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Smallpox: Infections
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Smallpox is believed to have arrived in the Americas in 1520 on a Spanish ship sailing from Cuba, carried by an infected African slave. As soon as the party landed in Mexico, the infection began its deadly voyage through the continent. Even before the arrival of Pizarro, smallpox had already devastated the Inca Empire, killing the Emperor Huayna Capac and unleashing a bitter civil war that distracted and weakened his successor, Atahuallpa.
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Smallpox is characterised in its classical form by the sudden onset of fever, headache, backache, vomiting, marked prostration and even delirium. At this early stage the patient may be very ill and compelled to take to his bed. Early in the illness there may appear in about 10% of patients a fleeting rash in the form of a reddening of the skin, not unlike the rash of German Measles. This is the so-called prodromal rash and, in the absence of a history of exposure to a source of infection, there is nothing about this rash to arouse suspicion of smallpox. The incubation period from exposure to the onset of this feverish illness is nearly always 12 days with very little variation either way.
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Smallpox is a potentially deadly infection caused by the variola virus. The telltale signs of smallpox are severe illness including a high fever. This is followed by a blisterlike body rash. Symptoms of smallpox develop about 12 days after exposure.
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Smallpox can be lethal, usually due to bacterial infection of the open skin lesions, pneumonia, or bone infections. A severe and quickly fatal form of smallpox is known as "sledgehammer smallpox." This form of smallpox is characterized by bleeding from the skin lesions, as well as from the mouth, nose, and other areas of the body.
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Smallpox localizes in small blood vessels of the skin and in the mouth and throat. In the skin, this results in a characteristic maculopapular rash, and later, raised fluid-filled blisters. V. major produces a more serious disease and has an overall mortality rate of 30–35%. V. minor causes a milder form of disease (... known as alastrim, cottonpox, milkpox, whitepox, and Cuban itch) which kills ~1% of its victims.[3][4] Long-term complications of V. major infection include characteristic scars, commonly on the face, which occurred in 65-85% of survivors.[5] Blindness resulting from corneal ulceration and scarring, and limb deformities due to arthritis and osteomyelitis are less common complications, seen in about 2-5% of cases.
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Smallpox is strictly an infection of human beings. Animals and insects can neither be infected by smallpox, nor carry the virus in any form. Most infections are caused by contact with a person who has already developed the characteristic skin lesions (pox) of the disease, although a person who has a less severe infection (not symptomatic or diagnosable in the usual way) can unwittingly spread the virus.
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