Oct 26, 2001 10:43 PM
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I have worked in a medical office for 17 years. I have never, until September 11, received calls about smallpox. As a result, I have researched the subject in order to be more informative to my patients. I would like to take this time to share the facts I have gathered. Knowledge will make you more prepared to deal with any other threat of terror.
WHAT IS SMALLPOX?
Smallpox is a viral infection that has been around for 3000 years, killing millions. The most distinguishing feature is the rash, which starts midline working it's way to the outside of the body. Most commonly, the rash occupies the head and extremities. The severity of the disease determines this, however. About 30% of those exposed and and without vaccine protection, die. It is highly contagious spreading through the air and by direct contact. The incubation period is between twelve and fourteen days. The most contagious period is the first week, and lasts until the scabs fall off.
DIAGNOSIS
Diagnosis can be made by evaluation of the rash. Also there will be a low white blood cell count, low platelets, and a positive viral culture. Diagnosis can be difficult, depending on the symptoms exhibited.
SYMPTOMS
Symptoms include a rash, as mentioned earlier. It is usually, but not limited to, the head and the extremities. The rash has several stages of development. Initially, tiny raised bumps appear on the skin. These develop into pus-filled sores that crust over. Although much smaller than the chicken pox rash, it can cause scarring and disfigurement.
TREATMENT
No cure is available at this time, but if detected early, the vaccine can help the severity of the disease process. If the vaccine is given no later than four days after exposure, smallpox may be prevented. If the vaccine is given later than 4 days, death can be prevented. Treatment mainly is focused on alleviating the symptoms. Those infected are isolated and every attempt is made to find any contacts. Comfort measures such as pain and fever control are stressed. Nutrition is important as well as using aseptic technique to prevent secondary infections. If death occurs, cremation is strongly recommended, but not forced.
PREVENTION
We all know that prevention is an ideal solution. However, the administration of smallpox vaccine was terminated in 1972 in the USA. Smallpox was declared eradicated by the World Health Organization in 1977. Vaccine production halted shortly after. USA citizens have not been vaccinated in over 20 years! Officially, the smallpox virus can be found in laboratories of two countries. USA and Russia have these for purposes of research and possibly vaccine production when needed. Unfortunately, several areas around the globe are suspected of having stockpiles of smallpox virus, manipulated for bioterrorism. I will not take the time to address man's inhumanity to man right now. But I will remind everyone that bioterrorism dates back to the Roman Empire. The Roman soldiers would throw dead animal into the enemy's water supply, thus causing disease. It is not an original idea.
CONCLUSION
It is with sincere hope that we will not have to look into the face of this disease. However, in view of the current events around the world, I feel compelled to increase knowledge and awareness any way I can. One is better prepared when aware. It will take a lot of time and money, but vaccine production will increase, and smallpox will once more be a memory.
