Child With Smallpox - Causes, Symptoms & Vaccination

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As a parent, you are probably worried about your child contracting various illnesses. One of them that could be a childhood disease is smallpox.

While smallpox is a disease that infants, toddlers and younger children may contact, not giving it proper medical attention can lead to lifelong scarring, and even turn fatal. Understanding the causes and symptoms and knowing about the various treatment options can be a good way to control smallpox in its inception stage. Read below to know the information and facts about Smallpox, also the causes, symptoms, treatment and vaccination precautions!

What Is Smallpox – A Brief History:

Smallpox is thought to have originated in ancient agrarian communities in Africa from whence it spread via Egypt to India and the rest of the world. The virus is thought to have mutated from an animal-based format to one that attacks humans. There are records of cases of smallpox dating back to more than 12,000 years. It was brought to Europe and other continents by traders and conquerors who traveled frequently between different countries and carried the virus with them. Millions of people have died from smallpox, even as recently as the 20th century and it is considered to be even more of a scourge than tuberculosis.

The English scientist Edward Jenner was the first person to create a vaccine for smallpox in the 18th century. He discovered that exposure to a similar virus (cow-pox) gave immunity to agricultural communities in rural England. Large-scale vaccination and immunization, better hygiene and awareness, isolating and identifying the virus early in its onset etc. provided good results.

Smallpox is the first disease to be completely eradicated in the world through widespread vaccination. Currently it is the only disease to have been effectively removed from humans. The last reported case was in 1977 in Somalia.

Smallpox is highly contagious. Its scars last throughout the victim’s lifetime and it can also cause blindness in case the eyes are affected. Smallpox in infants and young children is an extremely dangerous virus which may provoke death. Death occurs due to toxemia and internal bleeding. There is no known cure for the disease and all treatment can only be symptomatic to ease pain and suffering.

[ Read: Common Childhood Diseases ]

Causes Of Smallpox:

Smallpox was a disease that typically attacked young adults and children. It was highly contagious and smallpox epidemics were common in earlier times.

  1. The disease is caused by the Variola virus. There are two strains of the Variola virus: major and minor.
  2. The major strain is the more virulent one, and occurs in people who have not been vaccinated. It can be life-threatening.
  3. The minor strain is a milder form and rarely results in death.

There are four important subtypes of the variola major virus:

  • Ordinary
  • Flat
  • Modified
  • Hemorrhagic

The last two forms are rare and always fatal.

Variola minor also has four subtypes. These are:

  • Variola sine eruptione
  • Pulmonary
  • Pharyngeal
  • Influenza-form

These forms are milder and may occur in people who have been previously immunized. Only in very rare cases do they result in death.

[ Read: Symptoms Of Chickenpox In Children ]

Breeding And Spreading:

The disease can occur in any place and under any climatic conditions. However, the virus thrives best under cool, dry conditions, especially during the early spring and late autumn months in Europe and the Americas, or in the dry, winter season in Asia and Australia.

Smallpox is classified as a droplet infection. This means it spreads via liquids and body fluids. The most common form of infection is via saliva droplets, infected bed-linen, clothes, towels, etc. When an infected person coughs or sneezes, the virus is expelled violently and finds its way to other victims.

This is why smallpox is highly contagious within families. Studies have shown that a single infected person can transmit the disease very easily to more than 60% of those he or she comes into contact with. The disease is most contagious during the first week of infection or the incubation stage. However, it remains contagious during the entire duration of the attack, right till the time the scabs begin to fall.

Under favorable conditions, the virus is able to stay potent for more than 24 hours. In non-favorable conditions, it can still stay alive for about six hours, making it one of the most tenacious viruses known to man. However, modern studies have shown that the virus does not survive release by aerosol for more than 24 hours, especially in the presence of ultraviolet light. Since it is a virus, it remains immune to anti-biotic. Any treatment can only be undertaken to keep the patient comfortable, dehydrated and tackle the secondary issues of septicemia and toxemia.

At present only a few laboratories have live strains of smallpox virus and as such, laboratory workers may be at risk. The virus is also the subject of huge ethical controversy as it is being kept alive by certain countries to unleash bio-terrorism if required.

Since the early 1970s, general immunization of people against smallpox has been discontinued.

Symptoms of Smallpox:

The virus begins to show symptoms only some two weeks after infection has entered the body. Once the incubation period or virus development phase was over, Smallpox symptoms typically include:

  1. Body aches
  2. Back ache
  3. Malaise
  4. High fever with delirium
  5. Severe headache and vomiting
  6. Diarrhea

[ Read: Diarrhea In Children ]

These are easily confused with many other illnesses and unless there has been another case in the vicinity, the symptoms are indistinguishable from those occurring in other common diseases.

  • Only when the characteristic raised pink rashes appear, some 24 to 48 hours later, can the final diagnosis can be made. The rashes appear all over the body, but typically on the legs, face, arms and mouth.
  • These soon begin to form crusts in about a week’s time. The rash spreads throughout the entire body. In severe cases, the patient may be afflicted with internal rashes. Severe internal bleeding and toxemia cause death, usually within the second week of full-blown symptoms appearing.
  • The lesions begin to spread all over the body and continue in the same stage of development. This is unlike chicken pox, where new lesions keep occurring while the old lesions dry up. In case the patient survives, the disease leaves typical deep, pitted scars wherever the lesions had occurred and these last throughout life.
  • It infects the skin, liver, kidneys, spleen, etc. Fatalities occur because of toxemia and the body’s reaction to the overwhelming number of viruses that enter the body. One of the reasons why scientists have been able to contain this virus is the fact that it attacks only humans.
  • It can easily be mistaken for chicken pox, but the difference is that the chicken-pox rashes are spread across the upper body and trunk, while smallpox rashes are seen across the face, legs and arms.

Treatment Of Smallpox:

Diagnosis of smallpox can be confirmed by collecting a sample from the lesion and testing in the laboratory with the aid of electron microscopy. Read below to know how to treat a child with smallpox.

  1. It has to be cultured and then tested. Hence great care has to be taken during this process to prevent inadvertent spread of the disease. All technicians have to wear gloves and masks and the testing area has to be specially isolated and sealed.
  2. There is no treatment for smallpox. Being a virus, it does not succumb to antibiotics and since it spreads via droplets or aerosol, it is highly contagious.
  3. If the vaccine can be given within three or four days of contracting the virus, there are some chances that the person may escape falling victim to the disease. In any case, the vaccine given after infection can only curtail the severity of the disease and make it less virulent and dangerous.
  4. However, once the symptoms are full-blown, there are very few or no treatment options available. There are no specific drugs that can be taken to cure the patient.
  5. Treatment is more in the nature of supportive management of the patient and precautionary measures regarding the disease and containing its spread. Secondary infections can be treated with antibiotics and the complications can be eased.

Hence the treatment regimen for smallpox is limited but has to be strictly followed. This includes:

  • Immediate isolation of the patient and others who have come in contact with this person.
  • Isolation should be ideally in negative-pressure rooms.
  • Isolation should be maintained till all scabs have dried and fallen (about 3-4 weeks).
  • Fluid electrolytes should be maintained to prevent dehydration.
  • Intravenous fluids if required.
  • Medications to control secondary bacterial infections.
  • Good and constant nursing.
  • Symptomatic treatment for fever and pain.
  • Adequate nutrition.
  • Regular monitoring of all systems to prevent complications of toxemia and septicemia.
  • Lesions in the eyes must be attended to immediately.
  • Skin care programs can be considered in later stages.
  • Information should be provided immediately to the main disease control centers in the country.

A strategic national stockpile of smallpox vaccine has been created by the United States Center for Disease control to manage any outbreak of the disease. Supplies and medications can be reached anywhere within the country within 12 hours. Millions of dollars of funding are being poured into research that will lead to a new antiviral drug that combats smallpox.

Smallpox Vaccination Precautions:

There are certain risks involved in taking smallpox vaccinations. People with known allergic reactions to such types of vaccines should consult their physicians before taking it. Pregnant and lactating women, children under one year of age, eczema patients, those with heart ailments or compromised immune systems will not be safe if they take a smallpox vaccination.

Post-Infection Care Of Smallpox Survivors:

Smallpox victims develop lifelong immunity to the disease if they are able to survive. However, in all cases, the disease leaves them with ugly, disfiguring, deep, pitted scars all over the face and body. In many cases, they may also lose their eyesight if there are corneal lesions.

  • Complications post-infection include heart diseases like myocarditis. Other complications can be arthritis, bronchopneumonia and osteomyelitis. Care should be taken to monitor the patient against such complications.
  • Scars can be treated by an experienced dermatologist. These scars are a more severe version of acne scars. Deep scars may need to be excised and then resurfaced. Laser treatments may not be very effective.
  • There are several popular, but untested home remedies reputed to remove smallpox scars. These may include diet based treatment like consuming more fresh green vegetables like cabbage and spinach. Other topical treatments like application of honey, oatmeal, tea-tree oil, cocoa butter etc., are also recommended by beauticians.

Smallpox is one of the most ancient and feared illness in human history. This is because apart from being a virus and thus immune to antibiotics, there is no known treatment or cure for the disease.

Recent laboratory experiments have shown the effectiveness of certain drugs like Cidofovir, but these are still in the experimental stage. However, dedicated research has succeeded in eradicating the disease completely in its natural state.

In case your child shows any of the above symptoms, do get a proper medical assessment done. This will help curb any infection in its inception stage and will help get your child the immediate treatment that is needed.

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