Smallpox dissemination

Other acquired disorders affecting myelin in humans may be secondary to viral infections, neoplasias or immunosuppressive therapy. Acute disseminated encephalomyelitis, also called postinfectious or postimmunization encephalitis, represents a group of disorders usually of mixed viral-immunological etiology. The condition is most commonly related to a spontaneous viral infection, of which major examples are measles, smallpox or chickenpox [1,2]. 

The antibody response to yellow fever vaccine was impaired in protein-deficient children with kwashiorkor compared to the well-nourished controls. Polio antibody production was normal in the malnourished children, all of whom also responded in the normal fashion to smallpox vaccination. They had no evidence of disseminated vaccinia (B8). In Guatemala, on the other hand, smallpox vaccination of children who had fully recovered from severe protein-calorie malnutrition led to a drop in their nitrogen retention with the added complication of disseminated vaccinia (V3). 

Vaccines Immunization may be ineffective when given during methotrexate therapy. Immunization with live virus vaccines is generally not recommended. Disseminated vaccinia infections after smallpox immunization have occurred in patients receiving methotrexate. 

British soldiers were possibly the first to use smallpox as a weapon during the French and Indian Wars (1754-1767) in North America. Intending to cause disease and mortality, the soldiers took blankets used by smallpox patients and gave them to American Indians. The resulting epidemics killed more than 50% of many of the tribes. Nine years later, Jenner discovered that inoculation of cowpox protected recipients from getting smallpox. The resulting worldwide dissemination of vaccination with cowpox diminished the potential of smallpox as a bioweapon (26). 

Those disseminating less easily, such as smallpox, tularemia, nerve agents, i.e. 

These are anthrax, smallpox, plague, botulism, tularemia, viral hemorrhagic fevers and ricin. They can disseminate and present a high risk on public health. Most of them require Level 4 Biosafety laboratories. 

Genetically Engineered Vaccinia Virus - The vaccinia viruses, or pox virus, cause a number of diseases characterized by skin lesions in both humans and animals. With some pox virus types, for example variola (smallpox), the lesions can be considerably disseminated and deadly. The virus is an enveloped DNA virus with a large genome (180,000 base pairs) coding for over a hundred proteins. The virus has its own RNA... 

Vidarabine is used mainly in human HSV-1 and HSV-2 encephalitis, decreasing the mortality rate from 70 to 30%. Whitley et al. (57) reported that early vidarabine therapy is helpful in controlling complications of localized or disseminated herpes zoster in immunocompromised patients. Vidarabine also is useful in neonatal herpes labialis or genitalis, vaccinia virus, adenovirus, RNA viruses, papovavirus, CMV, and smallpox virus infections. Given the efficacy of vidarabine in certain viral infections, the U.S. FDA approved a 3% ointment for the treatment of herpes simplex keratoconjunctivitis and recurrent epithelial keratitis, and a 2% IV injection for the treatment of herpes simplex encephalitis and herpes zoster infections (Table 43.3). A topical ophthalmic preparation of vidarabine is useful in herpes simplex keratitis but shows little promise in herpes simplex labialis or genitalis. The monophosphate esters of vidarabine are more water-soluble and can be used in smaller volumes and even intramuscularly. These esters are under clinical investigation for the treatment of hepatitis B, systemic and cutaneous herpes simplex, and herpes zoster virus infections in immunocompromised patients. 

The proposed use of biological weapons was not limited to Europe and Asia. In 1763, during Pontiac s Rebellion in New England, Colonel Henry Bouquet, a British officer, proposed giving the Indians at Fort Pitt, Pennsylvania, blankets infected with smallpox. The disease, whether purposely disseminated or not, proved devastating to the Native American population. A similar plan was executed in 1785, when Tunisians threw plague-infected clothing into La Calle, held by the Christians. 

Inhalation by human beings of the glanders agent can lead to a full-blown, systemic blood infection (septicemia), severe pulmonary infection, and chronic inflammation of the skin and eyes. There is an incubation period from 10-14 days, and septicemia can lead to smallpox-like rashes on the skin. Even with antibiotic treatment, dissemination of B. mallei in an aerosol could result in high mortality among humans. 

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