What is it all about?
Smallpox : An Introduction
What is Smallpox?
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.
Source : Wikipedia
History of Smallpox
So , where this began?
Timeline
Vaccination was not discovered by the famous Dr. Jenner. Some
believe a form of inoculation was practiced by Egyptians thousands
of years ago. There is some question about if both inoculation and
vaccination were used in India circa 1500 BC.
Timeline
In China, a dried powder made of dried smallpox scabs was blown
into the nostrils as a preventive of smallpox from before the birth
of Christ until about 1100 AD and then variolation, the taking of
smallpox infected matter from one human to another, was
practiced from 1100 through the 17th
century.
Timeline
The Arabs practiced inoculation from the Middle ages
onward. This practice was used in Denmark, Poland and
Scotland in the late 1600s. and was introduced to England
in 1717. This common place practice originated in the pre-
scientific age as a superstition.
Timeline
The origin of smallpox as a natural disease is lost in
prehistory. It is believed to have appeared around
10,000 BC, at the time of the first agricultural
settlements in northeastern Africa (3, 4). It seems
plausible that it spread from there to India by means
of ancient Egyptian merchants. The earliest evidence
of skin lesions resembling those of smallpox is found
on faces of mummies from the time of the 18th and
20th Egyptian Dynasties (1570–1085 BC).
• Smallpox was introduced to Europe sometime between
the fifth and seventh centuries and was frequently
epidemic during the Middle Ages. The disease greatly
affected the development of Western civilization. The
first stages of the decline of the Roman Empire (AD 108)
coincided with a large-scale epidemic: the plague of
Antonine, which accounted for the deaths of almost 7
million people (6)
• Unknown in the New World, smallpox was introduced
by the Spanish and Portuguese conquistadors. The
disease decimated the local population and was
instrumental in the fall of the empires of the Aztecs and
the Incas.
• Similarly, on the eastern coast of North America, the disease was
introduced by the early settlers and led to a decline in the native
population. The devastating effects of smallpox also gave rise to
one of the first examples of biological warfare
• During the French-Indian War (1754– 1767), Sir Jeffrey Amherst,
the commander of the British forces in North America, suggested
the deliberate use of smallpox to diminish the American Indian
population hostile to the British. Another factor contributing to
smallpox in the Americas was the slave trade because many
slaves came from regions in Africa where smallpox was endemic.
VARIOLATION AND EARLY ATTEMPTS
OF TREATMENT
• The most successful way of combating
smallpox before the discovery of vaccination
was inoculation. The word is derived from the
Latin inoculare, meaning “to graft.”
Inoculation referred to the subcutaneous
instillation of smallpox virus into non-immune
individuals.
Lady Mary Wortley Montagu
•Lady Mary Wortley Montagu was an English
aristocrat, letter writer and poet.
•In 1715, Lady Montague suffered from an
episode of smallpox, which severely
disfigured her beautiful face
•Her 20-year-old brother died of the illness
18 months later. In 1717, Lady Montague’s
husband, Edward Wortley Montague, was
appointed ambassador to the Sublime Porte
•A few weeks after their arrival in Istanbul,
Lady Montague wrote to her friend about
the method of variolation used at the
Ottoman court.
Edward Jenner
•Edward Jenner, FRS FRCPE
was an English physician
and scientist who was the
pioneer of smallpox vaccine,
the world's first vaccine.
The terms "vaccine" and
"vaccination" are derived
from Variolae vaccinae, the
term devised by Jenner to
denote cowpox
Jenner’s Experiment
• At age 13 he was apprenticed to a
country surgeon and apothecary in
Sodbury, near Bristol (16). The record
shows that it was there that Jenner
heard a dairymaid say, “I shall never
have smallpox for I have had cowpox. I
shall never have an ugly pockmarked
face.” It fact, it was a common belief
that dairymaids were in some way
protected from smallpox.
• In May 1796, Edward Jenner found a
young dairymaid, Sarah Nelms, who
had fresh cowpox lesions on her hands
and arms
• On May 14, 1796, using matter from Nelms’
lesions, he inoculated an 8-year-old boy, James
Phipps, which is the son of his gardener.
• Subsequently, the boy developed mild fever and
discomfort in the axillae. Nine days after the
procedure he felt cold and had lost his appetite,
but on the next day he was much better.
• In July 1796, Jenner inoculated the boy again,
this time with matter from a fresh smallpox
lesion. No disease developed, and Jenner
concluded that protection was complete
• In 1797, Jenner sent a short communication to the Royal
Society describing his experiment and observations. However,
the paper was rejected. Then in 1798, having added a few
more cases to his initial experiment, Jenner privately
published a small booklet entitled An Inquiry into the Causes
and Effects of the Variolae Vaccinae, a disease discovered in
some of the western counties of England, particularly
Gloucestershire and Known by the Name of Cow Pox (18, 10).
The Latin word for cow is vacca, and cowpox is vaccinia
• Jenner decided to call this new procedure vaccination.
Medications , Types and
Treatments
Transmission
Smallpox spreads from person to person by respiratory droplets or
direct contact with body fluids. Contaminated clothing or
bedding may also transmit the virus. Animals and insects are
not known to carry or spread the virus to humans. The
incubation period for smallpox is 7 to 17 days.
Types Of Smallpox
Types of Vaccine
• In 2002, World Health Assembly (WHA) Resolution 55.16 urged Member
States to share expertise, supplies and resources to rapidly contain a
public health emergency or mitigate its effects. The resolution further
requested the WHO Director General to examine the possible
development of collaborative mechanisms to prepare and stockpile
resources for a potential PHEIC. The SVES currently consists of two
components:
• A physical stockpile of vaccine held by WHO Headquarters in Switzerland,
which is composed of calf-lymph smallpox vaccines from a variety of
sources dating from the final years of the eradication program that are
regularly tested for potency. It is estimated to consist of approximately 2.4
million doses when reconstituted and delivered by bifurcated needle.
• A pledged stockpile held by Donor countries in their respective national
stockpiles for use in time of international need upon request by WHO,
which currently consists of 31.01 million doses of smallpox vaccine held by
France, Germany, Japan, New Zealand, and the United States.
A GROUP PRESENTATION OF GROUP 2
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