Abstract
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.
Highlights
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
Smallpox is caused by the variola virus (VARV), a member of the Orthopoxvirus (OPV) genus of the Poxviridae
As a disease, was relatively easy to recognize with its characteristic skin lesions, the following exanthematous illnesses have to be considered as differential diagnosis: severe chickenpox rash, monkeypox, generalized vaccinia virus or cowpox virus infections, eczema vaccinatum, disseminated varicella-zoster, herpes simplex virus infections, drug reactions, erythema multiforme, enteroviral infections, rickettsialpox rash, secondary syphilis, scabies, insect bites, impetigo, and molluscum contagiosum [3]
Summary
Smallpox is caused by the variola virus (VARV), a member of the Orthopoxvirus (OPV) genus of the Poxviridae. Before the 15th century, smallpox was observed in Europe and Asia. During colonialism smallpox was imported by the Europeans into the Americas, Southern Africa, and Australia between the 15th and. Confronted with a novel pathogen, the immunologically naïve indigenous populations of these continents suffered from high case-fatality rates in smallpox outbreaks with major historical consequences. Towards the end of the 19th century, a less lethal form of smallpox was documented in. South Africa and the United States and later on in South America. These viruses called amass, alastrim, and kaffir were designated variola minor to differentiate them from variola major, the causative agent of classical smallpox.
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