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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 texta
4 1954 France, Vannes [27, 38] 0.88 12 74b 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 texta
16 1961 Dusseldorf [21, 35] 0.50 2 5c 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] 0.44d 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 1e 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
  1. * 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:
  2. (1) Outbreak from Marseille, France (1952) broken into two components: Entries 3 and 15 [27].
  3. (2)Outbreak from Cardiff, U.K.(1963)broken into three components: Entries7, 24 and 26 [21, 28].
  4. (3) Outbreak from Poland (1963) broken into three components: Entries 8, 17 and 27 [41].
  5. (4)Outbreak from Kosovo, Yugoslavia (1972) broken into two components: Entries 10 and 19 [21].
  6. Footnotes for Table 2:
  7. a Nature of the index cases was not clear from the text (limited information) [27].
  8. b Total number of cases listed as 74, consistent with text [38] and second reference [27].
  9. c Total number of cases listed as 5 [28, 34] ; 6 is listed in World Health Organization Table 23.4 [21].
  10. 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].
  11. e Total number of cases listed as 1 [37]; 2 is listed in World Health Organization Table 23.4 [21].
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