Biological Events Series: Smallpox

Smallpox...5 points to remember

Read the Demon

#1 Smallpox does not exist outside of a lab. Smallpox is highly contagious virus that no longer exists in nature. Seriously, the World Health Organization along with Dr. D.A. Henderson, wiped the Smallpox virus off the face of the earth back in the 1970's. Yet, people often tell me that the virus is alive and well in "third world" countries.

#2 Smallpox, even one case anywhere on Planet Earth, will be a global health emergency. We stopped routine vaccination against smallpox back in the '70's here in the United States. If you were born after 1979 there is a good chance you were not vaccinated. If you were born prior to that, chances are equally good that you no longer have full immunity to the virus. Many experts believe that a majority of the population is susceptible to Smallpox infection. Since we stopped vaccination, you guessed it, we stopped vaccine production...meaning no vaccine available if the virus were to be released intentionally or reemerge naturally. No immunity, no vaccine. Big problem.

#3 Several types of Smallpox. Specifically, smallpox is a variola virus and there are two types; variola minor and variola major. Variola major is the most severe (and was) the most common type, causing extremely high fever and extensive rash. Variola major comes in four flavors - ordinary (most common, about 90% of historical cases), modified - more common for people with prior vaccination, flat and hemorrhagic round out the category - both are noted in history to be rarely seen, but deadly.

#4 Smallpox is really contagious. Historical data suggests that one person with Smallpox can infect over twenty other people. While this may not sound like much, think about how many people you come in contact with everyday. These number are also based on the assumption that exposure would be accidental. Consider the potential of dissemination of Smallpox, or any other biological agent for that matter, was conducted intentionally. Smallpox is spread by droplet transmission, by direct contact with the sores or eruptions on an infected persons, and by contact with clothing or other items of an infected person. The potential for infection lingers until all the scabs have healed.

#5 Smallpox, like many biologic agents, presents like influenza. The incubation period is generally thought to be 7 to 14 days (some sources say 10 -12 days). A person with Smallpox can spread the virus even before they develop the associated rash. Initial signs and symptoms include; general illness, fever, nausea, vomiting, headache...similar to flu. The rash sprouts in about 3 days, going quickly from lesions to vesicles. This rash develops in a centrifugal pattern...meaning it appears on the face, the palms of hands and the soles of the feet first. In contrast to other rashes like chickenpox (varicella) that concentrates on the trunk of the body.