Ospa prawdziwa – Rokowania, prognozy i postęp choroby

Ospa prawdziwa
Rokowania, prognozy i postęp choroby

Ospa prawdziwa, wywołana przez wirusa variola z rodzaju orthopoxvirus, charakteryzowała się zróżnicowanym rokowaniem zależnym od wariantu choroby, statusu szczepienia oraz stanu immunologicznego pacjenta. Variola major cechowała się śmiertelnością około 30% (zakres 15-50%) w populacji nieszczepionej, podczas gdy variola minor wykazywała śmiertelność około 1% lub mniej. Szczególnie ciężkie formy, takie jak ospa krwotoczna i ospa płaska, miały śmiertelność sięgającą niemal 100% i powyżej 90%, odpowiednio. W obrębie ospy zwykłej śmiertelność zależała od nasilenia wysypki: postać zlewna 50-75%, półzlewna 25-50%, a rozsiana poniżej 10%. Szczepienia znacząco obniżały śmiertelność, np. w przypadku variola major do około 3% w populacji zaszczepionej. Szczególnie wysokie ryzyko zgonu dotyczyło kobiet ciężarnych (około 70% u niezaszczepionych), noworodków i niemowląt (40-50%) oraz zakażeń wrodzonych (35% martwych urodzeń, 50% zgonów noworodków).

Ospa prawdziwa (Smallpox) – Rokowanie (prognoza)

Wskaźniki śmiertelności w zależności od typu ospy
Śmiertelność w zależności od postaci klinicznej ospy zwykłej
Wpływ szczepienia na rokowanie
Rokowanie w szczególnych grupach pacjentów
Przyczyny zgonu w ospie prawdziwej
Długoterminowe rokowanie u osób, które przeżyły
Możliwości leczenia i ich wpływ na rokowanie
Eradykacja ospy prawdziwej
Kolejne rozdziały

Ospa prawdziwa (Smallpox) – Rokowanie (prognoza)

Ospa prawdziwa (smallpox) to wysoce zakaźna choroba wywołana przez wirusa variola należącego do rodzaju orthopoxvirus. Rokowanie w przypadku ospy prawdziwej było zróżnicowane i zależało od wielu czynników, w tym typu choroby, wcześniejszego statusu szczepienia oraz stanu układu odpornościowego pacjenta.¹²

Wskaźniki śmiertelności w zależności od typu ospy

Wskaźniki śmiertelności w przypadku ospy prawdziwej znacznie różniły się w zależności od wariantu choroby:³⁴

Variola major – główny typ ospy prawdziwej, charakteryzował się ogólnym wskaźnikiem śmiertelności wynoszącym około 30% (zakres 15-50%) w populacji nieszczepionej⁵⁶⁷
Variola minor – łagodniejsza postać choroby, ze wskaźnikiem śmiertelności wynoszącym około 1% lub mniej⁸⁹
Ospa krwotoczna (hemorrhagic smallpox) – niemal 100% śmiertelność, szczególnie we wczesnej postaci krwotocznej¹⁰¹¹
Ospa płaska (flat smallpox) – śmiertelność powyżej 90%¹²¹³

Śmiertelność w zależności od postaci klinicznej ospy zwykłej

W obrębie ospy zwykłej (ordinary type) śmiertelność zależała od nasilenia wysypki:¹⁴

Postać zlewna (confluent) – śmiertelność na poziomie 50-75%
Postać półzlewna (semi-confluent) – śmiertelność na poziomie 25-50%
Postać rozsiana (discrete) – śmiertelność poniżej 10%

Wpływ szczepienia na rokowanie

Status szczepienia znacząco wpływał na rokowanie w przypadku zachorowania na ospę prawdziwą:¹⁵¹⁶

W populacji szczepionej wskaźnik śmiertelności dla variola major wynosił około 3% (w porównaniu do 30% w populacji nieszczepionej)
Badania przypadków ospy importowanych do Europy w okresie 20 lat wykazały śmiertelność na poziomie 52% u osób nigdy niezaszczepionych, w porównaniu do 11% u osób zaszczepionych ponad 20 lat przed zachorowaniem¹⁷
W przypadku ospy płaskiej z rozsianymi zmianami, wskaźnik śmiertelności u pacjentów zaszczepionych wynosił 45,4%, podczas gdy u niezaszczepionych pacjentów ze zlewną postacią choroby śmiertelność sięgała 99,3%¹⁸

Rokowanie w szczególnych grupach pacjentów

Niektóre grupy pacjentów charakteryzowały się szczególnie wysoką śmiertelnością:¹⁹²⁰

Kobiety ciężarne – wskaźnik śmiertelności u niezaszczepionych kobiet ciężarnych wynosił około 70%, a utrata płodów dochodziła do 80%²¹
Noworodki i niemowlęta – wskaźnik śmiertelności u dzieci poniżej 1 roku życia wynosił 40-50%²²
Zakażenia wrodzone – prowadziły do martwych urodzeń w 35% przypadków, a 50% noworodków umierało w ciągu pierwszych kilku dni życia²³

Przyczyny zgonu w ospie prawdziwej

Mechanizm prowadzący do śmierci w przebiegu ospy prawdziwej nie został jednoznacznie określony, ale badania wskazują na kilka możliwych przyczyn:²⁴²⁵

W typowym przebiegu ospy prawdziwej, śmierć zwykle następowała między 10. a 16. dniem choroby²⁶
Przyczynami zgonu mogły być: krążące kompleksy immunologiczne, przytłaczająca wiremia, niekontrolowana odpowiedź immunologiczna lub zajęcie wielu narządów²⁷
We wczesnej postaci krwotocznej, śmierć następowała nagle, około 6 dni po wystąpieniu gorączki, najczęściej z powodu niewydolności serca i obrzęku płuc²⁸
W późnej postaci krwotocznej przyczyną zgonu były często: utrzymująca się wysoka wiremia, ciężka trombocytopenia i słaba odpowiedź immunologiczna²⁹
W ospie płaskiej mechanizmy zgonu były podobne do tych obserwowanych w oparzeniach, z utratą płynów, białek i elektrolitów oraz piorunującą sepsą³⁰
Powszechną przyczyną zgonu w przebiegu ospy prawdziwej była przytłaczająca toksemia³¹

Długoterminowe rokowanie u osób, które przeżyły

Pacjenci, którzy pomyślnie zwalczyli zakażenie i przeżyli, najprawdopodobniej nigdy więcej nie zachorowaliby na ospę prawdziwą ze względu na nabytą odporność.³² Jednak należy zauważyć, że całe doświadczenie z ospą prawdziwą poprzedzało erę nowoczesnej intensywnej opieki medycznej, więc śmiertelność prawdopodobnie byłaby obecnie niższa niż w przeszłości.³³

Możliwości leczenia i ich wpływ na rokowanie

W czasie gdy ospa prawdziwa była chorobą endemiczną, nie istniało skuteczne leczenie przyczynowe. Chociaż niektóre leki przeciwwirusowe mogły pomóc w leczeniu choroby, nie przeprowadzono badań, które potwierdziłyby ich skuteczność u chorych na ospę prawdziwą.³⁴³⁵

Eradykacja ospy prawdziwej

Ospa prawdziwa jest jedyną chorobą ludzką, która została skutecznie eradykowana. Ostatnie zakażenie wirusem variola major zarejestrowano w Bangladeszu w październiku 1975 roku, a ostatnie zakażenie variola minor wystąpiło dwa lata później w Merce w Somalii, 26 października 1977 roku. W maju 1980 roku Światowe Zgromadzenie Zdrowia, organ zarządzający Światowej Organizacji Zdrowia, oficjalnie potwierdziło globalne wyeliminowanie ospy prawdziwej, co było pierwszą w historii ludzkości eradykacją choroby.³⁶

Kolejne rozdziały

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Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#2 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#3 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#4 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#5 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#6 About Smallpox | Smallpox | CDC
https://www.cdc.gov/smallpox/about/index.html
Most people with smallpox recovered, but about 3 out of every 10 people with the disease died. […] While some antiviral drugs may help treat smallpox disease, there is no treatment for smallpox that has been tested in people who are sick with the disease and proven effective.
#7 Smallpox – Our World in Data
https://ourworldindata.org/smallpox
Smallpox is the only human disease that has been successfully eradicated.1 […] The eradication of smallpox is therefore a major success story for global health. […] Among people known to be infected with the variola major virus, around 30% are estimated to have died. […] Patients who successfully fought off the infection and survived, would likely never catch smallpox again. […] While smallpox was endemic, there was never a treatment for it. […] The specific way a smallpox infection would lead to a patient’s death remains unclear. […] The last variola major infection was recorded in Bangladesh in October 1975, while the last variola minor infection occurred two years later in Merka, Somalia, on October 26th, 1977. […] In May 1980, the World Health Assembly, the governing body of the World Health Organization, officially certified the global elimination of smallpox, the first-ever eradication of a disease in human history.
#8 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#9 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#10 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#11 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#12 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#13 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#14 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#15 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#16 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#17 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#18 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#19 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#20 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#21 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#22 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#23 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#24 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#25 Smallpox – Our World in Data
https://ourworldindata.org/smallpox
Smallpox is the only human disease that has been successfully eradicated.1 […] The eradication of smallpox is therefore a major success story for global health. […] Among people known to be infected with the variola major virus, around 30% are estimated to have died. […] Patients who successfully fought off the infection and survived, would likely never catch smallpox again. […] While smallpox was endemic, there was never a treatment for it. […] The specific way a smallpox infection would lead to a patient’s death remains unclear. […] The last variola major infection was recorded in Bangladesh in October 1975, while the last variola minor infection occurred two years later in Merka, Somalia, on October 26th, 1977. […] In May 1980, the World Health Assembly, the governing body of the World Health Organization, officially certified the global elimination of smallpox, the first-ever eradication of a disease in human history.
#26 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#27 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#28 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#29 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#30 Smallpox – Wikipedia
https://en.wikipedia.org/wiki/Smallpox
The mortality rate from variola minor is approximately 1%, while the mortality rate from variola major is approximately 30%. […] Ordinary type-confluent is fatal about 50â75% of the time, ordinary-type semi-confluent about 25â50% of the time, in cases where the rash is discrete the case-fatality rate is less than 10%. The overall fatality rate for children younger than 1 year of age is 40â50%. Hemorrhagic and flat types have the highest fatality rates. The fatality rate for flat or late hemorrhagic type smallpox is 90% or greater and nearly 100% is observed in cases of early hemorrhagic smallpox. […] In fatal cases of ordinary smallpox, death usually occurs between days 10â16 of the illness. The cause of death from smallpox is not clear, but the infection is now known to involve multiple organs. Circulating immune complexes, overwhelming viremia, or an uncontrolled immune response may be contributing factors. In early hemorrhagic smallpox, death occurs suddenly about six days after the fever develops. The cause of death in early hemorrhagic cases is commonly due to heart failure and pulmonary edema. In late hemorrhagic cases, high and sustained viremia, severe platelet loss and poor immune response were often cited as causes of death. In flat smallpox modes of death are similar to those in burns, with loss of fluid, protein and electrolytes, and fulminating sepsis.
#31 Smallpox: Background, Etiology, Epidemiology
https://emedicine.medscape.com/article/237229-overview
The mortality rate in patients with untreated smallpox is 30% or higher. The more severe hemorrhagic and malignant forms of smallpox are usually fatal. […] Overwhelming toxemia has been the usual cause of death in smallpox. Variola major infection carries an overall fatality rate of approximately 30% (range, 15-50%) in an unvaccinated population and 3% in a vaccinated population. However, flat smallpox carries a 45.4% mortality rate in patients with discrete lesions who have been immunized. Unimmunized patients with confluent disease have a 99.3% mortality rate. Patients with hemorrhagic smallpox have a mortality rate of more than 96%, regardless of immunization status. […] Variola minor infection is a less common type of smallpox and a much less severe disease, with a death rate of 1% or less. […] Congenital smallpox infection results in a stillbirth rate of 35%; 50% of neonates die within their first few days of life.
#32 Smallpox – Our World in Data
https://ourworldindata.org/smallpox
Smallpox is the only human disease that has been successfully eradicated.1 […] The eradication of smallpox is therefore a major success story for global health. […] Among people known to be infected with the variola major virus, around 30% are estimated to have died. […] Patients who successfully fought off the infection and survived, would likely never catch smallpox again. […] While smallpox was endemic, there was never a treatment for it. […] The specific way a smallpox infection would lead to a patient’s death remains unclear. […] The last variola major infection was recorded in Bangladesh in October 1975, while the last variola minor infection occurred two years later in Merka, Somalia, on October 26th, 1977. […] In May 1980, the World Health Assembly, the governing body of the World Health Organization, officially certified the global elimination of smallpox, the first-ever eradication of a disease in human history.
#33 Azthena logo with the word Azthena
https://www.news-medical.net/health/Smallpox-Prognosis.aspx
Smallpox is a highly infectious disease caused by the variola virus, an orthopoxvirus. […] Prognosis can vary according to the disease type and patient status. […] Mortality rates varied with the type of smallpox, but were also partially dependent on prior vaccination status, as well as the patients immune system. […] The hemorrhagic form of the disease was uniformly fatal, whereas flat smallpox resulted in death in the majority of cases. […] Typical disease in individuals who were not previously vaccinated carried a mortality frequency as high as 30%. […] Death rate from smallpox among pregnant women was extraordinarily high. […] The case-fatality rate in unvaccinated pregnant women approached 70%, while fetal wastage was approximately 80%. […] Research of cases imported into Europe over a 20-year period found a mortality rate of 52% in those never vaccinated, compared to 11% in those vaccinated more than 20 years before contracting a disease. […] Still, it must be noted that all experience with smallpox predated the advent of modern critical care medicine, thus mortality would conceivably be lower than in the past.
#34 About Smallpox | Smallpox | CDC
https://www.cdc.gov/smallpox/about/index.html
Most people with smallpox recovered, but about 3 out of every 10 people with the disease died. […] While some antiviral drugs may help treat smallpox disease, there is no treatment for smallpox that has been tested in people who are sick with the disease and proven effective.
#35 Smallpox – Our World in Data
https://ourworldindata.org/smallpox
Smallpox is the only human disease that has been successfully eradicated.1 […] The eradication of smallpox is therefore a major success story for global health. […] Among people known to be infected with the variola major virus, around 30% are estimated to have died. […] Patients who successfully fought off the infection and survived, would likely never catch smallpox again. […] While smallpox was endemic, there was never a treatment for it. […] The specific way a smallpox infection would lead to a patient’s death remains unclear. […] The last variola major infection was recorded in Bangladesh in October 1975, while the last variola minor infection occurred two years later in Merka, Somalia, on October 26th, 1977. […] In May 1980, the World Health Assembly, the governing body of the World Health Organization, officially certified the global elimination of smallpox, the first-ever eradication of a disease in human history.
#36 Smallpox – Our World in Data
https://ourworldindata.org/smallpox
Smallpox is the only human disease that has been successfully eradicated.1 […] The eradication of smallpox is therefore a major success story for global health. […] Among people known to be infected with the variola major virus, around 30% are estimated to have died. […] Patients who successfully fought off the infection and survived, would likely never catch smallpox again. […] While smallpox was endemic, there was never a treatment for it. […] The specific way a smallpox infection would lead to a patient’s death remains unclear. […] The last variola major infection was recorded in Bangladesh in October 1975, while the last variola minor infection occurred two years later in Merka, Somalia, on October 26th, 1977. […] In May 1980, the World Health Assembly, the governing body of the World Health Organization, officially certified the global elimination of smallpox, the first-ever eradication of a disease in human history.