Symptoms appear several hours to one to two days after exposure.
Initial
Blurred vision, drooping eyelids, difficulty understanding language, difficulty in speaking, muscle weakness.
Progression—Day 3
Mucous in throat, neuromuscular symptoms, respiratory distress, difficulty in swallowing, feels like a cold without fever.
Progression—Day 4
Indistinct speech, pupils moderately dilated, retarded eye motions, “mental numbness.”
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An epidemic of cases of bulbar and neuromuscular disease.
Other causes could be considered; however, the extent and epidemiology of the outbreak will help diagnose and define whether or not there was an attack.
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Respiratory failure is the principal cause of death. Tracheostomy, endotrachael intubation, and ventilatory assistance may be required.
Antitoxins are available, but they are horse serums and may produce reactions in those allergic to horse serum. |
Incubation average 12 days.
Symptoms begin acutely.
Phase I Symptoms: Malaise, fever, chills, vomiting, headache, backache.
Light-skinned patients may exhibit rash during this phase.
Phase II Symptoms: Facial rash and eruptions on mucous membrane leading to infectious secretions. Eruptions on lower extremities
spreading to the trunk over the following eight to 14 days. (Later, these pustules form scabs.) |
It is necessary to distinguish smallpox from chicken pox. Examination of vesicular scrapings under a microscope is the usual method for diagnosis. |
Strict quarantine for 17 days of all persons in contact with index cases.
No specific therapy.
Supportive care to prevent secondary infections. |
Incubation two to six days (can be as short as 24 hours)
Symptoms: Chills, high fever, headache, malaise, sensitivity to light, sore throat, muscle pain, vomiting. |
Epidemic febrile illness.
White blood count shows striking leukopenia and lymphopenia.
Virus may be isolated in serum.
Sick or dying horses in the vicinity would be an indicator. |
Standard precautions for healthcare workers.
Analgesics for headaches. |
| Incubation one to five days. Small bump progressing to blister which ruptures, leaving an ulcer containing dead tissue. |
Development of a painless itchy lesion, blister, or ulcer which develops into a black scab. Fever. |
Penicillin (oral). Additional treatment required if there is evidence of spreading infection. |
| Nonspecific symptoms (“flu-like”). Possible non-productive cough and mild chest discomfort. Symptoms last two to three days, possibly followed by a short period of improvement followed by sudden onset of respiratory distress, chest pain, difficulty breathing, and purple coloration of mucous membrane. Shock and death follows within 24 to 36 hours. |
Diagnosis is difficult. Early symptoms are entirely nonspecific. Development of respiratory distress in association with X-ray evidence of widened mediastinum and hemorrhagic pleural effusion. |
Large doses of intravenous penicillin and cyprofloxin. |
