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Smallpox

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by Carson-DeWitt R
 

Symptoms

Symptoms usually occur about 12 days after exposure. Hemorrhagic or malignant symptoms usually do not appear until death is near.
Early symptoms include:
Two to three days later:
  • Rash appears on the mouth, throat, face, and arms, then spreads to the legs and trunk
  • Red, flat lesions
  • Lesions appear at the same time
  • Lesions fill with fluid, then pus
  • Crusts form during the second week
  • Scabs form and fall off after 3-4 weeks
Hemorrhagic symptoms include:
  • High fever
  • Fatigue
  • Headache
  • Backache
  • Possible stomach pain
  • Dark red coloration
  • Bleeding into the skin and mucus membranes
Malignant symptoms include:
  • High fever
  • Fatigue
  • Headache
  • Backache
  • Slowly developing lesions that remain soft and flat
  • Skin looks like reddish-colored crepe rubber
  • Large amounts of skin may peel, if the patient survives
 

Prevention

An emergency supply of the vaccine is kept. A vaccination within four days of exposure may prevent the disease. It can also make symptoms less severe. Anyone in close contact with a patient after the fever has started should receive the vaccine. Medical and emergency personnel also should be given the vaccine.
Two weeks or more could elapse before the first symptoms occur. The success of an attack would depend on the dose that was inhaled. Experts predict most of the released viruses could live in dry, cool air, without sunlight, for up to a day. Each person infected would likely pass the disease to 10 to 20 other people. Those people, in turn, could spread it to others. The fatality rate in naturally occurring smallpox is 30% or higher.
 

RESOURCES

Centers for Disease Control and Prevention
http://www.cdc.gov

National Library of Medicine
http://www.nlm.nih.gov

 

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

 

References


Breman JG, Henderson DA. Diagnosis and management of smallpox. N Engl J Med. 2002;25;346:1300-1308.


Dambro MR. Griffith's 5-Minute Clinical Consult. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.


Mandell GL, Bennett JE, et al. Principles and Practice of Infectious Diseases. 6th ed. United Kingdom: Churchill Livingstone, Inc; 2004.


Smallpox. World Health Organization website. Available at: http://www.who.int/csr/disease/smallpox/faq/en/index.html.


Working Group on Civilian Biodefense. Smallpox as a biological weapon: medical and public health management. JAMA. 1999;281:2127-2137.

 

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