When you think about the worst epidemics and pandemics of the century, smallpox comes first to mind. Responsible for millions of deaths over several centuries, smallpox was the inspiration for the world’s first vaccination efforts, leading eventually to its global eradication in 1980. But even though smallpox is no longer a threat, its viral cousin-monkeypox (Mpox) has recently come to attention due to appearances in numerous countries, including India. India reported its first case of Monkeypox in Kerala. Being a sibling to smallpox, and after the havoc covid pandemic caused, monkeypox has become a cause of concern for the nation’s medical fraternity.
Though both smallpox and monkeypox belong to the same viral family and share similar symptoms, they differ greatly in terms of transmission and severity. This blog discusses the differences between the two.
What is Smallpox?
Smallpox is a highly contagious viral disease caused by the Variola virus, which primarily affects humans. Known for its devastating impact over the centuries, smallpox was responsible for significant death tolls before a global vaccination campaign led to its eradication in 1980. Its symptoms include high fever, a characteristic rash, and severe body aches. Smallpox was a feared disease, with a high mortality rate of around 30% in those infected.
Once a person recovered from smallpox, they were typically immune for life. However, no treatment or cure existed apart from symptomatic relief. The best way to combat smallpox was through vaccination, which led to its eventual eradication.
What is Monkeypox?
Monkeypox, though related to smallpox, is a much less severe viral disease caused by the Mpox virus. First discovered in monkeys in 1958 and in humans in 1970, monkeypox primarily occurs in Central and West African regions, though outbreaks have occurred in other parts of the world in recent years, including India just a few days ago. The symptoms of Mpox are similar to smallpox but tend to be milder and less deadly.
Key symptoms of monkeypox:
Fever: Like smallpox, monkeypox starts with a fever.
Swollen lymph nodes: A notable distinction from smallpox, monkeypox causes swelling of the lymph nodes.
Rash and lesions: A rash similar to smallpox, but the lesions tend to be less dense.
Muscle aches, fatigue, and chills.
The mortality rate for monkeypox is much lower than smallpox, typically around 1-10%, with higher risks in younger individuals and those with weakened immune systems.
Transmission: How does monkeypox spread?
Smallpox transmission occurs via close contact with an infected person or contaminated objects. The virus is primarily spread through respiratory droplets, making it highly contagious in crowded environments. Direct contact with bodily fluids or materials like bedding that have been in contact with an infected person can also lead to transmission. Once a person is infected, they become contagious as soon as the rash develops.
Mpox transmission also occurs through close contact with an infected person or animal. However, in addition to respiratory droplets, it can spread through contact with the bodily fluids of infected animals (such as monkeys, rats, and squirrels), contaminated materials, or bites from infected animals. Mpox does not spread as easily between humans as smallpox, making it less contagious overall. Still, recent outbreaks in regions outside Africa suggest the virus can spread through human-to-human contact in certain situations.
Severity and Mortality Rates
Smallpox is known for its high mortality rate and devastating impact. With a death rate of about 30%, it was one of the deadliest diseases known to humanity before its eradication. Survivors were often left with permanent scars, especially on the face, and some suffered from blindness.
Monkeypox, on the other hand, is generally less severe. Its mortality rate ranges between 1% and 10%, with most fatalities occurring in children or immunocompromised individuals. The severity of monkeypox infections can also depend on the strain of the virus, with the Central African strain being more virulent than the West African strain.
Closing thoughts
While both monkeypox and smallpox belong to the same viral family, they impact humans differently, in terms of severity, transmission, and mortality. Smallpox was a deadly disease that claimed millions of lives before its eradication, while Mpox is generally less severe but still poses a public health challenge in certain regions.
