by Smallpox is a highly contagious viral disease caused by the variola virus. Although smallpox was declared eradicated by the World Health Organization in 1980, currently no generally effective treatment exists for smallpox.
Isolation and Quarantine
Isolation and quarantine are crucial to controlling the spread of smallpox infection. Patients experiencing symptoms should be immediately isolated. Suspected cases require diagnostic testing before confirmation. Close contacts should be quarantined for up to 21 days to cover the incubation period and identify early symptoms. Strict isolation and quarantine protocols are necessary due to the highly contagious nature of smallpox.
Symptomatic Treatment
Supportive care focuses on treating symptoms and preventing complications. Antipyretics like acetaminophen can help reduce fever. Smallpox Treatment Ibuprofen may be used with caution for pain relief. Adequate hydration should be maintained to prevent dehydration from fever and inability to eat or drink. Topical calamine lotion may provide relief from itching. Secondary bacterial infections require antibiotics.
Lesion Care
For skin lesions, gentle cleaning with soap and water is sufficient. Scratching or disruption of scabs should be avoided to prevent bacterial superinfection and spread of the virus. Any secondary bacterial infections may be treated with topical or oral antibiotics. Analgesics can be used for pain. Antihistamines may relieve severe itching but should not be applied directly to skin lesions.
Vaccinia Immunoglobulin Therapy
Vaccinia immunoglobulin (VIG) is a passive immunization strategy sometimes used for severe cases. VIG contains antibodies against the vaccinia virus, which is related to variola virus and used in smallpox vaccinations. VIG may help reduce symptoms if given early. However, supply is limited as routine vaccination ended and several factors limit its effectiveness for treatment.
Potential Antiviral Therapies
No antiviral drugs are clinically proven to treat smallpox. Some options are under investigation:
– Cidofovir is approved for cytomegalovirus retinitis. It has shown effectiveness against poxviruses in animal models. Severe kidney toxicity is a concern.
– ST-246 is a next generation antiviral developed by Siga Technologies specifically for smallpox. It has demonstrated efficacy in animal models when administered early in infection. Phase 1 human trials showed it to be well-tolerated.
– Tecovirimat (ST-246) is an oral drug approved by the FDA for smallpox. It works by blocking a protein essential for releasing infectious virus particles. Animal studies showed it effective against lethal smallpox infections when given up to 4 days after exposure.
– Brincidofovir is an orphan drug approved for adenovirus and DNA viruses. In vitro studies demonstrated activity against various orthopoxviruses, including vaccinia and smallpox viruses. Safety and optimal dosing need validation.
– Therapeutics using monoclonal antibodies are also being investigated but are currently experimental. No antivirals have replaced the historical importance of vaccination.
Supportive Clinical Care
Effective supportive care requires intensive monitoring in a negative pressure isolation room. Parameters like temperature, breathing rate and oxygen status need close follow-up. IV fluids may be needed for severe dehydration. Oxygen therapy is critical for hypoxemia. Nutritional support is important if oral intake is compromised. Blood products, ventilation and dialysis may sometimes be life-saving. Complications like secondary infections, encephalitis or progression to toxic shock-like syndrome warrant multidisciplinary intensive care.
While smallpox is no longer endemic globally, preparedness remains important as the risk of re-emergence or bioterrorism still exists. Currently preventive vaccination is the most effective strategy. However, emerging options for post-exposure prophylaxis and treatment continue advancing our ability to respond. Close monitoring, isolation, symptomatic relief and supportive care remain the mainstay of clinical management pending availability of proven antiviral therapies. Constant research is still needed to validate emerging treatment approaches and develop new countermeasures.
*Note:
1.Source: Coherent Market Insights, Public sources, Desk research
2.We have leveraged AI tools to mine information and compile it
