What is Smallpox? Smallpox Symptoms and Treatment

by Abbas Jahangir · June 24, 2024

Smallpox, which emerged as a serious threat in the past and caused serious epidemics and loss of life, is a type of viral infection. This disease, which has almost disappeared today, is caused by a virus called variola virus. The last smallpox epidemic occurred in 1946, and with the introduction of the smallpox vaccine, the variola virus disappeared, and no person has been found to have contracted the disease naturally since 1977. Although this disease is confused with chickenpox due to its similar name, chickenpox and smallpox are different diseases. Although it resembles chickenpox in terms of skin rashes, smallpox progresses with much more serious and severe symptoms. Inflamed blisters that form on the skin in various parts of the body have a unique appearance and are deeper, unlike chickenpox.

What is Smallpox?

Smallpox, one of the epidemic diseases seen in history, is among the types of infectious diseases that caused the most deaths. Smallpox, caused by infection with the variola virus, has two different types: variola major and variola minor. Variola major, which is the much more severe form of the disease, has a serious mortality rate of 30%. Variola minor, which has a much lower lethality and is milder, causes a very low mortality rate of 1%.

This infection, which has caused serious epidemics and deaths throughout history, is also the first disease for which a vaccine has been developed. The smallpox vaccine, the first vaccine developed in history, was a very important development in the field of medicine and was a guide in public health studies. With the application of the vaccine for years, the smallpox virus disappeared, and the last case was seen in 1977.

Smallpox Symptoms

Smallpox is a serious infectious disease that occurs in different stages. Each stage of the disease has its own different symptoms. However, as the disease progresses, the symptoms become more severe. The process that begins after the virus is infected is called the incubation phase. During this period, which can last from 7 to 19 days, there are no symptoms or complaints, and there is no contagion. The first signs of bloom following the incubation period include:

High fever
Headachesand body aches
Chills and shivering
Nausea and vomiting
Weakness

At the stage when the first symptoms above are observed, the disease may be contagious, even in small amounts. However, the stages where contagion is highest are the following stages. When early rashes begin to appear, small red dots are observed on the surface of the tongue and inside the mouth. These formations, which initially appear as spots, can turn into sores that spread towards the throat over time. These sores and rashes then spread to different places such as the face, arms, legs, hands and feet.

After about four days, the wounds on the skin turn into blisters filled with pus. This process is usually accompanied by high fever. Then, for 10 days, the wounds turn into small pea-like lumps under the skin and take on a pustular appearance. At the end of two weeks, these wounds crust over, then the crusts begin to fall off and the disease begins the healing process.

How is Smallpox Transmitted?

Smallpox was a disease that could easily be transmitted in public or within families before the vaccine was discovered and the virus was eliminated. The contagion of the virus begins in the early rash stage, when red spots begin to appear on the tongue and mouth. Variola virus, which can be transmitted through droplets after this stage; It can easily be transmitted from person to person through droplets released from the respiratory tract during actions such as sneezing, coughing, speaking and breathing. The droplets in question contain smallpox viruses, and when these viruses reach the respiratory tract of a healthy person, they also infect that person.

Inflamed fluid in the lesions that appear on the body after the early rash stage and the crusts covering the lesions can also lead to the transmission of the virus. Therefore, contact with a person carrying smallpox or public areas where infected people are present may also be among the ways of transmission. There is no evidence that the disease is transmitted by insects or domestic animals. Therefore, the infection is considered to be transmitted only from people to people.

After the smallpox vaccine was discovered and began to be administered during periods when the disease caused serious epidemics, it was observed that immunity developed in people who were vaccinated. Nowadays, since the virus has disappeared, smallpox vaccination is not included in the mandatory vaccination schedules.

How to Treat Smallpox?

Smallpox can be easily diagnosed by physical examination following the appearance of an early rash. The most important reason for this is that it causes a more specific symptomatic appearance than similar diseases such as chickenpox and measles. The smallpox vaccine application, which was developed for disease prevention, can also be applied to prevent or alleviate the disease in people who have just come into contact with the infectious agent. The smallpox vaccine provides nearly 100 percent protection against the disease in people who have not yet come into contact with the virus.

In people known to have been exposed to the virus, administering the vaccine within the first 3 days after contact with the source of infection can prevent the development of the disease. Applying the vaccine between 4 days and 1 week after exposure to the virus helps alleviate the disease to a certain extent. It has been observed that many of the patients who were vaccinated in the appropriate period after diagnosis had a much milder illness than other people who were not vaccinated. However, after the rash develops in smallpox, the vaccine has no benefit or mitigating effect.

Antiviral drugs can be used in the treatment of the disease. The drug Tecovirimat (TPOXX) is one of the drugs approved by the FDA for the treatment of smallpox. Therefore, this medicine can be mentioned as an answer to the question of what is good for smallpox. Another area of use of the drug called Ecovirimat is to treat the adverse reactions that develop in people who received the smallpox vaccine.

Essentially, this medicine prevents the growth of the smallpox virus, thus curing the infection. Treatment can be supported with anti-inflammatory drugs for purposes such as relieving headaches and body aches and reducing fever. In addition, different supportive treatments such as healthy nutrition practices and the use of some vitamin and mineral supplements that support the immune system may also be recommended by the physician. Apart from the approved antiviral drug called tecovirimat, there are also different antiviral drugs called brincidofovir and cidofovir.

It is known that these have preventive effects on the growth and proliferation of the variola virus, which causes smallpox. However, since there is not enough data in terms of toxicity and safety and there have not been enough trials on smallpox patients, these drugs are not approved by the FDA for the treatment of smallpox. Although the smallpox virus has disappeared today, states keep ready stocks of these drugs in case smallpox comes to the fore again.

Since there are many different types of diseases that cause symptoms similar to smallpox, and most of them are contagious, isolation and early treatment are very important.

Therefore, if you observe symptoms similar to smallpox in yourself or your child, it would be beneficial for you to immediately contact a health institution and undergo examination.