Smallpox history

The HSA states, however, that "covered countermeasures" apply only to smallpox vaccines at this time, and although HSA protects manufacturers and others against liability, it does not directly set forth compensation procedures for vaccine recipients. Under Part C of the HSA, compensation for death benefits is capped at 262,100. If a case does end up in court, the plaintiff must "prove culpability equal to or rising above the level of negligence." It seems assured that the history of vaccine regulations and litigations will continue to change for some hme to come. The swine flu and other vaccine-related ADRs are discussed further in Section 28.4.4.1. 

The threat of a bioterrorist attack with smallpox is especially disturbing since the eradication of smallpox remains one of the great achievements in human history. Unfortunately, since routine vaccination against smallpox was discontinued in 1978, few people retain immunity today. Although there are only two official repositories of the smallpox virus today, it is still possible that terrorists will be able to obtain the virus. Thus, the government has had to stockpile supplies of the vaccine, and there is some debate about whether to resume routine smallpox vaccinations. Although the smallpox vaccine was discovered by accident, the story of how Louis Pasteur developed the first anthrax vaccine and his use of unvaccinated animals as controls remain as excellent lessons about the process of science (Trachtman 2002). 

Smallpox is a disease that has been present for centuries. Epidemics of this viral disease, unique to humans, have been reported since ancient history. Once one of the most feared of all diseases, smallpox was declared eradicated worldwide by WHO in 1980 (WHO, 1980). The last case occurred in Somalia in 1977. A worldwide vaccination program against smallpox was responsible for the elimination of the disease. Routine vaccination of the general U.S. population against smallpox ended more... 

Donald R. Hopkins, Princes and Peasants Smallpox in History (Chicago University of Chicago Press, 1983), p. 77, cited in Marglin, "Losing Touch, p. 112. For the scientific career of vaccination and its application to anthrax and rabies, see Gerald L. Geison, The Private Science of Louis Pasteur (Princeton Princeton University Press, 1995). 

The age distribntion of natnrally occnrring smallpox reflected the degree of susceptibility in different commnnities. In nrban areas where adults had a history of natural infection or vaccination, most of the cases occurred in children. In rural areas, cases reflected the population distribntion. 

One of the most distinguishing features between smallpox and chickenpox is the presence of a prodrome, including a fever, before rash onset. Patients with smallpox characteristically have a severe febrile prodrome beginning 1 days before rash onset. The fever tends to be high, at least 101°F. but most frequently is between 102 and 104°F. hi comparison, children with chickenpox have either no prodrome or a short, mild prodrome, and have little fever before rash onset. Chickenpox in adults may be more severe, and adults are more likely to have some fever before rash onset. However, in either adults or children, if there is no history of a febrile prodrome, smallpox is very unlikely. 

The patient s history is also helpful in distinguishing chickenpox from smallpox. Most patients presenting with chickenpox will have no reliable history of having the disease or the chickenpox vaccination, and most patients will recall exposure to a case of chickenpox or Shingles 10-21 days before onset of their symptoms. 

Patients having a febrile prodrome and either one other major criterion or at least four minor criteria are at moderate risk for smallpox. For patients at moderate risk, physicians should alert infection control and immediately institute contact precautions and respiratory isolation. If possible, they should obtain dermatology and/or infectious disease consultation and obtain digital photographs of the lesions. Given a moderate risk situation, the appropriate clinical diagnosis is essential, and physicians must rule out varicella or complication of vaccinia (smallpox vaccine). Therefore, for moderate risk patients, the history is essential, specifically the history of clinical varicella infection, history of vaccination for varicella and history of possible exposure to vaccinia (smallpox) vaccine. 

Smallpox vaccine administration requires a bifurcated needle. Each bifurcated needle is sterile and individually wrapped. The vaccinator should first review the patient s history to ensure the patient has no contraindication to receiving the vaccine. However, dnring an ontbreak of smallpox, case contacts should receive the vaccine regardless of the contraindications, because the vaccine is safer than the disease. 

There is a long history of unethical human experiments. King George I of England offered pardons to inmates of Newgate Prison (London), in return for inoculation with smallpox, as part of a variolation experiment.16 We delude ourselves if we... 

Bloch H. Edward Jenner The history and effects of smallpox, inoculation, and vaccination. Am J Dis Child. 1993 147 772-774. 

Biological products have a longer and more illustrious history that is generally assumed at one time smallpox accounted for 10% of deaths in some countries, but today this is the only infectious disease ever to have been eradicated from our planet the development of cow pox vaccination was in... 

Link, Kurt The Vacdne Controversy The History, Use, and Safdy ofVacdnations. Westport, Conn. Praeger, 2005. Short synopses of the history behind most major vaccines, from smallpox to acellular vaccines. Plotkin, Stanley A., Walter A. Orenstein, and Paul A. Offit, eds. Vacdnes. 5th ed. Philadelphia Saun-ders/Elsevier, 2008. An excellent source for understanding the history of vaccine development s ainst most nwjor scents. 

The death rate from inhalation anthrax is close to 100 percent for those left untreated. For smallpox the death rate is considerably lower— perhaps 30 to 40 percent— but no effective treatment currently exists, and worse still, the disease is exceedingly contagious. Smallpox has ravaged human society at least from the beginning of recorded history, killing untold hundreds of millions and scarring for life untold hundreds of millions more. If ever there was a disease that deserved the name scourge, smallpox is it. 

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