smallpox - Smallpox Smallpox D GOLDBERG PED ID SVCE WRAMC...

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Unformatted text preview: Smallpox Smallpox D. GOLDBERG PED ID SVCE WRAMC SMALLPOX SMALLPOX • Genus Orthopoxvirus Smallpox, monkeypox, cowpox,vaccinia • DNA Virus • 200 nm brick shaped • Smallpox-person to person spread via respiratory secretions/direct contact • Spread best in low humidity/temperature SMALLPOX SMALLPOX SMALLPOX SMALLPOX • 2 principle formsvariola major-Europe/Asia variola minor-19th century USA • 2 minor forms-malignant & hemorrhagic • Spread via respiratory droplets/direct contact at time of rash • Historically spreads slower than chicken pox, measles SMALLPOX-Pathogenesis SMALLPOX-Pathogenesis • Incubation period (7-17 days): Virus infects respiratory/pharyngeal mucosa--> regional lymph nodes--> viremia-->spleen, bone marrow, lymph nodes-->second viremia--> fever, toxemia--> rash and infectivity SMALLPOX-Pathogenesis SMALLPOX-Pathogenesis • Clinical StageOnset fever (1030), HA, prostation, bachache, malaise, +/- abd pain, delerium, rash by day 3 Rash-macularpapular on oropharynx, face forearms-->trunk, legs -turns vesicular 24-48 hrs - turns tense round pustules SMALLPOX SMALLPOX SMALLPOX SMALLPOX SMALLPOX SMALLPOX SMALLPOX SMALLPOX • • • • • Secondary infection is rare Death in second week due to toxemia Variola minor-less severe symptoms, rash Vaccinated -milder form HIV-? (Disseminated vaccina in HIV+ HIV-? soldier in 1986) SMALLPOX- Laboratory Diagnosis SMALLPOX• Level BL-4 only EM of fluid/scabs Culture/PCR Oropharyn swabs-day 7/8 of infection AB titers (day 6 of rash) SMALLPOX- Clinical Diagnosis SMALLPOXProdrome: Rash: Lesions: Distribution: Stage: Smallpox 2-4 days 1-2 days deep/tense centrpetal (truncal) same Varicella Varicella 1-2 days several days superficial centrifugal (face/extremeties) new crops SMALLPOX SMALLPOX Chickenpox Chickenpox Shingles Shingles SMALLPOX-Therapy SMALLPOX-Therapy • Cidofovir ? •? SMALLPOX SMALLPOX • Postexposure ControlHome care vs hospital care (neg pressure) Mass “contact” vaccination (up to 4 days post exposure may ameliorate/prevent) Vaccinated individuals serve as caretakers Cremation of bodies Smallpox-Vaccination Smallpox-Vaccination SMALLPOX • Vaccinationlimited stock (6 million/ ? dilution) untrained administrators Special risk groups immunosuppressed/ pregnant women/eczema limited Vaccina IG (VIG) side effects SMALLPOX-Vaccine complications SMALLPOX-Vaccine * 70% children with fever > 39C day 4-14 SMALLPOX-Autoinoculation SMALLPOX-Autoinoculation ...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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