ad
This Article
Right arrow Images Only
Right arrow Full Version
Right arrow PDF Español
Services
Right arrow E-mail this link to a friend
Right arrow Related text in Red Book
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Articles in Pediatrics
Right arrow reprints & permissions
Right arrow Section 1
Section 2
Section 3
Section 4
Section 5
Appendices

The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Smallpox (Variola)

In 1980, the World Health Organization declared that smallpox (variola) had been eradicated successfully worldwide. The last naturally occurring case of smallpox occurred in Somalia in 1977, followed by 2 cases attributable to laboratory exposure in 1978. The United States discontinued routine childhood immunization against smallpox in 1971 and routine immunization of health care workers in 1976. The US military continued to immunize military personnel until 1990. Since 1980, the vaccine has been recommended only for people working with nonvariola orthopoxviruses. Two World Health Organization reference laboratories were authorized to maintain stocks of variola virus. There is increasing concern that the virus and the expertise to use it as a weapon of bioterrorism may have been misappropriated. Smallpox is included in this edition of the Red Book for the first time since 1977 because of this concern.

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

Top
 Next
CLINICAL MANIFESTATIONS: An individual infected with variola major develops a severe prodromal illness characterized by high fever (102°F–104°F [38.9°C–40.0°C]) and constitutional symptoms, including malaise, severe headache, backache, abdominal pain, and prostration, lasting for 2 to 5 days. Infected children may suffer from vomiting and seizures during this prodromal period. Most patients with smallpox tend to be severely ill and bedridden during the febrile prodrome. The prodromal period is followed by enanthemas (lesions on the mucosa of the mouth or pharynx), which may not be noticed by the patient. This stage occurs less than 24 hours before the onset of rash, which usually is the first recognized manifestation of infectiousness. With the onset of enanthemas, the patient becomes infectious and remains so until all skin crust lesions have separated. The exanthem, or rash, typically begins on the face and . . . [Go to Full Text]


Related text in Red Book:

Summary of Major Changes in the 2003 Red Book

Red Book 2003: xxv. [Extract] [Full Version]  



This topic has been referenced by these articles:

  • Abramson, J. S., McMillan, J. A., Baltimore, R. S. (2003). The US Smallpox Vaccination Plan. Pediatrics 111: 1431-1432 [Full Version]  
  • Puliyel, J. M. (2002). The Dummies' Guide to Risk-Benefit Analysis of Vaccines. Pediatrics 110: 193-193 [Full Version]  
  • Committee on Infectious Diseases, (2002). Smallpox Vaccine. Pediatrics 110: 841-845 [Abstract] [Full Version]  
  • Krugman, S., Giles, J. P., Jacobs, A. M., Friedman, H. (1963). STUDIES WITH A FURTHER ATTENUATED LIVE MEASLES-VIRUS VACCINE. Pediatrics 31: 919-928 [Abstract]  
  • Raju, T. N.K. (2006). Hot Brains: Manipulating Body Heat to Save the Brain. Pediatrics 117: e320-e321 [Full Version]  
  • Stiehm, E. R. (2006). Disease Versus Disease: How One Disease May Ameliorate Another. Pediatrics 117: 184-191 [Abstract] [Full Version]  
  • Neff, J. M., Levine, R. H., Lane, J. M., Ager, E. A., Moore, H., Rosenstein, B. J., Millar, J. D., Henderson, D. A. (1967). COMPLICATIONS OF SMALLPOX VACCINATION UNITED STATES 1963: II. Results Obtained by Four Statewide Surveys. Pediatrics 39: 916-923 [Abstract]  
  • American Academy of Pediatrics, (2006). AAP Publications Retired and Reaffirmed. Pediatrics 117: 1846-1847 [Full Version]