Rome during it's height. (Incidentally - this seriously weakened the Roman Empire when it most needed men to fight off invaders)). In India, around 400 a plague was described as coming with pustules & boils. In the 18th century smallpox killed about 400,000 people every year (including 5 reigning monarchs) The Franco-Prussian war triggered an outbreak that killed 500,000 people from 1870 - 1875. Smallpox has a 30% mortality rate (in those with some resistance). II. Causes A virus belonging to the poxviridae - a double stranded DNA virus. Closely related viruses cause cow pox, monkeypox & vaccinia III. Spread and infection Spreads through inhaling of the virus. It's highly contagious. This usually comes the mouth, nose or pharynx of an infected person. - Being around someone (face to face) who's infected is a good way to spread smallpox. - Also spreads through contact with bodily fluids or contaminated clothing. It's most contagious 7 - 10 days after rash first appears (more on that soon), but stays contagious until rash disappears. Humans are the only known hosts of smallpox (though monkeys have been infected in a lab setting). After infection, the virus spreads to the mouth and throat areas, and local lymph nodes. Eventually it spreads into the bloodstream. IV. Symptoms There are two clinical forms of smallpox: Variola minor: a rarer manifestation of smallpox. Symptoms are much milder and mortality rate is less than 1%. Variola major: the most severe form of smallpox, most common: Usually symptoms show up 10 to 12 days after infection. Initial symptoms are very similar to the flu (or even the cold):
- fever - muscle pain - malaise - headache - prostration (can't get up) - nausea/vomiting - backache This is followed by more classic symptoms: - lesions appear in mouth, throat, tongue, etc. - fever drops - lesions rupture, releasing large amounts of virus into saliva About two days after this: - skin lesions appear. Usually start on forehead, then spread to face, trunk, etc. fairly quickly (1 - 1 ½ days). Disease then takes one of several different courses: 1) Typical: - lesions become raised “papules”, filled with fluid - this is tissue debris, not