Smallpox

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Smallpox was an infectious disease caused by one of two virus variants, Variola major and Variola minor. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980. The risk of death following contracting the disease was about 30%, with higher rates among babies. Often those who survived had extensive scarring of their skin, and some were left blind.

SmallpoxThe initial symptoms of the disease included fever and vomiting. This was followed by formation of sores in the mouth and a skin rash. Over a number of days the skin rash turned into characteristic fluid-filled bumps with a dent in the center. The bumps then scabbed over and fell off, leaving scars. The disease was spread between people or via contaminated objects. Prevention was by the smallpox vaccine. Once the disease had developed, certain antiviral medication may have helped.

The origin of smallpox is unknown. The earliest evidence of the disease dates to the 3rd century BCE in Egyptian mummies. The disease historically occurred in outbreaks. In 18th-century Europe, it is estimated 400,000 people per year died from the disease, and one-third of the cases resulted in blindness. These deaths included six monarchs. Smallpox is estimated to have killed up to 300 million people in the 20th century and around 500 million people in the last 100 years of its existence. As recently as 1967, 15 million cases occurred a year.

Inoculation for smallpox appears to have started in China around the 1500s. Europe adopted this practice from Asia in the first half of the 18th century. In 1796 Edward Jenner introduced the modern smallpox vaccine. In 1967, the WHO intensified efforts to eliminate the disease. Smallpox is one of two infectious diseases to have been eradicated, the other being rinderpest in 2011. The term "smallpox" was first used in Britain in the early 16th century to distinguish the disease from syphilis, which was then known as the "great pox". Other historical names for the disease include pox, speckled monster, and red plague.

There were two forms of the smallpox virus. Variola major was the severe and most common form, with a more extensive rash and higher fever, which can result in confluent smallpox, which had a high death rate. Variola minor was a less common presentation, causing a less severe disease, typically discrete smallpox, with historical death rates of one percent or less. Subclinical (asymptomatic) infections with Variola virus were noted but were not common. In addition, a form called variola sine eruptione (smallpox without rash) was seen generally in vaccinated persons. This form was marked by a fever that occurred after the usual incubation period and could be confirmed only by antibody studies or, rarely, by virus isolation. More details