Objections to the Russo–Williamson Thesis
Donald Gillies in Causality, Probability, and Medicine, 2019
As we have seen, the very first hypothesis which Semmelweis considers is that puerperal fever is caused by a miasma, and he rejects this hypothesis. Semmelweis also states quite explicitly that, in his view, puerperal fever is not caused by a contagion. As he says (1861, p. 117): Childbed fever is not a contagious disease. A contagious disease is one that produces the contagion by which the disease is spread. This contagion brings about only the same disease in other individuals. Smallpox is a contagious disease because smallpox generates the contagion that causes smallpox in others. Smallpox causes only smallpox and no other disease. … Childbed fever is different. This fever can be caused in healthy patients through other diseases. In the first clinic it was caused by a discharging medullary carcinoma of the uterus, by exhalations from a carious knee, and by cadaverous particles from heterogeneous corpses. … However, childbed fever cannot be transmitted to a healthy maternity patient unless decaying animal-organic matter is conveyed.
Rocky Mountain Spotted Fever and Typhus Fever
James H. S. Gear in CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
A clinical feature common to many infectious diseases is an associated exanthem, often sufficiently distinctive to suggest a bedside diagnosis. When the rash appears sufficiently early in the illness, it is often possible to initiate specific chemotherapy well before the results of confirmatory laboratory tests are known. Smallpox, characterized by one of the most familiar skin lesions, is associated with fever, headache, backache, and considerable prostration. The early erythematous small lesion resembles varicella, even with the appearance of the vesicle. However, the mature vesicle of variola is multiocular and fails to collapse when probed by a needle; the vesicle of varicella, similar to those of herpes simplex and herpes zoster, is unilocular and collapses with needle puncture.
The Smallpox Story
Rae-Ellen W. Kavey, Allison B. Kavey in Viral Pandemics, 2020
Historically, a range of remedies were used to “treat” smallpox, with no effect. Once vaccination against smallpox was established and available, vaccination within 3 days of exposure was shown to prevent or significantly lessen the severity of smallpox symptoms in the vast majority of people. Even if performed later – 4–7 days after exposure – vaccination modified the severity of disease. Other than vaccination, treatment of smallpox was primarily supportive, including wound care, prevention of super-infection, and fluid therapy. People with semi-confluent and confluent types of smallpox had therapeutic issues similar to patients with extensive skin burns and required intensive fluid management– this would still be a primary focus of treatment in this setting today. Flat and hemorrhagic types of smallpox would be treated with the same therapies used to treat shock, including fluid resuscitation, inotropes to maintain blood pressure and respiratory support.33
Mpox: epidemiology, clinical manifestations and recent developments in treatment and prevention
Published in Expert Review of Anti-infective Therapy, 2023
Nikil Selvaraj, Shreya Shyam, Puvin Dhurairaj, Kaviarasan Thiruselvan, Akil Thiruselvan, Yochana Kancherla, Pritika Kandamaran
Although not all cellular receptors have been fully defined, glycosaminoglycans, which are ubiquitously produced on the surface of mammalian cells, are assumed to be essential for binding the virion to the cell membrane [5]. Although it is outside the scope of this review, a full description of the replication cycle has already been provided. Smallpox was one of the most feared contagious illnesses in human history, suspected to have killed millions of people globally. The effects of smallpox serve as a reminder that OPXV are potent viruses. There is some evidence indicating that the variola virus may have developed from a long-extinct rodent poxvirus thousands of years ago, while the origins of smallpox remain unknown [5]. Furthermore, it has long been known that zoonotic OPXV diseases such as MPXV are becoming more dangerous. A sizable section of the world’s population lacks immunity to smallpox and zoonotic OPXV as a result of smallpox immunization campaigns coming to a halt more than 40 years ago [5]. In summation, this raises the possibility that a zoonotic orthopoxvirus, such as MPXV, could develop the capacity to effectively transmit between humans and result in larger outbreaks under certain circumstances [8].
Reemergence of monkeypox: prevention and management
Published in Expert Review of Anti-infective Therapy, 2022
Sahaya Nadar, Tabassum Khan, Abdelwahab Omri
The CDC Drug Services provides the following vaccine recommendations for individuals placed in the high risk category by virtue of occupational exposure to this virus. A live, non-replicating vaccine, JYNNEOS is approved by the US FDA for the prevention of smallpox and monkeypox in adults (18 years and older) who were assessed to have a high risk of infection. The JYNNEOS vaccine is different from ACAM2000 and APSV as it is an attenuated live virus. Being in a replication-deficient form, it can be used toward certain immune deficiencies like AIDS or atopic dermatitis [75,76].The ACAM2000 is a live vaccine for active immunization against smallpox disease licensed by the US FDA for people who are at high risk of contracting smallpox. It is free from the variola virus, so they cannot cause smallpox but has the vaccinia virus belonging to the poxvirus family. There may be incidences of head and body aches, rash and fever owing to the presence of the vaccinia virus. Some groups of people, specifically those who are immunocompromised, are susceptible to severe complications caused by vaccinia [77,78].Aventis Pasteur Smallpox Vaccine (APSV)
Evaluating the relationship between myocarditis and mRNA vaccination
Published in Expert Review of Vaccines, 2022
A prospective study examined the incidence of new onset cardiac symptoms following smallpox and trivalent inactivated influenza vaccination in military service members [5]. This study found that healthy unvaccinated active-duty service members experienced myocarditis at a rate of 2.6 (1.9, 2.34) events per 100,000. In smallpox-vaccinated service members, the rate of myocarditis was 7.46 (6.89, 8.48) per 100,000, corresponding to a relative risk difference of 16.11 in the vaccinated group. Individuals vaccinated against smallpox were significantly more likely to experience new onset and severe cardiac symptoms (p < 0.001 for both). The relative risk of experiencing new onset chest pain was 5.1 (1.7–15.9) in smallpox vaccinees, as compared to influenza vaccinees. Relative risks of any new symptoms or severe cardiac symptoms in smallpox vaccinees were 4.0 (1.7–9.3) and 5.5 (1.9–17.5) respectively, both significant at p < 0.001. The incidence rate of vaccinia-associated myocarditis was found to be 463 per 100,000 (150–1079). The peak inflammatory period of reactogenicity occurred between 4 and 27 days post-vaccination, with most occurring on days 8–9. Inflammatory responses provoked by the vaccine were characterized by elevated IFN-Y, TNF-a, IL-10 and IL-6 cytokine expression and activity. The rise in cytokine levels was observed to correlated with rising troponin levels indicative of acute heart injury, and presentation of clinical symptoms, suggesting that the pro-inflammatory cytokines may be associated [5].
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