ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Smallpox: Health Significance And Clinical Manifestations

Updated on March 25, 2014

The Small Pox Pandemic


A General Overview Of Small Pox

Small pox is a natural infection in man caused by variola virus and the virus is seen only in man. The virus is 200 to 250 nm in size and belongs to the group of pox viruses which are DNA viruses. The virus is transmitted from man to man by respiratory route. There are no animal reservoirs or insect vectors in the transmission of this diseases. The transmission may be direct from patient to patient or through formites and other contaminated articles. Nasopharygneal secretions, vesicle fluid and dried scabs contain the virus. The virus can remain viable in dried scab for over one year. A patient is infective from the onset of early symptoms till the last scab has fallen off.

Though smallpox was one of the most dreaded diseases and outbreaks occurred in the tropics regularly, at present, the disease has been eradicated by worldwide efforts undertaken by the WHO from 1967 to 1977. The world was declared free of natural infection in October 1977. Except for the stock cultures of the virus maintained in a few laboratory, the virus is believed to have disappeared. This achievement was made possible by an intensive program of mass vaccination and early case reporting. Absence of any non-human reservoir and vector and the solid immunity produced by vaccination have made this achievement a reality. After entry, the virus reaches the lymph nodes, where it multiples and then enters the circulation. The skin and mucous membranes are effected thereafter. The effected epithelial cells show acidophilic cytoplasmic inclusion bodies called Guarnieri bodies. These are aggregates of the viral particles which are called Paschen bodies.

Small Pox Manifestation On The Skin


Clinical Presentations of Small Pox

The incubation period is 12 days (8 to 16 days). Prodromal symptoms occur 2 to 4 days before the eruptions start. These consist of high fever, myalgia, headache, backache, delirium and abdominal pain. The rash starts on the third day and the fever subsides when the rash appear. Fever reappears after varying intervals when the rash becomes pustular. The temperature comes down with scabbing. The rashes are characteristic. They are distributed on a centrifugal pattern. The face, arms and legs are more often and more heavily affected. Presence of vesicles in the palms and soles is characteristic. Initial lesions are erythematous macules, which progress successively into papules, vesicles and pustules and scabs at 48 hour intervals. The vesicles and pustules are deep set in the skin, multiloculated and the center is umbilicated. Unlike as in chicken pox, all the vesicles are at the same stage of development. When the scab separates, pitted scars are left behind, which tend to remain permanent.

In vaccinated individuals, who possess residual immunity, the clinical picture is modified and this is termed varioloid. This is abrupt in onset with the development of only a few rashes. The course is benign. Small pox may occur without the characteristic rash “Variola sine eruption”. A less virulent form of the virus capable of producing milder manifestations, ‘variolar minor” (alastrim), has also been recognized.

Other serious clinical types may occur less commonly. These are hemorrhagic smallpox which is highly fatal and the flat form in which the papules are velvety, which may become vesicular and lead to peeling off of the whole epidermis.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    • married2medicine profile imageAUTHOR

      Funom Theophilus Makama 

      4 years ago from Europe

      Thank you so much Phoebe... Your comment is definitely a huge encouragement to me.

    • profile image

      Phoebe Pike 

      4 years ago

      When I was younger I had read about smallpox, but the history books skimmed over it, so I studied it on my own... you did an awesome job of summing it up.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)