SmallpoxW11ToPost-2 - Lecture 9 February 8th Todays outline...

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Lecture 9 February 8th Today’s outline Finish Influenza Smallpox The disease Development of vaccination Ethical Considerations History Announcements Discussion this week DF p. 172-242 Exam 2 approaching
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Smallpox One of the largest DNA viruses Related to other pox viruses Monkeypox,cowpox, horsepox Variola minor--2% fatality rate More common in Europe until 17th century Thought to have mutated to more deadly form Variola major--up to 25% fatality rate
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Transmission Spread from person to person No animal reservoirs Enters via the lungs Inhalation of aerosol droplets, dust from pustules on contaminated clothing or bedding Contact with corpses too Material from pustules remain infectious for months
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Early Phase Virus replicates in mucous membranes then spreads to lymph nodes Virus replicates in lymph system and re- enters the blood stream No symptoms for first 7-10 days
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Symptoms develop Around day 10, fever, backache, headache, nausea Day 15-30, rash develops Progression from flat spots (macules) to papules (solid raised lesions) to fluid filled vesicles to scabs (drying and healing of papules) Death from Internal hemorrhaging
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Convalescence Day 31-32 Scars result from destruction of oil glands of the skin Leaves crater-like appearance, pockmarks (development of make-up?) Contagious from 1 day before rash till last scab falls off
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Mortality Seems worse in 1500-1800 than before During pregnancy About 60-70% spontaneous abortions Live births-->55% deaths in 1-2 weeks Mothers--> 50% death from hemorrhage Native Americans higher mortality Exaggerated numbers? Poor nutrition? Or genetic uniformity?
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Defenses Against Smallpox Quarantine (old practice) Acquired Immunity Variolation (innoculation) Use smallpox itself Vaccination Edward Jenner 1796, milkmaids and cowpox Vaccinia virus, not smallpox
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Variolation Introduced in Europe and N. America in 1700s Practiced in Africa and China 100 years before this In China, people would inhale dried scabs In Africa, would rub pustule material into a cut or scratch in the skin
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Lady Montague--innoculated prisoners, orphans and then her own children successfully
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