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Smallpox

Updated: Wikipedia source

Smallpox

Smallpox was an infectious disease caused by Variola virus (often called Smallpox virus), which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980, making smallpox the only human disease to have been eradicated to date. The initial symptoms of the disease included fever and vomiting. This was followed by formation of ulcers in the mouth and a skin rash. Over a number of days, the skin rash turned into the characteristic fluid-filled blisters with a dent in the center. The bumps then scabbed over and fell off, leaving scars. The disease was transmitted from one person to another primarily through prolonged face-to-face contact with an infected person or rarely via contaminated objects. Prevention was achieved mainly through the smallpox vaccine. Once the disease had developed, certain antiviral medications could potentially have helped, but such medications did not become available until after the disease was eradicated. The risk of death was about 30%, with higher rates among babies. Often, those who survived had extensive scarring of their skin, and some were left blind. The earliest evidence of the disease dates to around 1500 BCE in Egyptian mummies. The disease historically occurred in outbreaks. It was one of several diseases introduced by the Columbian exchange to the New World, resulting in large swathes of Native Americans dying. In 18th-century Europe, it is estimated that 400,000 people died from the disease per year, and that one-third of all cases of blindness were due to smallpox. Smallpox is estimated to have killed up to 300 million people in the 20th century and around 500 million people in the last 100 years of its existence. Earlier deaths included six European monarchs, including Louis XV of France in 1774. As recently as 1967, 15 million cases occurred a year. The final known fatal case occurred in 1978 in a laboratory in the United Kingdom. Inoculation for smallpox appears to have started in China around the 1500s. Europe adopted this practice from Asia in the first half of the 18th century. In 1796, Edward Jenner introduced the modern smallpox vaccine. In 1967, the WHO intensified efforts to eliminate the disease. Smallpox is one of two infectious diseases to have been eradicated, the other being rinderpest (a disease of even-toed ungulates) in 2011. The term "smallpox" was first used in England in the 16th century to distinguish the disease from syphilis, which was then known as the "great pox". Other historical names for the disease include pox, speckled monster, and red plague. The United States and Russia retain samples of variola virus in laboratories, which has sparked debates over safety.

Infobox

Other names
variola, variola vera, pox, red plague
Specialty
Infectious disease
Symptoms
mw- Early: Fever, vomiting, mouth sores Later: Fluid filled blisters which scab over
Complications
Scarring of the skin, blindness
Usual onset
1 to 3 weeks following exposure
Duration
About 4 weeks
Causes
variola major virus, variola minor virus (spread between people)
Diagnostic method
Based on symptoms and confirmed by PCR
Differential diagnosis
Chickenpox, impetigo, molluscum contagiosum, mpox
Prevention
Smallpox vaccine
Treatment
Supportive care
Medication
Brincidofovir
Prognosis
30% risk of death
Frequency
Eradicated (last naturally occurring case in 1977)

Tables

Case fatality rate and frequency of smallpox by type and vaccination status according to Rao case study[31] · Classification
Unvac.
Unvac.
Type of disease
Unvac.
Case fatality rate (%)
Vac.
Case fatality rate (%)
Unvac.
Frequency (%)
Vac.
Ordinary discrete
Ordinary discrete
Type of disease
Ordinary discrete
Case fatality rate (%)
9.3
Case fatality rate (%)
0.7
Frequency (%)
42.1
Frequency (%)
58.4
Ordinary confluent
Ordinary confluent
Type of disease
Ordinary confluent
Case fatality rate (%)
62
Case fatality rate (%)
26.3
Frequency (%)
22.8
Frequency (%)
4.6
Ordinary semiconfluent
Ordinary semiconfluent
Type of disease
Ordinary semiconfluent
Case fatality rate (%)
37
Case fatality rate (%)
8.4
Frequency (%)
23.9
Frequency (%)
7
Modified
Modified
Type of disease
Modified
Case fatality rate (%)
0
Case fatality rate (%)
0
Frequency (%)
2.1
Frequency (%)
25.3
Malignant aka Flat
Malignant aka Flat
Type of disease
Malignant aka Flat
Case fatality rate (%)
96.5
Case fatality rate (%)
66.7
Frequency (%)
6.7
Frequency (%)
1.3
Early hemorrhagic
Early hemorrhagic
Type of disease
Early hemorrhagic
Case fatality rate (%)
100
Case fatality rate (%)
100
Frequency (%)
0.7
Frequency (%)
1.4
Late hemorrhagic
Late hemorrhagic
Type of disease
Late hemorrhagic
Case fatality rate (%)
96.8
Case fatality rate (%)
89.8
Frequency (%)
1.7
Frequency (%)
2.0
Type of disease
Case fatality rate (%)
Frequency (%)
Unvac.
Vac.
Unvac.
Vac.
Ordinary discrete
9.3
0.7
42.1
58.4
Ordinary confluent
62
26.3
22.8
4.6
Ordinary semiconfluent
37
8.4
23.9
7
Modified
0
0
2.1
25.3
Malignant aka Flat
96.5
66.7
6.7
1.3
Early hemorrhagic
100
100
0.7
1.4
Late hemorrhagic
96.8
89.8
1.7
2.0

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    https://osp.od.nih.gov/wp-content/uploads/Final_Report_of_the_Variola_BRP.pdf
  164. PLOS ONE
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774680
  165. Science Magazine
    https://web.archive.org/web/20170709074157/http://www.sciencemag.org/news/2017/07/how-canadian-researchers-built-poxvirus-100000-using-mail-order-dna
  166. PLOS Pathogens
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171955
  167. "Russian Lab Explosion Raises Question: Should Smallpox Virus Be Kept Or Destroyed?"
    https://www.npr.org/sections/goatsandsoda/2019/09/19/762013515/russian-lab-explosion-raises-question-should-smallpox-virus-be-kept-or-destroyed
  168. Empire of fortune : crowns, colonies, and tribes in the Seven Years War in America
  169. Pontiac and the Indian Uprising
  170. The First Way of War: American War Making on the Frontier, 1607–1814
  171. Haughty Conquerors: Amherst and the Great Indian Uprising of 1763
  172. Never Come to Peace Again: Pontiac's Uprising and the Fate of the British Empire in North America
    https://books.google.com/books?id=UeaN0-Ra64oC
  173. Journal of Colonial Williamsburg
    http://www.history.org/Foundation/journal/Spring04/warfare.cfm
  174. BBC History
    https://www.bbc.co.uk/history/worldwars/coldwar/pox_weapon_01.shtml
  175. The Journal of American History
    https://doi.org/10.2307%2F2567577
  176. Journal of Australian Studies
    https://doi.org/10.1080%2F14443058.2013.849750
  177. Bulletin of the History of Medicine
    https://doi.org/10.1353%2Fbhm.0.0167
  178. Claiming a Continent: A New History of Australia
  179. Radio National
    http://www.abc.net.au/radionational/programs/ockhamsrazor/chicken-pox-or-smallpox-in-the-colony-at-sydney/2972652#transcript
  180. Aboriginal History
    https://web.archive.org/web/20160305174741/https://www.scribd.com/doc/49665744/Warren-AbHist31-2007
  181. www.ffghs.org.au
    https://web.archive.org/web/20200807054007/http://www.ffghs.org.au/page8.php
  182. Health Security
    https://doi.org/10.1089%2Fhs.2014.0092
  183. See a fuller discussion of their views and those of Dr. G. E. Ford in "The History Wars: Smallpox Debates".
  184. The 'myth' of smallpox at Sydney Cove in April 1789
    https://caepr.cass.anu.edu.au/events/myth-smallpox-sydney-cove-april-1789
  185. See also Chickenpox blamed for Aboriginal deaths Archived 30 June 2020 at the Wayback Machine, by Tom McIlroy, WA Today,
    https://www.watoday.com.au/national/act/chickenpox-blamed-for-aboriginal-deaths-20130807-2rh3m.html
  186. "USAMRIID's Medical Management of Biological Casualties Handbook"
    https://web.archive.org/web/20150812210729/http://www.dhhr.wv.gov/oeps/disease/Documents/USAMRIID_BlueBook.pdf
  187. Biohazard: The Chilling True Story of the Largest Covert Biological Weapons Program in the World – Told from Inside by the Man Who Ran It
    https://archive.org/details/biohazardchillin00alib_0
  188. Critical Reviews in Microbiology
    https://doi.org/10.1080%2F10408410490468812
  189. Interview with General Burgasov
    https://web.archive.org/web/20071014200222/http://mn.ru/issue.php?2001-46-48
  190. Science
    https://doi.org/10.1126%2Fscience.296.5576.2116
  191. Microbe: are we ready for the next plague?
    https://archive.org/details/microbeareweread00alan/page/101
  192. The Demon in the Freezer
  193. "History and Epidemiology of Global Smallpox Eradication"
    https://web.archive.org/web/20070715234749/http://www.bt.cdc.gov/agent/smallpox/training/overview/pdf/eradicationhistory.pdf
  194. The Guardian
    https://www.theguardian.com/world/2003/sep/20/iraq.oliverburkeman
  195. Smallpox: The Fight to Eradicate a Global Scourge
    https://archive.org/details/smallpoxfighttoe00kopl
  196. "President Abraham Lincoln: Health & Medical History"
    http://www.doctorzebra.com/prez/g16.htm#25
  197. Catherine the Great: Portrait of as Woman
  198. Viruses, Plagues, and History
  199. "Biography at the Edwards Center at Yale University"
    http://edwards.yale.edu/research/about-edwards/biography
  200. Young Stalin
  201. Magyar írók élete és munkái
    http://mek.niif.hu/03600/03630/html/k/k12495.htm
  202. Princes and Peasants: Smallpox in History
  203. When Plague Strikes: The Black Death, Smallpox, AIDS
  204. Man, past and present
  205. "Shapona, the Yoruba god of smallpox | David J. Sencer CDC Museum"
    https://www.cdc.gov/museum/history/shapona.html
  206. "Smallpox controlfrom Africa to America and back again | African Art"
    http://www.africanart.nl/en/pokken-in-afrika-amerika-en-terug-in-afrika/
  207. Hopkins 2002, pp. 16–17.
  208. Medical Anthropology: A Biocultural Approach
  209. Scourge: The Once and Future Threat of Smallpox
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