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Smallpox

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One of the most dreaded infections around the world that has now been successfully eradicated is smallpox. For many centuries, people around the world had been suffering from this incurable and  deadly infection. Worldwide immunization programs have helped in getting rid of this infection in 1979. Let us have a look at smallpox and its dangerous symptoms in the following paragraphs.

What is Small Pox?

Many people today might have heard of small pox or may have a mark on their arm from the vaccination shot given to prevent smallpox infection. However, not all are fully aware about the potential dangers of this infection. Smallpox was an infection that was caused by Variola virus. There were two variants of the virus Variola major and Variola minor. It causes pus-filled blisters and is very, very contagious. It caused death of more than 30% of the patients who were infected by this disease.

Classification of Smallpox

Smallpox was classified according to the virus variants that infected a person. Variola major was the most dangerous of the two. It leads to full body rash and very high fever. Variola minor caused less severe disease, but infected just 1% or less of the patients.

Causes of Smallpox

Smallpox as mentioned earlier is caused by Variola virus. It is highly contagious and spreads through the saliva or nasal droplets of an infected person.  It also spreads through indirect contact like touching infected clothes, bed sheets, towels, etc. It can even be transmitted to a fetus through the placenta, leading to congenital smallpox. However, such occurrences have been very rare. The infection is most contagious during the 1st week of appearance of rash. It begins to lose infectivity after 7 to 10 days of the appearance of scabs. However, the person remains contagious till the last scab remains.

Symptoms of Smallpox

Smallpox symptoms appear within 7 to 16 days after the virus gains entry into the cells. It leads to appearance of pus-filled blisters on the face and around the body. Other symptoms include:

Initial Symptoms

  • Fever
  • Malaise
  • Headache
  • Body pain
  • Vomiting
  • High Fever

Appearance of Rash

  • Small red spots in the mouth and tongue initially
  • Red spots develop into open sores that spread to the throat
  • Appearance of skin rash on the face, arms, legs, hands and feet
  • The rash turns into raised bumps containing thick, opaque pus
  • The bumps develop a depression in the center

Pustular Rash

  • The raised bumps develop into pustules after about 5 days
  • Pustules are shaped round and feel firm when touched
  • One may feel as if there are pellets inserted under the skin

Appearance of Scabs

  • Scabs form over the pustules after about a week
  • These scabs fall off leaving a pitted scar on the site of appearance
  • Scabs take about 3 weeks after the appearance of the rash to completely fall off

In some cases, one may develop serious complications. One may suffer from modified smallpox that causes no fever during the rash period. It leads to lesser number of lesions that are superficial in nature. Some develop malignant-type or flat smallpox. Here, the symptoms include high fever and severe toxemia. The lesions remain buried under the skin and this form is always fatal. The last type of smallpox is hemorrhagic smallpox. It causes bleeding under the skin, mucous membranes as well as the gastrointestinal tract. This condition is also called as black pox as the bleeding causes the skin to appear black. This form of smallpox is usually fatal.

Diagnosis of Smallpox

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Smallpox is usually recognized by the rash. For a definitive diagnosis, the virus is isolated from the blood or lesions in specialized labs.

Treatment of Smallpox

Smallpox vaccine given within 3 days of exposure to the virus can help in preventing or reducing the severity of the disease. If the vaccine is given after 3 days up to 7 days, the severity of the disease will be reduced to some extent. There is no other medication that can help cure smallpox. Only support care like infection control, fluid therapy, etc. will help keep the disease under check.

Prognosis for Smallpox

Smallpox  was considered to be a major illness before its worldwide eradication. It had a death rate as high as 30%. In case one developed malignant or flat smallpox, it had a death rate of about 97%. Hemorrhagic smallpox had a 100% fatality rate.

Complications of Smallpox

There are many complications of smallpox that include:

  • Respiratory complications like bronchitis or pneumonia that could turn fatal
  • Secondary bacterial skin infections
  • Encephalitis
  • Permanent pitted scars on skin
  • Blisters in the eyes that lead to conjunctivitis, corneal ulcers  and even blindness
  • Arthritis
  • Limb deformities like malformed bones

Vaccination was the only way to prevent smallpox in the past. Today, it is no longer required since the virus has been completely wiped out from the face of the earth. There is a scare around the world about dangerous elements using smallpox virus for biological warfare. However, the virus has been eradicated and countries around the world breathe a collective sigh of relief from this dreaded disease.

Written by: Saptakee sengupta
Date last updated: February 4, 2015