Smallpox - including symptoms, treatment and prevention
Smallpox, which was once a severe disease common around the world, was certified as globally eradicated by the World Health Assembly in 1980 after a successful worldwide immunisation campaign.The last naturally occurring case was detected in Somalia in 1977. Stocks of smallpox virus exist in two laboratories in the United States of America and Russia.
There were two forms of smallpox, variola major (which was more common and more severe) and variola minor.
Smallpox is a notifiable condition1.
How Smallpox is spread
Smallpox is caused by the variola virus and is spread from person to person.
Smallpox is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby or may contaminate objects.
Smallpox can also be spread by direct contact with blister fluid or contaminated objects.
Smallpox is a potential bioterrorism agent.
Signs and symptoms of smallpox
Signs and symptoms of smallpox may include:
sudden onset of high fever which may be recurrent
malaise (general feeling of unwellness)
widespread skin rash – flat spots which change into raised bumps then firm fluid filled blisters which then scab (see image)
In 30 to 50% of unvaccinated people with variola major the disease progressed with bleeding, low blood pressure, multi-organ failure and death.
Variola minor had a death rate of less than 1%.
Diagnosis of smallpox
Diagnosis is by laboratory testing of blister fluid or skin scrapings, or blood taken during the fever stage.
(time between becoming infected and developing symptoms)
From 7 to 19 days, usually 10 to 14 days.
(time during which an infected person can infect others)
From the start of the fever until all scabs have fallen off. People are most contagious during the early skin rash.
Treatment for smallpox
There is no specific treatment for smallpox. Persons with suspected or confirmed smallpox require supportive treatment in hospital.
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