When smallpox was still a natural disease, treatment used to be supportive. The patients were accommodated as comfortably as possible and the disease did not go away. There were no useful antiviral drugs. Post-exposure vaccination was the only viable treatment option that doctors could try, and they trusted the patient to know they had been exposed (or that health officials tracked down those who had contact with newly diagnosed patients ).
Since the World Health Organization (WHO) announced that smallpox was eradicated in 1980, researchers have only had animal counterparts to test treatment options.
Currently, the development of antiviral drugs for the treatment of smallpox is based solely on zoonotic versions of the orthopoxvirus.
Giving a smallpox vaccine to a patient after exposure was the primary method of choice if the vaccine was expected to have time to work. Treatment was not possible if the patient already had developing lesions. However, there has been a decrease in the severity of smallpox, and in some cases, smallpox may never develop as a result of post-exposure vaccination.
Unfortunately, data from the years that health officials actively eradicated the disease do not necessarily match the current outbreak.
Modern patients in many parts of the world are immunosuppressed due to HIV and aggressive modern treatments.
The vaccine used in the eradication years was the first generation, and the current version may be more or less effective . Similarly, the side effects of a vaccine may be different and will certainly have a different frequency of overall effects.
Since there have been no more cases of smallpox infection in humans since 1977, there is no way to test new antiviral drugs in a person infected with the smallpox virus. Instead, the researchers use humans infected with other orthopoxviruses or primates infected with live variola virus. Two potential new antiviral drugs are currently being developed, with one already piling up in the event of a smallpox outbreak .
Without human trials using the actual variola virus, it is impossible to know exactly how these drugs will behave and if they will be effective.
Animal tests show that the administration of antiviral drugs after lesions appear is an anticipated clinical sign that tells doctors that a patient has smallpox; in fact, it shortens the duration of the disease in a statistically significant way. However, antiviral drugs are not a panacea, and even if these drugs are effective for smallpox in humans, the dose may be far from correct in initial cases.
Since the treatment of smallpox is limited to vaccines and a couple of unproven antiviral drugs, prevention becomes the best treatment option.
Current stocks of live variola virus are maintained in just two laboratories worldwide: the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and the VECTOR Institute in Russia.
These live virus samples are kept for research purposes to help identify potential medications and other treatment options.
The two biggest threats that contribute to a smallpox outbreak are the release of a live variola virus (accidentally or intentionally) or a mutation of another orthopoxvirus, most likely the monkeypox virus, which affects humans in the same way. than smallpox does .
Frequently asked questions
No. Chickenpox is caused by the herpes virus and chickenpox is caused by the variola virus. In babies and people with weakened immune systems, chickenpox can cause complications, but its symptoms are usually mild. On the other hand, smallpox was fatal, killing approximately 30% of those affected.
It is not necessary to treat smallpox, as the disease was eradicated in 1980. However, the FDA has approved antiviral drugs to treat smallpox and they will be available in the event that the disease becomes active again.
There's no need. Immunity to the vaccine can only last 10-15 years, so people who received the vaccine during childhood may be susceptible to smallpox infection. But since the disease has been eradicated, there is currently no risk of infection.