SMALL POX (Variola Major)

smallpox

Ques : 1    What is small pox?

Ans :         It is a highly infectious viral disease with diphasic febrile episodes accompanied by skin eruption, which progresses through the stages of macule, papule, vesicle, pustule and crust, to end in pitting or scar formation.

Ques : 2    What are the causes of small pox?

Ans :         Caused by a filterable virus, affects all ages and both sexes and usually occurs in epidemic form. Incubation period is 7-10 days. (A patient is infectious from the onset of prodromal period till all the crusts have dropped off.)

Ques : 3    Which are the types of small pox?

Ans :         Types of Small pox :

  1. Variola hemorrhagica.
  2. Abortive or modified small pox,
  • Variola minor (Alastrim) of major.
  1. Mild type.
  2. Confluent type.
  3. semiconfluent type.

 

Ques : 4    What are the clinical features of small pox?

Ans :         Clinical Features : 1. Prodromal phase –

  1. prodromal fash, petechial or erythematous.
  2. Spleen may be palpable.
  • Abrupt onset
  1. Headache.
  2. Duration 2 – 4 days.
  3. High fever.
  • Severe muscular and joint pains.
  • Nausea & vomiting.
  1. Abdominal pain, occasionally.

 

  1. Eruptive phase –
  1. Secondary rise of temperature during pustular stage.
  2. Eruptions – macules, light & red spots, papules, within a few hours macules turn into papules and after 2-3 days papules turn to vesicles,pustule forms by the 6th days, crust –appears on 8 – 10th day by rupture of pustule. Dry and drop off last from the palms and soles, leave permanent pock, dry and drop off last from the palms and soles, leave permanent pock-mark,
  • Lesions Ist appear on face, neck, upper chest, or on hands and forearms, most marked on the exposed surfaces.
  1. Temperature drops to about normal,
  2. Stage of convalescence – Owing to the serious nature of the disease, convalescence in small-pox must be prolonged. The crusts may be very persistent in the scalp & take weeks to separate.

Complication :

  1. Furunculosis.
  2. Abscess.
  • Cellulitis.
  1. Gangrene.
  2. Pneumonia, pleurisy, empyema, bronchopneumonia.
  3. Laryngitis.
  • Otitis media.
  • Corneal ulcer, loss of vision.
  1. Myocarditis, heart failure, peripheral circulatory failure. 10. Viral osteomyelitis etc.

Ques : 5    Which are Investigations of small pox?

Ans :         Investigations :

  1. Blood-leucocyte count initially low, but may go up during the pustular stage.
  2. Isolation & identification of virus by inoculating in chick embryo may also be done.
  3. Agar gel diffusion test may also be positive.
  4. Complement fixation test-positive,
  5. Microscopic examination of the smears.

Prognosis : It depends upon the severity of particular case. With the advent of modern vaccination, rate of mortality is very low.

Prophylaxis : Primary vaccination should be given at the age of 1 to 2 months and re-vaccination should be given after every 3 years.

Ques : 6    What can be the treatment of small pox?

Ans :         Treatment :

  1. Severe inching controlled by the application of magnesium sulphate solution, tepid sponging of the skin may be done,
  2. Other symptomatic treatment may be applied.
  3. Isolation is most important.
  4. Liquid diet with high protein content.
  5. Good nursing care, e.g. care of skin and eyes by soothing lotions (liquid paraffin drops in the eyes).
  6. Antibiotics may be helpful to prevent secondary infection.

Ques : 7    Which Homoeopathic medicines are useful for small pox?

Ans :         Homoeopathic remedies.

  • BRYONIA – Precursory stage with gastric symptoms, or later when the chest symtoms indicate is; eruption slow in developing.
  • MERCURIUS – During suppurative stage. Moist, swollen tongue. Ulcerated throat, with profuse flow of saliva. Diarrhea with green or bloody mucous stools, with tenesmus. Perspiration without relief.
  • ACONITE – First stage and early part of second stage ; high fever ; great restlessness ; apprehension of a fatal tissue ; during the febrile stage.
  • CHAMOMILLA – Great fretfulness of children during eruptive stage, with usual impatience and coldness.

Ques : 8    Which Biochemic Remedies are useful for small pox?

Ans :         Biochemic remedies :-

  1. NATRUM MUR. – Salivary flew, confluence of pustules & drowsiness.
  2. FERRUM PHOS. – If the fever be high, alternately with Kali Mur.
  3. KALI SULPH. – To promote the formation of healthy skin and the falling off of the crusts.
  4. KALI PHOS. – Putrid conditions, heavy odor, exhaustion and stupor, Adynamic symptoms indicating blood-decomposition.
  5. KALI MUR – It controls the formation of pustules, it also effective as prophylactic of the disease.

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