Clinical Effects of Smallpox: Pathophysiology of Natural Infection

Infectious Stage

Infection marked by high fever and progressive centripetal rash. By the 3rd or 4th day of illness the temperature usually falls and the patient feels somewhat better. This coincides with the first visible lesions and the person becomes infectious.

The first visible lesions appear in the mouth as minute red spots on the tongue and oral and pharyngeal mucosa. This occurs about 24 hours before the appearance of rash on skin. (19:5) Enanthem, an eruption on a mucous membrane, are the first visible lesions. These lesions first appear in the mouth and pharynx and ulcerate quickly because of the absence of a stratum corneum. The ulceration results in a release of large amounts of virus into the saliva. (9:4) Virus titers in saliva are highest during the first week of the skin rash, corresponding with the period during which patients are most infectious. (9:4)

 

 

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