SMALLPOX

1. SMALLPOX Presentation by: Maria S Avila-Perez

2. History of the smallpox One of the deadliest diseases. This disease does not care who the person is, it will simple attack anyone.

3. History • An ancient menus that has been terrorizing human kind since the beginning of civilization. • It is not exactly known when smallpox makes it first appearance. • It is mostly believe that it beginning as an animal disease in Africa, middle east or the Asian sub continent. • And at some point making a its way to human population.

4. History • The first evidence of this deadly disease was found in ancient Egypt. • In 1898 an archeologist uncovers the mummy of Ramses the 5th. Which was believe to have died around 1157 BC. • The mummy of Ramses show evidence of a rush believe to be smallpox.

5. History • Smallpox had a great effect in the world history. • It’s a disease that follow the population; as it migrated, allowing it to spread. • Its was used as biological weapon by the French-Indian war when British commander decided to use the virus against the Indian.

6. History • Edward Jenner was the person responsible for the vaccine of smallpox. • His discovered the his when milkmaids become infected with cowpox, they some how become immune to smallpox. • In 1796 he tested his theory by infecting an 8 year old boy with cowpox. • Weeks later he infected the boy with smallpox. He then notice that the boy had no effect. So weeks later he tested it again and had the some results. The boy had no effect.

7. History • Finally in 1799, George Pearson confirmed Jenner's finding and started vaccinating.

8. History • Its is estimated that approximately 30% of those who contracted the virus died from it. • The recovery of the disease granted long life immunity of it.

9. Smallpox case in 1970 • In Germany the outbreak began with an electrician returning from Pakistan who got a fever and diarrhea. • In Jan 11 1970 he was admitted to the hospital suspected of typhoid fever he was placed in isolated room and came in contact with two nurses. • In Jan 14th he developed a rash. • In Jan 16th doctors confirmed it to be smallpox

10. Following procedures • He was immediately rushed to an isolation hospital. • 100,000 people were judged to be at risk and were vaccinated. • Hospital staff and patients were quarantined for 4 weeks and vaccinated.

11. A rare contagious cough • Patient developed a cough, a rare symptom rarely seen with smallpox. • Produces a large-volume, small-particle smallpox aerosol . A fine suspension of high-density liquid droplets that are easily inhaled • 19 cases of infected: 4 were in other rooms, 8 in floor above, 9 on third floor. Remainder a result of inhalation of aerosolized virus. One of them a visitor who spent 15 mins in hospital and had briefly opened a corridor door thirty feet from patients room to ask directions

12. The Virus • Smallpox Virus- The largest virus containing the most complex DNA sequence

13. The Virus • Belongs to the family Poxviridae • 1.) subfamily- chrodopoxvirinae • 2.) subfamily- Entomopoxvirinae • It belonged to the orthopoxvirus genus. Othopoxvirus are very large, brix-shaped viruses about 300x200nm (the size of a small bacteria)

14. The Virus • Have a complex internal structure, of a single double-stranded DNA genome. Its enclose within a core the is flaked by two lateral bodies. • The surface of the virus particle is covered with filamentous protein components • The entire particle is enclosed in an envelope derived from the host cell membranes

15. Types of the smallpox VirusThere are two types • Variola major • Is the severe and most common form of smallpox. • With a most extensive rash and fever. • There four types of this variol major. • Ordinary- the most frequent type, with 90% or more cases. • Modified- its mild and occurs on people who have been vaccinated. • Flat and hemophragic are very rare and severe. Usually fatal. With death rates of about 30%.

16. Types of the smallpox VirusThere are two types cont.. • Variola minor • A less common presentation of the smallpox • A less severe disease, with death rates of 1% or less.

17. Transmission • Can occur from face to face contact, direct contact with fluids or objects of that are contaminated by the infected individual and rarely by air as well.

18. Transmission • Variola major has less chance of being transmitted, do to it being very severe that it weakens people and doesn’t allow them to move and travel around as much. • Variola minor is less severe and with minor symptoms. Therefore people can spread it more widely.

19. Transmission • There are two ways smallpox can enter the body. Through the respiratory tract and through inoculation of the skin.

20. Transmission • The incubation period lasts an average of 12-14 days. (can range from 7-17 days) • During the incubation period, the person is NOT contagious and with out symptoms. • Sometimes the individual can be contagious with the onset of fever but more at the onset of the rash. • Its is only after the infected person has its scab fall of, that they are not longer contagious. • Animals and insects can not be infected by smallpox or carry it. Smallpox is only a human disease. Transmitted from human to human.

21. Couching the smallpox! • One can couch this virus face to face contact, this is done when a person inhales droplets of saliva from the infected person. • Also by direct contact, which can be with fluids and objects such as clothing of the infected person. • Another way to couch this virus is through air. Its rare but most likely in enclosed areas such as elevators, buildings, buses ect..

22. pathogenesis • The virus generally enters through the nose and attacks the cells in the lungs. • The virus expands in the cell and the next cell over and so on. • Its during incubation site where the virus grows and replicates. • It later moves to lymph nodes, then to deeper lymph node and may also move to the bloodstream. • In the evolution of the skin, dilation of capillaries in the papillary layer of the dermis will initially occur. After the swelling of the endothelial cells of the vessel walls; perivascular cuffing with lymphocytes, plasma cells, and macrophages are seen. • Re-epithilialization as well as scaring occur when healing. • There is absence of any lesion any where else like organ except in the skin and mucouse membranes, • Endothelial cells in sinusoid of liver were often swollen, . • The spleen and bone marrow had reticulum cell herplasia.

23. symptoms • Symptoms are noticeable after the incubation period. • One will develop headaches and body pains. Which will last for a couple of days. Unlike the fever which will last the duration of the illness. • During the two weeks one will develop the rash. These first appear in face, hands and feet. Then spread through out the whole body. • The rash become filled with a liquid (similar to a blister) • Which grow of about to dime size, and later become scabs on the skin.

24. diagnosis • Beside the symptoms, another way to find out if one actually has this disease is by the rash. • In the modern times, a diagnoses was made by using an electron microscope to identify the virus in fluid from the papules, urine and in the patients blood before the appearance of the rash.

25. Prevention • There is not a specific treatment for it but there is prevention by vaccination.

26. Prevention • Besides vaccination as a prevention there is other things one can. • Avoid contact with and infected individual. • Avoid there infected fluid and objects. • Avoid being enclosed in small areas with them. • The infected person must avoid doing these and not travel as well. • It is only after the scabs fall of that the person is no longer contagious.

27. Eradication • It took a 12th year campaign to ride the world of this disease. • In 1980, the world health organization (WHO) come up with a program to completely eradicate the virus. They did this by coming up with a vaccinations for the disease. However they made a exception of keeping samples of the virus stored in in two laboratories.

28. Smallpox historical statistics

29. Prevalence and incidence statistics for Smallpox today! • Incidence (annual) of Smallpox: 0 cases throughout the world. • Incidence Rate:approx. 1 in 0 or 0.00% or 0 people in USA • Incidence extrapolations for USA for Smallpox: 0 per year, 0 per month, 0 per week, 0 per day, 0 per hour, 0 per minute, 0 per second. Note: this extrapolation calculation uses the incidence statistic: 0 cases throughout the world

30. Why care? Biohazard • Stocks of viable variola virus were eventually transferred to reference laboratories in the Centers for Disease Control and Prevention (CDC) in Atlanta, and the Research Institute for Viral Preparations in Moscow.

31. Are we prepared for Bioterrorism? • Dr. D.A. Henderson, Director of the Johns Hopkins Center for Civilian Biodefense Studies, estimates that no more than 10 to 15% of the U.S. population today retains immunity to smallpox. • The CDC claims that it has approximately 15 million doses available for immediate use. • Experts like D.A. Henderson believe that, due to damage, poor storage conditions and the passage of time, the amount of useful smallpox vaccine is actually closer to 6 or 7 million doses. • Moreover, as these stocks have been frozen for twenty years, it is unclear how effectual they remain.

32. References • Ajayi, T. (2006, May 24). Smallpox and bioterrorism. In Standford Journal of International Relations. Retrieved July 15, 2013, from http://www.stanford.edu/group/sjir/3.2.02_ajayi.html This web article has a lot of very good information, not only does it mention the basics of smallpox such as history and what it is, but there is also two real case studies to support the argument of smallpox as bioterrorism. • Schoenstadt, A. (2006, October 6). Smallpox transmission. In eMedtv. Retrieved July 17, 2013, from http://virus.emedtv.com/smallpox/smallpox-transmission.html It informs how smallpox can be transmitted. However to view the entire article don’t forget to click on the second page available. • Smallpox disease overview (2007, February 6). In Centers for disease control. Retrieved July 16, 2013, from http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp This served as very good started. Yet not only can you view the overview of the disease there is more to it if you click on other links such as bioterrorism. • Statistics about smallpox (2013, May 7). In Right diagnosis from healthgrade. Retrieved July 17, 2013, from http://www.rightdiagnosis.com/s/smallpox/stats.htm Great website that provides important statistics about smallpox. Also under death statistics you can find the mortality rate of smallpox. • Terry, M. P. (2012, January 1). History of infectious disease and vaccination in united states. In VacTruth. Retrieved July 18, 2013, from http://vaxtruth.org/2011/08/history-of-infectious-disease-and-vaccination-in-the-united-states/ Basicly this site gives the history of the disease all in one webpage. Information such as smallpox in history and Edward Jenner’s vaccination.