Smallpox mortality

DNA viruses Poxviruses Variola Vaccinia Large particles 200 x 250nm complex symmetry Variola is the smallpox virus. It produces a systemic infection with a characteristic vesicular rash affecting the face, arms and legs, and has a high mortality rate. Vaccinia has been derived from the cowpox virus and is used to immunize against smallpox... 

The development and widespread use of vaccines is one of the greatest public health achievements of the twentieth century. Other than safe drinking water, no other modality has had a greater impact on reducing mortality from infectious diseases. The first accounts of deliberate inoculation to prevent disease date back as far as the tenth century. However it wasn t until 1798 that Edward Jenner published his work on inoculation of natural cowpox as a means to prevent infection with smallpox. This was the first scientific attempt to prevent infection by inoculation. Since 1900, vaccines have been developed against more than 20 diseases, with half of these recommended for... 

Smallpox Smallpox is a very contagious disease with a mortality rate as high as 30-35%. It is estimated that smallpox was responsible for 300-500 million deaths in the 20th century. Fortunately, it has been eradicated in 1979 through strict regimens of vaccination. 

The discovery of vaccines for smallpox, cholera, and typhoid and the variety of vaccines now available have led to a significant reduction in the mortality and morbidity due to many diseases, with smallpox being the first to have been completely eradicated and poliomyelitis targeted to be the next. At present, the World Health Organization is working toward the complete elimination of poliomyelitis throughout the world [188,189], However, since Jenner discovered the vaccine for smallpox more than two centuries ago [190], only some 50 vaccines have been approved for use, and few additional vaccines have been discovered. Most of those in current use are administered parenterally they can induce only a systemic immune response, not mucosal immunity. Obviously the latter is very important in the prevention and treatment of infectious diseases, be they due to viral, bacterial, or parasitic pathogens that attack via the mucosal surfaces [190],... 

Smallpox vaccine is not recommended for use in certain groups who may be at risk for complications of the vaccine, in up to 0.2% or more of immunized populations, immunosuppressed individuals, pregnant women, and patients with atopic dermatitis may develop complications related to vaccinia, the orthopox virus used in smallpox vaccine. Vaccinia immunoglobulin can be given to those at risk for these complications. Smallpox vaccine can also be given up to 4 days postexposure as postexposure prophylaxis with significant reduction in mortality. 

Centers for Disease Control and Prevention. (2003). Update Cardiac related events during the civilian smallpox vaccination program—United States, 2003. MMWR Morbidity and Mortality Weekly Report, 52, 492-496. 

Centers for Disease Control and Prevention (CDC). Update adverse events following civilian smallpox vaccination—United States, 2003. MMWR Morb Mortal Wkly Rep 2003 52(34) 819-20. 

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). 

For people with high-risk exposure to smallpox, there are no contraindications to the vaccine, because persons at greatest risk from vaccine complications are also at greatest risk for mortality from the disease (32). However, for preevent vaccination purposes, in the absence of circulating smallpox disease, the following groups of people should not receive smallpox vaccine (32) ... 

After an aerosol release of smallpox, public health authorities will make vaccine supplies available to affected communities. Postexposure vaccination is effective in preventing infection or lowering mortality up to 4 days after exposure. Physicians should give the vaccine to suspected cases to ensure that a mistaken diagnosis does not place patients at risk for smallpox. An emergency vaccination program should also include (26) ... 

Vaccination against infectious illnesses provides unseen protection against contagious diseases—afflictions causing permanent disability or even death. Vaccines have been responsible for dramatic decreases in morbidity and mortality secondary to infectious disease, and in the case of smallpox, has globally eradicated a once life-threatening illness.However, while true adverse consequences of vaccination have never exceeded the level of adverse consequences of infection in the absence of vaccination, the public perception of harm secondary to vaccine administration has threatened to overshadow the victory of disease prevention.With the inception and continued evolution of immunization, the number of individuals protected against diseases has steadily increased. Unfortunately, the number of vaccine-related adverse events has also increased proportionally to vac-... 

Agent Index A336 Class Index C24 Smallpox Type Virus Initial symptoms are flulike including headache, chills, high fever (106° to 107°F), and aches in back and limbs. An Initial macular rash appears progressing to papules, and then blisters. The blisters in turn form crusts. The blisters and crusts cause severe itching. Routes Inhalation Abraded Skin Mucous Membranes Secondary Hazards Aerosol Contact Body Fluids Fomites Incubation 7 to 16 days Mortality Rate < 35% Reservoir Humans Direct Person-to-Person Transmission is possible. 

Jenner s speckled monster (smallpox) has been defeated, but AIDS will be with us for many years to come. While smallpox was eradicated by means of a worldwide vaccination campaign, prevention of acquired immune deficiency syndrome or AIDS will require new drugs and more careful sexual behaviour. Both diseases do share a common feature - they are caused by Nature s most successful parasites - the viruses. In the developed world, it is not uncommon for a person to survive to a ripe old age without experiencing a serious bacterial infection or contracting one of the many forms of cancer. They will, however, have suffered from the effects of numerous viral infections of the respiratory tract, i.e., colds and flu, and most probably, from the common childhood virus-inflicted disease of chicken pox. It is unlikely that any of these afflictions will have been life-threatening, but they will have caused many days to be lost from school or work. In other words, the morbidity due to the common viral diseases is high, but the mortality is low. 

Isatin-j8-thiosemicarbazone was originally found to be a potent antivaccinia viral agent in mice and the activity of this compound was attributed to complex formation [545]. Subsequently, a derivative, jV-methylisatin-3-thiosemicarbazone (M-IBT), proved to be a very effective antiviral agent in humans for the prevention of morbidity and mortality due to smallpox epide-... 

Smallpox (also known by the Latin names Variola or Variola vera) is a highly contagious disease unique to humans. The causative virus has two variants called Variola major and Variola minor. V. major is the more deadly form, with a typical mortality of 20-40% of those infected. The other type, V. minor, only kills 1% of its victims. Many survivors are left blind in one or both eyes from corneal ulcerations, and persistent skin scarring—pockmarks—is nearly universal. Smallpox was responsible for an estimated 300-500 million deaths in the twentieth century. In 1967, for instance, still prevailing worldwide in spite of massive inoculations, the WHO estimated that 15 million people contracted the disease and that 2 million died in that year [245]. 

Some 200 tons of smallpox virus have been produced by the USSR as a weapon and inherited by Russia. Their fate is unclear. However, details of the development of smallpox as a weapon by the Soviets became available. A report was elicited from General Prof. Peter Burgasov, former Chief Sanitary Physician of the Soviet Army and a senior researcher within the BWP. Admitting that development of BW by the Soviets did take place, in the form of live field tests, he described a smallpox incident that happened in the 1970s, and was then hashed up On Vozrazhdenie Island in the Aral Sea, the strongest recipes of smallpox were tested. Suddenly I was informed that there were mysterious cases of mortalities in Aralsk. A research ship of the Aral fleet came 15 km away from the island (it was forbidden to come... 

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. 

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