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The epidemiology, pathogenesis, and clinical manifestations of smallpox

INTRODUCTION

Variola virus is the causative agent of smallpox, a highly infectious disease characterized by fever, rash, and a high mortality rate that was eradicated globally by 1979 through a program that included widespread immunization [1]. In the past, smallpox accounted for 10 percent of all deaths in the world.

The virology, pathogenesis, epidemiology, clinical manifestations, and treatment of smallpox will be reviewed here. Issues related to bioterrorism and vaccinia virus vaccination for the prevention of smallpox are discussed separately. (See "Vaccinia virus as the smallpox vaccine".)

GLOBAL ERADICATION OF SMALLPOX

The global eradication of smallpox was announced in 1979, marking one of the greatest achievements of modern medicine [1]. An unusual combination of factors facilitated eradication [2]:

  • Human beings were the only known reservoir for the virus
  • No asymptomatic carrier state existed
  • An effective vaccine was available
  • Vaccination of contacts resulted in prevention or modification of disease

Although there have been no reported cases since, continued interest in this virus remains because of the concern regarding smallpox as a potential agent of bioterrorism [3,4]. The use of variola virus as a bioterrorism agent and the use of the smallpox vaccine are discussed in detail elsewhere. (See "Identifying and managing casualties of biological terrorism".)

              

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Literature review current through: Sep 2014. | This topic last updated: Jan 28, 2014.
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References
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