Smallpox
Definition of Medical Terms:
Cutaneous:
Pertaining to the skin
Definition of
Smallpox
An acute, highly contagious disease, initiated by
sudden severe constitutional symptoms, and characterized by a
progressive cutaneous eruption, that
often results in permanent pits and scars on healing.
Incubation:
10-14 days. Communicable: Usually from 24 to
48 hours before onset of symptoms, and until all crusts have
disappeared.
Site:
Usually found on the face, neck, upper chest,
hands, but may be present on any exposed surface such as palms, soles
and throat.
Sores start out like blisters, developing into deep
ulcerated holes filled with pus. Usually only one crop of lesions are
seen, compared to many crops present in chickenpox. The lesions appear
on the 3rd or 4th day, and may last 2 to 5 weeks.
Note:
In case of known or suspected exposure to smallpox,
revaccination of all persons whose vaccination is more than 3 years old
should be done immediately. Persons
who are at high risk, or ill should not be vaccinated, nor should
vaccination against smallpox and yellow fever be done at the same time
since both are live virus vaccines.
Individuals with extensive skin eruptions and particularly
infants with eczema should not be vaccinated nor should they be allowed
near vaccinated persons.
Viral Source:
Virus. Transmitted through exposure to infected
person via sneezing, coughing, or contact with contaminated clothing or
household articles. Transmission
may occur throughout all stages of the disease. The virus resists drying
and may be transmitted in the dried scales of the lesions.
Symptoms:
After an incubation period of 10-14 days, there is
an abrupt onset of chills, high fever, great prostration, (signs not
unlike those of severe influenza).
Headache, backache, and muscular pains may occur.
Persistent vomiting, and convulsions are common in small
children.
Following a couple days of this, a rash develops
that starts out looking like measles. On the 3rd day, the
victims fever and symptoms subside.
The characteristic eruption of lesions, 1 to 2mm in
diameter appears, generally on the forehead, temples and about the
mouth. They spread rapidly to the scalp, ears, neck, arms and hands.
About 1 day is required for the rash to reach the trunk.
The individual lesions increase in size and are
deep in the skin. By the 3rd day, the lesions contain clear
serum. Around each is a
pinkish swelling. Lesions are so close they may flow into one another.
In the next couple of days, the lesions fill with
pus as the victim’s temperature rises, causing extreme prostration.
There is pronounced facial swelling along with painful lesions.
At this point, the lesions progress and ulcerate in the mouth, pharynx,
larynx, vagina, urethra, and rectum.
By the 8th or 9th day, the
lesions have reached their peak, and are beginning to subside, forming a
crust. Loss of hair, skin
and nails occur.
Healing is slow and may take another 2 weeks, with
the deeper lesions leaving permanent pockmarks.
Mortality is high in the elderly and very young,
and in those not vaccinated. When
smallpox occurs in persons who have been vaccinated many years before,
it is likely to be mild.
Complications affect the eyes. Gangrene and
hemorrhage may occur.
ALAS TRIM
There is another mild form known as alas trim with
manifestations entirely like smallpox except for the mildness and lack
of complications. The virus
of alas trim is indistinguishable from that of severe smallpox in
laboratory methods, but it reproduces true to form and continues to
cause mild disease even after many passages through susceptible persons.
Vaccinations:
Immunity develops within 8 days of a successful
vaccination and lasts 5 to 7 years.
Exposure to smallpox requires revaccination in
people who had a vaccination over 3 years ago.
Treatment:
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