However, the natural hosts of MPXV are more likely to be rodents and other small mammals 3. MPXV was first identified in 1958 in research monkeys that were shipped from Singapore 2, which is the likely reason for the disease being called ‘monkeypox’. A vaccination does exist for Smallpox (see blog entry Viruses – Vaccinia).Monkeypox is a zoonotic viral disease caused by the monkeypox virus (MPXV), an orthopoxvirus belonging to the Poxviridae family of viruses 1. Treatment of Smallpox is isolation of the patient and Cidofovir antiviral medicine. Diagnosis of smallpox is by viral culture or PCR. The mortality rate of Smallpox can be as high as 40%, but immunity is lifelong.

Other complications can occur such as: pneumonia, encephalitis, arthritis, and osteitis (bone inflammation). Patients become infectious at the beginning of the rash and for the next ten days.

The other skin lesions begins as flat erythematous (red) macules that form papules over two to four days then become pustules/vesicles for two weeks before rupturing and forming crusts and permanent scars. The lesions on the palms and soles appear like tender “BBs” under the skin. After the fever resolves, a rash occurs on the trunk, face, arms and legs with the palms and soles being the first areas affected.

Initially, patients present with a prodrome of fever, severe headache, and body aches. Smallpox is transmitted via the respiratory route and has an incubation period of one to three weeks. It was eradicated as a disease in 1977 but has become of interest recently as a possible bioterrorism agent. Smallpox, also called Variola Major, is a DNA virus in the orthopoxvirus family which I have never encountered in my The Woodlands dermatology and Conroe dermatology clinics.

Smallpox skin lesions