Smallpox

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Smallpox / Obituary / Variola

Definition : It is an acute viral disease caused by variola virus characterised by sudden onset of high grade fever associated with prostration malaise, headache, vomiting and sometime convulsion. Followed by typical rashes ( macule, papule, vesicle, pustule and scab) starting from limbs and face than spread toward the trunk. The disease eradicated now from the world.

  • Last case seen in India - 1975
  • India was free declare in - 1977
  • Last case of the world in Somalia - 1978
  • The disease eradicated from the world - 08/05/1988
FACTOR RESPONSIBLE FOR ERADICATION OF THE DISEASE :-
  1. Only single reservoir (Man). No animal reservoir.
  2. Vaccine was highly effective (100%).
  3. Low infectivity (30-40%).
  4. Long incubation period.
  5. Easy diagnosis.
  6. No sub-clinical cases.
  7. International co-operation. 

AGENT FACTORS
Agents : Variola virus.
Reservoir Of Infection : Only man.
Source Of Infection : Case - clinical case.
Infective Material : Nasopharyngeal secretion and vesicular fluid.
Period Of Communication : Till scab formation (8-10 days ).



HOST FACTORS 
Age : All ages are susceptible.
Mortality Rate : High in children.
Sex : Equal effects on both sexes.
Immunity : Life long immunity after single attack.



ENVIRONMENTAL FACTORS
Season : Winter season is favorable.
Area : Overcrowding area and unventilated houses.
Mode Of Transmission : Direct droplet and direct contact.
Incubation Period : 7-17 days ( average 12 days ).


CLINICAL FEATURES
i. Prodromal Phase : (2-3 days)
  • High grade fever ( fever comes down on appearance of rashes).
  • Prostration malaise.
  • Headache.
  • Vomiting.
  • Convulsion.
ii. Eruptive Phase : (7-10 days ) 
  1. Rashes appear (macule, papule, vesicle, pustule and scab) multilocular, umblicated deep seated. soles and palms are affected (axilla not affected).
  2. Distribution - Centrifugal (more rashes on face & limbs). Starts from face & limbs and spread centripetal limbs to trunk.
  3. Diagnosis - Vesicular fluid examination ( brick shaped bodies positive).


PREVENTION & CONTROLS
  1. Early diagnosis
  2. Notification
  3. Isolation
  4. Symptomatic treatment
  5. Vaccination - Live attenuated vaccine, inoculate in skin with bifid needle.



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