TY - JOUR AU - Lane, J. Michael T1 - Remaining Questions about Clinical Variola Major T2 - Emerging Infectious Disease journal PY - 2011 VL - 17 IS - 4 SP - 676 SN - 1080-6059 AB - After the recent summary of World Health Organization–authorized research on smallpox, several clinical issues remain. This policy review addresses whether early hemorrhagic smallpox is disseminated intravascular coagulation and speculates about the cause of the high mortality rate among pregnant women and whether ocular smallpox is partly the result of trachoma or vitamin A deficiency. The joint destruction common in children with smallpox might be prevented by antiviral drugs, but intraarticular infusion of antiviral drugs is unprecedented. Development of highly effective antiviral drugs against smallpox raises the issue of whether postexposure vaccination can be performed without interference by an antiviral drug. Clinicians should consider whether patients with smallpox should be admitted to general hospitals. Although an adequate supply of second-generation smallpox vaccine exists in the United States, its use is unclear. Finally, political and ethical forces suggest that destruction of the remaining stocks of live smallpox virus is now appropriate. KW - Smallpox KW - viruses KW - vaccinia KW - smallpox vaccines KW - variola major KW - antiviral drugs KW - bioterrorism and preparedness KW - policy review DO - 10.3201/eid1704.101960 UR - https://wwwnc.cdc.gov/eid/article/17/4/10-1960_article ER - End of Reference