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Lecture 6

Lecture 6 In-class Notes [smallpox]

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University of Toronto Scarborough
Health Studies
Caroline Barakat

Lecture 6 - Smallpox Feb 10, 2010 Disease Origins - Believed to have appeared around 10,000BC, at the time of the rst agricultural settlements in NEAfrica and spread to India by means of ancient Egyptian merchants - Earliest evidence of skin lesions resembling those of smallpox on Egyptian mummies (1570 - 1085 BC) - The mummied head of the Egyptian pharaoh Ramses V (died 1156 BC) bears evidence of teh disease - Concurrently, smallpox has been reported in ancientAsian cultures, described 1122 BC in China and is mentioned in ancient texts of India - Introduced to Europe between the fth and seventh centuries and was frequently epidemic during the Middle ages Effects of Smallpox - plague ofAntonine - decline of the Roman Empire (AD 108) - Introduction by the Spanish and Portugese led to the decimation of the local population and was instrumental in the fall of the empire of theAztees and the Incas - Eastern coast of NorthAmerica. the disease was introduced by the early settlers and led to a decline in the native population - Biological warfare - French-indian war (1754-1767) - Commander of the British forces in NorthAmerica (Amherst), suggested the deliberate use of smallpox to diminish theAmerican Indian population hostile to the British - Slave trade also contributed to the spread of smallpox in N.America Etiology - Genus - Orthopoxvirus, family Poxviridae - Common name - Variola virus - At least 2 strains exist: variola major (more virulent) and variola minor - The Orthopoxvirus genus also include the monkeypox, cowpox, camelpox, chickenpox, and ectromelia (mousepox) viruses - Variola minor is a milder disease - mortality rate is approximately 1% in unvaccinated person - Overall mortality rate for variola major is 3% in vaccinated individuals and 30% in unvaccinated - Malignant and hemorrhagic forms of variola major develop in approximately 5-10% of infected people. These forms are almost always fatal; the mortality in the malignant forms is 95%. - Hemorrhagic smallpox also known as black pox - accompanied by extensive bleeding into the skin, mucous membranes and gastrointestinal tract - In the past, serious vaccine complications occurred in approximately 100 per million primary vaccinations. Transmission - Must be continuously transmitted from human to human to survive - Humans do not become long-term carriers - Animal reservoirs do not exist - Spread by direct contact or inhalation of aerosols - Infectious virus is present in oronasal secretions and in skin scabs 1
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