Abstract
Smallpox is a serious systemic disease which may kill 40–50% of the unprotected individuals it afflicts. The disease has a characteristic exanthem and disfigures and sometimes blinds most of the survivors. A closely related poxvirus, that of variola minor (or alastrim), causes a similar exanthem but less severe illness and the case fatality rate is 2% or less.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Arita, I., and Henderson, D. A., Smallpox and monkeypox in non-human primates. Bull. WHO 39: 277–283 (1968).
Bedson, H. S., Dumbell, K. R., and Thomas, W. R. G., Variola in Tanganyika, Lancet 2: 1085–1088 (1963).
Benenson, A. S., Immediate (so-called “immune”) reaction to smallpox vaccination, J. Am. Med. Assoc. 143: 1238–1240 (1950).
Benenson, A. S., Routine vaccination for all is still indicated, in: Controversy in Internal Medicine II (F. I. Ingelfinger, R. V. Ebert, M. Finland, and A. J. Relman, eds.), pp. 371–381, Saunders, Philadelphia, 1974.
Benenson, A. S., Vaccination factors critical for eradication of smallpox, in: International Symposium on Smallpox Vaccine (R. Regamey and H. Cohen, eds.), pp. 17–22, Karger, Basel, 1973.
Berger, K., and Heinrich, W., Decrease of post-vaccinal deaths in Austria after introducing a less pathogenic virus strain, in: International Symposium on Smallpox Vaccine (R. Regamey and H. Cohen, eds.), pp. 199–203, Karger, Basel, 1973.
Bernstein, S. S., Smallpox and variolation: Their historical significance in the American colonies, J. Mt. Sinai Hosp. 18: 229–244 (1951).
Blake, J. B., Benjamin Waterhouse and the Introduction of Vaccination, p. 61, University of Pennsylvania Press, Philadelphia, 1957.
Christie, A. B., Infectious Diseases: Epidemiology and Clinical Practice, pp. 185–237, E. and S. Livingstone, Edinburgh, 1969.
Center for Disease Control, Public Health Service recommendation on smallpox vaccination. Morbidity Mortality Weekly Rep. 20: 339 (1971).
Center for Disease Control, Smallpox vaccinating hospital and health personnel. Morbidity and Mortality Weekly Rep. 25: 9 (1976).
Dekking, F., Rao, A. R., St. Vincent, L., and Kempe, C. H., The weeping mother, an unusual source of variola virus. Arch. Gesamte Virusforsch. 22: 215–218 (1967).
De Quadros, C. C. A., Morris, L., Da Costa, E. A., Arnt, N., and Tigre, C. H., Epidemiology of variola minor in Brazil based on a study of 33 outbreaks. Bull. WHO 46: 165–171 (1972).
Dick, G., Smallpox: A reconsideration of public health policies. Prog. Med. Virol. 8: 1–29 (1966).
Dixon, C. W., Smallpox, J. and A. Churchill, London, 1962.
Downie, A. W., Smallpox (variola major and variola minor), in: Virus and Rickettsial Diseases of Man, 4th ed. (S. Bedson, A. W. Downie, F. O. MacCallum, and C. H. Stuart-Harris), pp. 84–111, Edward Arnold Ltd., London, 1967.
Downie, A. W., Smallpox, in: Infectious Agents and Host Reactions (S. Mudd, ed.), pp. 487–518, Saunders, Philadelphia, 1970.
Downie, A. W., and Kempe, C. H., Variola and other pox virus infections, in: Diagnostic Procedures for Viral and Rickettsial Disease, 4th ed. (E. H. Lennette and N. J. Schmidt, eds.), pp. 281–320, American Public Health Association, New York, 1969.
Downie, A. W., McCarthy, K., MacDonald, A., MacCallum, F. O., and Macrae, A. D., Virus and virus antigen in the blood of smallpox patients: Their significance in early diagnosis and prognosis. Lancet 2: 164–166 (1953).
Downie, A. W., and McCarthy, K., The antibody response in man following infection with viruses of the pox group. III. Antibody response in smallpox, J. Hyg. 56: 479–487 (1958).
Downie, A. W., St. Vincent, L., Meiklejohn, G., Ratnakannan, N. R., Rao, A. R., Krishnan, G. N. V., and Kempe, C. H., Studies on the virus content of mouth washings in the acute phase of smallpox. Bull. WHO 25: 49–53 (1961).
Espmark, J. A.. Smallpox vaccination studies with serial dilutions vaccine. 1. Primary vaccination and revaccination in human adults. Acta Pathol. Microbiol. Scand. 63: 97–115 (1965).
Espmark, J. A., Rabo, E., and Heller, L., Smallpox vaccination before the age of three months: Evaluation of safety, in: International Symposium on Smallpox Vaccine (R. H. Regamey and H. Cohen, eds.), pp. 243–248, Karger, Basel, 1973.
Foege, W. H., Millar, J. D., and Lane, J. M., Selective epidemiologic control in smallpox eradication, Am. J. Epidemiol. 94: 311–315 (1971).
Foege, W. H., Millar, J. D., and Henderson, D. A., Smallpox eradication in West and Central Africa, Bull. WHO 52: 209–222 (1975).
Gibson, J. E., Dr. Bodo Otto and the Medical Background of the American Revolution, pp. 88–103, 131–135, Thomas, Baltimore, 1937.
Gispen, R., and Brand-Saathof, B., White poxvirus strains from monkeys. Bull. WHO 46: 585–592 (1972).
Gispen, R., and Brand-Saathof, B., Three specific antigens produced in vaccinia, variola, and monkeypox infections, J. Infect. Dis. 129: 289–295 (1974).
Great Britain Report of the Committee of Inquiry into the Smallpox Outbreak in London in March and April, 1973, Report, Her Majesty’s Printing Office, London, 1974.
Hahon, N., and Wilson, B. J., Pathogenesis of variola in Macaca irus monkeys. Am. J. Hyg. 71: 69–80 (1959).
Heiner, G. G., Fatima, N., Daniel, R. W., Cole, J. L., Anthony, R. L., and McCrumb, F. R., Jr., A study of inapparent infection in smallpox. Am. J. Epidemiol. 94: 252 (1971).
Heiner, G. G., Fatima, N., and McCrumb, F. R., Jr., A study of intrafamilial transmission of smallpox, Am. J. Epidemiol. 94: 316–326 (1971).
Henderson, D. A., Importations of smallpox into Europe, WHO Chron. 28: 428–430 (1974).
Henderson, D. A., Smallpox, in: Preventive Medicine and Public Health by Maxcy-Rosenau, 10th ed. (P. E. Sartwell, ed.), pp. 104–116, Appleton-Century-Crofts, New York, 1973.
Henderson, D. A., and Arita, L. Monkeypox and its relevance to smallpox eradication, WHO Chron. 27: 145–148 (1973).
Henderson, R. H., Davis, H., Eddins, D. L., and Foege, W. H., Assessment of vaccination coverage, vaccination scar rates, and smallpox scarring in five areas of West Africa, Bull. WHO 48: 183–194 (1973).
Herrlich, A., Mayr, A., Mahnel, H., and Munz, E., Experimental studies on transformation of the variola virus into the vaccinia virus. Arch. Gesamte Virusforsch. 12: 479–599 (1963).
Hull, E., Smallpox contagiousness, J. Am. Med. Assoc. 219: 750, 755 (1972).
Hunt, J. H., Dr. Benjamin Waterhouse and the introduction of vaccination into the United States, Brooklyn Med. J. 10: 391–395 (1896).
Irons, J. V., Sullivan, T. D., Cook, E. B. M., Cox, G. W., and Hale, R. A., Outbreak of smallpox in the lower Rio Grande Valley of Texas in 1949, Am. J. Public Health 43: 25–29 (1953).
Jefferson, T., Letter from Thomas Jefferson to Dr. Jenner (quoted by J. H. Hunt), Brooklyn Med. J. 10:395 (1896)
Jenner, E., An Inquiry into the Causes and Effects of the Variolae Vacciniae, a Disease Discovered in Some of the Western Counties of England, Particularly Gloucestershire, and Known by the Name of Cowpox, Sampson Low, London, 1798.
Kahn, C., History of smallpox and its prevention. Am. J. Dis. Child. 106: 597–609 (1963).
Kempe, C. H., Berge, T. O., and England, B., Hyperimmune vaccinal gamma globulin: Source, evaluation and use in prophylaxis and therapy. Pediatrics 18: 177–188 (1956).
Koplan, J. P., Goldstein, J., and Foster, S. O., Congenital vaccinia: Some doubts. Pediatrics 50: 971–972 (1972).
Lane, J. M., Complications following smallpox vaccination, in: International Symposium on Smallpox Vaccine (R. H. Regamey and H. Cohen, eds.), pp. 217–226, Karger, Basel, 1973.
Lane, J. M., Ruben, F. L., Neff, J. M., and Millar, J. D., Complications of smallpox vaccination, 1968, N. Engl. J. Med. 281: 1201–1208 (1969).
Langmuir, A. D., Vaccination should be abolished in the United States except for selected populations, in: Controversy in Internal Medicine II (F. J. Ingelfinger, R. V. Ebert, M. Finland, and A. J. Relman, eds.), pp. 363–370, Saunders, Philadelphia, 1974.
Leake, J. P., Smallpox or variola, Med. Clin. North Am. 27: 603–616 (1943).
Leikind, M. C., Variolation in Europe and America, Ciba Symp. 3: 1090–1101 (1942).
Leikind, M. C., The introduction of vaccination into the United States, Ciba Symp. 3: 1114–1124 (1942).
Long, G. W., Noble, J., Murphy, F. A., Herrmann, K. L., and Lourie, B., Experience with electron microscopy in the differential diagnosis of smallpox, Appl. Microbiol. 20: 497–504 (1970).
Macaulay, T. B., The History of England from the Accession of James the Second, Vol. 4, p. 369, E. H. Butler and Co., Philadelphia, 1856.
MacCallum, F. O., and McDonald, J. R., Survival of variola virus in raw cotton. Bull. WHO 16: 247–254 (1957).
Mack, T. M., Smallpox in Europe, 1950–1971, J. Infect. Dis. 125: 161–169 (1972).
Mack, T. M., Thomas, D. B., and Khan, M. M., Variola major in West Pakistan, J. Infect. Dis. 122: 479–488 (1970).
Mack, T. M., Thomas, D. B., Ali, A., and Khan, M. M., Epidemiology of smallpox in West Pakistan. I. Acquired immunity and the distribution of disease, Am. J. Epidemiol. 95: 157–168 (1972).
Mack, T. M., Thomas, D. B., and Khan, M. M., Epidemiology of smallpox in West Pakistan. II. Determinants of intravillage spread other than acquired immunity. Am. J. Epidemiol. 95: 169–177 (1972).
Marennikova, S. S., Seluhina, E. M., Mal’ceva, N. N., Cimiskjan, K. L., and Macevic, G. R., Isolation and prroperties of the causal agent of a new variola-like disease (monkeypox) in man. Bull. WHO 46: 599–611 (1972).
Marennikova, S. S., Seluhina, E. M., Mal’ceva, N. N., and Ladnyj, I. D., Poxviruses isolated from clinically ill and asymptomatically infected monkeys and a chimpanzee. Bull. WHO 46: 613–620 (1972).
Marshall, M. S., The first smallpox vaccine in the Americas, Am. Soc. Microbiol. News 40: 443–445 (1974).
Martin, H. A., Jefferson as a vaccinator, N. C. Med. J. 7: 1–35 (1881).
McCarthy, K., and Downie, A. W., The antibody response in man following infection with viruses of the pox group. 11. Antibody response following vaccination, J. Hyg. 56: 466–478 (1958).
Millar, J. D., Roberto, R. R., Wulff, H., Wenner, H. A., and Henderson, D. A., Smallpox vaccination by intradermal jet injection. I. Introduction, background and results of pilot studies. Bull. WHO 41: 749–760 (1969).
Nakano, J. H., Evaluation of virological laboratory methods for smallpox diagnosis. Bull. WHO 48: 529–534 (1973).
Nakano, J. H., and Bingham, P. G., Smallpox, vaccinia, and human infections with monkeypox viruses, in: Manual of Clinical Microbiology, 2nd ed. (E. H. Lennette, E. H. Spaulding, and J. P. Truant, eds.), pp. 782–794, American Society for Microbiology, Washington, D.C., 1974.
Nanning, W., Prophylactic effect of antivaccinia gamma-globulin against post-vaccinal encephalitis. Bull. WHO 27: 317–324 (1962).
Nizamuddin, M. D., and Dumbell, K. R., A simple laboratory test to distinguish the virus of smallpox from that of alastrim. Lancet 1: 68–69 (1961).
Noble, J., Jr., and Rich, J. A., Transmission of smallpox by contact and by aerosol routes in Macaca irus, Bull. WHO 40: 279–286 (1969).
Nyerges, G., Erdos, L., and Melly, E., Smallpox vaccination immunity in relation to number of insertions. Bull WHO 48: 397–400 (1973).
Palmquist, E. E., The 1946 smallpox experience in Seattle, Can. J. Public Health 38: 213–218 (1947).
Polak, M. P., Complications of smallpox vaccination in the Netherlands, 1959–1970, in: International Symposium on Smallpox Vaccine (R. H. Regamey and H. Cohen, eds.), pp. 235–242, Karger, Basel, 1973.
Polak, M. P., Beunders, J. J. W., Van Der Werff, A. R., Sanders, E. W., Van Klaveren, J. N., and Brans, L. M., A comparative study of clinical reaction observed after application of several smallpox vaccines in primary vaccination of young adults. Bull. WHO 29: 311–322 (1963).
Rao, A. R., Haemorrhagic smallpox, a study of 240 cases, J. Indian Med. Assoc. 43: 224r–229 (1964).
Rao, A. R., Smallpox, The Kothari Book Depot, Bombay 12, 1972.
Rao, A. R., Jacob, E. S., Kamalakshi, S., Appaswamy, S., and Bradbury, Epidemiological studies in smallpox: A study of intrafamilial transmission in a series of 254 infected families, Indian J. Med. Res. 56: 1826–1854 (1968).
Rao, A. R., Prahlad, I., Swaminathan, M., and Lakshmi, A.. Pregnancy and smallpox, J. Indian Med. Assoc. 40: 353–363 (1963).
Rao, A. R., Sukumar, M. S., Kamalakshi, S., Paramasivam, T. V., Parasuraman, T. A. R., and Shantha, M., Experimental variola in monkeys. Part 1. Studies on disease enhancing property of cortisone in smallpox: a preliminary report, Indian J. Med. Res. 56: 1855–1865 (1968).
Roberts, J. A., Histopathogenesis of mousepox. I. Respiratory infection, Br. J. Exp, Pathol. 43: 451–461 (1962).
Sarkar, J. K., Chatterjee, S. N., Mitra, A. C. and Mondal, A.. Antibody response in haemorrhagic smallpox, Indian J. Med. Res. 55: 1143–1149 (1967).
Sarkar, J. K., Hati, A. K., and Mitra, A. C., Role of mosquitoes in the spread of smallpox, J. Infect. Dis. 128: 781–783 (1973).
Sarkar, J. K., and Mitra, A. C., Virulence of variola virus isolated from smallpox cases of varying severity, Indian J. Med. Res. 55: 13–20 (1967).
Sarkar, J. K., Mitra, A. C., Mukherjee, M. K., De, S. K., and Mazumdar, D. G., Virus excretion in smallpox. 1. Excretion in the throat, urine, and conjunctiva of patients. Bull. WHO 38: 517–522 (1973).
Sarkar, J. K., Mitra, A. C., Mukherjee, M. K., and De, S. K., Virus excretion in smallpox. 2. Excretion in the throats of household contacts. Bull. WHO 48: 523–527 (1973).
Sarkar, J. K., Ray, S., and Manji, P., Epidemiological and virological studies on the off-season smallpox cases in Calcutta, Indian J. Med. Res. 58: 829–839 (1970).
Simpson, H. N., The impact of disease on American history, N. Engl. J. Med. 250: 679–682 (1954).
Stearn, E. W., and Stearn, A. E., The Effect of Smallpox on the Destiny of the Amerindian, pp. 44–45, Bruce Humphries, Inc., Boston, 1945.
Thomas, D. B., Arita, L, Mccormack, W. M., Khan, M. M., Islam, S., and Mack, T. M., Endemic smallpox in rural Pakistan. II. Intravillage transmission and infectiousness. Am. J. Epidemiol. 93: 373–383 (1971).
Thomas, D. B., Mack, T. M., Ali, A., and Khan, M. M., Epidemiology of smallpox in West Pakistan. III. Outbreak detection and interlocality transmission, Am. J. Epidemiol. 95: 178–189 (1972).
Thomas, D. B., Mccormack, W. M., Arita, I., Khan, M. M., Islam, M. S., and Mack, T. M., Endemic smallpox in rural East Pakistan. II. Methodology, clinical and epidemiological characteristics of cases, and intervillage transmission. Am. J. Epidemiol. 93: 361–372 (1971).
Wehrle, P. P., Posch, J., Richter, K. H., and Henderson, D. A., An airborne outbreak of smallpox in a German hospital and its significance with respect to other recent outbreaks in Europe, Bull. WHO 43: 669–679 (1970).
Weinstein, I., An outbreak of smallpox in New York City, Am. J. Public Health 37: 1376–1384 (1947).
Winslow, O. E., A Destroying Angel: The Conquest of smallpox in Colonial Boston, Houghton Mifflin, Boston, 1974.
Woodward, S. B., The story of smallpox in Massachusetts, N. Engl. J. Med. 206: 1182–1191 (1932).
World Health Organization, WHO Expert Committee on Smallpox, First Report, World Health Organization Technical Report Series No. 283 (1964).
World Health Organization, WHO Scientific Group, Smallpox Eradication, World Health Organization Technical Report Series No. 393 (1968).
World Health Organization, A decade of smallpox, WHO Chron. 22: 134–141 (1968).
World Health Organization, Guide to the Laboratory Diagnosis of Smallpox for Smallpox Eradication Programmes, WHO, Geneva, 1969.
World Health Organization, Smallpox surveillance. Weekly Epidemiol. Rec. 47: 18 (1972).
World Health Organization, Smallpox surveillance. Weekly Epidemiol. Rec. 47: 144 (1972).
World Health Organization, Smallpox, Weekly Epidemiol. Rec. 47: 161–162 (1972).
World Health Organization, WHO Expert Committee on Smallpox Eradication, Second Report, World Health Organization Technical Report Series No. 493 (1972).
World Health Organization, Smallpox surveillance. Weekly Epidemiol Rec. 49: 9–17 (1974).
World Health Organization, Progress in smallpox eradication, WHO Chron. 28: 361 (1974).
World Health Organization, Smallpox surveillance. Weekly Epidemiol. Rec. 50: 13–28 (1975).
World Health Organization, Smallpox surveillance. Weekly Epidemiol. Rec. 50: 254–256 (1975).
World Health Organization, Smallpox surveillance. Weekly Epidemiol. Rec. 51: 9–18 (1976).
Suggested Reading
Benenson, A. S., Routine vaccination for all is still indicated, in: Controversy in Internal Medicine II (F. J. Ingelfinger, R. V. Ebert, M. Finland, and A. J. Relman, eds.), pp. 371–381, Saunders, Philadelphia, 1974.
Christie, A. B., Infectious Diseases: Epidemiology and Clinical Practice, pp. 185–237, E. and S. Livingston, Edinburgh, 1969.
Dick, G., Smallpox: A reconsideration of public health policies. Prog. Med. Virol. 8: 1–29 (1966).
Dixon, C. W., Smallpox, J. and A. Churchill, London, 1962.
Downie, A. W., Smallpox, in: Infectious Agents and Host Reactions (S. Mudd, ed.), pp. 487–518, Saunders, Philadelphia, 1970.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1976 Plenum Publishing Corporation
About this chapter
Cite this chapter
Benenson, A.S. (1976). Smallpox. In: Evans, A.S. (eds) Viral Infections of Humans. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3988-5_20
Download citation
DOI: https://doi.org/10.1007/978-1-4613-3988-5_20
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-3990-8
Online ISBN: 978-1-4613-3988-5
eBook Packages: Springer Book Archive