Smallpox D. GOLDBERG PED ID SVCE WRAMC
SMALLPOX <ul><li>Genus Orthopoxvirus </li></ul><ul><li>Smallpox, monkeypox, cowpox,vaccinia </li></ul><ul><li>DNA Virus </...
SMALLPOX
SMALLPOX <ul><li>2 principle forms- </li></ul><ul><li>variola major-Europe/Asia </li></ul><ul><li>variola minor-19th centu...
SMALLPOX-Pathogenesis <ul><li>Incubation period (7-17 days): </li></ul><ul><li>Virus infects respiratory/pharyngeal mucosa...
SMALLPOX-Pathogenesis <ul><li>Clinical Stage- </li></ul><ul><li>Onset fever (103 0 ), HA, prostation, bachache, malaise, +...
 
SMALLPOX
SMALLPOX
SMALLPOX
SMALLPOX <ul><li>Secondary infection is rare </li></ul><ul><li>Death in second week due to toxemia </li></ul><ul><li>Vario...
SMALLPOX- Laboratory Diagnosis <ul><li>Level BL-4 only </li></ul><ul><li>EM of fluid/scabs </li></ul><ul><li>Culture/PCR <...
SMALLPOX- Clinical Diagnosis <ul><li>Smallpox   Varicella </li></ul><ul><li>Prodrome:   2-4 days   1-2 days </li></ul><ul>...
SMALLPOX Chickenpox Shingles
SMALLPOX-Therapy <ul><li>Cidofovir ? </li></ul><ul><li>? </li></ul>
SMALLPOX <ul><li>Postexposure Control- </li></ul><ul><li>Home care vs hospital care (neg pressure) </li></ul><ul><li>Mass ...
Smallpox-Vaccination
SMALLPOX <ul><li>Vaccination- </li></ul><ul><li>limited stock (6 million/ ? dilution) </li></ul><ul><li>untrained administ...
SMALLPOX-Vaccine complications * 70% children with fever > 39C day 4-14
SMALLPOX-Autoinoculation
Upcoming SlideShare
Loading in …5
×

Smallpox

1,542 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,542
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
69
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Smallpox

  1. 1. Smallpox D. GOLDBERG PED ID SVCE WRAMC
  2. 2. SMALLPOX <ul><li>Genus Orthopoxvirus </li></ul><ul><li>Smallpox, monkeypox, cowpox,vaccinia </li></ul><ul><li>DNA Virus </li></ul><ul><li>200 nm brick </li></ul><ul><li>shaped </li></ul><ul><li>Smallpox-person to person spread via respiratory secretions/direct contact </li></ul><ul><li>Spread best in low humidity/temperature </li></ul>
  3. 3. SMALLPOX
  4. 4. SMALLPOX <ul><li>2 principle forms- </li></ul><ul><li>variola major-Europe/Asia </li></ul><ul><li>variola minor-19th century USA </li></ul><ul><li>2 minor forms-malignant & hemorrhagic </li></ul><ul><li>Spread via respiratory droplets/direct contact at time of rash </li></ul><ul><li>Historically spreads slower than chicken pox, measles </li></ul>
  5. 5. SMALLPOX-Pathogenesis <ul><li>Incubation period (7-17 days): </li></ul><ul><li>Virus infects respiratory/pharyngeal mucosa--> regional lymph nodes--> viremia-->spleen, bone marrow, lymph nodes-->second viremia--> fever, </li></ul><ul><li>toxemia--> rash and infectivity </li></ul>
  6. 6. SMALLPOX-Pathogenesis <ul><li>Clinical Stage- </li></ul><ul><li>Onset fever (103 0 ), HA, prostation, bachache, malaise, +/- abd pain, delerium, rash by day 3 </li></ul><ul><li>Rash-macularpapular on oropharynx, face </li></ul><ul><li> forearms-->trunk, legs </li></ul><ul><li>-turns vesicular 24-48 hrs </li></ul><ul><li> - turns tense round pustules </li></ul>
  7. 8. SMALLPOX
  8. 9. SMALLPOX
  9. 10. SMALLPOX
  10. 11. SMALLPOX <ul><li>Secondary infection is rare </li></ul><ul><li>Death in second week due to toxemia </li></ul><ul><li>Variola minor-less severe symptoms, rash </li></ul><ul><li>Vaccinated -milder form </li></ul><ul><li>HIV-? (Disseminated vaccina in HIV+ soldier in 1986) </li></ul>
  11. 12. SMALLPOX- Laboratory Diagnosis <ul><li>Level BL-4 only </li></ul><ul><li>EM of fluid/scabs </li></ul><ul><li>Culture/PCR </li></ul><ul><li>Oropharyn swabs-day 7/8 of infection </li></ul><ul><li>AB titers (day 6 of rash) </li></ul>
  12. 13. SMALLPOX- Clinical Diagnosis <ul><li>Smallpox Varicella </li></ul><ul><li>Prodrome: 2-4 days 1-2 days </li></ul><ul><li>Rash: 1-2 days several days </li></ul><ul><li>Lesions: deep/tense superficial </li></ul><ul><li>Distribution: centrpetal centrifugal </li></ul><ul><li> (truncal) (face/extremeties) </li></ul><ul><li>Stage: same new crops </li></ul>
  13. 14. SMALLPOX Chickenpox Shingles
  14. 15. SMALLPOX-Therapy <ul><li>Cidofovir ? </li></ul><ul><li>? </li></ul>
  15. 16. SMALLPOX <ul><li>Postexposure Control- </li></ul><ul><li>Home care vs hospital care (neg pressure) </li></ul><ul><li>Mass “contact” vaccination (up to 4 days post exposure may ameliorate/prevent) </li></ul><ul><li>Vaccinated individuals serve as caretakers </li></ul><ul><li>Cremation of bodies </li></ul>
  16. 17. Smallpox-Vaccination
  17. 18. SMALLPOX <ul><li>Vaccination- </li></ul><ul><li>limited stock (6 million/ ? dilution) </li></ul><ul><li>untrained administrators </li></ul><ul><li>Special risk groups immuno- suppressed/ pregnant women/eczema </li></ul><ul><li>limited Vaccina IG (VIG) </li></ul><ul><li>side effects </li></ul>
  18. 19. SMALLPOX-Vaccine complications * 70% children with fever > 39C day 4-14
  19. 20. SMALLPOX-Autoinoculation

×