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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 emergency. NIH Vaccination Guidelines: Whats at risk? Whats the risk? http://www.nlm.nih.gov/medlineplus/magazine/issues/spring08/articles/spring08pg7.html When to Vaccinate Birth (or any age if not previously immunized) 1 to 4 Months What Vaccine Hepatitis B (HBV) (three doses)— HepB Why Prevents hepatitis B, a type of liver disease that can lead to liver scarring, cancer, or failure. HepB Diphtheria, tetanus and acellular pertussis— DTaP Prevents: Diphtheria, a serious bacterial infection that can lead to breathing problems Tetanus, a bacterial illness that causes a painful tightening of the muscles, such as "lock jaw" Pertussis (Whooping cough), an infectious bacterial disease that causes uncontrollable coughing 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 disease Pneumococcal conjugate vaccine— PCV Protects against the pneumococcal bacterium, the leading cause of 2 Months infections such as pneumonia, blood infections, and bacterial meningitis Rotavirus vaccine (three doses)—RV 4 Months 6 Months and Annually 6 Months 6 – 18 Months Protects against severe diarrhea, mostly in babies and young children DTaP, Hib, IPV, PCV, RV 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 flu 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 Committee 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 DTaP, MMR, IPV, Var In young girls, prevents most cases of genital warts and cervical cancer Tetanus, diphtheria and pertussis booster—Tdap Meningitis vaccine—MCV College Entrants Protects against a type of liver disease DTaP 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 aged—MCV4 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.