Monday, February 27, 2012

Preparedness: Treating Smallpox

In this part of my preparedness series, I will talk about different common and uncommon diseases, illnesses and other health inflictions that wouldn't be easily treated during a long term crisis. This is not a replacement for medical advice, it is just my notes on how to cope with the situation using herbs if no medical help was available due to a long term crisis or other disaster scenario. It is intended for educational purposes only. All cases of smallpox should be assessed and treated by a medical provider.

What is it?
It is an infectious disease caused by a virus. There are two variants of the virus, Variola major and Variola minor. V. major is the most common form of smallpox and is also the most severe. 
Infections are highest during the winter and spring in temperate climates. Tropical climates can see infections throughout the year with few seasonal variations.
Smallpox is considered a ‘filth’ disease so making sure your community keeps clean can help to reduce the chances of outbreaks. 
Smallpox looks similar to chickenpox and is often mistaken as chickenpox or vice versa. 
Why should it be feared?
Variola major has a mortality rate of 30% while V. minor has a mortality rate of 1%. It causes ulcerations of the cornea which can leave infected persons blind in one or both eyes. It can also leave severe scarring. There is no cure or conventional medication for smallpox. It can be spread by prolonged face-to-face contact as well as through direct contact with infected bodily fluids or contaminated items such as clothing and bedding linens.
What should be done?
During normal times, there is no treatment for the smallpox virus. Supportive care is given to control fever and pain. Fluids are also administered to prevent the patient from becoming dehydrated. 
The patient should be quarantined and all linens and clothing should be washed in hot, soapy water with bleach to kill the virus. All infected surfaces should be washed with a bleach water solution.
The caregiver should wear a face mask and wash their hands with hot, soapy water after any contact with the patient or patients belongings.
What are the stages?
Incubation Period: 7 - 17 days
During this time, infected people feel fine and do not show any symptoms. They are not contagious at this time. 
Stage 2/Initial Symptoms: 2 - 4 days
The first symptoms include general malaise, fever, headaches and backaches, and sometimes vomiting. The fever will range between 101° to 104° F. The patient is possibly contagious at this point.
Stage 3/Early Rash: 3 - 4 days
A rash will first be seen as small red spots in the mouth and on the tongue. These spots will develop into sores that break open and spread large amounts of the virus into the mouth and throat. This is the most contagious phase of the virus.
When the sores in the mouth break down, a rash appears on the skin, beginning on the face and spreading down the arms and legs then to the outer extremities. They will often be present on the palms and soles. The rash usually spreads to all parts of the body within 24 hours. The fever usually starts to fall when the rash appears and the patient will start to feel better.
On day 3 the rash becomes raised bumps or pustules. 
On day 4, the raised pustules fill with a thick, opaque fluid and the pustule will have a depression in the center, making the bumps look a bit like donuts. 
The location of the rash and the shape of the pustules are both major indicators that the patient has smallpox and not chickenpox. 
On day 4 the fever usually rises again and will remain high until the scabs for over the pustules.
The rash occurs at the same time during this period with the pustules on any part of the body remaining in the same stage of development.
Stage 4/Pustular Rash: 4 - 5 days
The pustules become sharply raised and round and often are described as feeling like there are bb pellets embedded in the skin. The patient is still contagious.
Stage 5/Scabbing: 4 - 5 days
The pustules begin to form a crust and then will scab over. About 14 days after the rash first appears most of the pustules will have scabbed over. The patient is still contagious. 
Stage 6/Scabs Heal: 5 - 6 days
The scabs begin to heal and fall off. Marks will remain on the skin that may eventually become pitted scars. Scabs typically fall off 14 - 28 days after the rash begins. Once the scabs have completely fallen off the patient is no longer contagious.
What are my options?
There are many herbal remedies which will be beneficial for treating smallpox. 
Keep the patient comfortable and avoid bright light since the eyes are weak at this time. 
Step 1: Diet
Keep the diet light and easy to digest so the body can concentrate on fighting the virus. Foods to feed the patient include:
Bone broth, vegetable broth
Oatmeal or barley water
Congee (12 parts water: 1 part rice)
Natural juices both vegetable and fruit
Ripe fruits, especially pears and apples to help cleanse the bowels
Step 2: Encourage the Fever and perspiration
Giving diaphoretic herbs and hot baths will encourage rash to break out quicker and encourage faster healing. Give teas made from any diaphoretic herb available. Store teas in a thermos after making to keep them warm for administering as the patient needs them. Offer a continuous cup of tea for sipping and encourage them to drink often. Alternate with rehydration fluids to keep the patient from becoming dehydrated.

Do not attempt to suppress the fever or stop the pustule eruptions. Only use herbs to bring them out faster, encourage perspiration to flush the body and support the body as it works through the process.
For best results try:

Yarrow (Achillea millefolium)
Yarrow is specific for smallpox. May be combined with equal parts of Pleurisy root (Asclepias tuberosa) and Lady’s Slipper (Cypripedium acaule) for best results. If Lady’s slipper is not available, substitute Catnip (Nepeta cataria) or Valerian root (Valeriana officinalis). 

Red Sage (Salvia miltiorrhiza)
Regular Sage (Salvia officinalis) may be effective if Red Sage is not available. 
Do not give medications or herbs to suppress the rash and pustules from erupting, this is part of the body’s cleansing process. The larger the break out, the more toxins that will leave the body. 

Step 3: Alleviate Itching
To soothe itching, wash pustules with either full strength lemon juice or a mixture of 50/50 apple cider vinegar and water. 
Make a bath tea of Burdock root (Arctium spp.), Yellow Dock root (Rumex crispus) and/or Goldenseal root (Hydrastis canadensis) to relieve itching. 
Step 4: Reduce Pitting/Scarring
Jethro Kloss suggests using a sterile needle to pop the pustules 4 days after they come to a head and washing them thoroughly with hydrogen peroxide to prevent pitting. 
Goldenseal  (Hydrastis canadensis)
Goldenseal is a specific to reduce pitting. Washes of Goldenseal root may be used to cleanse pustules as they burst. A salve made from Goldenseal root, fat and beeswax or even an oil of Goldenseal root and fat can be applied several times a day over the pustules to avoid much pitting.
Step 5: General Herbal Treatment
In addition to the above mentioned herbs, the following are various herbal treatments that have been used for treating smallpox. Use what you have available in your region.

Bistort (Polygonurn bistorta)
Decoction of root is cleansing, astringent and toning.
Red Raspberry (Rubus idaeus)
Red Raspberry leaves can be mixed with Bistort for a toning and astringent tea.
European Pennyroyal (Mentha pulegium)
Do not confuse this with American Pennyroyal (Hedeoma pulegioides). European Pennyroyal has a warming influence for the stomach and is also diaphoretic and stimulating which is good for treating feverish conditions, bronchial congestion and eruptive diseases. Give 6 - 8 oz. infusion every 1 - 2 hours.

Chamomile (Matricaria recutita, M. discoidea)
Chamomile and Pineapple weed (also known as wild Chamomile, M. discoidea)  are very soothing to the eyes and can help ease pain and inflammation of the eyes. Make a strong tea, soak some flannel cloth in the tea and drape over the closed eyes. It may be warm or cool, whichever the patient finds most soothing. The tea may also be used a was over the eyes. Be sure to strain all Chamomile plant material out first. 

Catnip (Nepeta cataria)
Tea or tincture from this plant can be soothing to the nerves, helping to calm an anxious patient. Catnip is also good for treating fever and can be used as an enema to help bring on perspiration. Catnip will also help to overcome the discomforts of smallpox. 1 cup of tea several times a day or 1 dropperful of tincture as needed.
Back To Eden by Jethro Kloss pgs. 369, 538 


nettlejuice said...

I love Jethro Kloss for information like this. You just don't find advice about dealing with smallpox, tetanus and such in modern herbals. Love the post.

Rita M said...

Interesting post, thanks for sharing!

Sarah Head said...

We had an outbreak of smallpox in our local medical school here several years ago. The virus travelled up a ventilation shaft from a laboratory and infected a secretary who was working on the floor above. She was taken to the last isolation hospital in the region and died several days later. The isolation hospital was burned to the ground afterwards deliberately. The poor professor who was in charge of the lab was so hounded by the press, he killed himself. A very very sad time.

tansy said...

thanks nettlejuice and rita.

oh, sarah, that's so awful! such a freak accident to cause so much pain and turmoil. why were they even working with the smallpox? trying to come up with new treatments?

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