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SMALLPOX:
ALSO KNOW AS VARIOLA OR VARIOLA VERA (from the
Latin).
HIGHLY CONTAGIOUS DISEASE THAT EMERGED IN
HUMANS THOUSANDS OF YEARS AGO. DURING THE
20th CENTURY RESPONSIBLE FOR 300 to 500 MILLION
DEATHS.
FAMOUS VICTIMS OF THE DISEASE INCLUDE:
RAMESSES V
SHUNZHI EMPEROR OF CHINA
MARY 11 OF ENGLAND
LOUIS XV OF FRANCE
PETER 11 OF RUSSIA
ANNE OF CLEVES (HENRY V111s) FOURTH WIFE
ELIZABETH 1 OF ENGLAND
ABRAHAM LINCOLN
JOSEPH STALIN
VIRUS CHARACTERISTICS
DNA ds
POXIVIRIDAE
TWO VIRUS VARIANTS:
VARIOLA major IS THE MORE VIRULENT FORM WITH A
TYPICAL MORTALITY OF 20 to 40%.
VARIOLA minor KILLS ABOUT 1% OF VICTIMS.
SURVIVORS OF SMALL POX CAN BE LEFT BLIND
FORM CORNEAL ULCERATION AND SEVERE
DISFIGUREMENT FROM POCKMARKS.
PATH OF INFECTION:
SMALLPOX IS NOT VERY INFECTIOUS IN THE
PRODROMAL PERIOD.
VIRAL SHEDDING OCCURS WITHT THE APPEARANCE
OF THE RASH.
TRANSMISSION IS A RISK OF PROLONGED SOCIAL
CONTACT, DIRECT CONTACT WITH BODY FLUIDS OR
CONTAMINATED OBJECTS eg: the British army gave
Delaware Indians contaminated blankets during the
Pontiac’s Rebellion in 1763.
Also introduction of the disease into South America
destroyed the Aztec and Inca Empires leading to the
Spanish conquest.
INCUBATION TAKES ABOUT 12 DAYS
VIRUS MOVES FORM CELL TO CELL AND HAS A
PREFERENCE FOR SKIN CELLS
OTHER SYMPTOMS ARE: FLU LIKE, FEVER, MUSCLE
PAIN, STOMACH ACHES & VOMITING.
AS INFECTED CELLS LYSE THE VIRUS ENTERS THE
BLOOD STREAM
BY DAY 12 TO 15 THE DAMAGE TO SKIN CELLS IS SO
EXTENSIVE THAT THE INFECTION BECOMES OBVIOUS
PIMPLES ERUPT IN THE MOUTH THEN ARMS & HANDS
BY DAY 16 THE PIMPLES GROW INTO VESICLES WITH
A CLEAR FLUID THAT SLOWLY FILL WITH PUS
(PUSTULES).
THE SKIN LESIONS TAKE TWO FORMS:
IN ‘DISCRETE’ ORDINARY SMALLPOX THE PUSTULES
STAND OUT-there is a greater chance of surviving this
form.
IN ‘CONFLUENT’SMALLPOX THE BLISTERS MERGE
TOGETHER INTO SHEETS THAT DETACH THE OUTER
LAYER OF THE SKIN FROM THE UNDERLYING FLESHthis form is usually fatal.
BY THE 28th. DAY IF THE PATIENT SURVIVES THE SKIN
LESIONS DEFLATE, DRY UP AND START TO FLAKE
OFF. PATIENT IS CONSIDERED TO BE NO LONGER
CONTAGIOUS WHEN ALL OF THE SCABS HAVE
FALLEN OFF
THE HAEMORRHAGIC FORM OF THE DISEASE HAS A
MORTALITY OF 96%.
IN THIS FORM THE SKIN DOES NOT BLISTER AND
BLEEDING OCCURS UNDER THE SKIN WHICH STARTS
TO LOOK BLACK (BLACK POX)
THE EYES HAEMORRHAGE, SO THE SCLERA LOOKS
RED AND EVENTUALLY BLACK.
BLEEDING OCCURS IN VITAL ORGANS INCLUDING
THE BRAIN
MASSIVE LOSS OF FLUID & ELECTROLYTES
LOSS OF THE SKIN / MUCOUS BARRIER CAUSES
OPPORTUNISTIC INFECTIONS AND MULTI ORGAN
FAILURE. DUE TO FULMINATING SEPSIS.
DEATH RATE IS 3 TO 25%