This document provides an overview of smallpox, including its history, microbiology, types, transmission, symptoms, treatment and vaccination. Smallpox is a highly contagious viral disease that was responsible for 300-500 million deaths in the 20th century. It first appeared in northeast Africa around 10,000 BC and was a major killer worldwide until the successful vaccination program led by Edward Jenner in the late 18th century. Jenner demonstrated that inoculating humans with cowpox conferred immunity to smallpox. The smallpox virus belongs to the orthopoxvirus family and causes a characteristic rash and pustules on the skin. Transmission occurs via airborne droplets from the respiratory tract. There is

1. RELIANCE INSTITUTE OF NURSING
TOPIC
PRESENTED BY :-
MR. ROMAN BAJRANG
BASIC BS.C NURSING 2ND YEAR
RELIANCE INSTITUTE OF NURSING

2. SMALLPOX
INTRODUCTION
 A highly contagious and frequently fatal viral disease.
 The disease is also known by the Latin names Variola or Variola Vera, which is a
derivative of the Latin Varius, meaning "spotted", or Varus, meaning "pimple".
 The term "Smallpox" was first used in Europe in the 15th century to distinguish Variola
from the "great pox" (Syphilis).
 Smallpox was responsible for an estimated 300–500 million deaths during the 20th
century.
 Believed to have begun in Africa and spread to India and china.
HISTORY
 First appeared in northeastern Africa around 10,000 BC
 Skin lesions on mummies 1570-1085 BC Ramses V
 In the elephant war in Mecca 568 AD, smallpox decimated the Ethiopian soldiers
 Introduction of smallpox into the new world (Carribean 1507, Mexico 1520, Peru 1524,
and brazil 1555 ) facilitated Spanish conquest
 Smallpox destroys Hottentots (1713)
 In 1738, smallpox killed half the Cherokee Indian population
 Smallpox disrupted colonial army in 1776
MICROBIOLOGY
 Caused by Variola virus
 Belongs to the genus Orthopoxvirus, the family Poxviridae and subfamily
Chordopoxvirinae
 Single, linear, double-stranded DNA molecules and replicate in cell cytoplasm.
 Shaped like bricks and measure about 300 x 200 nm in size
 Incubation: 12-14 days (range 7-17d)

3.  2 clinical forms:
 Variola major
 Variola minor
 Variola major
 Classic smallpox
 Predominant form in Asian epidemics
 Highest mortality (~30%)
 Variola minor
 Causes milder disease
 Discovered in 20th century
 Started in S. Africa
 Was most predominant form in N. America
TYPES
 Classic smallpox was considered the most communicable disease; about 30% of
unvaccinated people who came in contact with the virus were infected.
 The Hemorrhagic variety of Variola had a much higher death rate (95%) than classic
smallpox and lead to death more quickly.
 The Malignant or flat forms of smallpox affected 6% of the population and evolved
slower than the classic type of smallpox but with a death rate of almost 100%.
 The Modified variety of Variola essentially affected people who were vaccinated.
PATHOPHYSIOLOGY
Virus lands on respiratory/oral mucosa
Macrophages carry to regional nodes
Invades Reticuloendothelial organs

4. White blood cells infected
Systemic inflammatory response
SIGN & SYMPTOMS
 The initial symptoms that the person has are fever 1030, body aches, headache, chills and
vomiting.
 After the initial symptoms the virus creates a rash that starts as macules (flat, red lesions)
on the skin. Then vesicles (raised blisters) form and lastly pustules (pus filled blisters)
appear.
 Just after the rash appears, the virus is highly contagious as it moves into the mucous
membrane.
TRANSMISSION
 Airborne route
 Infectious materials:
 Saliva
 Vesicular fluid
 Scabs
 Urine
 Conjunctival fluid
 Possibly blood
 The virus can cross the placenta, but the incidence of congenital smallpox is relatively
low.
 Smallpox transmission does not occur through animals or insects.

5. PREVENTION
• The smallpox vaccine is the only known way to prevent smallpox in an exposed person.
The smallpox vaccine helps the body develop immunity to smallpox.
• Isolation of patients if they develop fever.
TREATMENT
 No proven treatment.
 Only thing done was to give those intravenous fluids and medicine to control fever and
pain.
 Antibiotics, given to prevent possible bacterial infections.
VACCINATION
 Edward Jenner demonstrated that immunity to smallpox could be produced by
inoculating a human with material from a lesion on the udder of a cow. Jenner called this
infectious material vaccine, and the procedure came to be called vaccination.
 The material Jenner used for his vaccine probably contained cowpox virus, a virus related
to Variola but not as virulent.
Smallpox (vaccinia ) vaccine dryvax®
 Lyophilized vaccinia containing calf lymph.
 Trace amounts of antibiotics:
 Polymyxin B.
 Streptomycin.
 Chlortetracycline.
 Neomycin.
THANKYOU!