Chapter 4 : Smallpox: the Speckled Monster

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Over the centuries, smallpox has killed hundreds of millions of people. In the 20th century alone, it killed at least 300 million people. Smallpox is indiscriminate, with no respect for social class, occupation, or age; it has killed or disfigured princes and paupers, kings and queens, children and adults, farmers and city dwellers, generals and their enemies, rich and poor. Smallpox traveled to West Africa with the caravans that moved from North Africa to the Guinea Coast. The cause of smallpox is a virus, one of the largest of the viruses; with proper illumination it can actually be seen under a light microscope. Most commonly the smallpox virus enters the body through droplet infection by inhalation. However, it can be transmitted by direct contact or through contaminated fomites (inanimate objects) such as clothing bedding, blankets, and dust. During the first week of infection there is no sign of illness; however, the virus can be spread by coughing or by nasal mucus at this time. The virus moves on to the lymph nodes and then to the internal organs via the bloodstream. There are two varieties of the smallpox (variola) virus: major and minor. They can be distinguished by differences in their genes. Smallpox spreads more rapidly during the winter in temperate climates and during the dry season in the tropics. Vaccination against smallpox results in protection because the antibodies produced against Variola vaccinae are able to neutralize the variola major virus.

Citation: Sherman I. 2007. Smallpox: the Speckled Monster, p 50-67. In Twelve Diseases That Changed Our World. ASM Press, Washington, DC. doi: 10.1128/9781555816346.ch4
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