1. Charlotte Laport 7/18/13

2. The first case of smallpox was found in Africa. The earliest case that we can trust is from about 3,000 years ago. The disease was found in an Egyptian mummy. They believe that the disease came from an African rodent. The disease then spread to China and India. It reached those countries when Egyptians traded with people from those countries. It was then also carried from China to Japan. The first smallpox epidemic was during the Egyptian-Hittite war in 1350 BC. Smallpox moved to Europe between the 5 th and 6 th century. It was present in major cities in Europe by the 18 th century. Epidemics occurred in North America between the 17 th and 18 th century. It was a deadly disease in most of the world except in Australia, which never got smallpox because it’s an isolated island. Millions of people died from this disease, mainly in Europe and Mexico. HISTORY OF SMALLPOX

3. The disease started to subside when the populations started to realize that survivors were immune for the rest of their lives. Due to this realization they started to give vaccines. The first were in the Buddhist communities between 1022 and 1063 AD. The vaccines were made by grinding up scabs from infected people and turning it into powder. To ingest it they would inhale the powder through their nose. By the late 1700’s Europe as well as China, Turkey, and India were using this method. This was the start of the eradication of the disease because by this method alone only 2-3% people died. This cut the death rate by tenfold. HISTORY OF SMALLPOX

4. This disease caused a change in the royal line in England. This happened because so many relatives of Henry the VIII had smallpox. Many survived but some died. His son, Edward VI, died from complications following the disease which left the royal title to his eldest daughter. Both George Washington and Abraham Lincoln had the disease. INTERESTING FACTS ON SMALLPOX

5. A man from Mexico was on a business trip to New York City in 1947 where he became ill with smallpox. The doctors weren’t able to diagnose him right away, but after 2 others were infected, they knew it was smallpox. New York doctors quickly started vaccinating adults who hadn’t had the vaccine since childhood. Quickly there were 9 cases in New York which caused the production of the vaccine to skyrocket. In one month’s time, 6.4 million New Yorkers were immunized. Only two patients died from the disease and 9 others died from the effects of the vaccine. EXAMPLE OF SMALLPOX

6. A steam boat was traveling from Belgium to the East Coast of the United States. A passenger on board became ill with smallpox. Since the disease is very contagious, the staff on board sterilized everything every three days to try to stop the spread of smallpox. They also gave their limited amount of vaccines to those who were in closest contact with the patient. Once they arrived on the East Coast (they had to have been given permission to arrive), doctors and nurses gave vaccines to those who didn’t get the shot on board. No deaths were noted in the article. EXAMPLE OF SMALLPOX

7. Because this disease was eradicated in 1987 it has been hard to study the structure of the microbe. This pathogen is a virus, and it has two etiologic agents: Variola major and Variola minor. It is classified as a part of the Orthopoxvirus family. Smallpox is a larger, brick shape virus with dimensions of 300 X 200nm. It has a fully developed internal structure including a double helix of DNA. The two membrane layers give the microbe a dumbbell shape. The outer surface is covered in filamentous protein components giving it the look of a ball of yarn. DESCRIPTION OF SMALLPOX

8. The disease uses the circulatory system to spread throughout the body. It only forms sores on the outside of the skin. It kills off a lot of macrophages causing a weakened immune system. It also kills off the white blood cells. This allows the disease to reproduce in mass quantities; usually within the spleen or bone marrow. DESCRIPTION OF SMALLPOX

9. After a 7-17day incubation period, where the host is not contagious, symptoms will start showing. A patient will likely start their symptoms by having a fever of 105 degrees Fahrenheit 10-14 days after they have been infected with the disease. They often also have body aches witch is often accompanied by vomiting. The next stage of symptoms will start with a rash that starts on the tongue or in the mouth. These will often grow sores that break open causing the disease to spread the quickest. This is also the stage at which the host is the most contagious. 24 hours after the sores break open, the rash is covering the patient from head to toe. Then the rash will grow bumps that are filled with pus like substance. The fever will often increase at this stage until scabs cover the bumps. The bumps become hard to the touch. Two weeks after the rash began, all the bumps should be scabbed over and start falling off. When the scabs fall off, they often leave a scar. After all the scabs are gone, the person is no longer contagious. SYMPTOMS OF SMALLPOX

10. Smallpox is spread virally. A person can become infected with smallpox by receiving small amounts of saliva, through coughing or sneezing, by having had face to face contact with the host. If a person touches the skin of an ill person or by sharing common household items such as tableware, razor or a toothbrush. If a person ill with smallpox were to sneeze or cough in a building, train or a bus they can also spread the illness through the recycled air. However, that way is less common because it is an indirect method of transmission. TRANSMISSION OF SMALLPOX

11. When smallpox was a common disease, doctors could take one look at their patient and be able to diagnose them right away. Since the disease has been eradicated, doctors aren’t familiar with the disease and often can’t diagnose their patient right away. Today if the doctor suspects smallpox, they will immediately alert their staff to get vaccinated. The doctor will then collect samples from the blisters, blood, and throat. The samples are then sent off to the CDC (Center for Disease Control), with prior authorization, to be tested. DIAGNOSING SMALLPOX

12. There are no statistics for this disease in Oregon, because it has been eradicated so many years ago. Between 1900 and 1904, 48,164 cases were reported annually in the United States with an average of 1,528 deaths per year. The last case that occurred in America happened in 1949, and the last case to naturally occur worldwide was in 1977 in Africa. There was an accident in England in a lab where one person died of smallpox in 1978. The disease was officially declared eradicated in 1979. STATISTICS OF SMALLPOX

13. THE IMPORTANCE OF STUDYING SMALLPOX “With the breakup of the Soviet Union and unemployment of many of the weapons program's scientists, there is concern that smallpox and the expertise to weaponize it may have become available to other governments or terrorist groups who might wish to use the virus as a means of biological warfare.” It is important to study and know about this disease because it still exist in laboratories. It only takes one person with an evil mind to use the disease as a biological weapon in a terrorist attack. Once the disease hits, millions of people will become ill because they are not immunized. Therefore it is important to have enough of the vaccine in store to vaccinate the entire population.

14. Brannon, H. (2004). The history of smallpox: The rise and fall of a disease. About.com. Retrieved from http://dermatology.about.com/cs/ smallpox/a/smallpoxhx.htm On this webpage they stated the history of smallpox. I used this page to get the basis of the history. I used other pages to gain a better understanding of how this disease became to be. Description of smallpox. Duke University DOI: (2007). Smallpox disease overview CDC. Retrieved from http://www.bt.cdc.gov/agent/ smallpox/overview/disease-facts.asp This webpage gives a good detailed description of the symptoms that smallpox has. It has a chart that goes through the stages and symptoms of this disease. Geo, S. (1896). One case of smallpox. Jsotre. Retrieved from http://archive.org /stream/jstor-41435979/41435979 This page gave me one the the first cases of smallpox. It wasn’t very detailed but it was interesting to see how they dealt with it. Gupta, S. (2002). Ny faced last u.s. smallpox outbreak. CNN.com/HEALTH. Retrieved from http://archives.cnn.com/2002/HEALTH/12/13/ smallpox.ny/ This page gave a description of one of the cases I used to show how this disease effected people. REFERENCES

15. Nattleman, M. (2012). Smallpox symptoms, causes, treatment-how is smallpox diagnosed?. Retrieved from http://www.medicinenet.com/smallpox/ page3.htm This page I used to show how to diagnose smallpox in both past and today. Smallpox biological warfare. News Medical Retrieved from http://www.news-medical.net /health/Smallpox-Biological-Warfare.aspx This article talks about how the smallpox virus is not truly eradicated and it could be used as a terrorist attack. Smallpox structure. Manbir Online. Retrieved from http://manbir-online.com /diseases/smallpox-2.htm This page gave a brief description of how smallpox is put together. Such as the pathogens and what shape it makes. Yakhin, S. (2012). Smallpox. Retrieved from http://www.austincc.edu /microbio/2421b/pox.htm This page gave a very detailed description of smallpox. It covered all areas that were nessecary to know and it did so in a well knowledgeable manor. (2007). Smallpox disease overview. CDC. Retrieved from http://www.bt.cdc.gov /agent/smallpox/overview/disease-facts.asp This webpage gave a very detailed description of the history of the disease and exactly how it came to be. (2013). Smallpox. CDC. Retrieved from http://sfcdcp.com/smallpox.html This gave a well description on how the disease is transmitted from person to person. (2013). Smallpox history. News Medical. Retrieved from http://www.news -medical.net/health/Smallpox-History.aspx This page gave lots of great historical information as well as the others. This page however only focused on the history so it could give an even more in-depth explanation. REFERENCES