{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:41:30Z","timestamp":1777470090348,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2003,4,1]],"date-time":"2003-04-01T00:00:00Z","timestamp":1049155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biological Research For Nursing"],"published-print":{"date-parts":[[2003,4]]},"abstract":"<jats:p>The global eradication of smallpox in the late 1970s was a major achievement of the 20th century and brought out the best in science and public health. Prior to eradication, smallpox was a devastating disease with an overall mortality rate of approximately 5% to 30% for the most common form of the disease depending on vaccination status and the clinical presentation. The more severe forms of smallpox (i.e., flat and hemorrhagic type) had case fatality rates of approximately 96% to 100%. Currently, there is heightened international concern regarding the potential use of the smallpox virus as an agent for bioterrorism. Therefore, it is imperative that health care workers become familiar with clinical aspects of this disease as part of the national efforts to ensure homeland security. This article reviews the history, disease progression, and adverse events of smallpox; immunization practices; and nursing considerations.<\/jats:p>","DOI":"10.1177\/1099800403252014","type":"journal-article","created":{"date-parts":[[2003,4,28]],"date-time":"2003-04-28T06:36:11Z","timestamp":1051511771000},"page":"282-294","source":"Crossref","is-referenced-by-count":2,"title":["Smallpox: An Update for Nurses"],"prefix":"10.1177","volume":"4","author":[{"given":"Carolyn M.","family":"Constantin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela M.","family":"Martinelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Bonney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ora L.","family":"Strickland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2003,4,1]]},"reference":[{"key":"atypb1","unstructured":"Advisory Committee on Immunization Practices. 2001. Vaccinia (smallpox) vaccine recommendations of the advisory committee on immunization practices (ACIP), 2001. Morb Mortal Wkly Rep 50(RR10): 1-25."},{"key":"atypb2","unstructured":"[Anonymous]. 1980. How much did it cost? World Health: The Magazine of the World Health Organization May: 18."},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020025"},{"key":"atypb4","unstructured":"Centers for Disease Control and Prevention. 2002a. Draft supplemental recommendation of the ACIP\u2014smallpox (vaccinia) vaccine, June. Available from: http:\/\/www.bt.cdc.gov\/agent\/smallpox\/vaccination\/acip-guidelines.asp. Accessed 2003 Jan 24."},{"key":"atypb5","unstructured":"Centers for Disease Control and Prevention. 2002b. Smallpox fact sheet: people who should NOT get the smallpox vaccine (unless they are exposed to the smallpox virus) (December 9). Available from: http:\/\/www.bt.cdc.gov\/agent\/smallpox\/vaccination\/pdf\/contraindications-public.pdf. Accessed 2003 Jan 24."},{"key":"atypb6","unstructured":"Centers for Disease Control and Prevention. 2002c. Summary of October 2002 ACIP smallpox vaccination recommendations, October 21. Available from: http:\/\/www.bt.cdc.gov\/agent\/smallpox\/vaccination\/acip-recs-oct2002.asp. Accessed 2003 Jan 24."},{"key":"atypb7","unstructured":"Fauci AS. 2001. Responding to the challenges of the 21st century: NIH\u2019s role in vaccine research and development. Washington, DC: National Institute of Allergy and Infectious Diseases, National Institutes of Health. Available from: http:\/\/www.niaid.nih.gov\/director\/congress\/2001\/112901.htm. Accessed 2003 Jan 24."},{"key":"atypb8","unstructured":"Fenner F. 1996. Poxviruses. In: Fields BN, Knipe DM, Howley PM, Chanock RM, Melnick JL, Monath TP, Roizman B, Straus SE, editors. Fields virology. 3rd ed. Philadelphia: Lippincott-Raven. p 2673-702."},{"key":"atypb9","unstructured":"Fenner F, Henderson DA, Arita I, Jezek Z, Ladnyi ID. 1988. Smallpox and its eradication. Geneva: World Health Organization."},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/9.4.329"},{"key":"atypb11","doi-asserted-by":"crossref","unstructured":"Goldstein JA, Neff JM, Lane JM, Koplan JP. 1975. Smallpox vaccination reactions, prophylaxis, and therapy of complications. Pediatrics 55(3): 342-7.","DOI":"10.1542\/peds.55.3.342"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1126\/science.1074674"},{"key":"atypb13","unstructured":"Henderson DA, Moss B. 1999. Smallpox and vaccinia. In: Plotkin SA, Orenstein WA, editors. Vaccines. 3rd ed. Philadelphia: W.B. Saunders. p 74-97."},{"key":"atypb14","unstructured":"Ironside AG. 1975. Smallpox vaccine. Practitioner 215(1287): 294-8."},{"key":"atypb15","doi-asserted-by":"crossref","unstructured":"Koopman J. 2002. Controlling smallpox. Science 298(5597): 1342-4.","DOI":"10.1126\/science.1079370"},{"key":"atypb16","doi-asserted-by":"crossref","unstructured":"Lane JM, Ruben FL, Neff JM, Millar JD. 1969. Complications of smallpox vaccination, 1968: national surveillance in the United States. N Engl J Med 281: 251-72.","DOI":"10.1056\/NEJM196911272812201"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.3201\/eid0807.020032"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1006\/viro.1996.0378"},{"key":"atypb19","unstructured":"Moss B. 1996. Poxviridae: the viruses and their replication. In: Fields BN, Knipe DM, Howley PM, Chanock RM, Melnick JL, Monath TP, Roizman B, Straus SE, editors. Fields virology. 3rd ed. Philadelphia: Lippincott-Raven. p 2637-71."},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.15.1901"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196701052760101"},{"key":"atypb22","unstructured":"Rao AR. 1972. Smallpox. Bombay: Kothari Book Depot."},{"key":"atypb23","unstructured":"Sarkar JK, Mitra AC, Mukherjee MK, De SK. 1973. Virus excretion in smallpox. 1. Excretion in the throat of household contacts. Bulletin World Health Organization 48: 517-22."},{"key":"atypb24","doi-asserted-by":"crossref","unstructured":"Sibley CL. 2002. Smallpox vaccination revisited. Am J Nurs 102(9): 26-32.","DOI":"10.1097\/00000446-200209000-00031"},{"key":"atypb25","doi-asserted-by":"publisher","DOI":"10.1038\/nri845"},{"key":"atypb26","doi-asserted-by":"crossref","unstructured":"Suarez VR, Hankins GDV. 2002. Smallpox and pregnancy: from eradicated disease to bioterrorist threat. Obstet Gynecol 100(1): 87-93.","DOI":"10.1097\/00006250-200207000-00014"},{"key":"atypb27","doi-asserted-by":"crossref","unstructured":"Veenema TG. 2002. The smallpox vaccine debate. A J Nurs 102(9): 33-9.","DOI":"10.1097\/00000446-200209000-00032"},{"key":"atypb28","unstructured":"Wehrle PF, Posch J, Richter KH, Henderson DA. 1970. An airborne outbreak of smallpox in a German hospital and its significance with respect to other recent outbreaks in Europe. Bulletin World Health Organization 43: 669-79."}],"container-title":["Biological Research For Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1099800403252014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1099800403252014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:38:16Z","timestamp":1777383496000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1099800403252014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,4]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2003,4]]}},"alternative-id":["10.1177\/1099800403252014"],"URL":"https:\/\/doi.org\/10.1177\/1099800403252014","relation":{},"ISSN":["1099-8004","1552-4175"],"issn-type":[{"value":"1099-8004","type":"print"},{"value":"1552-4175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,4]]}}}