From Ancient Pharaohs to Modern Science: The Jaw-Dropping History of Variola Disease!

Brace yourself for an eye-opening adventure through time as we peel back the layers of one of history’s most feared diseases: variola disease. This sneaky little devil has plagued humanity for centuries, striking fear into hearts and leaving countless lives shattered in its wake.

From whispers of ancient outbreaks to tales of brave scientists fighting on the frontlines against this invisible enemy, prepare to be fascinated and horrified by the deadly secrets within Variola’s sinister grasp.

Get ready to have your mind blown with shocking revelations as we take you on an unforgettable journey through the dark corners of medical history about “Variola Desease”.

What is Variola Disease?

Variola disease, commonly known as smallpox, ravaged humanity for centuries. This infectious disease once claimed the lives of millions, with a death rate of around 30% for those infected.

Brief History

Dating back over 3,000 years, ancient texts and mummified remains from Egyptian pharaohs suggest the presence of smallpox. In the 18th century alone, it caused the deaths of an estimated 400,000 Europeans annually.

Symptoms & Signs

Variola disease presents a range of symptoms that could vary in severity. Here’s a deeper dive into the signs and progression of this historic disease:

1.     Incubation Period (7 to 17 days):

During this phase, the infected person would not exhibit any symptoms, but they’re incubating the virus.

2.     Initial Onset (Prodromal Phase: 2 to 4 days):

• Fever: Often sudden and intense, with temperatures reaching up to 104°F (40°C).
• Headaches: Severe and persistent.
• Fatigue: Overwhelming tiredness often left patients bedridden.
• Backaches: Intense pain, particularly in the lower back region.
• Muscle Aches: Widespread myalgia.
• Malaise: A general feeling of being unwell.
• Vomiting: Nausea and vomiting, especially in the early stages.

3.     Early Rash Phase (about 3 days):

• Macules: The first noticeable skin changes are reddish spots called macules, primarily appearing on the face.
• Spread: These macules spread to the arms, legs, and torso.

4.     Progressive Rash Phase (next 4 days):

• Papules: The macules become raised, turning into papules.
• Fluid-filled Blisters: These bumps fill with a thick, opaque fluid over the next few days and transform into vesicles.
• Pustules: These vesicles further evolve into spots – round, firm, and deeply embedded in the skin.

5.     Pustular Rash Phase (about 5 days):

• Spread & Intensity: The bumps become more painful and can cover the entire body.

6.     Scabbing Phase (about 5 days):

• Scabs Form: Pustules begin to form a crust and eventually scab over.
• Scarring: Once the scabs fall off, they can leave deeply pitted scars, known as pockmarks.

7.     Other Symptoms:

• Mouth sores: Painful sores could develop in the mouth and throat, making it challenging to eat or drink.
• Coughing: This not only caused discomfort but also played a role in transmitting the virus to others.

Understanding these symptoms is crucial, as they help medical professionals identify and isolate cases during outbreaks and offer a haunting glimpse into the painful journey patients endure.

The Causative Agent: Variola Virus

This deadly disease owes its potency to the variola virus, an Orthopoxvirus, which comes in two strains.

Variola Major vs. Variola Minor

While both strains are concerning, variola major was the more lethal variant, with a death rate of up to 30%. In contrast, variola minor was less aggressive, boasting a mortality rate of just 1%.

Variola Virus Treatment

Dealing with the deadly variola virus, the causative agent of smallpox, has always been daunting. Throughout history, treatments have been varied, with modern medicine offering a more comprehensive approach to managing the disease.

1.     Traditional Treatment Approaches

• Supportive Care: Fluid Intake: Ensuring adequate hydration was pivotal, especially given the severe dehydration caused by fever and other symptoms.
• Nutrition: Proper nutrition is crucial for helping the body fight off the infection and speed up recovery.
• Pain Management: Natural remedies, like willow bark (a precursor to modern-day aspirin), were sometimes used to manage pain and fever.
• Skin Care: Ointments and salves were applied to soothe the skin and help with the intense itching from the rash.
• Isolation: Historically, during the 18th-century smallpox epidemic in Europe, infected individuals were often isolated, reducing the disease’s spread. London, for instance, had “smallpox hospitals” dedicated entirely to patients of the disease.

2.     Modern Innovations in Treatment

• Antiviral Medications: Cidofovir: While not explicitly approved for smallpox, studies have shown it possesses in vitro activity against variola virus. However, given its renal toxicity, its use is primarily reserved for emergency scenarios.
• Tecovirimat (ST-246): The U.S. FDA approved Tecovirimat in 2018 to treat smallpox. During its development, this drug was found to be effective against Variola in animal models.
• Vaccination Post Exposure: According to the WHO, the smallpox vaccine can prevent or lessen the severity of the disease if given within three days after exposure to the virus. The vaccine might still offer protection up to a week post-exposure.

3.     Advanced Supportive Care:

• IV Fluids: For hydration and maintaining electrolyte balance.
• Antibiotics: According to the CDC, secondary bacterial infections occurred in about 30% of smallpox cases, emphasizing the importance of antibiotics.
• Wound Care: Modern dressings and antiseptics can prevent further complications from the skin lesions.
• Respiratory Support: Variola could sometimes lead to pneumonia; respiratory support became crucial in such cases.

While we might not have a specific “cure” for the variola virus, our understanding and treatment options have evolved immensely. Considering that smallpox was declared eradicated in 1980 by the WHO after a rigorous global vaccination campaign, the primary focus now is on preparedness and response in the unlikely event of its re-emergence.

Non-Variola Orthopoxvirus: What Is It?

It refers to other viruses within the Orthopoxvirus genus but distinct from the variola virus. Some of these, like the vaccinia virus, were instrumental in creating smallpox vaccines.

Prevention & Control

As the scourge of the variola virus wreaked havoc for centuries, its eventual containment and eradication were nothing short of a monumental achievement in global public health. By the mid-20th century, smallpox’s days were numbered due to strategic interventions.

1.     Vaccination Strategies:

• Vaccinia Virus: The smallpox vaccine wasn’t made from the variola virus but from the vaccinia virus, a pox-type virus related to smallpox. Edward Jenner developed This vaccine in the late 18th century, a discovery that led him to be often called “the father of immunology.”
• Ring Vaccination: This strategy was pivotal during the eradication campaign. Instead of vaccinating entire populations, those around an infected individual (a “ring”) were vaccinated, thus controlling and preventing the spread.
• Global Collaboration: In 1967 the World Health Organization (WHO) launched an intensified plan to eradicate smallpox. It involved mass vaccinations and surveillance and containment measures in over 50 countries.
• Eradication: The persistence of these campaigns bore fruit when, by 1980, WHO officially declared smallpox eradicated, marking it the first disease to be eliminated through human intervention.

2.     Quarantine Measures:

• Smallpox Hospitals: In earlier centuries, dedicated hospitals or isolation units were set up in cities like London and Boston to treat smallpox patients away from the general population.
• Travel Restrictions: During outbreaks, strict travel restrictions were often imposed on affected regions. For instance, during the 20th-century epidemics in India, railway stations and ports had health checkpoints to screen passengers.
• Public Awareness: Governments and health organizations conducted awareness campaigns about the importance of quarantine, especially in densely populated areas. This community cooperation was crucial in containing outbreaks.
• Immediate Response: On identification of a case, health officials would swiftly move in to isolate the patient and vaccinate the surrounding community, effectively creating a barrier against the disease’s spread.

The tale of smallpox’s eradication stands as a testament to global cooperation, scientific ingenuity, and the relentless pursuit of a world free from the terror of Variola.

The Significance of Understanding Variola

Revisiting the history of smallpox offers invaluable lessons in managing pandemics, especially in our current globalized world.

1.     Global Health Impacts:

• Mortality and Morbidity: Smallpox is estimated to have caused between 300 to 500 million deaths in the 20th century alone. Beyond fatalities, survivors often bore lifelong scars, both physical (from pockmarks) and psychological.
• Economic Toll: The disease had significant financial implications. Outbreaks often decreased workforce productivity, impacted trade, and strained healthcare resources.
• Legacy in Public Health: The smallpox eradication campaign provided a foundation for contemporary global health initiatives. It underscored the importance of surveillance, early detection, and rapid response, which remain fundamental in managing global health threats today.
• Boost to Immunization: The success against smallpox boosted other vaccination campaigns, reinforcing the belief in vaccines as an effective tool against infectious diseases.

2.     Recent Outbreaks:

• Laboratory Incidents: While there have been no natural outbreaks post-eradication, there were a few incidents related to laboratory exposures. For instance, in 1978, a medical photographer in the U.K. contracted the disease from a nearby lab and unfortunately passed away, leading to increased biosafety measures.
• Bioterrorism Threat: The variola virus’s potential use as a bioterrorism agent remains a concern, especially since the younger global population hasn’t been vaccinated and lacks immunity. It underscores the importance of retaining vaccine stockpiles and researching antiviral treatments.

3.     Achievements in Eradication:

• Unparalleled Success: The eradication of smallpox is a unique success story, unprecedented in the annals of public health. It demonstrated the feasibility of eradicating a significant human disease.
• Collaborative Effort: Over a decade, around 2.4 billion vaccine doses were produced and delivered, involving multiple countries, organizations, and individuals.
• Legacy: The smallpox campaign’s infrastructure laid the groundwork for other health initiatives, like the Expanded Programme on Immunization, which aims to ensure routine immunization services for children globally.

In understanding the journey of Variola and its eventual eradication, we gain insights into the past and invaluable lessons and strategies that can guide global health responses in the future.

How can I protect myself from variola disease?

The best way to protect yourself from variola disease is to get vaccinated. The smallpox vaccine is very effective and one of the safest vaccines ever developed.

If you are travelling to a region where variola disease is known to be present, you should also take the following precautions:

• Avoid contact with wild animals and rodents.
• Avoid contact with people who are sick.
• Wash your hands frequently with soap and water.
• Avoid touching your eyes, nose, and mouth.

Read more about symptoms of small pox.

Conclusion & Key Takeaways

Variola disease’s journey from ancient scourge to eradication underscores the importance of scientific advancements and international cooperation. As we face new health challenges, the lessons from our battle against smallpox remain ever-pertinent.