-
Viruses Jan 2020Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been... (Review)
Review
Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been no case of smallpox anywhere in the world. However, the viable variola virus (VARV), the causative agent of smallpox, is still kept in two maximum security laboratories in Russia and the USA. Despite the eradication of the disease smallpox, clandestine stocks of VARV may exist. In a rapidly changing world, the impact of an intentional VARV release in the human population would nowadays result in a public health emergency of global concern: vaccination programmes were abolished, the percentage of immunosuppressed individuals in the human population is higher, and an increased intercontinental air travel allows for the rapid viral spread of diseases around the world. The WHO has authorised the temporary retention of VARV to enable essential research for public health benefit to take place. This work aims to develop diagnostic tests, antiviral drugs, and safer vaccines. Advances in synthetic biology have made it possible to produce infectious poxvirus particles from chemicals in vitro so that it is now possible to reconstruct VARV. The status of smallpox in the post-eradication era is reviewed.
Topics: Antiviral Agents; Biohazard Release; Disease Eradication; Evolution, Molecular; Genome, Viral; Humans; Immunization Programs; Risk; Smallpox; Smallpox Vaccine; Synthetic Biology; Variola virus; World Health Organization
PubMed: 31991671
DOI: 10.3390/v12020138 -
The Lancet. Infectious Diseases Jan 2004Human monkeypox is a rare viral zoonosis endemic to central and western Africa that has recently emerged in the USA. Laboratory diagnosis is important because the virus... (Comparative Study)
Comparative Study Review
Human monkeypox is a rare viral zoonosis endemic to central and western Africa that has recently emerged in the USA. Laboratory diagnosis is important because the virus can cause disease that is clinically indistinguishable from other pox-like illnesses, particularly smallpox and chickenpox. Although the natural animal reservoir of the monkeypox virus is unknown, rodents are the probable source of its introduction into the USA. A clear understanding of the virulence and transmissibility of human monkeypox has been limited by inconsistencies in epidemiological investigations. Monkeypox is the most important orthopoxvirus infection in human beings since the eradication of smallpox in the 1970s. There is currently no proven treatment for human monkeypox, and questions about its potential as an agent of bioterrorism persist.
Topics: Adult; Africa; Animals; Bioterrorism; Child; Diagnosis, Differential; Disease Outbreaks; Disease Reservoirs; Dogs; Exanthema; Humans; Mpox (monkeypox); Monkeypox virus; Population Surveillance; Rabbits; Rats; Rodentia; Sciuridae; Smallpox Vaccine; United States
PubMed: 14720564
DOI: 10.1016/s1473-3099(03)00856-9 -
The Journal of Infectious Diseases Sep 2021
Topics: History, 20th Century; History, 21st Century; Humans; Population Surveillance; Smallpox; Smallpox Vaccine; Vaccination; Variola virus
PubMed: 34590143
DOI: 10.1093/infdis/jiaa588 -
Ciencia & Saude Coletiva Sep 2022This article aims to discuss the perceptions and actions of public authorities regarding the process of introduction, production, conservation, distribution, and...
This article aims to discuss the perceptions and actions of public authorities regarding the process of introduction, production, conservation, distribution, and application of the smallpox vaccine; the emergence of institutions associated with the vaccine and vaccination; and its main obstacles in Bahia in the nineteenth century. The article emphasizes the local and regional dynamics of this process. It addresses the problem of smallpox in colonial Bahia, the arrival of the Jennerian vaccine, the diffusion of the vaccination method, the establishment of health institutions, and the disease control measures implemented as of 1808. In the context of the post-independence and Imperial Brazil, this article addresses smallpox outbreaks and discusses the problems related to vaccine and vaccination listed by the governors of the province of Bahia and local efforts to introduce the animal vaccine. This article is based on printed primary sources published in Bahia in the nineteenth century, as well as through dialogues with specialized literature.
Topics: Animals; Brazil; History, 19th Century; History, 20th Century; Smallpox; Smallpox Vaccine; Vaccination; Vaccines
PubMed: 36000634
DOI: 10.1590/1413-81232022279.05082022 -
Expert Review of Vaccines Sep 2016Smallpox has shaped human history, from the earliest human civilizations well into the 20th century. With high mortality rates, rapid transmission, and serious long-term... (Review)
Review
Smallpox has shaped human history, from the earliest human civilizations well into the 20th century. With high mortality rates, rapid transmission, and serious long-term effects on survivors, smallpox was a much-feared disease. The eradication of smallpox represents an unprecedented medical victory for the lasting benefit of human health and prosperity. Concerns remain, however, about the development and use of the smallpox virus as a biological weapon, which necessitates the need for continued vaccine development. Smallpox vaccine development is thus a much-reviewed topic of high interest. This review focuses on the current state of smallpox vaccines and their context in biodefense efforts.
Topics: Animals; Bioterrorism; Disease Eradication; Disease Models, Animal; Humans; Smallpox; Smallpox Vaccine
PubMed: 27049653
DOI: 10.1080/14760584.2016.1175305 -
Environmental Health and Preventive... Sep 2011Smallpox, when used as a biological weapon, presents a serious threat to civilian populations. Core components of the public health management of a terrorism attack... (Review)
Review
Smallpox, when used as a biological weapon, presents a serious threat to civilian populations. Core components of the public health management of a terrorism attack using smallpox are: vaccination (ring vaccination and mass vaccination), adverse event monitoring, confirmed and suspected smallpox case management, contact management, identifying, tracing, monitoring contacts, and quarantine. Above all, pre-event and post-event vaccination is an indispensable part of the strategies. Since smallpox patients are most infectious from onset of the rash through the first 7-10 days of the rash, vaccination should be administered promptly within a limited time frame. However, vaccination can accompany complications, such as postvaccinial encephalitis, progressive vaccinia, eczema vaccinatum, and generalized vaccinia. Therefore, vaccination is not recommended for certain groups. Public health professionals, as well as physicians and government officials, should also be well equipped with all information necessary for appropriate and effective smallpox management in the face of such a bioterrorism attack.
Topics: Bioterrorism; Contraindications; Humans; Mass Vaccination; Public Health; Smallpox; Smallpox Vaccine; Vaccination
PubMed: 21431786
DOI: 10.1007/s12199-010-0200-z -
Ui Sahak Apr 2020In modern Shanghai, smallpox was one of the most threatening diseases with its mortality rate going up to 30 percent. In response to the disease, Dr. William Lockhart, a...
In modern Shanghai, smallpox was one of the most threatening diseases with its mortality rate going up to 30 percent. In response to the disease, Dr. William Lockhart, a medical missionary of the London Missionary Society, introduced vaccination to the Chinese people in Shanghai. He built the first western style hospital in Shanghai, Renji Hospital, in 1843. At this time, native doctors also played a very important role. For example, Huang Chun-pu was in charge of the dispensary in the Chinese City in Shanghai, and he was the one who introduced vaccination under Dr. Lockhart's direction. In 1868, the Health Office of Shanghai Municipal Council began to implement a vaccination program. Around the turn of the 20th century, the Health Office of Shanghai Municipal Council managed several sub-district offices, hospitals, dispensaries, gaol, and even the traditional place like simiao for the free vaccinations. Urban residents benefited from a sanitary system, such as wide and free vaccination, compared to people who lived in rural areas. Moreover, Shanghai possessed the advantage of having the vaccine as a staple product of the Municipal Laboratory. The number of units of the vaccine issued from the Laboratory in sequence of years from 1898 to 1920 has been 115,351 on average. Unlike the International Settlement, where systematic inoculation was conducted under the leadership of the Municipal Council, the Chinese City was still reliant on charity organizations in the early 1900s. The foreign residence in the International Settlement had a strong influence from the foreign governments, and foreign doctors were well-aware of the need for the vaccination. However, the Chinese City was a Chinese enclave that was still under the traditional rule of the Qing Dynasty. In addition, the people of Shanghai had different perceptions of the smallpox vaccination, and this became an obstacle to the establishment of urban sanitation systems. Some Chinese people still relied on the traditional Chinese variolation and Chinese custom. For example, Chinese people still applied for inoculation in the spring and avoided summer and fall following traditional Chinese variolation, even though the best time to get vaccinated was in early winter before the spread of smallpox. In addition, foreigners were often more problematic than Chinese because they often overlooked the importance of vaccines and relied on drugs instead. The municipal authority, therefore, provided a wide range of free vaccinations for the poor and needy people regardless of their nationalities, and with such measures, sought to establish a stable urban sanitation system. This had been the key to the success of hygiene policies.
Topics: China; Cities; Culture; Health Knowledge, Attitudes, Practice; History, 19th Century; History, 20th Century; Immunization Programs; Medicine, Chinese Traditional; Smallpox; Smallpox Vaccine
PubMed: 32418978
DOI: 10.13081/kjmh.2020.29.121 -
Signal Transduction and Targeted Therapy Sep 2023The ongoing pandemic caused by mpox virus (MPXV) has become an international public health emergency that poses a significant threat to global health. The vaccinia virus...
The ongoing pandemic caused by mpox virus (MPXV) has become an international public health emergency that poses a significant threat to global health. The vaccinia virus Tiantan strain (VTT) was used to vaccinate against smallpox in China 42 years ago. It is urgent to assess the level of immunity to smallpox in individuals vaccinated 43 or more years ago and evaluate their immunological susceptibility to MPXV. Here, we recruited 294 volunteers and detected the level of residual humoral immunity, including the vaccinia-specific IgG level and neutralizing antibody titer, and the cross-antibodies of MPXV A29L, B6R, A35R, and M1R. Our results showed that the humoral immunity from the smallpox vaccine in the population still remains, and VTT-specific NAb levels wane with age. The majority of the population pre-1981 who should be immunized with VTT still maintains certain levels of MPXV-specific antibodies, in particular, targeting A35R and B6R antigens. Furthermore, we separately analyzed the correlations between the OD450 values of VTT-specific IgG and A35R-specific IgG, B6R-specific IgG, and A29L-specific IgG with plasma samples diluted 1:40, showing a linear correlation (p < 0.0001). Our findings suggest that most Chinese populations still maintain VTT-specific IgG antibodies for 42 or more years after smallpox vaccination and could provide some level of protection against MPXV.
Topics: Humans; Antibodies, Neutralizing; Immunity, Humoral; Immunoglobulin G; Monkeypox virus; Smallpox; Vaccination; Smallpox Vaccine; Mpox (monkeypox)
PubMed: 37709783
DOI: 10.1038/s41392-023-01574-6 -
Vaccine Nov 2009Few diseases can match the enormous impact that smallpox has had on mankind. Its influence can be seen in the earliest recorded histories of ancient civilizations in... (Review)
Review
Few diseases can match the enormous impact that smallpox has had on mankind. Its influence can be seen in the earliest recorded histories of ancient civilizations in Egypt and Mesopotamia. With fatality rates up to 30%, smallpox left its survivors with extensive scarring and other serious sequelae. It is estimated that smallpox killed 500 million people in the 19th and 20th centuries. Given the ongoing concerns regarding the use of variola as a biological weapon, this review will focus on the licensed vaccines as well as current research into next-generation vaccines to protect against smallpox and other poxviruses.
Topics: Biological Warfare; Biological Warfare Agents; Humans; Smallpox; Smallpox Vaccine; Vaccines, Attenuated; Vaccines, Inactivated; Vaccines, Subunit
PubMed: 19837292
DOI: 10.1016/j.vaccine.2009.07.103 -
International Journal of Environmental... Feb 2023According to the World Health Organization, 83,339 laboratory-confirmed cases, including 72 deaths, of mpox (formerly known as monkeypox), have been reported from 110... (Meta-Analysis)
Meta-Analysis Review
According to the World Health Organization, 83,339 laboratory-confirmed cases, including 72 deaths, of mpox (formerly known as monkeypox), have been reported from 110 locations globally as of 20 December 2022, making the disease a public health concern. Most of the cases (56,171, 67.4%) were reported from countries in North America. Limited data on vaccine effectiveness in the current mpox outbreak are available. However, the modified vaccinia virus (smallpox vaccine) has been predicted to prevent or reduce the severity of the mpox infection. The present study of systematic review and meta-analysis aimed to evaluate the modified vaccinia vaccine's safety and efficacy on mpox by using reported randomized clinical trials. Following guidelines from the Cochrane Collaboration and PRISMA, multiple databases including PubMed, PLOS ONE, Google Scholar, British Medical Journal, and the U. S. National Library of Medicine were searched. Out of 13,294 research articles initially identified, 187 were screened after removing duplicates. Following the inclusion and exclusion criteria, the meta-analysis included ten studies with 7430 patients. Three researchers independently assessed the risk of bias in the included study. The pooled results suggest that the vaccinia-exposed group had fewer side effects when compared to the vaccinia naïve group (odds ratio: 1.66; 95% CI: 1.07-2.57; = 0.03). Overall, the modified vaccinia has proven safe and effective in both vaccinia naïve and previously exposed groups, with higher efficacy in the previously exposed groups.
Topics: Humans; Smallpox Vaccine; Vaccinia; Mpox (monkeypox); Vaccinia virus; Laboratories; Smallpox
PubMed: 36833653
DOI: 10.3390/ijerph20042963