Smallpox treatment

The collaboration between USAMRIID and the NIAID Drug Discovery Program that identified cidofovir as a potential smallpox treatment has also discovered a class of compounds (s-adenosyl homocysteine hydrolase inhibitors) that may be effective against filoviruses, such as Ebola. In a mouse Ebola model that produces 100 percent mortality within 7 days, treatment beginning on the day of exposure provided 100 percent protection, and treatment beginning 4 days after exposure saved 40 percent of infected mice (memo from John Huggins of USAMRIID to F Manning, May 21, 1998). 

Methisa2one [1910-68-5] C qH qN OS (l-methyl-3-thiosemicarba2one of 2-oxoindole, (7), one of the more active in the isatin-3-thiosernicarba2one [487-16-1] series, has been used in the treatment and prevention of smallpox and vaccinia infections that develop as complications of smallpox vaccination... 

There is no proven treatment for smallpox, but in persons exposed to smallpox who do not show symptoms as yet, the vaccine — if given within four days after exposure — can lessen the severity of or even prevent illness. However, once a patient shows symptom, treatment is limited to supportive therapy and antibiotics to treat bacterial infections. Patients with smallpox can benefit from supportive therapy such as intravenous fluids, and medicines to control fever or pain. 

Treatment — Vaccinia immune globulin must be used in conjunction with a vaccinia vaccine if exposure to a smallpox case occurred more than 4 days earlier. However, only the vaccinia vaccine is required less than 4 days after such contact. The vaccine starts to be protective in approximately 7 days. This vaccine does not provide life-long immunity. Revaccination is recommended at 5- to 10-year intervals. Certain antiviral drugs such as Cidofovir have demonstrated that they confer some protection against infection. Unfortunately, because smallpox has been eradicated, limited research on such drugs has been conducted.3... 

Through trade with many regions, the Arabians learned and extended medical knowledge. Their major contribution is perhaps the knowledge of medical preparations and distillation methods, although the techniques were probably derived from the practices of alchemists. Avicenna, around ad 900-1000, recorded a vast encyclopedia of medical description and treatment. Another noted physician was Rhazes, who accurately described measles and smallpox. 

Respiratory, skin, and soft-tissue infections UTIs pelvic inflammatory disease (PID) brucellosis trachoma Rocky Mountain spotted fever typhus Q fever lickettsia severe acne (Adoxa) smallpox psittacosis ornithosis granuloma inguinale lymphogranuloma venereum intestinal amebiasis (adjunctive treatment) prevention of rheumatic fever ... 

Other potential uses of cidofovir that are currently under investigation include treatment of the polyomavirus-associated progressive multifocal leukoencephalopathy syndrome in patients with AIDS, postexposure prophylaxis against smallpox, and topical treatment of molluscum contagiosum. Topical cidofovir is not currently available in a standardized preparation. 

Pre-1900 Treatment of rabies, anthrax, and smallpox Principles of infection control and pain relief Management of heart failure... 

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],... 

Next I examine my body for smallpox symptoms. A week ago my father told me that he had discovered a method that would protect me from ever having the disease. I shall engraft you with the pus taken from the pox of a child with a very mild form of the smallpox. You will probably feel unwell, but that s all. Afterward you will be safe forever from the infection. This is a method that I saw tried last year on six condemned convicts. Each was inoculated with the disease, recovered, and pardoned. I shall offer the same treatment to anyone in the village who wishes to accept. He made me roll up my sleeve, scratched my skin with a needle, and dropped a yellowish liquid from a phial onto the wound. My arm felt sore afterward but nothing worse has happened yet. 

The treatment for smallpox is primarily supportive. Research is ongoing into antiviral therapies for smallpox but currently therapy for patients infected with smallpox remains supportive, with intravenous fluids, pain medications, and antibiotics as needed for secondary bacterial infections (Henderson, 1999). Cidofovir, an antiviral agent used primarily against cytomegalovirus infection, has shown some promise against orthopox viruses such as vaccinia and cowpox in animal studies (De Clercq, 2002). Currently it is approved in its IV form for use in the treatment of adverse effects of smallpox vaccination (CDC, 2003). 

With a greater immunocompromised population caused by HIV, transplantation medicines, and other immrmosuppressive treatments for rheumatoid arthritis (RA), some vaccinations utilizing live vaccines such as the old smallpox vaccine, can be very risky. Society now rmwittingly... 

Accidental administration of 10 doses of smallpox vaccine to an already vaccinated girl resulted in a clinical picture characterized by neuraxitis with general tonic-clonic convulsions. Complete cure was attained after treatment with hyperimmune antivaccinia globulins and methisazone (38). 

Dixon CW, editor. Treatment and Nursing. Sequelae Complications. Smallpox. 1st ed. London J and A Churchill Ltd, 1962 143. 

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