Smallpox - Revision history

Danbot: Add evidence-based Disposition section

2026-03-22T10:03:55Z

Add evidence-based Disposition section

← Older revision		Revision as of 10:03, 22 March 2026
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			==Disposition==
			*Strict airborne and contact isolation required
			*Admit all suspected cases to negative-pressure isolation room
			*Immediately notify local and state health departments and CDC
			*Contact tracing and ring vaccination of exposed individuals
			*Quarantine of close contacts for 17 days

	==See Also==		==See Also==

Rossdonaldson1: /* Clinical Features */

2022-09-07T16:14:52Z

Clinical Features

← Older revision		Revision as of 16:14, 7 September 2022
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	==Clinical Features==		==Clinical Features==
	[[File:Child with Smallpox Bangladesh.jpg\|thumbnail\|Child with Smallpox]]		[[File:Child with Smallpox Bangladesh.jpg\|thumbnail\|Child with Smallpox]]
			[[File:PMC3223485 eplasty11e47 fig1.png\|thumb\|Man with small pox displaying the characteristic rash.]]
	*Incubation period: 7-19 days		*Incubation period: 7-19 days
	*Initial phase begins as a fever, fatigue/weakness, dorsal-lumbar pain, myalgias, nausea/vomiting		*Initial phase begins as a fever, fatigue/weakness, dorsal-lumbar pain, myalgias, nausea/vomiting

Hkm91450: /* Bioterrorism */

2018-02-27T06:21:14Z

Bioterrorism

← Older revision		Revision as of 06:21, 27 February 2018
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	===Bioterrorism===		===Bioterrorism===
	*There are stocks of the virus in 2 laboratories – one in Atlanta, Georgia, USA and one in Moscow, Russia		*There are stocks of the virus in 2 laboratories – one in Atlanta, Georgia, USA and one in Moscow, Russia
	*There are concerns some laboratories may illegally have the virus and could release it as a weapon of bioterrorism<ref>Anderson PD. Bokor G. Bioterrorism: pathogens as weapons. J Pharm Pract. 2012 Oct;25(5):521-9.</ref>\		*There are concerns some laboratories may illegally have the virus and could release it as a weapon of bioterrorism<ref>Anderson PD. Bokor G. Bioterrorism: pathogens as weapons. J Pharm Pract. 2012 Oct;25(5):521-9.</ref>
	*It is considered a potential bioterrorism threat as most people are now considered to be vulnerable to the virus because vaccination programs have stopped		*It is considered a potential bioterrorism threat as most people are now considered to be vulnerable to the virus because vaccination programs have stopped

Hkm91450: /* Clinical Forms */

2018-02-27T06:20:41Z

Clinical Forms

← Older revision		Revision as of 06:20, 27 February 2018
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	**Malignant		**Malignant
	***Soft, flattened lesions, does not progress to pustules		***Soft, flattened lesions, does not progress to pustules
	***Resolve without forming scabs		***Resolve without forming scabs <ref> Schultz, C., & Koenig, K. Weapons of Mass Destruction. In Rosen's Emergency Medicine: Concepts and Clinical Practice (9th ed.). Philadephia, PA: Elsevier/Saunders. </ref>

	<ref> ~~Walls~~, R., & ~~Rosen~~, P. ~~(2018)~~. Rosen's ~~emergency medicine~~: Concepts and ~~clinical practice~~ (9th ed.). ~~Philadelphia~~, PA: Elsevier/Saunders. </ref>

	==Differential Diagnosis==		==Differential Diagnosis==

Hkm91450: /* Clinical Forms */

2018-02-26T18:19:46Z

Clinical Forms

← Older revision		Revision as of 18:19, 26 February 2018
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	***Fewer pox		***Fewer pox
	*Other (10% of cases)		*Other (10% of cases)
	*Hemorrhagic		**Hemorrhagic
	**Hemorrhages occur within the blisters as well as mucus membranes and internal organs, death usually within 5-6 days		***Hemorrhages occur within the blisters as well as mucus membranes and internal organs, death usually within 5-6 days
	*Malignant		**Malignant
	**Soft, flattened lesions, does not progress to pustules		***Soft, flattened lesions, does not progress to pustules
	**Resolve without forming scabs		***Resolve without forming scabs

	<ref> Walls, R., & Rosen, P. (2018). Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders. </ref>		<ref> Walls, R., & Rosen, P. (2018). Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders. </ref>

Hkm91450: /* Disease courses */

2018-02-26T18:18:53Z

Disease courses

← Older revision		Revision as of 18:18, 26 February 2018
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	**Lesions begin as clear fluid-filled vesicles, progress to pustules, and then harden and form a crust, ultimately falling off in about 3-4 weeks		**Lesions begin as clear fluid-filled vesicles, progress to pustules, and then harden and form a crust, ultimately falling off in about 3-4 weeks

	===~~Disease courses~~===		===Clinical Forms===
	*Variola minor ~~– most common form~~ of ~~the disease~~, ~~described above~~		*Variola major and minor (90% of cases)
	*Variola ~~fulminans – rapid death during the initial phase~~		**Variola major
	*~~Variola confluens – initial maculopapular rash becomes confluent leading to 96~~% ~~mortality~~		***More severe, mortality rate 30%
	*~~Variola hemorrhagica – hemorrhages~~ occur within the blisters as well as mucus membranes and internal organs, death usually ~~occurs during the first 24 hours~~		**Variola minor
			***Less severe, mortality rate 1%
			***Fewer pox
			*Other (10% of cases)
			*Hemorrhagic
			**Hemorrhages occur within the blisters as well as mucus membranes and internal organs, death usually within 5-6 days
			*Malignant
			**Soft, flattened lesions, does not progress to pustules
			**Resolve without forming scabs

			<ref> Walls, R., & Rosen, P. (2018). Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders. </ref>

	==Differential Diagnosis==		==Differential Diagnosis==

Hkm91450: /* Background */

2018-02-26T18:10:35Z

Background

← Older revision		Revision as of 18:10, 26 February 2018
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	*Caused by the variola virus<ref>Rosen, Peter, John A. Marx, Robert S. Hockberger, and Ron M. Walls. "Smallpox." Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. Vol. 2. Philadelphia, PA: Elsevier/Saunders, 2013. 1579-1580.</ref>		*Caused by the variola virus<ref>Rosen, Peter, John A. Marx, Robert S. Hockberger, and Ron M. Walls. "Smallpox." Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. Vol. 2. Philadelphia, PA: Elsevier/Saunders, 2013. 1579-1580.</ref>
	*Passed through direct contact with the person, with body fluids, as well as with airborne droplets of an infected, symptomatic person		*Passed through direct contact with the person, with body fluids, as well as with airborne droplets of an infected, symptomatic person
			**Can survive for 24-48 hours in the environment
	*Most infectious during the first week of symptoms, but will remain infectious until the last pox scab falls off		*Most infectious during the first week of symptoms, but will remain infectious until the last pox scab falls off
	*Humans are the only known host<ref>Barquet, Nicolau, MD, and Pere Domingo, MD. "Smallpox: The Triumph over the Most Terrible of the Ministers of Death." Annals of Internal Medicine 127 (1997): 635-42.</ref>		*Humans are the only known host<ref>Barquet, Nicolau, MD, and Pere Domingo, MD. "Smallpox: The Triumph over the Most Terrible of the Ministers of Death." Annals of Internal Medicine 127 (1997): 635-42.</ref>

Hkm91450: /* Bioterrorism */

2018-02-26T18:09:37Z

Bioterrorism

← Older revision		Revision as of 18:09, 26 February 2018
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	===Bioterrorism===		===Bioterrorism===
	*There are stocks of the virus in 2 laboratories – one in Atlanta, Georgia, USA and one in Moscow, Russia		*There are stocks of the virus in 2 laboratories – one in Atlanta, Georgia, USA and one in Moscow, Russia
	*There are concerns some laboratories may illegally have the virus and could release it as a weapon of bioterrorism<ref>Anderson PD. Bokor G. Bioterrorism: pathogens as weapons. J Pharm Pract. 2012 Oct;25(5):521-9.</ref>		*There are concerns some laboratories may illegally have the virus and could release it as a weapon of bioterrorism<ref>Anderson PD. Bokor G. Bioterrorism: pathogens as weapons. J Pharm Pract. 2012 Oct;25(5):521-9.</ref>\
			*It is considered a potential bioterrorism threat as most people are now considered to be vulnerable to the virus because vaccination programs have stopped

	===Vaccination History===		===Vaccination History===

Hkm91450: /* Vaccination History */

2018-02-26T18:07:45Z

Vaccination History

← Older revision		Revision as of 18:07, 26 February 2018
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	*Does have serious side effects, especially in the immunocompromised, including death in rare cases		*Does have serious side effects, especially in the immunocompromised, including death in rare cases
	*Due to the side effects and the current eradication, it is not used anywhere in the world currently		*Due to the side effects and the current eradication, it is not used anywhere in the world currently
			**Only select groups of individuals will be vaccinated, including some members of the US military (depending on where they are deployed) <ref> http://www.usamma.amedd.army.mil/net/assets/doc/pdf/Vaccines/SVP_Q_A_8July2014.pdf </ref>
	*Many governments have large stockpiles of the vaccinia vaccine and plans in place for rapid response and vaccination if an outbreak were to occur		*Many governments have large stockpiles of the vaccinia vaccine and plans in place for rapid response and vaccination if an outbreak were to occur

Hkm91450: /* Vaccination History */

2018-02-26T18:05:03Z

Vaccination History

← Older revision		Revision as of 18:05, 26 February 2018
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	*Does have serious side effects, especially in the immunocompromised, including death in rare cases		*Does have serious side effects, especially in the immunocompromised, including death in rare cases
	*Due to the side effects and the current eradication, it is not used anywhere in the world currently		*Due to the side effects and the current eradication, it is not used anywhere in the world currently
	**Only select groups of individuals will be vaccinated, including some members of the US military (depending on where they are deployed) <ref> https://www.cdc.gov/anthrax/medical-care/prevention.html </ref>
	*Many governments have large stockpiles of the vaccinia vaccine and plans in place for rapid response and vaccination if an outbreak were to occur		*Many governments have large stockpiles of the vaccinia vaccine and plans in place for rapid response and vaccination if an outbreak were to occur