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Smallpox Paranoia: Variola vera, derived from varius ("spotted") or varus ("pimple") results in an acute
contagious disease caused by Variola virus, a member of the orthopoxvirus family.
What was it? The first symptoms of smallpox usually appear 12 to 14 days after you're infected. During the
incubation period of seven to 17 days, you look and feel healthy and can't infect others. Following the incubation
period, a sudden onset of flu-like signs and symptoms occurs. A few days later, flat, red spots appear first on your
face, hands and forearms, and later on your trunk that turn into small blisters filled with pus. Scabs begin to form
eight to nine days later and eventually fall off, leaving deep, pitted scars. Lesions also develop in the mucous
membranes of your nose and mouth and quickly turn into sores that break open, spreading the virus into your saliva
leading to easy transmission to others, especially family members/healthcare workers. Thanks to extensive
vaccination in the US and World by the CDC the last known natural case was in Somalia in 1977. Since then, the
only known cases were caused by a laboratory accident in 1978 in Birmingham, England, which killed one person
and caused a limited outbreak. Smallpox was officially declared eradicated in 1979
Why was it so feared? V. major (smallpox) kills about 33% of adults and over 80% of children who contracted it.
Long-term complications of V. major infection include characteristic scars, commonly on the face, which occur in
65–85% of survivors. Smallpox was responsible for an estimated 300–500 million deaths in the 20th century
What are the risks of Vaccination?
-If vaccinated you develop B-lymphocytes that can create antibodies to destroy the virus with an approximate
success rate of 95% for 3-5 years after immunization.
-In the late 1780s immunization meant giving the child, soldier, sailor, healthcare worker direct exposure to pus
from a person with the closely related “CowPox” which gave non-lethal chicken-pox like symptoms AND
protection from Variola vera.
-About 1,000 people for every 1 million people vaccinated experienced reactions that were serious.
-Between 14 and 52 people out of every 1 million people vaccinated experienced potentially life-threatening
reactions to the vaccine.
-It is estimated that 1 or 2 people in 1 million who receive the vaccine may die as a result. Careful screening of
potential vaccine recipients is essential to ensure that those at increased risk do not receive the vaccine (i.e. prior
hypersensitivities, immunodeficient, given while ill from another disease)
Smallpox Vaccine Availability and Current US Immunization Recommendation by CDC:
Routine smallpox vaccination among the American public stopped in 1972 after the disease was eradicated in the
United States. Until recently, the U.S. government provided the vaccine only to a few hundred scientists and medical
professionals working with smallpox and similar viruses in a research setting.
After the events of September and October, 2001, however, the U.S. government took further actions to improve its
level of preparedness against terrorism. One of many such measures—designed specifically to prepare for an
intentional release of the smallpox virus—included updating and releasing a smallpox response plan. In addition, the
U.S. government has enough vaccine to vaccinate every person in the United States in the event of a smallpox
NIH Vaccination Guidelines: Whats at risk? Whats the risk?
When to Vaccinate
Birth (or any age if
not previously
1 to 4 Months
What Vaccine
Hepatitis B (HBV) (three doses)—
Prevents hepatitis B, a
type of liver disease that
can lead to liver scarring,
cancer, or failure.
Diphtheria, tetanus and acellular
pertussis— DTaP
Diphtheria, a serious
bacterial infection that
can lead to breathing
Tetanus, a bacterial
illness that causes a
painful tightening of the
muscles, such as "lock
Pertussis (Whooping
cough), an infectious
bacterial disease that
causes uncontrollable
Haemophilus influenza type b
vaccine (three doses)—Hib
Protects against illnesses
like meningitis,
pneumonia, and
infections of the blood,
bones, and joints
Inactivated poliovirus vaccine—IPV
Protects against polio, a
contagious, paralyzing,
and life-threatening
Pneumococcal conjugate vaccine—
Protects against the
pneumococcal bacterium,
the leading cause of
2 Months
infections such as
pneumonia, blood
infections, and bacterial
Rotavirus vaccine (three doses)—RV
4 Months
6 Months and
6 Months
6 – 18 Months
Protects against severe
diarrhea, mostly in babies
and young children
Influenza – Flu vaccine or flu "shot"
(two doses, one month apart, for
those under 9 getting a flu shot for
the first time)
Protects against seasonal
DTaP, Hib, PCV, RV
Hep B, IPV
Hib, PCV
A "3 in 1" vaccine against
three potentially lifethreatening diseases:
Measles, a virus that causes
a rash, cough, runny nose,
eye irritation, and fever
Mumps, a virus causing
12 – 15 Months
Measles, mumps and rubella (German
measles) vaccine—MMR
fever, headache, and
swollen glands; can lead to
deafness, meningitis,
swollen testicles or ovaries,
and death in some cases
Rubella, also known as
German measles. A
generally mild disease, it
can cause serious birth
defects in the child of a
woman who becomes
infected while pregnant
Varicella (chickenpox) vaccine—Var
Note: In February 2008, the Advisory
on Immunization Practices (ACIP)
changed its recommendations. It had
recommended giving the MMR and
Varicella vaccines at the same time.
Now it does not express a preference
for giving them separately or at the
same time.
12 – 23 Months
15 – 18 Months
4 – 6 Years
Hepatitis A vaccine (two doses)—
Hep A
In young girls, prevents
most cases of genital warts
and cervical cancer
Tetanus, diphtheria and pertussis
Meningitis vaccine—MCV
College Entrants
Protects against a type of
liver disease
Human papillomavirus vaccine—HPV
11 – 12 Years
Protects against
chickenpox, a usually mild
infectious disease
characterized by an
uncomfortable, itchy rash,
fever, and headache; in
adults, can cause shingles
and other serious problems
Meningitis vaccine for college
Protects against meningitis,
an inflammation of the thin
tissue surrounding the brain
and spinal cord; there are
several types of meningitis
Protects against
meningitis, recommended
for previously
unvaccinated college
entrants planning to live
in dormitories.