OTHER NAMES

• Major Variola,
• Minor Variola.

DEFINITION

The smallpox is a serious infectious illness of which, at present, active cases known in the world do not exist. The last registered picture was in 1977 in Somalia.

The cause is an infection for the virus of the variola, and it presents itself as an intense feverish picture with cutaneous eruption in the shape of pustules exudativas.

CAUSES AND TRANSMISSION

The smallpox is a contagious illness produced by the transmission of the virus of the variola. This virus one can transmit from person person by means of saliva particles, since the virus can survive for 24 hours in favorable conditions of solar light. Another most frequent form of contagion is for contact of garments and of bed clothes where this virus can survive for weeks.

The contagion is more probable when the carrying person of the virus is in the first week of evolution, but it can transmit it until the pustules of the skin dry off completely. The symptoms of the illness can appear to the 8 to 15 days after the contagion.

SYMPTOMS

The principal initial symptom of the smallpox is unspecific for an infection for virus since there begin like other infections in form shakes, high fever, headache, pains of joints and muscular sometimes with morning sickness and vomiting. More specific is the appearance of the eruption in the skin, which appears to the days of the initial picture.

The sprout is characterized by injuries papulosas, then pustules form that exudan purulent liquid and crusts form a week. The sprout can affect to the whole skin and to the oral mucous membrane. On having transferred the sprout, the pustules leave injuries cicatriciales permanent.

There are two forms of clinical presentation:

• The biggest Variola, which is a serious illness with a valuation of mortality of 30 % or more in not vaccinated persons.
• The minor Variola, which is a lighter infection with a valuation of minor mortality to 1 %.

DIAGNOSIS

The clinical picture and the epidemic in which it appears does not give doubts about the diagnosis. For his cross-check it is possible to isolate the virus with tests in vitro.

There usually appears a low account of white globules and of thrombocytes.
The coagulation tests it can be shaken.
The antibodies anti-virus of the variola appear after transferring the illness.

TREATMENT

The smallpox does not have specific treatment. Some compounds are investigated with therapeutic ends like the cidofovir, in which promising results have been obtained in laboratory studies.

In general it is a question of symptomatic form supporting a special hygiene of the injuries to avoid associate infections, antibiotics if they are needed by it, and other treatments for the itch, the pain and the fever.

The principal thing is to isolate the patient and his nearby environment to avoid the appearance of an epidemic.

Putting a vaccine antivariola between the 1st and 4th of the contagion can prepare or relieve the illness. Also the specific antibody can do a role in this sense.

PREVENTION. VACCINE OF THE SMALLPOX

The vaccine of the smallpox is the only dose applied by means of a cutaneous curettage.

It has his complications or side, principally light effects at cutaneous level, but in 1 of every 300.000 vaccinations mortal encephalitis pictures appear. For this cause, on having eliminated the appearance of cases of smallpox from 1977, the WHO suggested the suspension of the vaccination in 1980.

The vaccine against the smallpox offers a high immunity level against the smallpox during 3 to 5 years, then the immunity is diminishing from there from now on and it is possible that the vaccinated ones in his moment have no protection at present.

CONTRAINDICATIONS OF THE VACCINE

• You present yourself with dermatitis atópica.
• Other skin diseases like burns, chicken pox, impetigo, herpes, serious acne or psoriasis.
• You present yourself with his flagging immune system (for a treatment of the cancer, one transplants of organ, the VIH, or medicines as the steroids).
• In the pregnancy.
• The allergic ones to the vaccine or to any of his components.
• The minor children of 12 months of age.

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