Smallpox: Clinical Features, Prevention, and Management

Guharoy, Roy; Panzik, Robert; Noviasky, John; Krenzelok, Edward P.; Blair, Donald C.

doi:10.1345/aph.1d272

Cited by 20 publications

(15 citation statements)

References 39 publications

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“…Patients remain asymptomatic during the 7-to 17-daylong incubation period, after which symptoms develop, including fever, malaise, and head and body aches, followed by oropharyngeal lesions and skin rash 2 to 4 days later. Sloughing of oropharyngeal lesions and respiratory tract release discharge infectious viral particles into the air, perpetuating human-tohuman spread (14,27,52). The high mortality rate associated with smallpox results from the overwhelming toxemia leading to respiratory and/or cardiac failure.…”

mentioning

confidence: 99%

“…In addition, while comparing cell culture models and human infection involves much uncertainty, there seem to be differences between predictions based on studies in cell lines and observations of the clinical course of smallpox. For example, vaccinia virus can cause relatively rapid cell lysis when it infects cultured cell lines, whereas cough and respiratory symptoms are not clinical characteristics of smallpox early during the course of disease (14,27). This difference suggests that the cellular response to infection might differ in vivo and in cultured cell lines.…”

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confidence: 99%

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Vaccinia Virus Entry, Exit, and Interaction with Differentiated Human Airway Epithelia

Vermeer

McHugh

Rokhlina

et al. 2007

J Virol

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Variola virus, the causative agent of smallpox, enters and exits the host via the respiratory route. To better understand the pathogenesis of poxvirus infection and its interaction with respiratory epithelia, we used vaccinia virus and examined its interaction with primary cultures of well-differentiated human airway epithelia. We found that vaccinia virus preferentially infected the epithelia through the basolateral membrane and released viral progeny across the apical membrane. Despite infection and virus production, epithelia retained tight junctions, transepithelial electrical conductance, and a steep transepithelial concentration gradient of virus, indicating integrity of the epithelial barrier. In fact, during the first four days of infection, epithelial height and cell number increased. These morphological changes and maintenance of epithelial integrity required vaccinia virus growth factor, which was released basolaterally, where it activated epidermal growth factor 1 receptors. These data suggest a complex interaction between the virus and differentiated airway epithelia; the virus preferentially enters the cells basolaterally, exits apically, and maintains epithelial integrity by stimulating growth factor receptors.The threat of bioterrorism has raised concern that smallpox could reemerge as a significant disease entity (10,21,46). The large population of unvaccinated individuals, the many immunocompromised people, and the lack of good treatments suggest that variola virus, the causative agent of smallpox, has the potential for extensive and rapid spread. Thus, there is a renewed interest in understanding poxvirus pathogenesis.Variola virus infection occurs following the inhalation of virus-laden airborne droplets (7, 12, 13a, 34). Virus replication within the lung and lymphoid system is followed by viremia (16,41,57). Patients remain asymptomatic during the 7-to 17-daylong incubation period, after which symptoms develop, including fever, malaise, and head and body aches, followed by oropharyngeal lesions and skin rash 2 to 4 days later. Sloughing of oropharyngeal lesions and respiratory tract release discharge infectious viral particles into the air, perpetuating human-tohuman spread (14, 27, 52). The high mortality rate associated with smallpox results from the overwhelming toxemia leading to respiratory and/or cardiac failure. These observations indicate that infection involves viral entry and exit through the oropharyngeal-respiratory route and suggest that the airways may play a key role in the viral life cycle.Because of the risks of experiments using variola virus, the limitations and difficulties associated with studies of nonhuman animals, and insufficient clinical information from humans, much of our knowledge about the interaction between poxvirus and the host has come from studies using vaccinia virus and cultured cells. Vaccinia virus is the orthopoxvirus used for immunization against smallpox, and it is widely substituted for variola virus in the investigation of poxvirus biology (20,28,4...

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confidence: 99%

mentioning

confidence: 99%

Vaccinia Virus Entry, Exit, and Interaction with Differentiated Human Airway Epithelia

Vermeer

McHugh

Rokhlina

et al. 2007

J Virol

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“…Human existence of variola virus since1763,orthopox genus 20,21 contagious 19 , double stranded DNA virus 19,22 structured with core ,lateral body, membrane and envelop. Virus spreads in human to human contacts 19 20 affects 90% and variola minor affects only 2% 19 in previously vaccinated ones.. Smallpox virus is resistant to environmental changes. 21 Its a infection of skin 20 (squamous epithelium )and mucous membrane%, oropharynx.…”

Section:  Smallpox (Variola)mentioning

confidence: 99%

“…20 It is completely eradicated by 1980 (WHO) with vaccines. Belief of use of massive endemic virus as bioterrorist weapons 19,20 was programmed for invading ohio river velly by the English 19 . Pathogenicity visualized after direct contact, body fluid and aerosol inhalation from infected person.…”

Section:  Smallpox (Variola)mentioning

confidence: 99%

Battle between Human and Viruses: An Antidisease Visual Approach on Viruses’ Aduptive Nature to Concentrate as an Endurance Endeavors

Mehta¹,

Kamlesh²

2020

IJISRT

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Humans were battling for survival before evolution till our modern lifestyle. Amongst all, viruses are such tiny organisms keep infecting a humans a decades ago and spreading in universe by many routes/pathways. Animal to human transmission is triggered outbreaks claiming thousands of lives, in a period of time by different species of viruses. RNA genome viruses are assumed to more virulent than DNA genome one due to its complex structural instability , environmental adoptability, mutational properties. Study of its entry in human body, attachment and replication into host cells, response of host defence cells by innate and adaptive immunity is helpful to know virus’ mild to lethal pathogenic nature. Marburg, Ebola, HIV,influenza, SARS-COV, and 2019 –nCoV( COVID 19 /SARS-COV2) are few deadly threats of a battle. Study by lab investigation, vaccines, antiviral drugs need to focus on antidisease approach then anti pathology visionary to eradicate and protect human from viruses’ bioweapon use.

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“…4). Currently, there are two confirmed places in the world where the smallpox virus is stored: the CDC in Atlanta, USA and the Vektor Institute in Novosibirsk, Russia (148). In the United States, nearly half the population has not been vaccinated.…”

Section: Poxvirusesmentioning

confidence: 99%

Therapy of other viral infections: herpes to hepatitis

Chakrabarty¹,

Beutner²

2004

Dermatol Ther

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Over the past several years, there has been an increase in knowledge pertaining to the diagnosis and management strategies for the herpes family (Types 1-8), the pox viruses, mumps, measles, rubella, and parvovirus B19 as well as the viral etiologies of hepatitis. Various antiviral treatments, such as nucleoside analogs and interferon therapy, have been available to reduce the signs and symptoms of these common viral infections. This article summarizes the preferred treatment strategies to be employed for each of the viruses for reducing severity, duration, recurrences (notably in the herpes family), transmission rates, as well as preventive alternatives. The majority of the therapeutic options attenuate the course of disease. Treatment decisions are driven by knowledge of the natural history and often are tailored to incorporate clinical circumstances for individual patients. Promotion of community awareness and the development of vaccines should be emphasized in the battle against these common viruses, particularly the herpes simplex viruses, the pox viruses, and hepatitis B.

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Smallpox: Clinical Features, Prevention, and Management

Abstract: The balance between the risks and benefits of mass vaccination in prevention of an epidemic is not clear. The Centers for Disease Control and Prevention has established a guideline for appropriate use of smallpox vaccine in the civilian population.

Cited by 20 publications

References 39 publications

Vaccinia Virus Entry, Exit, and Interaction with Differentiated Human Airway Epithelia

Vaccinia Virus Entry, Exit, and Interaction with Differentiated Human Airway Epithelia

Battle between Human and Viruses: An Antidisease Visual Approach on Viruses’ Aduptive Nature to Concentrate as an Endurance Endeavors

Therapy of other viral infections: herpes to hepatitis

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