- The last smallpox infection to occur in the
United States was in 1949; the last smallpox infec-
tion in the world was in 1977 (Somalia).
The name derives from the characteristic
appearance of small sores that BLISTERand then
crust, or pox, on the body when illness emerges.
The sores, along with FEVER, are the primary
symptom. They are also the means by which the
virus sheds; contact with the sores or the fluids
they contain spreads the virus and the infection.
Throughout history until its eradication in the
20th century, smallpox claimed the lives of a third
of those infected and often left disfiguring scars on
those who survived.
Because the risk for complications is relatively
high with the smallpox VACCINEand there are no
smallpox infections worldwide, routine vaccina-
tion for smallpox no longer occurs. Smallpox
reemerged as a potential public health concern in
the early 2000s with worries that it, along with
other infectious pathogens such as ANTHRAX, could
be used as a biologic weapon or bioterrorism
agent. Governments around the world have pre-
pared emergency response plans to cope with such
potential actions. Though when smallpox
occurred naturally as a disease there were no
known treatments, researchers believe modern
ANTIVIRAL MEDICATIONSwould be effective against
smallpox infection today.
See also IMMUNIZATION; PATHOGEN.
sneeze/cough etiquette A method of PERSONAL
HYGIENEto help prevent the spread of INFECTION.
Sneezing and coughing are among the mechanisms
the body uses to expel bacterial and viral particles
in illnesses such as COLDSand INFLUENZA. However,
these particles spread the infection to others who
breathe them in with the air or touch surfaces on
which they land. Health experts recommend these
procedures to reduce the risk of spreading infection
through sneezing and coughing:
•SNEEZEor COUGHinto a tissue that covers the
NOSEand MOUTH, then discard the tissue and
wash the hands with soap and warm water.
- Sneeze or cough into the crook of the arm,
which is less likely to be a point of contact with
surfaces and other people.- Avoid shaking hands with other people during
illnesses that cause sneezing or coughing.
- Avoid shaking hands with other people during
See also BACTERIA; VIRUS.strep throat An INFECTION of the pharynx
(throat), also called streptococcal PHARYNGITIS, with
various strains of group A beta-hemolytic strepto-
coccal BACTERIA. Strep throat is highly contagious
through contact with saliva and requires treat-
ment with ANTIBIOTIC MEDICATIONS to prevent
potentially serious complications such as RHEU-
MATIC HEART DISEASE.Symptoms and Diagnostic Path
The symptoms of strep throat come on suddenly,
usually within five days of exposure to the infec-
tion. A characteristic indication of strep throat is
the appearance of symptoms without other cold-
like symptoms. Only about 5 percent of sore
throats (pharyngitis) are strep throat; most sore
throats are viral infections. Key symptoms of strep
throat include- FEVER
- moderate to severe throat PAIN
- difficulty swallowing
- HEADACHE
- ABDOMINAL PAINand VOMITING
- enlarged, painful LY M P Hnodes in the neck
- MUSCLEaches and JOINTpain
Symptoms generally peak 48 hours after they
first appear. The throat looks very red and may
have pockets of pus (white patches or streaks),
particularly on the tonsils. However, the throat’s
appearance is not diagnostically conclusive. A
rapid ANTIGENtest, which produces results in min-
utes from a swab of the throat, is fairly accurate
when positive but inaccurate when negative. A
culture of the throat provides definitive diagnosis.Treatment Options and Outlook
Antibiotic medications are necessary to treat strep
throat. Because antibiotics do not help viral infec-
tions of the throat and because antibiotic-resistant
strains of strep are beginning to appear, doctors354 Infectious Diseases