Talk:Smallpox/Archive 2

Archive 1

Archive 2

Archive 3

Sick child picture

Is it necessary to have such a disturbing picture at the top of the article, or anywhere in the article for that matter? What do pictures of children add to the article that pictures of adults would not? —Preceding unsigned comment added by Flailing12 (talk • contribs) 00:19, 17 November 2010 (UTC)

Some Wikipedia people obviously have horrible taste. What if a child saw that awful picture? Wilsonbond (talk) 03:59, 17 November 2010 (UTC)

Are we supposed to find a nice picture for this horrible disease? Small pox was once the leading cause of death in the United States. Millions suffered and died. This is one of the great successes of medicine / immunization. It is one of the only disease that has ever been illuminated. Thus this picture stays. It reminds those who protest that we should no longer immunize children why we started in the first place. Hopefully people do see it so they understand.--Doc James (talk · contribs · email) 04:04, 17 November 2010 (UTC)

Replying to "What if a child saw that awful picture?" I showed my 2.5, 5, and 6 year children that picture this afternoon, explained to them what the disease was, how it killed so many people, what a virus is, etc. They are now more knowledgeable, and were not in the least "disturbed" by having seen it; rather, they were interested and inquisitive, and asked questions, which led to further wiki-exploring. What's the issue? Why should the rest of the world be forced to submit to your standards of "offensive"? Sasata (talk) 04:48, 17 November 2010 (UTC)

You don't get it. Just like an article on human reproduction does not need a pornographic picture, an article on a disease does not need a horror picture. It's not censorship, it's common courtesy. It's the same idea as not to tell colorful jokes at work place. Wilsonbond (talk) 04:27, 17 November 2010 (UTC)

Sure, the picture makes my heart hurt for the kid, but the image does it's job of showing the nastiness and horror of the disease.--intelati^talk 04:34, 17 November 2010 (UTC)

Smallpox was a horrible disease; trying to show it as something else isn't truthful. If people get offended by the truth, that's their problem. Allens (talk) 11:54, 18 October 2011 (UTC)

You don't educate people by offending them, that picture (not that poor girl) offends people. Wilsonbond (talk) 04:40, 17 November 2010 (UTC)

It is a great picture and the best one I have seen that illustrates the disease. Do you have a better one? Doc James (talk · contribs · email) 04:55, 17 November 2010 (UTC)

What you are pursuing is sensationalism, so don't pretend it's all for the truth. I'm sure there are plenty of less graphic picture of that disease. Just to show you what bad taste means:　Brandon Lee's death footage was destroyed without being developed, because watching it would be in bad taste. Thank god people like you did not get your dirty hands on that! Wilsonbond (talk) 05:02, 17 November 2010 (UTC)

This is simply what smallpoxs looks like. We are not going to censor it. Please WP:AGF. Doc James (talk · contribs · email) 05:22, 17 November 2010 (UTC)

Agreed that it is a good picture: smallpox was a horrible disease, which thankfully has been erradicated. We describe symptoms both with words and images, and for the latter I believe this is a great image. I am no physician, I did not knew how smallpox looked like and the image was produced a high impact on me, but also gave me more info in a single second that all the symptoms subsection.--Garrondo (talk) 07:17, 17 November 2010 (UTC)

On a side note: please do not make personal attacks or assume bad faith.(See: WP:civility)--Garrondo (talk) 11:44, 17 November 2010 (UTC)

This picture may be an efficient representation of the disease, however, it's pretty much on par with gore. For example, one could have a picture of a car accident with a severed head in the wikipedia page for decapitation. This would be the most likely modern cause of decapitation and it would accurately portray the article. You could also argue decapitation is a horribly socking thing, that needs an equally horribly shocking picture. Yes yes, I call strawman on myself, but to the point; Gore images affect the readability of the article for some users. It's not at all uncommon for children to have to research smallpox, so at the least there should be a way of hiding the image, like a link that says [hide image] above it. Rather than being artsy and trying to maximize representation I suggest we maximize the amount of information portrayed when deciding which picture to use. Technically a mound of rotting dead babies with smallpox is a better representation of the disease, but it's obviously in bad taste. As neutral writers we do not need to add more dramatic emphasis or find the most poetic representations, the content will speak for itself. Showing smallpox lesions are enough, having it be a child at an advanced stage only furthers the gore level while not contributing information. Furthermore, if a picture is used, it should be attached to the symptoms section. The physical manifestations are not the only definition of the disease. JimmyRuska (talk) —Preceding undated comment added 08:38, 22 November 2010 (UTC).

Feel free to propose or provide a superior image. There is a discussion about creating image settings for children and the faint of heart / easily offended. Not sure where they are currently in this process but this will make all potentially offense images easier to self censor. Wikimedia is in the process of hiring further staff so hopefully this will be possible soon. Doc James (talk · contribs · email) 09:15, 22 November 2010 (UTC)

Articles like rinderpest, HIV use a different approach, articles like chickenpox and measles use the physical manifestations, but in a more tasteful way. I do not know what is standard practice and I have no suggestions other than the assertion the current picture is probably inappropriate. I only passed by because there seemed to be debate and I felt strongly to chime in; as far as image rights and implementation, I am clueless. It's important to differentiate the level of gore though. Think back to what popular culture often uses for horror, you find: zombies, mutants, demons, dolls, aliens, and basically anything that looks like a diseased or horribly mutated, diseased or injured humanoid-looking creature, especially with detail in the face. The brain is used to automatically gauging attractiveness as a natural method of finding a healthy mate. The more carnage, the more deathly or sickly the picture is, the higher the emotional response will be, more so than any non human-looking entity could ever elicit in terms of reactive horror. On a scale of things that will most likely make people uncomfortable, I think a little girl, probably near death and covered with scarred sticky pustules ranks up there with a picture of a needle going into someone's eye, somewhere at the top of the scale of max-discomfort-inducing-efficiency. It's pretty strong, and not just another typical medical picture. JimmyRuska (talk) 09:56, 22 November 2010 (UTC)

The image can impose an emotional harm on the reader who may be passing by doing research on the subject. I agree with the person above, that the image of the little girl covered in diseases is very graphic. Some may argue it is needed to show whafft smallpox look like, and there is a lack of alternative. In that case, at the very least, there should be a warning on the image. Personally, I have had two nights of nightmare because I stumbled upon this article. Respectfully Yours. 68.6.110.128 (talk) 05:04, 11 December 2010 (UTC)

I am trypophobic and clusters of holes bother me physically (throat tightening, hands itching, skin crawling) as do clusters of bumps like the image (or what I could make of it; I closed it very quickly). Many people who have trypophobia may even start to hyperventilate if they see images that bother them. The image is a safety hazard for trypophobic people and others who are bothered by clusters of bumps/holes. I think the image should be removed for this reason. 72.219.176.11 (talk) 10:07, 2 March 2011 (UTC)

50-70% of physicians use Wikipedia weekly. No physician in practice less than 30 years has seen an active case of smallpox. If we do not see images as they are suppressed due to concerns of causing harm to trypophic people and a delay in a smallpox diagnosis occurs millions of excess people could die as a result. The risk that smallpox recurs is not that small. Both the USA and the former USSR have large about of smallpox in weapon form. Also we are an encyclopedia. This our goal is to provide the sum of all human knowledge. This is part of that knowledge.

So to conclude I am more worried about preventing real world nightmares. This can be done by not only educating people about how horrible small pox is but working with the USSR and the USA to decrease there stockpiles of this infectious disease and may be even eliminate it entirely. Doc James (talk · contribs · email) 17:04, 2 March 2011 (UTC)

That some percentage of physicians use Wikipedia seems irrelevant. It's not a resource for physicians; one expects specialists would have their own, specialized resources. The justification that this image would allow people to more rapidly identify smallpox doesn't seem applicable to the vast majority of users. Obonicus (talk) 02:47, 28 November 2012 (UTC)

This image does bother me, but I think it's not the rash, rather her black eyes. Could we change it to this image instead?

I would certainly vote to use a different picture. Seeing it makes me want to exit the page - not read on and learn more.Tklink (talk) 21:18, 11 May 2011 (UTC)

I like the current image. It illustrated the condition well. Doc James (talk · contribs · email) 21:33, 11 May 2011 (UTC)

Another vote for replacing this image with one less graphic. It may be that medical professionals need to consult an accurate representation of the disease; if this is the case I should hope that they consult an appropriate medical text, so that Wikipedia can remain usable for the rest of us. IronSheep (talk) 01:19, 1 July 2011 (UTC)

I've moved that image further down in the article. Evenfiel (talk) 13:38, 7 August 2011 (UTC)

No consensus for the move thus returned. Soon people will have a way to keep from seeing disturbing images on Wikipedia. Doc James (talk · contribs · email) 04:28, 9 August 2011 (UTC)

No consensus? As far as I'm concerned, there is no consensus for this photo to be in the lead. You're being egoistic for not taking into account several users complaints. Moving the photo further down is not hurting the article in any way, since the other lead picture is perfectly fine and your beloved photo will still be available to everyone. I'm proposing a solution to this conflict, while you're not proposing anything. Evenfiel (talk) 08:23, 9 August 2011 (UTC)

Wikipedia is not censored. The best image goes in the lead. The image in question is a "featured image" and is in color. You could try a request for comment. My proposal is that soon people who do not wish to see certain images can self censor themselves without forcing censorship on others.Doc James (talk · contribs · email) 19:01, 9 August 2011 (UTC)

The picture belongs in the lead. Smallpox was an horrendous disease and it is our duty to describe it as such. This image speaks volumes and alone goes a long way to explaining the enormous worldwide effort that went into eradication. I can't see how this image makes Wikipedia unusable. Does this mean that we should hide the truth? Seeing this image is an extremely important part of "learning about smallpox". I am probably right in thinking that no commentators here have seen a case of smallpox. I have. You have to see the symptoms of this disease to fully understand it. If casual readers are put off by the image, they are probably not that interested in learning about the disease. Wikipedia is not censored. If it were, I would not contribute to it. If our humble article has any tiny influence on making sure that suffering like this never happens again we should be very proud. Graham Colm (talk) 20:05, 9 August 2011 (UTC)

Agree completely with Graham. If this image is in peoples minds and if small pox ever gets out of the labs in which it exists having people remember this image has the potential to save millions of lives. If this pushes people to help the former USSR and USA protect / eliminate its stockpiles of the disease we at Wikipedia have done something great.Doc James (talk · contribs · email) 20:13, 9 August 2011 (UTC)

Could you explain to me how to move that picture further down in the article can be classified as "censoring" or "hiding" it? What I am trying to do is to give people time to decide whether they really want to keep on seeing pictures about smallpox or not, while saving the worst of the lot for the last. If they decide they do and continue reading the articles, or just seeing the pictures, at least they knew what was coming at them. What you are trying to do is to use shock & horror tactics in order to make people realize what a horrible disease it was. I see that both of you are doctors, so I guess you're quite used to seeing all kinds of deformities or bizarre aspects of human body. Unlike you, the vast majority of people have nothing to do with medicine and are uncomfortable with such pictures. As for Doc James's proposal that people will be able to self censor, this is a moot point, since the vast majority of Wikipedia users don't even have an account.

Anyway, if you wanna keep up with your shock & horror tactics, you still have a lot of work to do here in Wikipedia. You can start by going through the whole list of Sexually transmitted disease and change the lead photos for the most horrible pictures you can find. Pretty much all of these articles have a rather tame picture in their lead. Evenfiel (talk) 00:54, 10 August 2011 (UTC)

The point is not shock and awe but to accurately represent disease. It appears that we shall have to agree to disagree on this one.Doc James (talk · contribs · email) 02:30, 10 August 2011 (UTC)

Yes, the point is shock and awe. The other pictures shows the child with several pustules in his body, but in a less graphic way. You also chose to ignore my main point. I'm not removing the picture from the article, but just moving it further down. There is no consensus to maintain this picture. At least half of the users who posted here would like to see it replaced. I'm proposing a possible solution for this conflict. We don't need to remove it from the article, only from the lead. Evenfiel (talk) 10:53, 10 August 2011 (UTC)

Graham, which of the several images of smallpox is most typical of the disease? IMO, there is a tendency in medical publications to have illustrations that are towards the worst end of the scale for the same reason that books for identifying minerals or flowers or birds only show perfect specimens, rarely seen in the field, because they boldly illustrate the features. Although that approach has its merits, there is a danger that readers (physicians or lay) get the impression that it is commonly that bad. If that poor girl is typical of what occurred (in the third world, say) then I'm happy for it to the be the lead in this article. If the alternative offered by Evenfiel is actually more typical (even though it might not look much different to a bad case of chickenpox) then we should use that and move the worse-case image to later in the article.

The current image does highlight how much more potentially scarring and deadly smallpox is compared to chickenpox. So it is useful for the lead for that reason. But it is shocking and if untypical then I don't support it in the lead. The "Wikipedia is not censored" card is easy to play but we wouldn't, I hope, argue that this image would be a good choice to illustrate disease, infectious disease, infection, etc. Whereas we might be quite happy with a picture of someone sneezing to illustrate those. -- Colin°^Talk 12:16, 10 August 2011 (UTC)

The fact that it is in color I consider important.Doc James (talk · contribs · email) 15:26, 10 August 2011 (UTC)

The image is typical of variola major. I have seen more severe cases – unpublished images from the collection of the late Thomas Henry Flewett. The haemorrhagic form was even more extreme but less common. I don't know the full provenance of the monochrome picture of the girl, but to me it looks like a convalescing case. Smallpox only resembled chickenpox in the early stages of smallpox infection. This is what smallpox infection looked like. Let's hope we never see it again. Of course we could not justify its use to generically illustrate the more common and benign infectious diseases, but it belongs in this article and in the Lead. I concede that a colour picture of an adult showing these typical signs would be preferable, but I don't know of a free one we could use.Graham Colm (talk) 17:50, 10 August 2011 (UTC)

I dont find the image particularly disturbing and think it does authentically portray the effects of the disease on people. However - for a encyclopedic purposes an image showing the symptoms of the disease in a specific infected person is not the appropriate image to use in the infobox - rather a picture of the microscopic virus itself is whats called for here; it is much more general to the subject of the article. A quick scan at other wikipedia articles about infectious diseases (HIV, flu, cold etc) reveals this is the common precedent. So,I would propose we lower this picture where it is more relevant (in the discussion of symptoms) and replace it with the microscopic image of the virus. Solid State Survivor (talk) 21:13, 10 August 2011 (UTC)

We frequently use images of disease to illustrate said disease. Jaundice... Doc James (talk · contribs · email) 00:41, 11 August 2011 (UTC)

The effect of small pox is of more interest than the structure of the virus. Keep the sick child picture. Jim1138 (talk) 01:39, 11 August 2011 (UTC)

Thanks for the speedy response Doc. An image of the symptoms of a disease is not synonymous with a picture of the disease itself. With a disease like smallpox (one where there is a definite viral agent) a picture of the virus itself is most synonymous with the disease (for instance we would say a person infected with the virus who emited no symptoms carries the disease). The Jaundice article you reference uses its picture appropriately since Jaundice is itself a sort of symptom brought about from other health issues such as heptitis or liver failure.Solid State Survivor (talk) 01:57, 11 August 2011 (UTC)

Smallpox infection does not give rise to asymptomatic carriers. This is one of reasons why it could be eradicated. The image illustrates smallpox infection. Graham Colm (talk) 05:25, 11 August 2011 (UTC)

This article is about smallpox the disease, not variola virus. Our infectious disease articles are a bit inconsistent wrt whether the virus has its own article or not. Please nobody suggest rotavirus should have a picture of the symptoms in the lead :-) Colin°^Talk 08:00, 11 August 2011 (UTC)

The picture is scary as hell. It's not simply disturbing; it's actually haunting as it lingers in your head, and I'm a person who does not get scared easily. Wikipedia should not have "scary as hell" shock images, at least not in the lead. The reason behind this is because the image literally pops up when the page loads and can catch people by surprise. Wikipedia is an encyclopedia for research and education. Likewise, the image is very "artsy" in its composition (specifically the darkness of the eyes). The image seems to have been made to be deliberately disturbing and not simply a representation of the affects of the disease. — Preceding unsigned comment added by Anikom15 (talk • contribs) 05:51, 14 August 2011 (UTC)

I was rather taken aback by the striking photo. Like most people under the age of 40, I have never seen a real case of smallpox. Thank goodness I never will. In my opinion, the photo appropriately illustrates the nature of the disease. Axl ¤ [Talk] 23:19, 14 August 2011 (UTC)

We all hope we never see this disease but a number of countries still have large receives of it in culture vats ready to release upon the world at short notice either by accident or on purpose. Our best chance will be to identify it as soon as possible. Thus everyone needs to know what it looks like.Doc James (talk · contribs · email) 18:35, 18 October 2011 (UTC)

I am amazed that discussion about the use of this picture, despite its length, is exclusively centered on your reactions to it and never raises the question whether or not the actual person shown in it agrees to her picture being made public use of. Oh, I forgot: she's not white and she's poor, so she does not have any rights at all as far as Americans are concerned. 62.62.170.136 (talk) 07:07, 2 April 2012 (UTC)

I do not believe this is a reasonable objection. This is a file photo provided by the US Centers for Disease Control for illustrating the effects of smallpox. It is one of many such photos published in the public domain by the CDC library illustrating diseases from around the world. The place to register objection to this type use would be with the CDC and the US public health establishment, not Wikipedia. --MillingMachine (talk) 13:58, 17 May 2012 (UTC)

Link to image filter referendum

The Wikimedia Foundation has been working on a personal image filtering system for a while. There is information at meta:Image_filter_referendum/en. The basic idea is that any individual person would be able to say "I personally do not choose to see pictures that are gross/religiously offensive/pornographic/whatever, so please don't show them on my personal computer screen". You would get to pick and choose the types of images, rather than a one-size-fits-none approach). It is meant to be easy to override, so that if you don't normally want to see images of this type, but you change your mind for one page, then you would just have to click on it to override the setting (so what this doesn't do is provide a reliable system that would let parents prevent children from seeing pictures that the kids want to see, but the parents don't want them to look at).

The referendum has not started yet, but you can leave your comments at the talk page on Meta. Since "nauseating medical images" hasn't been discussed as much as other categories, they might like to hear from some of you. WhatamIdoing (talk) 21:08, 14 August 2011 (UTC)

Image

The Variola has two horms, the minor form of varioala does not have such rash distribution hopefully. The image is of a severe form of Variola major I believe. --Aleksd (talk) 17:05, 24 November 2011 (UTC)

Sure but that is no justification to remove the image. --Doc James (talk · contribs · email) 06:07, 25 November 2011 (UTC)

It is 2013 and nothing has been decided. I've never took part here, but just so you know, I've used the main picture (the very graphic one) several times to scare my adult friends. Therefore, the picture is basically a macabre laugh-stock among adults. I see some of the users are pretty keen to the picture (and I have no idea why; what would be the personal interests behind this?), what I find to be very macabre as well; since smallpox has been erradicated, it is impossible to determine whether the poor girl's condition was average (thus a proper illustration) or if she was suffering a terribly advanced stage of the disease. Searching google images, I do face several horrendous picture, but none of them gets even close to the disturbing state that the current picture gets me in. Again, please consider all the users claim that have surfaced here. Wikipedia is not to be censored; neither it is to be scary when there could be many other less-shocking portraits of the disease. Please, put your personal keenness to the picture aside this. — Preceding unsigned comment added by 189.73.166.240 (talk) 18:18, 29 March 2013 (UTC)

Given that you have used this image simply to scare your friends and your attempts to turn the poor child into a laughing stock, it is difficult to even consider your arguments about the ethics of its use. This is a serious and well referenced article on an horrendous infection. Although eradicated, the disease is extremely well documented and this image is typical of the clinical signs. Graham Colm (talk) 18:59, 29 March 2013 (UTC)

Eradicated as a circulating infection yes but not in the lab. While I have never seen a case I still keep it in the back of my mind. If a case was ever to appear early identification could save million of people. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:59, 29 March 2013 (UTC)

I hardly believe that Wikipedia would be the first resource of information a serious physician would resort to in case of identifying an unusual disease; a non-physician is not allowed to give diagnosis and they would go for a doctor in the earliest visible stage of the disease, as strong as it is. People with no doctors around (e.g., extremely poor areas in poor countries) hardly have access to the internet or any interest in medical articles from Wikipedia whatsoever. In any event, many other pictures seem to be just as accurate and, still, their graphic content is visibly less disturbing. As for the scaring and the laughing stock parts, it is just a clear example of what derogatory use this picture has been having, instead of being informative. It can even scare the public away from the page, what makes all the very useful information, developed over the years, simply invisible. If it is to victimize the girl as being a laughing stock, she has been having the most negative exposure as the main picture on the page. Finally, if the (pacifying) idea of placing the girl's picture elsewhere in the page, what would keep the article's accuracy and would assure early identification should another outbreak happen, has been rejected, I can only assume we are clearly before bad faith. — Preceding unsigned comment added by 200.180.179.101 (talk) 04:30, 30 March 2013 (UTC)

Other image

There is another image, File:Smallpox child.jpg.

Said file should have more information. Child's gender? (Girl, I think.) Nationality? Time when the scene took place? Did the child survive?

The file at the top, of the Bangladeshi girl (reminds me of Rahima, but it can't be) is appropriate. It is very mild compared to this. It illustrates how terrible a disease smallpox was. Besides, it is a featured picture.--Solomonfromfinland (talk) 07:21, 18 December 2013 (UTC)

status as now one of 3 eradicated

polio has now been eradicated. - Sireditprofusely (talk) 20:41, 2 April 2014 (UTC)

If only! Polio has been eradicated from India, but is still endemic in three coutries. Hopefully within our lifetimes... Adrian J. Hunter^{(talk•contribs)} 10:28, 3 April 2014 (UTC)

File:Child with Smallpox Bangladesh.jpg

I suspect this has been raised before, but is there any reason File:Child with Smallpox Bangladesh.jpg is not used in the article? J Milburn (talk) 19:11, 12 August 2010 (UTC)

Agree. Doc James (talk · contribs · email) 18:47, 6 September 2010 (UTC)

That picture was removed because it's absolutely nightmarish. Lots of people complained about it here. Wikipedia is an encyclopedia written for everyone, not only medical professionals. Evenfiel (talk) 23:22, 14 October 2010 (UTC)

What is wrong with this image? The others do not properly display the dimple. If we do not have a proper image of small pox in the lead and this disease comes back and people do not recognize it we have done the world a disservice. Returned the image again. Smallpox is BTW a disturbing disease. Little over a hundred years ago it was the leading cause of death in North America. It is one of the successes of modern medicine via vaccination. Russian and the USA still hold stockpiles of the stuff to us as biological warfare.Doc James (talk · contribs · email) 20:50, 24 October 2010 (UTC)

This picture is currently a featured picture. Doc James (talk · contribs · email) 14:47, 9 November 2010 (UTC)

GA Review

This review is transcluded from Talk:Smallpox/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Garrondo (talk) 18:26, 16 November 2010 (UTC)

I have taken a quick read of the article and it is great. I believe it is clearly above GAN, and there should be no important issues. Nevertheless I suppose the intention is to take the article to FAC so I will try to do a more in depth, useful, review as I have time (I myself have a GAN at a similar point). I also have to say that I am not a physician but a psychologist working in neurology research, so a I will not be able to check for accuracy, but I will for readership.

Some general comments:

• The article is very, very long, and therefore horrible to load. While I understand that sometimes seems a good idea to have all content in a centralized article in this case it is probably worth summarizing and creating a subarticle of the history section. At this point even the history section by itself could pass a GAN!!!
• To follow MEDMOS sections a "society" section could be created with two subsections: warfare and famous patients. (I would eliminate the and culture from the name per having warfare as subsection.
• When finishing writing a disease article I find it useful to try to eliminate the name of the disease as many times as possible in the article: overuse is most of the times the case. I will probably be also a good idea to do it here: a first clear example from classification: There are two clinical forms of smallpox. Variola major is the severe and most common form of smallpox, with a more extensive rash and higher fever. Variola minor is a less common presentation of smallpox, and a much less severe disease, with historical death rates of 1% or less can be converted into There are two clinical forms of smallpox. Variola major is the severe and most common form, with a more extensive rash and higher fever. Variola minor is a less common presentation of, and a much less severe disease, with historical death rates of 1% or less

Lead: summarizes adequately the article and it is interesting. As minor comments:

• It should be the most accesible part of the article: it would be a good idea to explain the meaning of Maculopapular
• Specific date of death of the Ramses is probably not needed in lead: everybody knows that they are ancient...
• 2 times year in the same sentence is not very nice. In er year during the closing years
• In the last 2 paragraphs it is quite clear that it was a terrible disease. Maybe some of the numbers could be eliminated for the sake of simplicity... with half of them is probably enough to make the point. Similarly it is quite clear that numbers are stimations, so there is no need to say it each time.
• Month of erradications unneded in lead (been bold and eliminated myself).

Classification Does a nice job classifying the disease subtypes according to symptoms.

Signs and symptoms

• Orofaringeal and respiratory are not the same?
• the virus seems to move from cell to cell: do not know much about virology, but this hardly seems an accurate description.
• An explanation of toxemia?
• bleeding into the skin: Sounds strange although it may be me since my mother-tongue is not English.
• This form develops in perhaps 2%: perhaps sounds strange. In addition all paragraph is unreferenced.
• In the early, or fulminating form, hemorrhaging appears on the second or third day as sub-conjunctival bleeding turns the whites of the eyes deep red. : Not sure I understand this sentence: too technical, akward wording, not clear meaning...

More to come...--Garrondo (talk) 19:35, 16 November 2010 (UTC)

Comment Hi, hope you don't mind me dropping in uninvited. I've had this article on my watchlist and my "to-do" list to bring to GA/FAC, so I'm glad someone else has picked up the ball! I've dropped a number of cite needed tags to various places that need them. There's more citations needed in the "Famous sufferers" section, but the whole section needs to be written into paragraphs rather than isolated sentences. Let me know if you need help with finding sources Nergaal, I have access to a lot of literature on the subject. Good luck! Sasata (talk) 19:07, 16 November 2010 (UTC)

I fully agree with comment above.--Garrondo (talk) 19:35, 16 November 2010 (UTC)

Comment I rewrote and expanded this article way back in December 2007, with the intention of taking it to FAC. I've kept an eye on it over the years, but unfortunately real life got in the way and I never found the time to get it up to FA-caliber snuff. I am happy to see that it has now been nominated as a GA. A few notes:

• I spun out a LOT of the original history section to its own article already, but the History of smallpox article is a mess, perhaps if the history article were cleaned up some of the information in the main article could find a home there.
• Most of the disease information (i.e. signs, complications, treatment, diagnosis) came from the CDC pink book (ref 18 in current version) or the AFIP (ref 4). If you are looking for citations for specific numbers they probably came from one of those sources.
• The "sufferers" sections will likely require a lot of work. One suggestion might be to turn it into List of smallpox sufferers or something. For a similar approach see List of poliomyelitis survivors.

Please let me know if I can be of any assistance.--DO11.10 (talk) 22:52, 16 November 2010 (UTC)

• Woow. Lots of things to fix. I thought this would make a good GA when I read it. Shooting for FA would be a nice idea but I am not sure I have the time in the near future to deal with something like that. I will try to fix the issues listed here over the weekend. Nergaal (talk) 05:17, 18 November 2010 (UTC)

Since the nominator will have time difficulties ammending the proposed changes and does not have the intention of taking the article to FAC in the near future I'll leave my comments as proposals for future improvement and a do a review only of GAC. If in the future this comments are fixed and anybody thinks it could be useful I will probably be willing to continue with the started review.--Garrondo (talk) 14:40, 23 November 2010 (UTC)

• 1. Well-written: Yes: I (a non expert) followed it easily, and learnt a lot of a disease I did not know. As pointed above some technical terms should be explained in the future
• 2. Factually accurate and verifiable: Yes: sources are of medium to high quality and most content is sourced.
• 3. Broad in its coverage: Yes, although it may be too broad, as pointed above with the history section. I found the article to be quite demanding due to its very broad coverage
• 4. Neutral: Yes
• 5. Stable: Yes, although there seems to be some debate over image use.
• 6. Illustrated, if possible, by images: Yes.

Please please take down that picture, it gives me nightmares, and I'm 42. I wonder how many people this pictures has scarred for life. God! —Preceding unsigned comment added by 99.146.20.134 (talk) 03:45, 17 November 2010 (UTC)

Sorry, but Wikipedia is not censored. Reaper Eternal (talk) 03:47, 17 November 2010 (UTC)

does anyone know if shes ok? (p.s.: i would move the pic down.)Jake1993811 (talk) 09:55, 30 December 2011 (UTC)

• Comment/question Have people gone mad? Who is there here who thought smallpox was a cutesy little childhood malady that we can now ignore, together with syphilis and seasickness? If you want to sit back and tsk tsk smugly about a disease that in its final 3/4 century or so, long after a cheap and effective vaccine had become available, took more human lives than all the wars of that century combined, and ruined more lives than it took, then go and read something else; this one is not for you. And if the picture is what it takes to convince you of that, then you needed it. If sanitised tragedy is your preferred genre, read about the history of Manchester United F.C. or about the career of Errol Flynn. For you the highly unsanitary likes of smallpox, plague, yellow fever or the like are unsuited, and you will never wish to understand what they once meant to people and to nations. HIV is a picnic in comparison; so is Ebola and it will remain so until it mutates into seriously human-contagious form. All that is fine, as long as you don't have to look at a nightmarish picture? Did you not want to know the dread of such a sickness or why it was dreaded? The article is about the facts and one fact is that no matter how great the eventual triumph of scientific medicine, the disease was hideous, which is what the picture shows. Obscenity? The real obscenity is the idea of consigning that picture, and by implication the sufferings of that child, to the waste-basket of history. Her picture is a lesson, an item of education too dearly bought to pay for in advance, and too valuable to discard in retrospect. If you want to ignore it, read something else, watch something else, but don't try to hobble the education of serious students by indulging your own grizzlings. JonRichfield (talk) 12:41, 3 April 2014 (UTC)

Smallpox picture

Are all authors who upload such pictures driven by psychic labil narzism? There is also a way to present an infection with Smallpox over a not such disturbing way, especially not showing children with it. — Preceding unsigned comment added by 46.115.54.171 (talk) 17:24, 30 January 2014 (UTC)

What do you mean by 'psychic labil narzism'?

The disease is extinct in the wild and the image would be disturbing whoever was shown.

Is there anybody still alive who had 'wild/non-laboratory originated' smallpox? 80.254.147.68 (talk) 18:01, 30 January 2014 (UTC)

Seeing the picture is absolutely nothing compared to the disease. IMO it is best not to make the article sterile; it should have some impact.

The last known case was in 1977. No reason people can not live to a ripe old age if they survive in reasonable shape. Jim1138 (talk) 19:11, 30 January 2014 (UTC)

Damned right about seeing the picture! Anyone who doesn't want to know about what the disease meant, needn't read about what it meant, and decidedly need not insist on other people being spared the sight of it, or being spared the facts. I commented along similar lines elsewhere on this page. Yo no lik'? Yo no look! JonRichfield (talk) 12:48, 3 April 2014 (UTC)

BBC article

A researcher is quoted in a BBC article about a 30,000 year-old amoeba-attacking virus becoming re-activated out of permafrost. He/she says that there is a risk of an old smallpox virus being frozen somewhere. If this view is not a fringe one, I imagine we could source it somewhere in the article. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 19:40, 4 March 2014 (UTC)

Hmmm... A reasonable question concerning an important point, but the article cited is a bit simplistic, no matter whom it quotes. There are many poxviruses in nature, and it is likely that in the past smallpox started out as a zoonosis that adapted to humans, effectively generating a new species. If so, the likelihood of any frozen and newly-thawed virus amounting to a human-virulent strain is very low. Now, I am not about to debate the facts of such prospects, but I do suggest at the very least that before we add anything so hand-waving to a WP article, we find someone who can contribute something both non-trivial and properly cited. JonRichfield (talk) 12:58, 3 April 2014 (UTC)

RIP?

I am not comfortable with omitting the name of the researcher in question. Is it not supposed to be notable? Is it even considerate to consign him to oblivion? Has anyone objected to his name being mentioned? I'm not about to start an edit war, but it seems to me that to omit factual material out of squeamishness is a betrayal. Ask Herostratus. JonRichfield (talk) 19:08, 18 March 2014 (UTC)

I agree. The name should go back. Incidently, Bedson's father was famous for discovering Chlamydia, (once called "Bedsonia"). Henry Bedson, whose name was removed from the article, was the subject of a newspaper story as recently as 2011 [1]. As for "RIP", we can't anonymise dead people on Wikipedia -that would be daft. Graham Colm (talk) 19:29, 18 March 2014 (UTC)

I agree as well. Mind you, I think it's possible he may very well have prefered to be forgotten in this respect, given that he was apparently a dedicated researcher and it was the fallout from the infection of Ms. Parker (notable as the last known person to be infected with the disease and the last to die from it), which drove him to suicide, but it remains pertinent (in ancillary) information, all the same. Snow (talk) 22:18, 30 March 2014 (UTC)

Thanks folks. As no one has actually done any editing, I did it and added a ref to the actual report mandated by the British house of commons. JonRichfield (talk) 14:15, 3 April 2014 (UTC)

Dead WHO Factsheet link

The link http://www.who.int/mediacentre/factsheets/smallpox/en/ was retrieved in 2007 and is now (as of April 2014) dead. The article relies on this link for five citations. The nearest links on the who web site are:

• http://www.who.int/topics/smallpox/en/ and
• http://www.who.int/csr/disease/smallpox/faq/en/

Neither of these links directly contain the information referred to in the article.

The information from the article can be found in various documents on the WHO site, but some of these could be considered primary sources so I don't know quite how to handle them in the context of this article:

• http://whqlibdoc.who.int/smallpox/WHO_SE_78.106.pdf "The Certification of Smallpox Eradication in Countries Without Recent Reported Endemic Transmission" aka WHO/SE/78.106 says that the last case of smallpox was the Variola minor strain(variant? I haven't verified the wording here), on 26 October 1977 as claimed in the article. Aside: The wording in the article could be understood to equate Variola minor with smallpox, whereas I understand major and minor are two variant of the smallpox virus. The source here says the final case of Variola major was two years earlier.
• http://www.who.int/about/bugs_drugs_smoke_chapter_1_smallpox.pdf "Smallpox, Eradicating an Ancient Scourge" partially supports the article content for its 1967 figures but instead of saying 15 million cases in 1967 it says "In 1967, there were around 10-15 million cases of smallpox in the world each year, a figure which had dropped from around 50 million cases a year in the 1950s.". I haven't found a good source for the claim that "two million died in that year" as yet.
• http://www.who.int/immunization/sage/nov2010_global_technical_consult_measles_eradication_durrheim.pdf and http://www.who.int/csr/resources/publications/PED_SmallpoxACVVR_report2013.pdf both make passing mention of the eradication of rinderpest, supporting the article... but I didn't find a great source on who.int for that claim.
• http://www.who.int/csr/disease/smallpox/en/ "Global Alert and Response (GAR), Smallpox" supports the article's claim that Smallpox was officially declared eradicated in 1979. The FAQ http://www.who.int/csr/disease/smallpox/faq/en/ says this occurred in December 1979.
• The article claims that "routine childhood vaccination was discontinued in the United States in 1972, and was abandoned in most European countries in the early 1970s". http://www.who.int/bulletin/volumes/84/2/editorial10206html/en/ "Bulliten of the World Health Organisation, Control, elimination, eradication and re-emergence of infections diseases: getting the message right" says that in 1980 routine smallpox vaccination was discontinued in all countries. http://apps.who.int/vaccine_safety/topics/smallpox/smallpox_aefi_cdc.pdf (a slideshow presentation) agrees that in 1972 US Routine childhood vaccination stopped, with routine health care worker vaccination stopping in 1976 and a halt to US vaccine production in 1982. http://whqlibdoc.who.int/smallpox/WHO_SE_73.58.pdf is something of an original source from 1973 I think that argues against the 1971 US Public Health Service Recommendation on Smallpox Vaccination, but I don't think clearly states a date when routine vaccination was discontinued.
• http://whqlibdoc.who.int/publications/a41438.pdf "The Global Eradication of Smallpox, Final Report of the Global Commission for the Certification of Smallpox Eradication, Geneva, December 1979" in its Foreward supports the article's claim that the eradication was certified on 8 May 1980.

 Fixed thanks to the miracle of the Wayback Machine. You're welcome to substitute in more recent sources and tweak the wording as required. Thanks, Adrian J. Hunter^{(talk•contribs)} 17:00, 8 April 2014 (UTC)

Hopefully I have put enough links and information here that someone a touch more competent could use them to replace the dead link and amend any text needing to change. Any takers? FuzzyBSc (talk) 15:56, 8 April 2014 (UTC)

Possible copyright problem

This article has been revised as part of a large-scale clean-up project of multiple article copyright infringement. (See the investigation subpage) Earlier text must not be restored, unless it can be verified to be free of infringement. For legal reasons, Wikipedia cannot accept copyrighted text or images borrowed from other web sites or printed material; such additions must be deleted. Contributors may use sources as a source of information, but not as a source of sentences or phrases. Accordingly, the material may be rewritten, but only if it does not infringe on the copyright of the original or plagiarize from that source. Please see our guideline on non-free text for how to properly implement limited quotations of copyrighted text. Wikipedia takes copyright violations very seriously. Diannaa (talk) 22:53, 29 March 2014 (UTC)

Does anyone know what material in specific this was in regards to? Less than useful notice without context.... Snow talk 02:32, 9 May 2014 (UTC)

Question

Is there anyone still alive who had 'wild' (as distinct from 'laboratory accident and similar') smallpox? 80.254.147.68 (talk) 16:32, 15 April 2014 (UTC) (Corrections due to usual computer snarly-ups) 80.254.147.68 (talk) 16:34, 15 April 2014 (UTC)

Presumably yes, particularly in Africa, Asia, and east Europe. But it is not clear how you could locate anyone. Wilcannia (talk) 02:52, 18 April 2014 (UTC)

Original resaerch for 'the proverbial someone' (when they have caught up with everything else). 80.254.147.68 (talk) 15:50, 13 May 2014 (UTC)

VARV Pathogenesis image from Plosone (macaque)

"Viremic blood is filtered through the spleen and liver following inoculation. Within 24 hours marginal zone macrophages and Kupffer cells begin expressing viral antigen indicating likely uptake and processing of the pathogen. When the immune response is effective these antigen presenting cells then traffic via the lymphatics to the lymph nodes where a hyperplastic response develops. Concurrently, trafficking to other preferred sites such as skin occurs, and lesions progress and regress as the ongoing adaptive immune response controls and clears the pathogen. In the face of an ineffective immune response, trafficking via macrophages also occurs, however, lymphoid necrosis rather than hyperplasia occurs, allowing unabated trafficking of the virus to other tissues. Infected cells undergo necrosis, pyroptosis, and/or apoptosis which, given the widespread state of infection, results in inflammation, hemorrhage and death.doi:10.1371/journal.pone.0024832.g007"

Uploaded this image to commons, if you wish to use it go ahead and add it to the article. CFCF (talk · contribs · email) 12:59, 6 June 2014 (UTC)

Edit Request: ordinary type and major/minor classification.

In lead picture "In ordinary type smallpox the bumps are filled with a thick, opaque fluid and often have a depression or dimple in the center."

It should say whether the type is major or minor.

Also the other picture

"Child showing rash due to ordinary-type smallpox (variola major)"

Does this mean that 'ordinary-type' = 'variola major' or that these are distinct classifications. This is somewhat confusing in the article

Macgroover (talk) 02:33, 17 July 2014 (UTC)

edit request

 Done

Regarding the sentence: "Fatality rates during outbreaks in Native American populations ere as high as 80–90%." This should be "Case fatality rates." As it stands, it sounds like 80-90% of the populations died. — Preceding unsigned comment added by 205.232.191.21 (talk) 16:06, 27 August 2014 (UTC)

That is exactly what it means, and adding the word makes no difference. Yet, I have made the edit because the source does use it. -- Brangifer (talk) 17:27, 27 August 2014 (UTC)

Smallpox and bodysnatchers

I read somewhere that one fear is that a 'sealed coffin' (whether or not against bodysnatchers) cracking and letting the virus 'escape.'

How feasible is this? 80.254.147.68 (talk) 13:38, 21 November 2013 (UTC)

Very low. More likely is that some of the stuff in vats in the former soviet union of the USA gets out. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:29, 21 November 2013 (UTC)

There are various stories about 'viruses' and 'corn etc seeds' found in sealed tombs being grown on in modern times (along with Grauniad Island). Are there any 'diseases' which could survive and be revived from such conditions (even discounting the SF/horror fiction staple) - assuming due precautions are taken with plague pits etc (regardless of known survival time of the disease causing organism). 80.254.147.68 (talk) 15:51, 21 November 2013 (UTC)

The fear that 'whatever killed them buried here might also kill me (so keep away)' is both rational and irrational. 80.254.147.68 (talk) 13:03, 5 December 2013 (UTC)

The question is whether smallpox virions could persist for decades or centuries inside a coffin containing a corpse, and retain their virulence. I'm not qualified to answer that, but it's worth framing the issue correctly. — Preceding unsigned comment added by 66.233.207.101 (talk) 00:55, 22 September 2014 (UTC)

Adding to the lead

A user wishes to add "on Ali Maow Maalin, in the Merca District, of Somalia. The source of this case was a known outbreak in the nearby district of Kurtuware. All 211 contacts were traced, revaccinated, and kept under surveillance." to the lead. This is already dealt well in the body of the article and in the lead is in my opinion undue weight. Others thoughts? Doc James (talk · contribs · email) 11:54, 5 February 2015 (UTC)

References

virus split

Should Variola virus get its own article? The section discussing it would be reduced in size and a lot of the information would be transferred to the virus article. ComfyKem (talk) 09:25, 16 March 2015 (UTC)

Section is not that long right now. Would be a good idea if it got larger though. Doc James (talk · contribs · email) 16:11, 16 March 2015 (UTC)

Smallpox and Native Americans

Supposedly, Native Americans suffered great losses of life because of Smallpox--more than any other population. If that's the case, why not add this information on this wiki? If not, I'll look up the numbers and edit it in myself. — Preceding unsigned comment added by 67.80.39.57 (talk) 14:00, 14 May 2015 (UTC)

Semi-protected edit request on 2 October 2015

Please add additional reference to this topic: Shurkin, Joel N. (1979): Invisible Fire: The story of mankind's triumph over the ancient scourge of smallpox. New York: G.P. Putnam's Sons ISBN 0-399-12286-9 Shurkin (talk) 19:05, 2 October 2015 (UTC) Shurkin (talk) 19:05, 2 October 2015 (UTC)

 Not done - From your username, you appear to be trying to promote your own book - Arjayay (talk) 20:17, 2 October 2015 (UTC)

Is v Was

The virus still exists. I don't understand why we are saying was in the intro? Gnevin (talk) 17:45, 12 June 2015 (UTC)

I agree that "is" would be more appropriate. Deli nk (talk) 18:25, 12 June 2015 (UTC)

The disease has not occurred since 1977 therefore "smallpox disease was an infectious disease" is better. This article is about the disease primarily rather than the variola virus which you are correct still exists. Either way get consensus first.Doc James (talk · contribs · email) 00:49, 15 June 2015 (UTC)

There is consensus . Much like we say The Wire is an American crime drama television series even though it's no longer being made . We also don't flip been is/was for rare genetic illness which may at certain points in time have not current cases. Smallpox could still in theory have an outbreak Gnevin (talk) 09:21, 15 June 2015 (UTC)

Smallpox is the only human disease that has ever been eradicated globally. "was" makes that a little more clear. Will ask for further input. Doc James (talk · contribs · email) 10:46, 15 June 2015 (UTC)

• support "was" I concur (the past tense "was" is appropriate in this case)--Ozzie10aaaa (talk) 11:40, 15 June 2015 (UTC)
• Support "was" I am coming in response to a post on WP:MED. Despite the virus existing there have been decades of healthcare propaganda which talk about the disease being eradicated and something in the past. The logic for this might be stretched as compared to other things but in the case of small pox writers using past tense for is normal. Blue Rasberry (talk) 13:01, 15 June 2015 (UTC)
• The chance that no one will ever get smallpox is not zero. The chances might be low, but it is something that governments and health organizations have taken seriously. In any case, as a matter of semantics, smallpox is a disease and always will be. It's a completely normal way of considering no-longer-existing things. Wikipedia says, for example, "Tyrannosaurus is a genus..." and it always will be. Deli nk (talk) 14:17, 15 June 2015 (UTC)
• Just be clear. Either "Smallpox was an infectious disease until its eradication" or "Smallpox is an eradicated disease" would work.LeadSongDog come howl! 15:16, 15 June 2015 (UTC)
• Support "is" - it will always be a disease but it was eradicated. I suspect it will pop up again due to its presence in collections that are probably not under impenetrable security. All you need is a coup. IF a case pops up sometime in the future, AND some low-income country medical worker comes to Wikipedia to check out the info on this disease and is re-assured that it no longer exists 'in the wild', the result could be disasterous...or am I just imagining a future science fiction plot for a medical mystery movie?

  Bfpage |leave a message  19:14, 15 June 2015 (UTC)

• "is a disease that has been eradicated". According to WHO: "Smallpox is an acute contagious disease ... smallpox was declared eradicated in 1980".[2] (And, btw, it hasn't really been eradicated, it's just a manner of speaking). Thincat (talk) 08:26, 16 June 2015 (UTC)

"is a disease believed to have been eradicated"

74.95.43.249 (talk) 19:01, 30 October 2015 (UTC)

• Is: "is a disease that has been eradicated", "is a disease believed to have been eradicated", or "is a disease that has been declared eradicated" all are fine. They accurately summarize the current situation in a grammatically correct way. In addition, I think there is a bit of medical hubris associated with "was". Edgeweyes (talk) 20:15, 30 October 2015 (UTC)

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Configure to hide page images

I haven't used this account in an extremely long time, I'm sad to say I logged back in to it specifically because I read that you could filter images by using an account. While I understand that not everyone will share the same opinions on the appropriateness of an image or if it should be censored, I simply don't want to see it myself and am trying to figure out how. I've added the following code to my custom CSS but have had no success so far in getting it to filter the images. If you could give me the correct code, I would appreciate it, and it would also make it easier for anyone else who does not want to view the images to do so.

body.page-smallpox img {display: none;} body.page-Variola img {display: none;} page-Variola img {display: none;} page-smallpox img {display: none;} — Preceding unsigned comment added by Dazric (talk • contribs) 18:03, 6 September 2016 (UTC)

Semi-protected edit request on 7 December 2016

I think it would be good if the images of smallpox cases were hidden by default and had a warning saying that they may cause discomfort. Many children use Wikipedia for educational purposes and may not be prepared to see images like these. 2607:FEA8:4EA0:F06:9ED6:43FF:FEB9:DEF6 (talk) 21:49, 7 December 2016 (UTC)

 Not done. Wikipedia policy, as described at Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_censored, says, "Wikipedia may contain content that some readers consider objectionable or offensive—​​even exceedingly so. Attempting to ensure that articles and images will be acceptable to all readers, or will adhere to general social or religious norms, is incompatible with the purposes of an encyclopedia." Hiding the images would be inconsistent with that policy. Deli nk (talk) 21:53, 7 December 2016 (UTC)

I agree, of course, and this issue had been discussed at length (see above). The consensus was that these images are important and should be retained. Graham Beards (talk) 21:58, 7 December 2016 (UTC)

Yeah, but maybe there should at least be a warning and a button to toggle the images. That way users who don't want to see the stuff don't have to install an image blocker extension. canine828 (talk) 22:15, 7 December 2016 (UTC)

See also link farm?

I think the See also section has become a little too "me too". It's supposed to be links to related articles, i.e. where one could find additional (possibly more detailed) information on the topic of this article. It could conceivably list any article in which the word 'smallpox' occurs, and it looks like that's occurred in some cases. I propose trimming the list by about half to just

• 1837 Great Plains smallpox epidemic
• Aral smallpox incident
• List of epidemics
• Smallpox 2002—film
• Smallpox demon

For example, consider the existing link to pandemic: rather than that general dictionary term, it would be better to list 'related'(?) pandemic diseases. We'd immediately have a couple dozen more entries, but they'd be better, more relevant entries than the term 'pandemic'. Along with pandemic, why not epidemic, pox, pox virus, vaccination, Edward Jenner, cowpox, variolation, polio (another almost eradicated disease), chicken pox, smallpox vaccine, germ theory of disease, and all the related animal pox (veterinary) diseases? They're all related. If they're related enough, maybe they ought to be summarized (and wikilinked) in the text, rather than listed without descriptive relevance in the See also section. (Actually, I just noticed that some like Biological warfare are already wikilinked in the text, and should not be listed separately in the See also section - I'll clean these out, and that'll help reduce the clutter).Sbalfour (talk) 18:55, 2 January 2017 (UTC)

Looking at the item CCR5-Δ32, a mutation of CCR5, a cellular protein expressed on lymphocytes that enables infection with HIV, and the Δ32 mutation confers immunity to HIV. It has been speculated that smallpox may select for that mutation, a role heretofore assigned to plague, based on European epidemiological data. The association is still hypothetical. Deriving this terse summary via the link is tedious. Sending the reader to a highly technical article to extract a fragment seems hardly justifiable. That mutation doesn't confer immunity to smallpox (the receptor for smallpox is unknown); it's about HIV. I suggest we cover this tidbit in the text (maybe under Virology section), or in the HIV article, and just delete the item from See also.Sbalfour (talk) 19:56, 2 January 2017 (UTC)

Looking at entries like 1837 Great Plains smallpox epidemic for smallpox epidemics, I added another one below. There are another handful of smallpox epidemics that have their own articles; about a dozen more that have sections in other articles, and maybe 50 other references to smallpox epidemics are mentioned in other articles, but don't have their own section. It has to be all or none here again. Most of these references are collected in List of epidemics. I think we have to let it go at that, and not attempt to list all the articles and sections, etc for the individual epidemics here. That's exactly what the list article is for. If it were worth doing, the list of smallpox epidemics could be split out into its own article. I'm going to delete the items for individual epidemics from the section.Sbalfour (talk) 20:36, 2 January 2017 (UTC)

Trimmed a few. Doc James (talk · contribs · email) 12:31, 3 January 2017 (UTC)

"Great Pox"

With the syphilis article, a photo of the pathogen is shown. The shame should be with variola major article. Allow for those motivated to scroll down and see images. It is not until "cause"-[[3]] the agent is shown. — Preceding unsigned comment added by 38.107.189.66 (talk) 00:07, 7 March 2017 (UTC)

smallpox vaccine scar, how about a pic?

• Unsigned, uncommented ancient message Jim1138 (talk) 23:50, 14 October 2018 (UTC)

— Preceding unsigned comment added by CorvetteZ51 (talk • contribs) 11:29 11 September 2011 (UTC)

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Suggestion

Would it be practical to have an image of a smallpox sufferer similar to that at the top of the chickenpox article at the top here, and move the other, more graphic, images further down the page? Thus those passing through (eg with the mention of smallpox on today's MP) will be less disconcerted on first coming to the page and skimming the intro - and they then have the choice of going further. Jackiespeel (talk) 11:47, 9 December 2017 (UTC)

Semi-protected edit request on 16 December 2017

Please read and edit this article for grammar mistakes. The first section has several, such as using "than" instead of "then," and the use of the wrong tense. I would change it myself but I'm not authorized to do so. Thanks. 2601:483:4100:3380:4493:CEF6:BD97:A3DF (talk) 15:10, 16 December 2017 (UTC)

Done DRAGON BOOSTER ★ 16:18, 16 December 2017 (UTC)

Past tense

Opening sentence, shouldn't it be Smallpox was?

Also, an indefinite semiprotection seems unwarranted for the level of vandalism that it was attracting and given good IP contributions at the time. Can we give it another shot please? 220.210.184.229 (talk) 12:09, 29 May 2011 (UTC)

Ditto as per above. Cooltrainer Hugh (talk) 00:24, 29 June 2011 (UTC)

The article alternates back and forth between past and present. SelectSplat (talk) 05:56, 13 August 2012 (UTC)

I would suggest that until we can confirm that all remaining samples of the virus have been destroyed, the article should be written in the present tense, because while it may eradicated in the larger world, the virus still exists. As long as the virus exists somewhere in the world, there is the potential, even if only a remote one, that it could reescape into the wild. Only when the virus no longer exists could it be considered completely extinct. — Preceding unsigned comment added by 66.233.207.101 (talk) 00:46, 22 September 2014 (UTC)

Agreed. The past tense comes across as "clever" and pretentious. Smallpox still exists in various places on earth, it's not like it's some thing that happened once in the past. It is a viral disease. – Acdx (talk) 23:40, 12 May 2015 (UTC)

I don't accept that past tense would be '"clever" and pretentious'. Chris Jefferies (talk) 08:48, 16 August 2018 (UTC)

Sure, but much of the article is about symptoms and prognosis, including words like 'usually' - this makes no sende when there are currently no cases of infection. 173.254.200.130 (talk) 14:18, 14 September 2015 (UTC)

Agreed. I propose converting the article to a consistent past tense. Chris Jefferies (talk) 08:48, 16 August 2018 (UTC)

Evolution under section Cause instead of History?

I was looking for that info, and knew it was in the article (because I wrote part of the section), and considered the evolutionary history to be part of History. Maybe instead of Evolution, the section should be renamed Origin, that makes it clear it's part of History. The 'Cause' of smallpox is the virus as it exists today, or at least has existed for a couple thousand years including diversification in the middle ages. Sbalfour (talk) 20:52, 24 November 2018 (UTC)

Under Disease emergence, we have "The earliest credible clinical evidence of smallpox is <some pox disease in 2nd millenium BC in India>." Since the study by Duggan et.al. in 2016 isolating a basal strain of the virus dated ~1650, it's clear that variola has not historically been the virus we consider the causative agent of smallpox today. How sure are we that pre-middleages poxes were smallpox? That basal strain wasn't Variola major or Variola minor. Sbalfour (talk) 21:30, 24 November 2018 (UTC)

Capitalize genus names?

Shouldn't variola major and variola minor in the lead be Variola major and Variola minor? We also have Variola major and Variola minor in the article. Someone should go thru check and fix all of these. MOS: Capitalize scientific names above the rank of species, and italicize them from the rank of genus downward. Sbalfour (talk) 21:39, 24 November 2018 (UTC)

Number of people killed

For a book I'm writing I researched the claim that "in the 20th century it is estimated that smallpox resulted in 300–500 million deaths". Wikipedia and newspapers will quote this figure, claiming "one group of experts" or "some experts" estimate this. But I haven't found any single expert actually estimating this. The sources provided in the article are not medical or disease experts, but politics books and the like. And they all claim "it is estimated", they don't include any real estimations.

Still, I think I know where the figure comes from. D. A. Henderson was the guy in charge of smallpox eradication at the WHO. In two separate places he once estimates that in the 20th century 200-300 million people were killed and in the last century of the existence of smallpox 'at least half a billion'.

• 1st figure is in Donald A. Henderson, “Smallpox Eradication,” in Microbe Hunters - Then and Now, ed. M. D. Hilary Koprowski and M. D. Michael B. A. Oldstone, 1 edition (Bloomington, Ill: Medi-Ed Pr, 1996), 39.

• 2nd figure is in D. A. Henderson and Richard Preston, Smallpox: The Death of a Disease - The Inside Story of Eradicating a Worldwide Killer, 1st edition (Amherst, N.Y: Prometheus Books, 2009).

So, yeah, I think that needs changing. Thanks, Lilchimy (talk) 14:08, 20 December 2018 (UTC)

OK I fixed it. Rjensen (talk) 14:35, 20 December 2018 (UTC)

Okay have formatted the new refs. Could not find the estimate in the WHO ref so removed it http://apps.who.int/iris/handle/10665/39485 Thanks User:Lilchimy Doc James (talk · contribs · email) 23:04, 20 December 2018 (UTC)

User:Doc James and User:Rjensen, it's back to 300-500 and the other references don't hold up: The CDC website doesn't say it and the other is a book about international relations, which I don't think should be our main source of info on epidemiology. I think the soundest formulation would be: "It is estimated that smallpox resulted in 200-300 million deaths in the 20th century (REF 1st figure) and at least 500 million deaths in the last 100 years of its existence.(REF 2nd figure) — Preceding unsigned comment added by Lilchimy (talk • contribs) 09:53, 23 December 2018 (UTC)

User:Doc James and User:Rjensen, I edited it with my proposal. Lilchimy (talk) 01:26, 23 February 2019 (UTC)

Thanks User:Lilchimy. Works for me. Doc James (talk · contribs · email) 08:34, 23 February 2019 (UTC)

Earliest evidence of the disease challenged in another article

See Ramesses V. Doug Weller talk 15:43, 15 August 2019 (UTC)

Origin of term "Smallpox"

Towards the top of the page, there is the claim 'The term "smallpox" was first used in Britain in the 15th century to distinguish the disease from syphilis, which was then known as the "great pox"'. That doesn't make a whole lot of sense. Syphilis was introduced to Europe only a few years earlier so why would they name a disease that had been known in the Old World for about 2000 years after one that had only shown up like 3 years earlier. The quoted paper is paywalled and cannot be verified. A paper that quotes the paywalled paper is available for access, but that quotes a book "Jenner and Vaccination" on page 26 that quotes History of the Smallpox from 1815, and that book comes to the conclusion that smallpox was named after the French "petite vérole" which was named in comparison to the black plague. Can an administrator change the article to fix this claim? ThanksCan an administrator change the article to fix this claim? Thanks — Preceding unsigned comment added by 77.56.210.240 (talk) 22:20, 3 November 2019 (UTC)

Origin of term "Smallpox"

The claim made in the 4th paragraph that the term smallpox emerged to distinguish the disease from Syphilis seems to be poorly supported. The citation provided for this claim is a medical journal article that cites an 1889 book titled Jenner and vaccination : a strange chapter of medical history for this fact. However, this book does not mention syphilis when discussing the origin of the term: https://archive.org/details/b21357067/page/26

I could find no other source that suggested the term smallpox has any connection to syphilis. The book instead states that the word smallpox, or rather "small pockes" was first used in 1577 as a translation of the Latin word pestilenia, and may also have originated from the French word petite vérole, which literally means "small pox" when translated.

The claim about syphilis should be removed, and possibly replaced with the explanation given in the book. — Preceding unsigned comment added by CrypticFox (talk • contribs) 22:58, 3 November 2019 (UTC)

• Agreed. However, there appears to be ample use of the term "great pox" to refer to syphilis in many other places on the Internet, often in contrast to "smallpox". Can these other instances also be refuted? It does remain a curious point that smallpox was known in Europe for centuries before the "great pox" (syphilis) appeared there, and the order of events does seem to be backward. A loose necktie (talk) 20:49, 6 November 2019 (UTC)

• ​Etymological dictionaries do give this explanation [4] – Thjarkur (talk) 13:29, 8 November 2019 (UTC)

Further images

There are some great ones here under an open license.[5] Doc James (talk · contribs · email) 19:35, 13 January 2020 (UTC)

Need for an introductory BOX

If a Virus Classification Box (usually, on the right-hand side) is given for the species Rinderpest (a.k.a. cattle plague) and for Viola minor (a subspecies of Smallpox), should not one be provided here as well?

And should this Wiki essay be also labeled as "Viola" or as "Viola major" so as to clarify matters? Dr.Bastedo (talk) 23:50, 16 March 2020 (UTC)

dedicated page for Variola Virus

I browse wikipedia trying to find an article on the virus that causes smallpox, Orthopoxvirus variola, but for some reason there is none. Is there any serious reason why there is no article on Orthopoxvirus variola, or do people not see it as important? I'm just curious. 🜚 Yatagarasu 🜚 01:04, 28 March 2020 (UTC)

I should also mention that Polio, Covid-19, SARS, and even WNF have pages dedicated to the viruses that cause them, I just forgot to mention that in the OP 🜚 Yatagarasu 🜚 01:11, 28 March 2020 (UTC)

The organization of pages inconsistent. Editors apparently don't see it as being particularly important. WhatamIdoing (talk) 22:07, 4 June 2020 (UTC)

CEO Yatagarasu 4567, a redirect would be appropriate. The virus and the disease are only one subject, really. Guy (help!) 16:24, 5 June 2020 (UTC)

We have a single page for rotavirus. I agree with adding a redirect. It would work here. Graham Beards (talk) 16:36, 5 June 2020 (UTC)

Involuntary exposure to extremely disturbing images in this article

If I want to read an article about a disease or any other disaster or hazard, I don't want to be surprised with the worst possible disturbing image of the most severe cases in the front page that will haunt me for days and prevent me for reading the information for which I came. Hide the image at least with a warning that something extremely disturbing will pop up. 87.116.178.123 (talk) 23:59, 13 March 2020 (UTC)

I am adding this comment. I am browsing another Wiki article, that references the Smallpox article. My mouse only hovers over it, and this horrifying image pops up: https://imgur.com/CHHyyxS Please, I beg you: if you put microscopic virus images or other non-gross stuff as main images in other contagious diseases' articles, do the similar about this one. I cannot be the only one to be disturbed by this. 87.116.178.123 (talk) 08:46, 22 March 2020 (UTC)

I can see no good justification for a mouse hover on a totally different article to show disturbing *unrelated* content. Censorship is a slippery slope, but we know that violent, sexual, and medical images (as well as images of the death and suffering) can be disturbing. Showing them in content not directly related to the image is just plain wrong. It should be obvious to all that a 'mouse hover' can't meet that criteria for relevancy (without some sort of rating mechanism). Incidentally, I'd be "ok" if the pop-up from the mouse hover had a show/hide button for 'possibly disturbing' images - as long as the default is 'hidden'. Assuming that the link can't be changed, and the image selection can't be, either, then the image i n the Box should be changed. It need not be there.174.130.70.61 (talk) 18:08, 5 June 2020 (UTC)

Long-term prognosis

I think this page should be expanded a little to talk about the long-term psychosocial outcomes. Smallpox scarring had really significant effects on people's lives. If you ended up with significant facial scarring, people looked at you with disgust for the rest of your life. The disgust people felt when they saw your scarred face meant reduced marriage prospects, problems getting hired, fewer friendships, and all sorts of other social difficulties. I don't have any sources at hand, but IMO it would be worth putting this "patient perspective" into the article. WhatamIdoing (talk) 22:14, 4 June 2020 (UTC)

Yes indeed. For those who survived, the scarring was life-long. See Joseph Stalin face for example.Graham Beards (talk) 22:21, 4 June 2020 (UTC)

And we all know where that led. EEng 19:40, 14 June 2020 (UTC)

If I will need a picture of a disease effect on human I will find it without Wikipedia.

No longer a productive conversation

Can you please remove NSFW title picture? This is very ugly and inappropriate. All such pictures need to be put in a special section in all ilnesses articles. Thx. — Preceding unsigned comment added by 46.34.142.117 (talk) 07:52, 12 April 2017 (UTC) Wikipedia is not censored. If you do not want to see images, possibly helpful instructions are located here. Regards, Xenophrenic (talk) 18:14, 12 April 2017 (UTC) This is an article about a disease, if people are squeamish about seeing pictures of the effects what are they doing looking it up in the first place? Czarnibog (talk) 22:20, 14 October 2018 (UTC) Do articles related to pornography have explicit NSFW pictures next to the title, following the same logic?87.116.178.123 (talk) 08:23, 22 March 2020 (UTC) The particular picture is a poor choice, since it illustrates the absolute worst case and doesn't aid the illustration of the diseases' common effects. because it is so graphical, it is – in my opinion – rather off-putting, since many people are unlikely to actually study the picture (or even the whole article). This defies the purpose of Wikipedia as an encyclopedia. Also, consider that this article pops up when you search for "Smallpox" in search engines. I wouldn't remove the image, just move it to a different part of the page, possibly to its own section (e.g. "Images"). Wikipedia not being censored doesn't mean that unsuitable images have to be in the infobox at the top section of the page. TucanHolmes (talk) 13:40, 11 July 2019 (UTC) I suggest switching the image with the black-and-white picture in the Signs and symptoms section, in accordance with the style manual's section regarding offensive images and a consideration of the guidelines for MOS:LEADIMAGE. If there are no reasonable objections that go beyond a simple invocation of WP:UNCENSORED, I will perform the switch myself. TucanHolmes (talk) 21:54, 30 May 2020 (UTC) I object. How is the image either vulgar or obscene ? The inclusion of this image has been debated at length before see [6]. Graham Beards (talk) 22:05, 30 May 2020 (UTC) To me, the point that matters is whether it is a representative depiction of the disease. As indicated in the discussion linked to by Graham, sadly, that appears to be the case. I don’t see any ground to move it therefore. DeCausa (talk) 22:30, 30 May 2020 (UTC) I have read that discussion, and while I do agree with the sentiment that this is a horrible disease and needs to be represented as such, the number of valid concerns by users who did not expect this image to appear when searching for "Smallpox" on Wikipedia (or even worse, search engines) weighs heavily. I am particularly concerned with the following passages from the aforementioned MOS:LEADIMAGE: Lead images should be of least shock value; an alternative image that accurately represents the topic without shock value should always be preferred. For example, using an image of deportees being subjected to selection as the lead image at this version of Holocaust is far preferable to the appropriate images that appear later in the article that show the treatment of the prisoners or corpses from the camps. / Sometimes it is impossible to avoid using a lead image with perceived shock value, for example in articles on human genitalia. Editors may assume, per Wikipedia:Content disclaimer, that readers are aware that such articles may contain such images. — MOS:LEADIMAGE However, I would argue (given the many reported reported cases of shock), that such awareness can not be assumed, and that because alternative images that accurately represent the topic without (or with less) shock value do exist, a simple image swap with another image from the same article is justified. TucanHolmes (talk) 22:37, 30 May 2020 (UTC) That's illogical. How many readers have reported not to be shocked by the image? It is also a Featured Picture on this and several other Wikipedias and the Commons Wikipedia:Featured picture candidates/Smallpox [7]. Reviewers comments included: "Very powerful", "A stunning candidate. Horrific, but amazing", "very powerful" and "Terrifying, but very educative". "I'm sure that people after seeing this will be happy that they live in a generation that no longer has smallpox." This thread is over three years old and there is no consensus to change the image.Graham Beards (talk) 09:52, 31 May 2020 (UTC) Again, I am not suggesting to remove the image, but to simply move it down a section and replace it with the image currently in that section, in accordance with the style guide for lead images. Other Wikipedias that do feature the images do so in a less prominent way, for example the German wikipedia. Lead images should be of least shock value; an alternative image that accurately represents the topic without shock value should always be preferred. TucanHolmes (talk) 11:14, 31 May 2020 (UTC) I don't think the other image that clearly shows Variola major is less "problematic". The ones that show Variola minor and the hemorrhagic form are not representative. If there is a consensus to swap the image, I will concede.Graham Beards (talk) 11:28, 31 May 2020 (UTC) How about File:Smallpox_child.jpg? It would be helpful for someone to just ask 5-10 random people what are their reactions to this photo (that is, current title picture) (if it wasn't done in previous discussion) so we have a clearer picture of the prevalence of the nagative reaction. As for me, I had a very strong visceral response to the specific image (more than any other wikipedia image), to the point of not being able to view the article, or quickly scrolling down not to see it. Had to see it many times to be able to look at it for more than a second. Now I'm fine with it, but I think many will just give up and escape rather than go through a self-administered exposure therapy. This is not my vote to replace (move down) this image, I just say that there is a real tradeoff. Also, how is it that there is no pornography in Pornography? I'm shocked to learn that, how did it happen? Where are the wikipedia ideals? – attomir (talk | contribs) 12:32, 31 May 2020 (UTC) ; edited 18:04, 1 June 2020 (UTC) I would be willing to conduct such a survey. However, I am still partially in lockdown, so it will take some time. If somebody else wants to get some numbers on this, please do so. If people's reactions don't clearly indicate that other images have a reduced shock value, I would keep the current lead image. TucanHolmes (talk) 12:49, 31 May 2020 (UTC) Please remember to comply with Wikipedia:Canvassing or any consensus might be deemed invalid.Graham Beards (talk) 12:55, 31 May 2020 (UTC) I’m not sure what the point would be per WP:VOTE or do you mean opening an RfC? DeCausa (talk) 15:28, 31 May 2020 (UTC) I meant asking ordinary people whether they feel a strong reaction, to see whether it is common or all the people who complain here are just a loud minority of faint-hearted outliers. This is to gain perspective and inform any possible further decision. And I'm not volunteering to do any survey myself, just inventing ideas for others to implement. – attomir (talk | contribs) 22:05, 31 May 2020 (UTC) Why did your edit summary say “have you heard of ordinary people”? As an insult it’s simultaneously pointless and dumb.DeCausa (talk) 22:13, 31 May 2020 (UTC) Were it an insult, it would have been a pointless one. That is correct. – attomir (talk | contribs) 17:54, 1 June 2020 (UTC) Were you not being disingenuous, your edit summary would remain a pointless and crass question. As far as your idea is concerned, I don’t believe it has any value. Unless YouGov is to be commissioned for the “survey”, it would be as informative as a self-selecting Daily Mail online poll. I don’t think it would have much influence on WP editors’ consensus, which is the only way the picture position could change. There has been a consistent consensus over long period to retain the picture in the current position and the only way that that might change is soliciting a wider input through an RfC. My own view is that I would oppose any change in an RfC because the picture’s representative quality overrides any squeamishness which I find to be disturbingly trivialising given the context of the tragedy of this disease. DeCausa (talk) 19:40, 1 June 2020 (UTC) it would be as informative as a self-selecting Daily Mail online poll - that was the explicit goal I had in mind, to escape from self-selection. squeamishness which I find to be disturbingly trivialising - this I do not understand. A reaction is a reaction, it has no intent. – attomir (talk | contribs) 20:38, 1 June 2020 (UTC) There was no reference to intent to my post. Using the supposed reaction to determine how a perfectly legitimate image should be used trivialises the tragedy in my view. Having a goal of escaping from self-selection doesn’t alter the fact that an “amateur” attempt at an opinion survey without the rigour applied in professional opinion polls will always generate a misleading result. DeCausa (talk) 20:56, 1 June 2020 (UTC) I see your point. However, the goal of whatever external input being gathered will not be to inform consensus, but to provide some data for the discussion of the picture's shock value. This issue has been brought up again and again, and the usual defence for the current picture is: "It provides representative quality". As was outlined multiple times (see MOS:LEADIMAGE and the above parts of the discussion), this is not the only thing that should inform our choices here, because we are, again, not talking about just any image, but the lead image of the article. Nobody questions that the image should be a prominent part of the article (One proposal was to feature it in the "Signs and Symptoms" section). The only concern is that the image is too prominent—because it's the lead image, it shows up in thumbnails for this article, it's the first thing you see when you open it, and it shows up on every Google search for "Smallpox"—and I understand that some people think that's a good thing, given that this is a horrific disease. The problematic thing about this image is that people do not expect something like this to come up without warning (again, see MOS:LEADIMAGE), as evidenced by the number of people (specifically non-registered users of Wikipedia) who have said exactly that. This is a disease, but the difference ("gap", so to speak) between what users expect (symptoms of a disease, maybe pictures of its agent) and what users get (something that could be straight out of a modern horror movie) appears to be just too stark. Because other images that accurately represent the topic—but have less shock value—are available, more information about how (or if) a possible swapping of images would influence the shock potential of the article would be helpful. TucanHolmes (talk) 07:38, 2 June 2020 (UTC) A RfC will need to be opened on this if the placement of the image remains contested. I will strongly oppose moving the image. Frankly, I find sentiments about "shock" and "horror films" trivialises the subject. This disease ravaged victims for centuries until it was eradicated by a combined effort that is an enduring tribute to the fundamental goodness of humanity. I am almost certainly the only person on this page to have seen person with smallpox. Please stop this "Oh, I don't like that" sensibility. Would you apply similar arguments to the lead images here?Graham Beards (talk) 19:34, 2 June 2020 (UTC) This is a misrepresentation of what my actual argument was, and doesn't address any of the issues raised about the picture. I would apply similar arguments in the article you've mentioned, if that was necessary. However, no user, especially no external user, has commented about that article's lead image, and it is presented very differently (as not one prominent picture, but multiple pictures). Additionally, people will expect pictures of terror when they search for information about a terror attack. The same can not be said about the picture employed in this article. See MOS:LEADIMAGE. TucanHolmes (talk) 20:44, 2 June 2020 (UTC) Nonsense. I am tired of arguing in circles with you. Open a RfC if you feel so strongly. Graham Beards (talk) 21:07, 2 June 2020 (UTC) This is just WP:IDONTLIKEIT: ”people will expect pictures of terror when they search for information about a terror attack. The same can not be said about the picture employed in this article.” Why not? What would they expect in article about a tragic and horrific disease. It’s inherent in the subject matter and I don’t think we should be sanitizing to pander to trivialising squeamishness. I share Graham’s frustration. DeCausa (talk) 18:51, 3 June 2020 (UTC) MOS:LEADIMAGE. TucanHolmes (talk) 17:24, 4 June 2020 (UTC) Literally the third sentence in WP:IDONTLIKEIT contradicts what you just said: Content on Wikipedia is judged based on its compliance with policies and guidelines, not its physical appearance. Once you can make all the content comply, you can then work with that and tidy it up. TucanHolmes (talk) 17:28, 4 June 2020 (UTC) As for my idea for someone to just ask 5-10 random people what are their reactions to this photo: Actually I've collected some results. Before I show them, I'd like to quickly ask a question to the participants of this discussion: how many readers would need to be disturbed by the image (and in what way) for you to find it unacceptable? Half? One in five? 1%? – attomir (talk | contribs) 15:51, 4 June 2020 (UTC) Your "results" are not helpful, sorry. Wikipedia does not work that way.Graham Beards (talk) 15:56, 4 June 2020 (UTC) MOS:LEADIMAGE. TucanHolmes (talk) 17:24, 4 June 2020 (UTC) Attomir, the reason that it's not helpful to count the number of people who are disturbed is because Wikipedia's purpose isn't to prevent people from being disturbed. The goal is to educate people. People who see that image will learn, with no more than a quick glance, that smallpox was a disgusting, disfiguring disease. That's one of the things people need to learn on this page. WhatamIdoing (talk) 22:02, 4 June 2020 (UTC) As you can see below, I (and 7 other people) now agree with you. However I'll still argue with you gratuitously, because why not? :) I asked the question "what proportion is ok?" because people reported things like will haunt me for days and prevent me for reading the information for which I came. I trust such reports and understand they are not willed, but physiological (though can be overcome). Wikipedia already caters to some cultural norms (lack of pornography on Pornography and tameness of beheading and similar articles was mentioned here), and in the end it is meant to be read by fallible human beings. So I think it warrants more than a simple dismissal. In the end our response to this harm can be "it's your problem", but I wouldn't like it to be the default one. – attomir (talk | contribs) 22:47, 4 June 2020 (UTC) As promised, here it is. The statistical power was not too great, but for me it is enough to stop being involved in attempts to swap the photo. – attomir (talk | contribs) 22:19, 4 June 2020 (UTC) Abstract: Seven subjects were tested for the possible adverse effects to viewing current title image of Smallpox article. No strong adverse reaction was observed in any of them, which suggests that likely below 13% and at most 30% of viewers would have difficulty looking at the photo. In additional discussion with some of the subjects, all preferred the original picture over the alternative one. Prevalence of adverse reactions to title photo of Smallpox article on English Wikipedia Introduction: Once in a while someone comes to Smallpox article's talk page and demands the title picture (File:Child_with_Smallpox_Bangladesh.jpg) to be removed or changed, citing emotional distress. As I myself was unable to look at the very picture for more than a second, I conjectured that this reaction is rather prevalent, and it prevents people from reading the article. Materials and methods: Participants were a convenience sample of 7 acquitances of mine, 6 male, 1 female, aged 20-40, WEIRD. I've shown the title picture to each participant on a smartphone, holding it in front of them. The participants were in the same room, so later participants may have overheard discussion with previous ones. I've discussed the subject and shown the alternative photo (File:Smallpox child.jpg) to some. I looked for any revulsive reaction, inability to stare at the photo for over a second, signs of irritation or anger at me along the lines of "Why are you showing it to me? Why do you want to hurt me?" and all other reactions that would suggest the diminished ability to read the content. Results: During the experiment: I've shown the photo to first subject (S1). There was no adverse reaction. When asked about his feelnigs, S1 said "this person must be very ill". When asked about alternative photo, S1 did not prefer it, saying that it does not show the disease adequately and it's hard to tell what the photo is about - "is it about that the girl is poor?", as the disease was not easily visible. I've shown the photo to S2 and S3 in sequence. They did not react visibly. In discussion they said they did not find the image very revulsive, but understood that someone may feel that way. I've shown the photo to S4. She looked at it for quite a while, first not recognizing a human, but something resembling an earth crust. She found the photo "strong" but appropriate. When shown alternative photo, she said that it was more "artistic" and less suited for wikipedia, which is more factual. Subjects S5-57 were shown the photo as a group, did not react negatively, and did not prefer the alternative picture. Mathematics: With 0 observation of 7, the prevalence of adverse effects is at most 28% at 95%CL (Wilson interval). Using bayesian analysis with uniform prior, the 95th percentile of the posterior distribution is 31.2%, with 66th percentile at 13%, median at 8.3%. Discussion: None of the 7 participants have shown any strong bad reaction to the photo, which would interfere with reading content. Generalizing, it would suggest that the proportion of such reaction is unlikely to be over 13% and very unlikely above 31.2%. In addition, none of the participants preferred the swapping of title image with the alternative image. This suggests that adverse reactions are not too prevalent. It remains to be determined what prevalence would be unacceptable. More research is needed to obtain narrower limit on the proportion of people who react negatively to the photo. Preregistration: Did not preregister the protocol, as the study was rather spontaneous. COI: Lead author was actually interested in a different outcome, one which would not suggest that they are faint-hearted. There seems to be a misunderstanding towards my stance on the image's position as lead image. I do not have any personal issues with it. The only issues are those in conflict with a guideline (MOS:LEADIMAGE), indicated by the fact that this is a recurring problem, and the continuing complaints from ordinary users. If the image's position and presentation was totally compliant with Wikipedia guidelines, we would not have to have this discussion. TucanHolmes (talk) 17:34, 4 June 2020 (UTC) Can you stop monotonously answering LEADIMAGE to everything: Firstly, it’s a guideline not a policy. It can be optional. Secondly, as with many guidelines, it’s written intentionally to be flexible. So, it says use the least shocking image except when not possible because of the article context. Thirdly, least shocking is a subjective opinion. You think there is a conflict with LEADIMAGE. I don’t. So every time you give LEADIMAGE as the “answer” to a point, I just think you haven’t answered the point. DeCausa (talk) 17:56, 4 June 2020 (UTC) {{outdent}] You cite WP:IDONTLIKEIT when I bring up the issue of least shock value, which specifically states that images should not be kept on the basis of personal opinion, but rather according to policies and guidelines, but then proceed to say that guidelines don't matter. The reason I cited that style guide is that it's the one thing we should try to solve: Whether an alternative image is preferable to the current one, and you keep dodging it. I have no personal opinion on whether there's a conflict with MOS:LEADIMAGE, I am just reacting to users who think there is, because they have been subject to an issue with certain lead images which the style guide specifically says should not occur. This is why I (and others) believe we should get more external views on this. You have not once stated why this image should be preferred over alternative images which are equally representative of the article, but with less shock value, or why it's presentation shouldn't be altered in some way. The only reasons you give can be reduced to "I think it's good", which is something the rule you yourself cited (WP:IDONTLIKEIT) specifically dismisses. TucanHolmes (talk) 19:48, 4 June 2020 (UTC) We are at loggerheads. There is no point in your constantly referring to LEADIMAGE (I have lost count how many times), which is a flexible guideline. I don't think you know much about smallpox and that is why you remain unconvinced that the image is appropriate. And, for the same reason, you cannot know about "alternative images which are equally representative". I suggest you read WP:BLUDGEON. As I have said (twice), either open a RfC or move on. I will request an uninvolved admin to close this discussion.Graham Beards (talk) 20:30, 4 June 2020 (UTC) I have made a request at WP:ANI. See [8]. Graham Beards (talk) 20:44, 4 June 2020 (UTC) Perhaps this page should get a {{faq}} at the top. I'd suggest something that acknowledges that people feel disgust, and tells them that's because it was a disgusting disease. WhatamIdoing (talk) 22:05, 4 June 2020 (UTC) That's a great suggestion. Maybe that will prevent this issue from continually resurfacing, and address users (especially non-registered ones) who take issue with the image. Maybe put in a link to the page Xenophrenic has mentioned in the beginning (that one). TucanHolmes (talk) 10:19, 5 June 2020 (UTC) Graham Beards, the solution is for those who oppose the current image to propose a better one via an RfC. In the end, this is Wikipedia, we're not censored, a medical article is expected to contain gross shit and the image is tame by comparison to the more than a quarter of a billion people who died of the disease in the 20th Century alone, but let people bring a better one and gain consensus for it. Guy (help!) 22:09, 4 June 2020 (UTC) Thanks. I agree. Graham Beards (talk) 22:30, 4 June 2020 (UTC) I agree too. DeCausa (talk) 06:34, 5 June 2020 (UTC) Since a user has now actually surveyed non-registered Wikipedia users, I will rest my case, since the complaints by users here seem to be outliers. I have conducted a similar survey, and got similar results. As for the bludgeoning, you do not seem to actually read my comments, instead arguing with a version made of straw, which is why I am forced to constantly clarify points. If you actually read them, you would know I don't take any personal issue with the image, but instead tried to discuss a guideline, and whether any actions should be taken. Also, please do not try to assess my knowledge of a particular subject without knowing anything about me, but try to argue on the subject instead (WP:TALKNO). TucanHolmes (talk) 10:12, 5 June 2020 (UTC) Are there any objections towards the inclusion of a FAQ section at the beginning of this talk page for users who take issue with the image, as was mentioned here? TucanHolmes (talk) 16:25, 5 June 2020 (UTC) I agree in principle. The wording would require consensus. Graham Beards (talk) 16:30, 5 June 2020 (UTC) I've started the FAQ. It's at the top of the page. Anyone can edit it, just like an article. Please try to keep it short. The longer it is, the less likely people are to read it. WhatamIdoing (talk) 18:36, 5 June 2020 (UTC) Why was this 3 year old thread necroed? Few people care enough to complain. In my own view the image is fine, and Toucan should drop the matter Hemiauchenia (talk) 15:44, 6 June 2020 (UTC) Had already been solved before your comment. TucanHolmes (talk) 21:39, 14 June 2020 (UTC)

Semi-protected edit request on 14 August 2020

Please change the introduction's comment on blindness. The source says "In 18th century Europe, a third of all reported cases of blindness was due to smallpox." It doesn't say anything about how many smallpox victims became blind. It says that one-third of blindness victims were blinded by smallpox. Something like "In 18th-century Europe, it is estimated 400,000 people per year died from the disease, and one-third of the blind population had lost their sight to the disease" would be a good way to word the introduction's sentence. 64.203.187.98 (talk) 16:31, 14 August 2020 (UTC)

 Done more or less. Nice catch! –Deacon Vorbis (carbon • videos) 17:09, 14 August 2020 (UTC)

Organization of the lead

I suggest following the flow of the whole article (general intro. & symptoms before causes, diagnosis, prevention, treatments and epidemiology ), as do in many other disease-related articles. Biomedicinal (talk)

Verb tenses

Since the disease is certified as eradicated by the World Health Organization, I can understand the use of past tenses in the descriptions of the signs and symptoms for the four different classifications of smallpox, and elsewhere throughout the article. However awkward the past tense(s) seem(s) to me, given that the vast majority of disease descriptions on Wikipedia are not put in a past tense, it is important for there to at least be consistent use of past tenses. It seems there is some confusion between the present perfect tense and various past tenses, which makes the reading of the article exceedingly awkward and confusing. Sotuman (talk) 15:42, 26 January 2020 (UTC)

I completely agree with you Sotuman. Past tense is for when something doesn't exist anymore. The virus is being held in two labs right now so it clearly still exists, hence we should not be talking about it in the past tense. No one has had the disease for a long time, but they theoretically could get it from one of those two labs, hence we shouldn't be referring to the disease in the past tense until there are no known samples of it. Archlinux (talk) 14:07, 4 February 2020 (UTC)

You mean samples of the virus I presume. Graham Beards (talk) 14:17, 4 February 2020 (UTC)

Yes I did, thank you. To expand on my previous comment, imagine the unlikely but entirely conceivable scenario in which a sample of the virus from one of the two labs managed to infect an individual. The article would immediately have the wrong tense, at least for the duration of that persons illness. It is bold to assume that just because no one has been infected for 40 odd years that no one will ever be infected again, ever, for the duration of humanity, which is what past tense implies. Maybe when all samples are declared destroyed can we be bold enough to assume that the disease is gone for good. Archlinux (talk) 11:53, 20 February 2020 (UTC)

I don't really have a preference but if pushed I would stick with the past tense. If someone is unfortunate enough to become infected, we can easily change the tenses. (Indeed, that would be the very least of our concerns).Graham Beards (talk) 12:10, 20 February 2020 (UTC)

Surely just because there is a possibility it might re-emerge, that isn’t a reason to move away from the past tense as of now. Imagine Witch-burning in the UK. Would we use the present tense because it was theoretically possible it could happen again? I couldn’t think of a reason why that analogy doesn’t apply - but may be there is one. DeCausa (talk) 16:50, 20 February 2020 (UTC)

I think (granting from the start that the tense choices here have a reasonable basis) that I agree with Sotuman's original contention that the tense choices are jarring. Of course, once the (reasonable) decision was made to extend the past tense beyond the "history of the disease" section of the article into the symptoms, mechanism discussion, etc., it's messy drawing a line. But in my view it really clanks when one reads, for example, "smallpox virus preferentially attacked skin cells"; this didn't, except in a *very* particular reading, stop being the case in 1979.

I also think arguing the significance of the lab samples is perhaps a side-excursion that could be argued in either direction when the objection is mostly one of style expectations. If we're talking about the way one organism infects, damages, causes such and such a case fatality rate in another organism, including in the abstract or hypothetical sense, the conventional style is present tense—if for no other reason than that only smallpox and rinderpest are in this unique situation where an alternative tense choice is reasonable. I don't think anyone would be comparably jarred by the use of the present tense simply because it can be understood to be an abstraction. 156.57.136.144 (talk) 07:24, 7 October 2020 (UTC)

Although smallpox has been eradicated in the wild, it is inappropriate and misleading to use the past tense for this article. As long as live samples of the variola virus remain preserved in Atlanta and Koltsovo, the variola virus remains capable of infecting humans. From a biological warfare standpoint, smallpox is and has always been considered a threat of the highest priority. Furthermore, incidents such as the 2014 discovery of unsecured vials of smallpox virus in Bethesda, and the 2019 lab accident in Koltsovo should serve to remind us that an outbreak can occur as the result of an accidental or deliberate release of this virus. The COVID-19 pandemic has demonstrated our inability to contain outbreaks of even a moderately infectious virus in immunologically naive populations. The infectivity of the variola virus dwarfs that of SARS-CoV-2, and it is entirely possible that a smallpox outbreak could lead to a worldwide pandemic of unprecedented scale. Military, emergency medical services, and health care facilities of every major country teach and train for this threat on a regular basis. It is our resonsibility to convey these facts to the reader. DiverDave (talk) 15:11, 4 December 2020 (UTC)

History?

The article currently (Feb 2021) states that inoculation started in the 1500s in China, but if I recall different virology textbooks, the practice was most likely significantly older than 1500 (well, variolation at the least). Could someone review this and check on it? Right now I am not entirely sure if that statement is accurate; would not hurt to add more sources to it as well. 2A02:8388:1602:6D80:3AD5:47FF:FE18:CC7F (talk) 09:38, 22 February 2021 (UTC)]

It says "Accounts of inoculation against smallpox in China can be found as early as the late 10th century, and the procedure was widely practiced by the 16th century, during the Ming dynasty.[52]", and a reference is given. There is evidence that the technique was in use as early as 1000 CE, but the method was not described in Chinese medical texts until the sixteenth century. Graham Beards (talk) 10:47, 22 February 2021 (UTC)

Viewer protection?

The profile picture of this page can be disrupting to some viewers, therefore I recommend that some form of warning be placed ahead, or that it gets replaced by a less-striking image. Windywendi (talk) 09:10, 7 June 2021 (UTC)

Smallpox is estimated to have killed up to 300 million people in the 20th century[16][17] and around 500 million people in the last 100 years of its existence,[18] including six monarchs.[10][15]

Doesn't it sounds a little conflicting? 20th century is pretty much the last 100 years minus 21 years. Does it mean 300 million were killed on 20th century and the rest 200 million between 1897-1900? What monarchs? Citation links 10 and 15 don't seem to have the source anymore. — Preceding unsigned comment added by Vgrinberg (talk • contribs)

The last case was in 1977 so the last century includes 1877–1900. The first link [9] in reference 10 works. It says: "Smallpox killed Queen Mary II of England, Emperor Joseph I of Austria, King Luis I of Spain, Tsar Peter II of Russia, Queen Ulrika Elenora of Sweden, and King Louis XV of France." PrimeHunter (talk) 03:13, 17 September 2021 (UTC)

Thanks for replying yes, correct. Only according Wikipedia Queen Mary II of England died in December 28, 1694; Emperor Joseph I of Austria death was a result of developing pneumonia of the right lung several days after catching a cold while walking in Schönbrunn Park with the King of Bavaria.[38]; King Luis I of Spain died in 31 August 1724; Tsar Peter II of Russia died in 30 January 1730; Queen Ulrika Elenora of Sweden died in 24 November 1741; and King Louis XV of France died in 10 May 1774 — Preceding unsigned comment added by Vgrinberg (talk • contribs)

It's Joseph I, Holy Roman Emperor in 1711, not Franz Joseph I of Austria. You are right about the time. Adrian J. Hunter changed "as well as six monarchs" to "including six monarchs",[10] incorrectly indicating the monarchs died in the last century of smallpox. It seems confusing to have it in the same sentence. I have changed it to a new sentence saying "Earlier deaths included six monarchs".[11] PrimeHunter (talk) 22:46, 18 September 2021 (UTC)

I see what you mean. Thanks for this, PrimeHunter. Adrian J. Hunter^{(talk•contribs)} 12:05, 20 September 2021 (UTC)

30% Mortality isn't supported by citation

In the title card, citation [5] which is next to the claim of 30% mortality links to the CDC website (https://www.cdc.gov/smallpox/symptoms/index.html) which only lists symptoms and does not list any percentages on mortality. In-fact, it makes absolutely no mention of mortality whatsoever and seems like an inappropriate citation of which to base the claim.

The citation requires the appropriate citation warning or a suitable replacement, neither is possible for me given the locked page. — Preceding unsigned comment added by 79.71.235.134 (talk) 12:54, 12 October 2021 (UTC)

Reference 29

The referenced material says nothing about being closer than 6 feet. 68.70.15.145 (talk) 00:03, 18 November 2021 (UTC)

smallpox no longer exists in nature

can we include this info in the intro because most people simply do not understand "smallpox no longer exists in nature" - i think simple english can help — Preceding unsigned comment added by 2601:646:9A80:EA0:3D4A:D8F5:CB34:90A7 (talk) 03:22, 5 May 2022 (UTC)

from wikipedia itself:

"The concept of disease eradication is sometimes confused with disease elimination, which is the reduction of an infectious disease's prevalence in a regional population to zero, or the reduction of the global prevalence to a negligible amount. Further confusion arises from the use of the term 'eradication' to refer to the total removal of a given pathogen from an individual (also known as clearance of an infection), particularly in the context of HIV and certain other viruses where such cures are sought." — Preceding unsigned comment added by 2601:646:9A80:EA0:3D4A:D8F5:CB34:90A7 (talk) 03:28, 5 May 2022 (UTC)

Semi-protected edit request on 11 May 2022

ADD the following section under the Virology subheading:

Genome Composition

The genome of Variola major is about 186,000 base pairs in length. It is made from linear double stranded DNA and contains the coding sequence for about 200 genes. The genes are usually not overlapping and typically occur in blocks that point towards the closer terminal region of the genome. The coding sequence of the central region of the genome is highly consistent across orthopoxviruses, and the arrangement of genes is consistent across chordopoxviruses

The center of the Variola genome contains the majority of the essential viral genes, including the genes for structural proteins, DNA replication, transcription, and mRNA synthesis.The ends of the genome vary more across strains and species of orthopoxviruses. These regions contain proteins that modulate the hosts’ immune systems, and are primarily responsible for the variability in virulence across the orthopoxvirus family. These terminal regions in poxviruses are inverted terminal repetitions (ITR) sequences. These sequences are identical but oppositely oriented on either end of the genome, leading to the genome being a continuous loop of DNA Components of the ITR sequences include an incompletely base paired A/T rich hairpin loop, a region of roughly 100 base pairs necessary for resolving concatomeric DNA (a stretch of DNA containing multiple copies of the same sequence), a few open reading frames, and short tandemly repeating sequences of varying number and length. The ITRs of poxviridae vary in length across strains and species. The coding sequence for most of the viral proteins in Variola major have at least 90% similarity with the genome of Vaccinia, a related virus used for vaccination against smallpox.

Gene Expression

Gene expression of Variola occurs entirely within the cytoplasm of the host cell, and follows a distinct progression during infection. After entry of an infectious virion into a host cell, synthesis of viral mRNA can be detected within 20 minutes. About half of the viral genome is transcribed prior to the replication of viral DNA. The first set of expressed genes are transcribed by pre-existing viral machinery packaged within the infecting virion. These genes encode the factors necessary for viral DNA synthesis and for transcription of the next set of expressed genes. Unlike most DNA viruses, DNA replication in Variola and other poxviruses takes place within the cytoplasm of the infected cell. The exact timing of DNA replication after infection of a host cell varies across the poxviridae. Recombination of the genome occurs within actively infected cells. Following the onset of viral DNA replication, an intermediate set of genes codes for transcription factors of late gene expression. The products of the later genes include transcription factors necessary for transcribing the early genes for new virions, as well as viral RNA polymerase and other essential enzymes for new viral particles. These proteins are then packaged into new infectious virions capable of infecting other cells.

Research


Two live samples of Variola major remain, one in the United States at the CDC in Atlanta, and one at the Vector Institute in Koltsovo, Russia. Research with the remaining virus samples is tightly controlled, and each research proposal must be approved by the WHO and the World Health Assembly (WHA). Most research on poxviruses is performed using the closely related Vaccinia virus as a model organism. Vaccinia virus, which is used to vaccinate for smallpox, is also under research as a viral vector for vaccines for unrelated diseases.

The genome of Variola major was first sequenced in its entirety in the 1990s. The complete coding sequence is publicly available online.The current reference sequence for Variola major was sequenced from a strain that circulated in India in 1967 . In addition, there are sequences for samples of other strains that were collected during the WHO eradication campaign. A genome browser for a complete database of annotated sequences of Variola and other poxviruses is publicly available through the Viral Bioinformatics Resource Center.

Genetic Engineering

The WHO currently bans genetic engineering of the smallpox virus. However, in 2004, a committee advisory to the WHO voted in favor of allowing editing of the genome of the two remaining samples of Variola major to add a marker gene. This gene, called GFP, or green fluorescent protein, would cause live samples of the virus to glow green under fluorescent light. The insertion of this gene, which would not influence the virulence of the virus, would be the only allowed modification of the genome. The committee stated the proposed modification would aid in research of treatments by making it easier to assess whether a potential treatment was effective in killing viral samples. The recommendation could only take effect if approved by the WHA. When the WHA discussed the proposal in 2005, it refrained from taking a formal vote on the proposal, stating that it would review individual research proposals one at a time. Addition of the GFP gene to the Vaccinia genome is routinely performed during research on the closely related Vaccinia virus.

Controversies

The public availability of Variola's complete sequence has raised concerns about the possibility of illicit synthesis of infectious virus. Vaccinia, a cousin of the smallpox virus, was artificially synthesized in 2002 by NIH scientists. They used a previously established method that involved using a recombinant viral genome to create a self-replicating bacterial plasmid that produced viral particles.

In 2016, another group synthesized the horsepox virus using publicly available sequence data for horsepox. The researchers argued that their work would be beneficial to creating a safer and more effective vaccine for smallpox, although an effective vaccine is already available. The horsepox virus had previously seemed to have gone extinct, raising concern about potential revival of Variola major and causing other scientists to question their motives. Critics found it especially concerning that the group was able to recreate viable virus in a short time frame with relatively little cost or effort. Although the WHO bans individual laboratories from synthesizing more than 20% of the genome at a time, and purchases of smallpox genome fragments are monitored and regulated, a group with malicious intentions could compile, from multiple sources, the full synthetic genome necessary to produce viable virus. Several teeth (talk) 08:02, 11 May 2022 (UTC)

I have added the text. Thank you. Graham Beards (talk) 14:43, 11 May 2022 (UTC)

References

Merger Discussion

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

The result of this discussion was Merge . Sneasel talk 17:35, 14 September 2022 (UTC)

---

Request received to merge articles: Alastrim into Smallpox; dated: September 2022. Proposer's Rationale: Merge. Discuss here. Sneasel talk 01:17, 5 September 2022 (UTC)

Variola major causes Smallpox. Variola minor (Alastrim) also causes Smallpox. There is no page for Variola major as it is a part of the Smallpox article. There shouldn't be a page for Variola minor then because Variola major doesn't have its own article. Also, I have no idea where the name Alastrim came from. It should just be Variola minor. Sneasel talk 01:25, 5 September 2022 (UTC)

• No merge - this article is about the notable strain of virus, and not the disease. The other articles are plenty long, and alastrim is notable in its own right.--awkwafaba (📥) 16:11, 5 September 2022 (UTC)

  If no merge then the least is to make a Variola major article and rename Alastrim article to Variola minor. I agree it is notable (despite only one source for the article). A quick google search of "Alastrim" has links saying "Variola minor, also known as Alastrim..."Sneasel talk 16:55, 5 September 2022 (UTC)

• I agree with the request to merge. We have WP:COMMONNAME and variola major and variola minor are both smallpox diseases and are both caused by smallpox virus. Variola minor (or "alastrim", the word comes from Portuguese "alastrar" (“to spread”)), is just a less pathogenic strain of the virus. I don't think the milder strain of the virus is notable in its own right. Graham Beards (talk) 20:24, 5 September 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Semi-protected edit request on 16 September 2022

In this phrase:

If a person is vaccinated again later, the immunity lasts even longer.

Please link "vaccinated again later" to Booster dose. 175.39.61.121 (talk) 05:26, 16 September 2022 (UTC)

 Not done for now: It's not clear that the text is specifically referring to Booster doses. ––FormalDude (talk) 08:22, 16 September 2022 (UTC)

User:FormalDude, how could it not be? Quoting the booster article: A booster dose is an extra administration of a vaccine after an earlier (primer) dose. An "again later" vaccination is a booster dose, by definition. 175.39.61.121 (talk) 11:58, 16 September 2022 (UTC)

Traditionally smallpox vaccine, vaccinia, was only administered once in a lifetime (despite the protection afforded waning after a decade or so) and when smallpox vaccination was universal the concept of booster doses did not exist. You are right in that these days a repeat smallpox vaccination would probably be called a "booster", but this was not the case in the middle decades of the last century. It would be interesting to know when the term was first used in vaccinology. I suspect it was during the 1960s, when booster rockets were invented, and it was probably for polio and certainly not smallpox. I think it's a trivial point to make in any case as the meaning is perfectly clear and what other Wikipedia articles say is irrelevant. Graham Beards (talk) 14:38, 16 September 2022 (UTC)

I am not sure that the consensus definition of a "booster dose" is _any_ vaccination done after the first. Even if we accept as gospel the definition that you quote, there is the qualifier 'primer' in parentheses. If the first dose is not a primer, then the followup may not be a booster. My thinking is that if the followup is not designed/intended to be a booster, then it is not. For example, annual flu shots are not 'booster' shots. Jaredroach (talk) 17:19, 16 September 2022 (UTC)

Semi-protected edit request on 22 December 2022

In the phrase:

It has been speculated that Egyptian traders brought smallpox to India during the 1st millennium BCE, where it remained as an endemic human disease for at least 2000 years.

The link to the endemic page should be changed to the endemic (epidemiology) page, as it is referring to "endemism" in the epidemiological sense, not the ecological sense. CannonEast (talk) 15:12, 22 December 2022 (UTC)

Thank you for suggesting this. I have made the edit. Graham Beards (talk) 17:19, 22 December 2022 (UTC)

Fomites

I have modified the statement that smallpox is spread by fomites (e.g. infected clothing or blankets) in the light of A R Rao's 1950s and 1960s research which suggested that it was not. The disappearance of smallpox epidemics soon after his researches on smallpox-transmission makes his conclusion that it normally spread via the lungs difficult to check or revise, but I think his book Smallpox has to be accepted as our "best source" on this. The source cited for the contrary view is a discontinued but web-archived public information website, last revised in 2007, by the USA's National Center for Preparedness, Detection, and Control of Infectious Diseases. Despite its later date, it probably represents an earlier medical orthodoxy. I note that a later paragraph in the Wikipedia article endorses, though without citation, Rao's view that smallpox, despite its spectacular effects upon the skin, is primarily a lung disease in its mode of transmission. It is perhaps not worth including in the article a comment that the medical practice of variolation , which normally produced only a mild and prophylactic infection, suggests that the virus was also not particularly well adapted to blood-borne transmission. Marcasella (talk) 00:34, 29 March 2023 (UTC)

One would need to see RS other than Rao himself supporting his 1950s research before making such a major change to the article. Rao may not have observed transmission by fomites, but other researchers have in fact observed it: "Smallpox virus can also be transmitted by fomites, such as clothing and bedding [14]. Laundry workers have developed smallpox. One study found a much higher recovery of smallpox virus from pillows and bedclothes than from air samples of the patient's coughs [17]." 2004 HouseOfChange (talk) 14:26, 29 March 2023 (UTC)

@Marcasella: Update, according to recent RS,[12][13] transmission by fomites is rare, so I now agree with you that the article shouldn't emphasize it, per WP:WEIGHT. HouseOfChange (talk) 17:32, 6 June 2023 (UTC)