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Pathophysiology
1) caused by infection with variola virus 2) occurs in two forms – variola major and variola minor (alastrim) which is much milder clinically 3) only threat of infection is via bioterrorism as the last cause of endemic smallpox was reported in 1977
Signs and Symptoms
1) fever 2) macular rash progressing to vesicular and pustular lesions over a 1- to 2-week course with subsequent scabbing 3) rash first appears on face, in mouth, and on arms before spreading to rest of body 4) some cases have bleeding into vesicles (hemorrhagic smallpox)
Histology/Gross Pathology
1) double-stranded DNA virus 2) replication occurs in cytoplasm where aggregates of viral particles form eosinophilic inclusions (Guarnieri’s bodies)
Associated Conditions
1) postvaccinal encephalomyelitis 2) postvaccinal pigmentary retinopathy
Inheritance/Epidemiology
1) incubation period of 10-12 days 2) mortality bor variola major is 20-50% and for alastrim is 1% 3) hemorrhagic smallpox is almost uniformly fatal
Treament
live attenuated vaccinia (cowpox) virus is available
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