Lecture 8 - Smallpox

Lecture 8 - Smallpox - Smallpox Edwin Oaks Ph.D George...

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EVO Smallpox Edwin Oaks, Ph.D. George Mason University Fall 2008
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EVO Smallpox Introduction Caused by variola virus “varius” Latin for spotted or “varus” meaning pimple Thought to have been in human populations as far back as 10,000 BC First written description in Chinese text in 4th century The term “smallpox” was used to distinguish the disease from the “great pox" (syphilis) One of first diseases where attempts to prevent disease by deliberate inoculation of a susceptible person Variolation Jenner demonstrated that inoculation with cowpox could prevent smallpox (1796) Since that time it was realized that smallpox could be prevented by vaccination
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EVO Significance as a Public Health Problem Smallpox historically would occur and spread in any country and case-fatality rates were little altered by therapy. The disease was not carried by a vector and therefore could occur anywhere in any season. Through the mid-1970s, travelers were required to present certificates proving they were vaccinated within the past 3 years. In 1968, nearly 15 million people were immunized in the United States. 240 people required hospitalization because of vaccination, 9 died and 4 were permanently disabled.
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EVO Smallpox in America During 1700s smallpox was a problem for colonists in North America Most were not immune Disease was imported from Europe where many smallpox outbreaks occurred Death rate could be high as 1 in 5 Variolation (“inoculation”) was used to protect against smallpox Death in “inoculated” individuals was much lower 1 in 20 But if variolation was used too frequently it became a source of new smallpox outbreaks!
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EVO July 4, 1776 Capitol of America was Philadelphia Endemic with smallpox in part due to unregulated use of variolation in upper class; Spread disease to poor and young People from all over country came to Philly to get variolated Smallpox was such a problem that during the meeting of the 2nd Continental Congress in 1776, the “variolators” were asked to stop inoculations to prevent spread of disease to the Congress. Smallpox was a major cause of disease in the Continental Army (George Washington had already contracted smallpox in his earlier years).
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EVO Smallpox Background, cont. 1949 - last case of smallpox in U.S. 1966 - WHO initiated global program to eradicate smallpox 1977 - last indigenous case of smallpox in Somalia 1979 - world declared smallpox free - global eradication accomplished
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EVO Number of Countries Experiencing Smallpox 0 5 10 15 20 25 30 35 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 Countries with endemic smallpox
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EVO Variola Virus Member of Poxviridae family Genus Orthopoxvirus Other poxviruses include Vaccinia, cowpox and monkeypox Vaccinia is the vaccine strain used to prevent smallpox Genome Double stranded DNA, non-segmented Replicates in cytoplasm of host cell (not nucleus) Appears as a brick-shaped structure, one of largest genomes for
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