Case 84: Variola Major

Question 1

what does the variola virus cause?

Answer 1

smallpox

Question 2

what are the presenting symptomsm of variola?

Answer 2

1. chickenpox-like rash
2. sudden onset fever, severe headache, backpain that were resolving when the rash started
3. papulovesicular lesions

Question 3

what is PE?

Answer 3

papulovesicular lesions

bumpy lesions filled with thick, opaque fluid

Question 4

where do the lesions in smallpox usually appear on the body?

Answer 4

more prominent on the face and extremities and often involves the palms and soles

smallpox lesions are also all at the same stage of development

Question 5

what are the characteristics of the variola virion?

Answer 5

large, complex DNA virus

linear dsDNA

dumbell-shaped core and complex membrane system containing many proteins = super distinct from herpes and varicella-zoster via EM

Question 6

what are the two strains of variola?

Answer 6

1. variola major = a virulent strain causing the severe and most common
   form of smallpox–with an extensive rash and higher fever
2. variola minor = mild

Question 7

which species are natural hosts of variola?

Answer 7

only humans

Question 8

how do you transmit variola?

Answer 8

1. inhalation of respiratory droplets from an infected person
2. direct contact with infected bodily fluids

Question 9

what is the pathogenesis of variola?

Answer 9

after an incubation period of 7 to 17 days, the individual becomes febrile and develops
flu-like symptoms, including backache, headache, and vomiting

2-3 days later, a
maculopapular eruption appears, prominently on the oropharyngeal mucosa and face,
and the patient becomes infectious to other persons = people are most contagious with rash onset

a person is contagious until the last smallpox scab falls off

Question 10

what are the stages of the HPV virus?

Answer 10

days 0-4: normal cold/fever symptoms

day 4-8:: rash on the tongue and mouth - highly contagious

then a skin rash appears starting on the face and spreading to the whole body within 24 hours

bumps are filled with opaque fluid and often have a depression

day 8-12: bumps become sharply raised pustules, round and firm to the touch

day 12-17: pustles scab over

day 17-23: scabs fall off leaving pitted scars

once the scabs resolve and have all fallen off you’re no longer contagious

Question 11

how do you treat smallpox?

Answer 11

no treatment….

IV fluids, pain meds and antibiotics can help with symptoms

Question 12

how do you prevent smallpox?

Answer 12

vaccination

Question 13

how do you know if the smallpox virus has been successful?

Answer 13

a painful pustule must develope indicating that the virus has multiplied in the recipient and elicited
an inflammatory response

Question 14

how can you differentiate between smallpox and chickenpox?

Answer 14

smallpox lesions are all the same age because they all appear at the same time

chickenpox lesions are different ages