The virus Orthopoxvirus variola is the trigger of smallpox, a dangerous infectious disease that has probably been around for thousands of years. The name smallpox means bladder or bag and refers to the skin lesions that are one of the clearest symptoms of this disease.

What is Orthopoxvirus variola?

The human poxvirus (Orthopoxvirus variola) was probably first detected around 1906 by the Mexican German vaccinologist Enrique Paschen. He succeeded in the lymphatic fluid of an infected child with the help of a light microscope to discover the so-called elementary bodies, which were named after him as Paschensche corpuscles.

However, the ancient Egyptians already knew this disease. They called her Uhedu's disease. In ancient China, at the time of the construction of the Great Wall, people spoke of the Hunpox and the ancient Romans called the smallpox Antoninic plague.

In addition to the true smallpox (variola major or variola vera), there are the white pox (variola minor) and the East African smallpox, also known as black pox. In addition to these human poxviruses, there are also various animal pox viruses, such as monkey pox, cowpox and camelpox, which can also be transmitted to humans via the respective intermediate hosts.

Occurrence, distribution & characteristics

Smallpox has in the past repeatedly caused devastating epidemics, in which millions of people died. They were considered one of the biblical plagues, raged in the Roman Empire for decades, eradicated parts of the natives of America, Africa and Australia and probably came with the Crusaders to Europe. It was estimated that over 400, 000 people died each year as a result of the disease. At times, the number of smallpox victims and victims even exceeded the numbers of the plague or cholera dead.

Famous figures in history such as Luis XV, King of France and Navarre or the Russian Tsar Peter II died of it. Beethoven probably became deaf due to the smallpox, the face of Josef Haydn was disfigured by pockmarks.

From the beginning of the 19th century, there were smallpox vaccinations with live vaccines, which succeeded in quickly reducing smallpox. The number of new infections dropped. In 1967, the World Health Organization (WHO) launched a global campaign to eradicate smallpox, a general vaccination requirement was introduced, and in 1980, the WHO established that the pox virus can virtually be considered extinct. As a result, the general smallpox vaccinations were abolished again. However, in many countries of the world (including Germany) there is still a supply of vaccines to prevent possible smallpox outbreaks and to treat early on potentially endangered or infected individuals.

Diseases & complaints

The last recorded cases of human pox occurred in 1975 in Bangladesh, 1978 in Birmingham and Somalia. However, there are still, at least in the US and in Russia, research institutions in which store pox viruses.

Since the abolition of smallpox vaccinations, especially in Africa, the number of people has increased, for example, the monkey pox (orthopoxvirus simiae) or cowpox (orthopoxvirus bovis) ill. So far, these smallpox species did not occur in vaccinated persons, since a so-called "cross-infection protection" is given. In addition, some researchers fear that the animal smallpox species could also mutate over time and thus a transmission from person to person is likely.

The human poxvirus is theoretically transmissible by droplet infection when coughing and sneezing, but also by inhalation of dust from infected bedding, clothing, dishes or other objects with which the patient had contact. Even laboratory accidents are possible.

The monkey pox can be transmitted to humans when infected rodents, rats or monkeys bite or scratch people or humans consume the meat of infected animals. Cow and camelpox are sometimes transferred when milking.

The incubation period of the poxviruses is on average 2 weeks. The onset of the disease leads to a serious feeling of illness. Those affected have high fever, chills, head and body aches, throat infections and swollen lymph nodes. The fever generally goes in two spurts, after the second fever, it comes to the skin lesions typical for smallpox. The pustules and blisters spread mainly on the face, neck, chest, groin and feet.

If the smallpox dry out and fall off after weeks, they often leave skin dings or pockmarks. In particularly severe disease, it can also lead to serious consequences such as paralysis, brain damage and blindness. But also easier gradients are common. The risk of infection with smallpox is very high. The treatment options are limited to strict bed rest, antipyretic and analgesics, as well as the treatment of secondary diseases.

In the past, the majority of people with smallpox died. In the 20th century, the mortality rate was about 30 percent. Patients with weakened immune systems, the elderly and children are particularly affected by the disease. In the case of people infected with chickenpox, the mortality rate is significantly lower and is about one percent. Anyone who survives smallpox is then resistant and thus protected for a lifetime from the disease.

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