Smallpox

Question 1

What is the causative organism for smallpox?

Answer 1

Causative agent: Variola virus

Question 2

What family of viruses does smallpox belong?

Answer 2

Family: Poxvirus

Question 3

What is the genome of this virus?

Answer 3

Genome: DNA Double stranded

Question 4

Does this virus always have an envelope?

Answer 4

Envelope: May or May not be Present

Question 5

What is the shape of the variola (smallpox) virus?

Answer 5

Smallpox viral particle: Brick shape

Question 6

What is the organization known as WHO?

Answer 6

World Health Organization

Question 7

How was smallpox eliminated as a naturally occurring infection?

Answer 7

WHO (World Health Organization) worked with governments to eliminate Small Pox threat
Successful vaccine program

Question 8

When was the last naturally occurring case of smallpox reported in the world?

Answer 8

Last reported case: 1977; Somalia, Africa

Question 9

What 2 labs are authorized to handle the smallpox virus?

Answer 9

Authorized storage in labs: 
United States (CDC) and Russia

Question 10

What are some possible modes of transmission for smallpox?

Answer 10

Main mode: contaminated air droplets person-to-person
coughing, breathing
Contact with skin sores
6 ½ feet from infected person for transmission
Contaminated clothing or bedding
1 person: infects 5 individuals

Question 11

Is smallpox contagious?

Answer 11

YES

Question 12

Is smallpox always fatal?

Answer 12

No
Death Rate of Smallpox Infection
Variola minor = 1% of victims
Variola major = 30% of victims (1 in 3)

Question 13

What are the clinical symptoms for smallpox?

Answer 13

Initial: high fever (1010F ), fatigue, headache, backache
2 – 3 days later:
Macular rash or pox
pink spots begin in mouth
spread to: face and arms then to trunk and legs

Question 14

What is the duration of a typical smallpox case until recovery?

Answer 14

1

Question 15

What is the difference between the macular, vesicular and pustular rash?

Answer 15

Macular Rash: Flat, Pink Spots
Vesicular Rash: Fluid-filled Pimples w/ Dip in Center
Pustular Rash: Hard, Round, Painful, Pus-Filled Blisters

Question 16

Is there a vaccine for smallpox?

Answer 16

Yes: Made of Vaccinia Virus (Today)

Made of Cowpox (Historically)

Question 17

What is the difference between variolation and vaccination?

Answer 17

Variolation: thread saturated with fluid from smallpox lesions introduced into a scratch of nonimmune person

Vaccination:

Question 18

Who was Lady Montagu and what is her significance in history?

Answer 18

Wife of British Ambassador to Turkey (1700’s)
Introduced Variolation to England
Variolation became popular in Europe

Question 19

Is cowpox in the same family of viruses as smallpox?

Answer 19

1

Question 20

Who was Edward Jenner and what was his contribution to the smallpox vaccine?

Answer 20

Improved Smallpox immunization
Cowpox (disease of cows) causes few – no symptoms in humans
Discovered Cowpox exposure immunized against Smallpox
Vaccination: vacca (cow)

Question 21

What is the component of the vaccine for smallpox?

Answer 21

Vaccinia virus (not cowpox!)
Possibly a hybrid between Cowpox and Smallpox virus
Horsepox?
Not clear where virus originated

Question 22

What is an attenuated vaccine?

Answer 22

An attenuated vaccine is a vaccine created by reducing the virulence of a pathogen, but still keeping it viable (or “live”). Attenuation takes an infectious agent and alters it so that it becomes harmless or less virulent.

Question 23

How long does immunity last after smallpox vaccine?

Answer 23

Protective for 3 – 5 years, no more than 10 years

Question 24

What is a bifurcated needle?

Answer 24

“Double prong” Needle designed for one time use

Needle designed to hold a tiny drop of vaccine

Question 25

Are there side effects from the smallpox vaccine? Is there any segment of the population that should not receive this vaccine because of high risk?

Answer 25

Encephalitis (Brain inflammation): 12.3 cases/1 million vaccinations (1/4 died)
Progressive vaccinia : 1.5 cases/million vaccinations (lesions fail to heal/immunocompromised)
Eczema vaccinatum( vaccine virus spreads with allergic rash): 38.5 cases/million vaccinations; spread of eczema with lesions
Generalized vaccinia(vaccine blister spreads all over the body): 241 cases/million vaccines; lesions erupt 6 – 9 days after vaccine
People at risk
Cancer patients
Immune deficiency (AIDs)
Skin condititions (eczema)
Pregnancy

Question 26

Is anyone vaccinated for smallpox today?

Answer 26

Scientists that handle smallpox or related viruses
Military personnel
Select Health care workers
Select Emergency personnel

Question 27

Is there treatment for smallpox?

Answer 27

No Drug Treatment; Vaccination immediately after exposure may prevent onset of disease

Question 28

Is smallpox always fatal?

Answer 28

No

Question 29

Is there immunity after recovery of a natural infection with smallpox?

Answer 29

Lifelong immunity after recovery of natural infection

Question 30

What is the availability of smallpox virus to a terrorist?

Answer 30

Availability: very low

Question 31

What is an N95 respirator?

Answer 31

N95 Respirator: Recommended that all family members have one
Filters at least 95% of particles
Reduces exposure doesn’t eliminate risk entirely
Cost: $1 -2

Question 32

What would be the danger of reintroducing smallpox in today’s world?

Answer 32

Catastrophic
Younger generations have never been vaccinated
Older generations vaccine is probably no longer protective
Very lethal disease