Small Pox by Dr. Rajiv Narula
Anthrax… Small Pox…Nuclear attacks…kamikaze middle eastern men …. Al kaieda….sounds like a suspense novel, no this is reality 2001. The new millennium that so many of us were looking forward to, has not been exactly been a predictable one. I started writing this column about 1 ½ years ago, as the title – Travel Medicine suggests, it has to do with medical issues faced by the traveler – usually when they were traveling. This column will deal with one of the above mentioned items – Small Pox . Even though there is no risk for travelers, this virus has been mentioned over and over again as a possible mode of a terrorist attack .
The small pox virus belongs to the Orthopoxvirus. This virus has been around for about 10,000 years , the first proof of it was seen in mummies from 1580-1350 BC The first known descriptions were made in the fourth century A.D. in China. Small pox was imported into the western hemisphere in the sixteenth century. This was followed by catastrophic epidemics which wiped out several American Indian tribes, and also the Aztec and Inca empires. In Europe several hundred thousands succumbed to this disease, including several members of Royal families. In recent centuries, small pox had become one of the most feared diseases, as it could strike anywhere and there is no effective treatment. In comparison to malaria and yellow fever, small pox requires no vector like the mosquito, and outbreaks can occur anytime.
Immunization against small pox began in 1800 in the US, but it was not routinely given out until the beginning of the twentieth century. On May 8,1980 the World Health Organization declared the world Small Pox free. The only two publicly known small pox reservoirs are in the US and Russia, however, news reports point to possibly Iran, Iraq and North Korea and some other countries may have it too. The destruction of the Small Pox virus had been set for sometime in 1999, however due to the possibility of it being in the hands of the unscrupulous individuals/countries, the US did not destroy its stockpile. Now due to recent events, this issue has been settled, the CDC will keep the deadly germ hidden, but on hand in case it is needed. If some one weaponized Small Pox, then scientists could use the saved virus for further research.
Small pox is extremely contagious from one person to another. It is spread from saliva droplets, from the scabs that form on one’s body, and unlike other diseases it can be spread from bed sheets and clothing. The incubation period for smallpox is approximately 12-1 4 days, symptoms include: fever, fatigue, headache, backache, malaise, a rash – usually with pus filled vesicles, lesions are usually of the same age, unlike Chicken Pox where the lesions are of varying age, delirium, vomiting and diarrhea, and also bleeding.
Protection from this dreaded disease is obtained from a vaccine. Many people were vaccinated in the past. However unless you have a booster after 10- 15 years, there is loss of immunity. Currently the CDC, has about 7 million doses and more are being made, the government wants enough to vaccinate everyone in the US. The vaccine does have some complications: since it is made with live virus, people who have immunodeficiency problems like HIV/AIDS, certain cancers, or on long term steroid therapy can have a serious side effect. Experts state that if everyone in the US was vaccinated, 400 people would die. Other vaccine associated risks include encephalitis 3/1,000,000, approximately 250/1,000,000 would get a small pox like rash, which if not treated appropriately could die.
The US government is spending a considerable of our money on this vaccine, I would hope that they would vaccinate us so that we would be protected from this disease. Also the shelf life of these vaccines will be a few years, and I do not think it would make sense to let them expire. This view is shared by a majority of Americans, according to the Associated Press 60 % of Americans, would want to get the small pox vaccine if available, even though, there maybe serious side effects associated with it. This poll suggests that the issue of bio-terrorism is foremost on the minds of Americans these days. The Anthrax issue is still unsolved, perhaps finding the culprit/s would ease people’s minds.