Smallpox medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
There is no antiviral treatment for smallpox. In case of disease, it is only possible to manage the wellbeing of the patient, hydrate and administer certain drugs to decrease the fever or pain and to treat concomitant bacterial and/or viral infections.
Medical Therapy
In case of a suspicious case of smallpox infection, the patient should be treated in a negative-pressure room whenever available. He should also be vaccinated, particularly if still in an early stage of the disease, in an attempt to minimize morbidity and mortality. In the presence of multiple patients with suspected or confirmed disease, a special facility or the whole hospital should be isolated and reserved for treating those patients.[1]
So far none of the available antiviral drugs have been proven effective against the smallpox virus. The investigation for a suitable drug has been impaired by:[2][3]
- Absence of human disease
- Difficulty in finding an animal host/model
- Reserved access to the virus
The main form of treatment is to keep the patient comfortable throughout the disease and prevent concomitant infections. This can be achieved by:[1]
- IV fluids for hydration
- Adequate nutrition
- Antibiotics for concomitant bacterial infections:
- Penicillinase-resistant antimicrobial agents - for bacterial infection of smallpox lesions, bacterial ophthalmologic infection and for widespread lesions
- Topical idoxuridine - for corneal lesions
- Antiviral drugs for concomitant viral infections:
- Cidofovir - for cytomegalovirus infections
- Antipyretics to manage the fever
- Analgesic drugs to manage the pain
References
- ↑ Jump up to: 1.0 1.1 Breman, Joel G.; Henderson, D.A. (2002). "Diagnosis and Management of Smallpox". New England Journal of Medicine. 346 (17): 1300–1308. doi:10.1056/NEJMra020025. ISSN 0028-4793.
- ↑ Moore, Zack S; Seward, Jane F; Lane, J Michael (2006). "Smallpox". The Lancet. 367 (9508): 425–435. doi:10.1016/S0140-6736(06)68143-9. ISSN 0140-6736.
- ↑ Smee DF, Sidwell RW (2003). "A review of compounds exhibiting anti-orthopoxvirus activity in animal models". Antiviral Res. 57 (1–2): 41–52. PMID 12615302.