Smallpox: disease progression after rash develops

[sleightly]

Setting: secondary world analogous to England in the 1350s, with some magic

The situation: A group of about 30 people suffers a smallpox outbreak.  They're relatively isolated from other people (though clearly not isolated enough!), and for plot reasons cannot call on anyone for outside assistance.  Food and drink aren't a concern, and a small

Comments

[dragonbat2006]

I'm in Montreal now and don't have access to my notes, but I had to research smallpox for a fic of my own not too long ago. I can point you to two books. The Demon in the Freezer by Richard Preston and Smallpox: The Death of a Disease by D.A. Henderson.

I'll be back home on Thursday if you want to message me and I can look it up if I you haven't got your hands on the titles yet. Demon in the Freezer is definitely available in e-book and it's a fascinating read.

ETA: Demon in the Freezer opens with an outbreak in Germany in the late 50s or early 60s and I'm 90% sure has the details you need. The other one is written by one of the doctors who spearheaded the eradication and does describe symptoms, etc.

[wendelah1]

I second the recommendation for The Demon in the Freezer. It's been awhile since I read it but I remember it as having the kind of details you'll need.

[sleightly]

For some reason that's now unclear to me, I had this book filed (in my head) in the political/social category rather than medical. I'll see if my local library has a copy. Thanks!

[lilacsigil]

The lesions of smallpox are supposed to be excruciatingly painful, hard and filled with pus, and the fever very high. I think you're underestimating the effect of a fever: it can kill in itself through dehydration and brain overheating, it makes people irrational and sometimes demented. While they could probably cope with drinking water that's been given to them, I doubt they would be capable of self-care let alone care of others.

Most lesions (e.g. from an allergy) don't fill with pus, don't scar and aren't nearly as painful. If you've ever had an infected wound, you probably wouldn't want to be running on that!

[sleightly]

Thanks! I could find sources to tell me that the lesions didn't itch the way chicken pox sores do, but I couldn't find anything to say if they were painful. Or maybe by the time I found it, I was skimming. I found that a lot of websites repeated the same information (sometimes verbatim), so I didn't always read line for line.

You know, I've just realized that I don't think I ever Googled, "Are smallpox lesions painful?" I just kept looking for sites that would list all the details, not for that one specific bit of info. OK, that's kind of embarrassing.

[silentg_canada]

According to Wikipedia, there are two forms of the virus, Major and Minor, and the minor one has much milder symptoms (that sound like yours), and only 1% of people die. http://en.wikipedia.org/wiki/Smallpox

[sleightly]

Except that I actually want at least a few of the characters to die. :) That sounds horrible, doesn't it? The smallpox outbreak is supposed to be one in a series of catastrophes.

[quatorze]

Even if it's just a mild case, patients are highly unlikely to be up and about within a few days looking after themselves, let alone looking after others. Just a look at the Wikipedia article (to refresh my memory) was enough to point out quite a few problems with that scenario

[sleightly]

Which is what I assumed when I wrote the first draft of the novel, but as I've been revising, I went looking for more details, and stumbled on this "and then the patient feels better" crap. Wait, what? And then I kept finding the same thing other places, without any explanation for what, exactly, got better. Gah! Most sites just wanted to tell me how to diagnose smallpox (with lots of time spent on differential diagnoses) and then show me pictures of the stages, without actually telling me what it feels like on the patient's end

[quatorze]

Yeah, researching things can get frustrating! :) I'm not a medical professional or anything, just took a look at what the Wikipedia article told me, then drew on my own experiences of when I've been ill with something and went on from there to list how the various symptoms would affect the patients. Glad to have been of some help!

[sleightly]

"...drew on my own experiences of when I've been ill with something and went on from there..."

This is problematical for me, though, and why I'm always very cautious of making assumptions about illnesses. When I get sick, I don't feel as bad as I "should." I had an "Oh my god, why didn't you go to the hospital, are you crazy??" fever once, and was still up and moving around, taking care of myself. I didn't feel great, but I wasn't flat on my back, either. I do stuff like this a lot, so I can't ever be sure whether my reaction to a particular symptom is a good baseline.

(This sounds like it would be great, but trust me, it isn't. I'm still sick, but because I don't feel sick, I don't rest the way I should, so I end being medium-grade sick for forever.)

[eglantine_br]

I am doing a Yale Open Course on epidemics. It is free. It has a session on smallpox. Very clear description of the symptoms, and the recovery.

If you want to check it out-- go to Yale Open Course. Just Google search those words it will pop up. Under the history section you should see epidemics. Under the sessions for that course is smallpox. It might be listed as the speckled monster.

[sleightly]

Thank you, this is great! And not just for this question, others too. I didn't know this program even existed.