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Definition:

Smallpox is an acute contagious disease caused by

variola virus, a member of the orthopoxvirus family. Smallpox gets its name from the pus-filled blisters (or pocks) that form during the illness. Although the names may sound alike, smallpox is not related to chickenpox, which is a milder disease caused by a different virus. Smallpox had two main forms: variola major and variola minor. The two forms showed similar lesions.

Alternative name:
Variola - major and minor;
Variola

Etiology:
Variola Virus is a large virus measuring about 200mm in

diameter, which contain a DNA core and is thermostable , remaining viable for months in a dry climate.

The virus is acquired from inhalation .Virus particles can remain

on such items as clothing, bedding, and surfaces for up to 1 week.


bloodstream and spreads to the skin, intestines, lungs, kidneys, and brain. The virus activity in the skin cells creates a rash that starts as macules (flat, red lesions). After this, vesicles (raised blisters) form. Then, pustules (pus-filled pimples) appear about 12-17 days after a person becomes infected. Survivors of smallpox often have severely deformed skin from the pustules.

The virus starts in the lungs. From there, the virus invades the

Types: Variola major, or smallpox, has a death rate of 30%. Variola

minor, or alastrim, is a milder form of the virus with a death rate of 1%. Four types of variola exist: classic, hemorrhagic, malignant, and modified.
Classic smallpox is believed to be the most communicable disease-

about 30% of unvaccinated people who come in contact with it become infected. The hemorrhagic variety of variola has a much higher death rate (95%) than classic smallpox and leads to death more quickly. Infected people often die before the pustules form. This variety is recognizable by certain types of bleeding sores in mucous tissues. Comprehensive studies documenting almost 7,000 cases of variola found 200 people had this form of the disease (192 died). Pregnant women are more likely to contract this version. Prior to eradication, the malignant or flat form of smallpox affected 6% of the population and evolved more slowly than the classic type. Lesions were flat, often described as feeling velvety. The death rate for this form approaches 100%. The modified variety of smallpox essentially affects people who have been vaccinated and still have some immune response to the vaccine. In a vaccinated population, this version could affect about 15%.

Signs and Symptoms:



High fever Fatigue Severe headache Backache Malaise Raised pink rash - turns into pus-filled lesions that become crusty on day 8 or 9 Delirium Vomiting Diarrhea Excessive bleeding

Diagnosis:
Throat swab to make the diagnosis of smallpox. A sample

from a freshly opened pustule may also be useful in diagnosis. For suspected cases of hemorrhagic smallpox, the doctor may sample fluid from a spinal tap (lumbar puncture). Under certain conditions, cytoplasmic inclusion bodies (also known as Guarnieri bodies) may be visible within the cells. This is also evidence of smallpox infection. The doctor sends the possible smallpox sample using special means. Viral cultures, polymerase chain reaction (PCR), and/or enzyme-linked immunoabsorbent assay (ELISA) may be undertaken to make a definitive diagnosis.

Prevention:
To control the spread of the virus, people who have

smallpox would be kept in isolation at a hospital. All the people they've had contact with would receive the smallpox vaccine, which can prevent or lessen the severity of the disease if given within three days of exposure to the smallpox virus. it can occasionally cause serious complications, such as infections affecting the heart or brain. That's why a general vaccination program for everyone isn't recommended at this time. The potential risks of the vaccine outweigh the benefits, in the absence of an actual smallpox outbreak.

The vaccine uses a live virus that's related to smallpox, and

Treatment:
No cure for smallpox exists. Treatment would focus on

relieving symptoms and keeping the person from becoming dehydrated. Antibiotics may be prescribed if the person also develops a bacterial infection in the lungs or on the skin.

Nursing Intervention:
Monitor vital signs especially the temperature
Eye care Good oral hygiene Diet as tolerated is given. Severe cases may require sedatives, I.V fluid, oxygen,

blood transfusion. No treatment except antibiotics for secondary infection.