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Concurrent smallpox and chickenpox.

Three patients showing smallpox- and chickenpox-like lesions simultaneously were investigated virologically. Both infections were confirmed in the laboratory and, in one case, by electron microscopy.

Adolescent↗

Smallpox diagnosed 400 years later: results of skin lesions examination of 16th century Italian mummy.

Results are presented on virological examination conducted on WHO request of a Naples infant mummy with smallpox-like lesions. Electron microscopy of lesions confirmed the findings of Italian researchers: well-preserved virus-like structures, whose size and morphology were identical to those of orthopoxviruses have been revealed. It was shown that the virus in mummy skin had lost its viability. Viral antigenic activity could not be detected in EIA or RPHA, nor was determined its DNA in the test of DNA molecular hybridization.

Child, Preschool↗

[Basocellular carcinoma in a smallpox vaccination scar].

A 52 year old housewife was vaccinated against smallpox at the age of 18, on her right deltoid area. At the age of 50 she noticed erythema and scaling on the vaccination scar and 2 years later a nodule appear that enlarged during the following 3 months. There was no history nor skin changes suggestive of significant sun exposure. The histological examination of an initial biopsy and of the subsequently excised lesion revealed a basal cell carcinoma of the solid type. The relevant literature was reviewed and discussed with emphasis on sex and age incidence, age and site of vaccination, free interval between inoculation and tumor appearance, coexistence or not of other sun induced neoplasias and precancerous lesions and other possibly relevant clinical and etiopathogenetic aspects.

Basal Cell Carcinoma↗

[Smallpox vaccination--Waterhouse-Friderichsen syndrome (author's transl)].

A fatal acute meningococcal sepsis (Waterhouse-Friderchsen syndrome) appearing 25 days after smallpox vaccination (re-vaccination) on military service is reported. In order to assume a causal connection between the vaccination reaction and the acute infectious complication on atypically long "unspecific negative phase" after the vaccination is postulated. The morphological findings at the vaccination pustule, which shows the same changes as a first vaccination, also support a pathological post-vaccinal course. In consideration of these observations, revaccination after 20 years is apparently a risk.

Adult↗

Assessment of vaccination coverage, vaccination scar rates, and smallpox scarring in five areas of West Africa.

In 1966, nineteen countries of West and Central Africa began a regional smallpox eradication and measles control programme in cooperation with the World Health Organization. This paper summarizes sample survey data collected to assess the results of the programme in Northern Nigeria (Sokoto and Katsina Provinces), Western Nigeria, Niger, Dahomey, and Togo. These data indicate that the programme, which used mass vaccination campaigns based on a collecting-point strategy, was generally successful in reaching a high proportion of the population. Analysis of vaccination coverage and vaccination scar rates by age underlined the importance to the programme of newborn children who accumulate rapidly following the mass campaign. Of all persons without vaccination scars at the time of the surveys, 34.4% were under 5 years of age; in the absence of a maintenance programme, this figure would rise to 40% after 1 year.

Adolescent↗

False positive results in V D R L slide test following smallpox immunization.

A study is conducted on the incidence of false positive results in the serological test for syphilis in 300 military recruits following smallpox immunization. It is found that 3.7% of individuals developed false reactivity in the V D R L Slide test. The false reactivity appeared two to four weeks following immunization, and disappeared from two to eight weeks later. All reactive sera were negative in the FTA-ABS test.

False Positive Reactions↗

Lack of correlation between complications after smallpox vaccination and the ABO blood-group system.

Blood group [ABO system] distribution was analysed in 245 children with complications after smallpox vaccination. One hundred and thirty-two children had neurological and 113 and skin or mucosal complications. 41.6% of the children were blood-group A or AB. 58.4% were blood group O or B, which was not a significant difference from the normal population [44.7%---48.7% and 51.0%---55.9%, respectively]. The analysis did not show in persons possessing blood groups A or AB an enhanced susceptibility to complications following antismallpox immunization or to particularly severe clinical forms of these complications. Immunological advantages in persons with blood group O or B were not found either.

ABO Blood-Group System↗

[Bacteriophages isolated from smallpox vaccine].

A number of lots of dermal and tissue culture smallpox vaccine was studied for the presence of bacteriophage. The presence of bacteriophage was established in lots of tissue culture vaccine but not in the dermal vaccine. Bacteriophage was detected by a modified method for phage isolation. The concentration and activity of the isolated bacteriophage were low. Its activity was increased by passages. The bacteriophage was stable and lysed the main serotypes of enteropathogenic E. coli as well as strains of Shigella sonnei and Salmonella of typhoid A.

Bacteriolysis↗

[Deaths due to smallpox vaccination in France 1968-1977 (author's transl)].

Between 1968 and 1977 there were 4 113 109 primary smallpox vaccinations in France. There were 30 deaths but no deaths occurred after re-vaccination. The mortality can be analysed as follows: -- proven or probable cases: 1.5 death/million vaccinations; -- proven, probable or possible cases 2.9/million vaccinations; -- proven, probable, possible or doubtful 7.3 cases/million vaccinations. The risk of death is 3 to 4 times greater under the age of one year and an overall death rate of 6/million vaccinations in reasonably accurate.

Adolescent↗

Congruences in Chinese and Western medicine from 1830-1911: smallpox, plague and cholera.

A close examination of three examples, smallpox, plague and cholera, suggest that for acute infectious diseases the Chinese viewed the symptomatologies, the causes, and the rational treatments of these illnesses in many ways similar to that of their contemporary Western counterparts. Rather than holding an opposing, clashing or incongruent system of medical thoughts for these common, well-recognized infectious diseases, the Chinese were prepared, by a long tradition of ontological thinking, to be receptive to the adoption, incorporation or modification of Western medical ideas in the late nineteenth century.

Americas↗

[Transitory monoclonal gammaopathy after smallpox vaccination].

The case is described of a 51-year-old female who developed monoclonal gammopathy of IgMk-type following smallpox vaccination. The Mcomponent was detectable, albeit in decreasing concentrations, over a period of 10 months and then disappeared spontaneously. The findings are discussed in relation to "essential" paraproteinemia and the literature on transient monoclonal gammopathy is reviewed. This immunoglobulin abnormality may occur in a variety of disorders and has mainly been observed during infectious or inflammatory processes.

Female↗

Comparative study of cutaneous scars and HAI antibodies after smallpox revaccination.

The number and aspect of cutaneous scars and the HAI antibody titer were recorded in 154 20-21-year-old subjects before smallpox revaccination, 30 and 300 days afterwards. In 38.3% of the vaccinees there were no postvaccinal scars 300 days after revaccination, but the absence of residual scars did not necessarily indicate a failure of immunization, since the increase in mean HAI antibody titer was significant in most of the cases.

Adult↗

Cardiac complications after vaccination for smallpox.

A case of severe myocardial damage 8 days after smallpox vaccination is described in a 6-year-old boy. A huge embolus overriding the bifurcation of the aorta complicated the disease and was removed surgically. Attention is called to the rapid recovery of this patient, which may be attributed to the use of massive doses of antivaccinia gamma globulin.

Aortic Diseases↗

Alastrim smallpox variola minor virus genome DNA sequences.

Alastrim variola minor virus, which causes mild smallpox, was first recognized in Florida and South America in the late 19th century. Genome linear double-stranded DNA sequences (186,986 bp) of the alastrim virus Garcia-1966, a laboratory reference strain from an outbreak associated with 0.8% case fatalities in Brazil in 1966, were determined except for a 530-bp fragment of hairpin-loop sequences at each terminus. The DNA sequences (EMBL Accession No. Y16780) showed 206 potential open reading frames for proteins containing >/=60 amino acids. The amino acid sequences of the putative proteins were compared with those reported for vaccinia virus strain Copenhagen and the Asian variola major strains India-1967 and Bangladesh-1975. About one-third of the alastrim viral proteins were 100% identical to correlates in the variola major strains and the remainder were >/=95% identical. Compared with variola major virus DNA, alastrim virus DNA has additional segments of 898 and 627 bp, respectively, within the left and right terminal regions. The former segment aligns well with sequences in other orthopoxviruses, particularly cowpox and vaccinia viruses, and the latter is apparently alastrim-specific.

3-Hydroxysteroid Dehydrogenases↗

Potential antiviral therapeutics for smallpox, monkeypox and other orthopoxvirus infections.

We assessed the activities of 24 different antiviral compounds against smallpox (two strains of variola major and one of variola minor), monkeypox, vaccinia and cowpox viruses by a neutral red uptake assay. To establish assay parameters, we examined viral replication and its inhibition at various times postinfection and at several multiplicities of infection. Drugs were selected to target a range of functions involved in viral replication. Eight compounds (cidofovir, cyclic HPMPC (cHPMPC), HPMPA, ribavirin, tiazofurin, carbocyclic 3-deazaadenosine, 3-deazaneplanocin A and DFBA (1-(2,4-difluorobenzyloxy)adenosine perchlorate)-a derivative of adenosine N1-oxide) inhibited the replication of all three variola strains and the other orthopoxviruses at drug concentrations within a pharmacologically achievable range. Two others (methisazone and bis-POM-PMEA) showed a lesser degree of antiviral effect, while the remainder were inactive. To examine possible naturally occurring drug resistance among a large number of variola isolates obtained from different geographical regions and at different times, we examined the sensitivity of 35 different strains of variola as well as other orthopoxviruses to a subset of three of the most active compounds: cidofovir, cHPMPC, and ribavirin. Preliminary data indicate that nearly all isolates appear to have similar drug sensitivities. These findings are currently being verified and expanded.

Animals↗

Antiviral activity of cyclopentenyl nucleosides against orthopox viruses (Smallpox, monkeypox and cowpox).

An improved method for the synthesis of enantiomerically pure D-cyclopentenyl nucleosides has been accomplished and their antiviral activity against orthopox viruses have been evaluated. The key intermediate, L-cyclopent-2-enone 13 was prepared from D-ribose using a ring closing metathesis reaction in eight steps. Among the synthesized nucleosides, the adenine 2 (Neplanocin A), cytosine 14, and 5-F-cytosine 15 analogues exhibited potent anti-orthopox virus activity, including smallpox virus.

Adenosine↗