You've probably heard of smallpox. But you may also have questions about what it is, how dangerous it was in the past, and why we don't have to worry about it now. Today, we'll talk about it all in a simple way that you can understand. This is a bit of a long story, but you'll learn a lot.
What is smallpox?
Simply put, smallpox was a very serious, deadly disease that existed in the past. It killed millions of people. When you get this disease, you get hard, water-filled blisters on your body. Even though they heal, they sometimes leave ugly scars on your face and body. Imagine, if you get this disease , on average, about one in three people died. That's how terrible it is.
But there is good news. Since the 1960s, the World Health Organization (WHO) has been working hard to eradicate smallpox from the world. By using vaccination and controlling the spread of the disease, they have succeeded. By 1980, smallpox had been eradicated from the world. The last natural case of the disease was reported in 1977.
Does smallpox still exist in the world?
No. No one has had smallpox in humans for more than 45 years. It is no longer spread naturally. However, samples of the virus that causes smallpox are kept for research purposes only in one laboratory in the United States and another in Russia. But that is nothing to be afraid of.
How did we eradicate smallpox from the world?
This is a major achievement. The eradication of smallpox may have been possible due to several factors:
- This disease only affects humans. It is not spread by animals or insects. Therefore, there are few ways in which the disease can be transmitted.
- The disease was easy to recognize. Everyone who got smallpox showed symptoms, especially those spots. That is, no one was unaware that they had the disease (there were no asymptomatic carriers).
- The disease spread slowly. Smallpox usually began to spread when the patient was too ill to go outside. It often spread among people living in the same household.
- The spread was controlled by "Ring Vaccination". Since the disease was only spreading among people in close contact, health officials were able to stop the spread by using a method called "ring vaccinations". That is, when a sick person is found, they only vaccinate those who have been in close contact with that person (like a "ring" around the sick person).
- This was a disease that had been around for thousands of years. So, people who had recovered from smallpox already had immunity. That meant that fewer people needed to be vaccinated to stop the spread of the disease.
Just think, it was because of these factors that it was possible to eradicate smallpox, one of the most devastating diseases of that time, from the world.
What are the symptoms of smallpox?
When smallpox is contracted, the disease progresses through several stages. The main symptoms are:
- High fever.
- Severe headache.
- Back pain.
- Stomach pain.
- Excessive fatigue and weakness.
- Vomiting.
- Spots that first start inside the mouth, then spread to the face, and then all over the body.
- These spots later become sores and become hard lumps (pustules).
Symptoms like fever, headache, and fatigue come first. They can last for two to four days. Sometimes the fever may persist or come back even after the spots appear. Then the spots appear. Even then, they improve in stages.
What do smallpox spots look like?
Smallpox lesions first appear inside the mouth and on the face, and then spread quickly over the entire body. They start as red spots, then become hard lumps that crust over and fall off. In the most common form of smallpox (`ordinary smallpox`), the lesions develop in several stages:
1. Early stages: After the initial symptoms, spots appear on the tongue, inside the mouth, and throat. The red spots in the mouth become sores and burst.
2. Spreading spots: These spots then spread to the face, arms, legs, back, and chest. After about a day, they spread to the entire body, even the palms and soles of the feet.
3. Pus-filled bumps: The bumps on the skin are filled with pus (a thick fluid). There may even be a small dent (`dent`) in the middle of each bump. These bumps take about two days to fill with pus.
4. Pustular rash and scabs: The bumps turn into hard, round bumps (pustules). Over the next ten days, scabs form on top of these pustules.
5. Scabs falling off: These scabs fall off after about a week, but scars remain.
Are there different types of smallpox?
Yes, there were several varieties of smallpox. The symptoms they caused also varied slightly:
- Ordinary smallpox: This was the most common type. It caused the symptoms described above. About 85% of all smallpox cases were from this type. About one in three people who developed ordinary smallpox died.
- Modified-type smallpox: This type of smallpox sometimes develops in people who have previously been vaccinated. It is similar to regular smallpox, but the rash is not as severe and does not last as long. Most people survive it.
- Flat-type (malignant) smallpox: This had more severe early symptoms than regular smallpox. The nodules from the spots coalesced and never hardened or filled with fluid. As a result, a flat, smooth rash was formed, with no crusting. This type was most common in children. It was almost always fatal.
- Hemorrhagic smallpox: This was common among pregnant women. It had severe early symptoms. The spots usually did not harden or become fluid-filled. Instead, the skin underneath would bleed, making the spot appear black or burned. Internal bleeding and organ failure could also occur. Hemorrhagic smallpox was almost always fatal.
What causes smallpox?
Smallpox is caused by a virus called Variola virus . There are two strains of the variola virus: Variola major and Variola minor (also known as Variola alastrim). Variola major caused most smallpox cases and deaths. Variola minor caused similar but less severe symptoms. Variola major caused more than 30% of deaths, while Variola minor caused only 1% of deaths.
How did smallpox spread?
Smallpox was spread mainly through close, face-to-face contact. For example, someone with smallpox could infect someone nearby when they coughed or spoke. It could also be spread by touching items such as bedding and clothing that had been used by the infected person.
What are the possible complications of smallpox?
The most common complication of smallpox is severe scarring. Other complications include:
- Blindness.
- Brain infection (Encephalitis).
- Infection of the small air sacs in the lungs (Bronchopneumonia).
- Bacterial infections.
- Arthritis.
Why was smallpox so deadly?
Although experts are not sure, it is possible that smallpox caused death due to a combination of factors:
- The virus kills a large number of cells (cytotoxicity).
- Kidney failure.
- Pneumonia is damage to the lungs. This causes difficulty breathing and a lack of oxygen to the tissues.
- Hypovolemic shock. Bleeding and organ failure due to hemorrhagic smallpox.
Do we still vaccinate against smallpox?
Doctors no longer vaccinate the general public against smallpox. However, some researchers and military personnel still give smallpox vaccines to selected groups. The U.S. government keeps a stockpile of smallpox vaccines, ready to use if the disease ever spreads again.
When did America stop giving smallpox vaccines?
In the United States, smallpox vaccination was discontinued from routine vaccination programs in 1972. The last outbreak of smallpox in the United States was in 1949.
Does the smallpox vaccine last a lifetime?
Some studies suggest that the smallpox vaccine can provide protection for decades. For those who need to get the smallpox vaccine because of work, the US Centers for Disease Control and Prevention (CDC) recommends getting a booster dose every three years.
Was smallpox the first disease for which a vaccine was discovered?
Yes. In the late 18th century, a doctor named Edward Jenner confirmed the story that dairymaids who contracted cowpox, a disease similar to chickenpox, were protected from smallpox. We now know that cowpox and smallpox are very similar viruses. So, when people got cowpox, a minor illness, and became immune to it, they also became immune to smallpox.
Jenner began infecting cows with smallpox to prevent people from getting smallpox. That was the world's first vaccine. The word "vaccine" comes from the Latin word for cow, "vacca."
Today, the smallpox vaccine is made from a virus called `vaccinia.` Because it is similar to smallpox, it provides immunity without causing smallpox.
What is this 'Variolation'?
Variolation is the earliest form of vaccination. People were deliberately induced to develop smallpox (smallpox) by injecting the Variola virus into their bodies. This was done by scratching the skin with pus from smallpox sores or by inhaling a powder made from scabies. The disease caused by variolation was less severe than naturally occurring smallpox, and people later developed immunity to smallpox. This method is thought to be hundreds of years old.
Why does the smallpox vaccine leave a scar?
Unlike other modern vaccines, smallpox vaccines use a live, unmodified, smallpox-like virus (called `vaccinia`). Instead of being injected with a needle, a health care worker dips a `bifurcated needle` into your shoulder and injects it into your arm. The area where the shot was given is then infected with `vaccinia`. This infection causes a blister to form, which later leaves a scar.
People who receive this type of smallpox vaccine should take good care of the injection site. Otherwise, they could infect someone else with `vaccinia`. These types of vaccines are `ACAM2000®` and `APSV`.
The `JYNNEOS™` vaccine (also used for `mpox`) is made from a weakened (`attenuated`) virus. It is given as a regular shot. It has fewer side effects than other smallpox vaccines. It is given as two doses under the skin, four weeks apart.
Is there a treatment for smallpox?
There are several antiviral medications approved for smallpox. They are:
- `Tecovirimat (TPOXX®)`
- `Brincidofovir (TEMBEXA®)`
- `Cidofovir (Vistide®)`
These were developed after smallpox was eradicated, so they haven't been tested on people who have had smallpox. But, based on other studies, experts think they could be used as a treatment if smallpox were to spread again. They have also been tested to see if they are safe for people.
How was smallpox diagnosed?
In the past, doctors diagnosed smallpox based on the appearance of your spots and the pattern of your symptoms. They can also test samples of your blood or skin tissue. The samples are sent to a lab to look for the virus's `DNA` or antibodies (antibodies) that are produced against smallpox. Smallpox was finally diagnosed in 1978.
What is the difference between Smallpox, Mpox, and Chickenpox?
Smallpox (`Smallpox`) and Mpox both belong to the same family of viruses called `Orthopoxvirus`. They have similar symptoms, but `Mpox` causes a less severe disease than smallpox. The `Vaccinia` vaccine can protect against both.
Despite the word "pox" in its name, chickenpox is caused by a virus called Varicella-zoster, which is not related to smallpox or other Orthopoxviruses. Therefore, chickenpox is a completely different disease.
Finally, a few things to remember
For centuries, smallpox was one of the world's deadliest diseases. But today, most of us don't even think about it. No one has had smallpox in nearly fifty years. Thanks to public health efforts, countries like the United States are prepared with treatments and vaccines to deal with any chance of the disease ever spreading again.
So, smallpox is a disease that has been added to history, but it has taught us many lessons. It is also a great example of how even the most serious disease can be controlled with the power of science and public health.
` Smallpox, Smallpox, Vaccine, Symptoms, Chickenpox, Virus, Eradication
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