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Adeno virus
DNA, non enveloped Host specific virus

Appearance of space vehicle > 40 types

Infection of RT, Eye, bladder, intestine & heart

Respiratory Pharyngo - conjunctival fever

Acute febrile pharyngitis Swimming pool conjunctivitis

Infants & young children School age children

Acute respiratory disease New military recruits

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Ocular Infantile

1-15% of all viral
diarrheal disease in
Follicular conjunctivitis (Serotypes 40 - 41)
Self limiting Hemorrhagic cystitis

Occurs primarily in boys-
Epidemic Kerato conjunctivitis self limited

(Serotypes 11 - 21)
Shared towels, ophthalmic
soln. unsterile instruments
Left ventricular
Leads to corneal opacity (ship
Both children
yard eye)
& adults
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Grape like clusters Serology Rise in titre of Abs in paired sera . urine or feces Culture Human embryonic kidney. HeLa. eye. HEP-2 Identification CPE. Lab diagnosis Specimens Swabs from throat.ELISA Treatment No drugs Prevention Live attenuated vaccine – only military population 11/26/08 4 .

shaving over the area 11/26/08 5 . rubbing. removal / Cryotherapy/ Laser scratching.Surgical Avoid touching. Molluscum Contagiosum DNA virus belong to pox viruses Causes pink or pearly white umbilicated wart like lesions on skin Children & young adults Spreads by direct contact (STD) Eosinophilic intra cytoplasmic inclusions Can not be cultured Diagnosis by clinical picture & HPE HPE: Molluscum bodies Disappears within 1yr To avoid spread .

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Abandoned small pox hospital 11/26/08 8 .

and in particular the use of inoculation against smallpox (variolation). She herself had suffered from a bout of smallpox in 1715 that disfigured her beautiful face. In the early eighteenth century. while resident at the Embassy in Istanbul. there was renewed interest in oriental medical practice. to inoculate her 5-year-old son in March 1718. in 1718. and her 20- year-old brother had died of the illness 18 months earlier. 11/26/08 9 . Charles Maitland. This arose in part from the fact that. especially in Britain. Lady Mary Wortley Montagu was so determined to prevent the ravages of smallpox and so impressed by the Turkish method that she ordered the Embassy surgeon at Istanbul.

Variola Virus 2 clinical varities Highly fatal seen in Asia . can be seen under microscope – 300 nm By inhalation. Small pox .reach reticulo endothelial cells – viremia – seeding of mucosa & skin 11/26/08 10 .Variola major (classical small pox) Non .fatal seen in Latin America -Variola minor (Alastrim) Vaccinia virus Artificial virus Employed as a vector for developing recombinant vaccine Brick shape.

greyish. necrotic & hemorrhagic hemorrhagic 11/26/08 11 . Pocks of vaccinia are large. shiny. Pocks of small pox virus on CAM of developing chick embryo Pocks of variola are small. white. non necrotic & non irregular.

Features Small pox Chicken pox Distribution of Centrifugal Centripetal Rash Palms & soles involved Seldom affected Axilla free Axilla affected Characteristics Deep seated Superficial of Rash Vesicles multilocular Unilocular & dew & umbilicated drop appearance Only one stage of Pleomorphic: rash in rash at one time successive crops No area of inflammation Area of inflammation around vesicles around vesicles Evolution of Slow – macule. papule. pustule Scabs form after 10-14 days After 4 .7 days 11/26/08 12 . Rapid Rash vesicle.

Successful eradication No known animal reservoir No long term carriers Life long immunity after recovery Case detection was simple with characteristic rashes Subclinical infections did not transmit disease Highly effective vaccine .heat stable & long term protection International cooperation 11/26/08 13 .

Unanswered Questions Are there hitherto unknown animal reservoirs of small pox virus? Can another orthopox virus be transferred to small pox virus? Are we absolutely certain that laboratory infection such as that which occurred in Birmingham. England will not occur? Will animal pox (Monkey) eventually replace the eradicated small pox virus as a wide spread pathogen? Lastly could biological warfare with small pox virus be waged in future? 11/26/08 14 .

Global Health Histories July 2006 11/26/08 15 .

“ Hal fdan Mahl er . Director.General . .1988. 1980 “The end of smallpox – but for WHO it is only the end of the beginning…victory over smallpox has implications that go far beyond the individuals directly concerned…It reasserts our ability to change the world around us for the better. W HO 11/26/08 16 1973.

Smallpox Eradication. Chief. 11/26/08 17 . 1988 “For centuries. causing unmeasured suffering.” Donald Ainslie Henderson. Today it is confined to glass vials kept under high security in six laboratories…smallpox is a disease which can be confined to history – the first disease ever eradicated by man. WHO 1966-1977. variola virus stalked the world with impunity. death and blindness.

” US President Bill Clinton 11/26/08 18 . we have a responsibility to develop the drug and vaccine tools to deal with any future contingency – a research and development process that would necessarily require smallpox virus. April 1999 "While we fervently hope smallpox would never be used as a weapon.

May 1999 During the World Health Assembly. recommending instead that stocks should be kept for therapeutic research purposes 11/26/08 19 . the USA successfully argues against calls for the destruction of smallpox stocks held in the USA and Russia.

smallpox represents a serious threat to civilian populations because of its case-fatality rate of 30% or more... 1999 "If used as a biological weapon.“ Henderson et al. JAMA 1999. June 9. Although smallpox has long been feared as the most devastating of all infectious diseases its potential for devastation today is far greater than at any previous time.281:2127-2137 11/26/08 20 .

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The UK government orders 20 million doses. costing £32 Million 2003: UK government sets up Health Protection Agency to help prevent terrorist attacks and limit their impact 2003: WHO. US. European Commission and 6 other countries stage "Global Mercury “ smallpox alert exercise 11/26/08 25 . UK. 2001 2002: US government orders 200 million doses of smallpox vaccine. After September 11. costing $428 million.

They confess they are members of a terrorist group who have infected themselves with smallpox and dispersed to 14 countries just as their infectivity is peaking. language difficulties and equipment failures. the exercise was described as a well coordinated.  Afterwards. realistic and valuable test of international communications. September 2003: Global Mercury  In this scenario." 11/26/08 26 .  Quarantine officers issue an international alert. Problems include cross-border coordination. Frantic communications ensue among the affected countries. two travelers collapse at Vancouver airport with a suspicious rash. possibly annually. "Participants believe that similar exercises should be scheduled regularly.

Exercise Global Mercury 11/26/08 27 .

” Gordon MacDonald. UK Health Protection Agency The Times August 24. 2005 11/26/08 28 . Head of Emergency Strategic Planning. 2005 "We are not saying there might not be fatalities. but we could prevent any widespread disaster.

Director of Emergency Response Capability. as there would be in a conventional attack using explosives. 2005 "We shouldn’t be complacent but it is important for the public to realise that while there would be deaths. UK Health Protection Agency . there wouldn't be the kind of widespread catastrophe they might imagine.” Dr Nigel Lightfoot. 11/26/08 29 .

2006: WHO Global Outbreak Network 11/26/08 30 .

Conclusions  The risk of a terrorist smallpox attack is currently low but is being taken very seriously  Many countries are staging prevention and control exercises  Multimillion doses of vaccine are being held in readiness  WHO is urging countries to develop and strengthen preparedness plans 11/26/08 31 .