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HLTB21H3 (204)


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University of Toronto Scarborough
Health Studies
Caroline Barakat

SMALLPOX Origin Old World indiscriminate disease 10000BCfirst agricultural settlements in NE Africa spread to India via trade by ancient Egyptian merchants Earliest evidence on Egyptian mummies 15701085BCPharoah Ramses V died 1156BC wpockmarks 1122 BCChinaancient Indian texts 100AD Plague of Antonine A frequent epidemic during Middle Ages thth16 C serious in EnglandEurope 18 C Europe known as age of powder and patches since pockmarks were common Pox comes from anglosaxton word pocca pocket pouch craterlike scars thEffects Plague of Antonine decline of Roman Empire New World in 16 Cfall of Aztec and Incas Empires Epidemic of natives contributed to the settlement of N America by FrenchEnglish 1617Biological warfare FrenchIndian War 17541767deliberate use of smallpox to diminish Americanindians w infected blankets Slave trade to supplement dying pop spread of smallpox to N America Etiology GenusOrthopoxvirus family Poxviridae Common name variola virus can be seen wnaked eye or w electron microscope Two strains exist variola majorvariola minor Orthopox virus genus also includes monkeypox cowpox camelpox chickenpox and ectromelia mousepox virus Mortality rate variola minor2 in unvaccinated ppl variola major 3 in vaccinated 30to 50 in nave pop in unvaccinated ppl Hemorrhagic smallpox or blackpox bleedingblack marks on skin most virulent form malignanthemorrhagic forms of variola major dvlp in approx 510 of infected pplalmost always fatal 95 mortality rate Transmission must be continuous only shortterm carriers no animal reservoirs Transmitted via Direct ContactInhalation of aerosols or contaminated fomites inanimate objpillows blankets towels handkerchiefs Virus multiplies in mucous membranes of mouth and nose lymph nodes internal organs reenters bloodstream Infectious virusoronasal secretions and in skin scabs Controversial Potl for longdistance aerosol spread Transmission on fomites possible for short periods of time Virus only remains viable up to 2 days outside human host Avg incubation period 1214days Clinical Manifestation acute onset not chronic 914 days for symptoms to appear fevermalaise preeruption phase rigors vomiting headache backache occasional delirium 23 days later skin lesionspimples common on faceextremities 814 days after symptoms appear pustules rash if onnear eyes lose sight eyebrows develop scabs dry skin then falls off 2wks and heal leading to severe scarring pockmarks lose skin elasticity Person infectious a day before rash appears until time scabs thhv separated fallen off Secondary infections Epidemiology 18 C60M Europeans Case fatality rate varied fr 2060 30 death rate Higher in kids under 5 13 of survivors became blind Acquired immunity Childhood disease Epidemic evry 515 yrs R510 1872peak then vaccination decreased incidence but smallpox still cyclical endemic Treatment earlier otreatment was prayer and quack remedies Eg Smallpox godsgoddesses enlisted for protection Eg like cures like Wear red to be helped as form of luck Variolation aka Inoculation variolato graft instill smallpox virus into nonimmune ppl wV minor less virulent less risky to produce mild cases but solid immunity used by upper class Practised initially
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