Transmission patterns of smallpox: systematic review of natural outbreaks in Europe and North America since World War II

Bhatnagar, Vibha; Stoto, Michael A; Morton, Sally C; Boer, Rob; Bozzette, Samuel A

doi:10.1186/1471-2458-6-126

Table 2 Outbreaks reported with more details, classifiable by setting

From: Transmission patterns of smallpox: systematic review of natural outbreaks in Europe and North America since World War II

	YEAR	COUNTRY, CITY	REFERENCE(S)	PROPORTION OF CASES ACQUIRED WITHIN A HOSPITAL	INITIAL R	TOTAL CASES	NUMBER OF DEATHS	NUMBER OF GENERA-TIONS	GENERATION OUTBREAK IDENTIFIED	NUMBER OF CASES NOT INITIALLY DIAGNOSED (MISSED CASES)	CLINICAL PRESENTATION OF INDEX CASE*
HOSPITAL OUTBREAKS
1	1947	United States, New York	[30]	0.91	4	12	2	2	1	1	Hemorrhagic
2	1950	United Kingdom, Glasgow	[29]	1.00	20	21	3	1	1	1	Atypical
3	1952	France, Marseille(1)	[27]	0.97	24	40	4	3	0	0	Not clear from text^a
4	1954	France, Vannes	[27, 38]	0.88	12	74^b	16	3	1	2	Atypical
5	1961	United Kingdom, Bromwich	[21, 28]	1.00	1	2	0	1	0	0	Typical
6	1961	United Kingdom, Bradford	[21, 28, 34]	1.00	10	14	6	2	1	1	Atypical
7	1962	United Kingdom, Cardiff (2)	[21, 28]	1.00	18	21	13	2	1	1	Hemorrhagic
8	1963	Poland, Lodz(3)	[39]	1.00	3	4	1	1	0	0	Hemorrhagic
9	1969	Meschede	[20, 31]	1.00	17	20	4	2	0	0	Typical
10	1972	Yugoslavia, Kosovo (4)	[21]	0.86	38	43	9	2	1	38	Hemorrhagic
11	1973	United Kingdom, London	[21, 25]	1.00	2	4	2	2	0	0	Typical
MIXED OUTBREAKS
12	1947	United Kingdom, Barnsley	[29]	0.38	5	17	0	3	0	1	Atypical
13	1949	United States, Hidalgo County	[40]	0.33	2	8	1	2	1	5	Atypical
14	1950	United Kingdom, Brighton	[29]	0.46	2	29	10	4	1	3	Atypical
15	1952	France, Marseille(1)	[27]	0.50	1	3	1	2	0	0	Not clear from text^a
16	1961	Dusseldorf	[21, 35]	0.50	2	5^c	2	2	0	0	Typical
17	1963	Poland, Wroclaw (3)	[21, 33]	0.48	2	90	6	6	2	4	Atypical
18	1963	Sweden, Stockholm	[21, 36]	0.44^d	4	27	4	6	2	5	Atypical
19	1972	Yugoslavia, Kosovo (4)	[21]	0.36	11	134	26	3	2	12	Atypical
COMMUNITY OUTBREAKS
20	1947	United Kingdom, Bilston	[29]	0.04	2	28	1	9	1	3	Atypical
21	1953	United Kingdom, Industrial Pennines	[29]	0.23	4	39	11	6	1	8	Atypical
22	1961	United Kingdom, London	[21] [28]	0.00	2	3	1	1	0	0	Atypical
23	1962	United Kingdom, Birmingham	[21] [28]	0.00	0	1	0	0	0	0	Typical
24	1962	United Kingdom, Cardiff (2)	[21] [28]	0.00	1	2	1	1	0	1	Typical
25	1962	Canada, Toronto	[21]	0.00	0	1	0	0	0	0	Typical
26	1962	United Kingdom, Cardiff (2)	[21] [28]	0.17	6	25	6	3	1	1	Hemorrhagic
27	1963	Poland, Opole (3)	[41]	0.00	1	4	0	1	0	0	Atypical
28	1965	Fed. Rep. Germany, Kulmbach	[21] [37]	0.00	0	1^e	0	0	0	0	Typical
29	1970	Denmark, Skodsborg	[21]	0.00	1	2	1	1	0	0	Hemorrhagic
30	1978	United Kingdom, Birmingham	[26]	0.00	1	2	1	1	0	0	Typical

* Atypical: index cases with a milder illness (usually seen with a previous vaccination for smallpox) or a rash not characteristic of smallpox. Detailed outbreaks (from Table 2) analyzed by components:
(1) Outbreak from Marseille, France (1952) broken into two components: Entries 3 and 15 [27].
(2)Outbreak from Cardiff, U.K.(1963)broken into three components: Entries7, 24 and 26 [21, 28].
(3) Outbreak from Poland (1963) broken into three components: Entries 8, 17 and 27 [41].
(4)Outbreak from Kosovo, Yugoslavia (1972) broken into two components: Entries 10 and 19 [21].
Footnotes for Table 2:
a Nature of the index cases was not clear from the text (limited information) [27].
b Total number of cases listed as 74, consistent with text [38] and second reference [27].
c Total number of cases listed as 5 [28, 34] ; 6 is listed in World Health Organization Table 23.4 [21].
d Proportion of hospital acquired cases listed as 0.44 because three nurses infected as a result of household exposure and were setting excluded as hospital contacts [21, 36].
e Total number of cases listed as 1 [37]; 2 is listed in World Health Organization Table 23.4 [21].

Back to article page

ISSN: 1471-2458

Contact us

Submission enquiries: bmcpublichealth@biomedcentral.com
General enquiries: ORSupport@springernature.com

BMC Public Health

Contact us