, syphilis, etc.
Non-specific early symptoms of Orthopoxviruses
Smallpox & Chickenpox two most confused
CDC created algorithm
Transmission

Person-to-person
Air droplets- cough, sneeze, talking
Indirectly
Ventilation systems
Contaminated Items
Bedding and clothing (Least likely)
Terroristic Actions
Deliberately released
Signs & Symptoms

Incubation period looks/feels healthy

After incubation flu-like symptoms
Fever, headache, severe fatigue, severe back pain vomiting, &
overall discomfort
Few days after S&S occur
Red spots on hands, face, forearms, trunk
Couple days after red spots occur
Blister & fill with fluid
Blisters turn into scabs (8-9 days later)
Scabs form deep pockmark scars
Vaccination & Immunization

Dr. Edward Jenner in 18th Century

Millions of Americans vaccinated
US has 100 million doses
Parents stopped children vaccination in 1972
Complications: Toxic/Allergic reaction, spread other parts of body,
spread to others
Approx. half US never vaccinated
Many never received boosters
Antiviral Prophylaxis

Long-lasting drug cidofovir

Problem: Requires additional hydration (nephrotoxicity)
Blocks airways if aerosolized
Respiratory tract barrier if smallpox is oral form